Self-management and self-management support are concepts very familiar to those of us in diabetes care. These concepts require openness to understanding the behaviours of persons with diabetes broadly, not only behaviours restricted to the biomedical perspective. Understanding the importance of health behaviour change and working within the Expanded Chronic Care Model define the context within which self-management support should occur. The purpose of this perspective is to identify a potential limitation in existing self-management support initiatives. This potential limitation reflects provider issues, not patient issues; that is, true self-management support might require changes by healthcare providers. Specifically, although behavioural interventions within the context of academic research studies are evidence based, behaviour change interventions implemented in general practice settings might prove less effective unless healthcare providers are able to shift from a practice based on the biomedical model to a practice based on the self-management support model. The purpose of this article is to facilitate effective self-management support by encouraging providers to switch from a model of care based on the expert clinician encountering the uninformed help seeker (the biomedical model) to one guided by collaboration grounded in the principles of description, prediction and choice. Key to understanding the value of making this shift are patient-centered communication principles and the tenets of complexity theory. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.
Madigan, Kathleen; Cross, Richard W.; Smolkowski, Keith; Strycker, Lisa A.
This study evaluated the long-term impact of schoolwide positive behavioural interventions and supports (PBIS) on student academic achievement. In this quasi-experimental study, academic achievement data were collected over 9 years. The 21 elementary, middle, and high schools that achieved moderate to high fidelity to the Save & Civil Schools'…
Hewitt, Olivia; Keeling, Natalie; Pearce, Malcom
Between 10% and 15% of people with a learning disability have behaviour that challenges others, and half of these people live within the family home (Emerson et al., "Research in Developmental Disabilities," 2001; 22, 77). Current best practice in managing challenging behaviour combines person-centred planning, functional analysis, and…
Bay, J L; Mora, H A; Sloboda, D M; Morton, S M; Vickers, M H; Gluckman, P D
A life-course approach to reduction of risk of non-communicable diseases (NCD) suggests that early-life interventions may be more effective than lifestyle modifications in middle age. Knowledge translation to develop understanding of the Developmental Origins of Health and Disease (DOHaD) within the community offers the potential to encourage informed diet and lifestyle choices supporting reduction of NCD risk in current and future generations. Many women do not make sustained dietary change before or during pregnancy, therefore appropriate nutritional behaviours need to be established prior to adulthood. This makes adolescence an appropriate stage for interventions to establish suitable dietary and lifestyle behaviours. Therefore, we engaged adolescents in a school-based educational intervention, and assessed the value of this in development of understanding of DOHaD concepts to support behaviour change that could lead to NCD risk reduction in the next generation. Modules of course work were written for 11-14 year olds and trialled in nine schools. Matched pre- and post-intervention questionnaire responses from 238 students and 99 parents, and post-intervention interviews evaluated the intervention. Understanding of a link between maternal diet during pregnancy and the health of the foetus in adulthood increased from 46% to 76% following intervention. Post-intervention evidence suggests the programme facilitated discussion of diet, lifestyle and DOHaD concepts in most families. The intervention was effective in improving understanding of DOHaD concepts and in some cases led to appropriate behaviour change. However, the sustainability of these changes remains to be determined through on-going evaluation of attitudes and behaviour within this cohort.
Fisher, Caroline A; Brown, Anahita
Aggression is common in Huntington's disease. However, at present there are no standard guidelines for managing aggression in Huntington's sufferers due to a lack of empirical research. This paper presents a case study of the treatment of very high levels of aggression with sensory modulation and behaviour support intervention in a Huntington's sufferer. The client exhibited a range of aggressive behaviours, including physical aggression to people, furniture and objects, and verbal aggression. Following an eight week baseline phase, five weeks of sensory modulation intervention were employed. A behaviour support plan was then implemented as an adjunct to the sensory intervention, with aggressive behaviour systematically audited for a further 11 weeks. The results indicate a significant reduction in reported levels of aggression during the combined sensory modulation and behaviour support phase, compared to both the baseline and the sensory modulation therapy alone phases. This case study highlights the efficacy non-pharmacological interventions may have for reducing aggression in HD.
Shirazi, Mandana; Emami, Amir Hossein; Mirmoosavi, Seyed Jamal; Alavinia, Seyed Mohammad; Zamanian, Hadi; Fathollahbeigi, Faezeh; Masiello, Italo
To assess the effects of a workshop on supportive leadership behaviour (SLB) on the performance of head nurses, using a randomized controlled trial design. The effect of transformational leadership on SLB in nursing management is emphasised. A total of 110 head nurses working at university hospitals were included randomly in two control and intervention groups. The head nurses in the intervention group participated in supportive leadership training, but the control group did not. Performance in supportive leadership was assessed with a validated instrument, which six subordinates used to assess their head nurse (n = 731). There was a significant difference in SLB scores from baseline to the 3 month follow-up (P leadership behaviour, particularly the interactive multifaceted training, improved the leadership performance of the head nurses who participated in this study. Health policy decision makers should apply SLB, which is a significant leadership style, to improve the outcomes in other groups of health-care management, such as physicians. Future studies are needed to investigate the effects of such workshops in longer periods of follow up. © 2015 John Wiley & Sons Ltd.
Ainscough, Kate M; Lindsay, Karen L; O'Sullivan, Elizabeth J; Gibney, Eileen R; McAuliffe, Fionnuala M
Antenatal healthy lifestyle interventions are frequently implemented in overweight and obese pregnancy, yet there is inconsistent reporting of the behaviour-change methods and behavioural outcomes. This limits our understanding of how and why such interventions were successful or not. The current paper discusses the application of behaviour-change theories and techniques within complex lifestyle interventions in overweight and obese pregnancy. The authors propose a decision tree to help guide researchers through intervention design, implementation and evaluation. The implications for adopting behaviour-change theories and techniques, and using appropriate guidance when constructing and evaluating interventions in research and clinical practice are also discussed. To enhance the evidence base for successful behaviour-change interventions during pregnancy, adoption of behaviour-change theories and techniques, and use of published guidelines when designing lifestyle interventions are necessary. The proposed decision tree may be a useful guide for researchers working to develop effective behaviour-change interventions in clinical settings. This guide directs researchers towards key literature sources that will be important in each stage of study development.
Lawrence, Wendy; Black, Christina; Tinati, Tannaze; Cradock, Sue; Begum, Rufia; Jarman, Megan; Pease, Anna; Margetts, Barrie; Davies, Jenny; Inskip, Hazel; Cooper, Cyrus; Baird, Janis; Barker, Mary
A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to 1 year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost. © The Author(s) 2014.
McIntosh, Kent; Moniz, Christina; Craft, Calli B.; Golby, Risha; Steinwand-Deschambeault, Tammy
This article examines the need for and importance of culturally responsive behaviour support for Indigenous students. Many of the educational challenges currently faced by Indigenous students can be explained by cultural disconnect and a mismatch between school expectations and cultural values. Principles of Indigenous approaches to behaviour…
Wiesemann, A; Metz, J; Nuessel, E; Scheidt, R; Scheuermann, W
The main goal of the preventive intervention study in one community of the German CINDI (Countrywide Integrated Non-Communicable Diseases Intervention programme of the WHO) area was to improve cardiovascular health by reducing the risk factors smoking, hypertension, obesity, hypercholesterolaemia, and by changing sedentary lifestyle. The intervention was performed by using the special "Three-Level-Strategy", which is characterised by activities of primary care physicians in the usual consulting hour (1st level), with patient groups in their practices (2nd level), and at community level (3rd level) where a special work group and a co-ordinating general practice are co-operating. To evaluate the occurrence of the risk factors in practice and the local population, four cross-sectional random samples (N(total) = 4881) were carried out in seven practices from 1992 to 1995. On the community level, 23 special exercise-based health groups (N(total) = 600) were established and were investigated by means of a questionnaire, related to behaviour and health beliefs. A "Local Health Information System" facilitated the evaluation, the management of the data, and the organisation of the health programme. The results of the practice samples showed a significant reduction of smoking (-17.8%) and hypertension (-31.5%) (p healthy nutrition, 52% of relaxation; 86.2% intended to regularly increase physical activity in leisure time and 82 % could not imagine regular health training without exercise meetings. We conclude that the practice-based "Three-Level-Strategy" provides a strong support for successful long-term prevention of cardiovascular risk, particularly, when exercise-based health training sessions are performed in order to change sedentary lifestyle. When organised on community level, they might have a positive impact on the health behaviour of the whole community. Physical activity can be used as a "prodrug" for health promotion in a holistic way.
Educational psychology has recently experienced something of a revival in the provision of psychological therapy. This revival has aligned with general developments in evidence-based psychology. A product of this has been more frequent delivery of empirically supported therapies in practice settings, for example, anxiety reduction programmes in…
Technological supports aiming to change the behaviour of healthcare professionals show considerable promise, particularly those involving computer-generated reminders and feedback. Due to the lack of theoretically-informed interventions, we were unable to draw conclusions around the effectiveness of theory-behaviour change interventions in this context. Interventions currently lack consistency in delivery method and content, which future research should address.
Full Text Available The paper is focused on existence and support of entrepreneurial behaviour and innovation in larger organizations. It first suggests why it is important to pay attention to entrepreneurship and innovation and then defines corporate entrepreneurship. Typical barriers of entrepreneurial activities are described as well as innovation dilemmas organizations solve. Innovation process is not linear, but six components of innovation behaviour may be identified, together with specific roles employees play when moving the idea forward from idea creation to implementation. Important factors influencing the success of entrepreneurial behaviour are discussed, involving the role of middle managers and reward systems. Recommendations for fostering entrepreneurial behaviour and innovation are provided together with a simple inventory for measuring employee perception of manager's and organizational support for innovation.
Fife-Schaw, Chris; Sheeran, Paschal; Norman, Paul
The theory of planned behaviour (TPB; Ajzen, 1991) has been used extensively to predict social and health behaviours. However, a critical test of the TPB is whether interventions that increased scores on the theory's predictors would engender behaviour change. The present research deployed a novel technique in order to provide this test. Statistical simulations were conducted on data for 30 behaviours (N=211) that estimated the impact of interventions that generated maximum positive changes in attitudes, subjective norms and perceived behavioural control (PBC) on subsequent intentions and behaviour. Findings indicated that interventions that maximized TPB variables had a substantial impact on behavioural intentions. Although TPB maximization increased the proportion of the sample that performed respective behaviours by 28% compared with baseline, the behaviour of a substantial minority of the sample (26%) did not change. The research also identified several interactions among TPB variables in predicting simulated intention and behaviour scores and investigated the mediating role of intentions in predicting behaviour.
Ali, Afia; Hall, Ian; Blickwedel, Jessica; Hassiotis, Angela
effectiveness of behavioural and cognitive-behavioural interventions on outwardly-directed aggression in children and adults with intellectual disabilities is limited. There is a paucity of methodologically sound clinical trials and a lack of long-term follow-up data. Given the impact of such behaviours on the individual and his or her support workers, effective interventions are essential. We recommend that randomised controlled trials of sufficient power are carried out using primary outcomes that include reduction in outward-directed aggressive behaviour, improvement in quality of life, and cost effectiveness.
Stead, Lindsay F; Koilpillai, Priya; Fanshawe, Thomas R; Lancaster, Tim
Both behavioural support (including brief advice and counselling) and pharmacotherapies (including nicotine replacement therapy (NRT), varenicline and bupropion) are effective in helping people to stop smoking. Combining both treatment approaches is recommended where possible, but the size of the treatment effect with different combinations and in different settings and populations is unclear. To assess the effect of combining behavioural support and medication to aid smoking cessation, compared to a minimal intervention or usual care, and to identify whether there are different effects depending on characteristics of the treatment setting, intervention, population treated, or take-up of treatment. We searched the Cochrane Tobacco Addiction Group Specialised Register in July 2015 for records with any mention of pharmacotherapy, including any type of NRT, bupropion, nortriptyline or varenicline. Randomized or quasi-randomized controlled trials evaluating combinations of pharmacotherapy and behavioural support for smoking cessation, compared to a control receiving usual care or brief advice or less intensive behavioural support. We excluded trials recruiting only pregnant women, trials recruiting only adolescents, and trials with less than six months follow-up. Search results were prescreened by one author and inclusion or exclusion of potentially relevant trials was agreed by two authors. Data was extracted by one author and checked by another.The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. We calculated the risk ratio (RR) and 95% confidence interval (CI) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. Fifty-three studies with a total of more than 25,000 participants met the inclusion criteria. A large proportion of studies recruited people in
Lanzini, Pietro; Thøgersen, John
This study tests hypotheses about behavioural spillover in the environmental domain as well as the impacts of monetary inducements and verbal praise on behavioural spillover by means of a field experiment. A sample of 194 students from a large university in Denmark were randomly allocated...... of environmentally relevant behaviours and after a six weeks intervention period where they were requested to keep track of their purchases by means of a shopping diary they answered a second survey with the same content as the first. This allowed us to analyse the change in self-reported pro- environmental...... behaviours over the six weeks, to identify instances of behavioural spillover from "green" purchase behaviour to other pro-environmental behaviours and to investigate if such spillover was affected by the nature of the intervention. The study revealed a positive spillover from "green" purchasing to other pro-environmental...
Full Text Available Behavioural Gerontology is concerned with the interaction of the aging individual and their environment. One aspect of behavioural gerontology has focussed on the use of behaviourist methods to improve the functioning and quality of life of individuals with dementia. Positive reinforcement techniques have shown to have an effect on dementia related behavioural excesses (wandering, disruptive vocalisations, behavioural deficits (incontinence, self feeding and mood changes (depression. One of the major concerns of using reinforcement techniques in the case of dementia is maintenance of the behavioural changes with the continual implementation of the intervention. Research has indicated that individuals with dementia meet behavioural extinction criteria at an advanced rate in comparison with individuals without dementia. Thus for a behavioural change to be successfully maintained it requires diligence on the part of the caregiver and/or nursing home staff. In the case of dementia care centres and nursing homes, when using behavioural interventions to modify the behavioural symptoms of dementia, there needs to be a considerable overlap between Behavioural Gerontology and Organisational Behavioural Management to ensure the successful maintenance of behavioural change.
Arden-Close, Emily; McGrath, Nuala
Partners are a significant influence on individuals' health, and concordance in health behaviours increases over time in couples. Several theories suggest that couple-focused interventions for health behaviour change may therefore be more effective than individual interventions. A systematic review of health behaviour change interventions for couples was conducted. Systematic search methods identified randomized controlled trials (RCTs) and non-randomized interventions of health behaviour change for couples with at least one member at risk of a chronic physical illness, published from 1990-2014. We identified 14 studies, targeting the following health behaviours: cancer prevention (6), obesity (1), diet (2), smoking in pregnancy (2), physical activity (1) and multiple health behaviours (2). In four out of seven trials couple-focused interventions were more effective than usual care. Of four RCTs comparing a couple-focused intervention to an individual intervention, two found that the couple-focused intervention was more effective. The studies were heterogeneous, and included participants at risk of a variety of illnesses. In many cases the intervention was compared to usual care for an individual or an individual-focused intervention, which meant the impact of the couplebased content could not be isolated. Three arm studies could determine whether any added benefits of couple-focused interventions are due to adding the partner or specific content of couple-focused interventions. Statement of contribution What is already known on this subject? Health behaviours and health behaviour change are more often concordant across couples than between individuals in the general population. Couple-focused interventions for chronic conditions are more effective than individual interventions or usual care (Martire, Schulz, Helgeson, Small, & Saghafi, ). What does this study add? Identified studies targeted a variety of health behaviours, with few studies in any one area. Further
Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity
Full Text Available Abstract Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'. This forms the hub of a 'behaviour change wheel' (BCW around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence
Chebli, Jaymee-Lee; Blaszczynski, Alexander; Gainsbury, Sally M
Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.
Full Text Available Internationally early intervention programmes for infants and preschoolers with disabilities have proved to be remarkably successful. In many countries, they began with teachers for visually impaired or hearing impaired children visiting the family home to teach parents how they could overcome the child's impairments. The logic of early intervention was inequitable. For example, the sooner children with visual impairments learnt to be independently mobile, then the greater their potential to learn and to kad an ordinary life. In time, this philosophy was extended to children with neurological and developmental delays, such as mental retardation, although success could be variable. In part, many different factors contributed to this variability: the form the interventions took, the extent of family involvement in the intervention and the lack of sensitivity of the measures used to assess a child's progress, to name but three. Perhaps the most extensive and intensive Early intervention schemes have been in the United States with their Head Start programmes. They were aimed at promoting the educational potential of preschoolers from deprived socio - economic backgrounds. Although the first phase of programmes had varying success, those in the second phase yielded impressive results which were mainly attributed to a greater focus on parental participation and links forged with the school system. Recently in developing countries, priority has been given to establishing early intervention as a means of creating new styles of family-based and community-based service in these countries in contrast to the hospital or institutional-services that were a legacy from a previous generation. Although formal evaluations are largely lacking, informal reports have been broadly enthusiastic. In sum, early intervention is no longer a new approach to developmental disabilities. It is an approach of proven effectiveness with children who have different impairments
Porcheret, Mark; Main, Chris; Croft, Peter; McKinley, Robert; Hassell, Andrew; Dziedzic, Krysia
Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised 'context-bound communication skills training.' Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. A stepped approach to the development of a behaviour change intervention, with the
Background Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. Methods The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. Results The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised ‘context-bound communication skills training.’ Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. Conclusions A stepped approach to the development of a
Kor, Kenny; Mullan, Barbara Ann
This study investigated the sleep hygiene behaviour of university students within the framework of the Theory of Planned Behaviour (TPB [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.]), and examined the predictive validity of additional variables including perceived autonomy support, past behaviour and response inhibition. A total of 257 undergraduate students from an Australian university were administered two online questionnaires at two time points. At time 1, participants completed the TPB questionnaire and the Go/NoGo task as a measure of response inhibition. A week later at time 2, participants completed a questionnaire measuring the performance of sleep hygiene behaviours. Multiple and hierarchical regression analyses showed that the TPB model significantly predicted intention and behaviour. Although intention and perceived behavioural control were statistically significant in predicting behaviour, past behaviour and response inhibition accounted for more variance when added to the TPB model. Subjective norm was found to be the strongest predictor of intention implying the importance of normative influences in sleep hygiene behaviours. Response inhibition was the strongest predictor of behaviour, reinforcing the argument that the performance of health protective behaviours requires self-regulatory ability. Therefore, interventions should be targeted at enhancing self-regulatory capacity.
Dombrowski, Stephan U; Campbell, Pauline; Frost, Helen; Pollock, Alex; McLellan, Julie; MacGillivray, Steve; Gavine, Anna; Maxwell, Margaret; O'Carroll, Ronan; Cheyne, Helen; Presseau, Justin; Williams, Brian
Failure to successfully implement and sustain change over the long term continues to be a major problem in health and social care. Translating evidence into routine clinical practice is notoriously complex, and it is recognised that to implement new evidence-based interventions and sustain them over time, professional behaviour needs to change accordingly. A number of theories and frameworks have been developed to support behaviour change among health and social care professionals, and models of sustainability are emerging, but few have translated into valid and reliable interventions. The long-term success of healthcare professional behavioural change interventions is variable, and the characteristics of successful interventions unclear. Previous reviews have synthesised the evidence for behaviour change, but none have focused on sustainability. In addition, multiple overlapping reviews have reported inconsistent results, which do not aid translation of evidence into practice. Overviews of reviews can provide accessible succinct summaries of evidence and address barriers to evidence-based practice. We aim to compile an overview of reviews, identifying, appraising and synthesising evidence relating to sustained social and healthcare professional behaviour change. We will conduct a systematic review of Cochrane reviews (an Overview). We plan to systematically search the Cochrane Database of Systematic Reviews. We will include all systematic reviews of randomised controlled trials comparing a healthcare professional targeted behaviour change intervention to a standard care or no intervention control group. Two reviewers will independently assess the eligibility of the reviews and the methodological quality of included reviews using the ROBIS tool. The quality of evidence within each comparison in each review will be judged based on the GRADE criteria. Disagreements will be resolved through discussion. Effects of interventions will be systematically tabulated and the
Diana, Augusto; Bennett, Nicole
This paper examines federal mechanisms that support program developers and researchers in disseminating effective interventions for public benefit. The purpose of this paper is not to discuss the dissemination of intervention research (i.e., how to inform stakeholders about research findings), nor is it intended to discuss the research of…
Mitsi, C; Efthimiou, K
Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term, however other causes can be found in both sexes. The diagnosis of infertility and the concurrent medical treatment are rather stressful events for the couple and can provoke a number of negative symptoms such as depression, anxiety and psychosomatic symptoms which may interfere with the medical therapeutic procedures especially with the in-vitro fertilisation technique. The relationship between infertility and psychological factors has not been explored fully and are still under research. However current findings can be summarized in three basic hypotheses; namely, the effect of psychological factors on the appearance of infertility, the psychological consequences of infertility at the couple, and the reciprocal relation of psychological factors and infertility. Stress and anxiety activate the hypothalamic-adrenal axis (HPA), and this activation can disturb the hormones of fertility. The presence of depressive/anxiety symptoms seems to have a negative impact on the treatment of infertility and sometimes can be a risk factor for lower pregnancy rate. There is a possibility that psychological complaints could develop, prior, during and after the diagnosis of infertility and may interfere with the fertilisation therapy. Should such psychological complaints develop it is suggested that psychotherapeutic treatment is used in conjunction with the treatment approach of infertility, e.g. IVF. The above mentioned suggestion is supported by a large number of researchers and current research efforts focus on different psychotherapeutic interventions such as Cognitive-Behavioural Therapy. Cognitive-Behavioural Therapy (CBT) has shown during research its superiority compared to other psychotherapeutic interventions and that could be an effective way to decrease the depressive
O'Reilly, G A; Cook, L; Spruijt-Metz, D; Black, D S
Mindfulness-based interventions (MBIs) targeting eating behaviours have gained popularity in recent years. A literature review was conducted to determine the effectiveness of MBIs for treating obesity-related eating behaviours, such as binge eating, emotional eating and external eating. A search protocol was conducted using the online databases Google Scholar, PubMed, PsycINFO and Ovid Healthstar. Papers were required to meet the following criteria to be included in this review: (i) describe a MBI or the use of mindfulness exercises as part of an intervention; (ii) include at least one obesity-related eating behaviour as an outcome; (iii) include quantitative outcomes; and (iv) be published in English in a peer-reviewed journal. A total of N = 21 papers were included in this review. Interventions used a variety of approaches to implement mindfulness training, including combined mindfulness and cognitive behavioural therapies, mindfulness-based stress reduction, acceptance-based therapies, mindful eating programmes, and combinations of mindfulness exercises. Targeted eating behaviour outcomes included binge eating, emotional eating, external eating and dietary intake. Eighteen (86%) of the reviewed studies reported improvements in the targeted eating behaviours. Overall, the results of this first review on the topic support the efficacy of MBIs for changing obesity-related eating behaviours, specifically binge eating, emotional eating and external eating. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.
Beukers, Laura; Berends, Tamara; de Man-van Ginkel, Janneke M; van Elburg, Annemarie A; van Meijel, Berno
An important part of inpatient treatment for adolescents with anorexia nervosa is to restore normal eating behaviour. Health-care professionals play a significant role in this process, but little is known about their interventions during patients' meals. The purpose of the present study was to describe nursing interventions aimed at restoring normal eating behaviour in patients with anorexia nervosa. The main research question was: 'Which interventions aimed at restoring normal eating behaviour do health-care professionals in a specialist eating disorder centre use during meal times for adolescents diagnosed with anorexia nervosa? The present study was a qualitative, descriptive study that used video recordings made during mealtimes. Thematic data analysis was applied. Four categories of interventions emerged from the data: (i) monitoring and instructing; (ii) encouraging and motivating; (iii) supporting and understanding; and (iv) educating. The data revealed a directive attitude aimed at promoting behavioural change, but always in combination with empathy and understanding. In the first stage of clinical treatment, health-care professionals focus primarily on changing patients' eating behaviour. However, they also address the psychosocial needs that become visible in patients as they struggle to restore normal eating behaviour. The findings of the present study can be used to assist health-care professionals, and improve multidisciplinary guidelines and health-care professionals' training programmes. © 2015 Australian College of Mental Health Nurses Inc.
Kok, Gerjo; Gottlieb, Nell H; Peters, Gjalt-Jorn Y; Mullen, Patricia Dolan; Parcel, Guy S; Ruiter, Robert A C; Fernández, María E; Markham, Christine; Bartholomew, L Kay
In this paper, we introduce the Intervention Mapping (IM) taxonomy of behaviour change methods and its potential to be developed into a coding taxonomy. That is, although IM and its taxonomy of behaviour change methods are not in fact new, because IM was originally developed as a tool for intervention development, this potential was not immediately apparent. Second, in explaining the IM taxonomy and defining the relevant constructs, we call attention to the existence of parameters for effectiveness of methods, and explicate the related distinction between theory-based methods and practical applications and the probability that poor translation of methods may lead to erroneous conclusions as to method-effectiveness. Third, we recommend a minimal set of intervention characteristics that may be reported when intervention descriptions and evaluations are published. Specifying these characteristics can greatly enhance the quality of our meta-analyses and other literature syntheses. In conclusion, the dynamics of behaviour change are such that any taxonomy of methods of behaviour change needs to acknowledge the importance of, and provide instruments for dealing with, three conditions for effectiveness for behaviour change methods. For a behaviour change method to be effective: (1) it must target a determinant that predicts behaviour; (2) it must be able to change that determinant; (3) it must be translated into a practical application in a way that preserves the parameters for effectiveness and fits with the target population, culture, and context. Thus, taxonomies of methods of behaviour change must distinguish the specific determinants that are targeted, practical, specific applications, and the theory-based methods they embody. In addition, taxonomies should acknowledge that the lists of behaviour change methods will be used by, and should be used by, intervention developers. Ideally, the taxonomy should be readily usable for this goal; but alternatively, it should be
Barker, Fiona; de Lusignan, Simon; Cooke, Deborah
The consequences of poorly managed hearing loss can be ameliorated with hearing aid use but rates of use are sub-optimal. The impact of audiologist behaviour on subsequent use, particularly over the long term, is unknown. This study aimed to describe the role of the behaviour change wheel in developing an intervention to introduce and embed particular clinical behaviours into adult hearing aid fitting consultations, within the framework of the Medical Research Council guidance on complex interventions. Following the steps of the behaviour change wheel, audiologist behaviours that might influence hearing aid use were identified based on a systematic review and qualitative work with audiologists. An analysis, using the COM-B model, identified potential drivers of the target behaviours. This was used to select intervention functions and behaviour change techniques likely to influence behaviour in this context. The target behaviours were as follows: giving information about the benefits of hearing aid use and the negative consequences of non-use, providing prompts for use and engaging in collaborative behavioural planning for use. The behavioural analysis suggested that psychological capability, opportunity and motivation were potential drivers of these behaviours. The intervention functions of education, coercion, training, environmental restructuring, modelling and enablement were selected and combined to develop a single complex intervention that seeks to address the target behaviours. This is the first study to use the behaviour change wheel to develop a complex intervention in the context of audiology. The theory-based development of the intervention will facilitate evaluation of its feasibility and effectiveness.
Five studies measuring condom use with regular non-paying partners recorded less consistent condom use with these partners. This review illustrates the existence of sufficient evidence showing the effectiveness of behavioural interventions targeting correct and consistent condom use by FSWs. Keywords: commercial sex ...
The target adolescent had a history of severely disruptive behaviour and was facing expulsion from a shelter for homeless children and his school. A thorough assessment served as the basis for a case formulation and treatment plan. Intervention included 23 individual sessions focussing on bereavement and the learning ...
Blais, Louise T; Mack, Diane E; Wilson, Philip M; Blanchard, Chris M
The objective of this study was to examine the effectiveness of a 12 week weight loss intervention within a commercial fitness centre on body weight, moderate to vigorous physical activity (MVPA), dietary intake, and behavioural regulations for exercise and healthy eating. Using a quasi-experimental design, the intervention group received weekly coaching sessions and bi-weekly seminars designed to increase MVPA and improve dietary intake. Outcome variables were assessed at three time points over a six month period. Results showed a significant interaction for body weight (p = .04) and dietary changes (p weight loss challenge but were not maintained across the six month period. Changes in behavioural regulations favoured the intervention condition. Results imply that a 12 week weight loss challenge within a commercial fitness centre may be effective at prompting short-term weight loss and support the internalization of behavioural regulations specific to healthy eating and exercise.
Verdellen, Cara; van de Griendt, Jolande; Hartmann, Andreas
This clinical guideline provides recommendations for the behavioural and psychosocial interventions (BPI) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted...... trials provided evidence for the current review. Most evidence was found for habit reversal training (HRT) and the available but smaller evidence also supports the efficacy of exposure with response prevention (ERP). Both interventions are considered first line behavioural treatments for tics for both...... children and adults and should be offered to a patient, taking into account his preference. Treatments that are considered second line or add-on behavioural treatments are contingency management, function based interventions and relaxation training. Neurofeedback is still experimental. Almost no research...
Morawska, Alina; Sanders, Matthew
Parents of gifted children identify a need for tailored parenting support, and gifted children have unique requirements and vulnerabilities. The aim of this study was to assess the efficacy of a tailored behavioural parenting intervention, for enhancing the parenting skills of parents of gifted children and to assess the effect of these changes on the behavioural and emotional adjustment of their gifted child. A randomised controlled trial of tailored Group Triple P - Positive Parenting Program was conducted with 75 parents of children identified as gifted. Results indicated significant intervention effects for the number and frequency of parent reported child behaviour problems, as well as hyperactivity in the intervention group, relative to a waitlist control. Parents also reported significant improvements in their own parenting style, including less permissiveness, harshness, and verbosity when disciplining their child. No intervention effects were evident for teacher reports, except for a trend in relation to hyperactivity. This study demonstrated that a tailored behavioural parenting intervention is effective and acceptable for parents of gifted children, and thus has clinical implications for the delivery of parenting interventions for this population.
Roshier, A L; McBride, E A
Veterinarians are professionals considered to be at the forefront of animal welfare, including behaviour medicine. However, concerns raised, both within the profession and without, highlight that the support offered is not optimal, due to deficiencies in veterinary training, which focuses on physical aspects and overlooks psychological aspects. This preliminary study explored the experiences and perceptions of six veterinarians (three male, three female, age range: 23-55 years) in two UK small-animal practices. Seventeen annual booster consultations were videoed and conversations thematically analysed for welfare topics discussed. Both veterinarians and clients completed questionnaires to gather demographic information and perspectives. All veterinarians recognised behaviour as a component of their caseload, and acknowledged that clients expected them to provide behaviour support. Veterinarians varied in their experiences of and confidence in providing behaviour support. Five felt unable to meet client expectations; four did not feel their training had prepared them sufficiently. Only one provided dedicated behaviour consultations, the others referred cases. All provided suggestions for behaviour skills needed for new veterinary graduates. The study has afforded an insight into the experiences of a small opportunistic sample of veterinarians. The data indicated important limitations regarding time available in general consultations to discuss behaviour concerns, and practitioner knowledge and skill in detection, anamnesis, assessment and provision of appropriate behaviour information. Suggestions for veterinary training in behaviour are provided.
Roshier, A. L.; McBride, E. A.
Veterinarians are professionals considered to be at the forefront of animal welfare, including behaviour medicine. However, concerns raised, both within the profession and without, highlight that the support offered is not optimal, due to deficiencies in veterinary training, which focuses on physical aspects and overlooks psychological aspects. This preliminary study explored the experiences and perceptions of six veterinarians (three male, three female, age range: 23–55 years) in two UK small-animal practices. Seventeen annual booster consultations were videoed and conversations thematically analysed for welfare topics discussed. Both veterinarians and clients completed questionnaires to gather demographic information and perspectives. All veterinarians recognised behaviour as a component of their caseload, and acknowledged that clients expected them to provide behaviour support. Veterinarians varied in their experiences of and confidence in providing behaviour support. Five felt unable to meet client expectations; four did not feel their training had prepared them sufficiently. Only one provided dedicated behaviour consultations, the others referred cases. All provided suggestions for behaviour skills needed for new veterinary graduates. The study has afforded an insight into the experiences of a small opportunistic sample of veterinarians. The data indicated important limitations regarding time available in general consultations to discuss behaviour concerns, and practitioner knowledge and skill in detection, anamnesis, assessment and provision of appropriate behaviour information. Suggestions for veterinary training in behaviour are provided. PMID:23475046
Franks, H; Hardiker, N R; McGrath, M; McQuarrie, C
This study identified and reviewed grey literature relating to factors facilitating and inhibiting effective interventions in three areas: the promotion of mental health and well-being, the improvement of food and nutrition, and interventions seeking to increase engagement in physical activity. Sourcing, reviewing and analysis of relevant grey literature. Evidence was collected from a variety of non-traditional sources. Thirty-six pieces of documentary evidence across the three areas were selected for in-depth appraisal and review. A variety of approaches, often short-term, were used both as interventions and outcome measures. Interventions tended to have common outcomes, enabling the identification of themes. These included improvements in participant well-being as well as identification of barriers to, and promoters of, success. Most interventions demonstrated some positive impact, although some did not. This was particularly the case for more objective measures of change, such as physiological measurements, particularly when used to evaluate short-term interventions. Objective health measurement as part of an intervention may act as a catalyst for future behaviour change. Time is an important factor that could either promote or impede the success of interventions for both participants and facilitators. Likewise, the importance of involving all stakeholders, including participants, when planning health promoting interventions was established as an important indicator of success. Despite its limited scope, this review suggests that interventions can be more efficient and effective. For example, larger-scale, longer-term interventions could be more efficient, whilst outcomes relating to the implementation and beyond could provide a clearer picture of effectiveness. Additionally, interventions and evaluations must be flexible, evolve in partnership with local communities, and reflect local need and context. Copyright © 2011 The Royal Society for Public Health
Smith, Anna Jo Bodurtha; Tennison, Imogen; Roberts, Ian; Cairns, John; Free, Caroline
To estimate the carbon footprint of behavioural support services for smoking cessation: text message support, telephone counselling, group counselling and individual counselling. Carbon footprint analysis. Publicly available data on National Health Service Stop Smoking Services and per unit carbon emissions; published effectiveness data from the txt2stop trial and systematic reviews of smoking cessation services. Carbon dioxide equivalents (CO2e) per 1000 smokers, per lifetime quitter, and per quality-adjusted life year gained, and cost-effectiveness, including social cost of carbon, of smoking cessation services. Emissions per 1000 participants were 8143 kg CO2e for text message support, 8619 kg CO2e for telephone counselling, 16 114 kg CO2e for group counselling and 16 372 kg CO2e for individual counselling. Emissions per intervention lifetime quitter were 636 (95% CI 455 to 958) kg CO2e for text message support, 1051 (95% CI 560 to 2873) kg CO2e for telephone counselling, 1143 (95% CI 695 to 2270) kg CO2e for group counselling and 2823 (95% CI 1688 to 6549) kg CO2e for individual counselling. Text message, telephone and group counselling remained cost-effective when cost-effectiveness analysis was revised to include the environmental and economic cost of damage from carbon emissions. All smoking cessation services had low emissions compared to the health gains produced. Text message support had the lowest emissions of the services evaluated. Smoking cessation services have small carbon footprints and were cost-effective after accounting for the societal costs of greenhouse gas emissions.
Kaya, Cahit; Blake, John; Chan, Fong
Peer-mediated interventions (PMIs) have been shown to be effective for increasing adaptive social and academic behaviours of children and youth. Although PMI efficacy is generally well supported, there have been relatively few published intervention studies that focus on elementary, middle and high school students with emotional and behavioural…
Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart JH
Sedentary behaviour – i.e., low energy-expending waking behaviour while seated or lying down – is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as ‘very promising’, ‘quite promising’, or ‘non-promising’ according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed. PMID:26315814
Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart J H
Sedentary behaviour - i.e., low energy-expending waking behaviour while seated or lying down - is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as 'very promising', 'quite promising', or 'non-promising' according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed.
Steinmo, Siri; Fuller, Christopher; Stone, Sheldon P; Michie, Susan
Sepsis is a major cause of death from infection, with a mortality rate of 36 %. This can be halved by implementing the 'Sepsis Six' evidence-based care bundle within 1 h of presentation. A UK audit has shown that median implementation rates are 27-47 % and interventions to improve this have demonstrated minimal effects. In order to develop more effective implementation interventions, it is helpful to obtain detailed characterisations of current interventions and to draw on behavioural theory to identify mechanisms of change. The aim of this study was to illustrate this process by using the Behaviour Change Wheel; Behaviour Change Technique (BCT) Taxonomy; Capability, Opportunity, Motivation model of behaviour; and Theoretical Domains Framework to characterise the content and theoretical mechanisms of action of an existing intervention to implement Sepsis Six. Data came from documentary, interview and observational analyses of intervention delivery in several wards of a UK hospital. A broad description of the intervention was created using the Template for Intervention Description and Replication framework. Content was specified in terms of (i) component BCTs using the BCT Taxonomy and (ii) intervention functions using the Behaviour Change Wheel. Mechanisms of action were specified using the Capability, Opportunity, Motivation model and the Theoretical Domains Framework. The intervention consisted of 19 BCTs, with eight identified using all three data sources. The BCTs were delivered via seven functions of the Behaviour Change Wheel, with four ('education', 'enablement', 'training' and 'environmental restructuring') supported by the three data sources. The most frequent mechanisms of action were reflective motivation (especially 'beliefs about consequences' and 'beliefs about capabilities') and psychological capability (especially 'knowledge'). The intervention consisted of a wide range of BCTs targeting a wide range of mechanisms of action. This study
McNamara, K. P.; O'Reilly, S. L.; George, J.; Peterson, G. M.; Jackson, S. L.; Duncan, G.; Howarth, H.; Dunbar, J. A.
Background: Delivery of cardiovascular disease (CVD) prevention programs by community pharmacists appears effective and enhances health service access. However, their capacity to implement complex behavioural change processes during patient counselling remains largely unexplored. This study aims to determine intervention fidelity by pharmacists…
Presseau, Justin; Ivers, Noah M; Newham, James J; Knittle, Keegan; Danko, Kristin J; Grimshaw, Jeremy M
Methodological guidelines for intervention reporting emphasise describing intervention content in detail. Despite this, systematic reviews of quality improvement (QI) implementation interventions continue to be limited by a lack of clarity and detail regarding the intervention content being evaluated. We aimed to apply the recently developed Behaviour Change Techniques Taxonomy version 1 (BCTTv1) to trials of implementation interventions for managing diabetes to assess the capacity and utility of this taxonomy for characterising active ingredients. Three psychologists independently coded a random sample of 23 trials of healthcare system, provider- and/or patient-focused implementation interventions from a systematic review that included 142 such studies. Intervention content was coded using the BCTTv1, which describes 93 behaviour change techniques (BCTs) grouped within 16 categories. We supplemented the generic coding instructions within the BCTTv1 with decision rules and examples from this literature. Less than a quarter of possible BCTs within the BCTTv1 were identified. For implementation interventions targeting providers, the most commonly identified BCTs included the following: adding objects to the environment, prompts/cues, instruction on how to perform the behaviour, credible source, goal setting (outcome), feedback on outcome of behaviour, and social support (practical). For implementation interventions also targeting patients, the most commonly identified BCTs included the following: prompts/cues, instruction on how to perform the behaviour, information about health consequences, restructuring the social environment, adding objects to the environment, social support (practical), and goal setting (behaviour). The BCTTv1 mapped well onto implementation interventions directly targeting clinicians and patients and could also be used to examine the impact of system-level interventions on clinician and patient behaviour. The BCTTv1 can be used to characterise
Costello, Nessan; McKenna, Jim; Sutton, Louise; Deighton, Kevin; Jones, Ben
Designing and implementing successful dietary intervention is integral to the role of sport nutrition professionals as they attempt to positively change the dietary behaviour of athletes. High-performance sport is a time-pressured environment where immediate results can often supersede pursuit of the most effective evidence-based practice. However, efficacious dietary intervention necessitates comprehensive, systematic and theoretical behavioural design and implementation if the habitual dietary behaviours of athletes are to be positively changed. Therefore, this case study demonstrates how the Behaviour Change Wheel was used to design and implement an effective nutritional intervention within professional rugby league. The eight-step intervention targeted athlete consumption of a high quality dietary intake of 25.1 MJ each day, to achieve an overall body mass increase of 5 kg across a twelve-week intervention period. The Capability, Opportunity, Motivation-Behaviour model and APEASE criteria were used to identify population-specific intervention functions, policy categories, behaviour change techniques and modes of intervention delivery. The resulting intervention was successful, increasing the average daily energy intake of the athlete to 24.5 MJ, which corresponded in a 6.2 kg body mass gain. Despite consuming 0.6 MJ less per day than targeted, secondary outcome measures of diet quality, strength, body composition and immune function all substantially improved, supporting a sufficient energy intake and the overall efficacy of a behavioural approach. Ultimately, the Behaviour Change Wheel provides sport nutrition professionals with an effective and practical step-wise method via which to design and implement effective nutritional interventions for use within high-performance sport.
Appels, Ad; van Elderen, Therese; Bär, Frits
The EXhaustion Intervention Trial investigated the effect of a behavioural intervention programme on exhaustion, health-related quality of life (HRQL), depression, anxiety, hostility, and anginal complaints in angioplasty patients who felt exhausted after percutaneous coronary intervention (PCI)....
Thome, Janine; Koppe, Georgia; Hauschild, Sophie; Liebke, Lisa; Schmahl, Christian; Lis, Stefanie; Bohus, Martin
Background Dysfunctional fear responses play a central role in many mental disorders. New insights in learning and memory suggest that pharmacological and behavioural interventions during the reconsolidation of reactivated fear memories may increase the efficacy of therapeutic interventions. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and thus prevent the spontaneous recovery and reinstatement of the fear response. Methods We investigated whether pharmacological (propranolol) and behavioural (reappraisal, multisensory stimulation) interventions reduce fear memory, and prevent reinstatement of fear in comparison to a placebo control group. Eighty healthy female subjects underwent a differential fear conditioning procedure with three stimuli (CS). Two of these (CS+) were paired with an electric shock on day 1. On day 2, 20 subjects were pseudo-randomly assigned to either the propranolol or placebo condition, or underwent one of the two behavioural interventions after one of the two CS+ was reactivated. On day 3, all subjects underwent an extinction phase, followed by a reinstatement test. Dependent variables were US expectancy ratings, fear-potentiated startle, and skin conductance response. Results Differential fear responses to the reactivated and non-reactivated CS+ were observed only in the propranolol condition. Here, the non-reactivated CS+ evoked stronger fear-potentiated startle-responses compared to the placebo group. None of the interventions prevented the return of the extinguished fear response after re-exposure to the unconditioned stimulus. Conclusions Our data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions. In conclusion, our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of
Pfaeffli Dale, Leila; Dobson, Rosie; Whittaker, Robyn; Maddison, Ralph
Mobile wireless devices (mHealth) have been used to deliver cardiovascular disease self-management interventions to educate and support patients in making healthy lifestyle changes. This systematic review aimed to determine the effectiveness of mHealth interventions on behavioural lifestyle changes and medication adherence for cardiovascular disease self-management. A comprehensive literature search was conducted from inception through to 3 March 2015 using MEDLINE, PubMed, PsycINFO, EMBASE and The Cochrane Library. Eligible studies used an experimental trial design to determine the effectiveness of an mHealth intervention to change lifestyle behaviours in any cardiovascular disease population. Data extracted included intervention and comparison group characteristics with a specific focus on the use of behaviour change techniques. Seven studies met our inclusion criteria and were included in the qualitative synthesis. All interventions were delivered in part by mobile phone text messaging. Three studies were effective at improving adherence to medication and two studies increased physical activity behaviour. No effects were observed on dietary behaviour or smoking cessation, measured in one study each. Simple text messaging interventions appeared to be most effective; however, no clear relationships were found between study findings and intervention dose, duration or behaviour change techniques targeted. Our review found mHealth has the potential to change lifestyle behaviour. Results are still limited to a small number of trials, inconsistent outcome measures and ineffective reporting of intervention characteristics. Large scale, longitudinal studies are now warranted to gain a clear understanding of the effects of mHealth on behaviour change in the cardiovascular disease population. © The European Society of Cardiology 2015.
Gardner, Benjamin; Jovicic, Ana; Belk, Celia; Kharicha, Kalpa; Iliffe, Steve; Manthorpe, Jill; Goodman, Claire; Drennan, Vari M; Walters, Kate
To identify trials of home-based health behaviour change interventions for frail older people, describe intervention content and explore its potential contribution to intervention effects. 15 bibliographic databases, and reference lists and citations of key papers, were searched for randomised controlled trials of home-based behavioural interventions reporting behavioural or health outcomes. Participants' homes. Community-dwelling adults aged ≥65 years with frailty or at risk of frailty. Trials were coded for effects on thematically clustered behavioural, health and well-being outcomes. Intervention content was described using 96 behaviour change techniques, and 9 functions (eg, education, environmental restructuring). 19 eligible trials reported 22 interventions. Physical functioning was most commonly assessed (19 interventions). Behavioural outcomes were assessed for only 4 interventions. Effectiveness on most outcomes was limited, with at most 50% of interventions showing potential positive effects on behaviour, and 42% on physical functioning. 3 techniques (instruction on how to perform behaviour, adding objects to environment, restructuring physical environment) and 2 functions (education and enablement) were more commonly found in interventions showing potential than those showing no potential to improve physical function. Intervention content was not linked to effectiveness on other outcomes. Interventions appeared to have greatest impact on physical function where they included behavioural instructions, environmental modification and practical social support. Yet, mechanisms of effects are unclear, because impact on behavioural outcomes has rarely been considered. Moreover, the robustness of our findings is also unclear, because interventions have been poorly reported. Greater engagement with behavioural science is needed when developing and evaluating home-based health interventions. ID=CRD42014010370. Published by the BMJ Publishing Group Limited. For
Michael A Andrews
Full Text Available Theoretical models of disease dynamics on networks can aid our understanding of how infectious diseases spread through a population. Models that incorporate decision-making mechanisms can furthermore capture how behaviour-driven aspects of transmission such as vaccination choices and the use of non-pharmaceutical interventions (NPIs interact with disease dynamics. However, these two interventions are usually modelled separately. Here, we construct a simulation model of influenza transmission through a contact network, where individuals can choose whether to become vaccinated and/or practice NPIs. These decisions are based on previous experience with the disease, the current state of infection amongst one's contacts, and the personal and social impacts of the choices they make. We find that the interventions interfere with one another: because of negative feedback between intervention uptake and infection prevalence, it is difficult to simultaneously increase uptake of all interventions by changing utilities or perceived risks. However, on account of vaccine efficacy being higher than NPI efficacy, measures to expand NPI practice have only a small net impact on influenza incidence due to strongly mitigating feedback from vaccinating behaviour, whereas expanding vaccine uptake causes a significant net reduction in influenza incidence, despite the reduction of NPI practice in response. As a result, measures that support expansion of only vaccination (such as reducing vaccine cost, or measures that simultaneously support vaccination and NPIs (such as emphasizing harms of influenza infection, or satisfaction from preventing infection in others through both interventions can significantly reduce influenza incidence, whereas measures that only support expansion of NPI practice (such as making hand sanitizers more available have little net impact on influenza incidence. (However, measures that improve NPI efficacy may fare better. We conclude that the
Andrews, Michael A; Bauch, Chris T
Theoretical models of disease dynamics on networks can aid our understanding of how infectious diseases spread through a population. Models that incorporate decision-making mechanisms can furthermore capture how behaviour-driven aspects of transmission such as vaccination choices and the use of non-pharmaceutical interventions (NPIs) interact with disease dynamics. However, these two interventions are usually modelled separately. Here, we construct a simulation model of influenza transmission through a contact network, where individuals can choose whether to become vaccinated and/or practice NPIs. These decisions are based on previous experience with the disease, the current state of infection amongst one's contacts, and the personal and social impacts of the choices they make. We find that the interventions interfere with one another: because of negative feedback between intervention uptake and infection prevalence, it is difficult to simultaneously increase uptake of all interventions by changing utilities or perceived risks. However, on account of vaccine efficacy being higher than NPI efficacy, measures to expand NPI practice have only a small net impact on influenza incidence due to strongly mitigating feedback from vaccinating behaviour, whereas expanding vaccine uptake causes a significant net reduction in influenza incidence, despite the reduction of NPI practice in response. As a result, measures that support expansion of only vaccination (such as reducing vaccine cost), or measures that simultaneously support vaccination and NPIs (such as emphasizing harms of influenza infection, or satisfaction from preventing infection in others through both interventions) can significantly reduce influenza incidence, whereas measures that only support expansion of NPI practice (such as making hand sanitizers more available) have little net impact on influenza incidence. (However, measures that improve NPI efficacy may fare better.) We conclude that the impact of
Tuti, Timothy; Nzinga, Jacinta; Njoroge, Martin; Brown, Benjamin; Peek, Niels; English, Mike; Paton, Chris; van der Veer, Sabine N
Audit and feedback is a common intervention for supporting clinical behaviour change. Increasingly, health data are available in electronic format. Yet, little is known regarding if and how electronic audit and feedback (e-A&F) improves quality of care in practice. The study aimed to assess the effectiveness of e-A&F interventions in a primary care and hospital context and to identify theoretical mechanisms of behaviour change underlying these interventions. In August 2016, we searched five electronic databases, including MEDLINE and EMBASE via Ovid, and the Cochrane Central Register of Controlled Trials for published randomised controlled trials. We included studies that evaluated e-A&F interventions, defined as a summary of clinical performance delivered through an interactive computer interface to healthcare providers. Data on feedback characteristics, underlying theoretical domains, effect size and risk of bias were extracted by two independent review authors, who determined the domains within the Theoretical Domains Framework (TDF). We performed a meta-analysis of e-A&F effectiveness, and a narrative analysis of the nature and patterns of TDF domains and potential links with the intervention effect. We included seven studies comprising of 81,700 patients being cared for by 329 healthcare professionals/primary care facilities. Given the extremely high heterogeneity of the e-A&F interventions and five studies having a medium or high risk of bias, the average effect was deemed unreliable. Only two studies explicitly used theory to guide intervention design. The most frequent theoretical domains targeted by the e-A&F interventions included 'knowledge', 'social influences', 'goals' and 'behaviour regulation', with each intervention targeting a combination of at least three. None of the interventions addressed the domains 'social/professional role and identity' or 'emotion'. Analyses identified the number of different domains coded in control arm to have the biggest
Menting, B.; van Lier, P.A.C.; Koot, H.M.
Difficulties in peer acceptance during elementary school have been associated with emotional and behavioural problems. This study used a randomized controlled intervention design to test whether improvements in peer acceptance mediated reduced rates of emotional and behavioural problems in
Williams, Sarah; Yardley, Lucy; Wills, Gary B
Previously, behavioural scientists seeking to create Internet-based behaviour change interventions have had to rely on computer scientists to actually develop and modify web interventions. The LifeGuide software was designed to enable behavioural researchers to develop and adapt Internet-based behavioural interventions themselves. This article reports a qualitative case study of users' experiences and perceptions of the LifeGuide software. The aim was to explore users' experiences and their perceptions of the benefits and limitations of this approach to intervention development. Twenty LifeGuide users took part in semi-structured interviews and one provided feedback via email. Thematic analysis identified three overarching themes: 'Recognising LifeGuide's potential', 'I'm not a programmer' and 'Knowledge sharing - the future of LifeGuide'. Users valued LifeGuide's potential to allow them to flexibly develop and modify interventions at little cost. However, users noted that their lack of programming experience meant that they needed to learn new skills for using the software, and they varied in the extent to which they felt able to develop interventions without any input from programmers. Respondents saw the potential of using the LifeGuide Community Website to share technical support and examples of intervention components to support their use of LifeGuide.
Hallward, Laura; Patel, Nisha; Duncan, Lindsay R
Physical activity interventions can improve prostate cancer survivors' health. Determining the behaviour change techniques used in physical activity interventions can help elucidate the mechanisms by which an intervention successfully changes behaviour. The purpose of this systematic review was to identify and evaluate behaviour change techniques in physical activity interventions for prostate cancer survivors. A total of 7 databases were searched and 15 studies were retained. The studies included a mean 6.87 behaviour change techniques (range = 3-10), and similar behaviour change techniques were implemented in all studies. Consideration of how behaviour change techniques are implemented may help identify how behaviour change techniques enhance physical activity interventions for prostate cancer survivors.
Full Text Available Because eating habits are inseparably linked with people’s physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases—PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies’ duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people’s dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.
Adair, P M; Burnside, G; Pine, C M
To improve oral health in children, the key behaviours (tooth brushing and sugar control) responsible for development of dental caries need to be better understood, as well as how to promote these behaviours effectively so they become habitual; and, the specific, optimal techniques to use in interventions. The aim of this paper is to describe and analyse the behaviour change techniques that have been used in primary school-based interventions to prevent dental caries (utilizing a Cochrane systematic review that we have undertaken) and to identify opportunities for improving future interventions by incorporating a comprehensive range of behaviour change techniques. Papers of five interventions were reviewed and data were independently extracted. Results indicate that behaviour change techniques were limited to information-behaviour links, information on consequences, instruction and demonstration of behaviours. None of the interventions were based on behaviour change theory. We conclude that behaviour change techniques used in school interventions to reduce dental caries were limited and focused around providing information about how behaviour impacts on health and the consequences of not developing the correct health behaviours as well as providing oral hygiene instruction. Establishing which techniques are effective is difficult due to poor reporting of interventions in studies. Future design of oral health promotion interventions using behaviour change theory for development and evaluation (and reporting results in academic journals) could strengthen the potential for efficacy and provide a framework to use a much wider range of behaviour change techniques. Future studies should include development and publication of intervention manuals which is becoming standard practice in other health promoting programmes. © 2013 S. Karger AG, Basel.
Effectiveness of the 'Who's Challenging Who' support staff training intervention to improve attitudes and empathy towards adults with intellectual disability and challenging behaviours: study protocol for a cluster randomised controlled trial.
Randell, Elizabeth; Hastings, Richard P; McNamara, Rachel; Knight, Roseanna; Gillespie, David; Taylor, Zachary
Findings suggest approximately one in six people with intellectual disability engage in 'challenging behaviours', which include aggression towards others/property and self-injurious actions. In residential settings, actions of staff members can make challenging behaviours more likely to occur, or make these behaviours worse. In particular, negative attitudes from members of staff and lack of understanding about the reasons for challenging behaviour are contributory factors. 'Who's Challenging Who?' (WCW) training is designed to emphasise the role of staff in residential settings as a challenge also to people with intellectual disability. The course is delivered jointly by a trainer with intellectual disability who has been labelled as having challenging behaviour, along with a trainer without intellectual disability. This is a cluster randomised two-arm trial of WCW training versus a waiting list control. Overall, 118 residential settings will be recruited and randomised on a 1:1 ratio. Within each setting, two members of staff will be invited to take part in the trial. Participants will complete assessments at baseline and at 6 and 20 weeks. WCW is a half day initial training course with some follow-on coaching to ensure implementation. The primary outcome is changes in staff empathy towards people with challenging behaviour. Secondary outcomes at the staff level include confidence, attitudes and work-related well-being. Secondary outcomes at the residential setting level include recorded incidents of aggressive challenging behaviour, and use of any restrictive practices. If the results of the cluster randomised trial are positive, we will disseminate the findings widely and make all training manuals and materials freely available for anyone in intellectual disability services (and beyond) to use. Our training approach may have wider implications in other areas of social care. It may also provide a generally applicable model for how to train people with
Boudet, Hilary; Ardoin, Nicole M.; Flora, June; Armel, K. Carrie; Desai, Manisha; Robinson, Thomas N.
Energy education programmes for children are hypothesized to have great potential to save energy. Such interventions are often assumed to impact child and family behaviours. Here, using a cluster-randomized controlled trial with 30 Girl Scout troops in Northern California, we assess the efficacy of two social cognitive theory-based interventions focused on residential and food-and-transportation energy-related behaviours of Girl Scouts and their families. We show that Girl Scouts and parents in troops randomly assigned to the residential energy intervention significantly increased their self-reported residential energy-saving behaviours immediately following the intervention and after more than seven months of follow-up, compared with controls. Girl Scouts in troops randomly assigned to the food-and-transportation energy intervention significantly increased their self-reported food-and-transportation energy-saving behaviours immediately following the intervention, compared with controls, but not at follow-up. The results demonstrate that theory-based, child-focused energy interventions have the potential to increase energy-saving behaviours among both children and their parents.
Full Text Available Abstract Background Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes. Methods Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71 with usual care (n = 85 was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life. Results Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD of frequency: 0.23 (0.87 days/week versus -.06 (0.40; duration: 15.53 (90.15 minutes/week versus −3.67 (22.60 minutes/week; intensity: 31.05 (105.98 Metabolic equivalents (METs versus 14.68 (90.40 METs. Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD of frequency: 3.15 (2.75 days/week versus 0.37 (1.83 days/week; duration: 150.90 (124.47 minutes/week versus 24.05 (195.93 minutes/week; intensity: 495.12 (413.74 METs versus14.62 (265.06 METs. Effect size was 0.36 for walking
Rawson, T M; Moore, L S P; Tivey, A M; Tsao, A; Gilchrist, M; Charani, E; Holmes, A H
To improve the quality of antimicrobial stewardship (AMS) interventions the application of behavioural sciences supported by multidisciplinary collaboration has been recommended. We analysed major UK scientific research conferences to investigate AMS behaviour change intervention reporting. Leading UK 2015 scientific conference abstracts for 30 clinical specialties were identified and interrogated. All AMS and/or antimicrobial resistance(AMR) abstracts were identified using validated search criteria. Abstracts were independently reviewed by four researchers with reported behavioural interventions classified using a behaviour change taxonomy. Conferences ran for 110 days with >57,000 delegates. 311/12,313(2.5%) AMS-AMR abstracts (oral and poster) were identified. 118/311(40%) were presented at the UK's infectious diseases/microbiology conference. 56/311(18%) AMS-AMR abstracts described behaviour change interventions. These were identified across 12/30(40%) conferences. The commonest abstract reporting behaviour change interventions were quality improvement projects [44/56 (79%)]. In total 71 unique behaviour change functions were identified. Policy categories; "guidelines" (16/71) and "service provision" (11/71) were the most frequently reported. Intervention functions; "education" (6/71), "persuasion" (7/71), and "enablement" (9/71) were also common. Only infection and primary care conferences reported studies that contained multiple behaviour change interventions. The remaining 10 specialties tended to report a narrow range of interventions focusing on "guidelines" and "enablement". Despite the benefits of behaviour change interventions on antimicrobial prescribing, very few AMS-AMR studies reported implementing them in 2015. AMS interventions must focus on promoting behaviour change towards antimicrobial prescribing. Greater focus must be placed on non-infection specialties to engage with the issue of behaviour change towards antimicrobial use.
T. M. Rawson
Full Text Available Abstract Background To improve the quality of antimicrobial stewardship (AMS interventions the application of behavioural sciences supported by multidisciplinary collaboration has been recommended. We analysed major UK scientific research conferences to investigate AMS behaviour change intervention reporting. Methods Leading UK 2015 scientific conference abstracts for 30 clinical specialties were identified and interrogated. All AMS and/or antimicrobial resistance(AMR abstracts were identified using validated search criteria. Abstracts were independently reviewed by four researchers with reported behavioural interventions classified using a behaviour change taxonomy. Results Conferences ran for 110 days with >57,000 delegates. 311/12,313(2.5% AMS-AMR abstracts (oral and poster were identified. 118/311(40% were presented at the UK’s infectious diseases/microbiology conference. 56/311(18% AMS-AMR abstracts described behaviour change interventions. These were identified across 12/30(40% conferences. The commonest abstract reporting behaviour change interventions were quality improvement projects [44/56 (79%]. In total 71 unique behaviour change functions were identified. Policy categories; “guidelines” (16/71 and “service provision” (11/71 were the most frequently reported. Intervention functions; “education” (6/71, “persuasion” (7/71, and “enablement” (9/71 were also common. Only infection and primary care conferences reported studies that contained multiple behaviour change interventions. The remaining 10 specialties tended to report a narrow range of interventions focusing on “guidelines” and “enablement”. Conclusion Despite the benefits of behaviour change interventions on antimicrobial prescribing, very few AMS-AMR studies reported implementing them in 2015. AMS interventions must focus on promoting behaviour change towards antimicrobial prescribing. Greater focus must be placed on non-infection specialties to
Menting, Barbara; Koot, Hans; van Lier, Pol
Difficulties in peer acceptance during elementary school have been associated with emotional and behavioural problems. This study used a randomized controlled intervention design to test whether improvements in peer acceptance mediated reduced rates of emotional and behavioural problems in intervention compared to control-group children. A total…
Knowler, Claire; Frederickson, Norah
The effectiveness of a 12-week, small group emotional literacy (EL) intervention in reducing bullying behaviour in school was evaluated. Participants were 50 primary school pupils identified through peer nomination as engaging in bullying behaviours. The intervention was implemented in schools already engaged with a universal social and emotional…
Räsänen, Tiina; Lintonen, Tomi; Tolvanen, Asko; Konu, Anne
During the adolescent period, risk-taking behaviour increases. These behaviours can compromise the successful transition from adolescence to adulthood. The purpose of this study was to examine social support as a mediator of the relation between problem behaviour and gambling frequency among Finnish adolescents. Data were obtained from the national School Health Promotion Study (SHPS) from the years 2010 and 2011 (N=102 545). Adolescents were classified in the most homogeneous groups based on their problem behaviour via latent class analysis. Path analysis indicated that social support was negatively associated with problem behaviour, and problem behaviour and social support were negatively related (except for social support from friends among boys) to gambling. Social support from parents and school mediated, albeit weakly, the relations between problem behaviour and gambling among girls and boys. Problem behaviour may affect gambling through social support from school and parents. Thus prevention and intervention strategies should focus on strengthening adolescents' social support. In addition, because of the clustering of different problem behaviours instead of concentrating on a single form of problem behaviour multiple-behaviour interventions may have a much greater impact on public health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Hawkes Anna L
Full Text Available Abstract Background Most skin cancers are preventable by encouraging consistent use of sun protective behaviour. In Australia, adolescents have high levels of knowledge and awareness of the risks of skin cancer but exhibit significantly lower sun protection behaviours than adults. There is limited research aimed at understanding why people do or do not engage in sun protective behaviour, and an associated absence of theory-based interventions to improve sun safe behaviour. This paper presents the study protocol for a school-based intervention which aims to improve the sun safe behaviour of adolescents. Methods/design Approximately 400 adolescents (aged 12-17 years will be recruited through Queensland, Australia public and private schools and randomized to the intervention (n = 200 or 'wait-list' control group (n = 200. The intervention focuses on encouraging supportive sun protective attitudes and beliefs, fostering perceptions of normative support for sun protection behaviour, and increasing perceptions of control/self-efficacy over using sun protection. It will be delivered during three × one hour sessions over a three week period from a trained facilitator during class time. Data will be collected one week pre-intervention (Time 1, and at one week (Time 2 and four weeks (Time 3 post-intervention. Primary outcomes are intentions to sun protect and sun protection behaviour. Secondary outcomes include attitudes toward performing sun protective behaviours (i.e., attitudes, perceptions of normative support to sun protect (i.e., subjective norms, group norms, and image norms, and perceived control over performing sun protective behaviours (i.e., perceived behavioural control. Discussion The study will provide valuable information about the effectiveness of the intervention in improving the sun protective behaviour of adolescents.
Larkin, Louise; Gallagher, Stephen; Cramp, Fiona; Brand, Charles; Fraser, Alexander; Kennedy, Norelee
Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.
Wilson, C; Marselle, MR
Improving the design and implementation of interventions to encourage end-use energy efficiency has the potential to contribute a substantive reduction in carbon emissions. A plethora of behaviour change frameworks is available to guide policymakers and designers but none have been found to be comprehensive or well-used. A new framework – the Behaviour Change Wheel (BCW) – purports to be a useful aid for developing all types of behaviour change interventions. This paper assesses whether the B...
Behavioural Gerontology is concerned with the interaction of the aging individual and their environment. One aspect of behavioural gerontology has focussed on the use of behaviourist methods to improve the functioning and quality of life of individuals with dementia. Positive reinforcement techniques have shown to have an effect on dementia related behavioural excesses (wandering, disruptive vocalisations), behavioural deficits (incontinence, self feeding) and mood changes (depression). One o...
Pieper, M.J.C.; Dalen-Kok, A.H. van; Francke, A.L.; Steen, J.T. van der; Scherder, E.J.A.; Husebo, B.S.; Achterberg, W.P.
Background: Both pain and challenging behaviour are highly prevalent in dementia, and multiple studies show that some of these behaviours may be correlated. Pain, especially in non-communicative patients, can cause challenging behaviour, and treatment of pain therefore may have an effect on
Biondolillo, Mathew J; Pillemer, David B
This study tested a novel memory-based experimental intervention to increase exercise activity. Undergraduate students completed a two-part online survey ostensibly regarding college activity choices. At Time 1, they completed questionnaires that included assessments of exercise-related attitudes, motivation and self-reported behaviours. Next, they described a memory of a positive or negative experience that would increase their motivation to exercise; students in a control condition did not receive a memory prompt. Finally, they rated their intentions to exercise in the future. Eight days following Time 1, students received a Time 2 survey that included an assessment of their self-reported exercise during the prior week. Students in the positive memory condition reported higher levels of subsequent exercise than those in the control condition; students in the negative memory condition reported intermediate levels of exercise. Activating a positive motivational memory had a significant effect on students' self-reported exercise activity even after controlling for prior attitudes, motivation and exercise activity.
Chamberlain, Catherine; O’Mara-Eves, Alison; Oliver, Sandy; Caird, Jenny R; Perlen, Susan M; Eades, Sandra J; Thomas, James
Background Tobacco smoking in pregnancy remains one of the few preventable factors associated with complications in pregnancy, stillbirth, low birthweight and preterm birth and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and increasing in low- to middle-income countries. Objectives To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. Search methods In this fifth update, we searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (1 March 2013), checked reference lists of retrieved studies and contacted trial authors to locate additional unpublished data. Selection criteria Randomised controlled trials, cluster-randomised trials, randomised cross-over trials, and quasi-randomised controlled trials (with allocation by maternal birth date or hospital record number) of psychosocial smoking cessation interventions during pregnancy. Data collection and analysis Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, and subgroup analyses and sensitivity analysis were conducted in SPSS. Main results Eighty-six trials were included in this updated review, with 77 trials (involving over 29,000 women) providing data on smoking abstinence in late pregnancy. In separate comparisons, counselling interventions demonstrated a significant effect compared with usual care (27 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.75), and a borderline effect compared with less intensive interventions (16 studies; average RR 1.35, 95% CI 1.00 to 1.82). However, a significant effect was only seen in subsets where counselling was provided in conjunction with other strategies. It was unclear whether any type of counselling strategy is more effective than others (one study; RR
Girelli, Laura; Hagger, Martin; Mallia, Luca; Lucidi, Fabio
A motivational model integrating self-determination theory, the theory of planned behaviour, and the health action process approach was tested in three samples in three behavioural contexts: fruit and vegetable, breakfast, and snack consumption. Perceived support for autonomous (self-determined) forms of motivation from parents and autonomous motivation from self-determination theory were hypothesised to predict intention and behaviour indirectly via the mediation of attitude and perceived behavioural control from the theory of planned behaviour. It was also expected that planning strategies would mediate the effect of intention on behaviour. Relations in the proposed models were expected to be similar across the behaviours. A two-wave prospective design was adopted. Three samples of high-school students (total N = 1041; 59.60% female; M age = 17.13 years ± 1.57) completed measures of perceived autonomy support, autonomous motivation, theory of planned behaviour constructs, planning strategies and behaviour for each of the three behavioural contexts. Three months later, 816 participants (62,24% female; M age: 17.13 years, SD = 1.58) of the initial sample self-reported their behaviour referred to the previous three months. Structural equation models provided support for the key hypothesised effects of the proposed model for the three health-related behaviours. Two direct effects were significantly different across the three behaviours: the effect of perceived autonomy support on perceived behavioural control and the effect of attitude on intention. In addition, planning strategies mediated the effect of intention on behaviour in fruit and vegetable sample only. Findings extend knowledge of the processes by which psychological antecedents from the theories affect energy-balance related behaviours. Copyright © 2015 Elsevier Ltd. All rights reserved.
Zhou, Xiao; Perez-Cueto, Armando; dos Santos, Quenia
Because eating habits are inseparably linked with people’s physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence...... and direction for further research. Three electronic bibliographic databases—PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were...... of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet...
Hegarty, Kelsey; Tarzia, Laura; Hooker, Leesa; Taft, Angela
Experiences of domestic and sexual violence are common in patients attending primary care. Most often they are not identified due to barriers to asking by health practitioners and disclosure by patients. Women are more likely than men to experience such violence and present with mental and physical health symptoms to health practitioners. If identified through screening or case finding as experiencing violence they need to be supported to recover from these traumas. This paper draws on systematic reviews published in 2013-2015 and a further literature search undertaken to identify recent intervention studies relevant to recovery from domestic and sexual violence in primary care. There is limited evidence as to what interventions in primary care assist with recovery from domestic violence; however, they can be categorized into the following areas: first line response and referral, psychological treatments, safety planning and advocacy, including through home visitation and peer support programmes, and parenting and mother-child interventions. Sexual violence interventions usually include trauma informed care and models to support recovery. The most promising results have been from nurse home visiting advocacy programmes, mother-child psychotherapeutic interventions, and specific psychological treatments (Cognitive Behaviour Therapy, Trauma informed Cognitive Behaviour Therapy and, for sexual assault, Exposure and Eye Movement Desensitization and Reprocessing Interventions). Holistic healing models have not been formally tested by randomized controlled trials, but show some promise. Further research into what supports women and their children on their trajectory of recovery from domestic and sexual violence is urgently needed.
Austin, S.F.; Sumbundu, A.D.; Lykke, J.
Panic disorder is a common and debilitating disorder that has a prevalence rate of 3-5% in the general population. Cognitive-behavioural interventions have been shown to be an efficacious treatment for panic, although a limited number of studies have examined the effectiveness of such interventions...... of significant clinical change displayed and resources required to carry out the intervention. A small sample of GP-referred patients displaying panic symptoms completed a 2-week intensive cognitive-behavioural intervention. Results collected post-intervention revealed significant clinical reductions in panic...... of implementing effective treatments in everyday clinical practice and developing a stepped care approach to treating panic symptoms Udgivelsesdato: 2008...
Sinnott, Carol; Mercer, Stewart W; Payne, Rupert A; Duerden, Martin; Bradley, Colin P; Byrne, Molly
Multimorbidity, the presence of two or more chronic conditions, affects over 60 % of patients in primary care. Due to its association with polypharmacy, the development of interventions to optimise medication management in patients with multimorbidity is a priority. The Behaviour Change Wheel is a new approach for applying behavioural theory to intervention development. Here, we describe how we have used results from a review of previous research, original research of our own and the Behaviour Change Wheel to develop an intervention to improve medication management in multimorbidity by general practitioners (GPs), within the overarching UK Medical Research Council guidance on complex interventions. Following the steps of the Behaviour Change Wheel, we sought behaviours associated with medication management in multimorbidity by conducting a systematic review and qualitative study with GPs. From the modifiable GP behaviours identified, we selected one and conducted a focused behavioural analysis to explain why GPs were or were not engaging in this behaviour. We used the behavioural analysis to determine the intervention functions, behavioural change techniques and implementation plan most likely to effect behavioural change. We identified numerous modifiable GP behaviours in the systematic review and qualitative study, from which active medication review (rather than passive maintaining the status quo) was chosen as the target behaviour. Behavioural analysis revealed GPs' capabilities, opportunities and motivations relating to active medication review. We combined the three intervention functions deemed most likely to effect behavioural change (enablement, environmental restructuring and incentivisation) to form the MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) intervention. MY COMRADE primarily involves the technique of social support: two GPs review the medications prescribed to a complex multimorbid patient together. Four other
Full Text Available Topic. Additional interventions used to enhance the effectiveness of individual placement and support (IPS. Aim. To establish whether additional interventions improve the vocational outcomes of IPS alone for people with severe mental illness. Method. A rapid evidence assessment of the literature was conducted for studies where behavioural or psychological interventions have been used to supplement standard IPS. Published and unpublished empirical studies of IPS with additional interventions were considered for inclusion. Conclusions. Six published studies were found which compared IPS alone to IPS plus a supplementary intervention. Of these, three used skills training and three used cognitive remediation. The contribution of each discrete intervention is difficult to establish. Some evidence suggests that work-related social skills and cognitive training are effective adjuncts, but this is an area where large RCTs are required to yield conclusive evidence.
High stakes assessments conducted in the southwestern United States demonstrate that fewer than 50% of English language learners (ELLs) are achieving proficiency levels in reading fluency. The purpose of this study was to understand if reading interventions using the framework of Samuels's repeated reading (RR) strategy increased student…
Three sources of data were used to inform the intervention development process: the existing research literature on school-based physical activity interventions, teacher interviews (N=12 and pupil focus groups (N=18 and an experimental feasibility study (N=85; Norris, Shelton, Dunsmuir, Duke-Williams, & Stamatakis, 2015b. The Behaviour Change Wheel was used as a framework to guide synthesis of evidence into the resulting intervention. Potential appropriate Behaviour Change Techniques were reviewed and embedded within the intervention. Conclusions The resulting 6-week Virtual Traveller programme with a 3-month follow-up period is currently in its final stages of evaluation in ten Greater London primary schools. Using the Behaviour Change Wheel and Behaviour Change Techniques allows development of replicable health interventions in applied settings such as schools.
Murray, Jennifer; Williams, Brian; Hoskins, Gaylor; Skar, Silje; McGhee, John; Treweek, Shaun; Sniehotta, Falko F; Sheikh, Aziz; Brown, Gordon; Hagen, Suzanne; Cameron, Linda; Jones, Claire; Gauld, Dylan
Visualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing. Our final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions. We have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However
Corporate social responsibility: the role of public policy: a systematic literature review of the effects of government supported interventions on the corporate social responsibility (CSR) behaviour of enterprises in developing countries
Ingram, V.; de Grip, K.; de Ruyter de Wildt, M.; Ton, G.; Douma, M.; Boone, K.; van Hoeven, H.
Corporate social responsibility (CSR) focuses on creating social and environmental value in addition to economic performance: people, planet and profit (or Triple P). Public authorities are increasingly supporting companies that choose to do so. What has become of the Dutch government’s efforts to
Bain, Andrew John
Education, training and employment (ETE) are considered of great importance to desistance from crime and the rehabilitation of the offender (Clarke, 2010; Farrall, 2002; SEU: 2002). This study sets out to investigate the use and success of such an intervention in a local Probation Trust area, with a convenience sample drawn from a population of adult offenders (aged 18 years+). It makes use of a triangulation (mixed) methodology conducted through a series of assisted questionnaires undertaken...
Chien, Hui-Ching; Chung, Yu-Chu; Yeh, Mei-Ling; Lee, Jia-Fu
The aim of this study was to investigate the effects of a cognitive behavioural intervention combined with a breathing relaxation exercise on sleep quality and heart rate variability in patients with major depression. Depression is a long-lasting illness with significant effects not only in individuals themselves, but on their family, work and social relationships as well. Cognitive behavioural therapy is considered to be an effective treatment for major depression. Breathing relaxation may improve heart rate variability, but few studies have comprehensively examined the effect of a cognitive behavioural intervention combined with relaxing breathing on patients with major depression. An experimental research design with a repeated measure was used. Eighty-nine participants completed this study and entered data analysed. The experimental group (n = 43) received the cognitive behavioural intervention combined with a breathing relaxation exercise for four weeks, whereas the control group (n = 46) did not. Sleep quality and heart rate variability were measured at baseline, posttest1, posttest2 and follow-up. Data were examined by chi-square tests, t-tests and generalised estimating equations. After adjusting for age, socioeconomic status, severity of disease and psychiatric history, the quality of sleep of the experimental group improved, with the results at posttest achieving significance. Heart rate variability parameters were also significantly improved. This study supported the hypothesis that the cognitive behavioural intervention combined with a breathing relaxation exercise could improve sleep quality and heart rate variability in patients with major depression, and the effectiveness was lasting. The cognitive behavioural intervention combined with a breathing relaxation exercise that included muscle relaxation, deep breathing and sleep hygiene could be provided with major depression during hospitalisation. Through group practice and experience sharing
Medlow, Sharon; Klineberg, Emily; Jarrett, Carmen; Steinbeck, Katharine
Parenting skills training is an established means of treating challenging behaviours among young children, but there has been limited research on its efficacy when used to treat challenging adolescent behaviour. The aim of this systematic review was to evaluate the efficacy and effectiveness of community-based parenting interventions designed for families with adolescents, as judged in terms of increased knowledge and skills among parents, improvements in adolescent behaviour, and program feasibility within community settings. Results indicated that intervention group parents typically made greater gains than did control group parents on measures of good parenting, with positive flow-on effects to some aspects of challenging adolescent behaviours. Limited evidence suggests that group and individual intervention formats may be equally effective and that there is no advantage to the participation of the target adolescent in the intervention. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. All rights reserved.
Biddle, Stuart J H; Petrolini, Irene; Pearson, Natalie
Leisure time is increasingly spent in sedentary pursuits such as screen-viewing (eg, television/DVD viewing and computer use), motorised travel, school/work and sitting-based socialising (eg, social media and chatting). Sedentary screen time, particularly TV, appears to play an important role in the aetiology of obesity due to its co-occurrence with other unhealthy behaviours such as snacking on energy-dense foods, low levels of physical activity and inadequate sleep. More information is needed on how to reduce sedentary behaviours. Most interventions have focused on young people and a number of systematic reviews exist on this topic. To synthesise systematic reviews and meta-analyses of interventions aimed at decreasing sedentary behaviours among children and adolescents. Papers were located from computerised and manual searches. Included articles were English language systematic reviews or meta-analyses of interventions aiming at reducing sedentary behaviour in children (<11 years) and adolescents (12-18 years). Ten papers met the inclusion criteria and were analysed. All reviews concluded some level of effectiveness in reducing time spent in sedentary behaviour. When an effect size was reported, there was a small but significant reduction in sedentary time (highest effect size=-0.29; CI -0.35 to -0.22). Moderator analyses showed a trend favouring interventions with children younger than 6 years. Effective strategies include the involvement of family, behavioural interventions and electronic TV monitoring devices. Results from systematic reviews and meta-analyses show that interventions to reduce children's sedentary behaviour have a small but significant effect. Future research should expand these findings examining interventions targeting different types of sedentary behaviours and the effectiveness of specific behaviour change techniques across different contexts and settings.
Full Text Available Abstract Background Health clinicians perceive certain patients as 'difficult' across all settings, including mental health care. In this area, patients with non-psychotic disorders that become long-term care users may be perceived as obstructing their own recovery or seeking secondary gain. This negative perception of patients results in ineffective responses and low-quality care by health clinicians. Using the concept of illness behaviour, this paper describes the development, implementation, and planned evaluation of a structured intervention aimed at prevention and management of ineffective behaviours by long-term non-psychotic patients and their treating clinicians. Methods The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the intervention. Qualitative (individual and group interviews, quantitative (survey, and mixed methods (Delphi-procedure research was used to gain a broad perspective of the problem. Empirical findings, theoretical models, and existing evidence were combined to construct a program tailored to the needs of the target groups. Results A structured program to increase effective illness behaviour in long-term non-psychotic patients and effective professional behaviour in their treating clinicians was developed, consisting of three subsequent stages and four substantial components, that is described in detail. Implementation took place and evaluation of the intervention is being carried out. Conclusions Intervention Mapping proved to be a suitable method to develop a structured intervention for a multi-faceted problem in mental health care.
Tse, Wai S; Bond, Alyson J
Deficiencies in serotonin function have been associated with irritability and aggression but enhancing serotonin has also been shown to promote social status and affiliative behaviour in non-human primates and more recently in humans. To investigate the effects of citalopram, a selective serotonin reuptake inhibitor (SSRI), on social behaviour with a flatmate and a stranger. Ten pairs of healthy volunteers took part in a randomized double-blind crossover study of 2 weeks treatment with citalopram (20 mg/day) and placebo with a 2-week washout period. In each pair, one person (subject) took the tablets and the other (flatmate) received no treatment. On the last day of each treatment period, the subjects socially interacted with a confederate behaving as a responsive person in a stranger-dyadic social interaction paradigm. After the interaction, subjects played the Mixed-motive game, which measures cooperative behaviour and communication, with the confederate. The flatmates evaluated the social behaviour of the subjects before and at the end of the treatment periods. On citalopram, the subjects were rated as significantly less submissive by their flatmates and they showed a dominant pattern of eye contact in the stranger-dyadic social interaction paradigm. They also reduced the number of points they awarded themselves and sent more cooperative messages during the game. These results indicate that administration of an SSRI can modify social status in different interactions and increase affiliative behaviour. They implicate a role for serotonin in modulating social aspects of behaviour.
A review of international research literature on teacher strategies for effective intervention with students presenting social, emotional and behavioural difficulties (SEBD) is presented. Particular attention is given to evidence defining the qualities and skills of effective teachers and the value of behavioural and cognitive behavioural…
Murtagh, E M; Barnes, A T; McMullen, J; Morgan, P J
The majority of adolescent girls fail to meet public health guidelines for physical activity. Engaging mothers in the promotion of physical activity for their daughters may be an important strategy to facilitate behaviour change. The aim of this study was to use the behaviour change wheel (BCW) framework to design the components of an intervention to improve adolescent girls' physical activity. Cross-sectional study to inform intervention development. The BCW framework was used to (1) understand the behaviour, (2) identify intervention functions and (3) select content and implementation options. A circular development process was undertaken by the research team to collectively design the intervention in accordance with the steps recommended by the BCW. The BCW design process resulted in the selection of six intervention functions (education, persuasion, incentivization, training, modelling, enablement) and 18 behaviour change techniques delivered via group-based, face-to-face mode. Behaviour change technique groupings include: goals and planning; feedback and monitoring; social support; shaping knowledge; natural consequences; comparison of behaviour; associations; comparison of outcomes; reward and threat; identity; and, self-belief. The BCW process allowed an in-depth consideration of the target behaviours and provided a systematic framework for developing the intervention. The feasibility and preliminary efficacy of the programme will be examined. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Hassiotis, Angela; Poppe, Michaela; Strydom, Andre; Vickerstaff, Victoria; Hall, Ian; Crabtree, Jason; Omar, Rumana; King, Michael; Hunter, Rachael; Bosco, Alessandro; Biswas, Asit; Ratti, Victoria; Blickwedel, Jessica; Cooper, Vivien; Howie, William; Crawford, Mike
Preliminary studies have indicated that training staff in Positive Behaviour Support (PBS) may help to reduce challenging behaviour among people with intellectual disability (ID). To evaluate whether or not such training is clinically effective in reducing challenging behaviour in routine care. The study also included longer-term follow-up (approximately 36 months). A multicentre, single-blind, two-arm, parallel-cluster randomised controlled trial. The unit of randomisation was the community ID service using an independent web-based randomisation system and random permuted blocks on a 1 : 1 allocation stratified by a staff-to-patient ratio for each cluster. Community ID services in England. Adults (aged > 18 years) across the range of ID with challenging behaviour [≥ 15 Aberrant Behaviour Checklist - Community total score (ABC-C T )]. Manual-assisted face-to-face PBS training to therapists and treatment as usual (TAU) compared with TAU only in the control arm. Carer-reported changes in challenging behaviour as measured by the ABC-C T over 12 months. Secondary outcomes included psychopathology, community participation, family and paid carer burden, family carer psychopathology, costs of care and quality-adjusted life-years (QALYs). Data on main outcome, service use and health-related quality of life were collected for the 36-month follow-up. A total of 246 participants were recruited from 23 teams, of whom 109 were in the intervention arm (11 teams) and 137 were in the control arm (12 teams). The difference in ABC-C T between the intervention and control arms [mean difference -2.14, 95% confidence interval (CI) -8.79 to 4.51; p = 0.528] was not statistically significant. No treatment effects were found for any of the secondary outcomes. The mean cost per participant in the intervention arm was £1201. Over 12 months, there was a difference in QALYs of 0.076 in favour of the intervention (95% CI 0.011 to 0.140 QALYs) and a 60% chance that the
Knowler, Claire; Frederickson, Norah
The effectiveness of a 12-week, small group emotional literacy (EL) intervention in reducing bullying behaviour in school was evaluated. Participants were 50 primary school pupils identified through peer nomination as engaging in bullying behaviours. The intervention was implemented in schools already engaged with a universal social and emotional learning initiative, including an anti-bullying component. Within schools, participants were randomly assigned to an intervention or a wait-list comparison group. Response to the intervention was found to be dependent on baseline levels of EL. Only children whose baseline level was low showed a significant reduction in peer-rated bullying behaviour. No effect of the intervention was detected on victimisation or adjustment scores, although positive changes in adjustment were associated with increased EL.
Baird, Janis; Jarman, Megan; Lawrence, Wendy; Black, Christina; Davies, Jenny; Tinati, Tannaze; Begum, Rufia; Mortimore, Andrew; Robinson, Sian; Margetts, Barrie; Cooper, Cyrus; Barker, Mary; Inskip, Hazel
The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds. Non-randomised controlled evaluation of a complex public health intervention. 527 women attending Sure Start Children's Centres (SSCC) in Southampton (intervention) and 495 women attending SSCCs in Gosport and Havant (control). Training SSCC staff in behaviour change skills that would empower women to change their health behaviours. Main outcomes dietary quality and physical activity. Intermediate outcomes self-efficacy and sense of control. 1-year post-training, intervention staff used skills to support behaviour change significantly more than control staff. There were statistically significant reductions of 0.1 SD in the dietary quality of all women between baseline and follow-up and reductions in self-efficacy and sense of control. The decline in self-efficacy and control was significantly smaller in women in the intervention group than in women in the control group (adjusted differences in self-efficacy and control, respectively, 0.26 (95% CI 0.001 to 0.50) and 0.35 (0.05 to 0.65)). A lower decline in control was associated with higher levels of exposure in women in the intervention group. There was a statistically significant improvement in physical activity in the intervention group, with 22.9% of women reporting the highest level of physical activity compared with 12.4% at baseline, and a smaller improvement in the control group. The difference in change in physical activity level between the groups was not statistically significant (adjusted difference 1.02 (0.74 to 1.41)). While the intervention did not improve women's diets and physical activity levels, it had a protective effect on intermediate factors-control and self-efficacy-suggesting that a more prolonged exposure to the
Clarkson, Paul; Hughes, Jane; Roe, Brenda; Giebel, Clarissa M; Jolley, David; Poland, Fiona; Abendstern, Michele; Chester, Helen; Challis, David
The aim of this study was to explicate the outcomes of home support interventions for older people with dementia and/or their carers to inform clinical practice, policy and research. Most people with dementia receive support at home. However, components and effectiveness of home support interventions have been little explored. Systematic review with narrative summary. Electronic searches of published studies in English using PubMed, Cochrane Central Register of Controlled Trials, PsychINFO, CINAHL, Applied Social Science Index and CSA Social Services Abstracts. Databases and sources were searched from inception to April 2014 with no date restrictions to locate studies. The PRISMA statement was followed and established systematic review methods used. Using 14 components of care for people with dementia and their carers, identified previously, data across studies were synthesized. Interventions were grouped and described and effectiveness ratings applied. Qualitative studies were synthesized using key themes. Seventy studies (four qualitative) were included. Most were directed to carers and of high quality. Seven interventions for carers and two for people with dementia were identified, covering 81% of studies. Those relating to daily living, cognitive training and physical activity for people with dementia were absent. Measures of effectiveness were influenced mainly by the intensity (duration and frequency) of interventions. Those containing education, social support and behaviour management appeared most effective. These interventions reflect emergent patterns of home support. Research is required to identify effective interventions linked to the stage of dementia, which can be applied as part of routine clinical care. © 2017 John Wiley & Sons Ltd.
Guner, Dogukan; Ozturk, Hasan
All underground excavations (tunnels, mines, caverns, etc.) need a form of support to ensure that excavations remain safe and stable for the designed service lifetime. In the last decade, a new support material, thin spray-on liner (TSL) has started to take place of traditional underground surface supports of bolts and shotcrete. TSLs are generally cement, latex, polymer-based and also reactive or non-reactive, multi-component materials applied to the rock surface with a layer of few millimeter thickness. They have the advantages of low volume, logistics, rapid application and low operating cost. The majority of current TSLs are two-part products that are mixed on site before spraying onto excavation rock surfaces. Contrary to the traditional brittle supports, the high plastic behaviour of TSLs make them to distribute the loads on larger lining area. In literature, there is a very limited information exist on the creep behavior of TSLs. In this study, the creep behavior of a polymer-based TSL was investigated. For this purpose, 7-day cured dogbone TSL specimens were tested under room temperature and humidity conditions according to ASTM-D2990 creep testing standard. A range of dead weights (80, 60, 40, and 20 % of the tensile strength) were applied up to 1500 hours. As a result of this study, the time-dependent strain behavior of a TSL was presented for different constant load conditions. Moreover, a new equation was derived to estimate tensile failure time of the TSL for a given loading condition. If the tensile stress acting on the TSL is known, the effective permanent support time of the TSL can be estimated by the proposed relationship.
Studer, Nadja; Gundelfinger, Ronnie; Schenker, Tanja
BACKGROUND: There is a major gap between the US and most European countries regarding the implementation of early intensive behavioural intervention (EIBI) for children with autism. The present paper reports on the current status of EIBI in Switzerland and on the effectiveness of EIBI under...... clinical conditions in a Swiss pilot project. METHODS: The paper combines a narrative report of the care system for children with autism in Switzerland and an initial evaluation of EIBI as implemented in the Department of Child and Adolescent Psychiatry, University of Zurich. RESULTS: The current situation...... of the implementation of EIBI for children with autism in Switzerland is characterized by marked deficits in its acceptance. Major reasons include insufficient governmental approval and lacking legal and financial support. In addition, ignorance among health care providers and educational professionals has contributed...
McSweeney, Lorraine; Araújo-Soares, Vera; Rapley, Tim; Adamson, Ashley
Around a fifth of children starting school in England are now overweight/obese. There is a paucity of interventions with the aim of obesity prevention in preschool-age children in the UK. Previous research has demonstrated some positive results in changing specific health behaviours, however, positive trends in overall obesity rates are lacking. Preschool settings may provide valuable opportunities to access children and their families not only for promoting healthy lifestyles, but also to develop and evaluate behaviour-change interventions. This paper presents a cluster randomised feasibility study of a theory based behaviour-change preschool practitioner-led intervention tested in four preschool centres in the North East of England. The primary outcome measures were to test the acceptability and feasibility of the data collection measures and intervention. Secondary measures were collected and reported for extra information. At baseline and post intervention, children's anthropometric, dietary and physical activity measures as well as family 'active' time data were collected. The preschool practitioner-led intervention included family intervention tasks such as 'family goal-setting activities' and 'cooking challenges'. Preschool activities included increasing physical activity and providing activities with the potential to change behaviour with increased knowledge of and acceptance of healthy eating. The process evaluation was an on-going monthly process and was collected in multiple forms such as questionnaires, photographs and verbal feedback. 'Gatekeeper' permission and lower-hierarchal adherence were initially a problem for recruitment and methods acceptance. However, at intervention end the preschool teachers and parents stated they found most intervention methods and activities acceptable, and some positive changes in family health behaviours were reported. However, the preschool centres appeared to have difficulties with enforcing everyday school healthy
Dirk J. Geldenhuys
Motivation for the study: Team research and practice is not on a par with the complexities that teams actually experience. Traditional group interventions use humanistic and functionalistic paradigms that do not consider the unconscious functioning of groups. Interventions that use the system psychodynamic paradigm could address these dynamics because they study behaviour of individual group members in the context of the group-as-a-whole. Research design, approach and method: The researcher conducted action research in a publishing company. He used purposive sampling and analysed the data using qualitative content analysis. Main findings: The researcher found that the group-as-a-whole partly explains the behaviour of team members and that intervening from this perspective could improve negative relationships. Practical/managerial implications: Managers can use interventions that use the groupas- a-whole concept as a diagnostic intervention to study and possibly change the complex behavioural issues that team members experience. Contribution/value-add: The findings give one an understanding of the behaviour of individual group members when one views it from a systems psychodynamic stance. Furthermore, the researcher proposes a group diagnostic intervention that will allow some of the root causes of poor interpersonal behaviour to surface and group members to diagnose and take ownership of their own behaviour.
D. van Dierendonck (Dirk); C. Haynes (Clare); C. Borrill (Carol); C. Stride (Chris)
textabstractA sample of 48 managers and 308 staff members of a community health care organization took part in a study to investigate the influence of participating in an upward feedback program on leadership behaviour, both as indicated be self-ratings and subordinates’ ratings. The research design
Heléne Zetterström Dahlqvist
Full Text Available Background: Adolescents are a vulnerable group when it comes to the risk of developing depression. Preventing the onset of depressive episodes in this group is therefore a major public health priority. In the last decades, school-based cognitive-behavioural interventions have been a common primary prevention approach. However, evidence on what girls actually are allocated to such interventions when no researchers are involved is scarce. Objective: To explore how a selective cognitive-behavioural program (Depression In Swedish Adolescents developed to prevent depression in adolescents, was implemented in a naturalistic setting in schools in northern part of Sweden. The focus was on characteristics of participants allocated to the intervention. Design: Cross-sectional baseline data on depressive symptoms, school environment and socio-economic factors were collected in 2011 by means of questionnaires in schools in a municipality in the northern part of Sweden. Intervention participants were identified in a follow-up questionnaire in 2012. Students (n=288 included in the analyses were in the ages of 14–15. Results: Sixty-six girls and no boys were identified as intervention participants. They reported higher levels of depressive symptoms, lower personal relative affluence, more sexual harassment victimization and less peer support compared to female non-participants (n=222. Intervention participants were more likely to attend schools with a higher proportion of low parental education levels and a lower proportion of students graduating with a diploma. Conclusions: The developers of the intervention originally intended the program to be universal or selective, but it was implemented as targeted in these schools. It is important for school administrations to adhere to program fidelity when it comes to what students it is aimed for. Implications for effectivenss trials of cognitive-behavioural interventions in the school setting is discussed.
Dirk J. Geldenhuys
Full Text Available Orientation: Traditionalists view group interventions from three perspectives: singletons, dyads and whole groups. The focus of this research was on interventions from the third perspective, that of the whole group, using a systems psychodynamic stance. Research purpose: The purpose of the research was to use group-as-a-whole to study individual behaviour in organisations.Motivation for the study: Team research and practice is not on a par with the complexities that teams actually experience. Traditional group interventions use humanistic and functionalistic paradigms that do not consider the unconscious functioning of groups. Interventions that use the system psychodynamic paradigm could address these dynamics because they study behaviour of individual group members in the context of the group-as-a-whole. Research design, approach and method: The researcher conducted action research in a publishing company. He used purposive sampling and analysed the data using qualitative content analysis.Main findings: The researcher found that the group-as-a-whole partly explains the behaviour of team members and that intervening from this perspective could improve negative relationships.Practical/managerial implications: Managers can use interventions that use the groupas- a-whole concept as a diagnostic intervention to study and possibly change the complex behavioural issues that team members experience.Contribution/value-add: The findings give one an understanding of the behaviour of individual group members when one views it from a systems psychodynamic stance. Furthermore, the researcher proposes a group diagnostic intervention that will allow some of the root causes of poor interpersonal behaviour to surface and group members to diagnose and take ownership of their own behaviour.
Loitz, Christina C; Potter, Robert J; Walker, Jessica L; McLeod, Nicole C; Johnston, Nora J
consistency of the intervention effect across the studies using similar intervention strategies. Follow-up knowledge mobilization activities and products will be developed to support the use of this knowledge in practice. This protocol paper describes a systematic review assessing the effectiveness of various types of workplace interventions on increasing physical activity and decreasing sedentary behaviour at work. Collaborating with an advisory group of potential knowledge users throughout the process postulates a greater use and reach of the information gained from this systematic review by knowledge users. PROSPERO CRD42015019398.
Närhi, Vesa; Kiiski, Tiina; Savolainen, Hannu
Disruptive behaviour in classrooms is a significant challenge for learning in schools and a risk factor for students' academic achievement and a significant source of teachers' work-related stress. Earlier research shows that clear behavioural expectations, monitoring students' adherence to them and behaviour-specific praise are effective…
Bates, Geoff; Begley, Emma; Tod, David; Jones, Lisa; Leavey, Conan; McVeigh, Jim
We examined intervention effectiveness of strategies to prevent image- and performance-enhancing drug use. Comprehensive searches identified 14 interventions that met review inclusion criteria. Interventions were predominantly educational and delivered within school sport settings, but targeted a wide range of mediating factors. Identification of effective components was limited across studies by brief or imprecise descriptions of intervention content, lack of behavioural outcome measures and short-term follow-up times. However, studies with components in addition to information provision may be more promising. Interventions outside of sport settings are required to reflect the transition of this form of substance use to the general population.
Fife-Schaw, Chris; Abraham, Charles
For those planning interventions based on social cognition models, it is usually not clear what impact on behaviour will follow from attempts to change the cognitions specified in these models. We describe a statistical simulation technique to assess the likely impact of health promotion targeting Theory of Reasoned Action (TRA)-based predictors of condom use. We apply regression-based simulation techniques to data from the SHARE project (n = 756 Scottish adolescents) to assess the potential impact of changes in cognitions on condom use. Results support the predictive utility of TRA-based models of psychological antecedents of condom use but also provide a cautionary warning about the magnitude of behaviour change likely to be achieved by interventions based on such models.
Naranbhai, Vivek; Abdool Karim, Quarraisha; Meyer-Weitz, Anna
Homeless youth are at high risk for HIV infection as a consequence of risky sexual behaviour. Interventions for homeless youth are challenging. Assessment of the effectiveness of interventions to modify sexual risk behaviours for preventing HIV in homeless youth is needed. To evaluate and summarize the effectiveness of interventions for modifying sexual risk behaviours and preventing transmission of HIV among homeless youth. We searched electronic databases (CENTRAL, MEDLINE, EMBASE, AIDSearch, Gateway, PsycInfo, LILACS), reference lists of eligible articles, international health agency publication lists, and clinical trial registries. The search was updated January 2010. We contacted authors of published reports and other key role players. Randomised studies of interventions to modify sexual risk behaviour (biological, self-reporting of sexual-risk behaviour or health-seeking behaviour) in homeless youth (12-24 years). Data from eligible studies were extracted by two reviewers. We assessed risk of bias per the Cochrane Collaborations tool. None of the eligible studies reported any primary biological outcomes for this review. Reports of self-reporting sexual risk behaviour outcomes varied across studies precluding calculation of summary measures of effect; we present the outcomes descriptively for each study. We contacted authors for missing or ambiguous data. We identified three eligible studies after screening a total of 255 unique records. All three were performed in the United States of America and recruited substance-abusing male and female adolescents (total N=615) through homeless shelters into randomised controlled trials of independent and non-overlapping behavioural interventions. The three trials differed in theoretical background, delivery method, dosage (number of sessions,) content and outcome assessments. Overall, the variability in delivery and outcomes precluded estimation of summary of effect measures. We assessed the risk of bias to be high for
Lecomte, Tania; Corbière, Marc
Workplace depression is one of the major causes for sick leave and loss of productivity at work. Many studies have investigated factors predicting return to work for people with depression, including studies evaluating return to work programs and organizational factors. Yet, a paucity of studies have targeted the prevention of depressive relapses at work, even though more than half of those having had a depression will have a depressive relapse in the near future.Objectives This article describes a research protocol involving a novel group intervention based on cognitive behavioural principles with the aim to optimize return to work and diminish risk of depressive relapses.Method This pilot study follows a randomized controlled trial design, with half the participants (N=25) receiving the group intervention and the other half (N=25) receiving usual services. The theoretical and empirical underpinnings of the intervention are described, along with a detailed presentation of the intervention and of the study's objectives. The group intervention consists of 8 sessions whereby Cognitive behavioural therapy (CBT) principles and techniques are applied to the following themes: (1) Coping with stress at work; (2) Recognizing and modifying my dysfunctional beliefs linked to work; (3) Overcoming obstacles linked to work functioning and maintaining work; (4) Negotiating needed work adjustments with the support of the immediate supervisor; (5) Finding my strengths and competencies related to work; (6) Accepting criticism and asserting myself appropriately at work; (7) Uncovering my best coping strategies for work.Results Qualitative information pertaining to the first two cohorts' participants' subjective appreciation of the group experience revealed that the intervention was perceived as very useful by all, with group support, namely harmony and interpersonal support, as well as CBT strategies being mentioned specifically.Conclusion Finally, the potential relevance of the
Despite years of research in residential energy conservation, means of inducing conservation behaviour through feedback are not well understood. In this thesis I take a novel approach to feedback design by addressing temporal inconsistencies that may hinder individuals from forming an intention to conserve. To help understand conservation compliance strategies, I proposed a visual framework to categorize interventions. I present two design heuristics that were inspired by temporal construal theory (Liberman & Trope, 2003). They were the impetus for the design of three feedback display prototypes, which were examined. Due to methodological limitations, significant improvements to compliance were not found. However, evidence suggests that comparative feedback may have supported reasoning about conservation rather than supporting conservation compliance directly. Future work includes refinement of feedback displays to avoid direct comparisons, exploring the use of nature imagery, and the study of a possible interaction between environmental values and comparative feedback on compliance.
Full Text Available In any given field, the psychological examination represents a prerequisite for ensuring that the work process is properly and appropriately directed towards increasing its efficiency. An important aspect of the psychological examination is to identify risk and protective factors associated with developing and maintaining emotional and behavioural problems. Special conditions resulting from emergency situations are likely to lead to physical and emotional tensions. In some intervention and rescue personnel these are accompanied by mobilization of internal resource, while in others they can generate inadequacy phenomena and symptoms of mental distress. From this perspective, stress is regarded as a result of the marked disparity between environmental requirements and the individual’s response possibilities. To highlight both cognitive and behavioural coping strategies most often used by rescuers trained in NRDI INSEMEX we used two instruments, namely Strategic Approach to Coping Scale SACS and Cognitive Emotion Regulation Questionnaire CERQ. This paper displays the results of the project no. PN 16 43 01 12, study conducted through Nucleu program, implemented with the support of NASR.
Correia Leite, Carina Sofia; Da Silva Pereira, Ana Paula
This study investigated the support and benefits of early intervention (EI) in families with children with special needs. Data were gathered through a written questionnaire, "Family Benefits Inventory," completed by 126 families with children with special needs supported by EI teams, with ages from six months to six years in Portugal.…
Travis J. Saunders
Full Text Available North Americans spend half their waking hours engaging in sedentary behaviour. Although several recent interventions suggest that short bouts of uninterrupted sedentary behaviour may result in acute increases in cardiometabolic risk, this literature has not been reviewed systematically. This study performed a systematic review of the impact of uninterrupted sedentary behaviour lasting ≤7 days on markers of cardiometabolic risk (insulin sensitivity, glucose tolerance, and fasting insulin, glucose, and lipid levels in humans. Interventions were identified through systematic searches of Medline and Embase and screened by 2 independent reviewers. A total of 25 interventions were identified that examined the impact of imposed sedentary behaviour on biomarkers of interest. The majority of these studies focused on healthy young men, with very little identified research on females or other age groups. We found consistent, moderate quality evidence that uninterrupted sedentary behaviour ≤7 days results in moderate and deleterious changes in insulin sensitivity, glucose tolerance, and plasma triglyceride levels. In contrast, there is inconsistent, very low-quality evidence linking uninterrupted sedentary behaviour with changes in insulin, glucose, and HDL- and LDL-cholesterol levels. These findings suggest that uninterrupted bouts of sedentary behaviour should be avoided in order to prevent or attenuate transient increases in metabolic risk.
Saunders, Travis J.; Larouche, Richard; Colley, Rachel C.; Tremblay, Mark S.
North Americans spend half their waking hours engaging in sedentary behaviour. Although several recent interventions suggest that short bouts of uninterrupted sedentary behaviour may result in acute increases in cardiometabolic risk, this literature has not been reviewed systematically. This study performed a systematic review of the impact of uninterrupted sedentary behaviour lasting ≤7 days on markers of cardiometabolic risk (insulin sensitivity, glucose tolerance, and fasting insulin, glucose, and lipid levels) in humans. Interventions were identified through systematic searches of Medline and Embase and screened by 2 independent reviewers. A total of 25 interventions were identified that examined the impact of imposed sedentary behaviour on biomarkers of interest. The majority of these studies focused on healthy young men, with very little identified research on females or other age groups. We found consistent, moderate quality evidence that uninterrupted sedentary behaviour ≤7 days results in moderate and deleterious changes in insulin sensitivity, glucose tolerance, and plasma triglyceride levels. In contrast, there is inconsistent, very low-quality evidence linking uninterrupted sedentary behaviour with changes in insulin, glucose, and HDL- and LDL-cholesterol levels. These findings suggest that uninterrupted bouts of sedentary behaviour should be avoided in order to prevent or attenuate transient increases in metabolic risk. PMID:22754695
Spoelstra, Sandra L; Schueller, Monica; Hilton, Melissa; Ridenour, Kimberly
This article presents an integrative review of the evidence for combined motivational interviewing and cognitive behavioural interventions that promote medication adherence. We undertook this review to establish a scientific foundation for development of interventions to promote medication adherence and to guide clinical practice. The World Health Organization has designated medication adherence as a global problem. Motivational interviewing and cognitive behaviour interventions have been found to individually promote medication adherence. However, there is a gap in the literature on the effect of combined motivational interviewing and cognitive behavioural approaches to promote medication adherence. Integrative review. COCHRANE, PubMed and CINAHL were searched to access relevant studies between 2004-2014. Inclusion criteria were interventions combining motivational interviewing and cognitive behavioural therapy with medication adherence as the outcome. Articles were assessed for measures of adherence and methodological rigour. Analysis was performed using an integrative review process. Six articles met the inclusion criteria. A randomised controlled trial reported pretreatment missed doses of 5·58 and post-treatment of 0·92 and trended towards significance. Four cohort studies had effect sizes of 0·19-0·35 (p motivational interviewing and cognitive behavioural interventions, five out of six were effective at improving medication adherence. Future studies with large rigorous randomised trials are needed. This review provides clinicians with the state of the science in relation to combined motivational interviewing and cognitive behavioural therapy interventions that promote medication adherence. A summary of intervention components and talking points are provided to aid nurses in informing decision-making and translating evidence into practice. © 2014 John Wiley & Sons Ltd.
Gibbs, Andrew; Jacobson, Jessica; Kerr Wilson, Alice
Intimate partner violence (IPV) and HIV are co-occurring global epidemics, with similar root causes of gender and economic inequalities. Economic interventions have become a central approach to preventing IPV and HIV. We undertook a comprehensive scoping review of published evaluations of economic interventions that sought to prevent IPV and/or HIV risk behaviours. Forty-five separate analyses of interventions met our criteria. Broadly, unconditional cash transfer interventions showed either flat or positive outcomes; economic strengthening interventions had mixed outcomes, with some negative, flat and positive results reported; interventions combining economic strengthening and gender transformative interventions tended to have positive outcomes. The review highlighted a number of gaps. Specifically, there were limited studies evaluating the impact of economic interventions on female sex workers, young women, and men. In addition, there were missed opportunities, with many evaluations only reporting either IPV- or HIV-related outcomes, rather than both, despite overlaps.
Fitzgerald, Martin; McClelland, Tracy
Introduction: Health promotion apps designed to support and reinforce health behaviours or to reduce risk behaviours are the most commonly downloaded apps. Such technologies have the potential to reach and deliver health care to new populations. But the extent to which they are successful in enabling the adoption of new and desired behaviours can…
Barbadoro, Pamela; Ponzio, Elisa; Pertosa, Maria Elisabetta; Aliotta, Federica; D'Errico, Marcello M; Prospero, Emilia; Minelli, Andrea
To evaluate the nutritional status and the impact of an educational intervention on nutritional behaviour in alcohol-dependent patients. A pre-and post-intervention questionnaire and a follow-up interview were administered to 58 patients of a residential alcohol treatment service. Females were at lower risk of being overweight than males, even after adjusting for amount and preferred type of alcohol beverage. Before intervention, 19% consumed 3 meals/day. Following the educational intervention, 22.2% of participants improved their knowledge. After 6 months, when 45 patients agreed to a telephone interview of whom 80% reported continued abstinence, 70.7% reported eating more than 3 meals/day. Nutritional behaviour of alcohol patients after residential treatments improved during follow-up, and it is possible that an educational intervention to increase knowledge on healthy nutrition style may have contributed.
Bello-Mojeed, Mashudat; Ani, Cornelius; Lagunju, Ike; Omigbodun, Olayinka
Autism Spectrum Disorders (ASD) is a disabling and lifelong neuro-developmental disorder. Challenging behaviours such as aggression and self injury are common maladaptive behaviours in ASD which adversely affect the mental health of both the affected children and their caregivers. Although there is evidence-base for parent-delivered behavioural intervention for children with ASD and challenging behaviours, there is no published research on the feasibility of such an intervention in sub-Saharan Africa. This study assessed the feasibility of parent-mediated behavioural intervention for challenging behaviour in children with ASD in Nigeria. This was a pre-post intervention pilot study involving 20 mothers of children with DSM-5 diagnosis of ASD recruited from a Child and Adolescent Mental Health Service out-patient Unit. All the mothers completed five sessions of weekly manualised group-based intervention from March to April, 2015. The intervention included Functional Behavioural Analysis for each child followed by an individualised behaviour management plan. The primary outcome measure was the Aggression and Self Injury Questionnaire, which assessed both Aggression towards a Person and Property (APP) and Self Injurious Behaviour (SIB). The mothers' knowledge of the intervention content was the secondary outcome. All outcome measures were completed at baseline and after the intervention. The mothers' level of satisfaction with the programme was also assessed. Treatment effect was evaluated with Wilcoxon Signed Rank Tests of baseline and post-intervention scores on outcome measures. The children were aged 3-17 years (mean = 10.7 years, SD 4.6 years), while their mothers' ages ranged from 32 to 52 years (mean 42.8 years, SD 6.4 years). The post intervention scores in all four domains of the APP and SIB were significantly reduced compared with pre-intervention scores. The mothers' knowledge of the intervention content significantly increased post-intervention
Quartel, Dick; Ferreira Pires, Luis; van Sinderen, Marten J.
During the top-down design of distributed systems, abstract designs have to be replaced by more concrete designs, which add details that define how these systems can be implemented using available building blocks. Behaviour refinement is a design operation in which abstract behaviours are replaced
Sainsbury, Kirby; Mullan, Barbara; Sharpe, Louise
To determine whether changes in theory of planned behaviour (TPB) constructs could predict intention and gluten-free diet (GFD) adherence following participation in an online theory-based intervention designed to improve adherence in coeliac disease. Theory-based process evaluation of the mechanisms of change over the course of a six-week online intervention. Measures of GFD adherence and TPB variables were administered at baseline and follow-up (immediate post-intervention: n = 74; three-month: n = 68; six-month: n = 65). Hierarchical regression analyses using residualised change scores were conducted at each time point (dependent variables: intention and adherence). Baseline intention and GFD adherence were the strongest predictors of follow-up intention and adherence, respectively. Change in attitude accounted for significant variance in intention. Change in intention accounted for significant variance in GFD adherence immediately post-intervention; by the six-month follow-up change in perceived behavioural control was the stronger predictor. Partial support for the hypotheses suggests that, for certain behaviours, the TPB may be relevant in explaining the mechanism of action responsible for changes in intention and behaviour following participation in a behaviour change intervention. Additional predictive pathways are also likely to exist and, in the area of GFD adherence, may include habit strength and actual behavioural control.
Studer, Nadja; Gundelfinger, Ronnie; Schenker, Tanja; Steinhausen, Hans-Christoph
There is a major gap between the US and most European countries regarding the implementation of early intensive behavioural intervention (EIBI) for children with autism. The present paper reports on the current status of EIBI in Switzerland and on the effectiveness of EIBI under clinical conditions in a Swiss pilot project. The paper combines a narrative report of the care system for children with autism in Switzerland and an initial evaluation of EIBI as implemented in the Department of Child and Adolescent Psychiatry, University of Zurich. The current situation of the implementation of EIBI for children with autism in Switzerland is characterized by marked deficits in its acceptance. Major reasons include insufficient governmental approval and lacking legal and financial support. In addition, ignorance among health care providers and educational professionals has contributed to this situation precluding that children with autism receive the most beneficial assistance. The authors have initiated and been working in an intervention centre offering EIBI for a decade and report on their experience with the implementation of EIBI. Based on their clinical practice, they document that EIBI also works efficiently under ordinary mental health service conditions. EIBI needs to be implemented more intensively in Switzerland. Although the effects of EIBI as implemented in Zurich are promising, the results are not as pronounced as under controlled research conditions.
Pugh, Roger; Chitiyo, Morgan
Bullying in schools is recognised as a global problem. In the USA, school shootings and increasing school aggression focused research on the causes of bullying and interventions that could reduce or eliminate bullying behaviours. A variety of bullying programs have generated mixed results with some actually increasing bullying behaviours. There…
Freijy, Tanya; Kothe, Emily J
Increasing evidence suggests that various health behaviours are amenable to change following the induction of cognitive dissonance. This systematic review sought to evaluate the effectiveness and methodological quality of dissonance-based health behaviour interventions and to explore identified sources of heterogeneity in intervention effects. Bibliographic databases were searched for relevant articles from inception to March 2012. Only studies targeting non-clinical health behaviour in non-clinical populations were included in the review. One author extracted data and assessed quality of evidence and a second author verified all content. Reports of 20 studies were included. A variety of health behaviours and outcome measures were addressed across studies. Most studies produced one or more significant effects on measures of behaviour, attitude or intention. Across studies, methodological risk for bias was frequently high, particularly for selection bias. Gender and self-esteem were identified as potential moderator variables. The evidence for the effectiveness of dissonance-based interventions was generally positive. The hypocrisy paradigm was found to be the most commonly applied research paradigm and was most effective at inciting change across a range of health behaviours. There was no observable link between type of target behaviour and positive outcomes. Researchers are encouraged to minimize potential for bias in future studies and explore moderators of the dissonance effect. What is already known on this subject? A recent meta-analysis indicates that dissonance-based interventions primarily based on the induced compliance paradigm are effective for eating disorder prevention (Stice, Shaw, Becker, & Rohde, 2008, Prev. Sci., 9, 114). However, it is currently unclear whether such outcomes are generalizable to interventions targeting non-clinical health behaviours such as smoking, sun protection and sexual risk taking. Other research indicates that studies based
Darker, C D; French, D P; Eves, F F; Sniehotta, F F
Theory of planned behaviour (TPB) studies have identified perceived behavioural control (PBC) as the key determinant of walking intentions. The present study investigated whether an intervention designed to alter PBC and create walking plans increased TPB measures concerning walking more, planning and objectively measured walking. One hundred and thirty UK adults participated in a waiting-list randomised controlled trial. The intervention consisted of strategies to boost PBC, plus volitional strategies to enact walking intentions. All TPB constructs were measured, along with self-reported measures of action planning and walking, and an objective pedometer measure of time spent walking. The intervention increased PBC, attitudes, intentions and objectively measured walking from 20 to 32 min a day. The effects of the intervention on intentions and behaviour were mediated by PBC, although the effects on PBC were not mediated by control beliefs. At 6 weeks follow-up, participants maintained their increases in walking. The findings of this study partially support the proposed causal nature of the extended TPB as a framework for developing and evaluating health behaviour change interventions. This is the first study using the TPB to develop, design and evaluate the components of an intervention which increased objectively measured behaviour, with effects mediated by TPB variables.
Draper, C E; Grobler, L; Micklesfield, L K; Norris, S A
The prevalence of non-communicable diseases (NCDs) in adulthood is rapidly increasing, and it is essential that risk factors for NCDs be addressed in adolescence, both for the health of individuals during adolescence and for their health in later life. These risk factors include diet, physical activity and sedentary behaviour. No literature has been published that comprehensively summarizes the impact of social norms and social support on these behaviours among adolescents. Therefore, a scoping review was conducted to determine the extent of recent (since 2000) literature available on this topic. A comprehensive search strategy was used to search PubMed and EMBASE for eligible reviews. Review papers (narrative reviews, systematic and non-systematic reviews) published in English in peer-reviewed journals from 2000 to February 2013 were included in the overview. Two of the authors screened the titles and abstracts of the search results independently. Thirty reviews were included in the scoping review. This scoping review has shown sufficient evidence for parental influences, and especially the positive impact of an authoritative parenting style, on healthy behaviours of adolescents, although the evidence is somewhat more compelling for diet than for physical activity and sedentary behaviour. More research is needed to investigate parental and family influences on physical activity and sedentary behaviour. And the effect of peer influences on diet, physical activity and sedentary behaviour of adolescents requires further investigation. The evidence presented affirms the consideration of social norms and social support in the development of interventions to address these behaviours in adolescents. The evidence regarding parenting style provides some concrete guidance for such interventions. © 2015 John Wiley & Sons Ltd.
Baker-Henningham, H; Walker, S
Based on extensive piloting work, we adapted the Incredible Years (IY) teacher-training programme to the Jamaican preschool setting and evaluated this adapted version through a cluster-randomised trial. Twenty-four community preschools in Kingston, Jamaica were randomly assigned to intervention (12 schools, 37 teachers) or control (12 schools, 36 teachers). The intervention involved training teachers in classroom management through eight full-day training workshops and four individual 1-h in-class support sessions. Outcome measurements included direct observation of teachers' positive and negative behaviours to the whole class and to high-risk children and four observer ratings: two measures of class-wide child behaviour and two measures of classroom atmosphere. Measures were repeated at a six-month follow-up. Significant benefits of intervention were found for teachers' positive [effect size (ES) = 3.35] and negative (ES = 1.29) behaviours to the whole class and to high-risk children (positive: ES = 0.83; negative: ES = 0.50) and for observer ratings of class-wide child behaviour (ES = 0.73), child interest and enthusiasm (ES = 0.98), teacher warmth (ES = 2.03) and opportunities provided to share and help (ES = 5.72). At 6-month follow-up, significant benefits of intervention were sustained: positive behaviours (ES = 2.70), negative behaviours (ES = 0.98), child behaviour (ES = 0.50), child interest and enthusiasm (ES = 0.78), teacher warmth (ES = 0.91), opportunities to share and help (ES = 1.42). The adapted IY teacher-training programme produced large benefits to teacher's behaviour and to class-wide measures of children's behaviour, which were sustained at 6-month follow-up. Benefits were of a similar magnitude to those found in a pilot study of the minimally adapted version that required significantly more in-class support for teachers.
Ray, John M; Kemp, Lakiesha L; Hubbard, Amanda; Cucciare, Michael A
Computer-delivered cognitive behavioural therapy (cCBT) is an effective alternative to provider-delivered treatment for depression and anxiety, but high attrition poses a significant challenge to its use. Peer support is a feasible approach to improving cCBT engagement, but less is known about its acceptability among Veterans. To obtain feedback from Veterans (n = 24) with depression and/or anxiety on their preferences for (a) activities of Veterans Administration Peer Support Specialists (VA PSS) in helping Veterans use Moving Forward, a cCBT-based protocol developed by VA, and (b) methods for delivering support to Veterans using this programme. Four focus groups (5-7 Veterans per group) provided feedback to be used in the development of a peer-supported engagement intervention to help Veterans with depression and anxiety use Moving Forward. Content areas included roles that a VA PSS might play in supporting the use of and engagement in Moving Forward, as well as methods of delivering that support. Veteran preferences for PSS activity focused on practical aspects of using Moving Forward, including orientation to the programme, technical support, and monitoring progress. Feedback also suggested that Veterans preferred more personal roles for the PSS, including emotional support, as well as application of Moving Forward to 'real life' problems. The findings extend the literature on online, patient-facing mental health protocols by identifying emotional support and 'real life' skills application as Veteran-preferred components of a peer-support protocol designed to enhance use of and engagement in cCBT for depression and anxiety.
Chen, Sheng-Hwang; Yu, Hsing-Yi; Hsu, Hsiu-Yueh; Lin, Fang-Chen; Lou, Jiunn-Horng
The purpose of this study was to explore the relationship between organisational support, organisational identification, and organisational citizenship behaviour and the predictors of organisational citizenship behaviour in Taiwanese male nurses. The turnover rate among male nurses is twice that of female nurses. Organisational citizenship behaviour is the predictor of turnover intention. Little information is available on the relationship between organisational support, organisational identification and organisational citizenship behaviour, particularly for male nurses. Data were collected in 2010 from a questionnaire mailed to 167 male nurses in Taiwan. A cross-sectional survey with simple sampling was used in this study. The results showed that organisational identification and organisational support were correlated with organisational citizenship behaviour. Organisational distinctiveness, organisational support of work conditions and the type of organisation were the main predictors of organisational citizenship behaviour. Together they accounted for 40.7% of the total variation in organisational citizenship behaviour. Organisational distinctiveness was the most critical predictor, accounting for 29.6% of the variation. Organisational support and organisational identification have positive relationships with organisational behaviour. Organisational distinctiveness is an important factor in explaining organisational citizenship behaviour in male nurses. This finding provides concrete directions for managers to follow when providing organisational identification, in particular, the organisational distinctiveness will help male nurses to display increasingly more organisational citizenship behaviour. © 2012 John Wiley & Sons Ltd.
Fisk, Malcolm John
There is significant evidence of the poor health of seafarers that arises both from the rigours of their trade and, for many, the associated lifestyles. Such poor health can continue in later life. The objective of the research is to report on a specific project that provided brief interventions to assist older (ex-) seafarers and to establish the effect of those interventions on their knowledge, behaviours, health and wellbeing. Older seafarers were recruited to the project. Brief interventions were provided by which the knowledge of a number of older seafarers with health needs was raised about the options available to them; and the implications for their lifestyles and behaviours were addressed. Initial and final interviews were undertaken to determine any changes in self-reported health and wellbeing using both EQ5D and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) measures. Post project interviews took place with a sample of the older seafarers. A good level of understanding was found among the older seafarers regarding their own health. This meant that a precondition was in place, for many, by which changes in behaviours and lifestyles could take place. An important outcome was the indicated benefits of the brief interventions for self-reported wellbeing, though not statistically significant at the 95% level of confidence. Endeavours within the project to reach some of those who could benefit from the brief interventions were successful. Just over half changed their behaviours or were thinking of so doing. Wellbeing gains arising were indicated.
Full Text Available Autism Spectrum Disorder (ASD is amongst the most familial of psychiatric disorders. Twin and family studies have demonstrated a monozygotic concordance rate of 70–90%, dizygotic concordance of around 10% and more than a 20-fold increase in risk for first-degree relatives. Despite major advances in the genetics of autism, the relationship between different aspects of the behavioural and cognitive phenotype and their underlying genetic liability is still unclear. This is complicated by the heterogeneity of autism, which exists at both genetic and phenotypic levels. Given this heterogeneity, one method to find homogeneous entities and link these with specific genotypes would be to pursue endophenotypes. Evidence from neuroimaging, eye tracking and electrophysiology studies supports the hypothesis that, building on genetic vulnerability, ASD emerges from a developmental cascade in which a deficit in attention to social stimuli leads to impaired interactions with primary caregivers. This results in abnormal development of the neurocircuitry responsible for social cognition, which in turn adversely affects later behavioural and functional domains dependent on these early processes, such as language development. Such a model begets a heterogeneous clinical phenotype, and is also supported by studies demonstrating better clinical outcomes with earlier treatment. Treatment response following intensive early behavioural intervention in ASD is also distinctly variable; however, relatively little is known about specific elements of the clinical phenotype that may predict response to current behavioural treatments. This paper overviews the literature regarding genotypes, phenotypes and predictors of response to behavioural intervention in ASD and presents suggestions for future research to explore linkages between these that would enable better identification of, and increased treatment efficacy for, ASD.
Griffith, Gemma Maria; Jones, Robert; Hastings, Richard Patrick; Crane, Rebecca S; Roberts, Judith; Williams, Jonathan; Bryning, Lucy; Hoare, Zoe; Edwards, Rhiannon Tudor
Approximately 10-20 % of adults with intellectual disabilities engage in challenging behaviours such as aggression, destructiveness, and self-injury, which are often accompanied by feelings of anger. The inability to manage anger can reduce quality of life. For example, aggression is a strong predictor of out-of-area placements and is a risk variable for abuse. Recent research suggests that mindfulness-based therapies (specifically, Singh's Soles of the Feet meditation) can help people with intellectual disabilities manage angry emotions, with resultant reductions in challenging behaviour. However, previous research has been single-case design studies, and no group studies have been published with people with intellectual disabilities and aggressive behaviour. For this feasibility study, a UK protocol will be developed for use by health professionals within National Health Service (NHS) Intellectual Disability (ID) teams, based upon Singh's Soles of the Feet manual. Twenty adults with intellectual disabilities and identified problems with anger control will be recruited and six sessions will be delivered by a trained ID clinician. The study will monitor participant's aggressive behaviour, health-related quality of life, anxiety, depression, and use of support services (medication, hospital appointments etc.). These will be measured at three time points: (1) Baseline (within 2 weeks prior to the first session of the intervention), (2) 2 months post-baseline, and (3) 6 months post-baseline. Qualitative interviews will be conducted with participants, their carers, and the therapists who delivered the intervention. In order to help design an economic evaluation alongside a future full trial, we will cost the intervention and test the acceptability and validity of health economics measures to record resource use and health-related quality of life outcomes. The data from this study will inform the feasibility of the project protocol and intervention, which will help
Full Text Available It is estimated that workers worldwide suffer 250 million accidents each year, with 330 000 fatalities. This is despite the implementation of traditional safety interventions like safety engineering. Little emphasis has thus far been placed on behavioural interventions to improve safety culture and performance in the workplace. The aim of this study was to determine to what extent the safety culture and safety performance in an iron ore mine were affected by the implementation of a behaviour-based safety intervention. A longitudinal design was used. The sample consisted of 562 employees of an iron ore mine. The results showed that the implementation of the safety intervention brought about an improvement in the safety culture at the mine, and positively impacted on the number of lost-time injuries.
Wood, Caroline E; Hardeman, Wendy; Johnston, Marie; Francis, Jill; Abraham, Charles; Michie, Susan
Behaviour change interventions are likely to be reproducible only if reported clearly. We assessed whether the behaviour change technique taxonomy version 1 (BCTTv1), with and without training in identifying BCTs, improves the clarity and replicability of written reports of observed behaviour change interventions. Three studies assessed effects of using and training in the use of BCTTv1 on the clarity and replicability of intervention descriptions written after observing videos of smoking cessation interventions. Study 1 examined the effects of using and not using BCTTv1. Study 2 examined the effects of using BCTTv1 and training in use of BCTTv1 compared no use and no training. Study 3 employed a within-group design to assess change in descriptions written before and after training. One-hundred and 66 'writers' watched videos of behaviour change interventions and wrote descriptions of the active components delivered. In all studies, the participants' written descriptions were evaluated by (i) 12 'raters' (untrained in BCTTv1) for clarity and replicability and (ii) 12 'coders' (trained in BCTTv1) for reliability of BCT coding. Writers rated the usability and accessibility of using BCTTv1 to write descriptions. Ratings of clarity and replicability did not differ between groups in study 1 (all ps > 0.05), were poorer for trained users in study 2 (all ps < 0.01) and improved following training in study 3 (all ps < 0.05). BCT identification was more reliable from descriptions written by trained BCTTv1 users (p < 0.05; study 2) but not simple use of BCTTv1 (p = 0.93; study 1) or by writers who had written a description without BCTTv1, before training (p = 0.50; study 3). Writers reported that using BCTTv1 was difficult but 'useful', 'good' and 'desirable' and that their descriptions would be clear and replicable (all means above mid-point of the scale). Effects of training to use BCTTv1 on the quality of written reports of observed interventions
Omaki, Elise; Rizzutti, Nicholas; Shields, Wendy; Zhu, Jeffrey; McDonald, Eileen; Stevens, Martha W; Gielen, Andrea
The aims of this literature review are to (1) summarise how computer and mobile technology-based health behaviour change applications have been evaluated in unintentional injury prevention, (2) describe how these successes can be applied to injury-prevention programmes in the future and (3) identify research gaps. Studies included in this systematic review were education and behaviour change intervention trials and programme evaluations in which the intervention was delivered by either a computer or mobile technology and addressed an unintentional injury prevention topic. Articles were limited to those published in English and after 1990. Among the 44 technology-based injury-prevention studies included in this review, 16 studies evaluated locally hosted software programmes, 4 studies offered kiosk-based programmes, 11 evaluated remotely hosted internet programmes, 2 studies used mobile technology or portable devices and 11 studies evaluated virtual-reality interventions. Locally hosted software programmes and remotely hosted internet programmes consistently increased knowledge and behaviours. Kiosk programmes showed evidence of modest knowledge and behaviour gains. Both programmes using mobile technology improved behaviours. Virtual-reality programmes consistently improved behaviours, but there were little gains in knowledge. No studies evaluated text-messaging programmes dedicated to injury prevention. There is much potential for computer-based programmes to be used for injury-prevention behaviour change. The reviewed studies provide evidence that computer-based communication is effective in conveying information and influencing how participants think about an injury topic and adopt safety behaviours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Stephenson, Aoife; McDonough, Suzanne M; Murphy, Marie H; Nugent, Chris D; Mair, Jacqueline L
High levels of sedentary behaviour (SB) are associated with negative health consequences. Technology enhanced solutions such as mobile applications, activity monitors, prompting software, texts, emails and websites are being harnessed to reduce SB. The aim of this paper is to evaluate the effectiveness of such technology enhanced interventions aimed at reducing SB in healthy adults and to examine the behaviour change techniques (BCTs) used. Five electronic databases were searched to identify randomised-controlled trials (RCTs), published up to June 2016. Interventions using computer, mobile or wearable technologies to facilitate a reduction in SB, using a measure of sedentary time as an outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Collaboration's tool and interventions were coded using the BCT Taxonomy (v1). Meta-analysis of 15/17 RCTs suggested that computer, mobile and wearable technology tools resulted in a mean reduction of -41.28 min per day (min/day) of sitting time (95% CI -60.99, -21.58, I2 = 77%, n = 1402), in favour of the intervention group at end point follow-up. The pooled effects showed mean reductions at short (≤ 3 months), medium (>3 to 6 months), and long-term follow-up (>6 months) of -42.42 min/day, -37.23 min/day and -1.65 min/day, respectively. Overall, 16/17 studies were deemed as having a high or unclear risk of bias, and 1/17 was judged to be at a low risk of bias. A total of 46 BCTs (14 unique) were coded for the computer, mobile and wearable components of the interventions. The most frequently coded were "prompts and cues", "self-monitoring of behaviour", "social support (unspecified)" and "goal setting (behaviour)". Interventions using computer, mobile and wearable technologies can be effective in reducing SB. Effectiveness appeared most prominent in the short-term and lessened over time. A range of BCTs have been implemented in these interventions. Future studies need to improve reporting
Full Text Available Introduction: Autism spectrum disorders (ASD comprise typical or infantile autism (Kanner syndrome, Asperger’s disorder and atypical autism or pervasive developmental disorder - not otherwise specified. The syndrome is characterized by deficits in (1 verbal and nonverbal communication, (2 reciprocal social interaction and (3 repetitive patterns of behaviour, interests and activities. Early behavioural interventions are based on learning theory and behaviour therapy. They take into account specific deficits in perception, emotional reactions, social interaction and communication. In Germany, these comprehensive models are not widely evaluated and implemented. Research questions: * What are the clinical effectiveness and safety of early behavioural or skills-based early interventions in autism compared to other interventions or to treatment as usual? * What are specific factors responsible for the effectiveness? * What are the cost-effectiveness and cost consequences of different early interventions in autism? * Which legal, social and ethical aspects are relevant with regard to the implementation of the respective interventions in persons with autism? Methods: Following a systematic review of the literature, controlled studies on early behavioural or skills-based interventions published since 2000 in English or German with children until the age of twelve are included and critically appraised. Studies must have at least ten participants per intervention group. Results: In total, 15 publications based on 14 studies, eight systematic reviews and one health economic study are included. Most studies evaluate early interventions based upon the Lovaas model (Early intensive behavioural treatment (EIBT, Applied behavioural analysis (ABA. Other evaluate pragmatic interventions or interventions based on other theoretical models like specific parent interventions, responsive education and prelinguistic milieu teaching, joint attention, symbolic play, and
Munir, Fehmidah; Biddle, Stuart J H; Davies, Melanie J; Dunstan, David; Esliger, David; Gray, Laura J; Jackson, Ben R; O'Connell, Sophie E; Yates, Tom; Edwardson, Charlotte L
Sitting (sedentary behaviour) is widespread among desk-based office workers and a high level of sedentary behaviour is a risk factor for poor health. Reducing workplace sitting time is therefore an important prevention strategy. Interventions are more likely to be effective if they are theory and evidence-based. The Behaviour Change Wheel (BCW) provides a framework for intervention development. This article describes the development of the Stand More AT Work (SMArT Work) intervention, which aims to reduce sitting time among National Health Service (NHS) office-based workers in Leicester, UK. We followed the BCW guide and used the Capability, Opportunity and Motivation Behaviour (COM-B) model to conduct focus group discussions with 39 NHS office workers. With these data we used the taxonomy of Behaviour Change Techniques (BCTv1) to identify the most appropriate strategies for facilitating behaviour change in our intervention. To identify the best method for participants to self-monitor their sitting time, a sub-group of participants (n = 31) tested a number of electronic self-monitoring devices. From our BCW steps and the BCT-Taxonomy we identified 10 behaviour change strategies addressing environmental (e.g. provision of height adjustable desks,), organisational (e.g. senior management support, seminar), and individual level (e.g. face-to-face coaching session) barriers. The Darma cushion scored the highest for practicality and acceptability for self-monitoring sitting. The BCW guide, COM-B model and BCT-Taxonomy can be applied successfully in the context of designing a workplace intervention for reducing sitting time through standing and moving more. The intervention was developed in collaboration with office workers (a participatory approach) to ensure relevance for them and their work situation. The effectiveness of this intervention is currently being evaluated in a randomised controlled trial. ISRCTN10967042 . Registered on 2 February 2015.
Hurley, Deirdre A; Murphy, Laura Currie; Hayes, David; Hall, Amanda M; Toomey, Elaine; McDonough, Suzanne M; Lonsdale, Chris; Walsh, Nicola E; Guerin, Suzanne; Matthews, James
The Medical Research Council framework provides a useful general approach to designing and evaluating complex interventions, but does not provide detailed guidance on how to do this and there is little evidence of how this framework is applied in practice. This study describes the use of intervention mapping (IM) in the design of a theory-driven, group-based complex intervention to support self-management (SM) of patients with osteoarthritis (OA) and chronic low back pain (CLBP) in Ireland's primary care health system. The six steps of the IM protocol were systematically applied to develop the self-management of osteoarthritis and low back pain through activity and skills (SOLAS) intervention through adaptation of the Facilitating Activity and Self-management in Arthritis (FASA) intervention. A needs assessment including literature reviews, interviews with patients and physiotherapists and resource evaluation was completed to identify the programme goals, determinants of SM behaviour, consolidated definition of SM and required adaptations to FASA to meet health service and patient needs and the evidence. The resultant SOLAS intervention behavioural outcomes, performance and change objectives were specified and practical application methods selected, followed by organised programme, adoption, implementation and evaluation plans underpinned by behaviour change theory. The SOLAS intervention consists of six weekly sessions of 90-min education and exercise designed to increase participants' physical activity level and use of evidence-based SM strategies (i.e. pain self-management, pain coping, healthy eating for weight management and specific exercise) through targeting of individual determinants of SM behaviour (knowledge, skills, self-efficacy, fear, catastrophizing, motivation, behavioural regulation), delivered by a trained physiotherapist to groups of up to eight individuals using a needs supportive interpersonal style based on self-determination theory
Washington, Karla N.; Warr-Leeper, Genese A
This study was conducted as a follow-up analysis to two prior studies using existing data gathered in those original studies. In the current study, we focus on those preschoolers who received one of two interventions that varied in terms of the level of visual supports for grammatical elements (n = 22 of the original 34 participants). Utilizing…
Boulden, Walter T.
The Behavior Intervention Support Team (BIST) is a proactive school-wide behavior management plan for all students, emphasizing schools partnering with students and parents through caring relationships and high expectations. The BIST program is well-grounded in behavioral theory and combines strength-based and resiliency principles within the…
Nese, Rhonda N. T.; McIntosh, Kent; Nese, Joseph F. T.; Ghemraoui, Adam; Bloom, Jerry; Johnson, Nanci W.; Phillips, Danielle; Richter, Mary F.; Hoselton, Robert
This study examines predictors of abandonment of evidence-based practices through descriptive analyses of extant state-level training data, fidelity of implementation data, and nationally reported school demographic data across 915 schools in 3 states implementing school-wide positive behavioral interventions and supports (SWPBIS). Schools…
Wampold, Bruce E.; Lichtenberg, James W.; Waehler, Charles A.
The authors present background on the development of principles for the identification of empirically supported interventions in counseling psychology by the American Psychological Association's Division 17 and include an overview of guiding considerations around which these principles were developed. As a context for these principles, the authors…
Verweij, L.M.; Coffeng, J.; Mechelen, W. van; Proper, K.I.
This meta-analytic review critically examines the effectiveness of workplace interventions targeting physical activity, dietary behaviour or both on weight outcomes. Data could be extracted from 22 studies published between 1980 and November 2009 for meta-analyses. The GRADE approach was used to
Nooijen, Carla F. J.; Stam, Henk J.; Schoenmakers, Imte; Sluis, Tebbe; Post, Marcel; Twisk, Jos; van den Berg-Emons, Rita J. G.
OBJECTIVE: In order to unravel the working mechanisms that underlie the effectiveness of a behavioural intervention promoting physical activity in persons with subacute spinal cord injury, the aim of this study was to assess the mediating effects of physical and psychosocial factors on the
Utens, E. M.; Versluis-den Bieman, H. J.; Witsenburg, M.; Bogers, A. J.; Verhulst, F. C.; Hess, J.
To assess the cognitive, and behavioural and emotional functioning of children aged 3 months to 7 years shortly before elective cardiac surgery or elective interventional catheterisation. We used the Bayley Scales of Infant Development, and the McCarthy Scales of Children's Abilities, to measure
Ingrid V. Sellschop
Clinical implications: The clinical contribution of this study to our healthcare system is that through the early identification and intervention of the poor ergonomics in a school environment, a positive impact on reducing poor postural behaviour amongst learners can be achieved.
Beukers, Laura; Berends, Tamara; de Man-van Ginkel, Janneke M.; van Elburg, Annemarie A.; van Meijel, Berno
An important part of inpatient treatment for adolescents with anorexia nervosa is to restore normal eating behaviour. Health-care professionals play a significant role in this process, but little is known about their interventions during patients' meals. The purpose of the present study was to
Beukers, L.; Berends, T.; van Ginkel, J.; van Elburg, A.A.; van Meijel, B.
An important part of inpatient treatment for adolescents with anorexia nervosa is to restore normal eating behaviour. Health-care professionals play a significant role in this process, but little is known about their interventions during patients' meals. The purpose of the present study was to
Mackenzie, Catherine; Lowit, Anja
Background: Dysarthria is a common post-stroke presentation. Its management falls within the remit of the speech and language therapy profession. Little controlled evaluation of the effects of intervention for dysarthria in stroke has been reported. Aims: The study aimed to determine the effects of a period of behavioural communication…
Verdellen, Cara; van de Griendt, Jolande; Hartmann, Andreas; Murphy, Tara
This clinical guideline provides recommendations for the behavioural and psychosocial interventions (BPI) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted to
Murray, Jennifer M; Brennan, Sarah F; French, David P; Patterson, Christopher C; Kee, Frank; Hunter, Ruth F
Physical activity (PA) interventions are generally effective in supporting short-term behaviour change, but increases are not always maintained. This review examined the effectiveness of PA interventions for behaviour change maintenance in young and middle-aged adults, and investigated which Behaviour Change Techniques (BCTs) and other intervention features were associated with maintenance. Six databases (Medline, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, CINAHL, Web of Science) were systematically searched. Eligibility criteria were controlled trials investigating the effectiveness of PA interventions with adult (mean age 18-64 years) non-clinical populations using validated measures of PA behaviour at baseline and ≥six months' post-baseline. Results were pooled in meta-analyses using standardised mean differences (SMD) at five time intervals (6-9, 9-15, 15-21, 21-24, >24 months). Moderator analyses investigated the influence of sample and intervention characteristics on PA maintenance at 6-9 months. Sixty-two studies were included. PA interventions had a significant effect on behaviour maintenance 6-15 months post-baseline relative to controls. Interventions had a larger effect on maintenance at 6-9 months (SMD = 0.28; 95% CI: 0.20, 0.35; I 2 = 73%) compared to 9-15 months (SMD = 0.20; 95% CI: 0.13, 0.26; I 2 = 70%). Beyond 15 months, PA measurements were infrequent with little evidence supporting maintenance. Moderator analyses showed some BCTs and intervention settings moderated PA outcomes at 6-9 months. A multivariable meta-regression model showed interventions using the BCTs 'Prompt self-monitoring of behavioural outcome' (b = 1.46, p behaviour to 15 months. Greater consideration must be given to how future interventions encourage and measure maintenance of changes, and investigate broader psychological, social and environmental influences of PA behaviour. PROSPERO 2015:CRD42015025462. Copyright © 2017 Elsevier Ltd. All
Carla FJ Nooijen
Full Text Available Questions: For people with subacute spinal cord injury, does rehabilitation that is reinforced with the addition of a behavioural intervention to promote physical activity lead to a more active lifestyle than rehabilitation alone? Design: Randomised, controlled trial with concealed allocation, intention-to-treat analysis, and blinded assessors. Participants: Forty-five adults with subacute spinal cord injury who were undergoing inpatient rehabilitation and were dependent on a manual wheelchair. The spinal cord injuries were characterised as: tetraplegia 33%; motor complete 62%; mean time since injury 150 days (SD 74. Intervention: All participants received regular rehabilitation, including handcycle training. Only the experimental group received a behavioural intervention promoting an active lifestyle after discharge. This intervention involved 13 individual sessions delivered by a coach who was trained in motivational interviewing; it began 2 months before and ended 6 months after discharge from inpatient rehabilitation. Outcome measures: The primary outcome was physical activity, which was objectively measured with an accelerometer-based activity monitor 2 months before discharge, at discharge, and 6 and 12 months after discharge from inpatient rehabilitation. The accelerometry data were analysed as total wheeled physical activity, sedentary time and motility. Self-reported physical activity was a secondary outcome. Results: The behavioural intervention significantly increased wheeled physical activity (overall between-group difference from generalised estimating equation 21 minutes per day, 95% CI 8 to 35. This difference was evident 6 months after discharge (28 minutes per day, 95% CI 8 to 48 and maintained at 12 months after discharge (25 minutes per day, 95% CI 1 to 50. No significant intervention effect was found for sedentary time or motility. Self-reported physical activity also significantly improved. Conclusion: The behavioural
Allom, Vanessa; Mullan, Barbara
Inhibitory control training has been shown to influence eating behaviour in the laboratory; however, the reliability of these effects is not yet established outside the laboratory, nor are the mechanisms responsible for change in behaviour. Two online Stop-Signal Task training interventions were conducted to address these points. In Study 1, 72 participants completed baseline and follow-up measures of inhibitory control, self-regulatory depletion, fat intake and body-mass index. Participants were randomly assigned to complete one of three Stop-Signal Tasks daily for ten days: food-specific inhibition--inhibition in response to unhealthy food stimuli only, general inhibition--inhibition was not contingent on type of stimuli, and control--no inhibition. While fat intake did not decrease, body-mass index decreased in the food-specific condition and change in this outcome was mediated by changes in vulnerability to depletion. In Study 2, the reliability and longevity of these effects were tested by replicating the intervention with a third measurement time-point. Seventy participants completed baseline, post-intervention and follow-up measures. While inhibitory control and vulnerability to depletion improved in both training conditions post-intervention, eating behaviour and body-mass index did not. Further, improvements in self-regulatory outcomes were not maintained at follow-up. It appears that while the training paradigm employed in the current studies may improve self-regulatory outcomes, it may not necessarily improve health outcomes. It is suggested that this may be due to the task parameters, and that a training paradigm that utilises a higher proportion of stop-signals may be necessary to change behaviour. In addition, improvements in self-regulation do not appear to persist over time. These findings further current conceptualisations of the nature of self-regulation and have implications for the efficacy of online interventions designed to improve eating
Rackow, Pamela; Scholz, Urte; Hornung, Rainer
Received social support is considered important for health-enhancing exercise participation. The enabling hypothesis of social support suggests an indirect association of social support and exercising via constructs of self-regulation, such as self-efficacy. This study aimed at examining an expanded enabling hypothesis by examining effects of different kinds of social support (i.e., emotional and instrumental) on exercising not only via self-efficacy but also via self-monitoring and action planning. An 8-week online study was conducted. Participants were randomly assigned to an intervention or a control group. The intervention comprised finding and then exercising regularly with a new exercise companion. Intervention and control group effects were compared by a manifest multigroup model. Received emotional social support predicted self-efficacy, self-monitoring, and action planning in the intervention group. Moreover, received emotional social support was indirectly connected with exercise via the examined mediators. The indirect effect from received emotional social support via self-efficacy mainly contributed to the total effect. No direct or indirect effect of received instrumental social support on exercise emerged. In the control group, neither emotional nor instrumental social support was associated with any of the self-regulation constructs nor with exercise. Actively looking for a new exercise companion and exercising together seems to be beneficial for the promotion of received emotional and instrumental social support. Emotional support in turn promotes exercise by enabling better self-regulation, in particular self-efficacy. Statement of contribution What is already known on this subject? With the 'enabling hypothesis', Benight and Bandura (2004, Behav. Res. Ther., 42, 1129) claimed that social support indirectly affects behaviour via self-efficacy. Research in the domain of physical exercise has provided evidence for this enabling hypothesis on a
Maria B Ospina
Full Text Available BACKGROUND: Much controversy exists regarding the clinical efficacy of behavioural and developmental interventions for improving the core symptoms of autism spectrum disorders (ASD. We conducted a systematic review to summarize the evidence on the effectiveness of behavioural and developmental interventions for ASD. METHODS AND FINDINGS: Comprehensive searches were conducted in 22 electronic databases through May 2007. Further information was obtained through hand searching journals, searching reference lists, databases of theses and dissertations, and contacting experts in the field. Experimental and observational analytic studies were included if they were written in English and reported the efficacy of any behavioural or developmental intervention for individuals with ASD. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively and, where possible, meta-analyses of the study results were conducted. One-hundred-and-one studies at predominantly high risk of bias that reported inconsistent results across various interventions were included in the review. Meta-analyses of three controlled clinical trials showed that Lovaas treatment was superior to special education on measures of adaptive behaviour, communication and interaction, comprehensive language, daily living skills, expressive language, overall intellectual functioning and socialization. High-intensity Lovaas was superior to low-intensity Lovaas on measures of intellectual functioning in two retrospective cohort studies. Pooling the results of two randomized controlled trials favoured developmental approaches based on initiative interaction compared to contingency interaction in the amount of time spent in stereotyped behaviours and distal social behaviour, but the effect sizes were not clinically significant. No statistically significant differences were found for: Lovaas versus special
Evans, Stephanie; Alden, Kieran; Cucurull-Sanchez, Lourdes; Larminie, Christopher; Coles, Mark C; Kullberg, Marika C; Timmis, Jon
A calibrated computational model reflects behaviours that are expected or observed in a complex system, providing a baseline upon which sensitivity analysis techniques can be used to analyse pathways that may impact model responses. However, calibration of a model where a behaviour depends on an intervention introduced after a defined time point is difficult, as model responses may be dependent on the conditions at the time the intervention is applied. We present ASPASIA (Automated Simulation Parameter Alteration and SensItivity Analysis), a cross-platform, open-source Java toolkit that addresses a key deficiency in software tools for understanding the impact an intervention has on system behaviour for models specified in Systems Biology Markup Language (SBML). ASPASIA can generate and modify models using SBML solver output as an initial parameter set, allowing interventions to be applied once a steady state has been reached. Additionally, multiple SBML models can be generated where a subset of parameter values are perturbed using local and global sensitivity analysis techniques, revealing the model's sensitivity to the intervention. To illustrate the capabilities of ASPASIA, we demonstrate how this tool has generated novel hypotheses regarding the mechanisms by which Th17-cell plasticity may be controlled in vivo. By using ASPASIA in conjunction with an SBML model of Th17-cell polarisation, we predict that promotion of the Th1-associated transcription factor T-bet, rather than inhibition of the Th17-associated transcription factor RORγt, is sufficient to drive switching of Th17 cells towards an IFN-γ-producing phenotype. Our approach can be applied to all SBML-encoded models to predict the effect that intervention strategies have on system behaviour. ASPASIA, released under the Artistic License (2.0), can be downloaded from http://www.york.ac.uk/ycil/software.
Simmons, David; Bunn, Christopher; Nakwagala, Fred; Safford, Monika M.; Ayala, Guadalupe X.; Riddell, Michaela; Graffy, Jonathan; Fisher, Edwin B.
PURPOSE Ethical review processes have become increasingly complex. We have examined how 8 collaborating diabetes peer-support clinical trials were assessed by ethics committees. METHODS The ethical reviews from the 8 peer-support studies were collated and subjected to a thematic analysis. We mapped the recommendations of local Institutional Review Boards and ethics committees onto the “4+1 ethical framework” (autonomy, beneficence, non-maleficence, and justice, along with concern for their scope of application). RESULTS Ethics committees did not consistently focus on tasks within the 4+1 framework: many conducted reviews of scientific, organizational, and administrative activities. Of the 20 themes identified across the ethical reviews, only 4 fell within the scope of the 4+1 framework. Variation in processes and requirements for ethics committees were particularly evident between study countries. Some of the consent processes mandated by ethical review boards were disproportionate for peer support, increased participant burden, and reduced the practicality of testing an ethical intervention. Across the 8 studies, ethics committees’ reviews included the required elements to ensure participant safety; however, they created a range of hurdles that in some cases delayed the research and required consent processes that could hinder the spontaneity and/or empathy of peer support. CONCLUSION Ethics committees should avoid repeating the work of other trusted agencies and consider the ethical validity of “light touch” consent procedures for peer-support interventions. The investigators propose an ethical framework for research on peer support. PMID:26304976
Heath, Gemma; Cooke, Richard; Cameron, Elaine
In this article we introduce a Health Psychology approach to changing patient behaviour, in order to demonstrate the value of Health Psychology professional practice as applied within healthcare settings. Health Psychologists are experts in understanding, predicting and changing health-related behaviours at the individual, group and population level. They combine psychological theory, research evidence and service-user views to design interventions to solve clinically relevant behavioural problems and improve health outcomes. We provide a pragmatic overview of a theory and evidence-based Intervention Mapping approach for developing, implementing and evaluating interventions to change health-related behaviour. An example of a real behaviour change intervention designed to improve medication adherence in an adolescent patient with poorly controlled asthma is described to illustrate the main stages of the intervention development process.
Full Text Available In this article we introduce a Health Psychology approach to changing patient behaviour, in order to demonstrate the value of Health Psychology professional practice as applied within healthcare settings. Health Psychologists are experts in understanding, predicting and changing health-related behaviours at the individual, group and population level. They combine psychological theory, research evidence and service-user views to design interventions to solve clinically relevant behavioural problems and improve health outcomes. We provide a pragmatic overview of a theory and evidence-based Intervention Mapping approach for developing, implementing and evaluating interventions to change health-related behaviour. An example of a real behaviour change intervention designed to improve medication adherence in an adolescent patient with poorly controlled asthma is described to illustrate the main stages of the intervention development process.
Webb, J; Foster, J; Poulter, E
Being physically active has multiple benefits for cancer patients. Despite this only 23% are active to the national recommendations and 31% are completely inactive. A cancer diagnosis offers a teachable moment in which patients might be more receptive to lifestyle changes. Nurses are well placed to offer physical activity advice, however, only 9% of UK nurses involved in cancer care talk to all cancer patients about physical activity. A change in the behaviour of nurses is needed to routinely deliver physical activity advice to cancer patients. As recommended by the Medical Research Council, behavioural change interventions should be evidenced-based and use a relevant and coherent theoretical framework to stand the best chance of success. This paper presents a case study on the development of an intervention to improve the frequency of delivery of very brief advice (VBA) on physical activity by nurses to cancer patients, using the Behaviour Change Wheel (BCW). The eight composite steps outlined by the BCW guided the intervention development process. An iterative approach was taken involving key stakeholders (n = 45), with four iterations completed in total. This was not defined a priori but emerged during the development process. A 60 min training intervention, delivered in either a face-to-face or online setting, with follow-up at eight weeks, was designed to improve the capability, opportunity and motivation of nurses to deliver VBA on physical activity to people living with cancer. This intervention incorporates seven behaviour change techniques of goal setting coupled with commitment; instructions on how to perform the behaviour; salience of the consequences of delivering VBA; a demonstration on how to give VBA, all delivered via a credible source with objects added to the environment to support behavioural change. The BCW is a time consuming process, however, it provides a useful and comprehensive framework for intervention development and greater control
Hayes, Laura; Brophy, Lisa; Harvey, Carol; Tellez, Juan Jose; Herrman, Helen; Killackey, Eoin
The aim of this study was to identify the most effective interventions for early intervention in psychosocial disability in the National Disability Insurance Scheme (NDIS) through an evidence review. A series of rapid reviews were undertaken to establish possible interventions for psychosocial disability, to develop our understanding of early intervention criteria for the NDIS and to determine which interventions would meet these criteria. Three interventions (social skills training, supported employment and supported housing) have a strong evidence base for effectiveness in early intervention in people with psychosocial disability, with the potential for adoption by the NDIS. They support personal choice and recovery outcomes. Illness self-management, cognitive remediation and cognitive behavioural therapy for psychosis demonstrate outcomes to mitigate impairment. The evidence for family psycho-education is also very strong. This review identified evidence-based, recovery-oriented approaches to early intervention in psychosocial disability. They meet the criteria for early intervention in the NDIS, are relevant to participants and consider their preferences. Early intervention has the potential to save costs by reducing participant reliance on the scheme.
Salberg, Johanna; Folke, Fredrik; Ekselius, Lisa; Öster, Caisa
A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staff-led behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care. © 2018 Australian College of Mental Health Nurses Inc.
Perski, Olga; Blandford, Ann; West, Robert; Michie, Susan
"Engagement" with digital behaviour change interventions (DBCIs) is considered important for their effectiveness. Evaluating engagement is therefore a priority; however, a shared understanding of how to usefully conceptualise engagement is lacking. This review aimed to synthesise literature on engagement to identify key conceptualisations and to develop an integrative conceptual framework involving potential direct and indirect influences on engagement and relationships between engagement and intervention effectiveness. Four electronic databases (Ovid MEDLINE, PsycINFO, ISI Web of Knowledge, ScienceDirect) were searched in November 2015. We identified 117 articles that met the inclusion criteria: studies employing experimental or non-experimental designs with adult participants explicitly or implicitly referring to engagement with DBCIs, digital games or technology. Data were synthesised using principles from critical interpretive synthesis. Engagement with DBCIs is conceptualised in terms of both experiential and behavioural aspects. A conceptual framework is proposed in which engagement with a DBCI is influenced by the DBCI itself (content and delivery), the context (the setting in which the DBCI is used and the population using it) and the behaviour that the DBCI is targeting. The context and "mechanisms of action" may moderate the influence of the DBCI on engagement. Engagement, in turn, moderates the influence of the DBCI on those mechanisms of action. In the research literature, engagement with DBCIs has been conceptualised in terms of both experience and behaviour and sits within a complex system involving the DBCI, the context of use, the mechanisms of action of the DBCI and the target behaviour.
Duncan, Mitch J; Vandelanotte, Corneel; Trost, Stewart G; Rebar, Amanda L; Rogers, Naomi; Burton, Nicola W; Murawski, Beatrice; Rayward, Anna; Fenton, Sasha; Brown, Wendy J
Many adults are insufficiently physically active, have prolonged sedentary behaviour and report poor sleep. These behaviours can be improved by interventions that include education, goal setting, self-monitoring, and feedback strategies. Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods. This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objectively measured physical activity, sedentary, and sleep behaviours, in a 9 week 2-arm randomised trial. Participants will be adults (n = 64) who report being physically inactive, sitting >8 h/day and frequent insufficient sleep (≥14 days out of last 30). The "Balanced" intervention is delivered via a smartphone 'app', and includes education materials (guidelines, strategies to promote change in behaviour), goal setting, self-monitoring and feedback support. Participants will be randomly allocated to either a device-entered or user-entered self-monitoring method. The device-entered group will be provided with a activity tracker to self-monitor behaviours. The user-entered group will recall and manually record behaviours. Assessments will be conducted at 0, 3, 6, and 9 weeks. Physical activity, sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer. Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01. This study will evaluate an app-based multi-behavioural intervention to improve physical activity, sedentary behaviour and sleep; and the relative efficacy of two different approaches to self-monitoring these behaviours. Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours. ACTRN12615000182594 (Australian New Zealand Clinical Trials Registry. Registry URL: www.anzctr.org.au ; registered
Lopez, Pablo Luis; Torrente, Fernando Manuel; Ciapponi, Agustín; Lischinsky, Alicia Graciela; Cetkovich-Bakmas, Marcelo; Rojas, Juan Ignacio; Romano, Marina; Manes, Facundo F
Attention deficit hyperactivity disorder (ADHD) is a developmental condition characterised by symptoms of inattention, hyperactivity and impulsivity, along with deficits in executive function, emotional regulation and motivation. The persistence of ADHD in adulthood is a serious clinical problem.ADHD significantly affects social interactions, study and employment performance.Previous studies suggest that cognitive-behavioural therapy (CBT) could be effective in treating adults with ADHD, especially when combined with pharmacological treatment. CBT aims to change the thoughts and behaviours that reinforce harmful effects of the disorder by teaching people techniques to control the core symptoms. CBT also aims to help people cope with emotions, such as anxiety and depression, and to improve self-esteem. To assess the effects of cognitive-behavioural-based therapy for ADHD in adults. In June 2017, we searched CENTRAL, MEDLINE, Embase, seven other databases and three trials registries. We also checked reference lists, handsearched congress abstracts, and contacted experts and researchers in the field. Randomised controlled trials (RCTs) evaluating any form of CBT for adults with ADHD, either as a monotherapy or in conjunction with another treatment, versus one of the following: unspecific control conditions (comprising supportive psychotherapies, no treatment or waiting list) or other specific interventions. We used the standard methodological procedures suggested by Cochrane. We included 14 RCTs (700 participants), 13 of which were conducted in the northern hemisphere and 1 in Australia.Primary outcomes: ADHD symptomsCBT versus unspecific control conditions (supportive psychotherapies, waiting list or no treatment)- CBT versus supportive psychotherapies: CBT was more effective than supportive therapy for improving clinician-reported ADHD symptoms (1 study, 81 participants; low-quality evidence) but not for self-reported ADHD symptoms (SMD -0.16, 95% CI -0.52 to 0
Harrison, Jennifer; Cousins, Linwood; Spybrook, Jessaca; Curtis, Amy
Adults with co-occurring mental illness and substance use disorders have poor outcomes in important quality of life areas, including hospitalization, incarceration, employment, and community housing. Integrated dual disorder treatment (IDDT) is a research-supported intervention for individuals with co-occurring disorders associated with improvements in outcome measures when implemented with high fidelity. Research-supported intervention IDDT was not designed with peer services, provided by people with lived experience with mental illness, but the practice has been altered to include peers. IDDT fidelity data were evaluated from 20 teams that also reported on peer services on their team in one state over a 7 year period, and paired with their fidelity data for the most recent review to analyze the relationship between peers and IDDT fidelity. Analysis of variance was utilized to determine a dose effect peers on fidelity. Of these IDDT teams, 85% of teams incorporated a peer and 40% of teams had a full-time peer. Having a full-time peer (M = 4.22, SD = .41) was associated with significantly higher fidelity compared to teams with a part-time (M = 3.68, SD = .56) or no peer (M = 3.21, SD = .18, F(2, 17) = 5.88, p = .01). Peers on IDDT teams are associated with higher fidelity, leading to important possibilities about the incorporation of those with lived experience into research-supported interventions. Implications for team composition, implementation measurement, policy, and funding are discussed.
Alias, Mazni; Rasdi, Roziah Mohd; Ismail, Maimunah; Samah, Bahaman Abu
Purpose: The purpose of this paper is to develop a theoretical model of the determinants of workplace deviant behaviour among support personnel in Malaysian Public Service organisations. Design/methodology/approach: This study is based on reviews of past studies on workplace deviant behaviour. To conduct the literature review, several keywords…
Full Text Available Studies have shown preventive effects of an active lifestyle during childhood on later life; therefore, health promotion has to start early. The programme “Join the Healthy Boat” promotes a healthy lifestyle in primary school children. In order to evaluate it, children’s behaviours in respect of increased physical activity (PA, a decrease in screen media use (SMU, more regular breakfast, and a reduction of the consumption of soft drinks (SDC were investigated. 1943 children (7.1 ± 0.6 years participated in the cluster-randomised study and were assessed at baseline and 1736 of them at follow-up. Teachers delivered lessons, which included behavioural contracting and budgeting of SMU and SDC. Daily SMU, PA behaviours, SDC, and breakfast patterns were assessed via parental questionnaire. After one-year intervention, significant effects were found in the intervention group for SMU of girls, children without migration background, and children with parents having a low education level. In the control group, second grade children skipped breakfast significantly more often. Tendencies but no significant differences were found for PA and SDC. This intervention seems to affect groups, which are usually hard to reach, such as children of parents with low education levels, which shows that active parental involvement is vital for successful interventions.
Gale, Nicola K; Kenyon, Sara; MacArthur, Christine; Jolly, Kate; Hope, Lucy
Levels of social support are strongly associated with health outcomes and inequalities. The use of lay health workers (LHWs) has been suggested by policy makers across the world as an intervention to identify risks to health and to promote health, particularly in disadvantaged communities. However, there have been few attempts to theorize the work undertaken by LHWs to understand how interventions work. In this article, the authors present the concept of 'synthetic socialsupport' and distinguish it from the work of health professionals or the spontaneous social support received from friends and family. The authors provide new empirical data to illustrate the concept based on qualitative, observational research, using a novel shadowing method involving clinical and non-clinical researchers, on the everyday work of 'pregnancy outreach workers' (POWs) in Birmingham, UK. The service was being evaluated as part of a randomized controlled trial. These LHWs provided instrumental, informational, emotional and appraisal support to the women they worked with, which are all key components of social support. The social support was 'synthetic' because it was distinct from the support embedded in spontaneous social networks: it was non-reciprocal; it was offered on a strictly time-limited basis; the LHWs were accountable for the relationship, and the social networks produced were targeted rather than spontaneous. The latter two qualities of this synthetic form of social support may have benefits over spontaneous networks by improving the opportunities for the cultivation of new relationships (both strong and weak ties) outside the women's existing spontaneous networks that can have a positive impact on them and by offering a reliable source of health information and support in a chaotic environment. The concept of SSS can help inform policy makers about how deploying lay workers may enable them to achieve desired outcomes, specify their programme theories and evaluate
Haakma, Ineke; Janssen, Marleen; Minnaert, Alexander
Research on Self-Determination Theory has shown that teachers' need-supportive behaviour is associated with student motivation and engagement. The purpose of this study is to examine the effectiveness of an intervention aimed at increasing the motivation of students with congenital and acquired deafblindness by enhancing teachers' need-supportive…
Haakma, Ineke; Janssen, Marleen; Minnaert, Alexander
Research on Self-Determination Theory has shown that teachers’ need-supportive behaviour is associated with student motivation and engagement. The purpose of this study is to examine the effectiveness of an intervention aimed at increasing the motivation of students with congenital and acquired
O'Dwyer, Tom; Monaghan, Ann; Moran, Jonathan; O'Shea, Finbar; Wilson, Fiona
Does a 3-month behaviour change intervention targeting physical activity (PA) increase habitual physical activity in adults with ankylosing spondylitis (AS)? Does the intervention improve health-related physical fitness, AS-related features, and attitude to exercise? Are any gains maintained over a 3-month follow-up? Parallel-group, randomised, controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. Forty adults with a diagnosis of AS, on stable medication, and without PA-limiting comorbidities. Over a 3-month period, the experimental group engaged in individually-tailored, semi-structured consultations aiming to motivate and support individuals in participating in PA. The control group continued with usual care. The primary outcome was PA measured by accelerometry over 1 week. Secondary outcomes included clinical questionnaires and measures of health-related physical fitness. Measures were taken at baseline, post-intervention, and after a 3-month follow-up period. Baseline characteristics were similar across groups, except age and body composition. There were statistically significant, moderate-to-large time-by-group effects in health-enhancing PA (mixed-design ANOVA for overall effect F(2, 76)=14.826, pmobility (F(2, 76)=5.691, pquality of life (χ 2 (2)=8.400, pmobility and quality of life were significantly improved after the intervention, and improvements were maintained at 3-month follow-up. NCT02374502. [O'Dwyer T, Monaghan A, Moran J, O'Shea F, Wilson F (2016) Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial.Journal of PhysiotherapyXX: XX-XX]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
Nørnberg, Trine Riebeling; Houlby, Louise; Skov, Laurits Rohden
Aims: The primary objective of this review is to assess the prevalence and quality of published studies on the effect of choice architectural nudge interventions promoting vegetable consumption among adolescents. Additionally, this review aims to identify studies estimating adolescents’ attitude...... evaluated as of high, moderate or weak quality. Finally, studies were grouped by type of intervention and underwent a narrative synthesis. Results: The search showed that only very few studies investigated the effects of choice architectural nudging interventions on vegetable consumption and none of them...... had attitude towards behavioural interventions as an outcome measure. Twelve studies met the inclusion criteria. The results of the twelve studies were inconclusive and the majority of studies were of weak or moderate quality. Conclusion: This review uncovers a gap in knowledge on the effect of choice...
Horyl, P.; Šňupárek, Richard; Maršálek, P.
Roč. 59, č. 3 (2014), s. 723-734 ISSN 0860-7001 R&D Projects: GA MŠk ED2.1.00/03.0082; GA MŠk ED1.1.00/02.0070 Institutional support: RVO:68145535 Keywords : steel arch yielding support * friction al joints * bolt connection * slip support * fem Subject RIV: DH - Mining, incl. Coal Mining Impact factor: 0.608, year: 2013
Austin, Ashley; Craig, Shelley L
When empirically supported treatments (ESTs) are effectively adapted for use with minority populations, they may be more efficacious. As such, there is a need to adapt existing ESTs for use with diverse sexual and gender minority youth (SGMY). The unique bias-based challenges faced by SGMY require the integration of affirmative practices into ESTs to effectively address the specific needs of this underserved group of youth. The primary purpose of the authors in this article is to present a clearly articulated stakeholder driven model for developing an affirmative adapted version of cognitive behavioral therapy (CBT) for use with diverse SGMY. The authors' approach to adaptation follows the "adapt and evaluate" framework for enhancing cultural congruence of interventions for minority groups. A community based participatory research approach, consistent with a stakeholder driven process, is utilized to develop the intervention from the ground up through the voices of the target community. Researchers conducted 3 focus groups with culturally diverse SGMY to explore salient aspects of youths' cultural and SGM identities in order to inform the intervention and ensure its applicability to a wide range of SGMY. Focus group data is analyzed and integrated into an existing group-based CBT intervention. The following themes emerge as critical to affirmative work with diverse SGMY: (1) the interplay between cultural norms, gender norms, sexual orientation, and gender identity; (2) the complex role of religious community within the lives of SGMY; and (3) consideration of extended family and cultural community as youth navigate their SGM identities.
Daniels, Jo; Pauling, John D; Eccelston, Christopher
Raynaud's phenomenon (RP) describes excessive peripheral vasospasm to cold exposure and/or emotional stress. RP episodes are associated with digital colour changes, pain and reduced quality of life. Pharmacological interventions are of low to moderate efficacy and often result in adverse effects such as facial flushing and headaches. Recommended lifestyle and behavioural interventions have not been evaluated. The objectives of the proposed systematic review are to assess the comparative safety and efficacy of behaviour change interventions for RP and identify what we can learn to inform future interventions. Studies eligible for inclusion include randomised controlled trials testing behaviour change interventions with a control comparator. A comprehensive search strategy will include peer review and grey literature up until 30 April 2017. Search databases will include Medline, Embase, PsychINFO and Cochrane. Initial sifting, eligibility, data extraction, risk of bias and quality assessment will be subject to review by two independent reviewers with a third reviewer resolving discrepancies. Risk of bias assessment will be performed using Cochrane risk of a bias assessment tool with quality of evidence assessed using Grading of Recommendations Assessment, Development and Evaluation(GRADE). A meta-analysis will be performed if there are sufficient data. Two subgroup analyses are planned: primary versus secondary RP outcomes; comparison of theoretically informed interventions with pragmatic interventions. This review does not require ethical approval as it will summarise published studies with non-identifiable data. This protocol complies with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Findings will be disseminated in peer-reviewed articles and reported according to PRISMA. This review will make a significant contribution to the management of RP where no review of behaviour-change interventions currently exist
Nichols, Kim; Burgh, Gilbert; Kennedy, Callie
Developing students' skills to pose and respond to questions and actively engage in inquiry behaviours enables students to problem solve and critically engage with learning and society. The aim of this study was to analyse the impact of providing teachers with an intervention in inquiry pedagogy alongside inquiry science curriculum in comparison to an intervention in non-inquiry pedagogy alongside inquiry science curriculum on student questioning and other inquiry behaviours. Teacher participants in the comparison condition received training in four inquiry-based science units and in collaborative strategic reading. The experimental group, the community of inquiry (COI) condition, received training in facilitating a COI in addition to training in the same four inquiry-based science units. This study involved 227 students and 18 teachers in 9 primary schools across Brisbane, Australia. The teachers were randomly allocated by school to one of the two conditions. The study followed the students across years 6 and 7 and students' discourse during small group activities was recorded, transcribed and coded for verbal inquiry behaviours. In the second year of the study, students in the COI condition demonstrated a significantly higher frequency of procedural and substantive higher-order thinking questions and other inquiry behaviours than those in the comparison condition. Implementing a COI within an inquiry science curriculum develops students' questioning and science inquiry behaviours and allows teachers to foster inquiry skills predicated by the Australian Science Curriculum. Provision of inquiry science curriculum resources alone is not sufficient to promote the questioning and other verbal inquiry behaviours predicated by the Australian Science Curriculum.
Tan, Ai May; Lamontagne, Anthony D; Sarmugam, Rani; Howard, Peter
prevention. The intervention used locally relevant behavioural strategies previously shown to support good outcomes in other countries. The combination of these elements have not been incorporated in similar studies in the past, supporting the study hypothesis that the intervention will be more efficacious than standard practice in osteoporosis prevention through improvements in calcium intake and physical activity.
Quearry, Amy Garcia; Lundervold, Duane A
A functional analysis of behaviour was conducted to determine the controlling variables related to the perseverative verbal behaviour (PBV) of a 60-year-old female with a long-standing traumatic brain injury receiving educational assistance. Functional analyses (FA) of antecedent and consequent conditions related to PCB were conducted to determine controlling influence of: (a) content of verbal interaction and, (b) social reinforcement. After isolating the controlling variables, the functioned-based intervention was implemented in 60 minute tutoring sessions. A reversal condition was used to demonstrate experimental control of the behavior during tutoring sessions. PVB which occurred in the context of tutoring for an undergraduate course significantly interfered with the delivery of instruction. Multiple replications of the functional relation between social reinforcement and PVB duration was demonstrated using an A-B-A-B reversal design during functional analysis and tutoring conditions. PVB markedly declined, but did not extinguish over the course of weekly tutoring (extinction) sessions, most likely due to 'bootleg reinforcement' occurring in other situations. Results indicate that perseverative verbal behaviour following closed head injury may be strongly influenced by the social contingencies operating in various contexts and is amenable to applied behaviour analysis interventions.
Nutritional behaviour is framed by biological, anthropological, economic, psychological, socio-cultural, and home economics related determinants and it is shaped by the individual situation. From a public health point of view, the outcome is often unsatisfactory, because it is associated with preventable cases of various diseases. This situation evoked the founding of the German Association for Nutritional Behaviour (Arbeitsgemeinschaft Ernährungsverhalten, AGEV) which celebrated its 25th anniversary within the scope of the 10th Food Choice Conference in the summer of 2002 with a plenary session on 'Sensible policies for nutrition and life-style intervention'. One might assume that the many determinants of nutritional behaviour provide a whole set of means to intervene into people's food choices. But closer deliberations make clear that there are two important aspects that tend to hinder dietary changes: on the one hand, nutritional behaviour is characterized by many conflicts of its related determinants. In order to cope with them, people develop individual guiding strategies for food choice situations which are quite stable as soon as they proved their suitability. On the other hand, any dietary modification leads to certain gains (like increased health), but losses, as well (like decreased palatability). Thus, a sustainable change can only be expected, if its gains are evaluated higher than its losses. These aspects need to be carefully considered when designing nutrition and life-style related intervention concepts.
Brennan, Leah; Walkley, Jeff; Wilks, Ray; Fraser, Steve F; Greenway, Kate
This study evaluates the efficacy of the Choose Health program, a family-based cognitive behavioural lifestyle program targeting improved eating and activity habits, in improving body composition, cardiovascular fitness, eating and activity behaviours in overweight and obese adolescents. The sample comprised 29 male and 34 female overweight (n = 15) or obese (n = 48) adolescents aged 11.5-18.9 years (M = 14.3, SD = 1.9). Participants were randomly allocated to treatment or waitlist control conditions; waitlist condition participants were offered treatment after 6 months. DEXA-derived and anthropometric measures of body composition; laboratory-based cycle ergometer and field-assessed cardiovascular fitness data; objective and self-report physical activity measures; and self-report measures of eating habits and 7-day weighed food diaries were used to assess treatment outcome. Adherence to treatment protocols was high. Treatment resulted in significant (p physical activity and dietary data. Participation in the Choose Health program resulted in significant improvement in body composition. Longer-term follow up is required to determine the durability of intervention effects. Alternative approaches to the measurement of diet and physical activity may be required for adolescents. © 2013 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.
Fabrizio, Cecilia S; van Liere, Marti; Pelto, Gretel
As stunting moves to the forefront of the global agenda, there is substantial evidence that behaviour change interventions (BCI) can improve infant feeding practices and growth. However, this evidence has not been translated into improved outcomes on a national level because we do not know enough about what makes these interventions work, for whom, when, why, at what cost and for how long. Our objective was to examine the design and implementation of complementary feeding BCI, from the peer-reviewed literature, to identify generalisable key determinants. We identified 29 studies that evaluated BCI efficacy or effectiveness, were conducted in developing countries, and reported outcomes on infant and young children aged 6–24 months. Two potential determinants emerged: (1) effective studies used formative research to identify cultural barriers and enablers to optimal feeding practices, to shape the intervention strategy, and to formulate appropriate messages and mediums for delivery; (2) effective studies delineated the programme impact pathway to the target behaviour change and assessed intermediary behaviour changes to learn what worked. We found that BCI that used these developmental and implementation processes could be effective despite heterogeneous approaches and design components. Our analysis was constrained, however, by the limited published data on how design and implementation were carried out, perhaps because of publishing space limits. Information on cost-effectiveness, sustainability and scalability was also very limited. We suggest a more comprehensive reporting process and a more strategic research agenda to enable generalisable evidence to accumulate. PMID:24798264
Sofronoff, Kate; Attwood, Tony; Hinton, Sharon; Levin, Irina
The purpose of the study described was to evaluate the effectiveness of a cognitive behavioural intervention for anger management with children diagnosed with Asperger syndrome. Forty-five children and their parents were randomly assigned to either intervention or wait-list control conditions. Children in the intervention participated in six 2-h…
Govender, Roganie; Smith, Christina H; Taylor, Stuart A; Grey, Daphne; Wardle, Jane; Gardner, Benjamin
Dysphagia (difficulty in swallowing) is a predictable consequence of head and neck cancer and its treatment. Loss of the ability to eat and drink normally has a devastating impact on quality of life for survivors of this type of cancer. Most rehabilitation programmes involve behavioural interventions that include swallowing exercises to help improve swallowing function. Such interventions are complex; consisting of multiple components that may influence outcomes. These interventions usually require patient adherence to recommended behaviour change advice. To date, reviews of this literature have explored whether variation in effectiveness can be attributed to the type of swallowing exercise, the use of devices to facilitate use of swallowing muscles, and the timing (before, during or after cancer treatment). This systematic review will use a behavioural science lens to examine the content of previous interventions in this field. It aims to identify (a) which behaviour change components are present, and (b) the frequency with which they occur in interventions deemed to be effective and non-effective. Clinical trials of behavioural interventions to improve swallowing outcomes in patients with head and neck cancers will be identified via a systematic and comprehensive search of relevant electronic health databases, trial registers, systematic review databases and Web of Science. To ascertain behaviour change intervention components, we will code the content for its theory basis, intervention functions and specific behaviour change techniques, using validated tools: the Theory Coding Scheme, Behaviour Change Wheel and Behaviour Change Technique Taxonomy v1. Study quality will be assessed for descriptive purposes only. Given the specialisation and focus of this review, a small yield of studies with heterogeneous outcome measures is anticipated. Therefore, narrative synthesis is considered more appropriate than meta-analysis. We will also compare the frequency of
Ennis, Robin Parks; Hirsch, Shanna E.; MacSuga-Gage, Ashley S.; Kennedy, Michael J.
Teaching expectations is an essential component of schoolwide positive behavioral interventions and supports (PBIS). Creating PBIS videos is a tool for teaching expectations and other targeted skills within a schoolwide PBIS framework. In this article, we offer the why, how, when, where, and what of producing/screening PBIS videos to effectively…
McQueen, Meg; Blinkhorn, Ashleigh; Broad, Adam; Jones, Jessica; Naeem, Farooq; Ayub, Muhammad
Despite strong evidence for cognitive behaviour therapy (CBT) in treating mental health, its use, thus far, has been limited for people with intellectual disabilities. This study describes a CBT-based guided self-help (CBT-GSH) manual for individuals with intellectual disability, and focus groups explore the views of clinicians, therapists, support staff and managers. Using a qualitative methodology, an expert team adapted the manual. Focus groups provided feedback, followed by thematic content analysis for modifications. Participants supported using the manual, with varying views about the delivery. Quality of relationships and competence of the administrator determined the best person to deliver the treatment. Heterogeneity in the intellectual disability population was a challenge to delivering manual-based interventions. Participants made suggestions about language and organization. Amendments were made to the manual in line with expert feedback. An evaluation is warranted to test for feasibility, delivery, acceptability and efficacy. © 2018 John Wiley & Sons Ltd.
Horyl, P.; Šňupárek, Richard
Roč. 116, č. 3 (2007), s. 119-128 ISSN 0371-7844 Institutional research plan: CEZ:AV0Z30860518 Keywords : steel arch support * rockbursts * dynamic loading Subject RIV: DH - Mining , incl. Coal Mining
Vissenberg, Charlotte; Nierkens, Vera; van Valkengoed, Irene; Nijpels, Giel; Uitewaal, Paul; Middelkoop, Barend; Stronks, Karien
This paper aims to explore the effect of the social network based intervention Powerful Together with Diabetes on diabetes self-management among socioeconomically deprived patients. This 10-month group intervention targeting patients and significant others aimed to improve self-management by stimulating social support and diminishing social influences that hinder self-management. This intervention was evaluated in a quasi-experimental study using a mixed methods approach. Of 131 socioeconomically deprived patients with suboptimal glycaemic control, 69 were assigned to the intervention group and 62 to the control group (standard diabetes education). 27 qualitative in-depth interviews with the participants and 24 with their group leaders were held to study the subjective impact of the intervention. Further, self-management behaviours (medication adherence, diet and physical activity) were assessed at baseline, 10 and 16 months. Data were analysed using framework analyses and a linear mixture model. Qualitative data showed that the intervention group had a better understanding of the way self-management influences diabetes. The intervention group showed more complex self-management behaviours, such as planning ahead, seeking adequate food and physical activity alternatives, and consistently taking their diabetes into consideration when making choices. In participants with complete follow-up data, we found a significant increase in physical activity in the intervention group (3.78 vs. 4.83 days) and no changes in medication adherence and diet. This study indicates that an intensive support group and simultaneously involving significant others might improve diabetes self-management behaviours among socioeconomically deprived patients. More studies are needed to justify further implementation of the intervention. This study is registered in the Dutch Trial Register NTR1886. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1886.
Verweij, L M; Coffeng, J; van Mechelen, W; Proper, K I
This meta-analytic review critically examines the effectiveness of workplace interventions targeting physical activity, dietary behaviour or both on weight outcomes. Data could be extracted from 22 studies published between 1980 and November 2009 for meta-analyses. The GRADE approach was used to determine the level of evidence for each pooled outcome measure. Results show moderate quality of evidence that workplace physical activity and dietary behaviour interventions significantly reduce body weight (nine studies; mean difference [MD]-1.19 kg [95% CI -1.64 to -0.74]), body mass index (BMI) (11 studies; MD -0.34 kg m⁻² [95% CI -0.46 to -0.22]) and body fat percentage calculated from sum of skin-folds (three studies; MD -1.12% [95% CI -1.86 to -0.38]). There is low quality of evidence that workplace physical activity interventions significantly reduce body weight and BMI. Effects on percentage body fat calculated from bioelectrical impedance or hydrostatic weighing, waist circumference, sum of skin-folds and waist-hip ratio could not be investigated properly because of a lack of studies. Subgroup analyses showed a greater reduction in body weight of physical activity and diet interventions containing an environmental component. As the clinical relevance of the pooled effects may be substantial on a population level, we recommend workplace physical activity and dietary behaviour interventions, including an environment component, in order to prevent weight gain. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.
The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development.
Flowers, Paul; Wu, Olivia; Lorimer, Karen; Ahmed, Bipasha; Hesselgreaves, Hannah; MacDonald, Jennifer; Cayless, Sandi; Hutchinson, Sharon; Elliott, Lawrie; Sullivan, Ann; Clutterbuck, Dan; Rayment, Michael; McDaid, Lisa
Men who have sex with men (MSM) experience significant inequalities in health and well-being. They are the group in the UK at the highest risk of acquiring a human immunodeficiency virus (HIV) infection. Guidance relating to both HIV infection prevention, in general, and individual-level behaviour change interventions, in particular, is very limited. To conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate intervention. All major electronic databases (British Education Index, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Educational Resource Index and Abstracts, Health and Medical Complete, MEDLINE, PsycARTICLES, PsycINFO, PubMed and Social Science Citation Index) were searched between January 2000 and December 2014. A systematic review of the clinical effectiveness of individual behaviour change interventions was conducted. Interventions were examined using the behaviour change technique (BCT) taxonomy, theory coding assessment, mode of delivery and proximity to HIV infection testing. Data were summarised in narrative review and, when appropriate, meta-analysis was carried out. Supplemental analyses for the development of the candidate intervention focused on post hoc realist review method, the assessment of the sequential delivery and content of intervention components, and the social and historical context of primary studies. Expert panels reviewed the candidate intervention for issues of implementation and optimisation. Overall, trials included in this review ( n = 10) demonstrated that individual-level behaviour change interventions are effective in reducing key HIV infection risk
Background Overweight and obesity in youth has increased dramatically. Therefore, overweight prevention initiatives should start early in life and target modifiable energy balance-related behaviours. Parental participation is often advocated as important for school-based interventions, however, getting parents involved in school-based interventions appears to be challenging based on earlier intervention experiences. The purpose of this study was to get insight into the determinants of and perspectives on parental participation in school-interventions on energy balance-related behaviours (physical activity, healthy eating, sedentary behaviours) in parents of ten- to twelve-year olds in order to develop an effective parental module for school-based interventions concerning energy balance-related behaviours. Methods Four countries (Belgium, Hungary, Norway and Spain) conducted the focus group research based on a standardised protocol and a semi-structured questioning route. A variation in parental socio-economic status (SES) and parental school involvement was taken into account when recruiting the parents. The audio taped interviews were transcribed, and a qualitative content analysis of the transcripts was conducted in each country. Results Seventeen focus group interviews were conducted with a total of 92 parents (12 men, 80 women). Physical activity was considered to be a joint responsibility of school and parents, nutrition as parent's responsibility but supported by the school, and prevention of sedentary behaviours as parent's sole responsibility. Parents proposed interactive and practical activities together with their child as the best way to involve them such as cooking, food tasting, nutrition workshops, walking or cycling tours, sport initiations together with their child. Activities should be cheap, on a convenient moment, focused on their children and not on themselves, not tutoring, not theoretical, and school-or home-based. Conclusions Parents want to
Van Lippevelde Wendy
Full Text Available Abstract Background Overweight and obesity in youth has increased dramatically. Therefore, overweight prevention initiatives should start early in life and target modifiable energy balance-related behaviours. Parental participation is often advocated as important for school-based interventions, however, getting parents involved in school-based interventions appears to be challenging based on earlier intervention experiences. The purpose of this study was to get insight into the determinants of and perspectives on parental participation in school-interventions on energy balance-related behaviours (physical activity, healthy eating, sedentary behaviours in parents of ten- to twelve-year olds in order to develop an effective parental module for school-based interventions concerning energy balance-related behaviours. Methods Four countries (Belgium, Hungary, Norway and Spain conducted the focus group research based on a standardised protocol and a semi-structured questioning route. A variation in parental socio-economic status (SES and parental school involvement was taken into account when recruiting the parents. The audio taped interviews were transcribed, and a qualitative content analysis of the transcripts was conducted in each country. Results Seventeen focus group interviews were conducted with a total of 92 parents (12 men, 80 women. Physical activity was considered to be a joint responsibility of school and parents, nutrition as parent's responsibility but supported by the school, and prevention of sedentary behaviours as parent's sole responsibility. Parents proposed interactive and practical activities together with their child as the best way to involve them such as cooking, food tasting, nutrition workshops, walking or cycling tours, sport initiations together with their child. Activities should be cheap, on a convenient moment, focused on their children and not on themselves, not tutoring, not theoretical, and school-or home
Van Lippevelde, Wendy; Verloigne, Maïté; De Bourdeaudhuij, Ilse; Bjelland, Mona; Lien, Nanna; Fernández-Alvira, Juan M; Moreno, Luis A; Kovacs, Eva; Brug, Johannes; Maes, Lea
Overweight and obesity in youth has increased dramatically. Therefore, overweight prevention initiatives should start early in life and target modifiable energy balance-related behaviours. Parental participation is often advocated as important for school-based interventions, however, getting parents involved in school-based interventions appears to be challenging based on earlier intervention experiences. The purpose of this study was to get insight into the determinants of and perspectives on parental participation in school-interventions on energy balance-related behaviours (physical activity, healthy eating, sedentary behaviours) in parents of ten- to twelve-year olds in order to develop an effective parental module for school-based interventions concerning energy balance-related behaviours. Four countries (Belgium, Hungary, Norway and Spain) conducted the focus group research based on a standardised protocol and a semi-structured questioning route. A variation in parental socio-economic status (SES) and parental school involvement was taken into account when recruiting the parents. The audio taped interviews were transcribed, and a qualitative content analysis of the transcripts was conducted in each country. Seventeen focus group interviews were conducted with a total of 92 parents (12 men, 80 women). Physical activity was considered to be a joint responsibility of school and parents, nutrition as parent's responsibility but supported by the school, and prevention of sedentary behaviours as parent's sole responsibility. Parents proposed interactive and practical activities together with their child as the best way to involve them such as cooking, food tasting, nutrition workshops, walking or cycling tours, sport initiations together with their child. Activities should be cheap, on a convenient moment, focused on their children and not on themselves, not tutoring, not theoretical, and school-or home-based. Parents want to be involved in activities related to
Barker, Fiona; Atkins, Lou; de Lusignan, Simon
To introduce a psychological model of behaviour; the COM-B model and describe how this has been used in combination with the behaviour change wheel (BCW) in developing an intervention which aims to promote regular, long-term use of hearing aids by adults with acquired hearing loss. Qualitative structured interview study using the COM-B model to identify the determinants of behavioural planning on the part of audiologists; a potentially important factor in encouraging long-term hearing-aid use. Ten audiologists drawn from a random sample of five English audiology departments. The analysis suggests that behavioural planning might be more likely to occur if audiologists' psychological capability, physical and social opportunity, and reflective and automatic motivation were addressed. This analysis forms the basis of an intervention design, using the BCW, to encourage behavioural planning by audiologists and subsequent hearing-aid use by people with hearing loss. The COM-B model and BCW can be applied successfully in the context of audiology to analyse the behaviour of both people with hearing loss and professionals working with them, supplying information that is being used in intervention design. The effectiveness of the intervention will be tested in a clinical trial.
Papies, Esther K.
ABSTRACT Recent research has shown the limited effects of intentions on behaviour, so that novel methods to facilitate behaviour change are needed that do not rely on conscious intentions. Here, it is argued that nonintentional effects on health behaviour, such as the effects of habits, impulses, and nonconscious goals, occur through the activation of cognitive structures by specific situations. Interventions should therefore be situated to change these effects, either by changing the critical cognitive structures (training interventions), or by changing which cognitive structures get activated (cueing interventions). The current article presents this framework for situated interventions, as well as examples of interventions of each type. Then, it introduces goal priming as a cueing intervention tool to activate health goals and thus facilitate healthier behaviour, even in tempting situations that typically activate short-term hedonic goals. Following a review of empirical evidence, five principles for the effective application of health goal primes are proposed, namely (1) to target individuals who value the primed goals, (2) by activating their specific motivation, (3) through effective cues (4) that attract attention at the right time. Finally, (5) an effective goal-directed behaviour needs to be known and accessible to the primed individual. These principles are illustrated with examples of different health behaviours in order to facilitate their application for successful behaviour change. PMID:27144729
Jessie-Lee D. McIsaac
Full Text Available Health promoting schools (HPS is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students.
McIsaac, Jessie-Lee D; Hernandez, Kimberley J; Kirk, Sara F L; Curran, Janet A
Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students.
McIsaac, Jessie-Lee D.; Hernandez, Kimberley J.; Kirk, Sara F.L.; Curran, Janet A.
Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students. PMID:26861376
Rasmussen, Charlotte Diana Nørregaard; Holtermann, Andreas; Jørgensen, Marie Birk
Aims: The aims of this study were to test whether a multi-faceted intervention effective for low back pain was effective for physical capacity, work demands, maladaptive pain behaviours, work ability and sickness absence due to low back pain. Methods: A stepped wedge cluster randomised, controlled...... trial with 594 nurses' aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support...... from management, work ability and sickness absence due to low back pain were measured every 3 months. Before and after the intervention we measured physical capacity, kinesiophobia and need for recovery. Linear mixed models adjusted for baseline values of the outcome were used to estimate the effect...
Hareva, David H; Okada, Hiroki; Kitawaki, Tomoki; Oka, Hisao
The authors previously developed a mobile ecological momentary assessment (EMA) system as a real-time data collection device using a mobile phone. In this study, a real-time advice function and real-time reporting function were added to the previous system as a supportive intervention. The improved system was found to work effectively and was applied to several clinical cases, including patients with depressive disorder, dizziness, smoking habit, and bronchial asthma. The average patient compliance rate was high (89%) without the real-time advice and higher (93%) with the advice. The trends in clinical data for patients using a mobile EMA with/without the new function were analyzed for up to several months. In the case of dizziness, an improving trend in its clinical data was observed after applying the real-time advice, and in the case of depressive disorder, a stabilizing trend was observed. The mobile EMA system with the real-time advice function could be useful as a supportive intervention in behavior modification and for motivating patients in self-management of their disease.
Downing, Katherine L; Salmon, Jo; Hinkley, Trina; Hnatiuk, Jill A; Hesketh, Kylie D
Sedentary behaviour (e.g. television viewing, sitting time) tracks over time and is associated with adverse health and developmental outcomes across the lifespan. Young children (5 years or younger) spend up to 12 h/day sedentary, of which around 2 h is spent in screen time (e.g. watching television). Interventions to reduce sedentary behaviour in early childhood report mixed results and many have limited potential for scalability. Mobile phones offer a wide-reaching, low-cost avenue for the delivery of health behaviour programmes to parents but their potential to reduce young children's sedentary behaviour has not been widely tested. This study aims to test the feasibility and efficacy of a parent-focused, predominantly mobile telephone-delivered intervention to support parents to minimise the amount of time their child spends using screens and in overall sitting time. Mini Movers is a pilot randomised controlled trial recruiting 100 parents and children. Inclusion criteria include having a child aged between 2 and 4 years, being able to speak, read and write English, and smartphone ownership. Participants will be randomised to the intervention or a wait-list control group at a 1:1 ratio. Intervention group parents will receive printed materials including a content booklet and goal-checking magnet and will participate in a one-on-one discussion with the interventionist to plan two goals to reduce their child's sedentary behaviour. Subsequently, the intervention will be delivered over 6 weeks via personalised and interactive text messages promoting positive health behaviours (strategies for decreasing screen time and overall sitting time), goal setting and self-monitoring. Outcomes to be assessed include intervention feasibility and children's screen time and objectively-assessed sitting time. Few studies have used mobile phone technology to deliver health behaviour programmes to parents of young children. Findings will inform the development of larger
Mackie, Hamish W; Charlton, Samuel G; Baas, Peter H; Villasenor, Pablo C
The self-explaining roads (SER) approach uses road designs that evoke correct expectations and driving behaviours from road users to create a safe and user-friendly road network. Following the implementation of an SER process and retrofitting of local and collector roads in a suburb within Auckland City, lower speeds on local roads and less variation in speed on both local and collector roads were achieved, along with a closer match between actual and perceived safe speeds. Preliminary analyses of crash data shows that the project has resulted in a 30% reduction crash numbers and an 86% reduction in crash costs per annum, since the road changes were completed. In order to further understand the outcomes from this project, a study was carried out to measure the effects of the SER intervention on the activity and behaviour of all road users. Video was collected over nine separate days, at nine different locations, both before and after SER construction. Road user behaviour categories were developed for all potential road users at different location types and then used to code the video data. Following SER construction, on local roads there was a relatively higher proportion of pedestrians, less uniformity in vehicle lane keeping and less indicating by motorists along with less through traffic, reflecting a more informal/low speed local road environment. Pedestrians were less constrained on local roads following SER construction, possibly reflecting a perceptually safer and more user-friendly environment. These behaviours were not generally evident on collector roads, a trend also shown by the previous study of speed changes. Given that one of the objectives of SER is to match road user behaviour with functionally different road categories, the road user behaviour differences demonstrated on different road types within the SER trial area provides further reinforcement of a successful SER trial. Copyright © 2012 Elsevier Ltd. All rights reserved.
Långh, Ulrika; Hammar, Martin; Klintwall, Lars; Bölte, Sven
Early intensive behavioural intervention (EIBI) for children with autism spectrum disorder (ASD) is often delivered using a community model. Behaviour modification experts train and supervise non-experts (e.g. preschool personnel) to teach children according to applied behaviour analysis principles in their natural environment. Several factors predict EIBI outcomes in ASD, for example, knowledge of EIBI and EIBI allegiance among trainers. The aim of the present study was to survey levels of knowledge about and allegiance towards EIBI. Formal knowledge of EIBI and EIBI allegiance was surveyed in supervised preschool staff conducting EIBI (n = 33), preschool staff not involved in EIBI (n = 26), behaviour modification experts (n = 60), school staff (n = 25) and parents of children with ASD (n = 150) [N = 294]. A 27-item (15 knowledge and 12 allegiance questions) online questionnaire was collected. Supervised preschool staff conducting EIBI had more knowledge than preschool staff not using EIBI, but they were not more allegiant. Compared with behaviour modification experts, the supervised EIBI preschool staff group showed markedly less knowledge and allegiance. Findings indicate potential for improvement regarding formal knowledge levels of preschool staff delivering EIBI to children with ASD in real-world settings. In addition, fostering EIBI allegiance might be prioritized when teaching EIBI among non-experts. Broadly increased EIBI knowledge levels among all preschool teachers should be achieved by adding behaviour modification techniques to common university curricula in preschool education. Allegiance of preschool personnel might be accomplished by EIBI supervisors meeting skepticism in practice with conveyance of evidence-based principles and discussions of ethical issues. © 2016 John Wiley & Sons Australia, Ltd.
Sharon Anne Simpson
Conclusions: This detailed user-centred development process and feasibility testing will lead to an intervention, designed and tested by users, which will have the potential to change weight related behaviours.
This paper examines the underlying theoretical philosophy of one of the most widely used cognitive behaviour therapies, rational emotive behaviour therapy. It examines whether two central theoretical principles are supported by research evidence: firstly, that irrational beliefs lead to dysfunctional emotions and inferences and that rational beliefs lead to functional emotions and inferences and, secondly, that demand beliefs are the primary core irrational belief. The established criteria for evaluating the efficacy of the theories are detailed and used to evaluate the strength of evidence supporting these two assumptions. The findings indicate there is limited evidence to support these theories. Copyright 2004 Elsevier Ltd.
Jovicic, Ana; Gardner, Benjamin; Belk, Celia; Kharicha, Kalpa; Iliffe, Steve; Manthorpe, Jill; Goodman, Claire; Drennan, Vari; Walters, Kate
Meeting the needs of the growing number of older people is a challenge for health and social care services. Home-based interventions aiming to modify health-related behaviours of frail older people have the potential to improve functioning and well-being. Previous reviews have focused on whether such interventions are effective, rather than what might make them effective. Recent advances in behavioural science make possible the identification of potential 'active ingredients' of effective interventions, such as component behaviour change techniques (BCTs), and intended intervention functions (IFs; e.g. to educate, to impart skills). This paper reports a protocol for a systematic review that seeks to (a) identify health behaviour change interventions for older frail people, (b) describe the content of these interventions, and (c) explore links between intervention content and effectiveness. The protocol is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 guidelines. Studies will be identified through a systematic search of 15 electronic databases, supplemented by citation tracking. Studies will be retained for review where they report randomised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community settings, written in English, and either published from 1980 onwards, or, for registered trials only, unpublished but completed with results obtainable from authors. Interventions will be coded for their content (BCTs, IFs) and for evidence of effectiveness (outcome data relating to behavioural and health outcomes). Analyses will describe characteristics of all interventions. Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence. The potential for each intervention characteristic to contribute to change in behaviour or
Devine, Kay; Hunter, Karen H.
This research examines doctoral student perceptions of emotional exhaustion relative to supportive supervision and the use of impression management (IM) and facades of conformity (FOC). Results indicated that supportive supervision significantly reduced emotional exhaustion and the use of self-presentation behaviours, while the use of FOC…
Tate, Robyn L; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H; Wilson, Barbara
We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.Reporting guidelines, such as the Consolidated Standards of Reporting Trials (CONSORT) Statement, improve the reporting of research in the medical literature (Turner et al., 2012). Many such guidelines exist and the CONSORT Extension to Nonpharmacological Trials (Boutron et al., 2008) provides suitable guidance for reporting between-groups intervention studies in the behavioral sciences. The CONSORT Extension for N-of-1 Trials (CENT 2015) was developed for multiple crossover trials with single individuals in the medical sciences (Shamseer et al., 2015; Vohra et al., 2015), but there is no reporting guideline in the CONSORT tradition for single-case research used in the behavioral sciences. We developed the Single
Douglass, Sarah; Palmer, Katherine; O'Connor, Chris
An anxiety management group utilizing a cognitive behavioural intervention, of 12 weeks duration, for six people with mild to moderate learning disabilities is described. A number of techniques to assist in developing clients' understanding of their anxiety, cognitive and behavioural coping strategies and maximizing generalizability of skills…
Full Text Available Abstract Background Many hazardous and harmful drinkers do not receive clinician advice to reduce their drinking. Previous studies suggest under-detection and clinician reluctance to intervene despite awareness of problem drinking (PD. The Healthy Habits Project previously reported chart review data documenting increased screening and intervention with hazardous and harmful drinkers after training clinicians and implementing routine screening. This report describes the impact of the Healthy Habits training program on clinicians' rates of identification of PD, level of certainty in identifying PD and the proportion of patients given advice to reduce alcohol use, based on self-report data using clinician exit questionnaires. Methods 28 residents and 10 faculty in a family medicine residency clinic completed four cycles of clinician exit interview questionnaires before and after screening and intervention training. Rates of identifying PD, level of diagnostic certainty, and frequency of advice to reduce drinking were compared across intervention status (pre vs. post. Findings were compared with rates of PD and advice to reduce drinking documented on chart review. Results 1,052 clinician exit questionnaires were collected. There were no significant differences in rates of PD identified before and after intervention (9.8% vs. 7.4%, p = .308. Faculty demonstrated greater certainty in PD diagnoses than residents (p = .028 and gave more advice to reduce drinking (p = .042 throughout the program. Faculty and residents reported higher levels of diagnostic certainty after training (p = .039 and .030, respectively. After training, residents showed greater increases than faculty in the percentage of patients given advice to reduce drinking (p = .038, and patients felt to be problem drinkers were significantly more likely to receive advice to reduce drinking by all clinicians (50% vs. 75%, p = .047. The number of patients receiving advice to reduce drinking
Chen, Huiqin; Chen, Lei
Alcohol is the root cause of numerous traffic accidents due to its pharmacological action on the human central nervous system. This study conducted a detection process to distinguish drunk driving from normal driving under simulated driving conditions. The classification was performed by a support vector machine (SVM) classifier trained to distinguish between these two classes by integrating both driving performance and physiological measurements. In addition, principal component analysis was conducted to rank the weights of the features. The standard deviation of R-R intervals (SDNN), the root mean square value of the difference of the adjacent R-R interval series (RMSSD), low frequency (LF), high frequency (HF), the ratio of the low and high frequencies (LF/HF), and average blink duration were the highest weighted features in the study. The results show that SVM classification can successfully distinguish drunk driving from normal driving with an accuracy of 70%. The driving performance data and the physiological measurements reported by this paper combined with air-alcohol concentration could be integrated using the support vector regression classification method to establish a better early warning model, thereby improving vehicle safety.
Full Text Available Alcohol is the root cause of numerous traffic accidents due to its pharmacological action on the human central nervous system. This study conducted a detection process to distinguish drunk driving from normal driving under simulated driving conditions. The classification was performed by a support vector machine (SVM classifier trained to distinguish between these two classes by integrating both driving performance and physiological measurements. In addition, principal component analysis was conducted to rank the weights of the features. The standard deviation of R–R intervals (SDNN, the root mean square value of the difference of the adjacent R–R interval series (RMSSD, low frequency (LF, high frequency (HF, the ratio of the low and high frequencies (LF/HF, and average blink duration were the highest weighted features in the study. The results show that SVM classification can successfully distinguish drunk driving from normal driving with an accuracy of 70%. The driving performance data and the physiological measurements reported by this paper combined with air-alcohol concentration could be integrated using the support vector regression classification method to establish a better early warning model, thereby improving vehicle safety.
Middelkamp, P.J.C.; Wolfhagen, P.; Steenbergen, B.
Introduction: The transtheoretical model of behaviour change (TTM) is often used to understand and predict changes in health related behaviour, for example exercise behaviour and eating behaviour. Fitness professionals like personal trainers typically service and support clients in improving
Laureane du Plessis
Full Text Available Purpose and objective: The purpose of this paper is to provide a better understanding of different generations' supporting behaviour towards non-profit organisations (NPOs. It more specifically focuses on uncovering the different methods with which the generations support NPOs; how frequently they support NPOs; the type of NPOs that they prefer supporting; and the reasons why they support NPOs. Problem Investigated: Non-profit organisations (NPOs are facing greater challenges than ever before. They have to compete with a growing number of other NPOs for donations and volunteers. Their traditional support from Baby Boomers is declining as this generation grows older and supports NPOs to a lesser extent than before. NPOs are therefore compelled to pay more attention to younger generations as a possible donor base and source for volunteers. It is therefore critical for an NPO that wishes to survive and prosper to understand the supporting behaviour of the different generations in order to successfully target them to grow the donor and volunteer base. Methodology: A descriptive research design was followed. A self-administered questionnaire was fielded amongst a target population that included Baby Boomers, Generation X and Generation Y consumers residing in Gauteng who have supported an NPO in the previous year. Quota sampling was used to ensure that equal numbers of respondents from the different generations were included, while each quota was filled on the basis of convenience to collect 602 responses for analysis. Findings: The results reveal significant associations between the different generations and different supporting behaviours. Significant differences were also uncovered between the different generations and the reasons for supporting NPOs. The paper reveals a number of marketing strategies NPOs could follow to encourage supporting behaviour from the different generations. Value of the research: This research provides insights into the
Flaherty, Sarah-Jane; McCarthy, Mary; Collins, Alan; McAuliffe, Fionnuala
To assess the quality of nutrition content and the integration of user quality components and behaviour change theory relevant to food purchasing behaviour in a sample of existing mobile apps. Descriptive comparative analysis of eleven mobile apps comprising an assessment of their alignment with existing evidence on nutrition, behaviour change and user quality, and their potential ability to support healthier food purchasing behaviour. Mobile apps freely available for public use in GoogePlay were assessed and scored according to agreed criteria to assess nutrition content quality and integration of behaviour change theory and user quality components. A sample of eleven mobile apps that met predefined inclusion criteria to ensure relevance and good quality. The quality of the nutrition content varied. Improvements to the accuracy and appropriateness of nutrition content are needed to ensure mobile apps support a healthy behaviour change process and are accessible to a wider population. There appears to be a narrow focus towards behaviour change with an overemphasis on behavioural outcomes and a small number of behaviour change techniques, which may limit effectiveness. A significant effort from the user was required to use the mobile apps appropriately which may negatively influence user acceptability and subsequent utilisation. Existing mobile apps may offer a potentially effective approach to supporting healthier food purchasing behaviour but improvements in mobile app design are required to maximise their potential effectiveness. Engagement of mobile app users and nutrition professionals is recommended to support effective design.
Schüz, Benjamin; Wiedemann, Amelie U; Mallach, Natalie; Scholz, Urte
Regular dental flossing has been widely recommended to prevent periodontal diseases. Nevertheless, compliance is below a desirable level. This study evaluates the effects of a brief behavioural intervention on dental flossing and determines whether the effects of such an intervention are stronger in a specific subgroup of individuals (those intending to floss regularly=implemental mindset). Behavioural intervention (planning when, where and how to floss) trial was conducting with 194 participants assigned to an intervention or a control group by a random time schedule; the primary outcome was validated self-report of flossing behaviour. Follow-up data were collected 2 and 8 weeks post-intervention. Individuals receiving the planning intervention significantly outperformed those in the control condition at both the 2- and the 8-week follow-up (4.24 times flossing/week versus 3.9 at 2 weeks; 4.02 versus 2.98 at 8 weeks). Intervention effects were stronger in individuals in the implemental mindset. Dropout rates were higher for participants who received the planning intervention but were not in the implemental mindset. Planning interventions are an economic and effective way to change oral self-care behaviour, and are more effective in individuals in an implemental mindset.
Mackenzie, Catherine; Lowit, Anja
There is little published intervention outcome literature concerning dysarthria acquired from stroke. Single case studies have potential for more detailed specification and interpretation than is generally possible in larger studies so are informative for clinicians dealing with similar cases. Such research also contributes to planning of larger scale investigations. Behavioural intervention is described which was carried out between 7-9 months after stroke with a 69-year-old man with severe dysarthria. Pre-intervention stability between 5-7 months contrasted with post-intervention gains. Significant improvement was demonstrated using randomized, blinded assessment by 10 judges on measures of word and reading intelligibility and communication effectiveness in conversation. A range of speech analyses were undertaken (rate, pause, and intonation characteristics in connected speech and single word phonetic transcription), with the aim of identifying speech components which might explain the listeners' perceptions of improvement. Changes were detected mainly in parameters related to utterance segmentation and intonation. The basis of post-intervention improvement in dysarthria is complex, both in terms of the active therapeutic dimensions and also the specific speech alterations which account for changes to intelligibility and effectiveness.
Itziar Iruarrizaga Díez
Full Text Available In Spain, the importance and relevance of substance dependence and other addictive behaviours has generated great interest among the scientific community. Since its creation in 1992, Psychosocial Intervention. Journal on Equality and Quality of Life has transmitted the needs and training demands of psychologists, paying special attention to those aspects related to prevention, health outcomes and psychosocial factors involved in the onset and maintenance of drug addiction, psychosocial intervention and the treatment of addictive behaviours. As an introduction to this report on the Scientific evidence in the study and treatment of addictive behaviours, all topics covered by this journal throughout the years will be addressed.
Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael
Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people.
Bergh, I.H.; van Stralen, M.M.; Bjelland, M.; Grydeland, M.; Lien, N.; Klepp, K.I.; Anderssen, S.A.; Ommundsen, Y.
Background: To improve effectiveness of future screen behaviour interventions, one needs to know whether an intervention works via the proposed mediating mechanisms and whether the intervention is equally effective among subgroups. Parental regulation is identified as a consistent correlate of
Mc Sharry, J; Murphy, P J; Byrne, M
Decreased sexual activity and sexual problems are common among people with cardiovascular disease, negatively impacting relationship satisfaction and quality of life. International guidelines recommend routine delivery of sexual counselling to cardiac patients. The Cardiac Health and Relationship Management and Sexuality (CHARMS) baseline study in Ireland found, similar to international findings, limited implementation of sexual counselling guidelines in practice. The aim of the current study was to develop the CHARMS multi-level intervention to increase delivery of sexual counselling by healthcare professionals. We describe the methods used to develop the CHARMS intervention following the three phases of the Behaviour Change Wheel approach: understand the behaviour, identify intervention options, and identify content and implementation options. Survey (n = 60) and focus group (n = 14) data from two previous studies exploring why sexual counselling is not currently being delivered were coded by two members of the research team to understand staff's capability, opportunity, and motivation to engage in the behaviour. All potentially relevant intervention functions to change behaviour were identified and the APEASE (affordability, practicability, effectiveness, acceptability, side effects and equity) criteria were used to select the most appropriate. The APEASE criteria were then used to choose between all behaviour change techniques (BCTs) potentially relevant to the identified functions, and these BCTs were translated into intervention content. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention including the who, what, how and where of proposed intervention delivery. Providing sexual counselling group sessions by cardiac rehabilitation staff to patients during phase III cardiac rehabilitation was identified as the target behaviour. Education, enablement, modelling, persuasion and
Clarkesmith, Danielle E; Pattison, Helen M; Khaing, Phyo H; Lane, Deirdre A
Current guidelines recommend oral anticoagulation therapy for patients with atrial fibrillation (AF) with one or more risk factors for stroke; however, anticoagulation control (time in therapeutic range (TTR)) with vitamin K antagonists (VKAs) is dependent on many factors. Educational and behavioural interventions may impact patients' ability to maintain their international normalised ratio (INR) control. This is an updated version of the original review first published in 2013. To evaluate the effects of educational and behavioural interventions for oral anticoagulation therapy (OAT) on TTR in patients with AF. We updated searches from the previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) in The Cochrane Library (January 2016, Issue 1), MEDLINE Ovid (1949 to February week 1 2016), EMBASE Classic + EMBASE Ovid (1980 to Week 7 2016), PsycINFO Ovid (1806 to Week 1 February 2016) and CINAHL Plus with Full Text EBSCO (1937 to 16/02/2016). We applied no language restrictions. We included randomised controlled trials evaluating the effect of any educational and behavioural intervention compared with usual care, no intervention, or intervention in combination with other self-management techniques among adults with AF who were eligible for, or currently receiving, OAT. Two of the review authors independently selected studies and extracted data. Risk of bias was assessed using the Cochrane 'Risk of bias' tool. We included outcome data on TTR, decision conflict (patient's uncertainty in making health-related decisions), percentage of INRs in the therapeutic range, major bleeding, stroke and thromboembolic events, patient knowledge, patient satisfaction, quality of life (QoL), beliefs about medication, illness perceptions, and anxiety and depression. We pooled data for three outcomes - TTR, anxiety and depression, and decision conflict - and reported mean differences (MD). Where
Gaydos, C A; Hsieh, Y-H; Galbraith, J S; Barnes, M; Waterfield, G; Stanton, B
A community-based intervention, Focus-on-Kids (FOK) has demonstrated risk-behaviour reduction of urban youth. We modified FOK to Focus-on-Teens (FOT) for high schools. High school adolescents (n=1190) were enrolled over successive school semesters. The small-group sessions were presented during the school-lunch hours. Confidential surveys were conducted at baseline, immediate, six-, and 12-month postintervention for demographics, parental communication/monitoring, sexual risk behaviours and sexually transmitted diseases (STDs)/HIV/condom-usage knowledge. Sexually active participants were encouraged to volunteer for urine-based STDs testing at the School-Based Health Centres. Many (47.4%) students reported having had sexual intercourse at baseline. Overall behaviours changed towards 'safer' sex behaviours (intent-to-use and using condoms, communicating with partner/parents about sex/condoms/STDs) with time (Pcorrect knowledge of STDs/HIV increased to 88% at time 4 from 80% at baseline after adjusting for age, gender and sexual activity (Pcondom usage, decreases in sexual risk behaviours supported the effectiveness of this intervention.
Sowden, Hannah; Perkins, Mick; Clegg, Judy
There are many different approaches to intervention aimed at facilitating the social and communicative abilities of children with Autistic Spectrum Disorders (ASD). Behavioural interventions seek to improve the social and communicative abilities of children with ASD through interaction. Recently there has been a move towards naturalistic…
Full Text Available Questions: Does a 3-month behaviour change intervention targeting physical activity (PA increase habitual physical activity in adults with ankylosing spondylitis (AS? Does the intervention improve health-related physical fitness, AS-related features, and attitude to exercise? Are any gains maintained over a 3-month follow-up
Schüz, Benjamin; Wiedemann, Amelie U.; Mallach, Natalie; Scholz, Urte
Regular dental flossing has been widely recommended to prevent periodontal diseases. Nevertheless, compliance is below a desirable level. This study evaluates the effects of a brief behavioural intervention on dental flossing and determines whether the effects of such an intervention are stronger in a specific subgroup of individuals (those intending to floss regularly=implemental mindset).
Koskinen, Esa; Salminen, Jukka
Recorded self-observations on a regular basis is an important component in many health behavior interventions. Using information and communication technologies (ICT) and especially mobile eHealth applications is a promising way of improving user-friendliness and possibly the overall effectiveness of self-monitoring. Mobility as such brings the added value of continuous availability and timely information access. One additional benefit of ICT based solutions is the possibility for various types of customization, allowing support for a wider set of application requirements than was originally planned, and meeting changing needs and targets of individuals, groups or larger user segments. In this paper, we present a customizable mobile application for recording and managing health related self-observations, Wellness Diary, and the ideas and technical solutions for supporting tailoring of the application. The main idea is to allow end-users to freely change the data model in the application, and customize related data presentations. This work has been done in Nuadu ITEA project, as well as further work where the effectiveness of the mobile tool and other ICT technologies will be investigated in a controlled trial in Finland. We'll also present shortly a counterpart for the mobile application, a web service that should bring some added value for the end user.
Johnson, Mark J; May, Carl R
Translating research evidence into routine clinical practice is notoriously difficult. Behavioural interventions are often used to change practice, although their success is variable and the characteristics of more successful interventions are unclear. We aimed to establish the characteristics of successful behaviour change interventions in healthcare. We carried out a systematic overview of systematic reviews on the effectiveness of behaviour change interventions with a theory-led analysis using the constructs of normalisation process theory (NPT). MEDLINE, CINAHL, PsychINFO and the Cochrane Library were searched electronically from inception to July 2015. Primary and secondary care. Participants were any patients and healthcare professionals in systematic reviews who met the inclusion criteria of having examined the effectiveness of professional interventions in improving professional practice and/or patient outcomes. Professional interventions as defined by the Cochrane Effective Practice and Organisation of Care Review Group. Success of each intervention in changing practice or patient outcomes, and their mechanisms of action. Reviews were coded as to the interventions included, how successful they had been and which NPT constructs its component interventions covered. Searches identified 4724 articles, 67 of which met the inclusion criteria. Interventions fell into three main categories: persuasive; educational and informational; and action and monitoring. Interventions focusing on action or education (eg, Audit and Feedback, Reminders, Educational Outreach) acted on the NPT constructs of Collective Action and Reflexive Monitoring, and reviews using them tended to report more positive outcomes. This theory-led analysis suggests that interventions which contribute to normative restructuring of practice, modifying peer group norms and expectations (eg, educational outreach) and relational restructuring, reinforcing modified peer group norms by emphasising the
Stuttard, Lucy; Beresford, Bryony; Clarke, Susan; Beecham, Jennifer; Todd, Samantha; Bromley, Jo
Evidence on the effectiveness of interventions to support parents of disabled children to manage their child's behaviour problems is limited. The aim of this study was to evaluate a group-delivered intervention (Riding the Rapids) which was specifically developed for parents of a child with a disability or autistic spectrum condition. This programme has been routinely delivered by a community-based mental health team across an urban, multi-ethnic locality for a number of years. A non-randomised controlled study design comprising an intervention group (n=48) and comparator (no intervention) group (n=28) was used to evaluate the effects of the intervention on child behaviour (Eyberg Child Behaviour Inventory; parent-set goals) and parenting efficacy and satisfaction (Parents Sense of Competence Scale) at post-intervention and six-month follow-up. Data on costs to the service provider of delivering the intervention were also collected. Receipt of the intervention was associated with significant reductions in parent-reported behaviour problems and significant improvements in parenting efficacy and satisfaction. At six-month follow-up, progress towards achieving parent-set child behaviour goals and parenting satisfaction had been maintained. Post hoc analysis suggests parents who do not have English as a first language may not benefit as much as other parents from this intervention. Findings suggest this is a promising intervention for parents of a child with a disability that is likely to be less resource intensive to service providers than individually delivered interventions. Limitations and implications for future research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Wright, Kath; Golder, Su; Rodriguez-Lopez, Rocio
The value of citation searches as part of the systematic review process is currently unknown. While the major guides to conducting systematic reviews state that citation searching should be carried out in addition to searching bibliographic databases there are still few studies in the literature that support this view. Rather than using a predefined search strategy to retrieve studies, citation searching uses known relevant papers to identify further papers. We describe a case study about the effectiveness of using the citation sources Google Scholar, Scopus, Web of Science and OVIDSP MEDLINE to identify records for inclusion in a systematic review.We used the 40 included studies identified by traditional database searches from one systematic review of interventions for multiple risk behaviours. We searched for each of the included studies in the four citation sources to retrieve the details of all papers that have cited these studies.We carried out two analyses; the first was to examine the overlap between the four citation sources to identify which citation tool was the most useful; the second was to investigate whether the citation searches identified any relevant records in addition to those retrieved by the original database searches. The highest number of citations was retrieved from Google Scholar (1680), followed by Scopus (1173), then Web of Science (1095) and lastly OVIDSP (213). To retrieve all the records identified by the citation tracking searching all four resources was required. Google Scholar identified the highest number of unique citations.The citation tracking identified 9 studies that met the review's inclusion criteria. Eight of these had already been identified by the traditional databases searches and identified in the screening process while the ninth was not available in any of the databases when the original searches were carried out. It would, however, have been identified by two of the database search strategies if searches had been
Tate, Robyn L.; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H.; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J.; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H.; Wilson, Barbara
ABSTRACT We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts. SCIENTIFIC ABSTRACT Reporting guidelines, such as the Consolidated Standards of Reporting Trials (CONSORT) Statement, improve the reporting of research in the medical literature (Turner et al., 2012). Many such guidelines exist and the CONSORT Extension to Nonpharmacological Trials (Boutron et al., 2008) provides suitable guidance for reporting between-groups intervention studies in the behavioural sciences. The CONSORT Extension for N-of-1 Trials (CENT 2015) was developed for multiple crossover trials with single individuals in the medical sciences (Shamseer et al., 2015; Vohra et al., 2015), but there is no reporting guideline in the CONSORT tradition for single-case research used in the behavioural sciences. We
Full Text Available Self-esteem is related to the individuals understanding and accepting the existing character and attitude to themselves. Failure to understand and accept their own strengths and weaknesses and in the same time do not have the skills to cope with it will caused them to be classified in the group who have low levels of self esteem. The up and down in self esteem will seriously affect the person emotional development and their reasoning process. Thus, reforming self esteem is an important key to help the rehabilition of drug abuser. Therefore, the purpose of this study is to investigate the effects of Brief Group Cognitive Behavioural Therapy on self-esteem among drug users. The quasi experimental design with one treatment group and one control group and four measurements (Pre Test, Post 1, Post 2 and Post 3 were employed in this study. The sample of 108 drugs users was chosen using purposive sampling procedure. Data were collected using standardized psychometric instruments, including Internal Control Index (Patricia Duttweiler, 1984 and The Rosenberg Self-Esteem Scale and were analysed using descriptive analysis. The findings shows the intervention of group Brief Cognitive Behavioural Therapy CBT (B are succeed in increasing self-esteem mean score compared to control group in different time interval. As a conclusion, self-esteem among the subjects can be enhanced with an intervention of proper and systematic therapy instead of unplanned therapy sessions
Lopez-Gomez, Irene; Chaves, Covadonga; Hervas, Gonzalo; Vazquez, Carmelo
There is growing evidence on the efficacy of positive psychology interventions (PPI) to treat clinical disorders. However, very few studies have addressed their acceptability. The present study aimed to analyse 2 key components of acceptability (i.e., client satisfaction and adherence to treatment) of a new PPI programme, the Integrative Positive Psychological Intervention for Depression (IPPI-D), in comparison to a standard cognitive behavioural therapy (CBT) programme in the treatment of clinical depression. One hundred twenty-eight women with a DSM-IV diagnosis of major depression or dysthymia were allocated to a 10-session IPPI-D or CBT group intervention condition. Results showed that both interventions were highly acceptable for participants. Attendance rates were high, and there were no significant differences between conditions. However, the IPPI-D condition showed significantly higher client satisfaction than the CBT condition. Moreover, acceptability did not differ based on participants' severity of symptoms, regardless of condition. These findings encourage further investigations of the applicability of PPI in clinical settings in order to broaden the range of acceptable and suitable therapies for depressed patients. Key Practitioner Message This study sheds light on the client satisfaction and adherence to a positive intervention. For participants, positive psychology interventions (PPI) may be more satisfactory than CBT as PPI are framed within a positive mental health model and, consequently, may reduce the risk of stigmatization Because acceptability of treatments and preferences may affect the efficacy of treatments, this study provides an excellent opportunity to offer professionals more therapeutic options to tailor treatments to clients' needs and expectations. Copyright © 2017 John Wiley & Sons, Ltd.
Mohammadifard, Noushin; Kelishadi, Roya; Safavi, Morteza; Sarrafzadegan, Nizal; Sajadi, Firoozeh; Sadri, Gholam Hosein; Maghroon, Maryam; Alikhasi, Hasan; Heydari, Said; Sarmadi, Fereshteh
The present study was conducted to determine the impact of a community-based intervention on the nutritional behaviour of a representative sample of Iranian adults. The Isfahan Healthy Heart Programme (IHHP), a six-year, action-oriented, integrated community-based study aimed at health promotion through the reduction of CVD risk factors, targeted the whole population living in two intervention cities, and compared outcomes with the population of a non-intervention city considered as reference. Dietary interventions were performed as educational, environmental and/or legislative strategies. A global dietary index (GDI) was calculated representing the general dietary behaviour. In addition, two consumption indices were calculated for specific food groups, i.e. meat products and major sources of fat. Univariate AVOVA was conducted to evaluate the impact of the intervention on dietary behaviours. Isfahan and Najaf-Abad (intervention cities) and Arak (reference city), central Iran. The baseline survey was conducted among 12514 randomly selected adults aged > or =19 years in both intervention and reference areas. The survey was repeated annually among about 5000 persons (2002-2005) in the intervention and reference communities. According to significant year x group interactions in mean fat consumption index (FCI) and meat consumption index (MCI) in the total population, a significant improvement in FCI and MCI was found in the intervention areas v. the reference area (P intervention areas v. the reference area (P interventions were effective in improving dietary behaviours at the population level. The highest effectiveness was documented in the change in the type of fat consumed. Such simple and integrated interventions can be adopted in other developing countries with limited financial resources.
Boccaccini, Dino; Frandsen, Henrik Lund; Sudireddy, Bhaskar Reddy
The creep behaviour of porous ironechromium alloy used as solid oxide fuel cell support was investigated, and the creep parameters are compared with those of dense strips of similar composition under different testing conditions. The creep parameters were determined using a thermo-mechanical anal......The creep behaviour of porous ironechromium alloy used as solid oxide fuel cell support was investigated, and the creep parameters are compared with those of dense strips of similar composition under different testing conditions. The creep parameters were determined using a thermo......-mechanical analyser with applied stresses in the range from 1 to 15 MPa and temperatures between 650 and 800 _C. The GibsoneAshby and Mueller models developed for uniaxial creep of open-cell foams were used to analyse the results. The influence of scale formation on creep behaviour was assessed by comparing the creep...
Full Text Available Participant reports of their own behaviour are critical for the provision and evaluation of behavioural interventions. Recent developments in brief alcohol intervention trials provide an opportunity to evaluate longstanding concerns that answering questions on behaviour as part of research assessments may inadvertently influence it and produce bias. The study objective was to evaluate the size and nature of effects observed in randomized manipulations of the effects of answering questions on drinking behaviour in brief intervention trials.Multiple methods were used to identify primary studies. Between-group differences in total weekly alcohol consumption, quantity per drinking day and AUDIT scores were evaluated in random effects meta-analyses. Ten trials were included in this review, of which two did not provide findings for quantitative study, in which three outcomes were evaluated. Between-group differences were of the magnitude of 13.7 (-0.17 to 27.6 grams of alcohol per week (approximately 1.5 U.K. units or 1 standard U.S. drink and 1 point (0.1 to 1.9 in AUDIT score. There was no difference in quantity per drinking day.Answering questions on drinking in brief intervention trials appears to alter subsequent self-reported behaviour. This potentially generates bias by exposing non-intervention control groups to an integral component of the intervention. The effects of brief alcohol interventions may thus have been consistently under-estimated. These findings are relevant to evaluations of any interventions to alter behaviours which involve participant self-report.
Horne, Justine; Madill, Janet; O'Connor, Colleen; Shelley, Jacob; Gilliland, Jason
Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provided to participants while aiming to determine whether or not genetic testing facilitates changes in lifestyle habits. This review is timely in light of a recently published "call-to-action" paper, highlighting the need to incorporate the TPB into personalized healthcare behaviour change research. Three bibliographic databases, one key website, and article reference lists were searched for relevant primary research articles. The PRISMA Flow Diagram and PRISMA Checklist were used to guide the search strategy and manuscript preparation. Out of 32,783 titles retrieved, 26 studies met the inclusion criteria. Three quality assessments were conducted and included: (1) risk of bias, (2) quality of genetic interventions, and (3) consideration of theoretical underpinnings - primarily the TPB. Risk of bias in studies was overall rated to be "fair." Consideration of the TPB was "poor," with no study making reference to this validated theory. While some studies (n = 11; 42%) made reference to other
Ojo, Olumuyiwa; Verbeek, Jos H; Rasanen, Kimmo; Heikkinen, Jarmo; Isotalo, Leena K; Mngoma, Nomusa; Ruotsalainen, Eija
The workplace provides an important avenue to prevent HIV. To evaluate the effect of behavioral interventions for reducing HIV on high risk sexual behavior when delivered in an occupational setting. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO up until March 2011 and CINAHL, LILACS, DARE, OSH Update, and EPPI database up until October 2010. Randomised control trials (RCTs) in occupational settings or among workers at high risk for HIV that measured HIV, sexual transmitted diseases (STD), Voluntary Counseling and Testing (VCT), or risky sexual behaviour. Two reviewers independently selected studies for inclusion, extracted data and assessed risk of bias. We pooled studies that were similar. We found 8 RCTs with 11,164 participants but one study did not provide enough data. Studies compared VCT to no VCT and education to no intervention and to alternative education.VCT uptake increased to 51% when provided at the workplace compared to a voucher for VCT (RR=14.0 (95% CI 11.8 to16.7)). After VCT, self-reported STD decreased (RR = 0.10 (95% CI 0.01 to 0.73)) but HIV incidence (RR=1.4 (95% CI 0.7 to 2.7)) and unprotected sex (RR=0.71 (0.48 to 1.06)) did not decrease significantly. .Education reduced STDs (RR = 0.68 (95%CI 0.48 to 0.96)), unprotected sex (Standardised Mean Difference (SMD)= -0.17 (95% CI -0.29 to -0.05), sex with a commercial sex worker (RR = 0.88 (95% CI 0.81 to 0.96) but not multiple sexual partners (Mean Difference (MD) = -0.22 (95% CI -0.52 to 0.08) nor use of alcohol before sex (MD = -0.01 (95% CI of -0.11 to 0.08). Workplace interventions to prevent HIV are feasible. There is moderate quality evidence that VCT offered at the work site increases the uptake of testing. Even though this did no lower HIV-incidence, there was a decrease in self-reported sexual transmitted diseases and a decrease in risky sexual behaviour. There is low quality evidence that educational interventions decrease sexually
Alberts, H J E M; Thewissen, R; Raes, L
This study explored the efficacy of a mindfulness-based intervention for problematic eating behavior. A non-clinical sample of 26 women with disordered eating behavior was randomly assigned to an 8-week MBCT-based eating intervention or a waiting list control group. Data were collected at baseline and after 8 weeks. Compared to controls, participants in the mindfulness intervention showed significantly greater decreases in food cravings, dichotomous thinking, body image concern, emotional eating and external eating. These findings suggest that mindfulness practice can be an effective way to reduce factors that are associated with problematic eating behaviour. Copyright © 2012 Elsevier Ltd. All rights reserved.
Ingemarson, Maria; Bodin, Maria; Rubenson, Birgitta; Guldbrandsson, Karin
Purpose: The purpose of this paper is to investigate how teachers received and perceived the school programme Prevention in School (PS), a positive behavioural support programme; how did the teachers perceive the programme characteristics and themselves as providers; and how did this affect programme implementation? Design/methodology/approach:…
A questionnaire survey among 170 employees of a Dutch company showed that supervisor supportiveness moderated the relationship between employees' perceived influence in the workplace and their levels of innovative behaviour. As hypothesized, the results suggest that when supervisors are perceived as
Merrick, Alistair D.; Grieve, Alan; Cogan, Nicola
Despite increased risk of experiencing challenging behaviour, psychological impacts on community and residential staff supporting adults with autistic spectrum conditions are under-explored. Studies examining related roles indicate protective psychological factors may help maintain staff well-being. This study investigated relationships between…
The article explores the relationship between social support and health behaviour of rural and urban women who are living with HIV in South Africa. .... access to medical and mental health care, elevated levels of loneliness, more community .... not have breakfast, 11% had no lunch and 16% did not have supper (N = 185).
Griggs, James; Walker, Lawrence; Hornby, Garry
This study examines the perceptions of teachers and other professionals of Team-Teach behaviour support training in New Zealand. Analysis of course evaluations, questionnaires, interviews and documents provide the findings. Comparisons are made with Team-Teach training in the UK and similarities and differences between New Zealand training…
Pfeiffer, Jens P.; Pinquart, Martin; Krick, Kathrin
Social development may vary depending on contextual factors, such as attending a day school or a boarding school. The present study compares students from these school types with regard to the achievement of specific social goals, perceived social support, and reported prosocial behaviour. A sample of 701 students was examined. Students from…
Coyl, Diana D.; Newland, Lisa A.; Freeman, Harry
Associations between preschoolers' attachment security, parenting behaviours (i.e. parent-child involvement, parenting consistency and co-parenting consistency) and parenting context (i.e. parents' internal working models (IWMs) and use of social support) were examined in a sample of 235 culturally diverse families. The authors predicted that…
Nijs, S; Vlaskamp, C; Maes, B
The multiple and complex disabilities of persons with profound intellectual and multiple disabilities (PIMD) form a barrier for peer interactions and peer-directed behaviours. In this study, we further explore the nature of peer-directed behaviours in persons with PIMD and its relationship with social scaffolding behaviour of direct support workers (DSWs). Fourteen dyads of children with PIMD, who knew each other for at least 12 months, participated. They were sitting in close proximity while they were filmed with and without the presence of the DSW. Video recordings were coded continuously making use of observation schemes for the peer-directed behaviours of the children and the peer interaction influencing behaviours of the DSW. Significantly more singular peer-directed behaviour (without DSW: 18.00%; with DSW: 3.81%) was observed than multiple peer-directed behaviour (without DSW: 4.01%; with DSW: 0.52%). The amount of time the singular and multiple peer-directed behaviours were observed was significantly lower in the presence of a DSW. When the DSW shows peer interaction influencing behaviour, it was mostly social scaffolding behaviour (2.17%). The conditional probability of observing social scaffolding behaviour in the 10 s following on singular peer-directed behaviour was 0.02 with a Yule's Q of 0.04 and following on multiple peer-directed behaviour 0.04 with a Yule's Q of 0.33. The way in which peer interactions in children with PIMD are defined could have an impact on the amount of observed peer-directed behaviours and on the effect of the social scaffolding behaviours presented by DSW. © 2015 John Wiley & Sons Ltd.
Beaulac, Julie; Sandre, Daniella
Patient selection of weight management treatment option is often guided by a variety of factors. Currently, there is no comprehensive tool to facilitate informed decision-making for patients and clinicians. This article aims to synthesise evidence on the treatment effectiveness, health benefits, risks, and patient experiences of treatment options presently available at the Weight Management Clinic at The Ottawa Hospital (TOH), as a first step towards developing a decision aid. Narrative and systematic reviews published in English between 1999 and 2014 were included that focused on one or more of the following weight management treatments in adults aged 18 years and over: roux-en-y gastric bypass (RYGB), sleeve gastrectomy (SG), medically supervised meal replacement, and behavioural or lifestyle intervention. Overall, bariatric surgeries have received the greatest research attention and have been associated not only with greater weight loss and health benefit but also with greater risks, complications, and financial cost. Dietary programmes demonstrated weight loss and health benefits to a lesser extent than with surgery but were associated with lower and shorter-term risks and complications. Behavioural and lifestyle interventions have been studied less yet have shown significant, albeit small, weight loss outcomes alone and in combination with dietary or surgical options; they also appear to be the lowest risk interventions. Patient experiences of weight management options are mixed and not well understood. Further research is needed; however, this review identified some general trends related to weight loss outcomes, benefits, risks, and barriers for weight management options that have implications for shared treatment decision-making.
Moore, Julia E; Mascarenhas, Alekhya; Marquez, Christine; Almaawiy, Ummukulthum; Chan, Wai-Hin; D'Souza, Jennifer; Liu, Barbara; Straus, Sharon E
As evidence-informed implementation interventions spread, they need to be tailored to address the unique needs of each setting, and this process should be well documented to facilitate replication. To facilitate the spread of the Mobilization of Vulnerable Elders in Ontario (MOVE ON) intervention, the aim of the current study is to develop a mapping guide that links identified barriers and intervention activities to behaviour change theory. Focus groups were conducted with front line health-care professionals to identify perceived barriers to implementation of an early mobilization intervention targeted to hospitalized older adults. Participating units then used or adapted intervention activities from an existing menu or developed new activities to facilitate early mobilization. A thematic analysis was performed on the focus group data, emphasizing concepts related to barriers to behaviour change. A behaviour change theory, the 'capability, opportunity, motivation-behaviour (COM-B) system', was used as a taxonomy to map the identified barriers to their root causes. We also mapped the behaviour constructs and intervention activities to overcome these. A total of 46 focus groups were conducted across 26 hospital inpatient units in Ontario, Canada, with 261 participants. The barriers were conceptualized at three levels: health-care provider (HCP), patient, and unit. Commonly mentioned barriers were time constraints and workload (HCP), patient clinical acuity and their perceived 'sick role' (patient), and lack of proper equipment and human resources (unit level). Thirty intervention activities to facilitate early mobilization of older adults were implemented across hospitals; examples of unit-developed intervention activities include the 'mobility clock' communication tool and the use of staff champions. A mapping guide was created with barriers and intervention activities matched though the lens of the COM-B system. We used a systematic approach to develop a guide
Kaner Eileen FS
Full Text Available Abstract Background Evidence shows that antibiotics have limited effectiveness in the management of upper respiratory tract infection (URTI yet GPs continue to prescribe antibiotics. Implementation research does not currently provide a strong evidence base to guide the choice of interventions to promote the uptake of such evidence-based practice by health professionals. While systematic reviews demonstrate that interventions to change clinical practice can be effective, heterogeneity between studies hinders generalisation to routine practice. Psychological models of behaviour change that have been used successfully to predict variation in behaviour in the general population can also predict the clinical behaviour of healthcare professionals. The purpose of this study was to design two theoretically-based interventions to promote the management of upper respiratory tract infection (URTI without prescribing antibiotics. Method Interventions were developed using a systematic, empirically informed approach in which we: selected theoretical frameworks; identified modifiable behavioural antecedents that predicted GPs intended and actual management of URTI; mapped these target antecedents on to evidence-based behaviour change techniques; and operationalised intervention components in a format suitable for delivery by postal questionnaire. Results We identified two psychological constructs that predicted GP management of URTI: "Self-efficacy," representing belief in one's capabilities, and "Anticipated consequences," representing beliefs about the consequences of one's actions. Behavioural techniques known to be effective in changing these beliefs were used in the design of two paper-based, interactive interventions. Intervention 1 targeted self-efficacy and required GPs to consider progressively more difficult situations in a "graded task" and to develop an "action plan" of what to do when next presented with one of these situations. Intervention 2
Vorderstrasse, Allison; Lewinski, Allison; Melkus, Gail D'Eramo; Johnson, Constance
eHealth interventions have been increasingly used to provide social support for self-management of type 2 diabetes. In this review, we discuss social support interventions, types of support provided, sources or providers of support, outcomes of the support interventions (clinical, behavioral, psychosocial), and logistical and clinical considerations for support interventions using eHealth technologies. Many types of eHealth interventions demonstrated improvements in self-management behaviors, psychosocial outcomes, and clinical measures, particularly HbA1c. Important factors to consider in clinical application of eHealth support interventions include participant preferences, usability of eHealth technology, and availability of personnel to orient or assist participants. Overall, eHealth is a promising adjunct to clinical care as it addresses the need for ongoing support in chronic disease management.
Glozah, Franklin N; Pevalin, David J
To examine the role of perceived social support and parental education on physical activity and eating behaviour of Ghanaian adolescents. Seven hundred and seventy Senior High School students (504 boys and 266 girls) between the ages of 14-21 years participated by completing questionnaires on perceived social support, physical activity and eating behaviour. The highest education attained by either parent or guardian was also obtained. Multivariate analysis of covariance was the main statistical test used to analyse the data. The results showed significant gender differences in physical activity and eating behaviour combined, with boys more likely to engage in physical activity than girls, and girls also more likely to engage in healthy eating behaviour than boys, albeit the effect was not statistically significant. While perceived social support had a significant positive effect on eating behaviour and physical activity, parental education had a significant effect only on eating behaviour but not physical activity. Perceived social support from family coupled with parental education provides more opportunities for adolescents to engage in healthy eating behaviour. Also, parents' educational attainment alone does not necessarily guarantee that adolescents will engage in physical activity; providing the needed social support and conducive home environment is more likely to induce physical activity behaviours. Finally, physical activity and eating behaviour should not be construed as alternative health behaviours as suggested by gender differentials in these health behaviours.
Iemmi, Valentina; Knapp, Martin; Brown, Freddy Jackson
Decision-makers with limited budgets want to know the economic consequences of their decisions. Is there an economic case for positive behavioural support (PBS)? A small before-after study assessing the impact of PBS on challenging behaviours and positive social and communication skills in children and adolescents with intellectual disabilities…
Rana, Fareez; Gormez, Aynur; Varghese, Susan
Self-injurious behaviour among people with intellectual disability is relatively common and often persistent. Self-injurious behaviour continues to present a challenge to clinicians. It remains poorly understood and difficult to ameliorate despite advances in neurobiology and psychological therapies. There is a strong need for a better evidence base in prescribing and monitoring of drugs in this population, especially since none of the drugs are actually licensed for self-injurious behaviour. To determine clinical effectiveness of pharmacological interventions in management of self-injurious behaviour in adults with intellectual disability. We searched the following databases on 19 February 2012: CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, Science Citation Index, Social Science Citation Index, Conference Proceedings Citation Index - Science, Conference Proceedings Citation Index - Social Science and Humanities, ZETOC and WorldCat. We also searched ClinicalTrials.gov, ICTRP and the reference lists of included trials. We included randomised controlled trials that examined drug interventions versus placebo for self-injurious behaviour (SIB) in adults with intellectual disability. Two review authors independently extracted data and assessed risk of bias for each trial using a data extraction form. We present a narrative summary of the results is presented. We did not consider meta-analysis was appropriate due to differences in study designs, differences between interventions and heterogeneous outcome measures. We found five double-blind placebo-controlled trials that met our inclusion criteria. These trials assessed effectiveness and safety of drugs in a total of 50 people with intellectual disability demonstrating SIB. Four trials compared the effects of naltrexone versus placebo and one trial compared clomipramine versus placebo.One of the naltrexone versus placebo trials reported that naltrexone had clinically significant effects (≥ 33% reduction) on the daily
Greenland, Katie; Chipungu, Jenala; Chilekwa, Joyce; Chilengi, Roma; Curtis, Val
Diarrhoea is a leading cause of child death in Zambia. As elsewhere, the disease burden could be greatly reduced through caregiver uptake of existing prevention and treatment strategies. We recently reported the results of the Komboni Housewives intervention which tested a novel strategy employing motives including affiliation and disgust to improve caregiver practice of four diarrhoea control behaviours: exclusive breastfeeding; handwashing with soap; and correct preparation and use of oral rehydration salts (ORS) and zinc. The intervention was delivered via community events (women's forums and road shows), at health clinics (group session) and via radio. A cluster randomised trial revealed that the intervention resulted in a small improvement in exclusive breastfeeding practices, but was only associated with small changes in the other behaviours in areas with greater intervention exposure. This paper reports the findings of the process evaluation that was conducted alongside the trial to investigate how factors associated with intervention delivery and receipt influenced caregiver uptake of the target behaviours. Process data were collected from the eight peri-urban and rural intervention areas throughout the six-month implementation period and in all 16 clusters 4-6 weeks afterwards. Intervention implementation (fidelity, reach, dose delivered and recruitment strategies) and receipt (participant engagement and responses, and mediators) were explored through review of intervention activity logs, unannounced observation of intervention events, semi-structured interviews, focus groups with implementers and intervention recipients, and household surveys. Evaluation methods and analyses were guided by the intervention's theory of change and the evaluation framework of Linnan and Steckler. Intervention reach was lower than intended: 39% of the surveyed population reported attending one or more face-to-face intervention event, of whom only 11% attended two or more
Sylvester, B D; Zammit, K; Fong, A J; Sabiston, C M
Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. All Canadian cancer centre Web sites ( n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London-Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity.
Olthuis, Janine V; Watt, Margo C; Bailey, Kristen; Hayden, Jill A; Stewart, Sherry H
Cognitive behavioural therapy (CBT) is an evidence-based treatment for anxiety disorders. Many people have difficulty accessing treatment, due to a variety of obstacles. Researchers have therefore explored the possibility of using the Internet to deliver CBT; it is important to ensure the decision to promote such treatment is grounded in high quality evidence. To assess the effects of therapist-supported Internet CBT (ICBT) on remission of anxiety disorder diagnosis and reduction of anxiety symptoms in adults as compared to waiting list control, unguided CBT, or face-to-face CBT. Effects of treatment on quality of life and patient satisfaction with the intervention were also assessed. We searched the Cochrane Depression, Anxiety and Neurosis Review Group Specialised Register (CCDANCTR) to 16 March 2015. The CCDANCTR includes relevant randomised controlled trials from MEDLINE, EMBASE, PsycINFO and CENTRAL. We also searched online clinical trial registries and reference lists of included studies. We contacted authors to locate additional trials. Each identified study was independently assessed for inclusion by two authors. To be included, studies had to be randomised controlled trials of therapist-supported ICBT compared to a waiting list, attention, information, or online discussion group; unguided CBT (that is, self-help); or face-to-face CBT. We included studies that treated adults with an anxiety disorder (panic disorder, agoraphobia, social phobia, post-traumatic stress disorder, acute stress disorder, generalized anxiety disorder, obsessive compulsive disorder, and specific phobia) defined according to the Diagnostic and Statistical Manual of Mental Disorders III, III-R, IV, IV-TR or the International Classification of Disesases 9 or 10. Two authors independently assessed the risk of bias of included studies and judged overall study quality. We used data from intention-to-treat analyses wherever possible. We assessed treatment effect for the dichotomous outcome
Dijkman, Marieke A. M.; Harting, Janneke; van der Wal, Marcel F.
Background and objective: The Good Behaviour Game (GBG) has been shown to be effective in preventing childhood disruptive behaviours and their long-term unfavourable health-related outcomes. Like many other evidence-based preventive health programmes, however, its current use in Dutch primary
Jørgensen, Marie B; Faber, Anne; Jespersen, Tobias
This study evaluates the implementation of physical coordination training (PCT) and cognitive behavioural training (CBTr) interventions in a randomised controlled trial at nine cleaners' workplaces. Female cleaners (n = 294) were randomised into a PCT, a CBTr or a reference (REF) group. Both 12...... intervention effects, more research on implementation is needed. Trial registration: ISRCTN96241850. Practitioner summary: Both physical coordination training and cognitive behavioural training are potential effective workplace interventions among low educated job groups with high physical work demands....... However, thorough consideration should be given to feasibility in the design of interventions. The optimal intervention should be tailored to closely match the implementation context and be robust and flexible to minimise susceptibility to changes in work organisation....
Full Text Available Athletes participating in sport are exposed to a relatively high injury risk. Previous research has suggested that it could be possible to reduce sports injuries through psychological skills training. The purpose of this study was to examine the extent to which a cognitive behavioural biofeedback intervention could reduce the number of sports injuries in a sample of players in Swedish elite football high schools. Participants from four elite football high schools (16-19 years old were divided into one experiment (n = 13 and one control group (n = 14. Participants were asked to complete three questionnaires to assess anxiety level (Sport Anxiety Scale, history of stressors (Life Event Scale for Collegiate Athletes and coping skills (Athletic Coping Skills Inventory - 28 in a baseline measure. Mann-Whitney U-tests showed no significant differences in pre-intervention scores based on the questionnaires. The experimental group participated in a nine-week intervention period consisting of seven sessions, including: somatic relaxation, thought stopping, emotions/problem focused coping, goal setting, biofeedback training as well as keeping a critical incident diary. A Mann-Whitney U test showed no significant difference between the control and experimental group U (n1 = 13, n2 = 14 = 51.00, p = 0.054. However, considering the small sample, the statistical power (0.05 for present study, to detect effects was low. The results of the study are discussed from a psychological perspective and proposals for future research are given
Tinoco, Rui; Paiva, Isabel
The eating habits modification is a clinical challenge, both on therapeutic and preventive levels, which requires tools from various areas of health, such as psychology and nutrition. In the structured work in these areas, that includes the referral to specialist consultants, there is a need of a first intervention in Primary Health Care, in clinical and community levels. In this paper, we attempt to systematize useful information for intervention. We will start by reviewing some important interviewing skills, some models of motivational interviewing, and we will make a brief reflection about the client. Then we will analyse an individual case structured in two complementary levels of interpretation: a closer look in general factors and another that reflect the antecedents, consequences and the description of the behaviour problem. We will also tackle issues related to the context in which the individual moves. We will analyse some group intervention programs within a clinical and preventive perspectives. Finally, we will discuss some concepts related to therapeutic adherence.
Schiøtz, M. L.; Bøgelund, M.; Almdal, T.
emotional distress, negative assessment of care, less health-promoting eating habits and less frequent foot examinations. Conclusions Good social support is significantly associated with health-promoting behaviours and well-being among patients with Type2 diabetes. However, HbA 1c levels are higher...... collected from 2572 patients with Type2 diabetes. After adjusting for gender, age and education, Tobit and logistic regression models were used to examine associations between social network and patient activation, psychosocial problems, self-management behaviours and HbA 1c levels. Results Frequent contact...
Delaney, Tessa; Wyse, Rebecca; Yoong, Sze Lin; Sutherland, Rachel; Wiggers, John; Ball, Kylie; Campbell, Karen; Rissel, Chris; Wolfenden, Luke
Introduction School canteens represent an opportune setting in which to deliver public health nutrition strategies given their wide reach, and frequent use by children. Online school canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer behaviour strategies that impact on purchasing decisions. The aim of this study is to assess the efficacy of a consumer behaviour intervention i...
Full Text Available Melioidosis, an often fatal infectious disease in Northeast Thailand, is caused by skin inoculation, inhalation or ingestion of the environmental bacterium, Burkholderia pseudomallei. The major underlying risk factor for melioidosis is diabetes mellitus. Recommendations for melioidosis prevention include using protective gear such as rubber boots and gloves when in direct contact with soil and environmental water, and consuming bottled or boiled water. Only a small proportion of people follow such recommendations.Nine focus group discussions were conducted to evaluate barriers to adopting recommended preventive behaviours. A total of 76 diabetic patients from northeast Thailand participated in focus group sessions. Barriers to adopting the recommended preventive behaviours and future intervention strategies were identified using two frameworks: the Theoretical Domains Framework and the Behaviour Change Wheel.Barriers were identified in the following five domains: (i knowledge, (ii beliefs about consequences, (iii intention and goals, (iv environmental context and resources, and (v social influence. Of 76 participants, 72 (95% had never heard of melioidosis. Most participants saw no harm in not adopting recommended preventive behaviours, and perceived rubber boots and gloves to be hot and uncomfortable while working in muddy rice fields. Participants reported that they normally followed the behaviour of friends, family and their community, the majority of whom did not wear boots while working in rice fields and did not boil water before drinking. Eight intervention functions were identified as relevant for the intervention: (i education, (ii persuasion, (iii incentivisation, (iv coercion, (v modeling, (vi environmental restructuring, (vii training, and (viii enablement. Participants noted that input from role models in the form of physicians, diabetic clinics, friends and families, and from the government via mass media would be required for them
Billerey, Antoine; Waeckel, Nicolas
New fuel management targets imply to increase fuel assembly discharge burnup. Therefore, the prediction of the mechanical behaviour of the irradiated fuel assembly is essential such as excessive fuel assembly distortion induce incomplete Rod Cluster Control Assembly insertion problems (safety issue) or fuel rod vibration induced wear leading to leaking rods (plant operation problems). Within this framework, one of the most important parameter is the knowledge of the fuel rod support in the grid cell because it directly governs the mechanical behaviour of the fuel assembly and consequently allows to predict the behaviour of irradiated structures in terms of (1) axial and lateral deformation (global behaviour of the assembly) and (2) rod vibration induced wear (local behaviour of the rod). Generally, fuel rod support is provided by a spring-dimple system fixed to the grid. During irradiation, the spring force decreases and a gap between the rod and the spring may occur. This phenomenon is due to (1) stress relieving in the spring and in the dimples, (2) grid growth and (3) reduction of the rod diameter. Two models have been developed to predict the behaviour of the rod in the cell. The first model is dedicated to the evaluation of the spring force relaxation during irradiation. The second one can assess the rotation characteristic of the fuel rod in the cell, function of the spring force. The main input parameters are (1) the creep laws of the grid materials, (2) the growth law of the grid, (3) the evolution of rod diameter and (4) the design of the fuel rod support. The aim of this paper is to: (1) evaluate the consequences of grid support design modifications on the rod vibration sensitivity in terms of predicted rod to grid maximum gap during irradiation and time in operation with an open rod to grid gap, (2) evaluate, using a linear or non-linear Finite Element assembly model, the impact of the evolution of grid support under irradiation on the overall mechanical
Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data).
Michie, Susan; Wood, Caroline E; Johnston, Marie; Abraham, Charles; Francis, Jill J; Hardeman, Wendy
Meeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) - the 'active ingredients', for example goal-setting, self-monitoring of behaviour. BCTs are 'the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs' (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012;6:1-6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health. (1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development. Four hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs. Development of the taxonomy involved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts; hierarchical structure of the list was developed using inductive
French, Simon D; Green, Sally E; O'Connor, Denise A; McKenzie, Joanne E; Francis, Jill J; Michie, Susan; Buchbinder, Rachelle; Schattner, Peter; Spike, Neil; Grimshaw, Jeremy M
There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a Series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research. The intervention was developed considering three main components: theory, evidence, and practical issues. We used a four-step approach, consisting of guiding questions, to direct the choice of the most appropriate components of an implementation intervention: Who needs to do what, differently? Using a theoretical framework, which barriers and enablers need to be addressed? Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? And how can behaviour change be measured and understood? A complex implementation intervention was designed that aimed to improve acute low back pain management in primary care. We used the TDF to identify the barriers and enablers to the uptake of evidence into practice and to guide the choice of intervention components. These components were then combined into a cohesive intervention. The intervention was delivered via two facilitated interactive small group workshops. We also produced a DVD to distribute to all participants in the intervention group. We chose outcome measures in order to assess the mediating mechanisms of behaviour change. We have illustrated a four-step systematic method for developing an intervention designed to change clinical practice based on a theoretical framework. The method of development provides a systematic framework that could be used by others developing complex implementation interventions. While this framework should be iteratively adjusted and refined to suit other contexts and settings, we believe that the four-step process should be maintained as the primary framework to guide researchers through a
White, Sian; Schmidt, Wolf; Sahanggamu, Daniel; Fatmaningrum, Dewi; van Liere, Marti; Curtis, Val
It is unclear how best to go about improving child feeding practices. We studied the effect of a novel behaviour change intervention, Gerakan Rumpi Sehat (the Healthy Gossip Movement), on infant and young child feeding practices in peri-urban Indonesia. The pilot intervention was designed based on the principles of a new behaviour change theory, Behaviour Centred Design (BCD). It avoided educational messaging in favour of employing emotional drivers of behaviour change, such as affiliation, nurture and disgust and used television commercials, community activations and house-to-house visits as delivery channels. The evaluation took the form of a 2-arm cluster randomised trial with a non-randomised control arm. One intervention arm received TV only, while the other received TV plus community activations. The intervention components were delivered over a 3-month period in 12 villages in each arm, each containing an average of 1300 households. There were two primary outcomes: dietary diversity of complementary food and the provision of unhealthy snacks to children aged 6-24 months. Dietary diversity scores increased by 0.8 points in the arm exposed to TV adverts only (95% CI: 0.4-1.2) and a further 0.2 points in the arm that received both intervention components (95% CI: 0.6-1.4). In both intervention arms, there were increases in the frequency of vegetable and fruit intake. We found inconsistent evidence of an effect on unhealthy snacking. The study suggests that novel theory-driven approaches which employ emotional motivators are capable of having an effect on improving dietary diversity and the regularity of vegetable and fruit intake among children aged 6-24 months. Mass media can have a measurable effect on nutrition-related behaviour, but these effects are likely to be enhanced through complementary community activations. Changing several behaviours at once remains a challenge. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley
van Nassau, Femke; Singh, Amika S; Cerin, Ester; Salmon, Jo; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai Jm
The Dutch Obesity Intervention in Teenagers (DOiT) programme is an evidence-based obesity prevention programme tailored to adolescents attending the first two years of prevocational education in the Netherlands. The initial programme showed promising results during an effectiveness trial. The programme was adapted and prepared for nationwide dissemination. To gain more insight into the process of translating evidence-based approaches into 'real world' (i.e., 'natural') conditions, our research aims were to evaluate the impact of the DOiT-implementation programme on adolescents' adiposity and energy balance-related behaviours during natural dissemination and to explore the mediating and moderating factors underlying the DOiT intervention effects. We conducted a cluster-controlled implementation trial with 20 voluntary intervention schools (n=1002 adolescents) and 9 comparable control schools (n = 484 adolescents). We measured adolescents' body height and weight, skinfold thicknesses, and waist circumference. We assessed adolescents' dietary and physical activity behaviours by means of self-report. Data were collected at baseline and at 20-months follow-up. We used multivariable multilevel linear or logistic regression analyses to evaluate the intervention effects and to test the hypothesised behavioural mediating factors. We checked for potential effect modification by gender, ethnicity and education level. We found no significant intervention effects on any of the adiposity measures or behavioural outcomes. Furthermore, we found no mediating effects by any of the hypothesised behavioural mediators. Stratified analyses for gender showed that the intervention was effective in reducing sugar-containing beverage consumption in girls (B = -188.2 ml/day; 95% CI = -344.0; -32.3). In boys, we found a significant positive intervention effect on breakfast frequency (B = 0.29 days/week; 95% CI = 0.01; 0.58). Stratified analyses for education level showed
Unravelling effectiveness of a nurse-led behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: study protocol for a cluster randomised controlled trial.
Westland, Heleen; Bos-Touwen, Irene D; Trappenburg, Jaap C A; Schröder, Carin D; de Wit, Niek J; Schuurmans, Marieke J
Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focus on behaviour change in both patients and nurses. The intervention aims for change in a single self-management behaviour, namely physical activity, in primary care patients at risk for cardiovascular disease. The aim of this study is to evaluate the effectiveness of the Activate intervention. A two-arm cluster randomised controlled trial will be conducted to compare the Activate intervention with care as usual at 31 general practices in the Netherlands. Approximately 279 patients at risk for cardiovascular disease will participate. The Activate intervention is developed using the Behaviour Change Wheel and consists of 4 nurse-led consultations in a 3-month period, integrating 17 behaviour change techniques. The Behaviour Change Wheel was also applied to analyse what behaviour change is needed in nurses to deliver the intervention adequately. This resulted in 1-day training and coaching sessions (including 21 behaviour change techniques). The primary outcome is physical activity, measured as the number of minutes of moderate to vigorous physical activity using an accelerometer. Potential effect modifiers are age, body mass index, level of education, social support, depression, patient-provider relationship and baseline number of minutes of physical activity. Data will be collected at baseline and at 3 months and 6 months of follow-up. A process evaluation will be conducted to evaluate the training of nurses, treatment fidelity, and to identify barriers to and facilitators of implementation as well as to assess participants' satisfaction. To increase physical activity in patients and to support nurses in delivering the intervention
Ihle, Kate E; Page, Robert E; Frederick, Katy; Fondrk, M Kim; Amdam, Gro V
In honeybee colonies, food collection is performed by a group of mostly sterile females called workers. After an initial nest phase, workers begin foraging for nectar and pollen, but tend to bias their collection towards one or the other. The foraging choice of honeybees is influenced by vitellogenin (vg), an egg-yolk precursor protein that is expressed although workers typically do not lay eggs. The forager reproductive ground plan hypothesis (RGPH) proposes an evolutionary path in which the behavioural bias toward collecting nectar or pollen on foraging trips is influenced by variation in reproductive physiology, such as hormone levels and vg gene expression. Recently, the connections between vg and foraging behaviour were challenged by Oldroyd and Beekman (2008), who concluded from their study that the ovary, and especially vg, played no role in foraging behaviour of bees. We address their challenge directly by manipulating vg expression by RNA interference- (RNAi) mediated gene knockdown in two honeybee genotypes with different foraging behaviour and reproductive physiology. We show that the effect of vg on the food-loading decisions of the workers occurs only in the genotype where timing of foraging onset (by age) is also sensitive to vg levels. In the second genotype, changing vg levels do not affect foraging onset or bias. The effect of vg on workers' age at foraging onset is explained by the well-supported double repressor hypothesis (DHR), which describes a mutually inhibitory relationship between vg and juvenile hormone (JH) - an endocrine factor that influences development, reproduction, and behaviour in many insects. These results support the RGPH and demonstrate how it intersects with an established mechanism of honeybee behavioural control.
Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.
This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…
Mitch J. Duncan
Full Text Available Abstract Background Many adults are insufficiently physically active, have prolonged sedentary behaviour and report poor sleep. These behaviours can be improved by interventions that include education, goal setting, self-monitoring, and feedback strategies. Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods. Methods/Design This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objectively measured physical activity, sedentary, and sleep behaviours, in a 9 week 2–arm randomised trial. Participants will be adults (n = 64 who report being physically inactive, sitting >8 h/day and frequent insufficient sleep (≥14 days out of last 30. The “Balanced” intervention is delivered via a smartphone ‘app’, and includes education materials (guidelines, strategies to promote change in behaviour, goal setting, self-monitoring and feedback support. Participants will be randomly allocated to either a device-entered or user-entered self-monitoring method. The device-entered group will be provided with a activity tracker to self-monitor behaviours. The user-entered group will recall and manually record behaviours. Assessments will be conducted at 0, 3, 6, and 9 weeks. Physical activity, sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer. Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01. Discussion This study will evaluate an app-based multi-behavioural intervention to improve physical activity, sedentary behaviour and sleep; and the relative efficacy of two different approaches to self-monitoring these behaviours. Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours. Trial registration ACTRN12615000182594
Full Text Available Abstract Background There is a rising prevalence of excessive weight gain in pregnancy and an increasing number of pregnant women who are overweight or obese at the start of the pregnancy. Excessive weight gain during pregnancy is associated with adverse maternal and neonatal consequences and increases the risk of long-term obesity. Pregnancy therefore may be a key time to prevent excessive weight gain and improve the health of women and their unborn child. This systematic review sought to assess the effectiveness of behavioural interventions to prevent excessive weight gain in pregnancy and explore the factors that influence intervention effectiveness. Methods We undertook a systematic review of quantitative and qualitative evidence. This included a meta-analysis of controlled trials of diet and physical activity interventions to prevent excessive weight gain during pregnancy and a thematic synthesis of qualitative studies that investigated the views of women on weight management during pregnancy. A thorough search of eleven electronic bibliographic databases, reference lists of included studies, relevant review articles and experts in the field were contacted to identify potentially relevant studies. Two independent reviewers extracted data. RevMan software was used to perform the meta-analyses. Qualitative data was subject to thematic analysis. Both quantitative and qualitative data were aligned using a matrix framework. Results Five controlled trials and eight qualitative studies were included. The overall pooled effect size found no significant difference in gestational weight gain amongst participants in the intervention group compared with the control group (mean difference -0.28 95% CI -0.64 to 0.09. The study designs, participants and interventions all varied markedly and there was significant heterogeneity within this comparison in the meta-analysis (I2 67%. Subgroup and sensitivity analysis did not identify contextual elements that
Full Text Available This research aimed to show the effectiveness cognitive behavioural educational intervention (CBEI in post trans urethral resection of the prostate in PKU Muhammadiyah Bantul Hospital. The research design used Quasi-eksperiment; posttest only control group. Sample was taken by nonprobability sampling with accidental sampling method (on February-June 2015. There were 20 respondent have TURP procedure and which were divided into two groups. The t-test independent indicated a significant difference in pain respon in two groups (p=0,000. From this study, CBEI was recommended for pain management in patient with TURP.Keywords: cognitive behavioural educational intervention, pain, TURP
Debnam, Katrina J.; Pas, Elise T.; Bradshaw, Catherine P.
Although the number of schools implementing School-Wide Positive Behavioral Interventions and Supports (SWPBIS) is increasing, and there is great demand for evidence-based Tier 2 and 3 interventions for students requiring additional support, little systematic research has examined administrator support for such programming. This article examines…
Castro-Sánchez, Enrique; Kyratsis, Yiannis; Iwami, Michiyo; Rawson, Timothy M; Holmes, Alison H
The uptake of improvement initiatives in infection prevention and control (IPC) has often proven challenging. Innovative interventions such as 'serious games' have been proposed in other areas to educate and help clinicians adopt optimal behaviours. There is limited evidence about the application and evaluation of serious games in IPC. The purposes of the study were: a) to synthesise research evidence on the use of serious games in IPC to support healthcare workers' behaviour change and best practice learning; and b) to identify gaps across the formulation and evaluation of serious games in IPC. A scoping study was conducted using the methodological framework developed by Arksey and O'Malley. We interrogated electronic databases (Ovid MEDLINE, Embase Classic + Embase, PsycINFO, Scopus, Cochrane, Google Scholar) in December 2015. Evidence from these studies was assessed against an analytic framework of intervention formulation and evaluation. Nine hundred sixty five unique papers were initially identified, 23 included for full-text review, and four finally selected. Studies focused on intervention inception and development rather than implementation. Expert involvement in game design was reported in 2/4 studies. Potential game users were not included in needs assessment and game development. Outcome variables such as fidelity or sustainability were scarcely reported. The growing interest in serious games for health has not been coupled with adequate evaluation of processes, outcomes and contexts involved. Explanations about the mechanisms by which game components may facilitate behaviour change are lacking, further hindering adoption.
Tully, Lucy A; Piotrowska, Patrycja J; Collins, Daniel A J; Mairet, Kathleen S; Hawes, David J; Kimonis, Eva R; Lenroot, Rhoshel K; Moul, Caroline; Anderson, Vicki; Frick, Paul J; Dadds, Mark R
-inclusive parenting intervention. The results from this study could be used to inform public policy about providing support to parents of children with behaviour problems, and enhancing the engagement of fathers in parenting interventions. ACTRN12616001223426 , registered 05/09/2016.
Dowding, Dawn; Lichtner, Valentina; Closs, S José
The Medical Research Council (MRC) framework for complex interventions provides useful guidance to assist with the development and evaluation of health technology interventions such as decision support. In this paper we briefly summarise a project that focused on designing a decision support intervention to assist with the recognition, assessment and management of pain in patients with dementia in an acute hospital setting. We reflect on our experience of using the MRC framework to guide our study design, and highlight the importance of considering decision support interventions as complex interventions.
Booth, Helen P; Prevost, Toby A; Wright, Alison J; Gulliford, Martin C
Overweight and obesity have negative health effects. Primary care clinicians are best placed to intervene in weight management. Previous reviews of weight loss interventions have included studies from specialist settings. The aim of this review was to estimate the effect of behavioural interventions delivered in primary care on body weight in overweight and obese adults. The review included randomized controlled trials (RCTs) of behavioural interventions in obese or overweight adult participants in a primary care setting, with weight loss as the primary outcome, and a minimum of 12 months of follow-up. A systematic search strategy was implemented in Medline, Embase, Web of Science and the Cochrane Central Registry of Controlled Trials. Risk of bias was assessed using the Cochrane Risk of Bias tool and behavioural science components of interventions were evaluated. Data relating to weight loss in kilograms were extracted, and the results combined using meta-analysis. Fifteen RCTs, with 4539 participants randomized, were selected for inclusion. The studies were heterogeneous with respect to inclusion criteria and type of intervention. Few studies reported interventions informed by behavioural science theory. Pooled results from meta-analysis indicated a mean weight loss of -1.36 kg (-2.10 to -0.63, P < 0.0001) at 12 months, and -1.23 kg (-2.28 to -0.18, P = 0.002) at 24 months. Behavioural weight loss interventions in primary care yield very small reductions in body weight, which are unlikely to be clinically significant. More effective management strategies are needed for the treatment of overweight and obesity. © The Author 2014. Published by Oxford University Press.
Francis, Jill J; Stockton, Charlotte; Eccles, Martin P; Johnston, Marie; Cuthbertson, Brian H; Grimshaw, Jeremy M; Hyde, Chris; Tinmouth, Alan; Stanworth, Simon J
Many theories of behaviour are potentially relevant to predictive and intervention studies but most studies investigate a narrow range of theories. Michie et al. (2005) agreed 12 'theoretical domains' from 33 theories that explain behaviour change. They developed a 'Theoretical Domains Interview' (TDI) for identifying relevant domains for specific clinical behaviours, but the framework has not been used for selecting theories for predictive studies. It was used here to investigate clinicians' transfusion behaviour in intensive care units (ICU). Evidence suggests that red blood cells transfusion could be reduced for some patients without reducing quality of care. (1) To identify the domains relevant to transfusion practice in ICUs and neonatal intensive care units (NICUs), using the TDI. (2) To use the identified domains to select appropriate theories for a study predicting transfusion behaviour. An adapted TDI about managing a patient with borderline haemoglobin by watching and waiting instead of transfusing red blood cells was used to conduct semi-structured, one-to-one interviews with 18 intensive care consultants and neonatologists across the UK. Relevant theoretical domains were: knowledge, beliefs about capabilities, beliefs about consequences, social influences, behavioural regulation. Further analysis at the construct level resulted in selection of seven theoretical approaches relevant to this context: Knowledge-Attitude-Behaviour Model, Theory of Planned Behaviour, Social Cognitive Theory, Operant Learning Theory, Control Theory, Normative Model of Work Team Effectiveness and Action Planning Approaches. This study illustrated, the use of the TDI to identify relevant domains in a complex area of inpatient care. This approach is potentially valuable for selecting theories relevant to predictive studies and resulted in greater breadth of potential explanations than would be achieved if a single theoretical model had been adopted.
MacMillan Uribe, Alexandra L; Winham, Donna M; Wharton, Christopher M
Community supported agriculture (CSA) programs have become a viable source of locally produced foods and represent a new way to increase fruit and vegetable consumption among individuals. Because CSAs represent a way for consumers to acquire healthy foods while providing financial support to local farmers, CSA involvement could reflect, and be related to, greater concern with both health and environmental impact of food choice. As such, the aim of this study was to examine whether ecological attitudes of CSA members could predict food- and sustainability-related behaviours. Using an online survey, respondents answered questions about attitudes towards the environment, as well behaviours related to food purchases, family food preparation, composting, recycling and minimising food-packaging waste. A total of 115 CSA member responses were collected. Ordinary least squares (OLS) multivariate regression analysis was used to investigate the predictive validity of environmental attitudes on measures of behaviours. A large portion of participants reported the amount and variety of fruits and vegetables their households ate increased as a result of joining a CSA program. Ecological sensitivity was a significant predictor of sustainability-related behaviours as well as money spent eating out and times eaten away from home per week. However, it was not predictive of family involvement in home food preparation. Copyright © 2012 Elsevier Ltd. All rights reserved.
Small, Rhonda; Taft, Angela J; Brown, Stephanie J
Social support interventions have a somewhat chequered history. Despite evidence that social connection is associated with good health, efforts to implement interventions designed to increase social support have produced mixed results. The aim of this paper is to reflect on the relationship between social connectedness and good health, by examining social support interventions with mothers of young children and analysing how support was conceptualised, enacted and valued, in order to advance what we know about providing support to improve health. CONTEXT AND APPROACH: First, we provide a brief recent history of social support interventions for mothers with young children and we critically examine what was intended by 'social support', who provided it and for which groups of mothers, how support was enacted and what was valued by women. Second, we examine the challenges and promise of lay social support approaches focused explicitly on companionship, and draw on experiences in two cluster randomised trials which aimed to improve the wellbeing of mothers. One trial involved a universal approach, providing befriending opportunities for all mothers in the first year after birth, and the other a targeted approach offering support from a 'mentor mother' to childbearing women experiencing intimate partner violence. Interventions providing social support to mothers have most often been directed to women seen as disadvantaged, or 'at risk'. They have also most often been enacted by health professionals and have included strong elements of health education and/or information, almost always with a focus on improving parenting skills for better child health outcomes. Fewer have involved non-professional 'supporters', and only some have aimed explicitly to provide companionship or a listening ear, despite these aspects being what mothers receiving support have said they valued most. Our trial experiences have demonstrated that non-professional support interventions raise myriad
Brown, L; Burns, Y R; Watter, P; Gray, P H; Gibbons, K S
Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5 years of age and whether intervention had a positive influence on behaviour. The relationship between behaviour, gender, and other areas of performance at 5 years was explored. Fifty 4-year-old children (born Behavior Checklist (CBCL) for preschool children was completed at baseline and at 1-year post-baseline. Other measures at follow-up included Movement Assessment Battery for Children Second Edition, Beery Visual-Motor Integration Test 5th Edition, and Peabody Picture Vocabulary Test 4th Edition. The whole cohort improved on CBCL total problems score between baseline (mean 50.0, SD 11.1) and 1-year follow-up (mean 45.2, SD 10.3), p = .004. There were no significant differences between groups over time on CBCL internalizing, externalizing, or total problems scores. The intervention group showed a mean difference in total problems score of -3.8 (CI [1.5, 9.1]) between times, with standard care group values being -4.4 (CI [1.6, 7.1]). Males had higher total problems scores than females (p = .026), although still performed within the "normal" range. CBCL scores did not correlate with other scores. The behaviour of nondisabled ELBW children was within the "normal" range at 4 to 5 years, and both intervention and standard care may have contributed to improved behavioural outcomes. Behaviour was not related to performance in other developmental domains. © 2017 John Wiley & Sons Ltd.
Fisher, H; Gardner, F E M; Montgomery, P
Many studies document a robust and consistent relationship between gang membership and elevated delinquency, with gang members disproportionately involved in crime compared to non-gang peers. Research also indicates that both delinquent youth and youth who join gangs often show a wide range of deficient or distorted social-cognitive processes compared to non-delinquent peers. Cognitive-behavioural interventions are designed to address cognitive deficits in order to reduce maladaptive or dysfunctional behaviour, and studies have documented their positive impact on a number of behavioural and psychological disorders among children and youth. To determine the effectiveness of cognitive-behavioural interventions for preventing youth gang involvement for children and young people (ages 7-16). Electronic searches of ASSIA, CINAHL, CJA, Cochrane Library, Dissertations Abstracts A, EMBASE, ERIC, IBSS, LILACs, LexisNexis Butterworths, MEDLINE, NCJR Service Abstracts Database, PsycINFO, and Sociological Abstracts, to April 2007. Reviewers contacted relevant organisations, individuals, and list-servs and searched pertinent websites and reference lists. All randomised controlled trials or quasi-randomised controlled trials of interventions with a cognitive-behavioural intervention as the majority component, delivered to youth and children aged 7-16 not involved in a gang. Searching yielded 2,284 unduplicated citations, 2,271 of which were excluded as irrelevant based on title and abstract. One was excluded following personal communication with investigators. One citation, of a large randomised prevention trial, awaits assessment; personal communication with study authors yielded unpublished reports addressing gang outcomes, but insufficient detail precluded determining inclusion status. Seven remaining reports were excluded as irrelevant because they were narrative reviews or descriptions of programs without evaluations, did not address a gang prevention programme, or did not
Mak, Vivian W M; Chan, Calais K Y
Despite rapid growth in the female prison population, there is little research on effectiveness of psychological interventions for them. To test the hypotheses that (1) each of two psychological interventions administered separately - cognitive behavioural therapy (CBT) or positive psychology intervention (PPI) - would be more effective than 'treatment-as-usual' alone in reducing psychological distress and enhancing psychological well-being; (2) outcomes would differ according to intervention; and (3) combining the interventions would be more effective than delivering either alone. We recruited 40 women in a special Hong Kong prison unit for female offenders with psychological distress. Half of them received eight sessions of CBT followed by eight sessions of PPI; the other half received the same interventions in the reverse order. We recruited another 35 women who received only 'treatment as usual' (TAU) in the same unit. We used various clinical scales to assess the women's psychological distress or well-being before and after the interventions or at similar time points for the comparison women. All intervention group women showed a significant reduction in psychological distress and enhancement in psychological well-being after each intervention alone compared to the TAU women. There were no significant differences between CBT and PPI in this respect. Receiving both treatments, however, did yield significantly more improvement than either intervention alone in reducing depressive thoughts and enhancing global judgement of life satisfaction, self-perceived strengths and hopeful thinking style. Our findings provide preliminary empirical support for the effectiveness of psychological interventions with psychologically distressed women in prison. It would be important now to conduct a full, randomised trial to determine optimal length and combinations of treatment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
Spector, Aimee; Orrell, Martin; Goyder, Judith
Behavioural and psychological symptoms of dementia (BPSD) are highly prevalent and problematic in care settings. Given the limited effectiveness of medical treatments, training care staff to understand and manage these symptoms is essential for the safety and quality of life of people with dementia. This review evaluated the effectiveness of staff training interventions for reducing BPSD. A systematic literature search identified 273 studies. Twenty studies, published between 1998 and 2010, were found to meet the inclusion criteria. Overall, there was some evidence that staff training interventions can impact on BPSD: twelve studies resulted in significant symptom reductions, four studies found positive trends and four studies found no impact on symptoms. No links were found between the theoretical orientation of training programmes and their effectiveness. Training was also found to impact on the way staff behaved towards residents. A quality screening, using pre-specified criteria, revealed numerous methodological weaknesses and many studies did not adhere to the recommended guidelines for the conduct of cluster randomised controlled trials. There is an urgent need for more high quality research and evidence-based practice in BPSD. Copyright © 2012 Elsevier B.V. All rights reserved.
Larue, Grégoire S; Kim, Inhi; Rakotonirainy, Andry; Haworth, Narelle L; Ferreira, Luis
Improving safety at railway level crossings is an important issue for the Australian transport system. Governments, the rail industry and road organisations have tried a variety of countermeasures for many years to improve railway level crossing safety. New types of intelligent transport system (ITS) interventions are now emerging due to the availability and the affordability of technology. These interventions target both actively and passively protected railway level crossings and attempt to address drivers' errors at railway crossings, which are mainly a failure to detect the crossing or the train and misjudgement of the train approach speed and distance. This study aims to assess the effectiveness of three emerging ITS that the rail industry considers implementing in Australia: a visual in-vehicle ITS, an audio in-vehicle ITS, as well as an on-road flashing beacons intervention. The evaluation was conducted on an advanced driving simulator with 20 participants per trialled technology, each participant driving once without any technology and once with one of the ITS interventions. Every participant drove through a range of active and passive crossings with and without trains approaching. Their speed approach of the crossing, head movements and stopping compliance were measured. Results showed that driver behaviour was changed with the three ITS interventions at passive crossings, while limited effects were found at active crossings, even with reduced visibility. The on-road intervention trialled was unsuccessful in improving driver behaviour; the audio and visual ITS improved driver behaviour when a train was approaching. A trend toward worsening driver behaviour with the visual ITS was observed when no trains were approaching. This trend was not observed for the audio ITS intervention, which appears to be the ITS intervention with the highest potential for improving safety at passive crossings. Copyright © 2015 Elsevier Ltd. All rights reserved.
Lerma, Abel; Perez-Grovas, Héctor; Bermudez, Luis; Peralta-Pedrero, María L; Robles-García, Rebeca; Lerma, Claudia
Psychological treatment of depression in end-stage renal disease (ESRD) has focused on severely depressed patients. We designed and tested a brief (5 weeks) cognitive behavioural intervention (CBI) to reduce mild and moderate depression and anxiety symptoms in patients with ESRD. For the purpose of this study, a single-blind, randomized controlled design was used to compare patients with ESRD under haemodialysis treatment with and without the CBI. Depression and anxiety symptoms were screened in 152 subjects (18-60 years old, 84 male). Sixty participants (age 41.8 ± 14.7, 29 males) with mild or moderate scores of depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) were randomly assigned to CBI or the control group. CBI techniques consisted of positive self-reinforcement, deep breathing, muscle relaxation, and cognitive restructuring. Depression, anxiety, quality of life (QoL), and cognitive distortion scores were evaluated at baseline, after 5 weeks (end of treatment) and after 4-week follow-up. All scores were compared by ANOVA for repeated measures with post-hoc tests adjusted by Bonferroni's method (p cognitive distortions had decreased, and QoL had increased in the intervention group, and there were no changes in the control group. Clinical utility was 33% for depression and 43% for anxiety. A brief CBI of 5 weeks is effective for decreasing mild or moderate depression and anxiety symptoms and improving QoL in ESRD haemodialysis patients. A brief, systematic and structured cognitive behavioural intervention (CBI) decreases anxiety and depression symptoms and improves quality of life in patients with end-stage renal disease (ESRD) who are being treated with haemodialysis. These benefits are not achieved when anxiety and depression symptoms are identified but not treated psychologically. This CBI consisted of cognitive restructuring of the distorted thoughts (perfectionism, catastrophic thinking, negative self-labelling, and
LILY HUI SING LAU
This thesis sought to inform the implementation of School-Wide Positive Behaviour Support (SWPBS) in Singapore preschools. Findings indicated that SWPBS implementation is likely to be perceived as needed by teachers, and that there is a need to focus on training teachers in SWPBS primary tier classroom management practices when SWPBS is implemented. Additionally, the Classroom Check-Up consultation model was shown to be a promising coaching model to be included in SWPBS training. A major cont...
Humaidi, Norshima; Balakrishnan, Vimala
Health information systems are innovative products designed to improve the delivery of effective healthcare, but they are also vulnerable to breaches of information security, including unauthorised access, use, disclosure, disruption, modification or destruction, and duplication of passwords. Greater openness and multi-connectedness between heterogeneous stakeholders within health networks increase the security risk. The focus of this research was on the indirect effects of management support (MS) on user compliance behaviour (UCB) towards information security policies (ISPs) among health professionals in selected Malaysian public hospitals. The aim was to identify significant factors and provide a clearer understanding of the nature of compliance behaviour in the health sector environment. Using a survey design and stratified random sampling method, self-administered questionnaires were distributed to 454 healthcare professionals in three hospitals. Drawing on theories of planned behaviour, perceived behavioural control (self-efficacy (SE) and MS components) and the trust factor, an information system security policies compliance model was developed to test three related constructs (MS, SE and perceived trust (PT)) and their relationship to UCB towards ISPs. Results showed a 52.8% variation in UCB through significant factors. Partial least squares structural equation modelling demonstrated that all factors were significant and that MS had an indirect effect on UCB through both PT and SE among respondents to this study. The research model based on the theory of planned behaviour in combination with other human and organisational factors has made a useful contribution towards explaining compliance behaviour in relation to organisational ISPs, with trust being the most significant factor. In adopting a multidimensional approach to management-user interactions via multidisciplinary concepts and theories to evaluate the association between the integrated management
Alam, Mahbub-Ul; Winch, Peter J; Saxton, Ronald E; Nizame, Fosiul A; Yeasmin, Farzana; Norman, Guy; Masud, Abdullah-Al; Begum, Farzana; Rahman, Mahbubur; Hossain, Kamal; Layden, Anita; Unicomb, Leanne; Luby, Stephen P
Shared toilets in urban slums are often unclean and poorly maintained, discouraging consistent use and thereby limiting impacts on health and quality of life. We developed behaviour change interventions to support shared toilet maintenance and improve user satisfaction. We report the intervention effectiveness on improving shared toilet cleanliness. We conducted a cluster-randomised controlled trial among users of 1226 shared toilets in 23 Dhaka slums. We assessed baseline toilet cleanliness in January 2015. The six-month intervention included provision of hardware (bin for solid waste, 4 l flushing bucket, 70 l water reservoir), and behaviour change communication (compound meetings, interpersonal household sessions, signs depicting rules for toilet use). We estimated the adjusted difference in difference (DID) to assess outcomes and accounted for clustering effects using generalised estimating equations. Compared to controls, intervention toilets were more likely to have water available inside toilet cubicles (DID: +4.7%, 95% CI: 0.2, 9.2), access to brush/broom for cleaning (DID: +8.4%, 95% CI: 2, 15) and waste bins (DID: +63%, 95% CI: 59, 66), while less likely to have visible faeces inside the pan (DID: -13%, 95% CI: -19, -5), the smell of faeces (DID: -7.6%, 95% CI: -14, -1.3) and household waste inside the cubicle (DID: -4%, 95% CI: -7, -1). In one of few efforts to promote shared toilet cleanliness, intervention compounds were significantly more likely to have cleaner toilets after six months. Future research might explore how residents can self-finance toilet maintenance, or employ mass media to reduce per-capita costs of behaviour change. © 2017 John Wiley & Sons Ltd.
Huntingdon, Ben; Schofield, Penelope; Wolfowicz, Zahava; Bergin, Rebecca; Kabel, Donna; Edmunds, Jennifer; Penberthy, Sylvia; Juraskova, Ilona
Research into dyadic (one-to-one) peer support has predominantly focused on the recipients of peer support whilst neglecting the impact on the peer support providers (PSPs). Increasingly, structured/protocolised peer support interventions are employed. The aim of this qualitative study was to explore the experience of providing peer support within a protocolised intervention and how common key characteristics of such interventions (guidelines and checklists, rigorous training and partnerships with health professionals) may influence PSPs' experiences. This research was conducted within the context of an ongoing randomised controlled trial investigating a protocolised peer support intervention (the Peer and Nurse support Trial to Assist women in Gynaecological Oncology (PeNTAGOn) study). Eleven women (gynaecological cancer survivors) providing peer support within the PeNTAGOn study participated in semi-structured telephone interviews. Transcribed interviews were analysed using interpretative phenomenological analysis. Five key themes were identified which described the overall experience of providing protocolised peer support: (i) fitting oneself to the protocolised PSP role, (ii) the impact of personal beliefs about the value of research, (iii) protocolisation as both blessing and curse, (iv) discussing taboo or sensitive topics and (v) the impact of interactions with study personnel. These insights into the advantages and disadvantages of protocolised peer support can be used to inform future research and social support programs and maximise the effectiveness of such programs for patients, PSPs and the health-care system.
van Koningsbruggen, Guido M; Veling, Harm; Stroebe, Wolfgang; Aarts, Henk
Palatable food, such as sweets, contains properties that automatically trigger the impulse to consume it even when people have goals or intentions to refrain from consuming such food. We compared the effectiveness of two interventions in reducing the portion size of palatable food that people select for themselves. Specifically, the use of dieting implementation intentions that reduce behaviour towards palatable food via top-down implementation of a dieting goal was pitted against a stop-signal training that changes the impulse-evoking quality of palatable food from bottom-up. We compared the two interventions using a 2 × 2 factorial design. Participants completed a stop-signal training in which they learned to withhold a behavioural response upon presentation of tempting sweets (vs. control condition) and formed implementation intentions to diet (vs. control condition). Selected portion size was measured in a sweet-shop-like environment (Experiment 1) and through a computerized snack dispenser (Experiment 2). Both interventions reduced the amount of sweets selected in the sweet shop environment (Experiment 1) and the snack dispenser (Experiment 2). On average, participants receiving an intervention selected 36% (Experiment 1) and 51% (Experiment 2) fewer sweets than control participants. In both studies, combining the interventions did not lead to additive effects: Employing one of the interventions appears to successfully eliminate instrumental behaviour towards tempting food, making the other intervention redundant. Both interventions reduce self-selected portion size, which is considered a major contributor to the current obesity epidemic. What is already known on this subject? Exposure to temptations, such as unhealthy palatable food, often frustrates people's attainment of long-term health goals. Current approaches to self-control suggest that this is partly because temptations automatically trigger impulsive or hedonic processes that override the
The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke/transient isch......The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke...... individualised interventions and team-based care, e.g. integrating a clinical pharmacist with particular focus on patients’ drug-related problems. One approach with growing evidence of improving medication adherence is motivational interviewing (MI). So far, no clinical pharmacist intervention using MI has...... targeted patients with hypertension or stroke in a hospital care setting. Thus, the aim of this thesis was to develop and evaluate in-hospital pharmacist interventions including MI to improve adherence to primary and secondary thrombopreventive therapy. The first study was a RCT, which investigated...
Schneider, J A; Dude, A; Dinaker, M; Kumar, V; Laumann, E O; Holloway-Beth, A; Oruganti, G; Saluja, G S; Chundi, V; Yeldandi, V; Mayer, K H
The relationships between hygiene, sexual behaviour and HIV infection are poorly understood. We examine these relationships in Indian truck drivers, a group at high risk for HIV infection. Truck drivers (n = 189) were recruited into an integrated HIV and hygiene Information Motivation (IM) programme. Sociodemographic characteristics, sexual and hygiene behaviour and HIV prevalence were determined. Multivariate logistic regression and linear generalized estimating equation models were utilized. At baseline, 2.1% of drivers were HIV infected and 34% who reported having contact with female sex workers (FSWs) had contact within the previous six months. Those who washed their hands postdefecation were less likely to report genital symptoms (OR 0.02; P = 0.01) and have sex with an FSW (OR [odds ratio] 0.21; P = 0.05). After an IM intervention, there were no changes in sexual risk-taking behaviour (coefficient -0.15 to -0.02; P = 0.13-0.75); however, hygiene behaviour improved from baseline (coefficient 0.09-0.31; P hygiene habits, like handwashing, seem to be a modifiable behaviour after a modest intervention, whereas HIV risk-taking behaviour was not. The association between hygiene and HIV risk-taking suggests the need for further evaluation of the relationship and that of other hygiene practices in high-risk men in India.
Conant, Darcy Lynn
Stochastic understanding of probability distribution undergirds development of conceptual connections between probability and statistics and supports development of a principled understanding of statistical inference. This study investigated the impact of an instructional course intervention designed to support development of stochastic…
Anderson, Shelley; Bucholz, Jessica L.; Hazelkorn, Michael; Cooper, Margaret A.
This study was designed to examine the effects of literacy-based behavioural interventions (Bucholz et al., 2008) to decrease acts of physical aggression with kindergarten and first grade students. The study used a multiple baseline design across three participants. The results showed a decrease in acts of physical aggression by students with…
Bremer, Emily; Crozier, Michael; Lloyd, Meghann
The purpose of this review was to systematically search and critically analyse the literature pertaining to behavioural outcomes of exercise interventions for individuals with autism spectrum disorder aged ?16 years. This systematic review employed a comprehensive peer-reviewed search strategy, two-stage screening process and rigorous critical…
McGillivray, J. A.; Kershaw, M.
Background: A growing literature suggests that people with mild intellectual disability (ID) who have depressed mood may benefit from cognitive--behavioural interventions. There has been some speculation regarding the relative merit of the components of this approach. The aim of this study was to compare (i) cognitive strategies; (ii) behavioural…
Humphrey, Neil; Brooks, A. George
An increasing number of children and young people are being excluded from school as a direct result of anger management problems. The research literature suggests that short cognitive-behavioural intervention programmes may be effective in helping young people understand and control their anger. The aim of the current study was to evaluate the…
Leamy, Mary; Clarke, Eleanor; Le Boutillier, Clair; Bird, Victoria; Janosik, Monika; Sabas, Kai; Riley, Genevieve; Williams, Julie; Slade, Mike
To investigate staff and trainer perspectives on the barriers and facilitators to implementing a complex intervention to help staff support the recovery of service users with a primary diagnosis of psychosis in community mental health teams. Process evaluation nested within a cluster randomised controlled trial (RCT). 28 interviews with mental health care staff, 3 interviews with trainers, 4 focus groups with intervention teams and 28 written trainer reports. 14 community-based mental health teams in two UK sites (one urban, one semi-rural) who received the intervention. The factors influencing the implementation of the intervention can be organised under two over-arching themes: Organisational readiness for change and Training effectiveness. Organisational readiness for change comprised three sub-themes: NHS Trust readiness; Team readiness; and Practitioner readiness. Training effectiveness comprised three sub-themes: Engagement strategies; Delivery style and Modelling recovery principles. Three findings can inform future implementation and evaluation of complex interventions. First, the underlying intervention model predicted that three areas would be important for changing practice: staff skill development; intention to implement; and actual implementation behaviour. This study highlighted the importance of targeting the transition from practitioners' intent to implement to actual implementation behaviour, using experiential learning and target setting. Second, practitioners make inferences about organisational commitment by observing the allocation of resources, Knowledge Performance Indicators and service evaluation outcome measures. These need to be aligned with recovery values, principles and practice. Finally, we recommend the use of organisational readiness tools as an inclusion criteria for selecting both organisations and teams in cluster RCTs. We believe this would maximise the likelihood of adequate implementation and hence reduce waste in research
Shepherd, J; Kavanagh, J; Picot, J; Cooper, K; Harden, A; Barnett-Page, E; Jones, J; Clegg, A; Hartwell, D; Frampton, G K; Price, A
-building activities, and a supportive school culture was also helpful. Recognition of young people's individual needs in relation to sexual health was another important factor. No conclusions could be drawn on the impact of the interventions on sexual health inequalities due to a lack of relevant data on socioeconomic status, gender and ethnicity. The results of the economic evaluation were considered to be illustrative, mainly due to the uncertainty of the effect of intervention on behavioural outcomes. The results were most sensitive to changes in parameter values for the intervention effect, the transmission probability of STIs and the number of sexual partners. The costs of teacher-led and peer-led behavioural interventions, based on the resources estimated from the relevant randomised controlled trials in our systematic review, were 4.30 pounds and 15 pounds per pupil, respectively. Teacher-led interventions were more cost-effective than peer-led interventions due to the less frequent need for training. The incremental cost-effectiveness of the teacher-led and peer-led interventions was 20,223 pounds and 80,782 pounds per quality-adjusted life-year gained, respectively. An analysis of individual parameters revealed that future research funding should focus on assessing the intervention effect for condom use from a school-based intervention. School-based behavioural interventions for the prevention of STIs in young people can bring about improvements in knowledge and increased self-efficacy, but the interventions did not significantly influence sexual risk-taking behaviour or infection rates. Future investigation should include long-term follow-up to assess the extent to which safer sexual behaviour is adopted and maintained into adulthood, and prospective cohort studies are needed to look at the parameters that describe the transmission of STIs between partners. Funding should focus on the effectiveness of the interventions on influencing behaviour.
Esposito De Falco, S.
The problem of the influence exerted on the firms behaviour from the introduction of the mechanisms of regulation of the Emissions Trading (E T) is the heart of this work. In fact, following the approach of the new-institutionalist school of Powell and Di Maggio, we wanted to test how much the business can be influenced by both the action of public and private institutions and the interaction with the socio-economical environment where it acts. In this context we tried to analyse the consequences induced by the dictates of the Kyoto Protocol on the strategic choices of the companies, with reference, above all, to the tendencies to change and innovation. The hypothesis of search is that mechanisms of regulation of the E T may change the competitive behaviour of the companies, for the advantage to pay the emissions permits rather than innovate the technological processes. To sustain such an hypothesis we developed a Decision Support System able to simulate the businesses behaviour after the share allotment. The work ends with a simulation carried out on the energy manufacturing equipment from which it is possible to make some considerations about the limited effectiveness of the mechanisms of regulation of the E T to stimulate virtuous businesses behaviours oriented to innovation. [it
Berryman, Mere; Woller, Paul
This paper examines Early Intervention (EI) service provision from within one Ministry of Education region in New Zealand. It does this in order to better understand what works well and what needs to change if children from Maori families, of Early Childhood age, are to be provided with the most effective EI services. By engaging with Maori…
Farrell, Anne F.; Collier-Meek, Melissa A.; Pons, Shelby R.
There is growing recognition that after-school programs (ASPs) provide opportunities for positive youth development. Many ASPs focus on behavior and socio-emotional challenges, provide evidence-based interventions to improve homework completion and academic skills, and offer physical activities and nutritious foods. Generally speaking, ASPs offer…
Kaminski, Ruth A.; Powell-Smith, Kelly A.
Phonemic awareness has been consistently identified as an essential skill for as well as an important predictor of later reading achievement. Children who lack these early literacy skills at kindergarten entry are more likely to demonstrate both short- and long-term reading difficulties. Despite the importance of providing intervention early,…
Reliability and Utility of the Behaviour Support Plan Quality Evaluation Tool (BSP-QEII) for Auditing and Quality Development in Services for Adults with Intellectual Disability and Challenging Behaviour
McVilly, K.; Webber, L.; Paris, M.; Sharp, G.
Background: Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II…
Burke, Mack D.; Rispoli, Mandy; Clemens, Nathan H.; Lee, Yuan-Hsuan; Sanchez, Lisa; Hatton, Heather
Universal behavioral screening is a major part of positive behavioral support and response to intervention systems. Program-wide positive behavioral interventions and supports (PBIS) focuses on establishing social, emotional, and behavioral competence through promotion of a small set of behavioral expectations that are agreed upon, taught, and…
Mattanah, Jonathan F.; Ayers, Jean F.; Brand, Bethany L.; Brooks, Leonie J.; Quimby, Julie L.; McNary, Scot W.
This study examined effects of a peer-led social support group intervention on college adjustment. Ninety first-year students, randomly assigned to participate in the intervention, reported higher levels of perceived social support and reduced loneliness when compared to controls (n = 94), after accounting for preintervention levels on these…
Burgess, E; Hassmén, P; Welvaert, M; Pumpa, K L
Poor adherence to lifestyle intervention remains a key factor hindering treatment effectiveness and health outcomes for adults with obesity. The aim of this systematic review and meta-analysis is to determine if behavioural treatment strategies (e.g. goal setting, motivational interviewing, relapse prevention, cognitive restructuring etc.) improve adherence to lifestyle intervention programmes in adults with obesity. Randomized controlled trials that investigated the use of behavioural treatment strategies in obesity management were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from their inception to August 2016. This meta-analysis shows that behavioural treatment interventions have a significant positive effect on session attendance (percentage) and physical activity (total min/week) in adults with obesity (M = 17.63 (95% confidence interval (CI) = 10.77, 24.50), z =5.0337, P intervention programmes in adults with obesity. These strategies should be routinely incorporated into lifestyle intervention, obesity management and weight loss programmes with the aim of improving engagement and adherence. If adherence were improved, treatment effectiveness, health outcomes and the ultimate burden of chronic disease could also be improved. © 2017 World Obesity Federation.
The vibrational behaviour of the generator support structure at Koeberg nuclear power station at frequencies primarily in the region of 80 Hz to 110 Hz was examined. The effect of soil-structure interaction and the change in stiffness of the foundation soil was investigated. Vibration tests were performed on the generator support structure and the results were compared with a theoretical finite element analysis of the structure. By varying the soil-cement foundation stiffness it was possible to demonstrate the change in dynamic behaviour of the structure in the higher frequency band 80 Hz to 110 Hz. Comment has been made on the design code DIN 4024 in view of the findings of this thesis. It was concluded that the empirical rules regarding the inclusion of the foundation in an analysis specified by the code do not cover all cases and greater cognisance of the effect of the foundation stiffness on the vibration behaviour of such machine foundations is necessary. Obvious machine frequencies higher than the operational frequencies should be analysed where it is considered necessary. 24 refs., 25 tabs., 83 figs
Chaudhury, Sumona; Kirk, Catherine M.; Ingabire, Charles; Mukunzi, Sylvere; Nyirandagijimana, Beatha; Godfrey, Kalisa; Brennan, Robert T.; Betancourt, Theresa S.
Introduction Few evidence-based interventions exist to support parenting and child mental health during the process of caregiver HIV status disclosure in sub-Saharan Africa. A secondary analysis of a randomized-controlled trial was conducted to examine the role of family-based intervention versus usual social work care (care as usual) in supporting HIV status disclosure within families in Rwanda. Method Approximately 40 households were randomized to family-based intervention and 40...
Morrison, Leanne; Moss-Morris, Rona; Michie, Susan; Yardley, Lucy
Internet-based health behaviour interventions have variable effects on health-related outcomes. Effectiveness may be improved by optimizing the design of interventions. This study examined the specific effect on engagement of providing two different design features - tailoring and self-assessment. Three versions of an Internet-delivered intervention to support the self-care of mild bowel problems were developed that provided (1) self-assessment without tailored feedback, (2) self-assessment with tailored feedback, and (3) generic information only. A qualitative study explored participants' engagement with each version of the intervention (N = 24). A larger quantitative study systematically compared participants' use of the intervention and self-reported engagement using a partial factorial design (n = 178). Findings from the qualitative study suggested that self-assessment without tailored feedback appeared to be less acceptable to participants because it was viewed as offering no personal benefit in the absence of personalized advice. In the quantitative study, self-assessment without tailored feedback was associated with greater dropout than when provided in conjunction with tailored feedback. There were significant group differences in participants' engagement with the intervention and perceptions of the intervention. Self-assessment without tailored feedback was rated as marginally less engaging and was associated with fewer positive perceptions than the generic information condition. The acceptability of self-assessment or monitoring components may be optimized by also providing tailored feedback. Without tailored feedback, these components do not appear to be any more engaging than generic information provision. Statement of contribution What is already known on this subject? Digital interventions can be effective for improving a range of health outcomes and behaviours. There is huge variation in the success of different interventions using different
Harris, A; Moe, T F; Eriksen, H R; Tangen, T; Lie, S A; Tveito, T H; Reme, S E
Cognitive-behavioural treatments (CBT) and physical group exercise (PE) have both shown promising effects in reducing disability and increasing work participation among chronic low back pain (CLBP) patients. A brief cognitive intervention (BI) has previously been demonstrated to reduce work disability in CLBP. The aim of this study was to test if the effect of BI could be further increased by adding either group CBT or group PE. A total of 214 patients, all sick listed 2-10 months due to CLBP, were randomized to BI (n = 99), BI + group CBT (n = 55) or BI + group PE (n = 60). Primary outcome was increased work participation at 12 months, whereas secondary outcomes included pain-related disability, subjective health complaints, anxiety, depression, coping and fear avoidance. There were no significant differences between the groups in work participation at 12 months follow-up (χ 2 = 1.15, p = 0.56). No significant differences were found on the secondary outcomes either, except for a statistically significant reduction (time by group) in pseudoneurology one domain of subjective health complaints (sleep problems, tiredness, dizziness, anxiety, depression, palpitation, heat flushes) (F 2,136 = 3.109, p = 0.048) and anxiety (F 2,143 = 4.899, p = 0.009) for the groups BI + group CBT and BI + group PE, compared to BI alone. However, these differences were not significant in post hoc analyses (Scheffé adjusted). There was no support for an effect of the added group CBT or group PE treatments to a brief cognitive intervention in this study of patients on sick leave due to low back pain. Our study demonstrates that treatments that previously were found to be effective and are included in most treatment guidelines, such as group cognitive-behavior therapy and exercise, were not effective in this given context compared to a brief, cognitive intervention. This implies that an optimized brief intervention is difficult to outperform in patients on
Wilkinson, Lee A.
Conjoint behavioural consultation (CBC) is an indirect form of service delivery that combines the resources of home and school to meet the academic, social and behavioural needs of children. The purpose of this paper is to demonstrate the utility of CBC as a service delivery model for supporting the inclusion of a student with Asperger syndrome in…
Dowey, Alan; Toogood, Sandy; Hastings, Richard P.; Nash, Susie
Background: The working culture surrounding challenging behaviour may have a strong effect on staff behaviour. As a first step to influencing staff talk about challenging behaviour, the aim of the present study was to explore whether a 1-day training workshop could have an effect on staff causal explanations. Methods: Fifty-four front line staff,…
Lichtwarck-Aschoff, Anna; van Geert, Paul
In this article we discussed a dynamic systems view on social behaviour in adolescence. Social behaviour is defined as a self-organizing attractor landscape, based on a network of proximal (i.e., direct) causes. In some cases, social development is disturbed, leading to problematic behaviour in
Robyn L. Tate
Full Text Available We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016 that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.
Full Text Available Dynamic simulation modelling is increasingly being recognised as a valuable decision-support tool to help guide investments and actions to address complex public health issues such as suicide. In particular, participatory system dynamics (SD modelling provides a useful tool for asking high-level ‘what if’ questions, and testing the likely impacts of different combinations of policies and interventions at an aggregate level before they are implemented in the real world. We developed an SD model for suicide prevention in Australia, and investigated the hypothesised impacts over the next 10 years (2015–2025 of a combination of current intervention strategies proposed for population interventions in Australia: 1 general practitioner (GP training, 2 coordinated aftercare in those who have attempted suicide, 3 school-based mental health literacy programs, 4 brief-contact interventions in hospital settings, and 5 psychosocial treatment approaches. Findings suggest that the largest reductions in suicide were associated with GP training (6% and coordinated aftercare approaches (4%, with total reductions of 12% for all interventions combined. This paper highlights the value of dynamic modelling methods for managing complexity and uncertainty, and demonstrates their potential use as a decision-support tool for policy makers and program planners for community suicide prevention actions.
Steed, Liz; Sohanpal, Ratna; James, Wai-Yee; Rivas, Carol; Jumbe, Sandra; Chater, Angel; Todd, Adam; Edwards, Elizabeth; Macneil, Virginia; Macfarlane, Fraser; Greenhalgh, Trisha; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert
To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. Phase I : We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. Phase II : We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. Phase III : We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials. Eight community pharmacies in three inner east London boroughs. 12 Stop Smoking Advisers. Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice. The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context. We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial. UKCRN ID 18446, Pilot. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Kent, Bridie; Cull, Emily; Phillips, Nicole M
Heart failure is a common chronic disease that is one of the leading causes of hospitalisations in many countries around the world. Poor compliance with recommended self-care behaviours, for example managing medication and diet regimes, rather than the deterioration of the cardiac condition, have contributed to a significant proportion of heart failure exacerbations. Patients with heart failure can benefit from interventions that aim to increase their knowledge of the disease and support them in managing their care. There is a need, however, to determine which interventions, if any, are more effective in achieving the aims of self-care. This review examined the evidence to answer the question: What are the most effective interventions for helping adults with heart failure comply with therapy and enhance self care behaviours? This review focused on adults (aged 18 years and over) diagnosed with heart failure.The review considered studies that evaluated interventions aimed to help people with heart failure to improve self-care behaviours.Randomised control trials, quasi-randomised designs and pre-test post-test studies were included in the review.The primary outcome measure was improvement in actual self-care behaviours, including adherence to medications, maintaining a healthy diet, daily weighing, reducing salt intake, recognising symptoms and contacting health professionals when assistance may be required. The search sought to identify published and unpublished, English language studies from 1990 until 2010. Databases searched included Medline, EMBASE, CINAHL, PsycInfo, Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews & JBI COnNECT, PubMed, Informit - Health Collection, MEDNAR, Dissertations & Theses, and Google Scholar METHODOLOGICAL QUALITY: Two independent reviewers independently used the standard critical appraisal tool, from the Joanna Briggs Institute, to assess the methodological quality of studies that matched with inclusion criteria
Full Text Available Abstract Background Although some interventions have been shown to improve adherence to medication for diabetes, results are not consistent. We have developed a theory-based intervention which we will evaluate in a well characterised population to test efficacy and guide future intervention development and trial design. Methods and Design The SAMS (Supported Adherence to Medication Study trial is a primary care based multi-centre randomised controlled trial among 200 patients with type 2 diabetes and an HbA1c of 7.5% or above. It is designed to evaluate the efficacy of a two-component motivational intervention based on the Theory of Planned Behaviour and volitional action planning to support medication adherence compared with standard care. The intervention is delivered by practice nurses. Nurses were trained using a workshop approach with role play and supervised using assessment of tape-recorded consultations. The trial has a two parallel groups design with an unbalanced three-to-two individual randomisation eight weeks after recruitment with twelve week follow-up. The primary outcome is medication adherence measured using an electronic medication monitor over 12 weeks and expressed as the difference between intervention and control in mean percentage of days on which the correct number of medication doses is taken. Subgroup analyses will explore impact of number of medications taken, age, HbA1c, and self-reported adherence at baseline on outcomes. The study also measures the effect of dispensing medication to trial participants packaged in the electronic medication-monitoring device compared with conventional medication packaging. This will be achieved through one-to-one randomisation at recruitment to these conditions with assessment of the difference between groups in self-report of medication adherence and change in mean HbA1c from baseline to eight weeks. Anonymised demographic data are collected on non-respondents. Central randomisation
Narváez, Santiago; Tobar, Angela M; López, Diego M
Stress-related disorders have become one of the main problems of public health in many countries and of worldwide organizations, and they are expected to become more common in the forthcoming decades. This article aims at providing a systematic review and a descriptive evaluation of the interventions supported by ICT for the prevention and treatment of occupational stress. A systematic review of five databases (EBSCO, The Cochrane Library, PubMed, ScienceDirect and IEEEXplorer) was carried out. This article provides a quantitative and qualitative description of 21 studies about occupational stress interventions supported by ICT. The following factors were considered for the analysis: impact of the intervention, design of the study, type of intervention, purpose of the intervention, type of instrument for the measurement of occupational stress, and type of ICT used. The systematic review demonstrated that interventions supported by ICT for the prevention and treatment of occupational stress are scarce but effective.
Full Text Available Recently, new interest in terrorism and psychological factors related to supporting the war on terrorism has been growing in the field of psychology. The aim of this study was to examine the effect of various socio-political attitudes on the level of agreement with military and humanitarian counterterrorism interventions. 270 Italian participants responded to a news article concerning measures against terrorism. Half of the participants read an article regarding a military intervention while the other half read about a humanitarian intervention. They then evaluated the other type of intervention. Results showed that military intervention was supported by people with high authoritarian, dominant, ethnocentric attitudes and by people who attach importance to both positive and negative reciprocity norms. Instead, none of these variables was correlated with humanitarian intervention. Finally, there was a considerable influence of media on the acceptance of both interventions.
We have also shown that it is possible to develop inference algorithms as a basis for unobtrusive monitoring and prediction of depressive mood disorders. The key open question is how to exploit the correlations between mobility metrics and depressive states we observe in the data. We are currently exploring a variety of possible solutions for enabling automatic delivery of behaviour intervention through real-time analysis of the sensed data. The focus of this initial work is on a specific modality, i.e., GPS location, but the results of this work can be indeed exploited to build more complex system based on the analysis of data extracted by means of other sensors, such as accelerometers, and other sources of information, such as call and SMS logs. We indeed plan to use the application in future studies that will focus on specific populations, such as clinically-diagnosed depressed individuals. Ethical considerations are also an important part of our investigation: we believe that the potential risks associated to the delivery of incorrect behaviour interventions should be analysed in depth. A possible solution might consist in mixed intervention methods, based on the automatic delivery of behaviour interventions by means of mobile phones with the involvement of mental healthcare officers and clinicians, at least in case of mild and severe depressive cases.
Sañudo Ortega, R.; Miranda Manzanares, M.; Markine, V.; Dell' Olio, L.
Different types of track infrastructure can be found along railway lines. Separation zones between these different types of structures are the source of a lot of problems. Transition zones on a railway line represent a gradual solution for the problems between conventional railway structure and singular structures located at different points along the line. The different nature, positioning and geometry used with the materials generate changes in the stiffness on both sides of these singular zones leading to an increase in wear and a loss of geometry, with the associated maintenance costs. This article describes the use of mathematical modelling to represent the behaviour of these zones as a function of train running direction and track supports. Available research into transition zones has not studied these separation points where high increases in load are generated for very short periods of time. Finite elements are used to model two types of track (conventional ballasted track and slab track), using a vehicle to dynamically simulate the behaviour in these zones as a function of train running direction and the position of track supports. The magnitudes analysed were the vertical stresses and the vertical displacements under the sleepers and the supports in both types of structure. The results show increased stresses at the separation zone between both structures which varied in magnitude and position depending most of track supports’ location than the train running direction. (Author)
Blecha, Flavio Peixoto; Guedes, Maria Teresa dos Santos
Radiation therapy is a locoregional treatment modality aimed at cure, remission, prophylaxis, or palliation and is indicated singly or in association (neoadjuvant, concomitant, or adjuvant) with treatments like chemotherapy and surgery. One of the complications arising from ionizing radiation involves skin lesions referred to as radiodermatitis, which can involve acute or late reactions. Radiodermatitis affects the individual's quality of life, with altered body image, self-image, and self-esteem, leading to social isolation. The nurse's role is important in prevention and especially in intervention in such reactions. The objective of the current study was to review the state of the art, identify the products and dressings used, and contribute to evidence-based nursing interventions based on treatment of radiodermatitis. A systematic literature review was performed without meta-analysis using the Lilacs, Medline, PubMed, and CINAHL databases from 1993 to 2004. The results identified in the review failed to demonstrate the frequent use of a product that could be recommended for nursing practice. The majority of the products identified are not available in Brazil. The principal publications were in nursing journals in which the nurse was the research coordinator or consultant. The current study revealed a knowledge gap and the need for controlled clinical research led by nurses as the basis for treatment of radiodermatitis. (author)
The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings
Background Promotion and provision of low-cost technologies that enable improved water, sanitation, and hygiene (WASH) practices are seen as viable solutions for reducing high rates of morbidity and mortality due to enteric illnesses in low-income countries. A number of theoretical models, explanatory frameworks, and decision-making models have emerged which attempt to guide behaviour change interventions related to WASH. The design and evaluation of such interventions would benefit from a synthesis of this body of theory informing WASH behaviour change and maintenance. Methods We completed a systematic review of existing models and frameworks through a search of related articles available in PubMed and in the grey literature. Information on the organization of behavioural determinants was extracted from the references that fulfilled the selection criteria and synthesized. Results from this synthesis were combined with other relevant literature, and from feedback through concurrent formative and pilot research conducted in the context of two cluster-randomized trials on the efficacy of WASH behaviour change interventions to inform the development of a framework to guide the development and evaluation of WASH interventions: the Integrated Behavioural Model for Water, Sanitation, and Hygiene (IBM-WASH). Results We identified 15 WASH-specific theoretical models, behaviour change frameworks, or programmatic models, of which 9 addressed our review questions. Existing models under-represented the potential role of technology in influencing behavioural outcomes, focused on individual-level behavioural determinants, and had largely ignored the role of the physical and natural environment. IBM-WASH attempts to correct this by acknowledging three dimensions (Contextual Factors, Psychosocial Factors, and Technology Factors) that operate on five-levels (structural, community, household, individual, and habitual). Conclusions A number of WASH-specific models and frameworks
Findings show that acceptability and desirability of Smart Companion App functions operationalising BCTs relating to aspects of motivation, increased self-efficacy, feedback on outcomes, incentives, prompts/cues, goal setting, self-monitoring, and information about health consequences. Results from further testing iterations over the next year will refine the PEGASO system functions and facilitate wider roll-out to allow cross-cultural exploration of the Behaviour Change Wheel and COM-B model (Michie et al 2011 as intervention design tools for healthy lifestyle behaviour change interventions in teenagers across Europe.
Free, Caroline; Phillips, Gemma; Galli, Leandro; Watson, Louise; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy
Background Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. Methods and Findings We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990–Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72–0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47–1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77–2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. Conclusions Text
Full Text Available Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers.We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010. Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART adherence, use of text messages reduced high viral load (>400 copies, with a relative risk (RR of 0.85 (95% CI 0.72-0.99, but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]. In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]. Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature.Text messaging interventions increased adherence to
Free, Caroline; Phillips, Gemma; Galli, Leandro; Watson, Louise; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy
Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72-0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. Text messaging interventions increased adherence to ART and
Full Text Available Abstract Background The proportion of Ugandan children who are fully vaccinated has varied over the years. Understanding vaccination behaviour is important for the success of the immunisation programme. This study examined influences on immunisation behaviour using the attitude-social influence-self efficacy model. Methods We conducted nine focus group discussions (FGDs with mothers and fathers. Eight key informant interviews (KIIs were held with those in charge of community mobilisation for immunisation, fathers and mothers. Data was analysed using content analysis. Results Influences on the mother's immunisation behaviour ranged from the non-supportive role of male partners sometimes resulting into intimate partner violence, lack of presentable clothing which made mothers vulnerable to bullying, inconvenient schedules and time constraints, to suspicion against immunisation such as vaccines cause physical disability and/or death. Conclusions Immunisation programmes should position themselves to address social contexts. A community programme that empowers women economically and helps men recognise the role of women in decision making for child health is needed. Increasing male involvement and knowledge of immunisation concepts among caretakers could improve immunisation.
Tilahun, Dejene; Birhanu, Zewdie
Background A great burden of infant and under-five childhood mortality occurs during the neonatal period, usually within a few days of birth. Community based behavioural change communication (such as interpersonal, group and mass media channels, including participatory methods at community level) intervention trials have been shown to be effective in reducing this mortality. However, to guide policy makers and programme planners, there is a need to systematically appraise and synthesise this evidence.Objective To systematically search, appraise and synthesise the best available evidence on the effect of community based behavioural change communication intervention to improve neonatal mortality in developing countries.Inclusion Criteria This review considered randomised controlled community trials on the effectiveness of community based behavioural change communication interventions aimed at decreasing neonatal mortality that were conducted in developing countries.Search Strategy This review considered English language articles on studies published between December, 2006 to January, 2011 and indexed in PubMed, CINAHL, EMBASE, Mednar, popline, Proquest, or Hinari.Methodological quality Studies that met the inclusion criteria were assessed for methodological quality using the Joanna Briggs Institute Meta Analysis of Statistical Assessment and Review Instrument by two independent reviewers. Data were analysed using a fixed effects model with RevMan5 software. Community based behavioural change communication interventions were found to be associated with a significant reduction in neonatal mortality of 19% (average OR 0.81; 95%CI 0. to 0.88), early neonatal mortality by 20% (average 0.80; 95%CI 0. to 0.91), late neonatal mortality by 21% (average 0.79; 95%CI 0. to 0.99). In addition, the intervention also resulted in significant improvement of newborn care practice; breast feeding initiation, clean cord cutting and delay in bathing were improved by 185%, 110% and 196
Everyone needs adjustment to get along or survive ones social and physical environment. The widows in this part of the world need it more than anyone due to the hardship culture has placed on them. The study examined the psychological and social support being rendered to the widows for adjustment. One hundred and ...
Frantz, Rebecca; Hansen, Sarah Grace; Squires, Jane; Machalicek, Wendy
Child development occurs within the context of the child's family, neighborhood, and community environment. Early childhood providers support positive outcomes, not only for the children with whom they directly work with but also for their families. Families of children with developmental delays often experience unique challenges. A family…
Šincek, Daniela; Humer, Jasmina Tomašić; Duvnjak, Ivana
This paper explores problematic Internet gaming in the context of other forms of risky behaviour. The basic premise is that children and adolescents at risk will display different types of risky behaviour in various settings. Children and adolescents (N=1150) were surveyed about (cyber)violence, problematic gaming (habits, motives and symptoms), self-disclosure via Facebook and self-esteem. Regular gamers were more violent both face-to-face and via the Internet, and were more prone to problematic gaming than occasional gamers. Those who played games for more than five hours per day (9% of respondents) were classified as potentially problematic gamers. They experienced and committed more violence both face-to-face and via the Internet, were more involved in self-disclosure and had more problematic gaming symptoms than those who played for less than five hours a day, but these groups did not differ in self-esteem. Participants could choose from a list of eight different motives for their gaming; those motivated by peer communication, a sense of control, relaxation, conformism, self-efficacy and to distract from problems reported more symptoms of problematic gaming than those not motivated by these factors. Gender, age, self-esteem, self-disclosure and committing violence contributed to explaining the variance in problematic gaming, accounting for about 26% of its variance. Boys, lower self-esteem, more self-disclosure and committing both types of violence more regularly were connected with reporting more symptoms of problematic gaming. The results will be discussed in the context of a general proneness to risky behaviour. Committing violence against peers (both traditional and cyber) predicts significantly problematic gaming. This supports the premise that children and adolescents at risk are prone to exhibiting different forms of risky behaviour in different settings.
Kassavou, Aikaterini; Sutton, Stephen
Automated telecommunication interventions, including short message service and interactive voice response, are increasingly being used to promote adherence to medications prescribed for cardio-metabolic conditions. This systematic review aimed to comprehensively assess the effectiveness of such interventions to support medication adherence, and to identify the behaviour change techniques (BCTs) and other intervention characteristics that are positively associated with greater intervention effectiveness. Meta-analysis of 17 randomised controlled trials showed a small but statistically significant effect on medication adherence, OR = 1.89, 95% CI [1.51, 2.36], I 2 = 89%, N = 25,101. Multivariable meta-regression analysis including eight BCTs explained 88% of the observed variance in effect size (ES). The BCTs 'tailored' and 'information about health consequences' were positively and significantly associated with ES. Future studies could explore whether the inclusion of these and/or additional techniques (e.g., 'implementation intentions') would increase the effect of automated telecommunication interventions, using rigorous designs and objective outcome measures.
Stuttard, L; Clarke, S; Thomas, M; Beresford, B
Resource constraints may inhibit the provision of appropriate interventions for children with neurodisabilities presenting with behavioural sleep problems. Telephone calls (TC), as opposed to home visits (HV), may be a more resource efficient means of supporting these families. To conduct a preliminary investigation exploring the feasibility and acceptability of replacing HV with TC to support parents implementing sleep management strategies and to gather evidence to inform the design and methods of a full trial. Parents referred to a sleep management intervention routinely delivered by a community paediatric team were alternately allocated to receive implementation support via HV (n = 7) or TC (n = 8). Activity logs recorded the frequency, duration and mode of support. Parents and practitioners were interviewed about their experiences of receiving/delivering the intervention. Intervention drop-out was low, the frequency, number of contacts and intervention duration appeared comparable. Parents allocated TC received less contact time. Parents valued implementation support irrespective of delivery mode and practitioners reported that despite initial reservations, implementation support via TC appeared to work well. TC appears an acceptable and convenient mode of delivering sleep support, valued by both parents and practitioners. We recommend a full-scale trial to investigate effectiveness. © 2015 John Wiley & Sons Ltd.
Miragall, Marta; Domínguez-Rodríguez, Alejandro; Navarro, Jessica; Cebolla, Ausiàs; Baños, Rosa M
The aim of this study was to analyse the effect of an Internet-based motivational intervention (IMI) supported by pedometers (in comparison with IMI alone and non-intervention) on increasing daily steps and changing constructs related to physical activity (PA) in a sample of sedentary students. A randomised-controlled trial was conducted with 76 sedentary or low-active college students. The purpose of the IMI was to deliver information to increase motivation and set individualised PA goals. It involved a 3-week intervention and a 3-months follow-up. Objective measures were used to measure daily steps, and self-report questionnaires to assess different constructs related to PA. Results revealed that IMI supported by pedometers condition increased significantly more the daily steps (post-intervention: M = 2069; SD = 1827; follow-up: M = 2227; SD = 2477) and enjoyment than non-intervention condition at both points in time. Moreover, results showed that IMI alone condition increased more the scores in variables involved in PA behaviour than non-intervention condition. This study shows the effectiveness of a self-administered IMI using pedometers in increasing PA and enjoyment, and the effectiveness of the IMI alone in changing different theoretical constructs related to the PA behaviour.
Thastum, Mille; Rask, Charlotte Ulrikka; Næss-Schmidt, Erhard
Background: Five – 15 % of patients with concussion experience impairing post-concussional symptoms (PCS) more than 3 months post-injury. Currently, treatment studies are scarce and no evidence-based treatment is available. Existing literature suggest that negative illness perceptions and maladap......Background: Five – 15 % of patients with concussion experience impairing post-concussional symptoms (PCS) more than 3 months post-injury. Currently, treatment studies are scarce and no evidence-based treatment is available. Existing literature suggest that negative illness perceptions...... and maladaptive illness behaviours may be involved in the development of persisting PCS. Aim: To develop an early behavioural intervention for young patients (15 – 30 years) with continuing PCS 3-6 months post-concussion, to explore hypothesised mediators, i.e. illness perceptions and illness behaviour...
Wycherley, T P; Mohr, P; Noakes, M; Clifton, P M; Brinkworth, G D
Sustainability of healthy lifestyle behaviours following participation in a research-based supervised lifestyle intervention programme is often poor. This study aimed to document factors reported by overweight and obese individuals with Type 2 diabetes as enhancing or impeding sustainability of lifestyle behaviours following participation in such a programme. Thirty patients who completed a 16-week research-based supervised lifestyle intervention programme, incorporating a structured energy restricted diet with or without supervised resistance-exercise training underwent a semi-structured qualitative interview about their experiences in maintaining programme components after 1 year. Participants maintained 8.8 ± 8.9 kg of the 13.9 ± 6.6 kg weight loss achieved with the research-based supervised lifestyle intervention programme. Only 23% of participants indicated continuation of the complete diet programme. Desire for 'variety' (33%) and increased portion size (27%) were the most commonly reported reasons for discontinuation. Participants who undertook supervised exercise training during the programme indicated access to appropriate programmes/facilities (38%), more affordable gym membership (21%) and having a personal trainer/motivator (17%) would have facilitated exercise continuation. In overweight and obese individuals with Type 2 diabetes, success of the research-based supervised lifestyle intervention programme was perceived as being primarily due to high levels of professional support and supervision, the discontinuation of which subsequently presented difficulties. The interview data provide insight into what people experience following the completion of a research-based intensive lifestyle intervention programme and suggest that programmes assembled for research purposes with the emphasis on compliance may not necessarily promote sustainable change. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
Full Text Available Background: Smokers are four times more likely to stop smoking with the help of an NHS Stop Smoking Service (SSS. However attendance is in decline, possibly due to the increase in popularity of e-cigarettes. SSS’s will support smokers who choose to use e-cigarettes as part of a quit attempt, therefore interventions are needed to encourage continued access and uptake of SSS. Aim: To design an evidence based intervention (Stop-app to increase referrals, 4 week quit rates and reduce ‘did not attend’ (DNA rates within SSS. Methods/Results: In Phase 1 we collected data to explore the barriers and facilitators to people using SSS. Smokers and ex-smokers identified a number of barriers, including a lack of knowledge about what happens at the service; the belief that there would be ’scare tactics’, ‘nagging’, that the service would be unfriendly and clinical; and a lack of perceived efficacy of the service. In Phase 2, data from extant literature and phase 1 were subject to behavioural analysis as outlined by the Behaviour Change Wheel framework. A range of factors were identified as needing to change. These aligned with capability (e.g. a lack of knowledge about the benefits of SSS, opportunity (e.g. beliefs that SSS are not easy to access and to motivation to act (e.g. beliefs that they did not need and would not benefit from SSS. We describe the content development process, illustrating the choice of 19 ‘Behaviour Change Techniques’ included in our digital intervention. In Phase 3 we assessed the acceptability of the proposed intervention by interviewing stop smoking service advisors and non-NHS provider sites (e.g. library services and children’s centres. Findings from interviews are presented and have been used to consider the best path for implementation of the web-app within service provision. Conclusion: The ‘Stop –app’ is in development and will be accessible online, linking with the SSS booking system used by Public
Full Text Available Melanie Paul, Melanie Baker, Robert N Williams, David J Bowrey Department of Surgery, Leicester Royal Infirmary, Leicester, UK Background and aims: Provision of adequate nutrition after esophagectomy remains a major challenge. The aims of this review were to describe the challenges facing this patient population and to determine the evidence base underpinning current nutritional and dietetic interventions after esophagectomy. Methods: Medline, Embase and CINAHL databases were searched for English language publications of the period 1990–2016 reporting on the outcome of nutritional or dietetic interventions after esophagectomy or patient-related symptoms. Results: Four studies demonstrated that early reintroduction of oral fluids was safe and was associated with a shorter hospital stay and ileus duration. One of three studies comparing in-hospital enteral nutrition against usual care showed that enteral feeding was well tolerated and was associated with a shorter hospital stay. Eight studies comparing enteral with parenteral nutrition showed similar surgical complication rates. Enteral feeding was associated with a shorter duration of ileus and lower health care costs. In hospital, all types of enteral access (nasoenteral, jejunostomy were equivalent in their safety profiles. Cohort studies indicate that technical (tube dysfunction and feed (diarrhea, distention problems were common with jejunostomies but are easily managed. The mortality risk associated with jejunostomy in hospital is 0.2% (reported range 0%–1%, principally due to small bowel ischemia. There have been no reports of serious jejunostomy complications in patients receiving home feeding. One study demonstrated the advantages of home feeding in weight, muscle and fat preservation. Studies reporting 12 months or more after esophagectomy indicate a high frequency of persistent symptoms, dumping syndrome 15%–75% (median 46%, dysphagia 11%–38% (median 27%, early satiety 40%–90
Ali, Eskinder Eshetu; Leow, Jo Lene; Chew, Lita; Yap, Kevin Yi-Lwern
Well-designed smartphone apps can potentially help in enhancing adherence to oral anticancer medications (OAMs). The objective of this study was to evaluate patients' perception on inclusion of various adherence-enhancing strategies as features of an app and their interest in using such app. A cross-sectional survey was conducted at the National Cancer Centre Singapore. A structured self-administered questionnaire was used to collect data from patients taking OAMs. Final analysis was based on 409 surveys and most of the respondents were female (291, 71.1%), Chinese (332, 81.2%), married (296, 72.4%) and breast cancer patients (211, 51.6%). Close to two-thirds of respondents rated medication information (65.0%), disease information (60.2%) and side effect self-management (60.2%) features as having the highest level of importance in an adherence app. Three hundred thirty-two (81.2%) of the respondents owned a smartphone, among which 92 (27.7%) reported using health-related apps. From respondents with smartphones, 219 (66.0%) were interested in using an app for OAM adherence. Age 65 and older compared to 21-54 years old (adjusted OR = 0.34; 95% CI = 0.15-0.76) and current use of a health app (adjusted OR = 1.91; 95% CI = 1.07-3.41) were significant predictors of interest to adopt an adherence app. In conclusion, patients value the inclusion of educational and behavioural interventions in adherence apps. Developers of adherence apps should consider including tools for side effect self-management and provision of information to educate patients on their medications and disease condition.
Werfel, Seth H.
Household actions and government policies are both necessary to mitigate the effects of climate change. However, household behaviour may crowd out public support for government action by creating the perception of sufficient progress. Here we demonstrate this crowding-out effect in public opinion using survey experiments with more than 14,000 participants in Japan. Subjects who were randomly assigned to report their energy-saving actions following the shutdown of the Fukushima power plant were less likely to support a tax increase on carbon emissions. Treatment effects were larger for subjects who had completed more actions. Further evidence suggests that the crowding-out effect may have been driven by an increase in the perceived importance of individual actions relative to government regulation and a decrease in the perceived issue importance of energy and environmental sustainability.
Marialuisa Di Stefano
Full Text Available This research discusses a single case study of a first-grade Latino English Learner (EL student, Allen (pseudonym, from a larger inquiry-based intervention on inversion and mental reversibility development. The purpose of this case study was to develop a better understanding of the relationship between Allen’s English language proficiency and his ability to solve inversion and compensation mathematics tasks. The integration of multiple paradigms confronting radical constructivism and sociocultural theory of learning via culturally relevant pedagogy provided us with a multi-faceted set of perspectives in understanding the interconnection between Allen’s cultural and linguistic background and his development of algebraic reasoning. Through conceptual and retrospective analyses, we found that Allen’s language features are highly correlated with the development of his thinking strategies and his ability to solve mathematics tasks. Implications of this study include the development of teaching strategies that address critical issues in mathematics, such as the individual differences of learners, specifically ELs from Latino background. We suggest further research is needed in the field of language acquisition and access to STEM related concepts.
Kennedy, Ryan David; Behm, Ilan; Craig, Lorraine; Thompson, Mary E.; Fong, Geoffrey T.; Guignard, Romain; Beck, Francois
Background: On January 1, 2008, the French government implemented a national ban on indoor smoking in hospitality venues. Survey results indicate the indoor ban has been successful at dramatically reducing indoor smoking; however, there are reports of an increased number of outdoor hospitality spaces (patios) where smoking can take place. This study sought to understand if the indoor ban simply moved smoking to the outdoors, and to assess levels of support for smoking restrictions in outdoor hospitality settings after the smoke-free law. Methods: Telephone interviews were conducted among 1067 adult smokers before and after the 2008 indoor ban as part of the International Tobacco Control (ITC) France Survey. Among other topics, this survey measures how the smoking ban has influenced smoking behaviour relevant to outdoor sections of hospitality venues. In addition, 414 non-smoking adults and 164 respondents who had quit smoking between waves were also asked about support for outdoor smoking restrictions. Results: Reported smoking outdoors at cafés/pubs/bars increased from 33.6% of smokers at Wave 1 to 75.9% at Wave 2. At restaurants, smoking outdoors increased from 28.9% to 59.0%. There was also an increase in reported non-smoking for both visits to cafés/pubs/bars, and restaurants from 13.4% to 24.7%, and 30.4% to 40.8% respectively. The majority of smokers (74.5%), non-smokers (89.4%) and quitters (74.0%) support a partial or complete ban on smoking in outdoor areas of restaurants. Conclusion: The indoor smoking ban moved smoking to outdoor spaces; however, the ban is also associated with increased non-smoking behaviour. The majority of respondents support outdoor smoking restrictions in patio environments. PMID:22294782
Kennedy, Ryan David; Behm, Ilan; Craig, Lorraine; Thompson, Mary E; Fong, Geoffrey T; Guignard, Romain; Beck, Francois
On January 1, 2008, the French government implemented a national ban on indoor smoking in hospitality venues. Survey results indicate the indoor ban has been successful at dramatically reducing indoor smoking; however, there are reports of an increased number of outdoor hospitality spaces (patios) where smoking can take place. This study sought to understand if the indoor ban simply moved smoking to the outdoors, and to assess levels of support for smoking restrictions in outdoor hospitality settings after the smoke-free law. Telephone interviews were conducted among 1067 adult smokers before and after the 2008 indoor ban as part of the International Tobacco Control (ITC) France Survey. Among other topics, this survey measures how the smoking ban has influenced smoking behaviour relevant to outdoor sections of hospitality venues. In addition, 414 non-smoking adults and 164 respondents who had quit smoking between waves were also asked about support for outdoor smoking restrictions. Reported smoking outdoors at cafés/pubs/bars increased from 33.6% of smokers at Wave 1 to 75.9% at Wave 2. At restaurants, smoking outdoors increased from 28.9% to 59.0%. There was also an increase in reported non-smoking for both visits to cafés/pubs/bars, and restaurants from 13.4% to 24.7%, and 30.4% to 40.8% respectively. The majority of smokers (74.5%), non-smokers (89.4%) and quitters (74.0%) support a partial or complete ban on smoking in outdoor areas of restaurants. The indoor smoking ban moved smoking to outdoor spaces; however, the ban is also associated with increased non-smoking behaviour. The majority of respondents support outdoor smoking restrictions in patio environments.
Rackow, Pamela; Scholz, Urte; Hornung, Rainer
The role of social support in physical exercise is well documented. However, the majority of studies that investigate the associations between social support and physical exercise target perceived instead of received social support. Moreover, most studies investigate the effects of received social support using a descriptive correlational design. Thus, our study aimed at investigating the effects of received social support by conducting an intervention study. Participants were randomly assigned to an intervention (n = 118) or control group (n = 102). The intervention comprised regularly exercising with a new sports companion for eight weeks. To investigate the time course of physical exercise and received social support, growth curve modelling was employed. Generally, both groups were able to improve their physical exercise. However, the control group tended to decrease again during the final point of measurement. Received social support, however, decreased slightly in the control group, but remained stable in the intervention group. The intervention was suitable to sustain received social support for physical exercise across a two-month interval. Overall, these findings highlight the importance of further investigating social support for physical exercise applying an experimental approach. © 2014 The International Association of Applied Psychology.
Full Text Available Abstract Background and objective Social support interventions have a somewhat chequered history. Despite evidence that social connection is associated with good health, efforts to implement interventions designed to increase social support have produced mixed results. The aim of this paper is to reflect on the relationship between social connectedness and good health, by examining social support interventions with mothers of young children and analysing how support was conceptualised, enacted and valued, in order to advance what we know about providing support to improve health. Context and approach First, we provide a brief recent history of social support interventions for mothers with young children and we critically examine what was intended by ‘social support’, who provided it and for which groups of mothers, how support was enacted and what was valued by women. Second, we examine the challenges and promise of lay social support approaches focused explicitly on companionship, and draw on experiences in two cluster randomised trials which aimed to improve the wellbeing of mothers. One trial involved a universal approach, providing befriending opportunities for all mothers in the first year after birth, and the other a targeted approach offering support from a ‘mentor mother’ to childbearing women experiencing intimate partner violence. Results Interventions providing social support to mothers have most often been directed to women seen as disadvantaged, or ‘at risk’. They have also most often been enacted by health professionals and have included strong elements of health education and/or information, almost always with a focus on improving parenting skills for better child health outcomes. Fewer have involved non-professional ‘supporters’, and only some have aimed explicitly to provide companionship or a listening ear, despite these aspects being what mothers receiving support have said they valued most. Our trial
Ross, Lynda J; Capra, Sandra; Baguley, Brenton; Sinclair, Kate; Munro, Kate; Lewindon, Peter; Lavin, Martin
Ataxia-telangiectasia (A-T) is a rare genomic syndrome resulting in severe disability. Chronic childhood disorders can profoundly influence growth and development. Nutrition-related issues in A-T are not well described, and there are no nutritional guidelines. This study investigated the nutrition-related characteristics and behaviours of Australian A-T patients attending a national clinic. A cross-sectional analysis of 13 A-T patients (nine females; aged: 4-23 years): nutritional status was assessed by anthropometric and body cell mass (BCM) calculations. Parents reported their child's diet history and physical and behavioural factors that affect nutrition including fatigue and need for assistance. Ten (77%) had short stature (height for age z scores nutritional barriers as chronic tiredness and the need for care giver assistance with meals. This study confirms profound malnutrition in Australian A-T patients. Poor intakes and diet quality suggest the need for early nutrition intervention. Ongoing support for families and early discussions on tube feeding are required to address changing needs in childhood and likely nutritional decline into adulthood. A prospective study is required to assess feasibility and effectiveness of nutrition interventions in young people with A-T. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Full Text Available Abstract Background The uptake of improvement initiatives in infection prevention and control (IPC has often proven challenging. Innovative interventions such as ‘serious games’ have been proposed in other areas to educate and help clinicians adopt optimal behaviours. There is limited evidence about the application and evaluation of serious games in IPC. The purposes of the study were: a to synthesise research evidence on the use of serious games in IPC to support healthcare workers’ behaviour change and best practice learning; and b to identify gaps across the formulation and evaluation of serious games in IPC. Methods A scoping study was conducted using the methodological framework developed by Arksey and O’Malley. We interrogated electronic databases (Ovid MEDLINE, Embase Classic + Embase, PsycINFO, Scopus, Cochrane, Google Scholar in December 2015. Evidence from these studies was assessed against an analytic framework of intervention formulation and evaluation. Results Nine hundred sixty five unique papers were initially identified, 23 included for full-text review, and four finally selected. Studies focused on intervention inception and development rather than implementation. Expert involvement in game design was reported in 2/4 studies. Potential game users were not included in needs assessment and game development. Outcome variables such as fidelity or sustainability were scarcely reported. Conclusions The growing interest in serious games for health has not been coupled with adequate evaluation of processes, outcomes and contexts involved. Explanations about the mechanisms by which game components may facilitate behaviour change are lacking, further hindering adoption.
Full Text Available The main behaviour change intervention available for coronary heart disease (CHD patients is cardiac rehabilitation. There is little recognition of what the active ingredients of behavioural interventions for CHD might be. Using a behaviour change technique (BCT framework to code existing interventions may help to identify this. The objectives of this systematic review are to determine the effectiveness of CHD behaviour change interventions and how this may be explained by BCT content and structure.A systematic search of Medline, EMBASE and PsycInfo electronic databases was conducted over a twelve year period (2003-2015 to identify studies which reported on behaviour change interventions for CHD patients. The content of the behaviour change interventions was coded using the Coventry Aberdeen and London-Refined (CALO-RE taxonomy. Meta-regression analyses examined the BCT content as a predictor of mortality. Twenty two papers met the criteria for this review, reporting data on 16,766 participants. The most commonly included BCTs were providing information, and goal setting. There was a small but significant effect of the interventions on smoking (risk ratio (RR = 0.89, 95% CI 0.81-0.97. The interventions did not reduce the risk of CHD events (RR = 0.86, 95% CI 0.68, 1.09, but significantly reduced the risk of mortality (RR = 0.82, 95% CI 0.69, 0.97. Sensitivity analyses did not find that any of the BCT variables predicted mortality and the number of BCTs included in an intervention was not associated with mortality (β = -0.02, 95% CI -0.06-0.03.Behaviour change interventions for CHD patients appear to have a positive impact on a number of outcomes. Using an existing BCT taxonomy to code the interventions helped us to understand which were the most commonly used techniques, providing information and goal setting, but not the active components of these complex interventions.
Goodwin, Laura; Ostuzzi, Giovanni; Khan, Nadia; Hotopf, Matthew H; Moss-Morris, Rona
The main behaviour change intervention available for coronary heart disease (CHD) patients is cardiac rehabilitation. There is little recognition of what the active ingredients of behavioural interventions for CHD might be. Using a behaviour change technique (BCT) framework to code existing interventions may help to identify this. The objectives of this systematic review are to determine the effectiveness of CHD behaviour change interventions and how this may be explained by BCT content and structure. A systematic search of Medline, EMBASE and PsycInfo electronic databases was conducted over a twelve year period (2003-2015) to identify studies which reported on behaviour change interventions for CHD patients. The content of the behaviour change interventions was coded using the Coventry Aberdeen and London-Refined (CALO-RE) taxonomy. Meta-regression analyses examined the BCT content as a predictor of mortality. Twenty two papers met the criteria for this review, reporting data on 16,766 participants. The most commonly included BCTs were providing information, and goal setting. There was a small but significant effect of the interventions on smoking (risk ratio (RR) = 0.89, 95% CI 0.81-0.97). The interventions did not reduce the risk of CHD events (RR = 0.86, 95% CI 0.68, 1.09), but significantly reduced the risk of mortality (RR = 0.82, 95% CI 0.69, 0.97). Sensitivity analyses did not find that any of the BCT variables predicted mortality and the number of BCTs included in an intervention was not associated with mortality (β = -0.02, 95% CI -0.06-0.03). Behaviour change interventions for CHD patients appear to have a positive impact on a number of outcomes. Using an existing BCT taxonomy to code the interventions helped us to understand which were the most commonly used techniques, providing information and goal setting, but not the active components of these complex interventions.
Engelborghs, S; Gilles, C; Ivanoiu, A; Vandewoude, M
Adequate nutrition plays an important role in the maintenance of cognitive function, particularly during aging. Malnutrition is amongst the risk factors for developing mild cognitive impairment (MCI) and Alzheimer's disease (AD). Epidemiological studies have associated deficiencies in some nutrients with a higher risk of cognitive dysfunction and/or AD. Cognitive decline in AD is correlated with synaptic loss and many of the components required to maintain optimal synaptic function are derived from dietary sources. As synapses are part of the neuronal membrane and are continuously being remodelled, the availability of sufficient levels of nutritional precursors (mainly uridine monophosphate, choline and omega-3 fatty acids) to make the phospholipids required to build neuronal membranes may have beneficial effects on synaptic degeneration in AD. In addition, B-vitamins, phospholipids and other micronutrients act as cofactors to enhance the supply of precursors required to make neuronal membranes and synapses. Despite this, no randomized controlled trial has hitherto provided evidence that any single nutrient has a beneficial effect on cognition or lowers the risk for AD. However, a multi-target approach using combinations of (micro)nutrients might have beneficial effects on cognitive function in neurodegenerative brain disorders like AD leading to synaptic degeneration. Here we review the clinical evidence for supplementation, based on a multi-target approach with a focus on key nutrients with a proposed role in synaptic dysfunction. Based on preclinical evidence, a nutrient mixture, Souvenaid(®) (Nutricia N.V., Zoetermeer, The Netherlands) was developed. Clinical trials with Souvenaid(®) have shown improved memory performance in patients with mild AD. Further clinical trials to evaluate the effects of nutritional intervention in MCI and early dementia due to AD are on-going.
O'Brien, O A; McCarthy, M; Gibney, E R; McAuliffe, F M
Overweight and obesity are associated with increased risk of adverse maternal and fetal outcomes. However, the actuality of delivering effective lifestyle interventions in clinical practice is hampered by a high demand for resources. The use of technology to assist lifestyle interventions needs to be explored as a valid method of reducing strain on resources, and enhancing the effectiveness and population reach of interventions. The aim was to systematically review the literature on the use of technology-supported lifestyle interventions for healthy pregnant women and their impact on maternal outcomes. Online databases and registries were searched in March 2013. Primary outcomes of selected English language studies were fasting maternal glucose, incidence of gestational diabetes mellitus (GDM) and maternal gestational weight gain. Secondary outcomes were intervention uptake and acceptance, and dietary or physical activity modification. Studies whose subjects were diagnosed with GDM prior to intervention were excluded. The minimal number of eligible studies and varying outcomes precluded formal meta-analysis of the data. Initially, 203 articles were identified and screened. Seven articles, including five randomised controlled trials, met inclusion criteria for the current review. Results demonstrate several potential benefits associated with technology-supported interventions in pregnancy, despite minimal search results. Although communication technology holds potential as a safe therapeutic tool for the support of lifestyle interventions in pregnancy, there is a paucity of data on its effectiveness. Further RCTs examining the effectiveness of communication technology are required, particularly among those most likely to benefit from lifestyle interventions, such as overweight and obese pregnant women.
Barberger-Gateau, P; Helmer, C; Ouret, S; Gendron, B
The French National Program on Nutrition and Health has defined two specific objectives targeting older persons: (i) to improve their status in calcium and vitamin D and (ii) to prevent undernutrition. Home help provides support in activities of daily living, including meals, to dependent persons. The objective of our study was to evaluate the impact of a nutritional education intervention on knowledge and practices among home support assistants for the elderly. Three facilities providing home support in Gironde (France) selected 132 home support assistants to follow an education program and 134 controls. Nutrition training was conducted in the intervention group by a dietician during two half-day sessions in May-June 2004. A non randomized controlled trial design was used for evaluation. Nutritional knowledge (20 questions) and practice (5 questions) of home support assistants were assessed by questionnaire before (April 2004) and after (September 2004) the training period in each group. Satisfaction of the intervention group was also assessed. The intervention group included 101 participants and the control group 106 persons who answered both questionnaires before and after the education program. The intervention group was significantly younger (p educated (p = 0.01) and had less often participated to previous nutrition training (p intervention for their mean scores of knowledge or practices. The intervention group significantly improved its knowledge score (mean gain 2.5 points, p nutritional education was very significant (p intervention in multivariate analyses. Satisfaction of trained home support assistants was very high. An education program of home support assistants for elderly persons can improve their nutritional knowledge, but this study cannot conclude that the intervention was efficient to improve the nutritional status of older persons.
Karen S. Ingersoll
Full Text Available While Internet interventions can improve health behaviors, their impact is limited by program adherence. Supporting program adherence through telephone counseling may be useful, but there have been few direct tests of the impact of support. We describe a Telephone Motivational Interviewing (MI intervention targeting adherence to an Internet intervention for drivers with Type 1 Diabetes, DD.com, and compare completion of intervention benchmarks by those randomized to DD.com plus MI vs. DD.com only. The goal of the pre-intervention MI session was to increase the participant's motivation to complete the Internet intervention and all its assignments, while the goal of the post-treatment MI session was to plan for maintaining changes made during the intervention. Sessions were semi-structured and partially scripted to maximize consistency. MI Fidelity was coded using a standard coding system, the MITI. We examined the effects of MI support vs. no support on number of days from enrollment to program benchmarks. Results show that MI sessions were provided with good fidelity. Users who received MI support completed some program benchmarks such as Core 4 (t176 df = −2.25; p < .03 and 11 of 12 monthly driving diaries significantly sooner, but support did not significantly affect time to intervention completion (t177 df = −1.69; p < .10 or rates of completion. These data suggest that there is little benefit to therapist guidance for Internet interventions including automated email prompts and other automated minimal supports, but that a booster MI session may enhance collection of follow-up data.
Noordman, Janneke; Driesenaar, Jeanine A.; Henselmans, Inge; Verboom, Jedidja; Heijmans, Monique; van Dulmen, Sandra
Objective: To enhance patient participation during (oncological) encounters, this study aims to gain insight into communication barriers and supportive interventions experienced by elderly patients with cancer. Method: A mixed method design, including both quantitative (secondary survey data
Chaudhury, Sumona; Kirk, Catherine M; Ingabire, Charles; Mukunzi, Sylvere; Nyirandagijimana, Beatha; Godfrey, Kalisa; Brennan, Robert T; Betancourt, Theresa S
Few evidence-based interventions exist to support parenting and child mental health during the process of caregiver HIV status disclosure in sub-Saharan Africa. A secondary analysis of a randomized-controlled trial was conducted to examine the role of family-based intervention versus usual social work care (care as usual) in supporting HIV status disclosure within families in Rwanda. Approximately 40 households were randomized to family-based intervention and 40 households to care as usual. Parenting, family unity, and child mental health during the process of disclosure were studied using quantitative and qualitative research methods. Many of the families had at least one caregiver who had not disclosed their HIV status at baseline. Immediately post-intervention, children reported lower parenting and family unity scores compared with those in the usual-care group. These changes resolved at 3-month follow-up. Qualitative reports from clinical counselor intervention sessions described supported parenting during disclosure. Overall findings suggest adjustments in parenting, family unity, and trust surrounding the disclosure process. Family-based intervention may support parenting and promote child mental health during adjustment to caregiver HIV status disclosure. Further investigation is required to examine the role of family-based intervention in supporting parenting and promoting child mental health in HIV status disclosure.
Hawkes, Anna L; Patrao, Tania A; Green, Anita; Aitken, Joanne F
This pilot study aimed to test the acceptability and short-term effectiveness of a telephone-delivered multiple health behaviour change intervention for relatives of colorectal cancer survivors. A community-based sample of 22 first-degree relatives of colorectal cancer survivors were recruited via a media release. Data were collected at baseline and at six weeks (post-intervention). Outcome measures included health behaviours (physical activity, television viewing, diet, alcohol, body mass index, waist circumference and smoking), health-related quality of life (Short Form-36) and perceived colorectal cancer risk. Intervention satisfaction levels were also measured. The intervention included six telephone health coaching sessions, a participant handbook and a pedometer. It focused on behavioural risk factors for colorectal cancer [physical activity, diet (red and processed meat consumption, fruit and vegetable intake), alcohol, weight management and smoking], and colorectal cancer risk. From baseline to six weeks, improvements were observed for minutes moderate-vigorous physical activity (150.7 minutes), processed meat intake (-1.2 serves/week), vegetable intake (1 serve/day), alcohol intake (-0.4 standard drinks/day), body mass index (-1.4 kg/m2), and waist circumference (-5.1 cm). Improvements were also observed for physical (3.3) and mental (4.4) health-related quality of life. Further, compared with baseline, participants were more likely to meet Australian recommendations post-intervention for: moderate-vigorous physical activity (27.3 vs 59.1%); fruit intake (68.2 vs 81.8%); vegetable intake (4.6 vs 18.2%); alcohol consumption (59.1 vs 72.7%); body mass index (31.8 vs 45.5%) and waist circumference (18.2 vs 27.3%). At six weeks participants were more likely to believe a diagnosis of CRC was related to family history, and there was a decrease in their perceived risk of developing CRC in their lifetime following participation in CanPrevent. The intervention
Hawkes Anna L
Full Text Available Abstract Background This pilot study aimed to test the acceptability and short-term effectiveness of a telephone-delivered multiple health behaviour change intervention for relatives of colorectal cancer survivors. Methods A community-based sample of 22 first-degree relatives of colorectal cancer survivors were recruited via a media release. Data were collected at baseline and at six weeks (post-intervention. Outcome measures included health behaviours (physical activity, television viewing, diet, alcohol, body mass index, waist circumference and smoking, health-related quality of life (Short Form-36 and perceived colorectal cancer risk. Intervention satisfaction levels were also measured. The intervention included six telephone health coaching sessions, a participant handbook and a pedometer. It focused on behavioural risk factors for colorectal cancer [physical activity, diet (red and processed meat consumption, fruit and vegetable intake, alcohol, weight management and smoking], and colorectal cancer risk. Results From baseline to six weeks, improvements were observed for minutes moderate-vigorous physical activity (150.7 minutes, processed meat intake (−1.2 serves/week, vegetable intake (1 serve/day, alcohol intake (−0.4 standard drinks/day, body mass index (−1.4 kg/m2, and waist circumference (−5.1 cm. Improvements were also observed for physical (3.3 and mental (4.4 health-related quality of life. Further, compared with baseline, participants were more likely to meet Australian recommendations post-intervention for: moderate-vigorous physical activity (27.3 vs 59.1%; fruit intake (68.2 vs 81.8%; vegetable intake (4.6 vs 18.2%; alcohol consumption (59.1 vs 72.7%; body mass index (31.8 vs 45.5% and waist circumference (18.2 vs 27.3%. At six weeks participants were more likely to believe a diagnosis of CRC was related to family history, and there was a decrease in their perceived risk of developing CRC in their lifetime following
Jonkers, E.; Martens, Marieke Hendrikje; Vonk, T.; van der Lindt, M.
To ease some of the major problems in the field of mobility and transport a change in travel and driving behaviour is needed. At this moment, too many travellers use the car and drive at the same moment in time. In order to change travel behaviour various measures can be taken. However, often one
Johnson, Gaige; Kohler, Kelly; Ross, Denise
The purpose of the current paper is to describe the impact of applied behaviour analysis on language treatment for children with autism spectrum disorders (ASDs) diagnoses. Specifically, this paper will describe Skinner's theory of verbal behaviour and its contributions to evidence-based treatments for communication deficits among individuals with…
Enggaard, Helle; Uhrenfeldt, Lisbeth
Review question/objective: The objective of this review is to identify, appraise and synthesize the best available evidence regarding people with ischemic heart disease and their experiences with peer support in self-management interventions. More specifically, the review question is: How do people...... with ischemic heart disease experience peer support in structured self-management interventions led or co-led by peers?...
Martin, Anne; Booth, Josephine N; Laird, Yvonne; Sproule, John; Reilly, John J; Saunders, David H
The global prevalence of childhood and adolescent obesity is high. Lifestyle changes towards a healthy diet, increased physical activity and reduced sedentary activities are recommended to prevent and treat obesity. Evidence suggests that changing these health behaviours can benefit cognitive function and school achievement in children and adolescents in general. There are various theoretical mechanisms that suggest that children and adolescents with excessive body fat may benefit particularly from these interventions. To assess whether lifestyle interventions (in the areas of diet, physical activity, sedentary behaviour and behavioural therapy) improve school achievement, cognitive function (e.g. executive functions) and/or future success in children and adolescents with obesity or overweight, compared with standard care, waiting-list control, no treatment, or an attention placebo control group. In February 2017, we searched CENTRAL, MEDLINE and 15 other databases. We also searched two trials registries, reference lists, and handsearched one journal from inception. We also contacted researchers in the field to obtain unpublished data. We included randomised and quasi-randomised controlled trials (RCTs) of behavioural interventions for weight management in children and adolescents with obesity or overweight. We excluded studies in children and adolescents with medical conditions known to affect weight status, school achievement and cognitive function. We also excluded self- and parent-reported outcomes. Four review authors independently selected studies for inclusion. Two review authors extracted data, assessed quality and risks of bias, and evaluated the quality of the evidence using the GRADE approach. We contacted study authors to obtain additional information. We used standard methodological procedures expected by Cochrane. Where the same outcome was assessed across different intervention types, we reported standardised effect sizes for findings from single
Felix A Achana
Full Text Available There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a "usual care or no intervention" which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i Medicines only, ii Other household products only, iii Poisons (both medicines and non-medicines, iv Poisonous plants; and v Possession of poison control centre (PCC telephone number in households with children.Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model.28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00 while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13, safe storage of poisons (11.10, 1.60 to 141.50 and possession of PCC number (38.82, 2.19 to 687.10. No one intervention package was more effective than the others in promoting safe storage of poisonous plants.The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the
Achana, Felix A; Sutton, Alex J; Kendrick, Denise; Wynn, Persephone; Young, Ben; Jones, David R; Hubbard, Stephanie J; Cooper, Nicola J
There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a "usual care or no intervention" which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children. Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model. 28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants. The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison
Nørnberg, Trine Riebeling; Houlby, Louise; Skov, Laurits Rohden; Peréz-Cueto, Federico Jose Armando
The primary objective of this review is to assess the prevalence and quality of published studies on the effect of choice architectural nudge interventions promoting vegetable consumption among adolescents. Additionally, this review aims to identify studies estimating adolescents' attitude towards choice architectural nudge interventions. Web of Science, Scopus and PubMed were searched systematically for experimental studies with a predefined search strategy in the period November-December 2013. Publications were included following predetermined inclusion criteria. Studies were evaluated as of high, moderate or weak quality. Finally, studies were grouped by the type of intervention and underwent a narrative synthesis. The search showed that only very few studies investigated the effects of choice architectural nudging interventions on vegetable consumption, and none of them had attitude towards behavioural interventions as an outcome measure. Twelve studies met the inclusion criteria. The results of the 12 studies were inconclusive, and the majority of studies were of weak or moderate quality. This review uncovers a gap in knowledge on the effect of choice architectural nudge interventions aiming to promote the intake of vegetables among adolescents in a school context. It also highlights that no previous studies have considered the attitudes towards choice architectural nudge interventions as a potential factor for their success - or lack thereof - in achieving the desired goal of increased vegetable consumption. © Royal Society for Public Health 2015.
Roberts, Susan J O; Demarco, Rosanna; Griffin, Martha
The aim of the present study was to review the current literature on oppressed group behaviours in nursing, with emphasis on interventions to change the behaviours, and on instruments that have been developed to measure it. Oppressed group behaviours have been described in nurses for over two decades and their presence has been related to decreased nurse self-advocacy, and other negative aspects of the nursing workplace. Systematic review of the literature on oppressed group behaviour in nursing. Oppressed group behaviours are frequently found in nurses. Interventions have been created and tested to decrease oppressed group behaviours. Oppressed group behaviours are frequently found in nurses. Interventions exist that can decrease oppressed group behaviours and the decrease is related to increased work force performance, satisfaction and retention of nurses in the workplace. Nurse Managers can improve the workplace by measuring oppressed group behaviours and utilizing interventions to break the cycle of oppression in the workplace culture. Utilizing these innovations improve the workplace culture for nursing.
Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael
Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large.
Deficits in self-regulatory skills underlie or contribute to a range of adverse developmental problems and disorders, including ADHD (Barkley, 1997), eating disorders (Attie & Brooks-Gunn, 1995) and risk -taking behaviour (Cantor & Sanderson 1998; Eisenberg et al., 2005). Self-regulation has been recognised as an important factor in aiding…
Kingkaew, Pritaporn; Glidewell, Liz; Walwyn, Rebecca; Fraser, Hamish; Wyatt, Jeremy C
Mobile health (mHealth) interventions for smoking cessation have been shown to be associated with an increase in effectiveness. However, interventions using mobile phones to change people's behaviour are often perceived as complex interventions, and the interactions between several components within them may affect the outcome. Therefore, it is important to understand how we can improve the design of mHealth interventions using mobile phones as a medium to deliver services. Randomised controlled trials (RCTs) of mHealth interventions to support smoking cessation or uptake of smoking cessation services for smokers will be included in this systematic review. A search will be performed by searching MEDLINE, MEDLINE(R) In-Process & Other Non-Indexed Citations, EMBASE, PsycINFO, Web of Science, and CINAHL. A search for new publications will be conducted 3 months prior to submission for publication as mHealth is an emerging area of research. A random-effects meta-analysis model will be used to summarise the effectiveness of mHealth interventions. The risk ratio will be used for the primary outcome, self-reported or verified smoking abstinence, and any binary outcomes for uptake of smoking cessation services. The standardised mean difference using Hedges' g will be reported for continuous data. Heterogeneity will be assessed using I 2 statistics. Where feasible, meta-regression analysis using random-effects multilevel modelling will be conducted to examine the association of pre-specified characteristics (covariates) at the study level with the effectiveness of interventions. Publication bias will be explored using Egger's test for continuous outcomes and Harbord and Peters tests for dichotomous outcomes. The funnel plot will be used to evaluate the presence of publication bias. The Cochrane Risk of Bias Tool will be used to assess differences in risks of bias. The results of this systematic review will provide future research with a foundation for designing and
Milton, Alyssa; Lloyd-Evans, Brynmor; Fullarton, Kate; Morant, Nicola; Paterson, Bethan; Hindle, David; Kelly, Kathleen; Mason, Oliver; Lambert, Marissa; Johnson, Sonia
A documented gap in support exists for service users following discharge from acute mental health services, and structured interventions to reduce relapse are rarely provided. Peer-facilitated self-management interventions have potential to meet this need, but evidence for their effectiveness is limited. This paper describes the development of a peer-provided self-management intervention for mental health service users following discharge from crisis resolution teams (CRTs). A five-stage iterative mixed-methods approach of sequential data collection and intervention development was adopted, following the development and piloting stages of the MRC framework for developing and evaluating complex interventions. Evidence review (stage 1) included systematic reviews of both peer support and self-management literature. Interviews with CRT service users (n = 41) regarding needs and priorities for support following CRT discharge were conducted (stage 2). Focus group consultations (n = 12) were held with CRT service-users, staff and carers to assess the acceptability and feasibility of a proposed intervention, and to refine intervention organisation and content (stage 3). Qualitative evaluation of a refined, peer-provided, self-management intervention involved qualitative interviews with CRT service user participants (n = 9; n = 18) in feasibility testing (stage 4) and a pilot trial (stage 5), and a focus group at each stage with the peer worker providers (n = 4). Existing evidence suggests self-management interventions can reduce relapse and improve recovery. Initial interviews and focus groups indicated support for the overall purpose and planned content of a recovery-focused self-management intervention for people leaving CRT care adapted from an existing resource: The personal recovery plan (developed by Repper and Perkins), and for peer support workers (PSWs) as providers. Participant feedback after feasibility testing was positive regarding facilitation of
Farquharson, Barbara; Johnston, Marie; Smith, Karen; Williams, Brian; Treweek, Shaun; Dombrowski, Stephan U; Dougall, Nadine; Abhyankar, Purva; Grindle, Mark
To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text + visual and text-only) with usual care. Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for acute coronary syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions. A three-arm web-based, parallel randomized controlled trial of a theory-based intervention. The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n = 177 participants who have experienced acute coronary syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care, ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text + visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of acute coronary syndrome ≥15-minute duration, assessed using two randomized series of eight scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014. Positive results changing intentions would lead to a randomized controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms. Registered at ClinicalTrials.gov: NCT02820103. © 2016 John Wiley & Sons Ltd.
Monroe, Jessica T; Lofgren, Ingrid E; Sartini, Becky L; Greene, Geoffrey W
To investigate the effectiveness of an online, interactive intervention, referred to as the Green Eating (GE) Project, to motivate university students to adopt GE behaviours. The study was quasi-experimental and integrated into courses for credit/extra credit. Courses were randomly stratified into experimental or non-treatment control. The 5-week intervention consisted of four modules based on different GE topics. Participants completed the GE survey at baseline (experimental, n 241; control, n 367) and post (experimental, n 187; control, n 304). The GE survey has been previously validated and consists of Transtheoretical Model constructs including stage of change (SOC), decisional balance (DB: Pros and Cons) and self-efficacy (SE: School and Home) as well as behaviours for GE. Modules contained basic information regarding each topic and knowledge items to assess content learning. The GE Project took place at a public university in the north-eastern USA. Participants were full-time students between the ages of 18 and 24 years. The GE Project was effective in significantly increasing GE behaviours, DB Pros, SE School and knowledge in experimental compared with control, but did not reduce DB Cons or increase SE Home. Experimental participants were also more likely to be in later SOC for GE at post testing. The GE Project was effective in increasing GE behaviours in university students. Motivating consumers towards adopting GE could assist in potentially mitigating negative consequences of the food system on the environment. Future research could tailor the intervention to participant SOC to further increase the effects or design the modules for other participants.
Cavallo, David N; Tate, Deborah F; Ward, Dianne S; DeVellis, Robert F; Thayer, Linden M; Ammerman, Alice S
Despite their widespread use and extensive technical features, little is known about how to use online social networking sites to increase physical activity. This study aims to examine Facebook engagement among participants in the online social networking arm of a randomized controlled physical activity promotion trial (n = 67). Facebook communications were double coded and analyzed using ATLAS.ti. Regression procedures were used to determine predictors of Facebook use and associations between types of use and changes in perceived social support and physical activity. Changes in perceived social support and physical activity were more strongly associated with participants' individual Facebook use than use of the Facebook intervention group. The way social media sites are used in intervention design could have an impact on their effects. Including existing friends in interventions and using applications that incorporate intervention activities into a more naturalistic use of Facebook may improve the efficacy of future interventions.
Full Text Available Background: Psychological debriefing has been widely advocated for routine use following major traumatic events. Cognitive Behavioral Interventions, art supportive therapies, and sport and recreational support activities are other interventions for reducing posttraumatic stress disorder. We assessed the effects of theses methods individually and in combination on reduction posttraumatic stress disorder symptoms in adolescents who had experienced Bam earthquake. Methods: In a field trial, we evaluated the efficacy of psychological debriefing, group cognitive-behavioral therapy, art and sport supportive interventions in 200 adolescents with PTSD symptoms who survived of Bam earthquake and compare it with a control group. Patients were randomly assigned to one of intervention programs including: group cognitive-behavioral therapy; group CBT plus art and sport interventions; art and sport interventions without group CBT; and control group. Results: Thirty one individuals were excluded because of migration. A statistically significant reduction in overall PTSD symptoms as well as in avoidance symptoms was observed after group cognitive-behavioral therapy. There was no significant difference in reduction of overall PTSD and avoidance symptoms between the other groups. Conclusion: Psychological interventions in form of group cognitive behavioral therapy can reduce the symptoms of PTSD symptoms but we couldn't find the art and sport supportive therapy alone or in combination with group CBT to be useful in this regard.
Peters, Gjalt-Jorn Ygram; de Bruin, Marijn; Crutzen, Rik
There is a need to consolidate the evidence base underlying our toolbox of methods of behaviour change. Recent efforts to this effect have conducted meta-regressions on evaluations of behaviour change interventions, deriving each method's effectiveness from its association to intervention effect size. However, there are a range of issues that raise concern about whether this approach is actually furthering or instead obstructing the advancement of health psychology theories and the quality of health behaviour change interventions. Using examples from theory, the literature and data from previous meta-analyses, these concerns and their implications are explained and illustrated. An iterative protocol for evidence base accumulation is proposed that integrates evidence derived from both experimental and applied behaviour change research, and combines theory development in experimental settings with theory testing in applied real-life settings. As evidence gathered in this manner accumulates, a cumulative science of behaviour change can develop.
Predictors of bisexual behaviour among MSM attending intervention sites may help in prevention interventions for this bridge to the heterosexual epidemic in India: data from HIV sentinel surveillance.
Full Text Available Indian cultural tradition demanding marriage, many MSM howsoever they self-identify are likely to be married or have sex with women. To consolidate India's HIV prevention gains, it is important to understand and address the interaction between the MSM and heterosexual epidemics in India and create specific interventions for bisexual MSM. The challenge is to identify and intervene this hard to reach population. Data from HIV Sentinel Surveillance 2011 among MSM in four Indian states were analyzed to assess predictors and prevalence of bisexual behaviour in MSM.Between March-May 2011, 4682 men (15-49 years who had anal/oral sex with a male partner in the past month, attending intervention sites and consenting for an un-linked anonymous survey answered an 11- item questionnaire and provided blood for HIV test by finger stick at 19 designated surveillance sites.Of 4682 MSM tested overall, 5% were illiterate, 51% reported only receptive anal intercourse, 21% only penetrative and 28% both. 36% MSM had ever received money for sex. Overall 6.8% were HIV infected. 44% MSM were bisexual in the last six months. On multivariate analysis, 'being bisexual' was found to be independently associated with 'older age': 26-30 years [AOR = 3.1, 95% CI(2.7, 3.7], >30 years [AOR = 6.5, 95% CI(5.5, 7.7]; 'reporting penetrative behaviour alone' with other men [AOR = 5.8, 95% CI(4.8, 7.0, p<0.01] and 'reporting both penetrative and receptive behaviour' [AOR = 2.7, 95% CI(2.3, 3.1 p<0.01]. Those who both paid and received money for sex [AOR = 0.49, 95% CI (0.38, 0.62] were significantly less likely to be bisexual.A substantial proportion of men receiving services from Targeted Intervention programs are bisexual and the easy opportunity for intervention in this setting should be capitalised upon. Focusing on older MSM, as well as MSM who show penetrative behaviour with other men, could help in reaching this population.
Protocol for the ADDITION-Plus study: a randomised controlled trial of an individually-tailored behaviour change intervention among people with recently diagnosed type 2 diabetes under intensive UK general practice care
one year. We will undertake an intention-to-treat analysis of the effect of the intervention on these measures, an assessment of cost-effectiveness, and analyse predictors of behaviour change in the cohort. Discussion The ADDITION-Plus trial will establish the medium-term effectiveness and cost-effectiveness of adding an externally facilitated intervention tailored to support change in multiple behaviours among intensively-treated individuals with recently diagnosed type 2 diabetes in primary care. Results will inform policy recommendations concerning the management of patients early in the course of diabetes. Findings will also improve understanding of the factors influencing change in multiple behaviours, and their association with health outcomes. Trial registration ISRCTN: ISRCTN99175498
Alageel, Samah; Gulliford, Martin C; McDermott, Lisa; Wright, Alison J
It is uncertain whether multiple health behaviour change (MHBC) interventions are effective for the primary prevention of cardiovascular disease (CVD) in primary care. A systematic review and a meta-analysis were performed to evaluate the effectiveness of MHBC interventions on CVD risk and CVD risk factors; the study also evaluated associations of theoretical frameworks and intervention components with intervention effectiveness. The search included randomised controlled trials of MHBC interventions aimed at reducing CVD risk in primary prevention population up to 2017. Theoretical frameworks and intervention components were evaluated using standardised methods. Meta-analysis with stratification and meta-regression were used to evaluate intervention effects. We identified 31 trials (36 484 participants) with a minimum duration of 12 months follow-up. Pooled net change in systolic blood pressure (16 trials) was -1.86 (95% CI -3.17 to -0.55; p=0.01) mm Hg; diastolic blood pressure (15 trials), -1.53 (-2.43 to -0.62; p=0.001) mm Hg; body mass index (14 trials), -0.13 (-0.26 to -0.01; p=0.04) kg/m 2 ; serum total cholesterol (14 trials), -0.13 (-0.19 to -0.07; p<0.001) mmol/L. There was no significant association between interventions with a reported theoretical basis and improved intervention outcomes. No association was observed between intervention intensity (number of sessions and intervention duration) and intervention outcomes. There was significant heterogeneity for some risk factor analyses, leading to uncertain validity of some pooled net changes. MHBC interventions delivered to CVD-free participants in primary care did not appear to have quantitatively important effects on CVD risk factors. Better reporting of interventions' rationale, content and delivery is essential to understanding their effectiveness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted
Valdois, Sylviane; Peyrin, Carole; Lassus-Sangosse, Delphine; Lallier, Marie; Démonet, Jean-François; Kandel, Sonia
We report the case study of a French-Spanish bilingual dyslexic girl, MP, who exhibited a severe visual attention (VA) span deficit but preserved phonological skills. Behavioural investigation showed a severe reduction of reading speed for both single items (words and pseudo-words) and texts in the two languages. However, performance was more affected in French than in Spanish. MP was administered an intensive VA span intervention programme. Pre-post intervention comparison revealed a positive effect of intervention on her VA span abilities. The intervention further transferred to reading. It primarily resulted in faster identification of the regular and irregular words in French. The effect of intervention was rather modest in Spanish that only showed a tendency for faster word reading. Text reading improved in the two languages with a stronger effect in French but pseudo-word reading did not improve in either French or Spanish. The overall results suggest that VA span intervention may primarily enhance the fast global reading procedure, with stronger effects in French than in Spanish. MP underwent two fMRI sessions to explore her brain activations before and after VA span training. Prior to the intervention, fMRI assessment showed that the striate and extrastriate visual cortices alone were activated but none of the regions typically involved in VA span. Post-training fMRI revealed increased activation of the superior and inferior parietal cortices. Comparison of pre- and post-training activations revealed significant activation increase of the superior parietal lobes (BA 7) bilaterally. Thus, we show that a specific VA span intervention not only modulates reading performance but further results in increased brain activity within the superior parietal lobes known to housing VA span abilities. Furthermore, positive effects of VA span intervention on reading suggest that the ability to process multiple visual elements simultaneously is one cause of successful
Al-Khudairy, Lena; Loveman, Emma; Colquitt, Jill L; Mead, Emma; Johnson, Rebecca E; Fraser, Hannah; Olajide, Joan; Murphy, Marie; Velho, Rochelle Marian; O'Malley, Claire; Azevedo, Liane B; Ells, Louisa J; Metzendorf, Maria-Inti; Rees, Karen
Adolescent overweight and obesity has increased globally, and can be associated with short- and long-term health consequences. Modifying known dietary and behavioural risk factors through behaviour changing interventions (BCI) may help to reduce childhood overweight and obesity. This is an update of a review published in 2009. To assess the effects of diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years. We performed a systematic literature search in: CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS, and the trial registers ClinicalTrials.gov and ICTRP Search Portal. We checked references of identified studies and systematic reviews. There were no language restrictions. The date of the last search was July 2016 for all databases. We selected randomised controlled trials (RCTs) of diet, physical activity and behavioural interventions for treating overweight or obesity in adolescents aged 12 to 17 years. Two review authors independently assessed risk of bias, evaluated the overall quality of the evidence using the GRADE instrument and extracted data following the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. We contacted trial authors for additional information. We included 44 completed RCTs (4781 participants) and 50 ongoing studies. The number of participants in each trial varied (10 to 521) as did the length of follow-up (6 to 24 months). Participants ages ranged from 12 to 17.5 years in all trials that reported mean age at baseline. Most of the trials used a multidisciplinary intervention with a combination of diet, physical activity and behavioural components. The content and duration of the intervention, its delivery and the comparators varied across trials. The studies contributing most information to outcomes of weight and body mass index (BMI) were from studies at a low risk of bias, but studies with a high risk of bias provided data on adverse events
Gilinsky, Alyssa Sara; Dale, Hannah; Robinson, Clare; Hughes, Adrienne R; McInnes, Rhona; Lavallee, David
This systematic review and meta-analysis reports the efficacy of post-natal physical activity change interventions with content coding of behaviour change techniques (BCTs). Electronic databases (MEDLINE, CINAHL and PsychINFO) were searched for interventions published from January 1980 to July 2013. Inclusion criteria were: (i) interventions including ≥1 BCT designed to change physical activity behaviour, (ii) studies reporting ≥1 physical activity outcome, (iii) interventions commencing later than four weeks after childbirth and (iv) studies including participants who had given birth within the last year. Controlled trials were included in the meta-analysis. Interventions were coded using the 40-item Coventry, Aberdeen & London - Refined (CALO-RE) taxonomy of BCTs and study quality assessment was conducted using Cochrane criteria. Twenty studies were included in the review (meta-analysis: n = 14). Seven were interventions conducted with healthy inactive post-natal women. Nine were post-natal weight management studies. Two studies included women with post-natal depression. Two studies focused on improving general well-being. Studies in healthy populations but not for weight management successfully changed physical activity. Interventions increased frequency but not volume of physical activity or walking behaviour. Efficacious interventions always included the BCTs 'goal setting (behaviour)' and 'prompt self-monitoring of behaviour'.
Mattanah, Jonathan F.; Brooks, Leonie J.; Brand, Bethany L.; Quimby, Julie L.; Ayers, Jean F.
The authors examined whether a social support intervention reduced loneliness and increased academic achievement among college freshmen. Eighty-eight 1st-year students randomly assigned to a social support group program reported less loneliness in the spring of their freshman year and obtained higher grade point averages in the fall of their…
McLachlan, Sarah; Hagger, Martin S.
Empirical evidence has attested to the benefits of autonomy support in a classroom context, in facilitating students' autonomous motivation, well-being, creativity, engagement, and persistence. However, most interventional research aiming to increase teachers' autonomy-supportive behaviors has been conducted in school and college contexts, with…
Tyre, Ashli D.; Feuerborn, Laura L.; Woods, Leslie
Understanding staff concerns about a systemic change effort allows leadership teams to better anticipate and address staff needs for professional development and support. In this study, staff concerns in nine schools planning for or implementing School-Wide Positive Behavior Interventions and Supports (SWPBIS) were explored using the…
Nascimento, Marcus; Silva, Danielle; Ribeiro, Sandra; Nunes, Marco; Almeida, Marcos; Mendes-Netto, Raquel
The objective of the present study is to evaluate and compare the effect of a nutritional intervention between adolescent and adult. In a before and after quasi-experimental clinical study, 32 athletes (21 adults, age range 20-32 years; 11 adolescents, age range: 12-19 years) participated in a nutritional counselling consisting of four consultations separated by an interval of 45 to 60 days. The athlete's eating behaviour, body composition and nutrition knowledge were evaluated at the beginning and at the end of the protocol. Both groups increased lean body mass and nutritional knowledge. Adolescents increased their mid-arm muscle circumference and improved meal frequency, and daily water intake. Athletes of both groups improved their ingestion of vegetables and fruits and decreased the ingestion of sweets and oils. Adolescents showed a higher prevalence of individuals that remained within or approached to the recommendations of sweets. This is the first study to evaluate and compare the effect of a nutritional intervention between adolescent and adult athletes body composition, eating behaviour and nutritional knowledge. The nutritional counselling has been effective in promoting beneficial changes on the athlete's eating behaviour, nutritional knowledge and body composition, however, some healthy changes were only experienced by adolescents, especially in the frequency of meals and the intake of sweets.
Munce, Sarah Elizabeth Patricia; Shepherd, John; Perrier, Laure; Allin, Sonya; Sweet, Shane N; Tomasone, Jennifer R; Nelson, Michelle L A; Guilcher, Sara J T; Hossain, Saima; Jaglal, Susan
Peer support is receiving increasing attention as both an effective and cost-effective intervention method to support the self-management of chronic health conditions. Given that an increasing proportion of Canadians have internet access and the increasing implementation of web-based interventions, online peer support interventions are a promising option to address the burden of chronic diseases. Thus, the specific research question of this scoping review is the following: What is known from the existing literature about the key characteristics of online peer support interventions for adults with chronic conditions? METHODS AND ANALYSIS: We will use the methodological frameworks used by Arksey and O'Malley as well as Levac and colleagues for the current scoping review. To be eligible for inclusion, studies must report on adults (≥18 years of age) with one of the Public Health Agency of Canada chronic conditions or HIV/AIDS. We will limit our review to peer support interventions delivered through online formats. All study designs will be included. Only studies published from 2012 onwards will be included to ensure relevance to the current healthcare context and feasibility. Furthermore, only English language studies will be included. Studies will be identified by searching a variety of databases. Two reviewers will independently screen the titles and abstracts identified by the literature search for inclusion (ie, level 1 screening), the full text articles (ie, level 2 screening) and then perform data abstraction. Abstracted data will include study characteristics, participant population, key characteristics of the intervention and outcomes collected. This review will identify the key features of online peer support interventions and could assist in the future development of other online peer support programmes so that effective and sustainable programmes can be developed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the
Andrewes, H E; Walker, V; O'Neill, B
To investigate the feasibility and effectiveness of conducting two positive psychology interventions to improve mood and self-concept with survivors of traumatic brain injury (TBI), within a neuro-rehabilitation hospital. Ten patients with brain injury were randomly allocated to an intervention and control group. The efficacy of the first intervention, 'three positive things in life' was measured via Seligman's Authentic Happiness Index (AHI), at base-line, directly following the intervention and at the end of the 12-week group programme. The second intervention, the 'Value in Action (VIA) signature strengths intervention' was measured by the Head Injury Semantic Differential Scale (HISDS) at baseline and at the end of the group. Compared to baseline and control group scores, the AHI index showed an increase in the intervention group's happiness following the intervention and at the end of the 12-week programme, albeit the latter increase was non-significant. The HISDS showed non-significant improvement in self-concept and reduction in polarization of the self in the present, future and past in the second intervention. Anecdotal evidence revealed a clear improved mood following the interventions. This study shows promising results for the effectiveness of Positive Psychology interventions and methods to improve feasibility when applying this treatment within a hospital setting.
Eiraldi, Ricardo; McCurdy, Barry; Khanna, Muniya; Mautone, Jennifer; Jawad, Abbas F; Power, Thomas; Cidav, Zuleyha; Cacia, Jaclyn; Sugai, George
Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program. The study follows six K - 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost. Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence
Anderson, Yvonne C; Wynter, Lisa E; Butler, Michelle S; Grant, Cameron C; Stewart, Joanna M; Cave, Tami L; Wild, Cervantée E K; Derraik, José G B; Cutfield, Wayne S; Hofman, Paul L
The aim of this study was to describe dietary intake and eating behaviours of obese children and adolescents, and also to determine how these differ in Indigenous versus non-Indigenous children at enrolment in an obesity programme. Baseline dietary intake and eating behaviour records were assessed from those enrolled in a clinical unblinded randomised controlled trial of a multi-disciplinary intervention. The setting was a community-based obesity programme in Taranaki, New Zealand. Children or adolescents who were enrolled from January 2012 to August 2014, with a BMI ≥98th percentile or >91st centile with weight-related comorbidities were eligible. 239 participants (45% Māori, 45% NZ Europeans, 10% other ethnicities), aged 5-17 years were assessed. Two-thirds of participants experienced hyperphagia and half were not satiated after a meal. Comfort eating was reported by 62% of participants, and daily energy intake was above the recommended guidelines for 54%. Fruit and vegetable intake was suboptimal compared with the recommended 5 servings per day (mean 3.5 [SD = 1.9] servings per day), and the mean weekly breakfasts were less than the national average (5.9 vs 6.5; peating behaviours and significant differences in dietary intake between obese participants and their national counterparts. Ethnic differences between Indigenous and non-Indigenous participants were also present, especially in relation to sweet drink consumption. Eating behaviours, especially sweet drink consumption and fruit/vegetable intake need to be addressed.
Kondo, Naoki; Ishikawa, Yoshiki
control sessions, adjusting for individual-level and parlour-level potential confounders. Even adjusting for health risks and within-parlour clustering, the intervention sessions gathered more socioeconomically vulnerable customers than the regular sessions. Compared with control sessions, in intervention sessions the adjusted prevalence ratios were 1.15 (95% CI 0.99 to 1.35) for not having a job (vs having a job) and 1.36 (95% CI 1.00 to 1.86) for holders of National Health Insurance (which includes more socially vulnerable people than other insurance programmes). The results supported our hypothesis. Offering health check-up opportunities equipped with 'tricks' that nudge people to act might be effective for anyone but is potentially more valuable for socially vulnerable people. Ethical discussions are needed to further consider the use of erotic stimuli and other essential drivers of human behaviour. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Muessig, Kathryn E; LeGrand, Sara; Horvath, Keith J; Bauermeister, José A; Hightow-Weidman, Lisa B
We describe recent mobile health (mHealth) interventions supporting antiretroviral therapy (ART) medication adherence among HIV-positive MSM. Keyword searches (1 January 2016-13 May 2017) identified 721 citations. Seven publications reporting on six studies met inclusion criteria. Five studies focused on MSM. Interventions primarily employed text messaging (n = 4), whereas two focused on smartphone apps and one on social media. Three studies measured intervention impact on adherence and found increased ART use intentions (n = 1), self-reported adherence (n = 1), and viral suppression (n = 1, no control group). Other mHealth interventions for HIV-positive MSM focused on status disclosure and reducing sexual risk. mHealth interventions to support ART adherence among MSM show acceptability, feasibility, and preliminary efficacy. No recent mHealth interventions for MSM measured impact on viral suppression compared with a control condition despite earlier (pre-2015) evidence for efficacy. Studies are underway that include multiple features designed to improve adherence within complex smartphone or internet-based platforms. Areas for future growth include overcoming measurement and engagement challenges, developing tools for coordinating patient and provider adherence data, testing combination interventions, and adapting efficacious interventions for new languages and geographic settings.
Williams, Gillian; Hamm, Michele P; Shulhan, Jocelyn; Vandermeer, Ben; Hartling, Lisa
To conduct a systematic review of randomised controlled trials (RCTs) examining the use of social media to promote healthy diet and exercise in the general population. MEDLINE, CENTRAL, ERIC, PubMed, CINAHL, Academic Search Complete, Alt Health Watch, Health Source, Communication and Mass Media Complete, Web of Knowledge and ProQuest Dissertation and Thesis (2000-2013). RCTs of social media interventions promoting healthy diet and exercise behaviours in the general population were eligible. Interventions using social media, alone or as part of a complex intervention, were included. Study quality was assessed using the Cochrane Risk of Bias Tool. We describe the studies according to the target populations, objectives and nature of interventions, outcomes examined, and results and conclusions. We extracted data on the primary and secondary outcomes examined in each study. Where the same outcome was assessed in at least three studies, we combined data in a meta-analysis. 22 studies were included. Participants were typically middle-aged Caucasian women of mid-to-high socioeconomic status. There were a variety of interventions, comparison groups and outcomes. All studies showed a decrease in programme usage throughout the intervention period. Overall, no significant differences were found for primary outcomes which varied across studies. Meta-analysis showed no significant differences in changes in physical activity (standardised mean difference (SMD) 0.13 (95% CI -0.04 to 0.30), 12 studies) and weight (SMD -0.00 (95% CI -0.19 to 0.19), 10 studies); however, pooled results from five studies showed a significant decrease in dietary fat consumption with social media (SMD -0.35 (95% CI -0.68 to -0.02)). Social media may provide certain advantages for public health interventions; however, studies of social media interventions to date relating to healthy lifestyles tend to show low levels of participation and do not show significant differences between groups in key outcomes.
Fatemeh Mokhtari1 , Soheila Ehsanpour2 and Ashraf Kazemi 3*
Background: Social support is one of the important effective factors on health-related behaviors in different groups. The present study has evaluated the effect of an educational intervention on parents’ nutritional social support for having a healthy diet by teenagers. Methods: This field trial was conducted in two groups on the parents of 63 female early adolescent.The level of parents’ nutritional social support for having a healthy diet were measured using a questionnaire. One month after...
Full Text Available Abstract Background Dementia is an important health and social care problem and is one of the main causes of disability in later life. The number of families affected by dementia will dramatically increase over the next five decades. Despite the implications for health and social care services in the future, the overwhelming majority of care for people with dementia takes place away from health care settings. Providing informal care for someone with dementia can be psychologically, physically and financially expensive and a range of health service interventions aimed at supporting and providing information to these carers has developed to help carers meet these demands. This review examines whether information and support interventions improve the quality of life of people caring for someone with dementia. Methods A systematic review examining evidence from randomised controlled trials in which technology, individualised or group-based interventions built around the provision of support and/or information were evaluated. Results Forty-four studies were included in the review. Controlling for the quality of the evidence, we found statistically significant evidence that group-based supportive interventions impact positively on psychological morbidity. However, whilst the improvement was unlikely to be due to chance, the clinical significance of this finding should be interpreted tentatively, due to the difficulties in interpreting the standardised mean difference as a measure of effect and the complex aetiology of depression. No evidence was found for the effectiveness of any other form of intervention on a range of physical and psychological health outcomes. Conclusion There is little evidence that interventions aimed at supporting and/or providing information to carers of people with dementia are uniformly effective. There is a pressing need to ensure that supportive interventions at the development stage are accompanied by good quality
Candy, Bridget; Jones, Louise; Drake, Robyn; Leurent, Baptiste; King, Michael
Patients in the terminal phase of a disease may have complex needs. It is often family and friends who play a central role in providing support, despite health professional input and regardless of whether the patient is at home or elsewhere. Such informal caring may involve considerable physical, psychological, and economic stresses. A range of supportive programmes for caregivers is being developed including psychological support and practical assistance. To assess the effects of supportive interventions that aim to improve the psychological and physical health of informal caregivers of patients in the terminal phase of their illness. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2 2010); MEDLINE (1950 to May 2010); EMBASE (1980 to May 2010); PsycINFO (1872 to May 2010); CINAHL (1937 to May 2010); National Health Service Research Register (2000 to November 2008) and Dissertation Abstracts (1716 to May 2010). We searched the reference lists of relevant studies; contacted experts; and handsearched journals. Randomised controlled trials (RCTs) of interventions to support adults who were caring for a friend or relative with a disease in the terminal phase. Interventions could include practical and emotional support and/or the facilitation of coping skills. Interventions could support caregivers indirectly via patient care. Two authors independently screened citations against the selection criteria. Data were extracted by one author and checked by another. This included extraction of any adverse effects. Risk of bias assessment was undertaken by two authors. We contacted trial authors to obtain missing information. Trial data were combined, where appropriate, on the review's primary outcomes. We included eleven RCTs involving 1836 caregiver participants. Nine interventions were delivered directly to the caregiver. Seven of these provided support in the caring role, another involved a family life review, and one
Cudney, Shirley A; Weinert, Clarann; Phillips, Larry D
The purposes of this article are to describe the telephone technical support system used in the Women to Women support and health education computer outreach project for chronically ill rural women, discuss the preparation and role of the information systems specialist, and examine the nature and quality of telephone support requested and received. Telephone support records were tallied and categorized to determine the number of participants requiring assistance and the nature of problems described. The quality of telephone support received was assessed through a postintervention mail survey. About one third of participants sought telephone support, most frequently for problems related to impaired Internet service provider delivery and the university's Web-application platform. The quality of telephone support was rated highly by 96% of respondents. It was concluded that telephone technical support is a useful adjunct to a computer-based intervention and that quality support can be provided by including a competent information systems specialist on the research team.
O'Halloran, Peter; Scott, David; Reid, Joanne; Porter, Sam
Multimedia interventions are increasingly used to deliver information in order to promote self-care among patients with degenerative conditions. We carried out a realist review of the literature to investigate how the characteristics of multimedia psychoeducational interventions combine with the contexts in which they are introduced to help or hinder their effectiveness in supporting self-care for patients with degenerative conditions. Electronic databases (Medline, Science Direct, PSYCHinfo, EBSCO, and Embase) were searched in order to identify papers containing information on multimedia psychoeducational interventions. Using a realist review approach, we reviewed all relevant studies to identify theories that explained how the interventions work. Ten papers were included in the review. All interventions sought to promote self-care behaviors among participants. We examined the development and content of the multimedia interventions and the impact of patient motivation and of the organizational context of implementation. We judged seven studies to be methodologically weak. All completed studies showed small effects in favor of the intervention. Multimedia interventions may provide high-quality information in an accessible format, with the potential to promote self-care among patients with degenerative conditions, if the patient perceives the information as important and develops confidence about self-care. The evidence base is weak, so that research is needed to investigate effective modes of delivery at different resource levels. We recommend that developers consider how an intervention will reduce uncertainty and increase confidence in self-care, as well as the impact of the context in which it will be employed.
Plaete, Jolien; De Bourdeaudhuij, Ilse; Verloigne, Maïté; Crombez, Geert
The study aims to evaluate the acceptability, feasibility and effectiveness of the eHealth intervention 'MyPlan', which targets health behaviour in adults. Flemish adults were randomly allocated to a control (n=155), or one of the three intervention groups: a physical activity (PA) (n=158), a fruit intake (n=161) or a vegetable intake group (n=48). PA, fruit or vegetable intake were measured at the start and after one month. Adults with low education, and over 40 years evaluated the personal advice and action plans as more motivating, but also the personal advice as too long than adults with high education and younger adults. Overall, 48% completed the follow-up module after one week, and only 24% after one month. At one-month follow-up, the fruit intake intervention resulted in more fruit intake (F=9.5, p=0.003) and the PA intervention in a higher total physically activity level (F=5.6, p=0.020) than the control group. There was no effect for vegetable intake. 'MyPlan' was feasible and acceptable, and has the potential to increase PA levels, and fruit and vegetable intake. Adaptations to the content of the intervention are further needed, and more attention is needed to motivate participants to complete the different follow-up parts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Kien Hoa Ly
Full Text Available There is need for more cost and time effective treatments for depression. This is the first randomised controlled trial in which a blended treatment--including four face-to-face sessions and a smartphone application--was compared against a full behavioural treatment. Hence, the aim of the current paper was to examine whether a blended smartphone treatment was non-inferior to a full behavioural activation treatment for depression.This was a randomised controlled non-inferiority trial (NCT01819025 comparing a blended treatment (n=46 against a full ten-session treatment (n=47 for people suffering from major depression. Primary outcome measure was the BDI-II, that was administered at pre- and post-treatment, as well as six months after the treatment.Results showed significant improvements in both groups across time on the primary outcome measure (within-group Cohen's d=1.35; CI [-0.82, 3.52] to d=1.47; CI [-0.41, 3.35]; between group d=-0.13 CI [-2.37, 2.09] and d=-0.10 CI [-2.53, 2.33]. At the same time, the blended treatment reduced the therapist time with an average of 47%.We could not establish whether the blended treatment was non-inferior to a full BA treatment. Nevertheless, this study points to that the blended treatment approach could possibly treat nearly twice as many patients suffering from depression by using a smartphone application as add-on. More studies are needed before we can suggest that the blended treatment method is a promising cost-effective alternative to regular face-to-face treatment for depression.Cognitive Behavioral Therapy Treatment of Depression With Smartphone Support NCT01819025.
Martin, Anne; Booth, Josephine N; Laird, Yvonne; Sproule, John; Reilly, John J; Saunders, David H
well in thinking tasks such as problem-solving. Physical activity and healthy eating benefit a healthy body weight and improve thinking skills and school performance in children with a healthy weight. Studies found that healthy-weight interventions can reduce obesity in children and teenagers, but it is unknown if and how well healthy-weight interventions can improve thinking skills and school performance in children and teenagers with obesity. What are the main results of this review? The review authors found 18 studies which included a total of 2384 children and teenagers with obesity. Five studies assigned individual children to intervention or control groups. Thirteen studies allocated entire classes, school or school districts to the intervention and control group. Of the 18 studies, 11 involved children at primary/elementary-school age. Eight studies offered physical activity interventions, seven studies combined physical activity programmes with healthy lifestyle education, and three studies offered dietary changes. The studies took place in 10 different countries. Seventeen studies had at least one flaw in how the study was done. This reduces the level of confidence we can have in the findings. Few studies shared the same type of school performance or thinking skills. Only three studies reported the same outcome. None of the studies reported on additional educational support needs and harmful events. We found that, compared with usual routine, physical activity interventions can lead to small improvements in problem-solving skills. This finding was based on high-quality evidence. Moderate-quality findings showed that physical activity interventions do not improve mathematics and reading achievement in children with obesity. Very low-quality evidence also suggested no benefits of physical activity interventions for improving uncontrolled behavioural responses. General school achievement was not reported in studies comparing physical activity interventions with
Nicholl, Barbara I; Sandal, Louise Fleng; Stochkendahl, Mette Jensen
-effective strategies for LBP management and there is increasing interest in the potential role of digital health. OBJECTIVE: The study aimed to synthesize and critically appraise published evidence concerning the use of interactive digital interventions to support self-management of LBP. The following specific...... Citation Index, and Science Citation Index. Reference and citation searching was also undertaken. Search strategy combined the following concepts: (1) back pain, (2) digital intervention, and (3) self-management. Only randomized controlled trial (RCT) protocols or completed RCTs involving adults with LBP...... questions were examined: (1) What are the key components of digital self-management interventions for LBP, including theoretical underpinnings? (2) What outcome measures have been used in randomized trials of digital self-management interventions in LBP and what effect, if any, did the intervention have...
Rosenzweig, Margaret; Brufsky, Adam; Rastogi, Priya; Puhalla, Shannon; Simon, Jacqueline; Underwood, Sandra
to test the effect of a supportive, one-time psychoeducational intervention on treatment adherence among African American women receiving first adjuvant therapy for breast cancer. a pilot, randomized, controlled clinical trial, two-group design, with one-time intervention and four data collection points. two University of Pittsburgh Cancer Institute clinics. 24 African American women. the Attitudes, Communication, Treatment, and Support (ACTS) intervention is a 45-minute one-on-one session with an African American woman recommended to have chemotherapy for breast cancer. The interventionist is an African American breast cancer survivor. The intervention consists of a discussion about chemotherapy and the importance of communicating knowledge needs and distress, an explanation of the specific treatment plan according to pathology, and support through the survivor testimonial and video clips from the African American community. dose of chemotherapy received and dose of chemotherapy prescribed. Twenty patients completed chemotherapy, and four chose not to begin or discontinued recommended chemotherapy. The groups were equal in key sociodemographic variables. Compared to usual care, the ACTS intervention participants demonstrated trends toward initiation of chemotherapy (100% versus 82%), overall adherence to chemotherapy (92% versus 73%), and percentage of total dose of chemotherapy received or prescribed (94% versus 74%). Compared to usual care, the ACTS intervention participants demonstrated more rapid initiation of chemotherapy and better overall adherence to chemotherapy. the pilot ACTS intervention shows promise as a psychoeducational intervention to assist with chemotherapy decision making among African American women. African American women are at high risk of not receiving the full dose of prescribed chemotherapy for breast cancer for multiple reasons. Nurses must be sensitive to the unique fears and concerns of this population regarding chemotherapy decisions
Abdulwadud, Omar A; Snow, Mary Elizabeth
In recent years there has been a rise in the participation rate of women in employment. Some may become pregnant while in employment and subsequently deliver their babies. Most may decide to return early to work after giving birth for various reasons. Unless these mothers get support from their employers and fellow employees, they might give up breastfeeding when they return to work. As a result, the duration and exclusivity of breastfeeding to the recommended age of the babies would be affected.Workplace environment can play a positive role to promote breastfeeding. For women going back to work, various types of workplace support interventions are available and this should not be ignored by employers. Notably, promoting breastfeeding in a workplace may have benefits for the women, the baby and also the employer. To assess the effectiveness of workplace interventions to support and promote breastfeeding among women returning to paid work after the birth of their children, and its impact on process outcomes pertinent to employees and employers. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 August 2012). Two authors independently assessed all identified studies for randomised controlled trials and quasi-randomised controlled trials that compared workplace interventions with no intervention or two or more workplace interventions against each other. Two authors planned to evaluate the methodological quality of the eligible trials and extract data. There were no randomised controlled trials or quasi-randomised controlled trials identified. No trials have evaluated the effectiveness of workplace interventions in promoting breastfeeding among women returning to paid work after the birth of their child. The impact of such intervention on process outcomes is also unknown. Randomised controlled trials are required to establish the benefits of various types of workplace interventions to support, encourage and promote breastfeeding among working
Frederickson, Norah; Jones, Alice P.; Warren, Laura; Deakes, Tara; Allen, Geoff
An initial evaluation of the utility of designing an intervention to address neuroscience-based subtyping of children who have conduct problems was undertaken in this pilot study. Drawing on the literature on callous-unemotional traits, a novel intervention programme, "Let's Get Smart", was implemented in a school for children with…
Wammes, Birgitte; Breedveld, Boudewijn; Kremers, Stef; Brug, Johannes
To help people prevent weight gain, the Netherlands Nutrition Centre initiated the "balance intervention", which promotes moderation of food intake and/or increased physical activity in response to occasions of overeating. The aim of this study was to determine whether intervention materials were appreciated, encouraged information…
Cooper, B; Toskin, I; Kulier, R; Allen, T; Hawkes, S
Throughout the last decade substantial research has been undertaken to develop evidence-based behaviour change interventions for sexual health promotion. Primary care could provide an opportunistic entry for brief sexual health communication. We conducted a systematic review to explore opportunistic sexual and reproductive health services for sexual health communication delivered at primary health care level. We searched for studies on PubMed, ProQuest, CINAHL, Jstor, Scopus/Science Direct, Cochrane database of systematic reviews, EBSCO, CINAHL, PsychoInfo, and Web of Knowledge. Both published and unpublished articles were reviewed. All randomised controlled trials and controlled clinical trials were included. Participants of all ages, from adolescence onwards were included. Brief (10-60 minutes) interventions including some aspect of communication on sexual health issues were included. Data were extracted by two reviewers independently using a standardised form. Interventions differed from each other, hence meta-analysis was not performed, and results are presented individually. A total of 247 articles were selected for full-text evaluation, 31 of which were included. Sexually transmitted infections (STIs)/HIV were less often reported in the intervention group compared with the control group. Condom use was higher in most studies in the intervention group. Numbers of sexual partners and unprotected sexual intercourse were lower in the intervention groups. There is evidence that brief counselling interventions have some effect in the reduction and prevention of STIs/HIV. Some questions could not be answered, such as the effect over time and in different settings and population groups. © 2014 Royal College of Obstetricians and Gynaecologists.
Native American and indigenous populations experience the greatest behavioural health disparities in the world. A constellation of factors impacting Native American Tribes contributes to high rates and co-morbidity of mental health disorders, substance use and sexually transmitted infection (STI),
Montgomery, Janine; Martin, Toby; Shooshtari, Shahin; Stoesz, Brenda M.; Heinrichs, Dustin J.; North, Sebastian; Dodson, Lindsay; Senkow, Quinn; Douglas, Joyce
This synthesis paper summarizes research literature addressing challenging behaviours in children and youth with autism spectrum disorders and developmental disabilities in school settings. We conducted a comprehensive literature review to identify relevant peer-reviewed articles published between the years 2000 and 2011. The methodological…
Blonk, R.W.B.; Brenninkmeijer, V.; Lagerveld, S.E.; Houtman, I.L.D.
We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions
Hodgson, Anna R.; Grahame, Victoria; Garland, Deborah; Gaultier, Fiona; Lecouturier, Jan; Le Couteur, Ann
Background: Early intervention for autism spectrum disorder (ASD) tends to focus on enhancing social communication skills. We report data collected via focus group discussions as part of a feasibility and acceptability pilot randomized controlled trial (RCT) about a new parent group intervention to manage restricted and repetitive behaviours (RRB)…
Beck Hansen, Nina; Johannsen, Maja; Støving, René K
Bariatric surgery is currently considered the most effective treatment of severe obesity, but considerable individual variations in weight loss results have been reported. We therefore conducted a systematic review and meta-analysis of studies investigating the effect of psychotherapeutic...... interventions and support groups on weight loss following bariatric surgery. A literature search was conducted in the databases PubMed and PsycINFO, identifying nine eligible studies reporting results of the effect of psychotherapeutic interventions and support groups on weight loss following bariatric surgery...
Delaney, Tessa; Wyse, Rebecca; Yoong, Sze Lin; Sutherland, Rachel; Wiggers, John; Ball, Kylie; Campbell, Karen; Rissel, Chris; Wolfenden, Luke
School canteens represent an opportune setting in which to deliver public health nutrition strategies given their wide reach, and frequent use by children. Online school canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer behaviour strategies that impact on purchasing decisions. The aim of this study is to assess the efficacy of a consumer behaviour intervention implemented in an online school canteen ordering system in reducing the kilojoule, saturated fat, sugar and sodium content of primary student lunch orders. The study will employ a cluster randomised controlled trial design. Approximately 1040 students (aged 5-12 years) from 10 primary schools in New South Wales, Australia, currently using an online canteen ordering system will be invited to participate. Schools will be randomised in a 1:1 ratio to receive either the intervention (enhanced system) or control (standard online ordering only). The intervention will include evidence-based strategies shown to influence healthy food purchasing (strategies targeting availability, menu labelling, placement and prompting). The primary outcomes of the trial will be the mean content per student online lunch order of (1) energy (kJ), (2) saturated fat (g), (3) sugar (g) and (4) sodium (mg). The impact of the intervention will be determined by between-group assessment of the nutritional content of lunch purchases over a 2-month period postintervention initiation. The study was approved by the Hunter New England Human Research Ethics Committee, University of Newcastle Human Research Ethics Committee and New South Wales Department of Education and School Communities. Study findings will be disseminated widely through peer-reviewed publications and relevant presentations in international conferences and to stakeholders. ACTRN12616000499482. Published by the BMJ Publishing Group Limited. For permission to
Delaney, Tessa; Wyse, Rebecca; Yoong, Sze Lin; Sutherland, Rachel; Wiggers, John; Ball, Kylie; Campbell, Karen; Rissel, Chris
Introduction School canteens represent an opportune setting in which to deliver public health nutrition strategies given their wide reach, and frequent use by children. Online school canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer behaviour strategies that impact on purchasing decisions. The aim of this study is to assess the efficacy of a consumer behaviour intervention implemented in an online school canteen ordering system in reducing the kilojoule, saturated fat, sugar and sodium content of primary student lunch orders. Methods and analysis The study will employ a cluster randomised controlled trial design. Approximately 1040 students (aged 5–12 years) from 10 primary schools in New South Wales, Australia, currently using an online canteen ordering system will be invited to participate. Schools will be randomised in a 1:1 ratio to receive either the intervention (enhanced system) or control (standard online ordering only). The intervention will include evidence-based strategies shown to influence healthy food purchasing (strategies targeting availability, menu labelling, placement and prompting). The primary outcomes of the trial will be the mean content per student online lunch order of (1) energy (kJ), (2) saturated fat (g), (3) sugar (g) and (4) sodium (mg). The impact of the intervention will be determined by between-group assessment of the nutritional content of lunch purchases over a 2-month period postintervention initiation. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee, University of Newcastle Human Research Ethics Committee and New South Wales Department of Education and School Communities. Study findings will be disseminated widely through peer-reviewed publications and relevant presentations in international conferences and to stakeholders. Trial registration number
Williamson, Wilby; Kluzek, Stefan; Roberts, Nia; Richards, Justin; Arden, Nigel; Leeson, Paul; Newton, Julia; Foster, Charlie
To assess effectiveness of osteoarthritis interventions to promote long-term physical activity behaviour change. A systematic review and meta-analysis. Protocol registration PROSPERO CRD4201300444 5 (http://www.crd.york.ac.uk/prospero/). Randomised controlled trials (RCTs) comparing physical activity interventions with placebo, no/or minimal intervention in community-dwelling adults with symptomatic knee or hip osteoarthritis. Primary outcomes were change in physical activity or cardiopulmonary fitness after a minimum follow-up of 6 months. Outcomes were measures of physical activity (self-reported and objectively measured) and cardiovascular fitness. Standard mean differences between postintervention values were used to describe the effect sizes. 27,984 titles were screened and 180 papers reviewed in full. Eleven RCTs satisfied inclusion criteria, total study population of 2741 participants, mean age 62.2. The commonest reasons for study exclusion were follow-up less than 6 months and no physical activity measures. The majority of included interventions implement an arthritis self-management programme targeting coping skills and self-efficacy. Seven studies used self-report measures, the pooled effect of these studies was small with significant heterogeneity between studies (SMD 0.22 with 95% CI -0.11 to 0.56, z=1.30 (p=0.19) I(2) statistic of 85%). Subgroup analysis of 6-12 month outcome reduced heterogeneity and increased intervention effect compared to control (SMD 0.53, 95% CI 0.41 to 0.65, z=8.84 (p<0.00001) I(2) of 66%). Arthritis self-management programmes achieve a small but significant improvement in physical activity in the short term. Effectiveness of intervention declines with extended follow-up beyond 12 months with no significant benefit compared to control. The small number of studies (11 RCTs) limited ability to define effective delivery methods. Investigation of behavioural lifestyle interventions for lower limb osteoarthritis populations would
Boots, L M M; de Vugt, M E; van Knippenberg, R J M; Kempen, G I J M; Verhey, F R J
Because of the expected increase in the number of dementia patients, the unlikelihood of a cure in the near future, and the rising cost of care, there is an increasing need for effective caregiver interventions. Internet interventions hold considerable promise for meeting the educational and support needs of informal dementia caregivers at reduced costs. The current study aims to provide an overview of the evidence for the effectiveness, feasibility, and quality of Internet interventions for informal caregivers of people with dementia. A systematic literature search of five scientific databases was performed, covering literature published up to 10 January 2013. Twelve studies were identified. The quality of the included studies was assessed according to the Cochrane level of evidence and the criteria list of the Cochrane Back Review Group. The intervention types, dosage, and duration differed widely, as did the methodological quality of the included studies. The overall level of evidence was low. However, the results demonstrate that Internet interventions for informal dementia caregivers can improve various aspects of caregiver well-being, for example, confidence, depression, and self-efficacy, provided they comprise multiple components and are tailored to the individual. Furthermore, caregivers could benefit from interaction with a coach and other caregivers. Internet interventions for informal dementia caregivers may improve caregiver well-being. However, the available supporting evidence lacks methodological quality. More randomized controlled studies assessing interventions performed according to protocol are needed to give stronger statements about the effects of supportive Internet interventions and their most promising elements. Copyright © 2013 John Wiley & Sons, Ltd.
Center for Mental Health in Schools at UCLA, 2011
Introduction into federal policy of response to intervention (RTI) and positive behavior intervention and supports (PBIS) led to widespread adoption and adaptation of the three tier intervention pyramid. As originally presented, the pyramid highlights three different levels of intervention and suggests the percent of students at each level. While…
Seamon, Mark J; Doane, Stephen M; Gaughan, John P; Kulp, Heather; D'Andrea, Anthony P; Pathak, Abhijit S; Santora, Thomas A; Goldberg, Amy J; Wydro, Gerald C
Advanced Life Support (ALS) providers may perform more invasive prehospital procedures, while Basic Life Support (BLS) providers offer stabilisation care and often "scoop and run". We hypothesised that prehospital interventions by urban ALS providers prolong prehospital time and decrease survival in penetrating trauma victims. We prospectively analysed 236 consecutive ambulance-transported, penetrating trauma patients an our urban Level-1 trauma centre (6/2008-12/2009). Inclusion criteria included ICU admission, length of stay >/=2 days, or in-hospital death. Demographics, clinical characteristics, and outcomes were compared between ALS and BLS patients. Single and multiple variable logistic regression analysis determined predictors of hospital survival. Of 236 patients, 71% were transported by ALS and 29% by BLS. When ALS and BLS patients were compared, no differences in age, penetrating mechanism, scene GCS score, Injury Severity Score, or need for emergency surgery were detected (p>0.05). Patients transported by ALS units more often underwent prehospital interventions (97% vs. 17%; p<0.01), including endotracheal intubation, needle thoracostomy, cervical collar, IV placement, and crystalloid resuscitation. While ALS ambulance on-scene time was significantly longer than that of BLS (p<0.01), total prehospital time was not (p=0.98) despite these prehospital interventions (1.8 ± 1.0 per ALS patient vs. 0.2 ± 0.5 per BLS patient; p<0.01). Overall, 69.5% ALS patients and 88.4% of BLS patients (p<0.01) survived to hospital discharge. Prehospital resuscitative interventions by ALS units performed on penetrating trauma patients may lengthen on-scene time but do not significantly increase total prehospital time. Regardless, these interventions did not appear to benefit our rapidly transported, urban penetrating trauma patients. Copyright © 2013 Elsevier Ltd. All rights reserved.
Winningham, R G; Pike, N L
Nearly all older adults experience social losses, which can disrupt their social support networks and impair their quality of life. Events such as retirement, an inability to drive, death of a spouse and/or close life-long friends, or moving to an elder care facility may negatively affect the quality of older adults' social support networks. Low levels of perceived social support are associated with increased depression, impaired immune functioning and reduced life expectancy. Moreover, social interactions can be cognitively stimulating and may help older adults preserve their cognitive abilities. In the present study, institutionalized older adults were exposed to either a cognitive enhancement programme designed to enhance social networks or a control group. Measures of perceived social support and loneliness were administered before and after a 3-month, group-based intervention. There was a significant interaction between group and time. Those who did not participate in the intervention experienced a decrease in perceived social support and an increase in perceived loneliness. Participants in the intervention group stayed the same on the above measures. Helping older adults increase or maintain the quality of their social networks may lead to enhanced cognitive functioning, decreased depression and improved quality of life. Recommendations to help assisted living facilities, nursing homes, retirement communities and senior centres develop social and cognitive interventions are provided.
DeBar, L L; Schneider, M; Ford, E G; Hernandez, A E; Showell, B; Drews, K L; Moe, E L; Gillis, B; Jessup, A N; Stadler, D D; White, M
The HEALTHY study was a randomized, controlled, multicenter, middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Participants were a racially, ethnically and geographically diverse cohort from across the United States. Here, we describe the conceptual underpinnings and design of the social marketing-based communications component of the HEALTHY study intervention that combined changes in the school nutrition and physical education (PE) environment with behavior change initiatives. The communications intervention component coordinated multiple elements to deliver campaigns that served to integrate and support all aspects of the HEALTHY intervention. The campaigns unfolded across five semesters of middle school, each targeting a specific theme related to the HEALTHY objectives. Communications campaigns comprised (1) core elements such as branding, posters, banners and visual and verbal messaging, (2) student events supporting the nutrition, PE and behavior intervention components through the application of social marketing and communications strategies, including the incorporation of student-generated media and (3) distribution of premiums and theme enhancers to extend the visibility of the study beyond the intervention environment. Formative research conducted with students, parents and school administrators was used to refine the communications strategy. Student peer communicators selected from the student body were involved to influence the normative student environment. Marketing and creative design experts developed a brand, logo, activities and materials. In the latter half of the study, student-generated messages and media were used to reflect local interests and culture and enhance peer influence. The HEALTHY intervention delivery and impact were strengthened by the
DeBar, LL; Schneider, M; Ford, EG; Hernandez, AE; Showell, B; Drews, KL; Moe, EL; Gillis, B; Jessup, AN; Stadler, DD; White, M
The HEALTHY study was a randomized, controlled, multicenter, middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Participants were a racially, ethnically and geographically diverse cohort from across the United States. Here, we describe the conceptual underpinnings and design of the social marketing-based communications component of the HEALTHY study intervention that combined changes in the school nutrition and physical education (PE) environment with behavior change initiatives. The communications intervention component coordinated multiple elements to deliver campaigns that served to integrate and support all aspects of the HEALTHY intervention. The campaigns unfolded across five semesters of middle school, each targeting a specific theme related to the HEALTHY objectives. Communications campaigns comprised (1) core elements such as branding, posters, banners and visual and verbal messaging, (2) student events supporting the nutrition, PE and behavior intervention components through the application of social marketing and communications strategies, including the incorporation of student-generated media and (3) distribution of premiums and theme enhancers to extend the visibility of the study beyond the intervention environment. Formative research conducted with students, parents and school administrators was used to refine the communications strategy. Student peer communicators selected from the student body were involved to influence the normative student environment. Marketing and creative design experts developed a brand, logo, activities and materials. In the latter half of the study, student-generated messages and media were used to reflect local interests and culture and enhance peer influence. The HEALTHY intervention delivery and impact were strengthened by the
Coren, Esther; Hossain, Rosa; Pardo, Jordi Pardo; Veras, Mirella M S; Chakraborty, Kabita; Harris, Holly; Martin, Anne J
behaviours or substance use. A meta-analysis was conducted for some outcomes though it was not possible for all due to differences in measurements between studies. Other outcomes were evaluated narratively. We included 11 studies evaluating 12 interventions from high income countries. We did not find any sufficiently robust evaluations conducted in low and middle income countries (LMICs) despite the existence of many relevant programmes. Study quality overall was low to moderate and there was great variation in the measurement used by studies, making comparison difficult. Participants were drop-in and shelter based. We found no consistent results on a range of relevant outcomes within domains of psychosocial health, substance misuse and sexual risky behaviours despite the many measurements collected in the studies. The interventions being evaluated consisted of time limited therapeutically based programmes which did not prove more effective than standard shelter or drop-in services for most outcomes and in most studies. There were favourable changes from baseline in outcomes for most particpants in therapy interventions and also in standard services. There was considerable heterogeneity between studies and equity data were inconsistently reported. No study measured the primary outcome of reintegration or reported on adverse effects. The review discussion section included consideration of the relevance of the findings for LMIC settings. Analysis across the included studies found no consistently significant benefit for the 'new' interventions compared to standard services for street-connected children and young people. These latter interventions, however, have not been rigorously evaluated, especially in the context of LMICs. Robustly evaluating the interventions would enable better recommendations to be made for service delivery. There is a need for future research in LMICs that includes children who are on the streets due to urbanisation, war or migration and who may be
Clarkson, Paul; Davies, Linda; Jasper, Rowan; Loynes, Niklas; Challis, David
Recent evidence signals the need for effective forms of home support to people with dementia and their carers. The cost-effectiveness evidence of different approaches to support is scant. To appraise economic evidence on the cost-effectiveness of home support interventions for dementia to inform future evaluation. A systematic literature review of full and partial economic evaluations was performed using the British National Health Service Economic Evaluation Database supplemented by additional references. Study characteristics and findings, including incremental cost-effectiveness ratios, when available, were summarized narratively. Study quality was appraised using the National Health Service Economic Evaluation Database critical appraisal criteria and independent ratings, agreed by two reviewers. Studies were located on a permutation matrix describing their mix of incremental costs/effects to aid decision making. Of the 151 articles retrieved, 14 studies met the inclusion criteria: 8 concerning support to people with dementia and 6 to carers. Five studies were incremental cost-utility analyses, seven were cost-effectiveness analyses, and two were cost consequences analyses. Five studies expressed incremental cost-effectiveness ratios as cost per quality-adjusted life-year (£6,696-£207,942 per quality-adjusted life-year). In four studies, interventions were dominant over usual care. Two interventions were more costly but more beneficial and were favorable against current acceptability thresholds. Occupational therapy, home-based exercise, and a carers' coping intervention emerged as cost-effective approaches for which there was better evidence. These interventions used environmental modifications, behavior management, physical activity, and emotional support as active components. More robust evidence is needed to judge the value of these and other interventions across the dementia care pathway. Copyright © 2017 International Society for Pharmacoeconomics and
Litvine, Dorian; Wuestenhagen, Rolf
While many consumer surveys show very positive attitudes towards renewable energy, the share of consumers actually purchasing green electricity is still in the single-digit percent range in most countries. What can be done to help consumers with positive attitudes towards green electricity to 'walk the talk', i.e. to behave consistently with their preferences? We developed a psychological model based on the theory of planned behaviour (TPB) to design a large-scale behavioural intervention survey with 1163 Swiss electricity consumers. Our results show that by providing information targeted at the key factors influencing the intention to purchase green electricity, namely attitudes towards purchase, social norms and perceived behavioural control, a significant increase in green electricity market share can be achieved. Our results show that price is not the only barrier to purchasing green electricity, and that information to increase the perceived benefit of buying green electricity as well as targeted communication to overcome inertia among retail electricity consumers are equally important factors. (author)
Hunt, Tara; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian
Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff's identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed.
McConkey, Roy; Gent, Clare; Scowcroft, Emma
Background: Specialist short break services aim to provide enhanced support to family carers as a means of preventing children whose behaviours severely challenge from being placed in full-time residential care. To date, there is limited evidence as to the functioning and effectiveness of such services. Methods: In all, 17 children were selected…
Meadows, Anthony; Burns, Debra S; Perkins, Susan M
Previous research has demonstrated modest benefits from music-based interventions, specifically music and imagery interventions, during cancer care. However, little attention has been paid to measuring the benefits of music-based interventions using measurement instruments specifically designed to account for the multidimensional nature of music-imagery experiences. The purpose of this study was to describe the development of, and psychometrically evaluate, the Music Therapy Self-Rating Scale (MTSRS) as a measure for cancer patients engaged in supportive music and imagery interventions. An exploratory factor analysis using baseline data from 76 patients who consented to participate in a music-based intervention study during chemotherapy. Factor analysis of 14 items revealed four domains: Awareness of Body, Emotionally Focused, Personal Resources, and Treatment Specific. Internal reliability was excellent (Cronbach alphas ranging from 0.75 to 0.88) and construct and divergent-discriminant validity supported. The MTSRS is a psychometrically sound, brief instrument that captures essential elements of patient experience during music and imagery interventions. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: email@example.com.
Shafran, Roz; Bennett, Sophie D; McKenzie Smith, Mhairi
There are strong calls from many national and international bodies for there to be a 'holistic' and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have demonstrated efficacy in improving holistic health outcomes, for example Cognitive Behaviour Therapy, Behavioural Therapies and Problem Solving Therapies. They have shown to impact upon a wide range of outcomes, including psychological distress, pain, physical health, medication adherence, and family outcomes. There is increasing recognition that the holistic goals of the child and family should be prioritised, and that interventions and outcomes should reflect these goals. A focus on holistic goals in therapy can be achieved through a combination of personalised goal-based outcomes in addition to symptom-based measures.
Facchini, Sergio; Martin, Valentina; Downing, George
This case series study evaluated the feasibility and acceptability of a behavioral/cognitive psychological intervention in a pediatric primary health care setting during standard well-baby visits. The aim of the intervention was to support caregivers’ sensitivity and mentalization in order to promote infant mental health. Four neonates from birth to eight months were consecutively enrolled to test a short video-feedback intervention (Primary Care - Video Intervention Therapy, an adaptation ...
Taha, Z.; Razman, M. A. M.; Adnan, F. A.; Ghani, A. S. Abdul; Majeed, A. P. P. Abdul; Musa, R. M.; Sallehudin, M. F.; Mukai, Y.
Fish Hunger behaviour is one of the important element in determining the fish feeding routine, especially for farmed fishes. Inaccurate feeding routines (under-feeding or over-feeding) lead the fishes to die and thus, reduces the total production of fishes. The excessive food which is not eaten by fish will be dissolved in the water and thus, reduce the water quality (oxygen quantity in the water will be reduced). The reduction of oxygen (water quality) leads the fish to die and in some cases, may lead to fish diseases. This study correlates Barramundi fish-school behaviour with hunger condition through the hybrid data integration of image processing technique. The behaviour is clustered with respect to the position of the centre of gravity of the school of fish prior feeding, during feeding and after feeding. The clustered fish behaviour is then classified by means of a machine learning technique namely Support vector machine (SVM). It has been shown from the study that the Fine Gaussian variation of SVM is able to provide a reasonably accurate classification of fish feeding behaviour with a classification accuracy of 79.7%. The proposed integration technique may increase the usefulness of the captured data and thus better differentiates the various behaviour of farmed fishes.
An active stabilization system for the Compact Linear Collider (CLIC) Main Beam Quadrupoles (MBQ) is needed to reach the strict requirements necessary to achieve high luminosity. A stiff supporting structure has been designed and is being tested both in simulations and experimentally for optimization and validation. The modal behaviour of the magnet on its supporting device highly affects the performance of the stabilization system. Several numerical modal analysis simulations have been performed and are presented in this paper.
Emma Norris; Sandra Dunsmuir; Oliver Duke-Williams; Emmanuel Stamatakis
Background Children spend a large amount of their time in obligatory seated school lessons, with notable effects on health and cognitive outcomes. A common issue reported by teachers is a lack of time to incorporate physical activity into the school day alongside academic pressures. As such, emerging research is attempting to convert educational time from sedentary to active via physically active lessons. However this existing research does not utilise Behaviour Change concepts, making co...