WorldWideScience

Sample records for culturally tailored intervention

  1. Native American Indian Adolescents: Response to a Culturally Tailored, School-Based Substance Abuse Intervention

    Science.gov (United States)

    Patchell, Beverly A.

    2011-01-01

    Native American Indian adolescent substance abuse has been a longstanding health concern. There are few culturally tailored interventions for mild to moderate substance users. The purpose of this study was to measure the response of Native American Indian adolescents from the Plains tribal groups to a school-based culturally tailored substance…

  2. Evaluation of a Culturally Tailored Skills Intervention for Latinos with Persistent Psychotic Disorders

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    Mausbach, Brent T.; Bucardo, Jesus; Cardenas, Veronica; McKibbin, Christine L.; Barrio, Concepcion; Goldman, Sherrill R.; Jeste, Dilip V.; Patterson, Thomas L.

    2009-01-01

    Fifty-nine Latino participants diagnosed with persistent psychotic disorders were assigned to either a culturally tailored skills-training intervention (n = 21), an equivalent non-tailored intervention (n = 15), or a community-based support group (n = 23). Participants completed a number of skills-based performance assessments (e.g., UCSD performance-based skills assessment; UPSA) and a well-being measure prior to and immediately post-treatment. Compared to those in the non-tailored intervention, participants receiving the tailored intervention showed significant improvement in several outcomes. These results indicate that Latino individuals with persistent psychotic disorders benefit from interventions which consider cultural values and mores. PMID:19779589

  3. Motivating underserved Vietnamese Americans to obtain colorectal cancer screening: evaluation of a culturally tailored DVD intervention.

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    Lee, Hee Yun; Tran, Marie; Jin, Seok Won; Bliss, Robin; Yeazel, Mark

    2014-01-01

    Colorectal cancer (CRC) is a leading cause of cancer death among Vietnamese Americans, yet screening remains underutilized. We investigated the effectiveness of a culturally tailored DVD intervention in promoting CRC screening among unscreened Vietnamese Americans age 50 and over. Using a community-based participatory research approach, we conducted a trial comparing twenty-eight subjects who received a mailed DVD in Vietnamese, with twenty-eight subjects who received a mailed brochure in Vietnamese. Subjects completed telephone surveys at baseline, One-month, and one-year. The primary outcome was receipt of screening. Secondary measures were participants' knowledge, attitudes, and beliefs about CRC screening. Two focus groups explored the intervention's acceptability and effectiveness. At one year, CRC screening rates of 57.1% and 42.9% were observed in experimental and control group respectively (p=0.42), Subjects in both groups showed increased knowledge about CRC after one month. Focus group findings revealed that the DVD was an effective method of communicating information and would help promote screening. The findings suggest that culturally tailored, linguistically appropriate content is more important than the type of media used. This relatively low intensity, low cost intervention utilizing a DVD can be another useful method for outreach to the often hard-to-reach unscreened population.

  4. THE EFFECT OF A CULTURALLY TAILORED SUBSTANCE ABUSE PREVENTION INTERVENTION WITH PLAINS INDIAN ADOLESCENTS.

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    Patchell, Beverly A; Robbins, Leslie K; Lowe, John A; Hoke, Mary M

    2015-01-01

    To examine the effects of incorporating tribal specific cultural beliefs into a tailored substance abuse prevention intervention for at risk rural Oklahoma Native American Indian (NAI) Plains adolescents. The 10 hour Native American Talking Circle Intervention, a school-based, group substance abuse prevention program, was implemented over a 8.5 week period and evaluated using a one group, pretest-posttest design. Measurements were from the Native Self-Reliance Questionnaire and the Substance Problems Scale from Global Appraisal of Individual Needs-Quick (GAIN-Q). One-tailed, paired sample t-tests demonstrated significant increase in self-reliance, from 86.227 to 92.204 (t (43) = -2.580, p = .007) and a decrease in substance abuse/use, from 2.265 to 1.265 (t (33) = 1.844, p = .007). The Native Talking Circle Intervention based on tribal-specific values and beliefs was shown to be effective with substance abuse/use at-risk NAI Plains tribal adolescents.

  5. Testing the Feasibility of a Culturally Tailored Breast Cancer Screening Intervention with Native Hawaiian Women in Rural Churches

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    Ka'opua, Lana Sue I.; Park, Soon H.; Ward, Margaret E.; Braun, Kathryn L.

    2011-01-01

    The authors report on the feasibility of delivering a church-based breast cancer screening intervention tailored on the cultural strengths of rural-dwelling Hawaiians. Native Hawaiian women are burdened by disproportionately high mortality from breast cancer, which is attributed to low participation in routine mammography. Mammography is proven to…

  6. Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco

    Directory of Open Access Journals (Sweden)

    Latifa Adarmouch

    2017-03-01

    Conclusions: There was a general improvement in foot-care practices after the intervention. Our findings suggest the role of literacy and previous patient education in shaping the observed variation. Culturally tailored interventions targeting other disease management domains are needed in our context.

  7. The need for a culturally-tailored gatekeeper training intervention program in preventing suicide among Indigenous peoples: a systematic review

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    Bushra Farah Nasir

    2016-10-01

    Full Text Available Abstract Background Suicide is a leading cause of death among Indigenous youth worldwide. The aim of this literature review was to determine the cultural appropriateness and identify evidence for the effectiveness of current gatekeeper suicide prevention training programs within the international Indigenous community. Method Using a systematic strategy, relevant databases and targeted resources were searched using the following terms: ‘suicide’, ‘gatekeeper’, ‘training’, ‘suicide prevention training’, ‘suicide intervention training’ and ‘Indigenous’. Other internationally relevant descriptors for the keyword “Indigenous” (e.g. “Maori”, “First Nations”, “Native American”, “Inuit”, “Metis” and “Aboriginal” were also used. Results Six articles, comprising five studies, met criteria for inclusion; two Australian, two from USA and one Canadian. While pre and post follow up studies reported positive outcomes, this was not confirmed in the single randomised controlled trial identified. However, the randomised controlled trial may have been underpowered and contained participants who were at higher risk of suicide pre-training. Conclusion Uncontrolled evidence suggests that gatekeeper training may be a promising suicide intervention in Indigenous communities but needs to be culturally tailored to the target population. Further RCT evidence is required.

  8. The need for a culturally-tailored gatekeeper training intervention program in preventing suicide among Indigenous peoples: a systematic review.

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    Nasir, Bushra Farah; Hides, Leanne; Kisely, Steve; Ranmuthugala, Geetha; Nicholson, Geoffrey C; Black, Emma; Gill, Neeraj; Kondalsamy-Chennakesavan, Srinivas; Toombs, Maree

    2016-10-21

    Suicide is a leading cause of death among Indigenous youth worldwide. The aim of this literature review was to determine the cultural appropriateness and identify evidence for the effectiveness of current gatekeeper suicide prevention training programs within the international Indigenous community. Using a systematic strategy, relevant databases and targeted resources were searched using the following terms: 'suicide', 'gatekeeper', 'training', 'suicide prevention training', 'suicide intervention training' and 'Indigenous'. Other internationally relevant descriptors for the keyword "Indigenous" (e.g. "Maori", "First Nations", "Native American", "Inuit", "Metis" and "Aboriginal") were also used. Six articles, comprising five studies, met criteria for inclusion; two Australian, two from USA and one Canadian. While pre and post follow up studies reported positive outcomes, this was not confirmed in the single randomised controlled trial identified. However, the randomised controlled trial may have been underpowered and contained participants who were at higher risk of suicide pre-training. Uncontrolled evidence suggests that gatekeeper training may be a promising suicide intervention in Indigenous communities but needs to be culturally tailored to the target population. Further RCT evidence is required.

  9. Turn off the TV and dance! Participation in culturally tailored health interventions: implications for obesity prevention among Mexican American girls.

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    Azevedo, Kathryn J; Mendoza, Sonia; Fernández, María; Haydel, K Farish; Fujimoto, Michelle; Tirumalai, Evelyn C; Robinson, Thomas N

    2013-01-01

    Our evaluation study identifies facilitators and barriers to participation among families participating in the treatment arm of Stanford ECHALE. This culturally tailored obesity prevention trial consisted of a combined intervention with two main treatment components: 1) a folkloric dance program; and 2) a screen time reduction curriculum designed for 7-11 year old Latinas and their families. We conducted 83 interviews (40 parents and 43 girls) in participant homes after 6 months of enrollment in the ECHALE trial. The Spradley ethnographic method and NVivo 8.0 were used to code and analyze narrative data. Three domains emerged for understanding participation: 1) family cohesiveness; 2) perceived gains; and 3) culturally relevant program structure. Two domains emerged for non-participation: program requirements and perceived discomforts. Non-parametric, Spearman's rank correlation coefficients were calculated to assess the relationships with participant attendance data. Sustained participation was most strongly influenced by the domain perceived gains when parents reported better self-esteem, confidence, improved attitude, improved grades, etc. (Spearman r = .45, P = .003). Alternatively, under the domain, perceived discomforts, with subthemes such as child bullying, participation in the combined intervention was inversely associated with attendance (Spearman r = -.38, P = .02). Family-centered, school-based, community obesity prevention programs that focus on tangible short-term gains for girls may generate greater participation rates, enhance social capital, and promote community empowerment. These factors can be emphasized in future obesity prevention program design and implementation.

  10. A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions

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    Owczarzak, Jill; Phillips, Sarah D.; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna

    2016-01-01

    The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to…

  11. Development of a culturally tailored Internet intervention promoting hepatitis B screening in the Turkish community in the Netherlands

    NARCIS (Netherlands)

    Van Der Veen, Ytje J. J.; Van Empelen, Pepijn; Richardus, Jan Hendrik

    2012-01-01

    Hepatitis B virus infections are an important health problem in the Turkish community in the Netherlands. Screening for hepatitis B should be promoted through public health interventions, which take into account the socio-cultural and behavioural determinants that influence screening. The Interventi

  12. Unity in diversity: results of a randomized clinical culturally tailored pilot HIV prevention intervention trial in Baltimore, Maryland, for African American men who have sex with men.

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    Tobin, Karin; Kuramoto, Satoko J; German, Danielle; Fields, Errol; Spikes, Pilgrim S; Patterson, Jocelyn; Latkin, Carl

    2013-06-01

    Unity in Diversity was a randomized controlled trial of a culturally tailored HIV prevention intervention for African American men who have sex with men. The intervention condition was six group-based sessions and one individual session. The control condition was a single-session HIV prevention review. Participants were aged 18 years or older, identified as African American/Black race, reported having at least two sex partners in the prior 90 days (at least one of whom must be a male partner), unprotected anal sex with male partner in the prior 90 days, and willing to test for HIV. Retention exceeded 95% at 3-month follow-up. Results of multivariate logistic regression analysis adjusting for baseline risk, HIV status, and health insurance indicate intervention efficacy in decreasing the number of male sex partners and marginal effects on condom use with male partners and HIV-negative/unknown partners. Specifically, intervention condition was associated with increased odds of zero male sex partners (adjusted odds ratio [AOR] = 3.03, 95% confidence interval [CI] = 1.26-7.28), condom use with male partners (AOR = 2.64, 95% CI = 0.95-7.36), and HIV-negative/unknown status partners (AOR = 3.19, 95% CI = 0.98-10.38) at follow-up. These results contribute to the limited number of culturally appropriate models of HIV prevention intervention that are urgently needed for African American men who have sex with men to address their persistently high rates of HIV.

  13. Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States

    Directory of Open Access Journals (Sweden)

    Rupal M. Patel

    2017-01-01

    Full Text Available This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM among Gujarati Asian Indians (AIs in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program (n=34 or a control group (n=36 that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c (p<0.0005 and waist circumference (p=0.04 significantly as compared to the control group. Findings demonstrated that participation in a culturally tailored, lifestyle intervention program in a community setting can effectively reduce weight, waist circumference, and HbA1c among Gujarati AIs living in the US.

  14. Improvement in Depressive Symptoms Among Hispanic/Latinos Receiving a Culturally Tailored IMPACT and Problem-Solving Intervention in a Community Health Center.

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    Camacho, Álvaro; González, Patricia; Castañeda, Sheila F; Simmons, Alan; Buelna, Christina; Lemus, Hector; Talavera, Gregory A

    2015-05-01

    The present study investigated whether a culturally-tailored problem-solving intervention delivered by a trained depression care specialist (DCS) would improve depressive symptoms over a 6 month period among Hispanic/Latino patients in a federally-qualified community health center by the California-Mexico border. Participants included 189 low income Hispanic/Latino patients of Mexican heritage. Based on the improving mood-promoting access to collaborative treatment (IMPACT) evidence-based treatment, patients received evidence-based problem-solving therapy. The Patient Health Questionnaire-9 (PHQ-9) was administered to assess changes in self-reported depressive symptoms between baseline and monthly for a 6-month follow up period. The majority of participants were female (72.5%) with a mean age of 52.5 (SD = 11.7). The mean PHQ-9 at baseline was 16.9 (SD = 4.0) and at the 6-month follow-up, the average PHQ-9 decreased to 9.9 (SD = 5.7). A linear mixed model analysis showed significant improvement in PHQ-9 scores over a 6 month period (F = 124.1; p Hispanic/Latino low-income patients.

  15. Lay Health Influencers: How They Tailor Brief Tobacco Cessation Interventions

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    Yuan, Nicole P.; Castaneda, Heide; Nichter, Mark; Nichter, Mimi; Wind, Steven; Carruth, Lauren; Muramoto, Myra

    2012-01-01

    Interventions tailored to individual smoker characteristics have increasingly received attention in the tobacco control literature. The majority of tailored interventions are generated by computers and administered with printed materials or web-based programs. The purpose of this study was to examine the tailoring activities of community lay…

  16. Lay Health Influencers: How They Tailor Brief Tobacco Cessation Interventions

    Science.gov (United States)

    Yuan, Nicole P.; Castaneda, Heide; Nichter, Mark; Nichter, Mimi; Wind, Steven; Carruth, Lauren; Muramoto, Myra

    2012-01-01

    Interventions tailored to individual smoker characteristics have increasingly received attention in the tobacco control literature. The majority of tailored interventions are generated by computers and administered with printed materials or web-based programs. The purpose of this study was to examine the tailoring activities of community lay…

  17. Healing of the canoe: preliminary results of a culturally tailored intervention to prevent substance abuse and promote tribal identity for Native youth in two Pacific Northwest tribes.

    Science.gov (United States)

    Donovan, Dennis M; Thomas, Lisa Rey; Sigo, Robin Little Wing; Price, Laura; Lonczak, Heather; Lawrence, Nigel; Ahvakana, Katie; Austin, Lisette; Lawrence, Albie; Price, Joseph; Purser, Abby; Bagley, Lenora

    2015-01-01

    Using Community-based and Tribal Participatory Research (CBPR/TPR) approaches, an academic-tribal partnership between the University of Washington Alcohol and Drug Abuse Institute and the Suquamish and Port Gamble S'Klallam Tribes developed a culturally grounded social skills intervention to promote increased cultural belonging and prevent substance abuse among tribal youth. Participation in the intervention, which used the Canoe Journey as a metaphor for life, was associated with increased hope, optimism, and self-efficacy and with reduced substance use, as well as with higher levels of cultural identity and knowledge about alcohol and drugs among high school-age tribal youth. These results provide preliminary support for the intervention curricula in promoting positive youth development, an optimistic future orientation, and the reduction of substance use among Native youth.

  18. Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States.

    Science.gov (United States)

    Patel, Rupal M; Misra, Ranjita; Raj, Sudha; Balasubramanyam, Ashok

    2017-01-01

    This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM) among Gujarati Asian Indians (AIs) in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c) and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program (n = 34) or a control group (n = 36) that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c (p Gujarati AIs living in the US.

  19. Targeting and Tailoring Health Communications in Breast Screening Interventions.

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    Shirazi, Mehra; Engelman, Kimberly K; Mbah, Olive; Shirazi, Aida; Robbins, Irma; Bowie, Janice; Popal, Rona; Wahwasuck, Arlene; Whalen-White, Denice; Greiner, Allen; Dobs, Adrian; Bloom, Joan

    2015-01-01

    Members of underrepresented minority (URM) groups are at higher risk of disproportionately experiencing greater breast cancer-related morbidity and mortality and thus, require effective interventions that both appropriately target and tailor to their unique characteristics. We sought to describe the targeting and tailoring practices used in the development and dissemination of three breast cancer screening interventions among URM groups. Three national Community Network Programs (CNPs) funded by the National Cancer Institute have focused on breast cancer screening interventions as their major research intervention. Each targeted different populations and used participatory research methods to design their intervention tailored to the needs of their respective audience. The Alameda County Network Program (ACNP) to Reduce Cancer Disparities partnered with community members to design and conduct 2-hour "Tea Party" education sessions for Afghan women. The Kansas Community Cancer Disparities Network co-developed and deployed with community members a computerized Healthy Living Kansas (HLK) Breast Health program for rural Latina and American Indian women. The Johns Hopkins Center to Reduce Cancer Disparities employed a train-the-trainer COACH approach to educate urban African-American women about breast cancer. Each CNP program targeted diverse URM women and, using participatory approaches, tailored a range of interventions to promote breast cancer screening. Although all projects shared the same goal outcome, each program tailored their varying interventions to match the target community needs, demonstrating the importance and value of these strategies in reducing breast cancer disparities.

  20. Cultural tailoring for the promotion of Hepatitis B screening in Turkish Dutch: A protocol for a randomized controlled trial

    NARCIS (Netherlands)

    O. de Zwart (Onno); J.P. Mackenbach (Johan); J.H. Richardus (Jan Hendrik); Y.J.J. van der Veen (Ytje)

    2010-01-01

    textabstractBackground. Chronic hepatitis B virus infection (HBV) is an important health problem in the Turkish community in the Netherlands, and promotion of screening for HBV in this risk group is necessary. An individually tailored intervention and a culturally tailored intervention have been dev

  1. Promoting a Culture of Tailoring for Systems Engineering Policy Expectations

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    Blankenship, Van A.

    2016-01-01

    NASA's Marshall Space Flight Center (MSFC) has developed an integrated systems engineering approach to promote a culture of tailoring for program and project policy requirements. MSFC's culture encourages and supports tailoring, with an emphasis on risk-based decision making, for enhanced affordability and efficiency. MSFC's policy structure integrates the various Agency requirements into a single, streamlined implementation approach which serves as a "one-stop-shop" for our programs and projects to follow. The engineers gain an enhanced understanding of policy and technical expectations, as well as lesson's learned from MSFC's history of spaceflight and science missions, to enable them to make appropriate, risk-based tailoring recommendations. The tailoring approach utilizes a standard methodology to classify projects into predefined levels using selected mission and programmatic scaling factors related to risk tolerance. Policy requirements are then selectively applied and tailored, with appropriate rationale, and approved by the governing authorities, to support risk-informed decisions to achieve the desired cost and schedule efficiencies. The policy is further augmented by implementation tools and lifecycle planning aids which help promote and support the cultural shift toward more tailoring. The MSFC Customization Tool is an integrated spreadsheet that ties together everything that projects need to understand, navigate, and tailor the policy. It helps them classify their project, understand the intent of the requirements, determine their tailoring approach, and document the necessary governance approvals. It also helps them plan for and conduct technical reviews throughout the lifecycle. Policy tailoring is thus established as a normal part of project execution, with the tools provided to facilitate and enable the tailoring process. MSFC's approach to changing the culture emphasizes risk-based tailoring of policy to achieve increased flexibility, efficiency

  2. Does tailoring really make a difference? : the development and evaluation of tailored interventions aimed at benzodiazepine cessation

    NARCIS (Netherlands)

    Wolde, Geeske Brecht ten

    2008-01-01

    Because of the problems associated with chronic benzodiazepine use, there is impetus to prevent and reduce chronic benzodiazepine use. The overall aim was to develop a 'tailor-made' intervention in order to reduce chronic use. Before developing tailored patient education, it is first of all importan

  3. LGBTQ Youth and Young Adult Perspectives on a Culturally Tailored Group Smoking Cessation Program.

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    Baskerville, Neill Bruce; Shuh, Alanna; Wong-Francq, Katy; Dash, Darly; Abramowicz, Aneta

    2017-01-25

    The prevalence of smoking among LGBTQ youth and young adults (YYAs) is much higher than that of non-LGBTQ young people. The current study explored LGBTQ YYA perceptions of a culturally tailored group smoking cessation counselling program, along with how the intervention could be improved. We conducted focus groups (n = 24) with 204 LGBTQ YYAs in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, concerns and additional ideas for a culturally tailored group cessation counselling intervention. Focus group transcripts were coded thematically and analyzed. Overall, YYAs were ambivalent towards the concept of a culturally tailored, group cessation counselling program. Although several participants were attracted to the LGBTQ friendly and social benefits of such a program (eg, good support system), many also had concerns. Particularly, the possibility that other group members might trigger them to smoke was a frequently stated issue. Focus group members also noted lack of motivation to attend the group, and that the group program may be inaccessible depending on where and when the program was offered. Several suggestions were made as to how to ameliorate the expressed issues related to inaccessibility or lack of attractiveness. This study is among the first to gain the perspectives of LGBTQ YYAs on culturally tailored group cessation strategies in Canada. We identified components of group cessation programs that are both favored and not favored among LGBTQ YYAs, as well as suggestions as to how to make group cessation programs more appealing. This study is particularly relevant as smoking cessation programs are one of the most commonly offered and published cessation interventions for the LGBTQ community, yet little is understood in terms of preferences of LGBTQ YYA smokers. Given the disparity in the prevalence of smoking among LGBTQ young people compared to their non-LGBTQ peers, research on effective intervention strategies

  4. Tailoring of Interventional Procedures for HCC Patients-Review Article

    Directory of Open Access Journals (Sweden)

    H Ghanaati

    2010-11-01

    Full Text Available One of the most frequent primary malignant tumors in the world is hepatocellular carcinoma (HCC."nCurrently, the optimal treatment methods for HCC are hepatic resection and liver transplantation."nUnfortunately, surgical therapies are suitable for 20% of patients and those who are not eligible"nfor surgery should undergo interventional therapies. In the past decade, a variety of interventional"nprocedures have been employed for local control of hepatocellular carcinoma (HCC including"ntranscatheter arterial chemoembolization (TACE and many tumor ablation techniques, such as"npercutaneous ethanol injection (PEI, radio-frequency ablation (RFA, percutaneous microwave"ncoagulation therapy (PMC, laser-induced interstitial thermotherapy (LITT, cryoablation, and"nacetic acid injection. By development of new technologies in imaging and drug delivery, it is likely"nthat in the future patients with HCC will be treated by combination therapies to improve patient"nsurvival. Computed tomography (CT and magnetic resonance imaging (MRI have a crucial role in"ndiagnosis and also follow-up of HCC patients treated by interventional procedures, by which the"ntreatment efficacy, recurrence of disease and certain complications are evaluated."nIn this review article, we discuss the imaging modalities and also tailoring of interventional"nprocedures for HCC patients.

  5. Culturally-Tailored Smoking Cessation for American Indians: Study protocol for a randomized controlled trial

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    Shireman Theresa I

    2011-05-01

    Full Text Available Abstract Background Cigarette smoking is the number one cause of preventable death among American Indian and Alaska Natives, AI/ANs. Two out of every five AI/AN will die from tobacco-related diseases if the current smoking rates of AI/ANs (40.8% persist. Currently, there is no proven, effective culturally-tailored smoking cessation program designed specifically for a heterogeneous population of AI. The primary aim of this group randomized clinical trial is to test the efficacy of "All Nations Breath of Life" (ANBL program compared to a non-tailored "Current Best Practices" smoking cessation program among AI smokers. Methods We will randomize 56 groups (8 smokers per group to the tailored program or non-tailored program for a total sample size of 448 American Indian smokers. All participants in the proposed study will be offered pharmacotherapy, regardless of group assignment. This study is the first controlled trial to examine the efficacy of a culturally-tailored smoking cessation program for American Indians. If the intervention is successful, the potential health impact is significant because the prevalence of smoking is the highest in this population. Trial Registration ClinicalTrials.gov: NCT01106456

  6. Evaluating Psychosocial and Behavioral Mechanisms of Change in a Tailored Communication Intervention

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    Elder, John P.; Ayala, Guadalupe X.; Slymen, Donald J.; Arredondo, Elva M.; Campbell, Nadia R.

    2009-01-01

    This study examined the impact of a tailored nutrition intervention at 3 and 6 months postintervention. In all, 357 Latinas were randomly assigned to one of three conditions: (1) a control condition comprised of previously developed Spanish language targeted materials, (2) tailored print materials, or (3) tailored print materials accompanied by…

  7. Cultural tailoring for the promotion of Hepatitis B screening in Turkish Dutch: a protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mackenbach Johan

    2010-11-01

    Full Text Available Abstract Background Chronic hepatitis B virus infection (HBV is an important health problem in the Turkish community in the Netherlands, and promotion of screening for HBV in this risk group is necessary. An individually tailored intervention and a culturally tailored intervention have been developed to promote screening in first generation 16-40 year old Turkish immigrants. This paper describes the design of the randomized controlled trial, which will be used to evaluate the effectiveness of the two tailored internet interventions as compared to generic online information on HBV, and to assess the added value of tailoring on socio-cultural factors. Methods/Design A cluster randomized controlled trial design, in which we invite all Rotterdam registered inhabitants born in Turkey, aged 16-40 (n = 10,000, to visit the intervention website is used. A cluster includes all persons living at one house address. The clusters are randomly assigned to either group A, B or C. On the website, persons eligible for testing will be selected through a series of exclusion questions and will then continue in the randomly assigned intervention group. Group A will receive generic information on HBV. Group B will receive individually tailored information related to social-cognitive determinants of screening. Group C will receive culturally tailored information which, next to social-cognitive factors, addresses cultural factors related to screening. Subsequently, participants may obtain a laboratory form, with which they can be tested free of charge at local health centres. The main outcome of the study is the percentage of eligible persons tested for HBV through to participation in one of the three groups. Measurements of the outcome behaviour and its determinants will be at baseline and five weeks post-intervention. Discussion This trial will provide information on the effectiveness of a culturally tailored internet intervention promoting HBV-screening in first

  8. Reactance to a tailored multimedia intervention encouraging teachers to promote cover-the-cough.

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    David, Prabu; Henry, Aletheia; Srivastava, Jatin; Orcena, Jason; Thrush, Jennifer

    2012-01-01

    Teachers were presented tailored multimedia messages encouraging them to offer cover-the-cough instruction to their students. Messages were tailored by grade level (elementary, higher grade) and stage of change (preaction, action). Among teachers in the action stages, message tailoring did not make a difference. Among teachers in the preaction stages, tailored messages were rated lower than were nontailored messages. The lower ratings of the tailored messages, seemingly a reactance response, did not carry over to postintervention self-efficacy. The intervention was effective in improving self-efficacy in elementary school teachers, particularly among those in the preaction stages.

  9. Culturally tailored postsecondary nutrition and health education curricula for indigenous populations

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    Sarah McConnell

    2013-08-01

    Full Text Available Background . In preparation for the initial offering of the University of Alaska Fairbanks (UAF, Interior–Aleutians Campus Rural Nutrition Services (RNS program, a literature review was conducted to establish the need for the proposed program and to substantiate the methodology for delivering integrated, culturally tailored postsecondary education and extension to Alaska Natives and rural Alaskans. There was a striking absence of peer-reviewed journal articles describing culturally tailored postsecondary health curricula for indigenous populations. Objective . To complete and discuss a current (November 2012 literature review for culturally tailored postsecondary health curricula designed and delivered for indigenous populations. Methods/Design . The author conducted an expanded online search that employed multiple configurations of key terms using Google and Google Scholar, as well as pertinent sources. The author located archived reports in person and contacted authors by email. Results . The expanded search produced a modest amount of additional literature for review. A disappointing number of publications describing or evaluating culturally tailored postsecondary health curricula in mainstream institutions are available. Related resources on culturally tailored extension and resources for the development and delivery of culturally tailored nutrition and health curricula were identified. Conclusions . The present results demonstrate a significant absence of literature on the topic, which may or may not indicate the absence of sufficient culturally tailored postsecondary health curricula for indigenous populations. There are indications that culturally tailored postsecondary health curricula for indigenous populations have the potential to effectively address certain issues of health literacy and health disparities.

  10. Design and evaluation protocol of "FATaintPHAT", a computer-tailored intervention to prevent excessive weight gain in adolescents

    NARCIS (Netherlands)

    N.P.M. Ezendam (Nicole); A. Oenema (Anke); P.M. van de Looij-Jansen (Petra); J. Brug (Hans)

    2007-01-01

    textabstractComputer tailoring may be a promising technique for prevention of overweight in adolescents. However, very few well-developed, evidence-based computer-tailored interventions are available for this target group. We developed and evaluated a computer-tailored intervention for adolescents

  11. Design and evaluation protocol of "FATaintPHAT", a computer-tailored intervention to prevent excessive weight gain in adolescents

    NARCIS (Netherlands)

    N.P.M. Ezendam (Nicole); A. Oenema (Anke); P.M. van de Looij-Jansen (Petra); J. Brug (Hans)

    2007-01-01

    textabstractComputer tailoring may be a promising technique for prevention of overweight in adolescents. However, very few well-developed, evidence-based computer-tailored interventions are available for this target group. We developed and evaluated a computer-tailored intervention for adolescents t

  12. Design and evaluation protocol of "FATaintPHAT", a computer-tailored intervention to prevent excessive weight gain in adolescents

    NARCIS (Netherlands)

    N.P.M. Ezendam (Nicole); A. Oenema (Anke); P.M. van de Looij-Jansen (Petra); J. Brug (Hans)

    2008-01-01

    textabstractComputer tailoring may be a promising technique for prevention of overweight in adolescents. However, very few well-developed, evidence-based computer-tailored interventions are available for this target group. We developed and evaluated a computer-tailored intervention for adolescents t

  13. Tailoring intervention procedures to routine primary health care practice; an ethnographic process evaluation

    Directory of Open Access Journals (Sweden)

    Bruijnzeels Marc

    2007-08-01

    Full Text Available Abstract Background Tailor-made approaches enable the uptake of interventions as they are seen as a way to overcome the incompatibility of general interventions with local knowledge about the organisation of routine medical practice and the relationship between the patients and the professionals in practice. Our case is the Quattro project which is a prevention programme for cardiovascular diseases in high-risk patients in primary health care centres in deprived neighbourhoods. This programme was implemented as a pragmatic trial and foresaw the importance of local knowledge in primary health care and internal, or locally made, guidelines. The aim of this paper is to show how this prevention programme, which could be tailored to routine care, was implemented in primary care. Methods An ethnographic design was used for this study. We observed and interviewed the researchers and the practice nurses. All the research documents, observations and transcribed interviews were analysed thematically. Results Our ethnographic process evaluation showed that the opportunity of tailoring intervention procedures to routine care in a pragmatic trial setting did not result in a well-organised and well-implemented prevention programme. In fact, the lack of standard protocols hindered the implementation of the intervention. Although it was not the purpose of this trial, a guideline was developed. Despite the fact that the developed guideline functioned as a tool, it did not result in the intervention being organised accordingly. However, the guideline did make tailoring the intervention possible. It provided the professionals with the key or the instructions needed to achieve organisational change and transform the existing interprofessional relations. Conclusion As tailor-made approaches are developed to enable the uptake of interventions in routine practice, they are facilitated by the brokering of tools such as guidelines. In our study, guidelines facilitated

  14. Tailoring intervention procedures to routine primary health care practice; an ethnographic process evaluation.

    Science.gov (United States)

    Jansen, Yvonne J F M; de Bont, Antoinette; Foets, Marleen; Bruijnzeels, Marc; Bal, Roland

    2007-08-07

    Tailor-made approaches enable the uptake of interventions as they are seen as a way to overcome the incompatibility of general interventions with local knowledge about the organisation of routine medical practice and the relationship between the patients and the professionals in practice. Our case is the Quattro project which is a prevention programme for cardiovascular diseases in high-risk patients in primary health care centres in deprived neighbourhoods. This programme was implemented as a pragmatic trial and foresaw the importance of local knowledge in primary health care and internal, or locally made, guidelines. The aim of this paper is to show how this prevention programme, which could be tailored to routine care, was implemented in primary care. An ethnographic design was used for this study. We observed and interviewed the researchers and the practice nurses. All the research documents, observations and transcribed interviews were analysed thematically. Our ethnographic process evaluation showed that the opportunity of tailoring intervention procedures to routine care in a pragmatic trial setting did not result in a well-organised and well-implemented prevention programme. In fact, the lack of standard protocols hindered the implementation of the intervention. Although it was not the purpose of this trial, a guideline was developed. Despite the fact that the developed guideline functioned as a tool, it did not result in the intervention being organised accordingly. However, the guideline did make tailoring the intervention possible. It provided the professionals with the key or the instructions needed to achieve organisational change and transform the existing interprofessional relations. As tailor-made approaches are developed to enable the uptake of interventions in routine practice, they are facilitated by the brokering of tools such as guidelines. In our study, guidelines facilitated organisational change and enabled the transformation of existing

  15. Effects of a Web-Based Tailored Intervention to Reduce Alcohol Consumption in Adults: Randomized Controlled Trial

    OpenAIRE

    Daniela N Schulz; Candel, Math JJM; Kremers, Stef PJ; Reinwand, Dominique A; Jander, Astrid; de Vries, Hein

    2013-01-01

    Background Web-based tailored interventions provide users with information that is adapted to their individual characteristics and needs. Randomized controlled trials assessing the effects of tailored alcohol self-help programs among adults are scarce. Furthermore, it is a challenge to develop programs that can hold respondents’ attention in online interventions. Objective To assess whether a 3-session, Web-based tailored intervention is effective in reducing alcohol intake in high-risk adult...

  16. Measuring organisational-level Aboriginal cultural climate to tailor cultural safety strategies.

    Science.gov (United States)

    Gladman, Justin; Ryder, Courtney; Walters, Lucie K

    2015-01-01

    Australian medical schools have taken on a social accountability mandate to provide culturally safe contexts in order to encourage Aboriginal and Torres Strait Islander people to engage in medical education and to ensure that present and future clinicians provide health services that contribute to improving the health outcomes of Aboriginal and Torres Strait Islander peoples. Many programs have sought to improve cultural safety through training at an individual level; however, it is well recognised that learners tend to internalise the patterns of behaviour to which they are commonly exposed. This project aimed to measure and reflect on the cultural climate of an Australian rural clinical school (RCS) as a whole and the collective attitudes of three different professional groups: clinicians, clinical academics and professional staff. The project then drew on Mezirow's Transformative Learning theory to design strategies to build on the cultural safety of the organisation. Clinicians, academic and professional staff at an Australian RCS were invited to participate in an online survey expressing their views on Aboriginal health using part of a previously validated tool. Survey response rate was 63%. All three groups saw Aboriginal health as a social priority. All groups recognised the fundamental role of community control in Aboriginal health; however, clinical academics were considerably more likely to disagree that the Western medical model suited the health needs of Aboriginal people. Clinicians were more likely to perceive that they treated Aboriginal patients the same as other patients. There was only weak evidence of future commitments to Aboriginal health. Importantly, clinicians, academics and professional staff demonstrated differences in their cultural safety profile which indicated the need for a tailored approach to cultural safety learning in the future. Through tailored approaches to cross-cultural training opportunities we are likely to ensure

  17. Patterns in Vegetable Consumption: Implications for Tailored School Meal Interventions

    Science.gov (United States)

    Orlowski, Marietta; Lee, Miryoung; Spears, William; Narayan, Roopsi; Pobocik, Rebecca S.; Kennel, Julie; Krafka, Erin; Patton, Susan

    2017-01-01

    Background: Vegetable consumption is a challenging behavioral target; consumption rates are below recommended levels and when interventions produce improvements, increases in vegetable consumption are typically a fraction of the change in fruit consumption. We describe vegetable consumption within Ohio school meals and examine how fruit selection,…

  18. Intervention Tailoring for Chinese American Women: Comparing the Effects of Two Videos on Knowledge, Attitudes and Intentions to Obtain a Mammogram

    Science.gov (United States)

    Wang, Judy Huei-yu; Schwartz, Marc D.; Luta, George; Maxwell, Annette E.; Mandelblatt, Jeanne S.

    2012-01-01

    This study utilized data from an ongoing randomized controlled trial to compare a culturally tailored video promoting positive attitudes toward mammography among Chinese immigrant women to a linguistically appropriate generic video and print media. Intervention development was guided by the Health Belief Model. Five hundred and ninety-two…

  19. Culturally tailored postsecondary nutrition and health education curricula for indigenous populations

    OpenAIRE

    McConnell, Sarah

    2013-01-01

    Background. In preparation for the initial offering of the University of Alaska Fairbanks (UAF), Interior Aleutians Campus Rural Nutrition Services (RNS) program, a literature review was conducted to establish the need for the proposed program and to substantiate the methodology for delivering integrated, culturally tailored postsecondary education and extension to Alaska Natives and rural Alaskans. There was a striking absence of peer-reviewed journal articles describing culturally tailored ...

  20. A scoping review of tailored self-management interventions among adults with mobility impairing neurological and musculoskeletal conditions

    Directory of Open Access Journals (Sweden)

    Matthew A. Plow

    2016-09-01

    Full Text Available A critical public health objective is to optimize and disseminate self-management interventions for the 56.7 million adults living with chronic disabling conditions in the United States. A possible strategy to optimize the effectiveness of self-management interventions is to understand how best to tailor self-management interventions to the needs and circumstances of each participant. Thus, the purpose of this scoping review was to describe randomized controlled trials (RCTs of tailored self-management interventions in adults with neurological and musculoskeletal conditions that characteristically result in mobility impairments. The 13 RCTs included in the scoping review typically compared tailored interventions to non-tailored interventions or usual care among adults with chronic pain, stroke, and/or arthritis. The tailored interventions were diverse in their delivery formats, dosing, behavior change techniques, and tailoring methodology. We identified 13 personal characteristics (e.g., preferences and theoretical constructs and 4 types of assessment formats (i.e., oral history, self-report questionnaires, provider-reported assessments, and medical records that were used to tailor the self-management interventions. It was common to tailor intervention content using self-report questionnaires that assessed personal characteristics pertaining to impairments and preferences. Content was matched to personal characteristics using clinical judgment or computer algorithms. However, few studies adequately described the decision rules for matching content. To advance the science of tailoring self-management interventions, we recommend conducting comparative effectiveness research and further developing a taxonomy to standardize descriptions of tailoring. We discuss the opportunities that are now coalescing to optimize tailored self-management. We also provide examples of how to merge concepts from the self-management literature with conceptual

  1. A Scoping Review of Tailored Self-management Interventions among Adults with Mobility Impairing Neurological and Musculoskeletal Conditions.

    Science.gov (United States)

    Plow, Matthew; Mangal, Sabrina; Geither, Kathryn; Golding, Meghan

    2016-01-01

    A critical public health objective is to optimize and disseminate self-management interventions for the 56.7 million adults living with chronic disabling conditions in the United States. A possible strategy to optimize the effectiveness of self-management interventions is to understand how best to tailor self-management interventions to the needs and circumstances of each participant. Thus, the purpose of this scoping review was to describe randomized controlled trials (RCTs) of tailored self-management interventions in adults with neurological and musculoskeletal conditions that characteristically result in mobility impairments. The 13 RCTs included in the scoping review typically compared tailored interventions to non-tailored interventions or usual care among adults with chronic pain, stroke, and/or arthritis. The tailored interventions were diverse in their delivery formats, dosing, behavior change techniques, and tailoring strategies. We identified 13 personal characteristics (e.g., preferences and theoretical constructs) and 4 types of assessment formats (i.e., oral history, self-report questionnaires, provider-reported assessments, and medical records) that were used to tailor the self-management interventions. It was common to tailor intervention content using self-report questionnaires that assessed personal characteristics pertaining to impairments and preferences. Content was matched to personal characteristics using clinical judgment or computer algorithms. However, few studies adequately described the decision rules for matching content. To advance the science of tailoring self-management interventions, we recommend conducting comparative effectiveness research and further developing a taxonomy to standardize descriptions of tailoring. We discuss the opportunities that are now coalescing to optimize tailored self-management. We also provide examples of how to merge concepts from the self-management literature with conceptual frameworks of tailoring

  2. Avoiding a knowledge gap in a multiethnic statewide social marketing campaign: is cultural tailoring sufficient?

    Science.gov (United States)

    Buchthal, O Vanessa; Doff, Amy L; Hsu, Laura A; Silbanuz, Alice; Heinrich, Katie M; Maddock, Jay E

    2011-03-01

    In 2007, the State of Hawaii, Healthy Hawaii Initiative conducted a statewide social-marketing campaign promoting increased physical activity and nutrition. The campaign included substantial formative research to develop messages tailored for Hawaii's multiethnic Asian and Pacific Islander populations. The authors conducted a statewide random digital dialing telephone survey to assess the campaign's comparative reach among individuals with different ethnicities and different levels of education and income. This analysis suggests that the intervention was successful in reaching its target ethnic audiences. However, a knowledge gap related to the campaign appeared among individuals with incomes less than 130% of the poverty level and those with less than a high school education. These results varied significantly by message and the communication channel used. Recall of supermarket-based messages was significantly higher among individuals below 130% of the poverty level and those between 18 and 35 years of age, 2 groups that showed consistently lower recall of messages in other channels. Results suggest that cultural tailoring for ethnic audiences, although important, is insufficient for reaching low-income populations, and that broad-based social marketing campaigns should consider addressing socioeconomic status-related channel preferences in formative research and campaign design.

  3. Evaluation of a Computer-Tailored Osteoporosis Prevention Intervention in Young Women

    Science.gov (United States)

    Lein, Donald H., Jr.; Clark, Diane; Turner, Lori W.; Kohler, Connie L.; Snyder, Scott; Morgan, Sarah L.; Schoenberger, Yu-Mei M.

    2014-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of a theory-based computer-tailored osteoporosis prevention program on calcium and vitamin D intake and osteoporosis health beliefs in young women. Additionally, this study tested whether adding bone density testing to the intervention improved the outcomes. Methods: One hundred…

  4. Evaluation of a Computer-Tailored Osteoporosis Prevention Intervention in Young Women

    Science.gov (United States)

    Lein, Donald H., Jr.; Clark, Diane; Turner, Lori W.; Kohler, Connie L.; Snyder, Scott; Morgan, Sarah L.; Schoenberger, Yu-Mei M.

    2014-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of a theory-based computer-tailored osteoporosis prevention program on calcium and vitamin D intake and osteoporosis health beliefs in young women. Additionally, this study tested whether adding bone density testing to the intervention improved the outcomes. Methods: One hundred…

  5. The cost of developing a computerized tailored interactive multimedia intervention vs. a print based Photonovella intervention for HPV vaccine education.

    Science.gov (United States)

    Karanth, Siddharth S; Lairson, David R; Savas, Lara S; Vernon, Sally W; Fernández, María E

    2017-08-01

    Mobile technology is opening new avenues for healthcare providers to create and implement tailored and personalized health education programs. We estimate and compare the cost of developing an i-Pad based tailored interactive multimedia intervention (TIMI) and a print based (Photonovella) intervention to increase human papillomavirus (HPV) immunization. The development costs of the interventions were calculated using a societal perspective. Direct cost included the cost of planning the study, conducting focus groups, and developing the intervention materials by the research staff. Costs also included the amount paid to the vendors who produced the TIMI and Photonovella. Micro cost data on the staff time and materials were recorded in logs for tracking personnel time, meeting time, supplies and software purchases. The costs were adjusted for inflation and reported in 2015 USD. The total cost of developing the Photonovella was $66,468 and the cost of developing the TIMI was $135,978. The amortized annual cost for the interventions calculated at a 3% discount rate and over a 7-year period was $10,669 per year for the Photonovella and $21,825 per year for the TIMI intervention. The results would inform decision makers when planning and investing in the development of interactive multimedia health interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Nutrition Education Research Brief: Message Framing, Use of Interactive Technology to Tailor Messages, and Intervention Intensity

    OpenAIRE

    Mary Kay Fox; Charlotte Hanson; Ronette Briefel

    2007-01-01

    This research brief is intended to assist nutrition educators in assessing whether specific characteristics of nutrition messages promote desired dietary behavior changes. Based on a computerized literature search targeting peer-reviewed journal articles, it highlights three topics pertinent to the design of nutrition education programs—message framing, use of interactive technology to tailor messages, and intervention intensity. While some promising results were found to be associated with...

  7. A cohort study of a tailored web intervention for preconception care

    OpenAIRE

    Agricola, Eleonora; Pandolfi, Elisabetta; Gonfiantini, Michaela V; Gesualdo, Francesco; Romano, Mariateresa; Carloni, Emanuela; Mastroiacovo, Pierpaolo; Alberto E Tozzi

    2014-01-01

    Background Preconception care may be an efficacious tool to reduce risk factors for adverse pregnancy outcomes that are associated with lifestyles and health status before pregnancy. We conducted a web-based cohort study in Italian women planning a pregnancy to assess whether a tailored web intervention may change knowledge and behaviours associated with risks for adverse pregnancy outcomes. Methods The study was entirely conducted on the web on a cohort of Italian women of childbearing age. ...

  8. Correlates of the intention to implement a tailored physical activity intervention: perceptions of intermediaries.

    Science.gov (United States)

    Peels, Denise; Mudde, Aart; Bolman, Catherine; Golsteijn, Rianne; de Vries, Hein; Lechner, Lilian

    2014-02-10

    The public health impact of health behaviour interventions is highly dependent on large-scale implementation. Intermediaries-intervention providers-determine to a large extent whether an intervention reaches the target population, and hence its impact on public health. A cross-sectional study was performed to identify the correlates of intermediaries' intention to implement a computer-tailored physical activity intervention. According to theory, potential correlates are intervention characteristics, organisational characteristics, socio-political characteristics and intermediary characteristics. This study investigated whether intermediary characteristics mediated the association between the intervention, organisational and socio-political characteristics and intention to implement the intervention. Results showed that intervention characteristics (i.e., observability (B = 0.53; p = 0.006); relative advantage (B = 0.79; p = 0.020); complexity (B = 0.80; p organisational characteristics (i.e., type of organization (B = 0.38; p = 0.002); perceived task responsibility (B = 0.66; p ≤ 0.001); capacity (B = 0.83; p organisations (B = 0.81; p strategy. Since self-efficacy and social norms perceived by the intermediary organisations partially mediated the effects of other variables on intention to implement the intervention (varying between 29% and 84%), these factors should be targeted to optimise the effectiveness of the implementation strategy.

  9. Exploring Cultural Predictors of Military Intervention Success

    Science.gov (United States)

    2015-04-01

    AU/ACSC/Wade, E/AY15 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY EXPLORING CULTURAL PREDICTORS OF MILITARY INTERVENTION SUCCESS by Dr...post facto exploration of predictors of military intervention success . As such, the research examined pre- and post-intervention political conditions as...qualitative analysis to identify cultural factors that might predict intervention success . The study concluded that Central American former Spanish

  10. Secretos de la Buena Vida: processes of dietary change via a tailored nutrition communication intervention for Latinas.

    Science.gov (United States)

    Baquero, Barbara; Ayala, Guadalupe X; Arredondo, Elva M; Campbell, Nadia R; Slymen, Donald J; Gallo, Linda; Elder, John P

    2009-10-01

    Secretos de la Buena Vida was a successful tailored nutrition communication intervention delivered to Latinas living along the US-Mexico border in California. The intervention was delivered over a 14-week period and consisted of three intervention conditions: weekly home visits with promotoras + weekly tailored mailed newsletters in the first condition, weekly tailored mailed newsletters in the second condition and targeted materials in the attention control condition. The current study examined what elements of the promotora + tailored newsletter and tailored newsletter-only conditions were most effective for behavioral adoption and maintenance in a sample of 238 Latina women. Process evaluation measures assessed the implementation, fidelity and dose of these two intervention conditions. Results indicate that there was high fidelity to program implementation and delivery. Perceived effort, perceived support and intervention length predicted adoption of a lower fat diet at the 15-month follow-up. In the promotora + tailored newsletter condition, married women were four times more likely to be adopters of dietary fat changes than single women. These findings highlight the importance of process evaluation measures and help us understand the mechanism by which tailored print materials and interpersonal health communication via promotoras can facilitate health behavior change.

  11. Correlates of the Intention to Implement a Tailored Physical Activity Intervention: Perceptions of Intermediaries

    Directory of Open Access Journals (Sweden)

    Denise Peels

    2014-02-01

    Full Text Available The public health impact of health behaviour interventions is highly dependent on large-scale implementation. Intermediaries—intervention providers—determine to a large extent whether an intervention reaches the target population, and hence its impact on public health. A cross-sectional study was performed to identify the correlates of intermediaries’ intention to implement a computer-tailored physical activity intervention. According to theory, potential correlates are intervention characteristics, organisational characteristics, socio-political characteristics and intermediary characteristics. This study investigated whether intermediary characteristics mediated the association between the intervention, organisational and socio-political characteristics and intention to implement the intervention. Results showed that intervention characteristics (i.e., observability (B = 0.53; p = 0.006; relative advantage (B = 0.79; p = 0.020; complexity (B = 0.80; p < 0.001; compatibility (B = 0.70; p < 0.001, organisational characteristics (i.e., type of organization (B = 0.38; p = 0.002; perceived task responsibility (B = 0.66; p ≤ 0.001; capacity (B = 0.83; p < 0.001, and the social support received by intermediary organisations (B = 0.81; p < 0.001 were associated with intention to implement the intervention. These factors should thus be targeted by an implementation strategy. Since self-efficacy and social norms perceived by the intermediary organisations partially mediated the effects of other variables on intention to implement the intervention (varying between 29% and 84%, these factors should be targeted to optimise the effectiveness of the implementation strategy.

  12. The use of instrumented gait analysis for individually tailored interdisciplinary interventions in children with cerebral palsy

    DEFF Research Database (Denmark)

    Rasmussen, Helle Mätzke; Pedersen, Niels Wisbech; Overgaard, Søren;

    2015-01-01

    in gait following individually tailored interventions when IGA is used are superior to those following ‘care as usual’. Methods/Design A prospective, single blind, randomised, parallel group study will be conducted. Children aged 5 to 8 years with spastic CP, classified at Gross Motor Function...... performance (1-min walk test) and patient-reported outcomes of functional mobility (Pediatric Evaluation of Disability Inventory), health-related quality of life (The Pediatric Quality of Life Inventory Cerebral Palsy Module) and overall health, pain and participation (The Pediatric Outcome Data Collection...

  13. A coping and communication support intervention tailored to older patients diagnosed with late-stage cancer

    Directory of Open Access Journals (Sweden)

    Julia Hannum Rose

    2008-03-01

    Full Text Available Julia Hannum Rose1,2,3, Rosanne Radziewicz4, Karen F Bowman5, Elizabeth E O’Toole11Case Western Reserve University School of Medicine, Cleveland, OH, USA; 2Louis Stokes Cleveland VAMC-GRECC, Cleveland, OH, USA; 3Center for Health Care Research and Policy, Case at MetroHealth Medical Center, Cleveland, OH, USA; 4Department of Nursing, MetroHealth Medical Center, Cleveland, OH, USA; 5Department of Sociology, Case Western Reserve University, Cleveland, OH, USAAbstract: As our society ages, increasing numbers of older Americans will be diagnosed and eventually will die of cancer. To date, psycho-oncology interventions for advanced cancer patients have been more successful in reaching younger adult age groups and generally have not been designed to respond to the unique needs and preferences of older patients. Theories and research on successful aging (Baltes and Baltes 1990; Baltes 1997, health information processing style (Miller 1995; Miller et al 2001 and non-directive client-centered therapy (Rogers 1951, 1967, have guided the development of a coping and communication support (CCS intervention. Key components of this age-sensitive and tailored intervention are described, including problem domains addressed, intervention strategies used and the role of the CCS practitioner. Age group comparisons in frequency of contact, problems raised and intervention strategies used during the first six weeks of follow up indicate that older patients were similar to middle-aged patients in their level of engagement, problems faced and intervention strategies used. Middle-aged patients were more likely to have problems communicating with family members at intervention start up and practical problems as well in follow up contacts. This is the first intervention study specifically designed to be age sensitive and to examine age differences in engagement from the early treatment phase for late-stage cancer through end of life. This tailored intervention is

  14. Rural Print Media and a Tailored Advocacy Intervention for Smoke-Free Policy.

    Science.gov (United States)

    Hahn, Ellen J; Kolpek, Jeslyn K; Lee, Erin; Record, Rachael; Wiggins, Amanda T; Butler, Karen M; Rayens, Mary Kay

    2017-01-01

    To examine frequency, prominence, and content of local print media after a 4-year policy advocacy intervention. This was a controlled community-based trial. The study took place in 39 rural counties (22 intervention, 17 comparison). Subjects consisted of 2525 newspaper articles monitored over 18 quarters (July 2007 to December 2011). One key element of the tailored policy advocacy intervention delivered by community advisors was building demand for smoke-free policy via media advocacy strategies. Media clips were coded to assess number of articles; percent of tobacco-related articles on the front page or bold heading section; percent of pro-health articles; and percent of articles with secondhand smoke (SHS)-relevant topics or themes. Coded data were entered into Atlas.ti software. Article frequencies and attributes were compared between groups and over time using negative binomial regression for longitudinal data, with county-level demographics as covariates. In the last 3 years, there were approximately twice as many articles in intervention than in comparison counties. Media clips from newspapers in intervention counties were between 1.4 and 2 times more likely to have front page placement and percent of relevant topic or theme than were those in comparison counties. There was no difference in rate of pro-health articles by group. The policy advocacy intervention to promote smoke-free policy increased media attention to SHS and may have increased public awareness of issues related to smoke-free policy.

  15. Comparing tailored and narrative worksite interventions at increasing colonoscopy adherence in adults 50-75: a randomized controlled trial.

    Science.gov (United States)

    Jensen, Jakob D; King, Andy J; Carcioppolo, Nick; Krakow, Melinda; Samadder, N Jewel; Morgan, Susan

    2014-03-01

    Research has identified several communication strategies that could increase adherence to colorectal cancer screening recommendations. Two promising strategies are tailoring and narrative-based approaches. Tailoring is the personalization of information based on individual characteristics. Narrative-based approaches use stories about similar others to counter perceived barriers and cultivate self-efficacy. To compare these two approaches, a randomized controlled trial was carried out at 8 worksites in Indiana. Adults 50-75 (N = 209) received one of four messages about colorectal cancer screening: stock, narrative, tailored, tailored narrative. The primary outcome was whether participants filed a colonoscopy claim in the 18 months following the intervention. Individuals receiving narrative messages were 4 times more likely to screen than those not receiving narrative messages. Tailoring did not increase screening behavior overall. However, individuals with higher cancer information overload were 8 times more likely to screen if they received tailored messages. The results suggest that narrative-based approaches are more effective than tailoring at increasing colorectal cancer screening in worksite interventions. Tailoring may be valuable as a strategy for reaching individuals with high overload, perhaps as a follow-up effort to a larger communication campaign.

  16. Design and evaluation protocol of "FATaintPHAT", a computer-tailored intervention to prevent excessive weight gain in adolescents

    Directory of Open Access Journals (Sweden)

    van de Looij-Jansen Petra M

    2007-11-01

    Full Text Available Abstract Background Computer tailoring may be a promising technique for prevention of overweight in adolescents. However, very few well-developed, evidence-based computer-tailored interventions are available for this target group. We developed and evaluated a computer-tailored intervention for adolescents targeting energy balance-related behaviours: i.e. consumption of snacks, sugar-sweetened beverages, fruit, vegetables, and fibre, physical activity, and sedentary behaviours. This paper describes the planned development of a school-based computer-tailored intervention aimed at improving energy balance-related behaviours in order to prevent excessive weight gain in adolescents, and the protocol for evaluating this intervention. Methods/design Intervention development: Informed by the Precaution Adoption Process Model and the Theory of Planned Behaviour, the computer-tailored intervention provided feedback on personal behaviour and suggestions on how to modify it. The intervention (VETisnietVET translated as 'FATaintPHAT' has been developed for use in the first year of secondary school during eight lessons. Evaluation design: The intervention will be evaluated in a cluster-randomised trial including 20 schools with a 4-months and a 2-years follow-up. Outcome measures are BMI, waist circumference, energy balance-related behaviours, and potential determinants of these behaviours. Process measures are appreciation of and satisfaction with the program, exposure to the program's content, and implementation facilitators and barriers measured among students and teachers. Discussion This project resulted in a theory and evidence-based intervention that can be implemented in a school setting. A large-scale randomised controlled trial with a short and long-term follow-up will provide sound statements about the effectiveness of this computer-tailored intervention in adolescents. Trial Registration ISRCTN15743786

  17. Tailoring of the Tell-us Card communication tool for nurses to increase patient participation using Intervention Mapping.

    Science.gov (United States)

    van Belle, Elise; Zwakhalen, Sandra M G; Caris, Josien; Van Hecke, Ann; Huisman-de Waal, Getty; Heinen, Maud

    2017-07-19

    To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting by using Intervention Mapping as a systematic approach. Even though patient participation is essential in any patient to nurse encounter, care plans often fail to take patients' preferences into account. The Tell-us Card intervention seems promising, but needs to be tailored and tested before implementation in a different setting or on large scale. Description of the Intervention Mapping framework to systematically tailor the Tell-us Card intervention to the Dutch hospital setting. Intervention Mapping consists of: (1) identification of the problem through needs assessment and determination of fit, based on patients and nurses interviews and focus group interviews; (2) developing a logic model of change and matrices, based on literature and interviews; (3) selection of theory based methods and practical applications; (4) producing program components and piloting; (5) planning for adoption, implementation and sustainability; and (6) preparing for program evaluation. Knowledge, attitude, outcome expectations, self-efficacy and skills were identified as the main determinants influencing the use of the Tell-us Card. Linking identified determinants and performance objectives with behaviour change techniques from the literature resulted in a well defined and tailored intervention and evaluation plan. The Tell-us Card intervention was adapted to fit the Dutch hospital setting and prepared for evaluation. The Medical Research Council-framework was followed, and the Intervention Mapping approach was used to prepare a pilot study to confirm feasibility and relevant outcomes. This article shows how Intervention Mapping is applied within the Medical Research Council framework to adapt the Tell-us Card intervention, which could serve as a guide for the tailoring of similar interventions. This article is protected by copyright. All rights reserved. This

  18. Culturally Tailored Smoking Cessation for Arab American Male Smokers in Community Settings: A Pilot Study

    OpenAIRE

    Haddad, Linda; Corcoran, Jacqueline

    2013-01-01

    Tobacco use is a serious public health problem among Arab Americans with limited English proficiency. The main goal of this study was to develop a culturally-tailored and linguistically-sensitive Arabic-language smoking cessation program. A secondary goal was to evaluate the feasibility of recruiting Arab Americans through a faith-based community organization which serves as a neighborhood social center for the city of Richmond’s Arab Americans. Eight first-generation Arab American men aged 2...

  19. Tailored behavioral support for smoking reduction: development and pilot results of an innovative intervention.

    Science.gov (United States)

    Levinson, Arnold H; Glasgow, Russell E; Gaglio, Bridget; Smith, Tammy L; Cahoon, Jana; Marcus, Alfred C

    2008-04-01

    Reduction of smoking may increase the likelihood of eventual smoking cessation among those not ready to quit. We describe the development and acceptance of a smoking-reduction intervention that integrates telephone counseling sessions with newsletters. A computer-assisted telephone interviewing program generates real-time-tailored counseling delivered by lay interviewers. Pilot participants (n = 53) were adult smokers scheduled for outpatient procedures in a health maintenance organization, randomized to intervention or a control condition (quarterly mailings). Smoking levels were measured by self-report and biochemically. Among intervention participants continuing at 3 months, all but one rated their telephone support person positively on all dimensions. Counseling calls were 'about right' in number, and newsletters were perceived as quite personal. Intervention recipients reported smoking significantly fewer mean cigarettes per day at 3 months than at baseline, and significantly fewer than control participants. Comparisons were non-significant under intent-to-treat analyses and on biochemical measures. The program was well received by outpatients who were not ready to quit smoking, and was implemented successfully by telephone staff who had no previous smoking cessation counseling experience. An ongoing trial is evaluating effectiveness, cost and relationship to eventual cessation.

  20. A Tailored Web-Based Psycho-Educational Intervention for Cancer Patients and Their Family Caregivers

    Science.gov (United States)

    Northouse, Laurel; Schafenacker, Ann; Barr, Kathryn L.C.; Katapodi, Maria; Yoon, Hyojin; Brittain, Kelly; Song, Lixin; Ronis, David L.; An, Larry

    2014-01-01

    Background Most programs addressing psychosocial concerns of cancer survivors are in-person programs that are expensive to deliver, have limited availability, and seldom deal with caregivers’ concerns. Objective This study examined the feasibility of translating an efficacious nurse-delivered program (FOCUS Program) for patients and their caregivers to a tailored, dyadic web-based format. Specific aims were to: (i) test the preliminary effects of the web-based intervention on patient and caregiver outcomes, (ii) examine participants’ program satisfaction, and (iii) determine the feasibility of using a web-based delivery format. Intervention/Methods A Phase II feasibility study was conducted with cancer patients (lung, breast, colorectal, prostate) and their family caregivers (N=38 dyads). The web-based intervention provided information and support tailored to the unique characteristics of each patient, caregiver, and their dyadic relationship. Primary outcomes were emotional distress and quality of life (QOL). Secondary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included descriptive statistics and repeated measures ANOVA. Results Dyads had a significant decrease in emotional distress, increase in QOL, and perceived more benefits of illness/caregiving. Caregivers also had significant improvement in self-efficacy. There were no changes in communication. Participants were satisfied with program usability, but recommended additional content. Conclusions It was possible to translate a clinician-delivered program to a web-based format that was easy to use and had positive effects on dyadic outcomes. Implications for Practice The web-based program is a promising way to provide psychosocial care to more patients and caregivers using fewer personnel. It needs further testing in a larger RCT. PMID:24945270

  1. Process evaluation of a tailored mobile health intervention aiming to reduce fatigue in airline pilots.

    Science.gov (United States)

    van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; Smid, Tjabe; van der Beek, Allard J

    2016-08-26

    MORE Energy is a mobile health intervention which aims to reduce fatigue and improve health in airline pilots. The primary objective of this process evaluation was to assess the reach, dose delivered, compliance, fidelity, barriers and facilitators, and satisfaction of the intervention. The second objective was to investigate the associations of adherence to the intervention with compliance and with participant satisfaction. Thirdly, we investigated differences between the subgroups within the target population. The intervention consisted of a smartphone application, supported by a website. It provided advice on optimal light exposure, sleep, nutrition, and physical activity, tailored to flight and personal characteristics. The reach of the intervention was determined by comparing the intervention group participants and the airline pilots who did not participate. The dose delivered was defined as the total number of participants that was sent an instruction email. Objective compliance was measured through the Control Management System of the application. To determine the fidelity, an extensive log was kept throughout the intervention period. Subjective compliance, satisfaction, barriers, facilitators, and adherence were assessed using online questionnaires. Associations between the extent to which the participants applied the advice in daily life (adherence), compliance, and satisfaction were analysed as well. Finally, outcomes of participants of different age groups and haul types were compared. A total of 2222 pilots were made aware of the study. From this group, 502 pilots met the inclusion criteria and did agree to participate. The reach of the study proved to be 22 % and the dose delivered was 99 %. The included pilots were randomized into the intervention group (n = 251) or the control group (n = 251). Of the intervention group participants, 81 % consulted any advice, while 17 % did this during four weeks or more. Fidelity was 67 %. The

  2. Cultural Intervention in English and Chinese Translation

    Institute of Scientific and Technical Information of China (English)

    ZHONG Wei-he

    2002-01-01

    In this paper, the author defines translation as an act of communication in a cross-cultural context, the main aim of which is to establish communication between members of different cultures in accordance with previously determined communicative target purpose. He then discusses the unavoidable cultural intervention in the process of translation. Cases in aesthetic preference, political involvement and ethical tradition are studied to prove his proposition that translation is not only linguistic transfer, but also cultural transfer, and that "the more inclusive the target culture is, the closer the translation is to the source culture, the more exclusive the target culture is, the closer the translation must be to the target culture." In the last part of the paper, he proposes strategies of translation (especially for the translation between English and Chinese) with which we can tackle the cultural barriers in the process of translation, i.e. distortion,ignoring and coinage.

  3. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain and stress among laboratory technicians

    DEFF Research Database (Denmark)

    Andersen, Kenneth Jay; Brandt, Mikkel; Hansen, Klaus

    2015-01-01

    pain using individually tailored physical and cognitive elements. STUDY DESIGN: This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial "Implementation of physical exercise at the Workplace (IRMA...... region separately showed significant pain reductions of the neck, shoulders, upper back and lower back, as well as a tendency for hand pain. Within the PCMT group, general linear models adjusted for age, baseline pain, and stress levels showed significant associations for the change in pain...... with the number of physical-cognitive training sessions per week (-0.60 [95%CI -0.95 to -0.25]) and the number of mindfulness sessions (0.15 [95%CI 0.02 to 0.18]). No such associations were found with the change in stress as outcome. LIMITATIONS: Limitations of behavioral interventions include the inability...

  4. Design of a comparative effectiveness evaluation of a culturally tailored versus standard community-based smoking cessation treatment program for LGBT smokers.

    Science.gov (United States)

    Matthews, Alicia K; McConnell, Elizabeth A; Li, Chien-Ching; Vargas, Maria C; King, Andrea

    2014-01-01

    Smoking prevalence rates among the lesbian, gay, bisexual, and transgender (LGBT) population are significantly higher than the general population. However, there is limited research on smoking cessation treatments in this group, particularly on culturally targeted interventions. Moreover, there are few interventions that address culturally specific psychosocial variables (e.g., minority stress) that may influence outcomes. This paper describes the protocol for a comparative effectiveness trial testing an evidence-based smoking cessation program, Courage to Quit, against a culturally tailored version for LGBT smokers, and examines the role of culturally specific psychosocial variables on cessation outcomes. To examine the effectiveness of a culturally targeted versus standard smoking cessation intervention, the study utilizes a 2-arm block, randomized, control trial (RCT) design. Adult LGBT participants (n = 400) are randomized to one of the two programs each consisting of a six-session group program delivered in a community center and an eight week supply of the transdermal nicotine patch. Four individualized telephone counseling sessions occur at weeks 2, 5, 7, and 9, at times of greatest risk for relapse. Study outcome measures are collected at baseline, and 1, 3, 6, and 12 months post quit date. Primary outcomes are expired air carbon monoxide verified 7-day point-prevalence quit rates at each measurement period. Secondary outcomes assess changes in cravings, withdrawal symptoms, smoking cessation self-efficacy, and treatment adherence. Additionally, study staff examines the role of culturally specific psychosocial variables on cessation outcomes using path analysis. Determining the efficacy of culturally specific versus standard evidence based approaches to smoking cessation is a critical issue facing the field today. This study provides a model for the development and implementation of a culturally tailored smoking cessation intervention for LGBT

  5. Cost-effectiveness of a tailored intervention designed to increase breast cancer screening among a non-adherent population: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ishikawa Yoshiki

    2012-09-01

    Full Text Available Abstract Background Although the percentage of women who initiate breast cancer screening is rising, the rate of continued adherence is poor. The purpose of this study was to examine the effectiveness and cost-effectiveness of a tailored print intervention compared with a non-tailored print intervention for increasing the breast cancer screening rate among a non-adherent population. Methods In total, 1859 participants aged 51–59 years (except those aged 55 years were recruited from a Japanese urban community setting. Participants were randomly assigned to receive either a tailored print reminder (tailored intervention group or non-tailored print reminder (non-tailored intervention group. The primary outcome was improvement in the breast cancer screening rate. The screening rates and cost-effectiveness were examined for each treatment group (tailored vs. non-tailored and each intervention subgroup during a follow-up period of five months. All analyses followed the intention-to-treat principle. Results The number of women who underwent a screening mammogram following the reminder was 277 (19.9% in the tailored reminder group and 27 (5.8% in the non-tailored reminder group. A logistic regression model revealed that the odds of a woman who received a tailored print reminder undergoing mammography was 4.02 times those of a women who had received a non-tailored print reminder (95% confidence interval, 2.67–6.06. The cost of one mammography screening increase was 2,544 JPY or 30 USD in the tailored intervention group and 4,366 JPY or 52 USD in the non-tailored intervention group. Conclusions Providing a tailored print reminder was an effective and cost-effective strategy for improving breast cancer screening rates among non-adherent women.

  6. Usability evaluation of an online, tailored self-management intervention for chronic obstructive pulmonary disease patients incorporating behavior change techniques

    NARCIS (Netherlands)

    Voncken-Brewster, V.; Moser, A.; Weijden, T.T. van der; Nagykaldi, Z.; Vries, H. de; Tange, H.

    2013-01-01

    BACKGROUND: An eHealth intervention using computer tailored technology including several behavior change techniques was developed to support the self-management of chronic obstructive pulmonary disease patients. OBJECTIVE: The goal of this study was to evaluate and improve the usability of the eHeal

  7. Randomized Trial Outcomes of a TTM-Tailored Condom Use and Smoking Intervention in Urban Adolescent Females

    Science.gov (United States)

    Redding, Colleen A.; Prochaska, James O.; Armstrong, Kay; Rossi, Joseph S.; Hoeppner, Bettina B.; Sun, Xiaowu; Kobayashi, Hisanori; Yin, Hui-Qing; Coviello, Donna; Evers, Kerry; Velicer, Wayne F.

    2015-01-01

    Smoking and sexual risk behaviors in urban adolescent females are prevalent and problematic. Family planning clinics reach those who are at most risk. This randomized effectiveness trial evaluated a transtheoretical model (TTM)-tailored intervention to increase condom use and decrease smoking. At baseline, a total of 828 14- to 17-year-old females…

  8. Using Qualitative and Quantitative Formative Research to Develop Tailored Nutrition Intervention Materials for a Diverse Low-Income Audience

    Science.gov (United States)

    Strolla, Leslie O.; Gans, Kim M.; Risica, Patricia M.

    2006-01-01

    More effective nutrition education to reach low-income and ethnic minority populations is needed. As part of a project to develop a tailored nutrition education intervention to meet the needs of low-income Hispanics and non-Hispanics, complementary, mixed methods of formative research were used to determine specific characteristics of the target…

  9. Efficacy and use of an internet-delivered computer-tailored lifestyle intervention, targeting saturated fat intake, physical activity and smoking cessation : A randomized controlled trial

    NARCIS (Netherlands)

    Oenema, Anke; Brug, Johannes; Dijkstra, Arie; de Weerdt, Inge; de Vries, Hein

    2008-01-01

    Background Although experts claim that computer-tailored interventions provided over the Internet have great potential to promote health behavior change, few studies have tested the efficacy of computer-tailored lifestyle interventions online-delivered over the Internet. Purpose To evaluate the shor

  10. Cluster Analysis of Acute Care Use Yields Insights for Tailored Pediatric Asthma Interventions.

    Science.gov (United States)

    Abir, Mahshid; Truchil, Aaron; Wiest, Dawn; Nelson, Daniel B; Goldstick, Jason E; Koegel, Paul; Lozon, Marie M; Choi, Hwajung; Brenner, Jeffrey

    2017-09-01

    We undertake this study to understand patterns of pediatric asthma-related acute care use to inform interventions aimed at reducing potentially avoidable hospitalizations. Hospital claims data from 3 Camden city facilities for 2010 to 2014 were used to perform cluster analysis classifying patients aged 0 to 17 years according to their asthma-related hospital use. Clusters were based on 2 variables: asthma-related ED visits and hospitalizations. Demographics and a number of sociobehavioral and use characteristics were compared across clusters. Children who met the criteria (3,170) were included in the analysis. An examination of a scree plot showing the decline in within-cluster heterogeneity as the number of clusters increased confirmed that clusters of pediatric asthma patients according to hospital use exist in the data. Five clusters of patients with distinct asthma-related acute care use patterns were observed. Cluster 1 (62% of patients) showed the lowest rates of acute care use. These patients were least likely to have a mental health-related diagnosis, were less likely to have visited multiple facilities, and had no hospitalizations for asthma. Cluster 2 (19% of patients) had a low number of asthma ED visits and onetime hospitalization. Cluster 3 (11% of patients) had a high number of ED visits and low hospitalization rates, and the highest rates of multiple facility use. Cluster 4 (7% of patients) had moderate ED use for both asthma and other illnesses, and high rates of asthma hospitalizations; nearly one quarter received care at all facilities, and 1 in 10 had a mental health diagnosis. Cluster 5 (1% of patients) had extreme rates of acute care use. Differences observed between groups across multiple sociobehavioral factors suggest these clusters may represent children who differ along multiple dimensions, in addition to patterns of service use, with implications for tailored interventions. Copyright © 2017 American College of Emergency Physicians

  11. Assessing a risk tailored intervention to prevent disabling low back pain - protocol of a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Marnitz Ulf

    2010-01-01

    Full Text Available Abstract Background Although most patients with low back pain (LBP recover within a few weeks a significant proportion has recurrent episodes or will develop chronic low back pain. Several mainly psychosocial risk factors for developing chronic LBP have been identified. However, effects of preventive interventions aiming at behavioural risk factors and unfavourable cognitions have yielded inconsistent results. Risk tailored interventions may provide a cost efficient and effective means to take systematic account of the individual risk factors but evidence is lacking. Methods/Design This study will be a cluster-randomised controlled trial comparing screening and a subsequent risk tailored intervention for patients with low back pain to prevent chronic low back pain compared to treatment as usual in primary care. A total of 600 patients from 20 practices in each study arm will be recruited in Berlin and Goettingen. The intervention comprises the following elements: Patients will be assigned to one of four risk groups based on a screening questionnaire. Subsequently they receive an educational intervention including information and counselling tailored to the risk group. A telephone/email consulting service for back pain related problems are offered independent of risk group assignment. The primary outcomes will be functional capacity and sick leave. Discussion This trial will evaluate the effectiveness of screening for risk factors for chronic low back pain followed by a risk tailored intervention to prevent chronic low back pain. This trial will contribute new evidence regarding the flexible use of individual physical and psychosocial risk factors in general practice. Trial registration ISRCTN 68205910

  12. A web-based computer-tailored smoking prevention programme for primary school children: intervention design and study protocol.

    Science.gov (United States)

    Cremers, Henricus-Paul; Mercken, Liesbeth; Oenema, Anke; de Vries, Hein

    2012-06-11

    Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking. This paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years) entitled 'Fun without Smokes'. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT) with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils' smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the 'Fun without Smokes' website. The main outcome measures will be ever smoking and the utilisation of the 'Fun without Smokes' website. Measurements will be carried out at baseline, 12 months and 24 months of follow-up. The present study protocol describes the purpose, intervention design and

  13. Developing Strategies for Waste Reduction by Means of Tailored Interventions in Santiago De Cuba

    Science.gov (United States)

    Tobias, Robert; Brugger, Adrian; Mosler, Hans-Joachim

    2009-01-01

    This article introduces an approach to tailoring behavior-change campaigns to target populations using the example of solid waste reduction in Santiago de Cuba. Tailoring is performed in the following steps: (1) Psychological constructs are selected to detect problems in performing the target behavior, and data are gathered on these constructs.…

  14. Developing Strategies for Waste Reduction by Means of Tailored Interventions in Santiago De Cuba

    Science.gov (United States)

    Tobias, Robert; Brugger, Adrian; Mosler, Hans-Joachim

    2009-01-01

    This article introduces an approach to tailoring behavior-change campaigns to target populations using the example of solid waste reduction in Santiago de Cuba. Tailoring is performed in the following steps: (1) Psychological constructs are selected to detect problems in performing the target behavior, and data are gathered on these constructs.…

  15. Why are Tailored Messages More Effective? A Multiple Mediation Analysis of a Breast Cancer Screening Intervention.

    Science.gov (United States)

    Jensen, Jakob D; King, Andy J; Carcioppolo, Nicholas; Davis, LaShara

    2012-10-01

    Past research has found that tailoring increases the persuasive effectiveness of a message. However, the observed effect has been small and the explanatory mechanism remains unknown. To address these shortcomings, a tailoring software program was created that personalized breast cancer screening pamphlets according to risk, health belief model constructs, and visual preference. Women aged 40 and older (N = 119) participated in a 2 (tailored vs. stock message) × 2 (charts/graphs vs. illustrated visuals) × 3 (nested replications of the visuals) experiment. Participants provided with tailored illustrated pamphlets expressed greater breast cancer screening intentions than those provided with other pamphlets. In a test of 10 different mediators, perceived message relevance was found to fully mediate the tailoring × visual interaction.

  16. Randomised controlled trial of tailored interventions to improve the management of anxiety and depressive disorders in primary care

    Directory of Open Access Journals (Sweden)

    Terluin Berend

    2011-07-01

    Full Text Available Abstract Background Anxiety and depressive disorders are highly prevalent disorders and are mostly treated in primary care. The management of these disorders by general practitioners is not always consistent with prevailing guidelines because of a variety of factors. Designing implementation strategies tailored to prospectively identified barriers could lead to more guideline-recommended care. Although tailoring of implementation strategies is promoted in practice, little is known about the effect on improving the quality of care for the early recognition, diagnosis, and stepped care treatment allocation in patients with anxiety or depressive disorders in general practice. This study examines whether the tailored strategy supplemented with training and feedback is more effective than providing training and feedback alone. Methods In this cluster randomised controlled trial, a total of 22 general practices will be assigned to one of two conditions: (1 training, feedback, and tailored interventions and (2 training and feedback. The primary outcome measure is the proportion of patients who have been recognised to have anxiety and/or depressive disorder. The secondary outcome measures in patients are severity of anxiety and depressive symptoms, level of functioning, expectation towards and experience with care, quality of life, and economic costs. Measures are taken after the start of the intervention at baseline and at three- and six-month follow-ups. Secondary outcome measures in general practitioners are adherence to guideline-recommended care in care that has been delivered, the proportion of antidepressant prescriptions, and number of referrals to specialised mental healthcare facilities. Data will be gathered from the electronic medical patient records from the patients included in the study. In a process evaluation, the identification of barriers to change and the relations between prospectively identified barriers and improvement

  17. Health literacy among insulin-taking African Americans: a need for tailored intervention in clinical practice.

    Science.gov (United States)

    Piatt, Gretchen A; Valerio, Melissa A; Nwankwo, Robin; Lucas, Stephanie M; Funnell, Martha M

    2014-01-01

    To determine the levels of functional health literacy (FHL) among insulin-taking African Americans with diabetes from an urban medical practice and to determine if associations exist between FHL levels and glycemic control. Seventy insulin-taking African Americans seen for diabetes management comprised the analysis cohort. Patients were 18 years or older, African American, had diabetes, and currently using insulin via syringe, pen, or insulin pump. All participants completed a one-time assessment of FHL levels, using the Newest Vital Sign (NVS). Scores ranged from 0 to 6 (0-1 = high likelihood of limited FHL; 2-3 = possibility of limited FHL; 4-6 = adequate FHL). A combination of t tests, Pearson's chi-square tests, and multivariate logistic regression models were used to determine associations between glycemic control and FHL. Average age was 58.7, 59.1% were female, 90.8% with type 2 diabetes, and 15.1% using an insulin pump. Glycemic control was: A1C < 7%: 22.9%, A1C < 8%: 47.1%. Of participants, 47.1% had adequate FHL, 31.4% had possible limited FHL, and 21.4% had a high likelihood of limited FHL. Also, 67.7% of participants with A1C ≥ 8% had a high likelihood of limited FHL. After adjusting for age and gender, participants with a high likelihood of limited FHL were 6.2 times (95% confidence interval [CI], 1.4-28.3) more likely to have A1C ≥ 8%. Insulin-taking African Americans with a high likelihood of limited FHL are approximately 6 times more likely to have an A1C ≥ 8% compared to patients with a possibility of limited FHL, or adequate FHL, demonstrating the need for focused interventions tailored to FHL needs.

  18. Sociocultural tailoring of a healthy lifestyle intervention to reduce cardiovascular disease and type 2 diabetes risk among Latinos.

    Science.gov (United States)

    Mudd-Martin, Gia; Martinez, Maria C; Rayens, Mary Kay; Gokun, Yevgeniya; Meininger, Janet C

    2013-11-27

    Suboptimal lifestyle factors in combination with genetic susceptibility contribute to cardiovascular disease and type 2 diabetes risk among Latinos. We describe a community-academic collaboration that developed and explored the feasibility of implementing a socioculturally tailored, healthy lifestyle intervention integrating genomics and family history education to reduce risk of cardiovascular disease and type 2 diabetes among Latinos. The community-based participatory research was conducted with communities in Kentucky, which has a rapidly growing Latino population. This growth underscores the need for socioculturally appropriate health resources. Su Corazon, Su Vida (Your Heart, Your Life) is a Spanish-language, healthy lifestyle educational program to reduce cardiovascular disease and type 2 diabetes risk among Latinos. Twenty natural leaders from an urban Latino community in Kentucky participated in sociocultural tailoring of the program and development of a genomics and family history module. The tailored program was presented to 22 participants to explore implementation feasibility and assess appropriateness for community use. Preintervention and postintervention assessments of genomic knowledge and lifestyle behaviors and qualitative postintervention evaluations were conducted. Postintervention improvements in health-promoting lifestyle choices and genomic knowledge specific to cardiovascular disease and type 2 diabetes suggested that the program may be effective in reducing risk. Feedback indicated the program was socioculturally acceptable and responsive to community needs. These findings indicated that a tailored healthy lifestyle program integrating genomics and family history education was socioculturally appropriate and may feasibly be implemented to reduce cardiovascular disease and type 2 diabetes risk in a Latino community with limited health care resources. The project highlights contributions of community-based processes in tailoring

  19. The efficacy of computerized alcohol intervention tailored to drinking motives among college students: a quasi-experimental pilot study.

    Science.gov (United States)

    Canale, Natale; Vieno, Alessio; Santinello, Massimo; Chieco, Francesca; Andriolo, Stefano

    2015-03-01

    Although motivational processes may influence the intervention effects and help prevention programmes identify students at great risk for alcohol-related problems, no computerized alcohol intervention has yet to be tailored to drinking motives. To describe the development and initial pilot testing of a computer-delivered intervention tailored to drinking motives, to prevent alcohol abuse and its adverse consequences among university students in general and among baseline hazardous drinkers specifically. 124 college students attending a public university in northeastern Italy participated in this study in October of 2012 (89.2% female- mean age = 21.64-34% baseline hazardous drinkers). Two classes (one undergraduate, one graduate) were assigned to one of two conditions: intervention and control group. Both groups received profile-specific feedback and then the intervention group received profile-specific online training for 4 weeks. This profile was based on their risk type (high-low) and drinking motives (enhancement-social-conformity-coping). Controlling for corresponding baseline alcohol measures, analyses showed a significant interaction between intervention condition and hazardous drinkers at baseline. For hazardous drinkers at baseline, the alcohol intervention results showed a significant decrease in frequency and quantity of alcohol use at follow-up, while no difference was observed between intervention conditions for non-hazardous drinkers at baseline. The results suggest that hazardous drinkers (college students) who completed the specific training and received personalized feedback seemed to do better on frequency and quantity of alcohol use than hazardous drinkers (college students) who received only personalized feedback. These results seem to provide support for a larger trial of the intervention and for more appropriate evaluations.

  20. Computer-tailored smoking cessation intervention in a general population setting in Germany: outcome of a randomized controlled trial.

    Science.gov (United States)

    Schumann, Anja; John, Ulrich; Baumeister, Sebastian E; Ulbricht, Sabina; Rumpf, Hans-Jürgen; Meyer, Christian

    2008-02-01

    This study reports the outcome of a randomized controlled trial testing a computer-tailored smoking cessation intervention based on the transtheoretical model in a general population setting in Germany. Participants of the smoking intervention study were recruited from an existing general population health examination survey in a university hospital. The sample consisted of 611 current and former smokers at baseline, and of 485 participants in the core group of baseline daily cigarette smokers. Follow-ups were conducted 6, 12, 18, and 24 months after baseline. The intervention was designed for both current and former smokers, involved up to three individualized feedback letters, and was created using expert-system technology. Based on 7-day point-prevalence abstinence and 6-month prolonged abstinence as the outcome measures, the study identified no significant differences between the intervention and control groups. Modeling the full longitudinal data in generalized estimation equation analyses, using different nonresponse procedures, and adjusting for covariates did not alter the results. We conclude that the computer-tailored transtheoretical model-based smoking cessation intervention, as delivered in this study and in this special setting, was ineffective.

  1. Cultural targeting and tailoring of shared decision making technology: a theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups.

    Science.gov (United States)

    Alden, Dana L; Friend, John; Schapira, Marilyn; Stiggelbout, Anne

    2014-03-01

    Patient decision aids are known to positively impact outcomes critical to shared decision making (SDM), such as gist knowledge and decision preparedness. However, research on the potential improvement of these and other important outcomes through cultural targeting and tailoring of decision aids is very limited. This is the case despite extensive evidence supporting use of cultural targeting and tailoring to improve the effectiveness of health communications. Building on prominent psychological theory, we propose a two-stage framework incorporating cultural concepts into the design process for screening and treatment decision aids. The first phase recommends use of cultural constructs, such as collectivism and individualism, to differentially target patients whose cultures are known to vary on these dimensions. Decision aid targeting is operationalized through use of symbols and values that appeal to members of the given culture. Content dimensions within decision aids that appear particularly appropriate for targeting include surface level visual characteristics, language, beliefs, attitudes and values. The second phase of the framework is based on evidence that individuals vary in terms of how strongly cultural norms influence their approach to problem solving and decision making. In particular, the framework hypothesizes that differences in terms of access to cultural mindsets (e.g., access to interdependent versus independent self) can be measured up front and used to tailor decision aids. Thus, the second phase in the framework emphasizes the importance of not only targeting decision aid content, but also tailoring the information to the individual based on measurement of how strongly he/she is connected to dominant cultural mindsets. Overall, the framework provides a theory-based guide for researchers and practitioners who are interested in using cultural targeting and tailoring to develop and test decision aids that move beyond a "one-size fits all" approach

  2. Development and Evaluation of a Culturally Tailored Educational Video: Changing Breast Cancer-Related Behaviors in Chinese Women

    Science.gov (United States)

    Wang, Judy H.; Liang, Wenchi; Schwartz, Marc D.; Lee, Marion M.; Kreling, Barbara; Mandelblatt, Jeanne S.

    2008-01-01

    This study developed and evaluated a culturally tailored video guided by the health belief model to improve Chinese women's low rate of mammography use. Focus-group discussions and an advisory board meeting guided the video development. A 17-min video, including a soap opera and physician-recommendation segment, was made in Chinese languages. A…

  3. Development and Evaluation of a Culturally Tailored Educational Video: Changing Breast Cancer-Related Behaviors in Chinese Women

    Science.gov (United States)

    Wang, Judy H.; Liang, Wenchi; Schwartz, Marc D.; Lee, Marion M.; Kreling, Barbara; Mandelblatt, Jeanne S.

    2008-01-01

    This study developed and evaluated a culturally tailored video guided by the health belief model to improve Chinese women's low rate of mammography use. Focus-group discussions and an advisory board meeting guided the video development. A 17-min video, including a soap opera and physician-recommendation segment, was made in Chinese languages. A…

  4. Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care

    NARCIS (Netherlands)

    Veer, S.N. van der; Vos, M.L. de; Jager, K.J.; Voort, P.H. van der; Peek, N.; Westert, G.P.; Graafmans, W.C.; Keizer, N.F. de

    2011-01-01

    ABSTRACT: BACKGROUND: Feedback is potentially effective in improving the quality of care. However, merely sending reports is no guarantee that performance data are used as input for systematic quality improvement (QI). Therefore, we developed a multifaceted intervention tailored to prospectively

  5. I Move: Systematic development of a web-based computer tailored physical activity intervention, based on motivational interviewing and self-determination theory

    NARCIS (Netherlands)

    Friederichs, S.A.; Oenema, A.; Bolman, C.; Guyaux, J.; Keulen, H.M. van; Lechner, L.

    2014-01-01

    Background: This article describes the systematic development of the I Move intervention: a web-based computer tailored physical activity promotion intervention, aimed at increasing and maintaining physical activity among adults. This intervention is based on the theoretical insights and practical a

  6. Effectiveness of a Web-Based Computer-Tailored Multiple-Lifestyle Intervention for People Interested in Reducing their Cardiovascular Risk: A Randomized Controlled Trial

    OpenAIRE

    Storm, Vera; Dörenkämper, Julia; Reinwand, Dominique A; Wienert, Julian; de Vries, Hein; Lippke, Sonia

    2016-01-01

    Background Web-based computer-tailored interventions for multiple health behaviors can improve the strength of behavior habits in people who want to reduce their cardiovascular risk. Nonetheless, few randomized controlled trials have tested this assumption to date. Objective The study aim was to test an 8-week Web-based computer-tailored intervention designed to improve habit strength for physical activity and fruit and vegetable consumption among people who want to reduce their cardiovascula...

  7. Process evaluation of a tailored intervention programme of cardiovascular risk management in general practices

    NARCIS (Netherlands)

    Huntink, E.; Wensing, M.; Timmers, I.M.; Lieshout, J. van

    2016-01-01

    BACKGROUND: A tailored implementation programme to improve cardiovascular risk management (CVRM) in general practice had little impact on outcomes. The questions in this process evaluation concerned (1) impact on counselling skills and CVRM knowledge of practice nurses, (2) their use of the various

  8. Integrating Parents' Views on Sibling Relationships to Tailor an Evidence-based Parenting Intervention for Sibling Conflict.

    Science.gov (United States)

    Pickering, John A; Sanders, Matthew R

    2017-03-01

    Parents play a crucial role in the development of their children's relationships with their siblings. Despite this, relatively few evidence-based parenting programs exist that specifically offer parents the strategies and techniques they desire and require for managing their children's sibling relationships. One way of bridging this gap is to design a tailored parenting intervention for sibling relationships that incorporates the parent voice in various aspects of program design. The current study recruited a convenience sample of 409 Australian parents to complete an online survey relating to their views on difficult sibling behaviors and what, if any, help they desire in dealing with the issue. The majority of respondents were Caucasian, middle- to upper-class mothers. Respondents predominantly attributed the causes of sibling conflict to their child's internal traits, but expressed strong desire for assistance with managing behavioral problems, especially when sibling relationships were marked by physical aggression. Respondents reported high levels of acceptability for positive, rather than punitive, parenting strategies and showed a clear preference for parenting interventions delivered in easy-to-access formats. The findings are interpreted in the context of guiding the development of a tailored parenting intervention for enhancing sibling relationships and reducing conflict. © 2015 Family Process Institute.

  9. The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice

    DEFF Research Database (Denmark)

    Due, Tina Drud; Thorsen, Thorkil; Kousgaard, Marius Brostrøm

    2014-01-01

    BACKGROUND: The Danish health care sector is reorganising based on disease management programmes designed to secure integrated and high quality chronic care across hospitals, general practitioners and municipalities. The disease management programmes assign a central role to general practice...... indicate that a semi-tailored facilitator-based intervention of relatively low intensity is unlikely to add substantially to the implementation of disease management programmes for DM2 and COPD in a context marked by important concurrent initiatives (including financial incentives and mandatory registry...

  10. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain and stress among laboratory technicians

    DEFF Research Database (Denmark)

    Andersen, Kenneth Jay; Brandt, Mikkel; Hansen, Klaus

    2015-01-01

    2014 (follow-up). METHODS: Participants (n = 112) were allocated to receive either physical, cognitive, and mindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at the worksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to the pain......, as outcome measures. RESULTS: A significant (P difference at follow-up of -1.0 (95%CI: -1.4 to -0.6). No significant effect on stress was observed (treatment by time P = 0.16). Exploratory analyses for each body...... pain using individually tailored physical and cognitive elements. STUDY DESIGN: This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial "Implementation of physical exercise at the Workplace (IRMA...

  11. Tailoring an intervention to the context and system redesign related to the intervention: A case study of implementing shared medical appointments for diabetes

    Directory of Open Access Journals (Sweden)

    Lawrence Renée H

    2008-06-01

    Full Text Available Abstract Background Incorporating shared medical appointments (SMAs or group visits into clinical practice to improve care and increase efficiency has become a popular intervention, but the processes to implement and sustain them have not been well described. The purpose of this study was to describe the process of implementation of SMAs in the local context of a primary care clinic over time. Methods The setting was a primary care clinic of an urban academic medical center of the Veterans Health Administration. We performed an in-depth case analysis utilizing both an innovations framework and a nested systems framework approach. This analysis helped organize and summarize implementation and sustainability issues, specifically: the pre-SMA local context; the processes of tailoring and implementation of the intervention; and the evolution and sustainability of the intervention and its context. Results Both the improvement intervention and the local context co-adapted and evolved during implementation, ensuring sustainability. The most important promoting factors were the formation of a core team committed to quality and improvement, and the clinic leadership that was supported strongly by the team members. Tailoring had to also take into account key innovation-hindering factors, including limited resources (such as space, potential to alter longstanding patient-provider relationships, and organizational silos (disconnected groups with core team members reporting to different supervisors. Conclusion Although interventions must be designed to meet the needs of the sites in which they are implemented, specific guidance tailored to the practice environment was lacking. SMAs require complex changes that impact on care routines, collaborations, and various organizational levels. Although the SMA was not envisioned originally as a form of system redesign that would alter the context in which it was implemented, it became clear that tailoring the

  12. Tailoring an intervention to the context and system redesign related to the intervention: a case study of implementing shared medical appointments for diabetes.

    Science.gov (United States)

    Kirsh, Susan R; Lawrence, Renée H; Aron, David C

    2008-06-04

    Incorporating shared medical appointments (SMAs) or group visits into clinical practice to improve care and increase efficiency has become a popular intervention, but the processes to implement and sustain them have not been well described. The purpose of this study was to describe the process of implementation of SMAs in the local context of a primary care clinic over time. The setting was a primary care clinic of an urban academic medical center of the Veterans Health Administration. We performed an in-depth case analysis utilizing both an innovations framework and a nested systems framework approach. This analysis helped organize and summarize implementation and sustainability issues, specifically: the pre-SMA local context; the processes of tailoring and implementation of the intervention; and the evolution and sustainability of the intervention and its context. Both the improvement intervention and the local context co-adapted and evolved during implementation, ensuring sustainability. The most important promoting factors were the formation of a core team committed to quality and improvement, and the clinic leadership that was supported strongly by the team members. Tailoring had to also take into account key innovation-hindering factors, including limited resources (such as space), potential to alter longstanding patient-provider relationships, and organizational silos (disconnected groups) with core team members reporting to different supervisors. Although interventions must be designed to meet the needs of the sites in which they are implemented, specific guidance tailored to the practice environment was lacking. SMAs require complex changes that impact on care routines, collaborations, and various organizational levels. Although the SMA was not envisioned originally as a form of system redesign that would alter the context in which it was implemented, it became clear that tailoring the intervention alone would not ensure sustainability, and therefore

  13. Brief Report: Adapting an In-Person Patient-Caregiver Communication Intervention to a Tailored Web-Based Format

    Science.gov (United States)

    Zulman, Donna M.; Schafenacker, Ann; Barr, Kathryn L.C.; Moore, Ian T.; Fisher, Jake; McCurdy, Kathryn; Derry, Holly A.; Saunders, Edward W.; An, Lawrence C.; Northouse, Laurel

    2011-01-01

    Background Interventions that target cancer patients and their caregivers have been shown to improve communication, support, and emotional well-being. Objective To adapt an in-person communication intervention for cancer patients and caregivers to a web-based format, and to examine the usability and acceptability of the web-based program among representative users. Methods A tailored, interactive web-based communication program for cancer patients and their family caregivers was developed based on an existing in-person, nurse-delivered intervention. The development process involved: 1) building a multidisciplinary team of content and web design experts, 2) combining key components of the in-person intervention with the unique tailoring and interactive features of a web-based platform, and 3) conducting focus groups and usability testing to obtain feedback from representative program users at multiple time points. Results Four focus groups with 2 to 3 patient-caregiver pairs per group (n = 22 total participants) and two iterations of usability testing with 4 patient-caregiver pairs per session (n = 16 total participants) were conducted. Response to the program's structure, design, and content was favorable, even among users who were older or had limited computer and internet experience. The program received high ratings for ease of use and overall usability (mean System Usability Score of 89.5 out of 100). Conclusions Many elements of a nurse-delivered patient-caregiver intervention can be successfully adapted to a web-based format. A multidisciplinary design team and an iterative evaluation process with representative users were instrumental in the development of a usable and well-received web-based program. PMID:21830255

  14. Randomised controlled trial of a theoretically grounded tailored intervention to diffuse evidence-based public health practice [ISRCTN23257060

    Directory of Open Access Journals (Sweden)

    Nordheim Lena

    2003-03-01

    Full Text Available Abstract Background Previous studies have shown that Norwegian public health physicians do not systematically and explicitly use scientific evidence in their practice. They work in an environment that does not encourage the integration of this information in decision-making. In this study we investigate whether a theoretically grounded tailored intervention to diffuse evidence-based public health practice increases the physicians' use of research information. Methods 148 self-selected public health physicians were randomised to an intervention group (n = 73 and a control group (n = 75. The intervention group received a multifaceted intervention while the control group received a letter declaring that they had access to library services. Baseline assessments before the intervention and post-testing immediately at the end of a 1.5-year intervention period were conducted. The intervention was theoretically based and consisted of a workshop in evidence-based public health, a newsletter, access to a specially designed information service, to relevant databases, and to an electronic discussion list. The main outcome measure was behaviour as measured by the use of research in different documents. Results The intervention did not demonstrate any evidence of effects on the objective behaviour outcomes. We found, however, a statistical significant difference between the two groups for both knowledge scores: Mean difference of 0.4 (95% CI: 0.2–0.6 in the score for knowledge about EBM-resources and mean difference of 0.2 (95% CI: 0.0–0.3 in the score for conceptual knowledge of importance for critical appraisal. There were no statistical significant differences in attitude-, self-efficacy-, decision-to-adopt- or job-satisfaction scales. There were no significant differences in Cochrane library searching after controlling for baseline values and characteristics. Conclusion Though demonstrating effect on knowledge the study failed to provide support for

  15. Do TQM interventions change management culture? Findings and implications.

    Science.gov (United States)

    Gerowitz, M B

    1998-01-01

    This study assesses the impact of TQM/CQI interventions on the culture and performance of top management teams. The findings suggest culture is related to performance but that TQM/CQI interventions are not associated with either performance or culture change. Implications for additional research and for practice are discussed.

  16. Effects Of Internet-Based Tailored Advice on the Use of Cholesterol-Lowering Interventions: A Randomized Controlled Trial

    Science.gov (United States)

    Li, Stephen CH; Sullivan, David R; Jayne, Kathy; Su, Steve YS; Neal, Bruce

    2010-01-01

    Background Elevated low-density lipoprotein (LDL) cholesterol is a leading risk factor for cardiovascular disease. Despite the availability of proven interventions to lower LDL cholesterol, their use remains subobtimal. Many websites provide interactive, tailored advice on cardiovascular risk in an attempt to help bridge this evidence-practice gap, yet there is little evidence that provision of such a tool is effective in changing practice. Objectives The objective was to define the effects on use of cholesterol-lowering interventions of a consumer-targeted tailored advice website. Methods This was a prospective, double-blind, randomized controlled trial open to any adult Australian with access to the Internet. A total of 2099 participants were randomized. Of these, 45% were male, the mean age of all participants was 56, and 1385 (66%) self-reported hypercholesterolemia. Follow-up information was obtained for 1945 (93%). Participants completed a brief online questionnaire. Individuals assigned to intervention received immediate, fully automated, personally tailored advice (based on current guidelines) regarding the need for commencement of statin therapy, increased statin therapy in those already on treatment, and nondrug intervention strategies. Control group participants were directed to static Web pages providing general information about cholesterol management. Results The primary outcome was the proportion of participants that commenced or increased use of prescribed cholesterol-lowering therapy. Of the total 2099 randomized participants, 304 (14%) met eligibility criteria for cholesterol-lowering therapy but were not prescribed treatment, and 254 (12%) were prescribed treatment but were not achieving the recommended target level. Treatment was commenced or increased in 64 (6.0%) of the 1062 intervention group participants and 79 (7.6%) of the 1037 control group participants (% difference = -1.6%, 95% confidence interval [CI] -3.75 to 0.57, P = .15). No

  17. 1+1=3? The systematic development of a theoretical and evidence-based tailored multimedia intervention to improve medication adherence

    NARCIS (Netherlands)

    Linn, A.J.; van Weert, J.C.M.; Smit, E.G.; Perry, K.; van Dijk, L.

    2013-01-01

    Objective To describe the development of a theoretical and evidence-based tailored multimedia intervention to improve medication intake behavior in patients with inflammatory bowel disease (IBD). The intervention integrates interpersonal and technology-mediated strategies with the expectation that t

  18. Impact of educational level on study attrition and evaluation of web-based computer-tailored interventions: results from seven randomized controlled trials

    NARCIS (Netherlands)

    Reinwand, D.A.; Crutzen, R.; Elfeddali, I.; Schneider, F.; Schulz, D.N.; Smit, E.S.; Stanczyk, N.E.; Tange, H.; Voncken-Brewster, V.; Walthouwer, M.J.L.; Hoving, C.; de Vries, H.

    2015-01-01

    Background: Web-based computer-tailored interventions have shown to be effective in improving health behavior; however, high dropout attrition is a major issue in these interventions. Objective: The aim of this study is to assess whether people with a lower educational level drop out from studies mo

  19. The Personal Nutrition Planner: A 5-Week, Computer-Tailored Intervention for Women

    Science.gov (United States)

    Mouttapa, Michele; Robertson, Trina P.; McEligot, Archana J.; Weiss, Jie W.; Hoolihan, Lori; Ora, Ann; Trinh, Linda

    2011-01-01

    Objective: To conduct a dietary intervention using the Personal Nutrition Planner (PNP), an on-line nutrition intervention tool. Design: Randomized controlled trial with pretest, posttest, and 2-month follow-up self-report assessments. Setting: Web/on-line. Participants: Female university staff (n = 307; 59.1% Caucasian) recruited via e-mail.…

  20. Tailored interventions to promote Active Ageing using mobile technology: a feasibility study

    NARCIS (Netherlands)

    Cabrita, M.; Melenk, J.; El Menshawy, N.; Tabak, Monique; Vollenbroek-Hutten, Miriam Marie Rosé

    2016-01-01

    Introduction: Mobile technologies facilitate innovative and ubiquitous interventions to promote Active Ageing in daily life. To ensure adoption, such interventions must be designed in co-operation with older adults. This work presents the results of a feasibility study of a system that monitors

  1. Provider Opinions Regarding the Development of a Stigma-Reduction Intervention Tailored for Providers

    Science.gov (United States)

    Mittal, Dinesh; Corrigan, Patrick; Drummond, Karen L.; Porchia, Sylvia; Sullivan, Greer

    2016-01-01

    Interventions involving contact with a person who has recovered from mental illness are most effective at reducing stigma. This study sought input from health care providers to inform the design of a contact intervention intended to reduce provider stigma toward persons with serious mental illness. Using a purposive sampling strategy, data were…

  2. Tailored interventions to promote Active Ageing using mobile technology: a feasibility study

    NARCIS (Netherlands)

    Cabrita, M.; Melenk, J.; El Menshawy, N.; Tabak, M.; Vollenbroek-Hutten, M.

    2016-01-01

    Introduction: Mobile technologies facilitate innovative and ubiquitous interventions to promote Active Ageing in daily life. To ensure adoption, such interventions must be designed in co-operation with older adults. This work presents the results of a feasibility study of a system that monitors phys

  3. Pregnant women's responses to a tailored smoking cessation intervention: turning hopelessness into competence

    Directory of Open Access Journals (Sweden)

    Zaino Petersen

    2010-12-01

    Full Text Available Background: Cognitive behavioral interventions consisting of brief counseling and the provision of self-help material designed for pregnancy have been documented as effective smoking cessation interventions for pregnant women. However, there is a need to understand how such interventions are perceived by the targeted group. Aim: To understand the cognitive, emotional, and behavioral responses of pregnant women to a clinic-based smoking cessation intervention. Methods: In-depth interviews with women attending four antenatal clinics in Cape Town, South Africa, who were exposed to a smoking intervention delivered by midwives and peer counselors. Women were purposively selected to represent a variation in smoking behavior. Thirteen women were interviewed at their first antenatal visit and 10 were followed up and reinterviewed later in their pregnancies. A content analysis approach was used, which resulted in categories and themes describing women's experiences, thoughts, and feelings about the intervention. Results: Five women quit, five had cut down, and three could not be traced for follow-up. All informants perceived the intervention positively. Four main themes captured the intervention's role in influencing women's smoking behavior. The process started with ‘understanding their reality,’ which led to ‘embracing change’ and ‘deciding to hold nothing back,’ which created a basis for ‘turning hopelessness into a feeling of competence.’Conclusion: The intervention succeeded in shifting women from feeling pessimistic about ever quitting to feeling encouraged to try and quit. Informants rated the social support they received very highly and expressed the need for the intervention to become a routine component of clinic services.

  4. A culturally appropriate intervention to improve health behaviors in Hispanic mother-child dyads.

    Science.gov (United States)

    Bender, Melinda S; Nader, Philip R; Kennedy, Christine; Gahagan, Sheila

    2013-04-01

    Obesity interventions targeting Hispanic preschool children are still nascent, and few are culturally appropriate. We evaluated the feasibility of a culturally relevant 9-month intervention program to improve health behaviors in low-income Mexican mothers with 3- to 5-year-old children. A community engagement approach was used to culturally and linguistically tailor an intervention program that was pilot tested with 33 mother-child dyads enrolled from a large California urban health center. A one-group, pretest-posttest design assessed changes in children's consumption of sugar-sweetened beverages (SSB), mothers' pedometer steps, and BMI. Data were collected at baseline, postintervention and at 6 months postintervention. At postintervention, SSB consumption had significantly decreased for soda and other sugary drinks with a modest reduction for 100% juice. Consumption of water had significantly increased, whereas milk had an increased trend. Maternal step counts significantly increased for weekdays by 69% and weekend days by 49%. Overall, maternal BMI decreased while children's BMI% remained stable. At 6 months postintervention, children's soda and juice consumption reverted toward baseline levels, as did maternal step counts, but children's consumption of sugary drinks remained lower, while water and milk remained higher. Findings suggest that a culturally relevant intervention was feasible for improving target health behaviors in a low-income Mexican community. Future work should assess an enhanced intervention including a maintenance phase for long-term adherence to health behavior changes and influence on maternal and child BMI.

  5. Cognitive changes in cardiovascular patients following a tailored behavioral smoking cessation intervention

    NARCIS (Netherlands)

    Oort, FJ; Dijkstra, A; de Haes, JCJM; Legemate, DA; Smets, EMA

    2005-01-01

    Background. Action aimed at changing smoking behavior to prevent cardiovascular patients from further impairing their health is advisable. Cognitive behavioral interventions can be effective in this regard since they attempt to influence cognitive determinants that presumably lead to smoking cessati

  6. A Model for Design of Tailored Working Environment Intervention Programmes for Small Enterprises

    Directory of Open Access Journals (Sweden)

    Peter Hasle

    2012-09-01

    Conclusion: The model provides a useful tool for a systematic design process. The model makes it transparent for both researchers and practitioners as to how existing knowledge can be used in the design of new intervention programmes.

  7. Programa Shortstop: A Culturally Focused Juvenile Intervention for Hispanic Youth

    Science.gov (United States)

    Cervantes, Richard C.; Ruan, Karen; Duenas, Norma

    2004-01-01

    Culturally sensitive juvenile delinquency and substance abuse interventions are relatively limited and unavailable to many first-time Hispanic juvenile offenders. The purpose of this study was to test the effectiveness of a culturally focused juvenile and substance abuse intervention program for first time Hispanic youth offenders. The intent of…

  8. Cultural Adaptation of Interventions in Real Practice Settings

    Science.gov (United States)

    Marsiglia, Flavio F.; Booth, Jamie M.

    2015-01-01

    This article provides an overview of some common challenges and opportunities related to cultural adaptation of behavioral interventions. Cultural adaptation is presented as a necessary action to ponder when considering the adoption of an evidence-based intervention with ethnic and other minority groups. It proposes a roadmap to choose existing…

  9. Cultural Adaptation of Interventions in Real Practice Settings

    Science.gov (United States)

    Marsiglia, Flavio F.; Booth, Jamie M.

    2015-01-01

    This article provides an overview of some common challenges and opportunities related to cultural adaptation of behavioral interventions. Cultural adaptation is presented as a necessary action to ponder when considering the adoption of an evidence-based intervention with ethnic and other minority groups. It proposes a roadmap to choose existing…

  10. Design and Delivery of a Tailored Intervention to Implement Recommendations for Multimorbid Patients Receiving Polypharmacy into Primary Care Practices

    Directory of Open Access Journals (Sweden)

    Cornelia Jäger

    2015-01-01

    Full Text Available Introduction. Managing polypharmacy is particularly demanding for general practitioners as coordinators of care. Recently, a German guideline for polypharmacy in primary care has been published. This paper describes the content and delivery of a tailored intervention, which aims at improving the implementation of guideline recommendations for polypharmacy into practice, considering individual barriers. Materials and Methods. Firstly, barriers for implementation and the corresponding strategies to address them have been identified. On this basis, an intervention consisting of a workshop for health care professionals and educational materials for patients has been developed. The workshop focused on knowledge, awareness, and skills. The educational materials included a tablet computer. Practice teams will elaborate individual concepts of how to implement the recommendations into their practice. The workshop has been evaluated by the participants by means of a questionnaire. Results. During the workshop 41 possible sources of medication errors and 41 strategies to improve medication management have been identified. Participants evaluated the workshop overall positively, certifying its relevancy to practice. Discussion. The concept of the workshop seemed appropriate to impart knowledge about medication management to the participants. It will have to be evaluated, if the intervention finally resulted in an improved implementation of the guideline recommendations.

  11. An Internet- and mobile-based tailored intervention to enhance maintenance of physical activity after cardiac rehabilitation: short-term results of a randomized controlled trial.

    Science.gov (United States)

    Antypas, Konstantinos; Wangberg, Silje C

    2014-03-11

    An increase in physical activity for secondary prevention of cardiovascular disease and cardiac rehabilitation has multiple therapeutic benefits, including decreased mortality. Internet- and mobile-based interventions for physical activity have shown promising results in helping users increase or maintain their level of physical activity in general and specifically in secondary prevention of cardiovascular diseases and cardiac rehabilitation. One component related to the efficacy of these interventions is tailoring of the content to the individual. Our trial assessed the effect of a longitudinally tailored Internet- and mobile-based intervention for physical activity as an extension of a face-to-face cardiac rehabilitation stay. We hypothesized that users of the tailored intervention would maintain their physical activity level better than users of the nontailored version. The study population included adult participants of a cardiac rehabilitation program in Norway with home Internet access and a mobile phone. The participants were randomized in monthly clusters to a tailored or nontailored (control) intervention group. All participants had access to a website with information regarding cardiac rehabilitation, an online discussion forum, and an online activity calendar. Those using the tailored intervention received tailored content based on models of health behavior via the website and mobile fully automated text messages. The main outcome was self-reported level of physical activity, which was obtained using an online international physical activity questionnaire at baseline, at discharge, and at 1 month and 3 months after discharge from the cardiac rehabilitation program. Included in the study were 69 participants. One month after discharge, the tailored intervention group (n=10) had a higher median level of overall physical activity (median 2737.5, IQR 4200.2) than the control group (n=14, median 1650.0, IQR 2443.5), but the difference was not significant

  12. Tailoring a Web-Based Weight Maintenance Intervention for Northern Plains American Indian Public University Students

    Science.gov (United States)

    Hemmingson, Kaitlyn; Lucchesi, Roxanne; Droke, Elizabeth; Kattelmann, Kendra K.

    2016-01-01

    Objective: High levels of obesity-related health disparities are common among US American Indian (AI) populations. AI public university students often face unique challenges that may contribute to weight gain and related consequences. Few weight maintenance interventions have been developed that meet the needs of AI public university students. The…

  13. Using health literacy profiles to tailor interventions to the needs of chronic disease patients.

    NARCIS (Netherlands)

    Heijmans, M.; Waverijn, G.; Rijken, M.; Osborne, R.; Rademakers, J.

    2015-01-01

    Health literacy (HL) is an important prerequisite for successful self-management and a determinant of health care use in chronic disease. HL is a multidimensional concept covering several functional, social and psychological dimensions. When developing interventions to improve HL it is an important

  14. Effectiveness of a Brief Dietetic Intervention for Hyperlipidaemic Adults Using Individually-Tailored Dietary Feedback.

    Science.gov (United States)

    Schumacher, Tracy L; Burrows, Tracy L; Rollo, Megan E; Spratt, Neil J; Callister, Robin; Collins, Clare E

    2016-10-11

    Dietary modifications can improve serum lipids and reduce cardiovascular disease (CVD) risk. However, attendance at multiple dietary consultations can be a barrier to achieving behaviour change. This study investigated the effectiveness of a brief dietetic intervention on CVD risk factors in hyperlipidaemic adults. Adults with total cholesterol ≥ 5.0 mmol/L or low density lipoprotein (LDL) cholesterol ≥ 4.0 mmol/L and not currently taking lipid-lowering medication were eligible for a minimum 6-week dietary intervention. Dietary intake data and blood lipids were acquired prior to a single counselling session with an Accredited Practising Dietitian (APD). The intervention used targeted feedback with purpose-developed education materials to supplement advice. CVD risk factors and dietary intakes were used to assess pre-post intervention change using linear mixed model regression analyses. Thirty-nine participants (59.3 ± 11.1 years, n = 28 female) were analysed. Mean ± SD follow-up from baseline time was 9.5 ± 2.5 weeks. Significant (p < 0.05) reductions in total cholesterol (-0.51 mmol/L), total:HDL (high density lipoprotein) ratio (-0.27 mmol/L), triglycerides (-0.38 mmol/L), total energy (-870 kJ/day), energy from nutrient-poor foods (-1006 kJ/day) and sodium (-325 mg/day), and improved dietary fat quality (-5.1% of energy/day saturated, +5.0% of energy/day polyunsaturated) and body mass index (-0.4 kg/m2) were achieved. A brief intervention by an APD incorporating targeted, personalised dietary feedback and education in a single counselling session can improve lipid profiles in adults with hyperlipidaemia.

  15. Effectiveness of a Brief Dietetic Intervention for Hyperlipidaemic Adults Using Individually-Tailored Dietary Feedback

    Directory of Open Access Journals (Sweden)

    Tracy L. Schumacher

    2016-10-01

    Full Text Available Dietary modifications can improve serum lipids and reduce cardiovascular disease (CVD risk. However, attendance at multiple dietary consultations can be a barrier to achieving behaviour change. This study investigated the effectiveness of a brief dietetic intervention on CVD risk factors in hyperlipidaemic adults. Adults with total cholesterol ≥ 5.0 mmol/L or low density lipoprotein (LDL cholesterol ≥ 4.0 mmol/L and not currently taking lipid-lowering medication were eligible for a minimum 6-week dietary intervention. Dietary intake data and blood lipids were acquired prior to a single counselling session with an Accredited Practising Dietitian (APD. The intervention used targeted feedback with purpose-developed education materials to supplement advice. CVD risk factors and dietary intakes were used to assess pre-post intervention change using linear mixed model regression analyses. Thirty-nine participants (59.3 ± 11.1 years, n = 28 female were analysed. Mean ± SD follow-up from baseline time was 9.5 ± 2.5 weeks. Significant (p < 0.05 reductions in total cholesterol (−0.51 mmol/L, total:HDL (high density lipoprotein ratio (−0.27 mmol/L, triglycerides (−0.38 mmol/L, total energy (−870 kJ/day, energy from nutrient-poor foods (−1006 kJ/day and sodium (−325 mg/day, and improved dietary fat quality (−5.1% of energy/day saturated, +5.0% of energy/day polyunsaturated and body mass index (−0.4 kg/m2 were achieved. A brief intervention by an APD incorporating targeted, personalised dietary feedback and education in a single counselling session can improve lipid profiles in adults with hyperlipidaemia.

  16. Effect of Individually Tailored Biopsychosocial Workplace Interventions on Chronic Musculoskeletal Pain and Stress Among Laboratory Technicians: Randomized Controlled Trial.

    Science.gov (United States)

    Jay, Kenneth; Brandt, Mikkel; Hansen, Klaus; Sundstrup, Emil; Jakobsen, Markus D; Schraefel, M C; Sjogaard, Gisela; Andersen, Lars L

    2015-01-01

    Chronic musculoskeletal pain is prevalent among laboratory technicians and work-related stress may aggravate the problem. This study investigated the effect of a multifaceted worksite intervention on pain and stress among laboratory technicians with chronic musculoskeletal pain using individually tailored physical and cognitive elements. This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial "Implementation of physical exercise at the Workplace (IRMA09)--Laboratory technicians" was registered at ClinicalTrials.gov prior to participant enrolment. The study was conducted at the head division of a large private pharmaceutical company's research and development department in Denmark. The study duration was March 2014 (baseline) to July 2014 (follow-up). Participants (n = 112) were allocated to receive either physical, cognitive, and mindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at the worksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to the pain affected area, 2) motor control training, 3) mindfulness, and 4) cognitive and behavioral therapy/education. Participants of the REF group were encouraged to follow ongoing company health initiatives. The predefined primary outcome measure was pain intensity (VAS scale 0-10) in average of the regions: neck, shoulder, lower and upper back, elbow, and hand at 10 week follow-up. The secondary outcome measure was stress assessed by Cohen´s perceived stress questionnaire. In addition, an explorative dose-response analysis was performed on the adherence to PCMT with pain and stress, respectively, as outcome measures. A significant (P change in pain with the number of physical-cognitive training sessions per week (-0.60 [95%CI -0.95 to -0.25]) and the number of mindfulness sessions (0.15 [95%CI 0.02 to 0.18]). No such associations were found with

  17. Computerized Tailored Interventions for Behavioral Sequelae of Post-Traumatic Stress Disorder in Veterans

    Science.gov (United States)

    2010-09-01

    Behavior Change (TTM) as the theoretical basis for generating personalized interventions ( Prochaska & Velicer, 1997; Velicer, Prochaska , & Redding, 2006...before the end of October, 2010. Drs. Jim Prochaska (originator of the TTM) and Kerry Evers (Pro-Change) will meet with the team October 21-22 to...returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295(9), 1023-1032. 2. Prochaska , J. O., & Velicer, W

  18. Rationale, design and baseline characteristics of a randomized controlled trial of a web-based computer-tailored physical activity intervention for adults from Quebec City.

    Science.gov (United States)

    Boudreau, François; Walthouwer, Michel Jean Louis; de Vries, Hein; Dagenais, Gilles R; Turbide, Ginette; Bourlaud, Anne-Sophie; Moreau, Michel; Côté, José; Poirier, Paul

    2015-10-09

    The relationship between physical activity and cardiovascular disease (CVD) protection is well documented. Numerous factors (e.g. patient motivation, lack of facilities, physician time constraints) can contribute to poor PA adherence. Web-based computer-tailored interventions offer an innovative way to provide tailored feedback and to empower adults to engage in regular moderate- to vigorous-intensity PA. To describe the rationale, design and content of a web-based computer-tailored PA intervention for Canadian adults enrolled in a randomized controlled trial (RCT). 244 men and women aged between 35 and 70 years, without CVD or physical disability, not participating in regular moderate- to vigorous-intensity PA, and familiar with and having access to a computer at home, were recruited from the Quebec City Prospective Urban and Rural Epidemiological (PURE) study centre. Participants were randomized into two study arms: 1) an experimental group receiving the intervention and 2) a waiting list control group. The fully automated web-based computer-tailored PA intervention consists of seven 10- to 15-min sessions over an 8-week period. The theoretical underpinning of the intervention is based on the I-Change Model. The aim of the intervention was to reach a total of 150 min per week of moderate- to vigorous-intensity aerobic PA. This study will provide useful information before engaging in a large RCT to assess the long-term participation and maintenance of PA, the potential impact of regular PA on CVD risk factors and the cost-effectiveness of a web-based computer-tailored intervention. ISRCTN36353353 registered on 24/07/2014.

  19. Sensible interventions: Cultural resistance post-9/11

    NARCIS (Netherlands)

    Chao, J.

    2013-01-01

    'Sensible interventions: Cultural resistance post-9/11' is anchored in the September 11, 2001 terrorist attacks in America and their cultural legacies, most prominently in the forms of cultural resistance. By investigating a multimedia assemblage of creative objects - hip hop album, TV sit-com, best

  20. The (cost-)effectiveness of a patient-tailored intervention programme to enhance adherence to antihypertensive medication in community pharmacies: study protocol of a randomised controlled trial.

    Science.gov (United States)

    van der Laan, Danielle M; Elders, Petra J M; Boons, Christel C L M; Bosmans, Judith E; Nijpels, Giel; Hugtenburg, Jacqueline G

    2017-01-19

    Medication non-adherence is a complex health care problem. Due to non-adherence, substantial numbers of cardiovascular patients benefit from their medication to only a limited extent. In order to improve adherence, a variety of pharmacist-led interventions have been developed. However, even the most effective interventions achieved only a modest positive effect. To be effective, interventions should be targeted at underlying barriers to adherence, developed in a systematic manner and tailored to specific features of a target group and setting. The current paper describes the design of the Cardiovascular medication non-Adherence Tailored Intervention (CATI) study aimed to evaluate the (cost-)effectiveness of a patient-tailored intervention programme in patients using antihypertensive medication. The CATI study is a randomised controlled trial that will be performed in 13 community pharmacies. Patients aged 45-75 years using antihypertensive medication and considered non-adherent according to pharmacy dispensing data, as well according to a self-report questionnaire, are eligible to participate. Patients in the intervention condition will receive a patient-tailored, pharmacist-led intervention programme. This programme consists of a structured interview at the pharmacy to identify patients' barriers to adherence and to counsel patients in order to overcome these barriers. The primary outcome is self-reported medication adherence measured with the MARS-5 questionnaire. Secondary outcome measures are blood pressure, illness perceptions, quality of life and societal costs. A cost-effectiveness analysis and process evaluation will also be performed. This study will provide insight into the (cost-)effectiveness of a patient-tailored, pharmacist-led intervention programme in non-adherent patients using antihypertensive medication. This intervention programme allows community pharmacists to support their patients in overcoming barriers to adherence and improving medication

  1. Recruitment Lessons Learned from a Tailored Web-Based Health Intervention Project Y.E.A.H. (Young Adults Eating and Active for Health)

    Science.gov (United States)

    Brown, Onikia; Quick, Virginia; Colby, Sarah; Greene, Geoffrey; Horacek, Tanya M.; Hoerr, Sharon; Koenings, Mallory; Kidd, Tandalayo; Morrell, Jesse; Olfert, Melissa; Phillips, Beatrice; Shelnutt, Karla; White, Adrienne; Kattelmann, Kendra

    2015-01-01

    Purpose: Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities. Design/methodology/approach: The…

  2. Evaluation of the Acceptability and Feasibility of a Computer-Tailored Intervention to Increase Human Papillomavirus Vaccination among Young Adult Women

    Science.gov (United States)

    Paiva, Andrea L.; Lipschitz, Jessica M.; Fernandez, Anne C.; Redding, Colleen A.; Prochaska, James O.

    2014-01-01

    Objective: To examine acceptability and feasibility of a Transtheoretical Model (TTM)-based computer-tailored intervention (CTI) for increasing human papillomavirus (HPV) vaccination in college-aged women. Participants: Two hundred forty-three women aged 18-26 were recruited between February and May of 2011. Methods: Participants completed the…

  3. Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery

    OpenAIRE

    2014-01-01

    Background Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions th...

  4. Effectiveness of a Computer-Tailored Print-Based Physical Activity Intervention among French Canadians with Type 2 Diabetes in a Real-Life Setting

    Science.gov (United States)

    Boudreau, Francois; Godin, Gaston; Poirier, Paul

    2011-01-01

    The promotion of regular physical activity for people with type 2 diabetes poses a challenge for public health authorities. The purpose of this study was to evaluate the efficiency of a computer-tailoring print-based intervention to promote the adoption of regular physical activity among people with type 2 diabetes. An experimental design was…

  5. Planned development and evaluation protocol of two versions of a web-based computer-tailored nutrition education intervention aimed at adults, including cognitive and environmental feedback

    OpenAIRE

    Springvloet, Linda; Lechner, Lilian; Oenema, Anke

    2014-01-01

    Background Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate and improve existing nutrition education interventions. This paper describes the development, design and evaluation protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable, high-energy snack and fat intake. Th...

  6. Comparing motivational, self-regulatory and habitual processes in a computer-tailored physical activity intervention in hospital employees - protocol for the PATHS randomised controlled trial.

    Science.gov (United States)

    Kwasnicka, Dominika; Vandelanotte, Corneel; Rebar, Amanda; Gardner, Benjamin; Short, Camille; Duncan, Mitch; Crook, Dawn; Hagger, Martin S

    2017-05-26

    Most people do not engage in sufficient physical activity to confer health benefits and to reduce risk of chronic disease. Healthcare professionals frequently provide guidance on physical activity, but often do not meet guideline levels of physical activity themselves. The main objective of this study is to develop and test the efficacy of a tailored intervention to increase healthcare professionals' physical activity participation and quality of life, and to reduce work-related stress and absenteeism. This is the first study to compare the additive effects of three forms of a tailored intervention using different techniques from behavioural theory, which differ according to their focus on motivational, self-regulatory and/or habitual processes. Healthcare professionals (N = 192) will be recruited from four hospitals in Perth, Western Australia, via email lists, leaflets, and posters to participate in the four group randomised controlled trial. Participants will be randomised to one of four conditions: (1) education only (non-tailored information only), (2) education plus intervention components to enhance motivation, (3) education plus components to enhance motivation and self-regulation, and (4) education plus components to enhance motivation, self-regulation and habit formation. All intervention groups will receive a computer-tailored intervention administered via a web-based platform and will receive supporting text-messages containing tailored information, prompts and feedback relevant to each condition. All outcomes will be assessed at baseline, and at 3-month follow-up. The primary outcome assessed in this study is physical activity measured using activity monitors. Secondary outcomes include: quality of life, stress, anxiety, sleep, and absenteeism. Website engagement, retention, preferences and intervention fidelity will also be evaluated as well as potential mediators and moderators of intervention effect. This is the first study to examine a tailored

  7. Cultural adaptation and health literacy refinement of a brief depression intervention for Latinos in a low-resource setting.

    Science.gov (United States)

    Ramos, Zorangelí; Alegría, Margarita

    2014-04-01

    Few studies addressing the mental health needs of Latinos describe how interventions are tailored or culturally adapted to address the needs of their target population. Without reference to this process, efforts to replicate results and provide working models of the adaptation process for other researchers are thwarted. The purpose of this article is to describe the process of a cultural adaptation that included accommodations for health literacy of a brief telephone cognitive-behavioral depression intervention for Latinos in low-resource settings. We followed a five-stage approach (i.e., information gathering, preliminary adaptation, preliminary testing, adaptation, and refinement) as described by Barrera, Castro, Strycker, and Toobert (2013) to structure our process. Cultural adaptations included condensation of the sessions, review, and modifications of materials presented to participants including the addition of visual aids, culturally relevant metaphors, values, and proverbs. Feedback from key stakeholders, including clinician and study participants, was fundamental to the adaptation process. Areas for further inquiry and adaptation identified in our process include revisions to the presentation of "cognitive restructuring" to participants and the inclusion of participant beliefs about the cause of their depression. Cultural adaptation is a dynamic process, requiring numerous refinements to ensure that an intervention is tailored and relevant to the target population.

  8. Assessment of a Culturally-Tailored Sexual Health Education Program for African American Youth

    Directory of Open Access Journals (Sweden)

    Tiffany Zellner Lawrence

    2016-12-01

    Full Text Available African American youth are affected disproportionately by sexually transmitted infections (STIs, human immunodeficiency virus (HIV/acquired immune deficiency syndrome (AIDS, and teenage pregnancy when compared to other racial groups. This paper evaluates the effectiveness of the To Help Young People Establish (2 HYPE Abstinence Club, a behavioral intervention designed to promote delayed sexual activity among African American youth ages 12–18 in Atlanta, Georgia. The intervention included 20 h of curriculum and creative arts instruction. Pre- and post-intervention survey data collected from 2008–2010 were analyzed to determine the effectiveness of the intervention. Intervention (n = 651 and comparison (n = 112 groups were compared through analysis of variance and multivariate logistic regression models. There was a statistically significant increase in intervention youth who were thinking about being abstinent (p = 0.0005. Those who had not been engaged in sexual activity were two times more likely to plan abstinence compared to participants that had been previously sexually active previously (odds ratio 2.41; 95% confidence interval 1.62, 3.60. Significant results hold implications for subsequent community-based participatory research and practice that broadens the understanding of the relevance of marriage, as just one among other life success milestones that may hold more importance to African American youth in positioning the value of delayed and responsible sexual activity towards effective STIs, HIV/AIDS, and teen pregnancy risk reduction interventions.

  9. Cultural and Linguistic Diversity Representation in School Psychology Intervention Research

    Science.gov (United States)

    Villarreal, Victor

    2014-01-01

    An understanding of the current intervention research is critical to the adoption of evidence-based practices in the delivery of psychological services; however, the generalizability and utility of intervention research for culturally and linguistically diverse youth may be limited by the types of research samples utilized. This study addresses…

  10. Perspectives of Early Intervention Professionals about Culturally-Appropriate Practices.

    Science.gov (United States)

    Lee, Hwa; Ostrosky, Michaelene M.; Bennett, Tess; Fowler, Susan A.

    2003-01-01

    A survey of 123 early intervention professionals found they considered recommendations for providing culturally appropriate services important. However, multiple barriers often hindered implementation. Lack of time was the most common barrier to providing culturally appropriate practices, followed by lack of training and lack of materials.…

  11. Guest Editorial: Cultural Analysis as Intervention

    DEFF Research Database (Denmark)

    Jespersen, Astrid Pernille; Petersen, Morten Krogh; Ren, Carina Bregnholm;

    2012-01-01

    Recently, cultural analyses – especially ethnographic descriptions of everyday-life practices – seem to have found new audiences situated within what Nigel Thrift has termed ‘soft capitalism’ (2006,1997). Ethnography is increasingly perceived by businesses, organizations, and industry as a key...... to producing surplus value due to its ability to gain access to the world of customers, users and citizens; for instance, by uncovering user demands (cf. Cefkin, 2009). This begs the question of what cultural analysis can and ought to do – beyond the scope of acting as a witness for truth and delivering facts...... to a whole new genre of business empiricism – and how to avoid reducing ethnographically-based cultural analysis to a simple matter of methods. What does it entail if we are to more strategically engage with compressed, to-the-point depictions of everyday life? The contributors to this special issue engage...

  12. The impact of culturally competent diabetes care interventions for improving diabetes-related outcomes in ethnic minority groups: a systematic review.

    Science.gov (United States)

    Zeh, P; Sandhu, H K; Cannaby, A M; Sturt, J A

    2012-10-01

    To examine the evidence on culturally competent interventions tailored to the needs of people with diabetes from ethnic minority groups. MEDLINE (NHS Evidence), CINAHL and reference lists of retrieved papers were searched from inception to September 2011; two National Health Service specialist libraries were also searched. Google, Cochrane and DARE databases were interrogated and experts consulted. Studies were included if they reported primary research on the impact of culturally competent interventions on outcome measures of any ethnic minority group with diabetes. Paper selection and appraisal were conducted independently by two reviewers. The heterogeneity of the studies required narrative analysis. A novel culturally competent assessment tool was used to systematically assess the cultural competency of each intervention. Three hundred and twenty papers were retrieved and 11 included. Study designs varied with a diverse range of service providers. Of the interventions, 64% were found to be highly culturally competent (scoring 90-100%) and 36% moderately culturally competent (70-89%). Data were collected from 2616 participants on 22 patient-reported outcome measures. A consistent finding from 10 of the studies was that any structured intervention, tailored to ethnic minority groups by integrating elements of culture, language, religion and health literacy skills, produced a positive impact on a range of patient-important outcomes. Benefits in using culturally competent interventions with ethnic minority groups with diabetes were identified. The majority of interventions described as culturally competent were confirmed as so, when assessed using the culturally competent assessment tool. Further good quality research is required to determine effectiveness and cost-effectiveness of culturally competent interventions to influence diabetes service commissioners. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  13. Guest Editorial: Cultural Analysis as Intervention

    DEFF Research Database (Denmark)

    Jespersen, Astrid Pernille; Petersen, Morten Krogh; Ren, Carina Bregnholm

    2012-01-01

    to a whole new genre of business empiricism – and how to avoid reducing ethnographically-based cultural analysis to a simple matter of methods. What does it entail if we are to more strategically engage with compressed, to-the-point depictions of everyday life? The contributors to this special issue engage...

  14. Childhood Development Cross Culturally:Implications for Designing Childhood Obesity Interventions and Providing Culturally Competent Care

    Institute of Scientific and Technical Information of China (English)

    Jiying Ling; PhD.MS.RN.Vicki Hines-Martin; PhD.CNS.RN.FAAN Hong Ji; MSN

    2013-01-01

    United States is experiencing significant growth in its foreign -born population , especially Chinese American population comprising of 1.2% of the U.S.population.Many healthcare providers are challenged in their efforts to provide culturally competent healthcare to this population. To provide culturally competent healthcare ,healthcare providers should understand variations in cultural at-tributes that impact health. One group in which cultural variation holds great influence is that of children. Culture influences a child's be-havior,development and health. This article provides a cross -cultural,comparative examination of important cultural influences on child behaviors development and health in China and the U. S.Using the findings about these two populations ,interventions for childhood obesity cross culturally are addressed through the analysis of a U. S.based Children's Obesity Program. The author suggests that uniquely different approaches to childhood obesity intervention research are needed based upon the cultural differences identified within this paper.

  15. Factors influencing voluntary premarital medical examination in Zhejiang province, China: a culturally-tailored health behavioral model analysis

    Science.gov (United States)

    2014-01-01

    Background Premarital medical examination (PME) compliance rate has dropped drastically since it became voluntary in China in 2003. This study aimed to establish a prediction model to be a theoretic framework for analyzing factors affecting PME compliance in Zhejiang province, China. Methods A culturally-tailored health behavioral model combining the Health Behavioral Model (HBM) and the Theory of Reasoned Action (TRA) was established to analyze the data from a cross-sectional questionnaire survey (n = 2,572) using the intercept method at the county marriage registration office in 12 counties from Zhejiang in 2010. Participants were grouped by high (n = 1,795) and low (n = 777) social desirability responding tendency (SDRT) by Marlowe-Crowne Social Desirability Scale (MCSDS). A structural equation modeling (SEM) was conducted to evaluate behavioral determinants for their influences on PME compliance in both high and low SDRT groups. Results 69.8% of the participants had high SDRT and tended to overly report benefits and underreport barriers, which may affect prediction accuracy on PME participation. In the low SDRT group, the prediction model showed the most influencing factor on PME compliance was behavioral intention, with standardized structural coefficients (SSCs) being 0.75 (P social environmental factors. The verified prediction model was tested to be an effective theoretic framework for the prediction of factors affecting voluntary PME compliance. It also should be noted that internationally available behavioral theories and models need to be culturally tailored to adapt to particular populations. This study has provided new insights for establishing a theoretical model to understand health behaviors in China. PMID:24972866

  16. Intervention Use and Action Planning in a Web-Based Computer-Tailored Weight Management Program for Overweight Adults: Randomized Controlled Trial

    Science.gov (United States)

    van Empelen, Pepijn; Oenema, Anke

    2014-01-01

    Background There are many online interventions aiming for health behavior change but it is unclear how such interventions and specific planning tools are being used. Objective The aim of this study is to identify which user characteristics were associated with use of an online, computer-tailored self-regulation intervention aimed at prevention of weight gain; and to examine the quality of the goals and action plans that were generated using the online planning tools. Methods Data were obtained with a randomized controlled effect evaluation trial in which the online computer-tailored intervention was compared to a website containing generic information about prevention of weight gain. The tailored intervention included self-regulation techniques such as personalized feedback, goal setting, action planning, monitoring, and other techniques aimed at weight management. Participants included 539 overweight adults (mean age 46.9 years, mean body mass index [BMI] 28.03 kg/m2, 31.2% male, 11% low education level) recruited from the general population. Use of the intervention and its planning tools were derived from server registration data. Physical activity, fat intake, motivational factors, and self-regulation skills were self-reported at baseline. Descriptive analyses and logistic regression analyses were used to analyze the results. Results Use of the tailored intervention decreased sharply after the first modules. Visiting the first tailored intervention module was more likely among participants with low levels of fat intake (OR 0.77, 95% CI 0.62-0.95) or planning for change in PA (OR 0.23, 95% CI 0.05-0.97). Revisiting the intervention was more likely among participants high in restrained eating (OR 2.45, 95% CI 1.12-5.43) or low in proactive coping skills for weight control (OR 0.28, 95% CI 0.10-0.76). The planning tools were used by 5%-55% of the participants, but only 20%-75% of the plans were of good quality. Conclusions This study showed that psychological

  17. The Effect of Tailored Web-Based Feedback and Optional Telephone Coaching on Health Improvements: A Randomized Intervention Among Employees in the Transport Service Industry.

    Science.gov (United States)

    Solenhill, Madeleine; Grotta, Alessandra; Pasquali, Elena; Bakkman, Linda; Bellocco, Rino; Trolle Lagerros, Ylva

    2016-08-11

    Lifestyle-related health problems are an important health concern in the transport service industry. Web- and telephone-based interventions could be suitable for this target group requiring tailored approaches. To evaluate the effect of tailored Web-based health feedback and optional telephone coaching to improve lifestyle factors (body mass index-BMI, dietary intake, physical activity, stress, sleep, tobacco and alcohol consumption, disease history, self-perceived health, and motivation to change health habits), in comparison to no health feedback or telephone coaching. Overall, 3,876 employees in the Swedish transport services were emailed a Web-based questionnaire. They were randomized into: control group (group A, 498 of 1238 answered, 40.23%), or intervention Web (group B, 482 of 1305 answered, 36.93%), or intervention Web + telephone (group C, 493 of 1333 answered, 36.98%). All groups received an identical questionnaire, only the interventions differed. Group B received tailored Web-based health feedback, and group C received tailored Web-based health feedback + optional telephone coaching if the participants' reported health habits did not meet the national guidelines, or if they expressed motivation to change health habits. The Web-based feedback was fully automated. Telephone coaching was performed by trained health counselors. Nine months later, all participants received a follow-up questionnaire and intervention Web + telephone. Descriptive statistics, the chi-square test, analysis of variance, and generalized estimating equation (GEE) models were used. Overall, 981 of 1473 (66.60%) employees participated at baseline (men: 66.7%, mean age: 44 years, mean BMI: 26.4 kg/m(2)) and follow-up. No significant differences were found in reported health habits between the 3 groups over time. However, significant changes were found in motivation to change. The intervention groups reported higher motivation to improve dietary habits (144 of 301 participants, 47

  18. Evaluation of a tailored intervention to improve management of overweight and obesity in primary care: study protocol of a cluster randomised controlled trial.

    Science.gov (United States)

    Krause, Jane; Agarwal, Shona; Bodicoat, Danielle H; Ring, Arne; Shepherd, David; Rogers, Stephen; Wensing, Michel; Baker, Richard

    2014-03-19

    In the UK around 22% of men and 24% of women are obese, and there are varying but worrying levels in other European countries. Obesity is a chronic condition that carries an important health risk. National guidelines, for use in England, on the management of people who are overweight or obese have been published by the National Institute for Health and Clinical Excellence (NICE, 2006). NICE recommendations for primary care teams are: determine the degree of overweight and obesity; assess lifestyle, comorbidities and willingness to change; offer multicomponent management of overweight and obesity; referral to external services when appropriate. This study investigates a tailored intervention to improve the implementation of these recommendations by primary care teams. The study is a cluster randomised controlled trial. Primary care teams will be recruited from the East Midlands of England, and randomised into two study arms: 1) the study group, in which primary care teams are offered a set of tailored interventions to help implement the NICE guidelines for overweight and obesity; or 2) the control group in which primary care teams continue to practice usual care. The primary outcome is the proportion of overweight or obese patients for whom the primary care team adheres to the NICE guidelines. Secondary outcomes include the proportion of patients with a record of lifestyle assessment, referral to external weight loss services, the proportion of obese patients who lose weight during the intervention period, and the mean weight change over the same period. Although often recommended, the methods of tailoring implementation interventions to account for the determinants of practice are not well developed. This study is part of a programme of studies seeking to develop the methods of tailored implementation. Current Controlled Trials ISRCTN07457585. Registered 09/08/2013. Randomisation commenced 30/08/2013.

  19. Tailoring microfluidic systems for organ-like cell culture applications using multiphysics simulations

    Science.gov (United States)

    Hagmeyer, Britta; Schütte, Julia; Böttger, Jan; Gebhardt, Rolf; Stelzle, Martin

    2013-03-01

    Replacing animal testing with in vitro cocultures of human cells is a long-term goal in pre-clinical drug tests used to gain reliable insight into drug-induced cell toxicity. However, current state-of-the-art 2D or 3D cell cultures aiming at mimicking human organs in vitro still lack organ-like morphology and perfusion and thus organ-like functions. To this end, microfluidic systems enable construction of cell culture devices which can be designed to more closely resemble the smallest functional unit of organs. Multiphysics simulations represent a powerful tool to study the various relevant physical phenomena and their impact on functionality inside microfluidic structures. This is particularly useful as it allows for assessment of system functions already during the design stage prior to actual chip fabrication. In the HepaChip®, dielectrophoretic forces are used to assemble human hepatocytes and human endothelial cells in liver sinusoid-like structures. Numerical simulations of flow distribution, shear stress, electrical fields and heat dissipation inside the cell assembly chambers as well as surface wetting and surface tension effects during filling of the microchannel network supported the design of this human-liver-on-chip microfluidic system for cell culture applications. Based on the device design resulting thereof, a prototype chip was injection-moulded in COP (cyclic olefin polymer). Functional hepatocyte and endothelial cell cocultures were established inside the HepaChip® showing excellent metabolic and secretory performance.

  20. Toward a multidimensional understanding of culture for health interventions.

    Science.gov (United States)

    Asad, Asad L; Kay, Tamara

    2015-11-01

    Although a substantial literature examines the relationship between culture and health in myriad individual contexts, a lack of comparative data across settings has resulted in disparate and imprecise conceptualizations of the concept for scholars and practitioners alike. This article examines scholars and practitioners' understandings of culture in relation to health interventions. Drawing on 169 interviews with officials from three different nongovernmental organizations working on health issues in multiple countries-Partners in Health, Oxfam America, and Sesame Workshop-we examine how these respondents' interpretations of culture converge or diverge with recent developments in the study of the concept, as well as how these understandings influence health interventions at three different stages-design, implementation, and evaluation-of a project. Based on these analyses, a tripartite definition of culture is built-as knowledge, practice, and change-and these distinct conceptualizations are linked to the success or failure of a project at each stage of an intervention. In so doing, the study provides a descriptive and analytical starting point for scholars interested in understanding the theoretical and empirical relevance of culture for health interventions, and sets forth concrete recommendations for practitioners working to achieve robust improvements in health outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Culturally informed and flexible family-based treatment for adolescents: a tailored and integrative treatment for Hispanic youth.

    Science.gov (United States)

    Santisteban, Daniel A; Mena, Maite P

    2009-06-01

    The increasing utilization of evidence-based treatments has highlighted the need for treatment development efforts that can craft interventions that are effective with Hispanic substance abusing youth and their families. The list of evidence-based treatments is extremely limited in its inclusion of interventions that are explicitly responsive to the unique characteristics and treatment needs of young Hispanics and that have been rigorously tested with this population. Some treatments that have been tested with Hispanics do not articulate the manner in which cultural characteristics and therapy processes interact. Other treatments have emphasized the important role of culture but have not been tested rigorously. The value of well designed interventions built upon an appreciation for unique patient characteristics was highlighted by Beutler et al. (1996) when they argued that "psychotherapy is comprised of a set of complex tasks, and practitioners need comprehensive knowledge of how different processes used in psychotherapy interact with patient characteristics in order to make treatment decisions that will maximize and optimize therapeutic power" (p. 30). A focus on how treatment processes interact with patient characteristics is particularly relevant in the Hispanic population because of the considerable heterogeneity beneath the Hispanic umbrella. Our new program of clinical research focuses on articulating how the varied profiles with regard to immigration stressors, acculturation processes, values clashes, sense of belonging to the community, discrimination, and knowledge about issues important to adolescent health can be more effectively addressed by a culturally informed treatment.

  2. Culturally-Tailored Education Programs to Address Health Literacy Deficits and Pervasive Health Disparities among Hispanics in Rural Shelbyville, Kentucky.

    Science.gov (United States)

    Ramos, Irma N; Ramos, Kenneth S; Boerner, Aisa; He, Qiang; Tavera-Garcia, Marco A

    2013-11-16

    This investigation was conducted to evaluate the impact of culturally-tailored education on health knowledge among Hispanic residents of rural, Shelbyville, KY. The program identified specific pathways to address health literacy deficits and disparities identified through a community-wide health assessment completed in 2010. A total of 43 Hispanic males who shared deficiencies in community-wide health infrastructure were enrolled in the program. The curriculum included an introductory session followed by five, subject-specific, sessions offered on a weekly basis from February to April 2011. Pre/post-test assessments showed marked improvement in knowledge base for all participants after each session, most notably related to cardiovascular disease, diabetes and metabolic syndrome. The group reconvened in January 2012 for follow-up instruction on cardiovascular disease and diabetes, as well as global assessment of knowledge retention over a nine-month period. Comparisons of pre/post testing in cardiovascular disease and diabetes, as well as global health-related knowledge showed significant gains for all parameters. Health education programs that embrace perceptions of the community of their own health, and that integrate knowledge into culturally-sensitive education, significantly improved health knowledge among Hispanic residents in rural Kentucky. Such gains may translate into sustainable improvements in health literacy and help reduce health disparities.

  3. 3D printing – a key technology for tailored biomedical cell culture lab ware

    Directory of Open Access Journals (Sweden)

    Schmieder Florian

    2016-09-01

    Full Text Available Today’s 3D printing technologies offer great possibilities for biomedical researchers to create their own specific laboratory equipment. With respect to the generation of ex vivo vascular perfusion systems this will enable new types of products that will embed complex 3D structures possibly coupled with cell loaded scaffolds closely reflecting the in-vivo environment. Moreover this could lead to microfluidic devices that should be available in small numbers of pieces at moderate prices. Here, we will present first results of such 3D printed cell culture systems made from plastics and show their use for scaffold based applications.

  4. Are the stages of change relevant for the development and implementation of a web-based tailored alcohol intervention? A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Schulz Daniela N

    2012-05-01

    Full Text Available Abstract Background Computer-tailored programs are a promising tool to stimulate health behavior change, such as reducing alcohol intake. Yet more research is needed to assess whether groups differing in their motivational level to change may need different types of feedback. Furthermore, it is unknown whether motivational level may also determine reactions to computer-tailored interventions. Our aim is to identify the potential relevance of the application of the stages of change concept in the development and implementation of alcohol interventions. Methods A web-based instrument was used to disseminate a questionnaire and to provide tailored feedback messages among adults in the Netherlands (N = 170; 96 females. Motivational level was assessed by the stage of change construct. The survey furthermore assessed alcohol consumption, attitude, social influence, self-efficacy, and program evaluation (i.e., survey items, tailored advice, layout and functionality of the program. The Least Significant Difference method was used to compare people in different stages of change with regard to psychosocial determinants of drinking behavior and program evaluation. Results Of the respondents, 34.1% (n = 58 reported no intention to change to healthier drinking habits in the foreseeable future (precontemplation, 22.9% (n = 39 intended to improve their drinking behavior in the near future (contemplation/preparation and 42.9% (n = 73 reported to currently adhere to the Dutch alcohol consumption guidelines (action/maintenance. When comparing the three groups, people in the action or maintenance stage reported the lowest number of pros of drinking alcohol, having most healthy drinking role models and the highest levels of self-efficacy regarding healthy drinking in difficult situations, whereas precontemplators reported to receive the least social support regarding healthy drinking. In general, the intervention was positively evaluated, but it

  5. Satisfaction with a 2-day communication skills course culturally tailored for medical specialists in Qatar.

    Science.gov (United States)

    Bylund, Carma L; Alyafei, Khalid; Afana, Abdelhamid; Al-Romaihi, Sheyma; Yassin, Mohammed; Elnashar, Maha; Al-Arab, Banan; Al-Khal, Abdullatif

    2017-01-01

    Health-care communication skills training may be particularly needed in the Arabian Gulf countries because of the variety of cultures within the physician and patient populations. This study describes the implementation and results of a communication skills training program for physicians in Qatar that assessed previous training, and effect of previous training on participants' course evaluations. We conducted a 2-day communication skills training course covering seven culturally adapted modules. Educational strategies included large and small group work with the standardized patient, demonstration videos, and lectures. At the end, participants completed a course evaluation survey. Data analysis performed with SPSS; frequencies and percentages were calculated, and Chi-square test applied to evaluate statistical significance. A total of 410 physicians in Qatar have participated in the course over a period of 2 years. Evaluation ratings of the course were high. Participants rated the module on Breaking Bad News as the most useful, and the small group role-play as the most helpful course component. One-third of participants had previously participated in experiential communication skills training. There was no association between previous experience and evaluation of the course. Physicians in Qatar positively evaluated a 2-day communication skills course, though the majority of participants did not have any previous exposure to experiential communication skills training.

  6. Formative research methods for designing culturally appropriate, integrated child nutrition and development interventions: an overview.

    Science.gov (United States)

    Bentley, Margaret E; Johnson, Susan L; Wasser, Heather; Creed-Kanashiro, Hilary; Shroff, Monal; Fernandez Rao, Sylvia; Cunningham, Melissa

    2014-01-01

    Nutritional and developmental insults in the first few years of life have profound public health implications, including substantial contributions to neonatal, infant, and early childhood morbidity and mortality, as well as longer term effects on cognitive development, school achievement, and worker productivity. Optimal development that can lead to the attainment of an individual's fullest potential, therefore, requires a combination of genetic capacity, adequate nutrition, psychosocial stimulation, and safe, clean physical environments. Researchers and policymakers have called for integrated child nutrition and development interventions for more than 20 years, yet there are only a handful of efficacy trials and even fewer examples of integrated interventions that have been taken to scale. While a critical component in the design of such interventions is formative research, there is a dearth of information in both the literature and policy arenas to guide this phase of the process. To move the field forward, this paper first provides an overview of formative research methods with a focus on qualitative inquiry, a description of the critical domains to be assessed (infant and young child feeding, responsive feeding, and child development), and currently available resources. Application of these methods is provided through a real-world case study--the design of an integrated nutrition and child development efficacy trial in Andhra Pradesh, India. Recommendations for next steps are discussed, the most important of which is the need for a comprehensive set of formative guidelines for designing locally tailored, culturally appropriate, integrated interventions.

  7. Validated adherence scales used in a measurement-guided medication management approach to target and tailor a medication adherence intervention: a randomised controlled trial.

    Science.gov (United States)

    Nguyen, Thi-My-Uyen; La Caze, Adam; Cottrell, Neil

    2016-11-30

    To determine if a targeted and tailored intervention based on a discussion informed by validated adherence scales will improve medication adherence. Prospective randomised trial. 2 community pharmacies in Brisbane, Australia. Patients recently initiated on a cardiovascular or oral hypoglycaemic medication within the past 4-12 weeks were recruited from two community pharmacies. Participants identified as non-adherent using the Medication Adherence Questionnaire (MAQ) were randomised into the intervention or control group. The intervention group received a tailored intervention based on a discussion informed by responses to the MAQ, Beliefs about Medicines Questionnaire-Specific and Brief Illness Perception Questionnaire. Adherence was measured using the MAQ at 3 and 6 months following the intervention. A total of 408 patients were assessed for eligibility, from which 152 participants were enrolled into the study. 120 participants were identified as non-adherent using the MAQ and randomised to the 'intervention' or 'control' group. The mean MAQ score at baseline in the intervention and control were similar (1.58: 95% CI (1.38 to 1.78) and 1.60: 95% CI (1.43 to 1.77), respectively). There was a statistically significant improvement in adherence in the intervention group compared to control at 3 months (mean MAQ score 0.42: 95% CI (0.27 to 0.57) vs 1.58: 95% CI (1.42 to 1.75); p<0.001). The significant improvement in MAQ score in the intervention group compared to control was sustained at 6 months (0.48: 95% CI (0.31 to 0.65) vs 1.48: 95% CI (1.27 to 1.69); p<0.001). An intervention that targeted non-adherent participants and tailored to participant-specific reasons for non-adherence was successful at improving medication adherence. ACTRN12613000162718; Results. 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/.

  8. A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward.

    Science.gov (United States)

    Lee, Seul; Oh, HyunSoo; Suh, YeonOk; Seo, WhaSook

    2017-03-01

    To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress

  9. Magical realism: a cultural intervention for traumatized Hispanic children.

    Science.gov (United States)

    De Rios, M D

    1997-01-01

    A case study is presented of two Spanish-speaking immigrant children who were run over in an automobile accident and hospitalized, to describe a culturally congruent play-therapy technique. Drawing on the work of Pynoos and Nader, the author argues for an anthropological approach in play therapy to create hyperaroused states for the traumatized child and to use cultural super heroes-what is termed "magical realism." Such an approach can be used with Latin American traumatized children as well as with children from other Third World countries to provide a culturally appropriate intervention to treat the psychological sequelae of trauma.

  10. Culturally tailored diabetes prevention in the workplace: focus group interviews with Hispanic employees.

    Science.gov (United States)

    Brown, Sharon A; García, Alexandra A; Steinhardt, Mary A; Guevara, Henry; Moore, Claire; Brown, Adama; Winter, Mary A

    2015-04-01

    The purpose was to conduct focus groups with Hispanic employees to obtain input into adaptation of previous DSME interventions for use as a workplace diabetes prevention program. From a list of interested Hispanic employees who attended a local health fair (n = 68), 36 were randomly selected to participate in focus groups held during supper mealtime breaks. An experienced bilingual moderator directed the sessions, using interview guidelines developed by the research team. Participants' ages ranged from 22 to 65 years (mean = 50.4, n = 36, SD = 10.7), 7 males and 29 females attended, and 53% had type 2 diabetes mellitus (T2DM). Employees expressed a keen interest in diabetes classes and recommended a focus on preparing healthier Hispanic foods. Primary barriers to promoting healthier lifestyles were work schedules; many employees worked 2 part-time or full-time jobs. Administrators and direct supervisors of the employees were highly supportive of a workplace diabetes prevention program. The consistent message was that a workplace program would be the ideal solution for Hispanic employees to learn about diabetes and healthy behaviors, given their busy schedules, family responsibilities, and limited resources. If found to be effective, such a workplace program would be generalizable to other service employees who have disproportionate diabetes rates. © 2015 The Author(s).

  11. Inequities of Intervention among Culturally and Linguistically Diverse Students

    Science.gov (United States)

    Cramer, Liz

    2015-01-01

    Although Response to Intervention (RTI) has been generally studied in relation to student outcomes, the system itself requires further study, particularly for culturally and linguistically diverse (CLD) students. CLD students have consistently suffered inequities in the educational system, including over representation in high incidence disability…

  12. Native American Youth and Culturally Sensitive Interventions: A Systematic Review

    Science.gov (United States)

    Jackson, Kelly F.; Hodge, David R.

    2010-01-01

    Objective: A systematic evaluation of the effectiveness of culturally sensitive interventions (CSIs) with Native American youth was conducted. Method: Electronic bibliographic databases, Web sites, and manual searches were used to identify 11 outcome studies that examined CSI effectiveness with Native American youth. Results: This review found…

  13. Initial design of culturally informed behavioral intervention technologies: developing an mHealth intervention for young sexual minority men with generalized anxiety disorder and major depression.

    Science.gov (United States)

    Burns, Michelle Nicole; Montague, Enid; Mohr, David C

    2013-12-05

    To our knowledge, there is no well-articulated process for the design of culturally informed behavioral intervention technologies. This paper describes the early stages of such a process, illustrated by the methodology for the ongoing development of a behavioral intervention technology targeting generalized anxiety disorder and major depression among young sexual minority men. We integrated instructional design for Internet behavioral intervention technologies with greater detail on information sources that can identify user needs in understudied populations, as well as advances in the understanding of technology-specific behavioral intervention technology dimensions that may need to be culturally tailored. General psychological theory describing how to effect change in the clinical target is first integrated with theory describing potentially malleable factors that help explain the clinical problem within the population. Additional information sources are then used to (1) evaluate the theory, (2) identify population-specific factors that may affect users' ability to relate to and benefit from the behavioral intervention technology, and (3) establish specific skills, attitudes, knowledge, etc, required to change malleable factors posited in the theory. User needs result from synthesis of this information. Product requirements are then generated through application of the user needs to specific behavioral intervention technology dimensions (eg, technology platform). We provide examples of considerations relevant to each stage of this process and how they were applied. This process can guide the initial design of other culturally informed behavioral intervention technologies. This first attempt to create a systematic design process can spur development of guidelines for design of behavioral intervention technologies aimed to reduce health disparities.

  14. Getting evidence-based pressure ulcer prevention into practice: a multi-faceted unit-tailored intervention in a hospital setting.

    Science.gov (United States)

    Sving, Eva; Högman, Marieann; Mamhidir, Anna-Greta; Gunningberg, Lena

    2016-10-01

    The aim of the study was to evaluate whether a multi-faceted, unit-tailored intervention using evidenced-based pressure ulcer prevention affects (i) the performance of pressure ulcer prevention, (ii) the prevalence of pressure ulcers and (iii) knowledge and attitudes concerning pressure ulcer prevention among registered and assistant nurses. A quasi-experimental, clustered pre- and post-test design was used. Five units at a hospital setting were included. The intervention was based on the PARIHS framework and included a multi-professional team, training and repeated quality measurements. An established methodology was used to evaluate the prevalence and prevention of pressure ulcers. Nurses' knowledge and attitudes were evaluated using a validated questionnaire. A total of 506 patients were included, of whom 105 patients had a risk to develop pressure ulcer. More patients were provided pressure ulcer prevention care (P = 0·001) and more prevention care was given to each patient (P = 0·021) after the intervention. Corresponding results were shown in the group of patients assessed as being at risk for developing pressure ulcers. Nurses' knowledge about pressure ulcer prevention increased (P pressure ulcer prevention remained high between pre- and post-test surveys. This multi-faceted unit-tailored intervention affected pressure ulcer prevention. Facilitation and repeated quality measurement together with constructed feedback of results seemed to be the most important factor for pressure ulcer prevention.

  15. Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care.

    Science.gov (United States)

    Niks, Irene M W; de Jonge, Jan; Gevers, Josette M P; Houtman, Irene L D

    2013-02-19

    It is well-known that health care workers in today's general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1) a longitudinal web-based survey study, and (2) a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1) how a balance between job demands, job resources, and recovery from work can be optimized, (2) the short-term and long-term effects of tailored work-oriented effects, and (3) indicators for successful or unsuccessful implementation of interventions.

  16. Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care

    Directory of Open Access Journals (Sweden)

    Niks Irene MW

    2013-02-01

    Full Text Available Abstract Background It is well-known that health care workers in today’s general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. Methods/Design A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1 a longitudinal web-based survey study, and (2 a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. Discussion The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1 how a balance between job demands, job resources, and recovery from work can be optimized, (2 the short-term and long-term effects of tailored work-oriented effects, and (3 indicators for successful or unsuccessful implementation of interventions.

  17. Do personally-tailored videos in a web-based physical activity intervention lead to higher attention and recall? – An eye-tracking study.

    Directory of Open Access Journals (Sweden)

    Stephanie eAlley

    2014-02-01

    Full Text Available Over half of the Australian population does not meet physical activity guidelines and has an increased risk of chronic disease. Web-based physical activity interventions have the potential to reach large numbers of the population at low cost, however issues have been identified with usage and participant retention. Personalised (computer-tailored physical activity advice delivered through video has the potential to address low engagement, however it is unclear whether it is more effective in engaging participants when compared to text-delivered personalised advice. This study compared the attention and recall outcomes of tailored physical activity advice in video- versus text-format. Participants (n=41 were randomly assigned to receive either video- or text-tailored feedback with identical content. Outcome measures included attention to the feedback, measured through advanced eye-tracking technology (Tobii 120, and recall of the advice, measured through a post intervention interview. Between group ANOVA’s, Mann-Whitney U tests and Chi square analyses were applied. Participants in the video-group displayed greater attention to the physical activity feedback in terms of gaze-duration on the feedback (7.7 min vs. 3.6 min, p< 001, total fixation-duration on the feedback (6.0 min vs. 3.3 min, p< 001, and focusing on feedback (6.8 vs. 3.5 min, p< 001. Despite both groups having the same ability to navigate through the feedback, the video-group completed a significantly (p< .001 higher percentage of feedback sections (95% compared to the text-group (66%. The main messages were recalled in both groups, but many details were forgotten. No significant between group differences were found for message recall. These results suggest that video-tailored feedback leads to greater attention compared to text-tailored feedback. More research is needed to determine how message recall can be improved, and whether video-tailored advice can lead to greater health

  18. Online Pestkoppenstoppen: systematic and theory-based development of a web-based tailored intervention for adolescent cyberbully victims to combat and prevent cyberbullying

    Science.gov (United States)

    2014-01-01

    Background The purpose of this article is to give an integrative insight into the theoretical and empirical-based development of the Online Pestkoppenstoppen (Stop Bullies Online/Stop Online Bullies). This intervention aims to reduce the number of cyberbully victims and their symptoms of depression and anxiety (program goal), by teaching cyberbully victims how to cope in an adequate and effective manner with cyberbully incidents (program’s outcomes). Method/Design In developing the program the different steps of the Intervention Mapping protocol are systematically used. In this article we describe each step of Intervention Mapping. Sources used for the development were a literature review, a Delphi study among experts, focus group interviews with the target group, and elements from a proven effective anti-bullying program. The result is a fully automated web-based tailored intervention for cyberbully victims (12-15 years) consisting of three web-based advice sessions delivered over three months. The first advice aims to teach participants how behavior is influenced by the thoughts they have, how to recognize and dispute irrational thoughts and how to form rational thoughts. In the second advice, participants will learn about the way bullying emerges, how their behavior influences bullying and how they can use effective coping strategies in order to stop (online) bullying. In the third advice, participants receive feedback and will learn how to use the Internet and mobile phones in a safe manner. Each advice is tailored to the participant’s personal characteristics (e.g., personality, self-efficacy, coping strategies used and (ir)rational thoughts). To ensure implementation of the program after testing it for effectiveness, the intervention was pretested in the target-population and an implementation plan was designed. Finally, we will elaborate on the planned randomized controlled trial in which the intervention will be compared to a general information group

  19. Cost-effectiveness and cost-utility of a Web-based or print-delivered tailored intervention to promote physical activity among adults aged over fifty: an economic evaluation of the Active Plus intervention.

    Science.gov (United States)

    Golsteijn, Rianne Hj; Peels, Denise A; Evers, Silvia Maa; Bolman, Catherine; Mudde, Aart N; de Vries, Hein; Lechner, Lilian

    2014-09-28

    The adverse health effects of insufficient physical activity (PA) result in high costs to society. The economic burden of insufficient PA, which increases in our aging population, stresses the urgency for cost-effective interventions to promote PA among older adults. The current study provides insight in the cost-effectiveness and cost-utility of different versions of a tailored PA intervention (Active Plus) among adults aged over fifty. The intervention conditions (i.e. print-delivered basic (PB; N = 439), print-delivered environmental (PE; N = 435), Web-based basic (WB; N = 423), Web-based environmental (WE; N = 432)) and a waiting-list control group were studied in a clustered randomized controlled trial. Intervention costs were registered during the trial. Health care costs, participant costs and productivity losses were identified and compared with the intervention effects on PA (in MET-hours per week) and quality-adjusted life years (QALYs) 12 months after the start of the intervention. Cost-effectiveness ratios (ICERs) and cost-utility ratios (ICURs) were calculated per intervention condition. Non-parametric bootstrapping techniques and sensitivity analyses were performed to account for uncertainty. As a whole (i.e. the four intervention conditions together) the Active Plus intervention was found to be cost-effective. The PB-intervention (ICER = €-55/MET-hour), PE-intervention (ICER = €-94/MET-hour) and the WE-intervention (ICER = €-139/MET-hour) all resulted in higher effects on PA and lower societal costs than the control group. With regard to QALYs, the PB-intervention (ICUR = €38,120/QALY), the PE-intervention (ICUR = €405,892/QALY) and the WE-intervention (ICUR = €-47,293/QALY) were found to be cost-effective when considering a willingness-to-pay threshold of €20,000/QALY. In most cases PE had the highest probability to be cost-effective. The Active Plus intervention was found to be a cost

  20. Assessing the cross-cultural applicability of tailored advertising: a comparative study between the Netherlands and Poland

    NARCIS (Netherlands)

    Maslowska, E.; Smit, E.G.; van den Putte, B.

    2013-01-01

    This study compares the effectiveness of tailored advertising in two European Union member states: a longstanding member with a long history of advertising, the Netherlands; and a new member with a shorter advertising tradition, Poland. The positive effects of tailored advertising are hypothesised

  1. Assessing the cross-cultural applicability of tailored advertising: a comparative study between the Netherlands and Poland

    NARCIS (Netherlands)

    Maslowska, E.; Smit, E.G.; van den Putte, B.

    2013-01-01

    This study compares the effectiveness of tailored advertising in two European Union member states: a longstanding member with a long history of advertising, the Netherlands; and a new member with a shorter advertising tradition, Poland. The positive effects of tailored advertising are hypothesised t

  2. Addressing health disparities through patient education: the development of culturally-tailored health education materials at Puentes de Salud.

    Science.gov (United States)

    Harvey, Isobel; O'Brien, Matthew

    2011-10-01

    The availability of culturally appropriate written health information is essential for promoting health in diverse populations. Lack of English fluency has been shown to negatively impact health outcomes for Latinos in the United States. The authors conducted a needs assessment at a clinic serving Latino immigrants, focusing on patients' health and previous experiences with written health information. Based on these results and a literature review, we developed 10 Spanish language brochures to better serve the target population. This article outlines the process of developing and implementing this intervention, which can serve as a model for similar projects targeting diverse populations.

  3. Impact of Educational Level on Study Attrition and Evaluation of Web-Based Computer-Tailored Interventions: Results From Seven Randomized Controlled Trials.

    Science.gov (United States)

    Reinwand, Dominique A; Crutzen, Rik; Elfeddali, Iman; Schneider, Francine; Schulz, Daniela Nadine; Smit, Eline Suzanne; Stanczyk, Nicola Esther; Tange, Huibert; Voncken-Brewster, Viola; Walthouwer, Michel Jean Louis; Hoving, Ciska; de Vries, Hein

    2015-10-07

    Web-based computer-tailored interventions have shown to be effective in improving health behavior; however, high dropout attrition is a major issue in these interventions. The aim of this study is to assess whether people with a lower educational level drop out from studies more frequently compared to people with a higher educational level and to what extent this depends on evaluation of these interventions. Data from 7 randomized controlled trials of Web-based computer-tailored interventions were used to investigate dropout rates among participants with different educational levels. To be able to compare higher and lower educated participants, intervention evaluation was assessed by pooling data from these studies. Logistic regression analysis was used to assess whether intervention evaluation predicted dropout at follow-up measurements. In 3 studies, we found a higher study dropout attrition rate among participants with a lower educational level, whereas in 2 studies we found that middle educated participants had a higher dropout attrition rate compared to highly educated participants. In 4 studies, no such significant difference was found. Three of 7 studies showed that participants with a lower or middle educational level evaluated the interventions significantly better than highly educated participants ("Alcohol-Everything within the Limit": F2,376=5.97, P=.003; "My Healthy Behavior": F2,359=5.52, P=.004; "Master Your Breath": F2,317=3.17, P=.04). One study found lower intervention evaluation by lower educated participants compared to participants with a middle educational level ("Weight in Balance": F2,37=3.17, P=.05). Low evaluation of the interventions was not a significant predictor of dropout at a later follow-up measurement in any of the studies. Dropout attrition rates were higher among participants with a lower or middle educational level compared with highly educated participants. Although lower educated participants evaluated the interventions better

  4. Cultural differences and shame in an expressive writing alcohol intervention.

    Science.gov (United States)

    Rodriguez, Lindsey M; Young, Chelsie M; Neighbors, Clayton; Tou, Reese; Lu, Qian

    2016-01-01

    The present study evaluates the relationships between shame, culture, and drinking behavior in predicting drinking intentions in the context of an expressive writing intervention. Theory and empirical findings have generally found that shame is maladaptive and can lead to anxiety, depression, and problematic alcohol use. However, research on cultural differences suggests that shame may be differentially damaging to individuals of collectivist, Asian cultures. Previous research evaluating expressive writing as a brief alcohol intervention has shown promising results such as reduced drinking intentions and increased readiness to change drinking behavior. The present study tested the hypothesis that feelings of shame after writing about a negative heavy drinking event would be associated with greater alcohol use generally and that this effect would differ for Caucasian compared to Asian individuals. We also explored whether this differed for light and heavy drinkers. Two hundred sixty-four undergraduates (74% female) who drank at least one alcoholic beverage in the past month completed measures of demographics, baseline drinking, event-related shame and guilt, pre- and postwriting affect, and drinking intentions. Results revealed that, independent of affect, social desirability, and event-related guilt, shame was generally negatively associated with drinking intentions for Caucasians and light drinking Asians. However, for heavy drinking Asians, shame was associated with increased drinking intentions. Results suggest that interventions that elicit shame are differentially effective and should be targeted accordingly.

  5. ?Can you keep it real?? : Practical, and culturally tailored lifestyle recommendations by Mexican American women diagnosed with type 2 diabetes: A qualitative study

    OpenAIRE

    Benavides-Vaello, Sandra; Brown, Sharon A.; Vandermause, Roxanne

    2017-01-01

    Background The purpose of this article is to engage clinicians in a dialogue about ideas on how to provide more specific, contextually relevant, practical and culturally tailored diabetes self-management recommendations as suggested by Mexican-American women diagnosed with type 2 diabetes. Current diabetes self-management recommendations, targeting Mexican Americans in particular, remain largely broad (?reduce your calorie intake? or ?cut back on carbs?), overly ambitious (?stop eating tortil...

  6. Identity text: an educational intervention to foster cultural interaction

    Directory of Open Access Journals (Sweden)

    Zareen Zaidi

    2016-11-01

    Full Text Available Background: Sociocultural theories state that learning results from people participating in contexts where social interaction is facilitated. There is a need to create such facilitated pedagogical spaces where participants can share their ways of knowing and doing. The aim of this exploratory study was to introduce pedagogical space for sociocultural interaction using ‘Identity Text’. Methods: Identity Texts are sociocultural artifacts produced by participants, which can be written, spoken, visual, musical, or multimodal. In 2013, participants of an international medical education fellowship program were asked to create their own Identity Texts to promote discussion about participants’ cultural backgrounds. Thematic analysis was used to make the analysis relevant to studying the pedagogical utility of the intervention. Result: The Identity Text intervention created two spaces: a ‘reflective space’, which helped participants reflect on sensitive topics such as institutional environments, roles in interdisciplinary teams, and gender discrimination, and a ‘narrative space’, which allowed participants to tell powerful stories that provided cultural insights and challenged cultural hegemony; they described the conscious and subconscious transformation in identity that evolved secondary to struggles with local power dynamics and social demands involving the impact of family, peers, and country of origin. Conclusion: While the impact of providing pedagogical space using Identity Text on cognitive engagement and enhanced learning requires further research, the findings of this study suggest that it is a useful pedagogical strategy to support cross-cultural education.

  7. Identity text: an educational intervention to foster cultural interaction.

    Science.gov (United States)

    Zaidi, Zareen; Verstegen, Daniëlle; Naqvi, Rahat; Dornan, Tim; Morahan, Page

    2016-01-01

    Sociocultural theories state that learning results from people participating in contexts where social interaction is facilitated. There is a need to create such facilitated pedagogical spaces where participants can share their ways of knowing and doing. The aim of this exploratory study was to introduce pedagogical space for sociocultural interaction using 'Identity Text'. Identity Texts are sociocultural artifacts produced by participants, which can be written, spoken, visual, musical, or multimodal. In 2013, participants of an international medical education fellowship program were asked to create their own Identity Texts to promote discussion about participants' cultural backgrounds. Thematic analysis was used to make the analysis relevant to studying the pedagogical utility of the intervention. The Identity Text intervention created two spaces: a 'reflective space', which helped participants reflect on sensitive topics such as institutional environments, roles in interdisciplinary teams, and gender discrimination, and a 'narrative space', which allowed participants to tell powerful stories that provided cultural insights and challenged cultural hegemony; they described the conscious and subconscious transformation in identity that evolved secondary to struggles with local power dynamics and social demands involving the impact of family, peers, and country of origin. While the impact of providing pedagogical space using Identity Text on cognitive engagement and enhanced learning requires further research, the findings of this study suggest that it is a useful pedagogical strategy to support cross-cultural education.

  8. SisterTalk: final results of a culturally tailored cable television delivered weight control program for Black women.

    Science.gov (United States)

    Risica, Patricia Markham; Gans, Kim M; Kumanyika, Shiriki; Kirtania, Usree; Lasater, Thomas M

    2013-12-27

    Obesity among Black women continues to exceed that of other women. Most weight loss programs created without reference to specific cultural contexts are less effective for Black than White women. Weight control approaches accessible to Black women and adapted to relevant cultural contexts are important for addressing this problem. This paper reports the final results of SisterTalk, the randomized controlled trial of a cable TV weight control program oriented toward Black women. A five group design included a comparison group and a 2 × 2 factorial comparison of a) interactive vs. passive programming and b) telephone social support vs no telephone support, with 12 weekly initial cable TV programs followed by 4 monthly booster videos. At baseline, 3, 8, and 12 months post randomization, telephone and in person surveys were administered on diet, physical activity, and physical measurements of height and weight were taken to calculate body mass index (BMI). Analysis of variance (ANOVA) was used to examine differences over time, and between treatment and comparison groups. Dose variables reflecting use of the TV/video and written materials were also assessed. At 3 months, BMI, weight, and dietary fat were significantly lower and physical activity significantly higher among women exposed to the Cable TV intervention compared to the wait-list comparison group. Significant dietary fat differences were still observed at 8 and 12 month evaluations, but not BMI or physical activity differences. Main effects were not observed for interactive programming or enhanced social support at any time point. Within the intervention group, higher watching of the TV series and higher reading of educational materials were both (separately) associated with significantly lower dietary fat. Cable TV was an effective delivery channel to assist Black women with weight control, increasing physical activity and decreasing dietary fat during an initial intervention period, but only dietary

  9. The effect of targeted and tailored patient depression engagement interventions on patient-physician discussion of suicidal thoughts: a randomized control trial.

    Science.gov (United States)

    Shah, Ruby; Franks, Peter; Jerant, Anthony; Feldman, Mitchell; Duberstein, Paul; Fernandez y Garcia, Erik; Hinton, Ladson; Strohecker, Lorrie; Kravitz, Richard L

    2014-08-01

    Despite improvements in the diagnosis and treatment of depression, primary care provider (PCP) discussion regarding suicidal thoughts among patients with depressive symptoms remains low. To determine whether a targeted depression public service announcement (PSA) video or an individually tailored interactive multimedia computer program (IMCP) leads to increased primary care provider (PCP) discussion of suicidal thoughts in patients with elevated risk for clinical depression when compared to an attention control. Randomized control trial at five different healthcare systems in Northern California; two academic, two Veterans Affairs (VA), and one group-model health maintenance organization (HMO). Eight-hundred sixty-seven participants, with mean age 51.7; 43.9% women, 43.4% from a racial/ethnic minority group. The PSA was targeted to gender and socio-economic status, and designed to encourage patients to seek depression care or request information regarding depression. The IMCP was an individually tailored interactive health message designed to activate patients to discuss possible depressive symptoms. The attention control was a sleep hygiene video. Clinician reported discussion of suicidal thoughts. Analyses were stratified by depressive symptom level (Patient Health Questionnaire [PHQ-9] score IMCP group than in the control group (adjusted odds ratio = 2.33, 95% confidence interval = 1.5, 5.10, p = 0.03). There were no significant effects of either intervention on PCP discussion of suicidal thoughts among patients with a PHQ-9 score < 9. Exposure of patients with at least moderate depressive symptoms to an individually tailored intervention designed to increase patient engagement in depression care led to increased PCP discussion of suicidal thoughts.

  10. Effects of Intervention and Team Culture on Operating Room Traffic.

    Science.gov (United States)

    Pulido, Ricardo W; Kester, Benjamin; Schwarzkopf, Ran

    How changes in the surgical team's culture can potentially reduce operating room (OR) traffic. Excessive OR traffic during surgical procedures can present a risk to the patient's safety and recovery. Data suggest that limiting the number of OR personnel during the intraoperative period can reduce excessive OR traffic. However, it is unclear whether the surgeon's verbal intervention can also successfully reduce intraoperative OR traffic. This study compares traffic rates in hip and knee arthroplasty cases against traffic rates during nonarthroplasty cases to examine the effects of verbal interventions implemented by the surgeon to reduce intraoperative traffic. The study consisted of 16 orthopedic surgeons in a noninterventional group and 1 orthopedic surgeon in the interventional group. The surgeon in the interventional group implemented verbal protocols to OR staff to limit excessive intraoperative traffic. Operating room traffic was monitored for 3 consecutive months (January-March 2015) with the use of infrared automated door counters that tracked door openings when someone entered or left the OR. A total of 50 hip and knee arthroplasties cases and 157 nonarthroplasty cases were tracked during the study period. A total of 134 hours and 4482 movements were collected for the hip and knee arthroplasty cases. A total of 498 hours and 22 902 movements were collected for the nonarthroplasty cases. Comparing the 2 groups, the interventional group averaged 33 movements per hour while the noninterventional group averaged 46 movements per hour (P traffic can be reduced through simple verbal protocols established by the surgical team.

  11. Tailored lighting intervention improves measures of sleep, depression, and agitation in persons with Alzheimer’s disease and related dementia living in long-term care facilities

    Directory of Open Access Journals (Sweden)

    Figueiro MG

    2014-09-01

    Full Text Available Mariana G Figueiro,1 Barbara A Plitnick,1 Anna Lok,1 Geoffrey E Jones,1 Patricia Higgins,2,3 Thomas R Hornick,3,4 Mark S Rea1 1Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA; 2School of Nursing, 3School of Medicine, Case Western Reserve University, 4Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USABackground: Light therapy has shown great promise as a nonpharmacological method to improve symptoms associated with Alzheimer’s disease and related dementias (ADRD, with preliminary studies demonstrating that appropriately timed light exposure can improve nighttime sleep efficiency, reduce nocturnal wandering, and alleviate evening agitation. Since the human circadian system is maximally sensitive to short-wavelength (blue light, lower, more targeted lighting interventions for therapeutic purposes, can be used. Methods: The present study investigated the effectiveness of a tailored lighting intervention for individuals with ADRD living in nursing homes. Low-level “bluish-white” lighting designed to deliver high circadian stimulation during the daytime was installed in 14 nursing home resident rooms for a period of 4 weeks. Light–dark and rest–activity patterns were collected using a Daysimeter. Sleep time and sleep efficiency measures were obtained using the rest–activity data. Measures of sleep quality, depression, and agitation were collected using standardized questionnaires, at baseline, at the end of the 4-week lighting intervention, and 4 weeks after the lighting intervention was removed. Results: The lighting intervention significantly (P<0.05 decreased global sleep scores from the Pittsburgh Sleep Quality Index, and increased total sleep time and sleep efficiency. The lighting intervention also increased phasor magnitude, a measure of the 24-hour resonance between light–dark and rest–activity patterns, suggesting an increase

  12. Use of tailored loading-dose clopidogrel in patients undergoing selected percutaneous coronary intervention based on adenosine diphosphate-mediated platelet aggregation

    Institute of Scientific and Technical Information of China (English)

    MENG Kang; L(U) Shu-zheng; ZHU Hua-gang; CHEN Xin; GE Chang-jiang; SONG Xian-tao

    2010-01-01

    Background Adenosine phosphate-mediated platelet aggregation is a prognostic factor for major adverse cardiac events in patients who have undergone selective percutaneous coronary interventions. This study aimed to assess whether an adjusted loading dose of clopidogrel could more effectively inhibit platelet aggregation in patients undergoing selected percutaneous coronary intervention.Methods A total of 205 patients undergoing selected percutaneous coronary intervention were enrolled in this multicenter, prospective, randomized study. Patients receiving domestic clopidogrel (n=104) served as the Talcom (Taijia)group; others (n=101) received Plavix, the Plavix group, Patients received up to 3 additional 300-mg loading doses of clopidogrel to decrease the adenosine phosphate-mediated platelet aggregation index by more than 50% (the primary endpoint) compared with the baseline. The secondary endpoint was major adverse cardiovascular events at 12 months.Results Compared with the rational loading dosage, the tailored loading dosage better inhibited platelet aggregation based on a >50% decrease in adenosine phosphate-mediated platelet aggregation (rational loading dosage vs. tailored loading dosage, 48% vs. 73%, P=0.028). There was no significant difference in the eligible index between the Talcom and Plavix groups (47% vs. 49% at 300 mg; 62% vs. 59% at 600 mg; 74% vs. 72% at 900 mg; P >0.05) based on a standard adenosine diphosphate-mediated platelet aggregation decrease of >50%. After 12 months of follow-up, there were no significant differences in major adverse cardiac events (2.5% vs. 2.9%, P=5.43). No acute or subacute stent thrombosis events occurred.Conclusion An adjusted loading dose of clopidogrel could have significant effects on antiplatelet aggregation compared with a rational dose, decreasing 1-year major adverse cardiac events in patients undergoing percutaneous coronary interventions based on adenosine phosphate-mediated platelet aggregation with no

  13. Effectiveness of a Web-Based Computer-Tailored Multiple-Lifestyle Intervention for People Interested in Reducing their Cardiovascular Risk: A Randomized Controlled Trial

    Science.gov (United States)

    Dörenkämper, Julia; Reinwand, Dominique Alexandra; Wienert, Julian; De Vries, Hein; Lippke, Sonia

    2016-01-01

    Background Web-based computer-tailored interventions for multiple health behaviors can improve the strength of behavior habits in people who want to reduce their cardiovascular risk. Nonetheless, few randomized controlled trials have tested this assumption to date. Objective The study aim was to test an 8-week Web-based computer-tailored intervention designed to improve habit strength for physical activity and fruit and vegetable consumption among people who want to reduce their cardiovascular risk. In a randomized controlled design, self-reported changes in perceived habit strength, self-efficacy, and planning across different domains of physical activity as well as fruit and vegetable consumption were evaluated. Methods This study was a randomized controlled trial involving an intervention group (n=403) and a waiting control group (n=387). Web-based data collection was performed in Germany and the Netherlands during 2013-2015. The intervention content was based on the Health Action Process Approach and involved personalized feedback on lifestyle behaviors, which indicated whether participants complied with behavioral guidelines for physical activity and fruit and vegetable consumption. There were three Web-based assessments: baseline (T0, N=790), a posttest 8 weeks after the baseline (T1, n=206), and a follow-up 3 months after the baseline (T2, n=121). Data analysis was conducted by analyzing variances and structural equation analysis. Results Significant group by time interactions revealed superior treatment effects for the intervention group, with substantially higher increases in self-reported habit strength for physical activity (F1,199=7.71, P=.006, Cohen’s d=0.37) and fruit and vegetable consumption (F1,199=7.71, P=.006, Cohen’s d=0.30) at posttest T1 for the intervention group. Mediation analyses yielded behavior-specific sequential mediator effects for T1 planning and T1 self-efficacy between the intervention and habit strength at follow-up T2 (fruit

  14. The differentiated effectiveness of a printed versus a Web-based tailored physical activity intervention among adults aged over 50

    NARCIS (Netherlands)

    Peels, D.A.; van Stralen, M.M.; Bolman, C.; Golsteijn, R.H.J.; de Vries, H.; Mudde, A.N.; Lechner, L.

    2014-01-01

    This study provides insight in the effectiveness of a print-delivered and a Web-based physical activity (PA) intervention (with or without additional environmental information on local PA possibilities) among people aged over 50. Intervention groups (print-delivered basic [PB; n = 439], print-delive

  15. The Differentiated Effectiveness of a Printed versus a Web-Based Tailored Physical Activity Intervention among Adults Aged over 50

    Science.gov (United States)

    Peels, D. A.; van Stralen, M. M.; Bolman, C.; Golsteijn, R. H. J.; de Vries, H.; Mudde, A. N.; Lechner, L.

    2014-01-01

    This study provides insight in the effectiveness of a print-delivered and a Web-based physical activity (PA) intervention (with or without additional environmental information on local PA possibilities) among people aged over 50. Intervention groups (print-delivered basic [PB; n = 439], print-delivered environmental [PE; n = 435], Web-based basic…

  16. Can a Website-Delivered Computer-Tailored Physical Activity Intervention Be Acceptable, Usable, and Effective for Older People?

    Science.gov (United States)

    Ammann, Rahel; Vandelanotte, Corneel; de Vries, Hein; Mummery, W. Kerry

    2013-01-01

    Despite the numerous health benefits, population physical activity levels are low and declining with age. A continued increase of Internet access allows for website-delivered interventions to be implemented across age-groups, though older people have typically not been considered for this type of intervention. Therefore, the purpose of this study…

  17. Systematic Development of the YouRAction program, a computer-tailored Physical Activity promotion intervention for Dutch adolescents, targeting personal motivations and environmental opportunities

    Directory of Open Access Journals (Sweden)

    Prins Richard G

    2010-08-01

    Full Text Available Abstract Background Increasing physical activity (PA among adolescents is an important health promotion goal. PA has numerous positive health effects, but the majority of Dutch adolescents do not meet PA requirements. The present paper describes the systematic development of a theory-based computer-tailored intervention, YouRAction, which targets individual and environmental factors determining PA among adolescents. Design The intervention development was guided by the Intervention Mapping protocol, in order to define clear program objectives, theoretical methods and practical strategies, ensure systematic program planning and pilot-testing, and anticipate on implementation and evaluation. Two versions of YouRAction were developed: one that targets individual determinants and an extended version that also provides feedback on opportunities to be active in the neighbourhood. Key determinants that were targeted included: knowledge and awareness, attitudes, self-efficacy and subjective norms. The extended version also addressed perceived availability of neighbourhood PA facilities. Both versions aimed to increase levels of moderate-to-vigorous PA among adolescents. The intervention structure was based on self-regulation theory, comprising of five steps in the process of successful goal pursuit. Monitoring of PA behaviour and behavioural and normative feedback were used to increase awareness of PA behaviour; motivation was enhanced by targeting self-efficacy and attitudes, by means of various interactive strategies, such as web movies; the perceived environment was targeted by visualizing opportunities to be active in an interactive geographical map of the home environment; in the goal setting phase, the adolescents were guided in setting a goal and developing an action plan to achieve this goal; in the phase of active goal pursuit adolescents try to achieve their goal and in the evaluation phase the achievements are evaluated. Based on the results

  18. Tailoring Healthy Workplace Interventions to Local Healthcare Settings: A Complexity Theory-Informed Workplace of Well-Being Framework.

    Science.gov (United States)

    Brand, Sarah L; Fleming, Lora E; Wyatt, Katrina M

    2015-01-01

    Many healthy workplace interventions have been developed for healthcare settings to address the consistently low scores of healthcare professionals on assessments of mental and physical well-being. Complex healthcare settings present challenges for the scale-up and spread of successful interventions from one setting to another. Despite general agreement regarding the importance of the local setting in affecting intervention success across different settings, there is no consensus on what it is about a local setting that needs to be taken into account to design healthy workplace interventions appropriate for different local settings. Complexity theory principles were used to understand a workplace as a complex adaptive system and to create a framework of eight domains (system characteristics) that affect the emergence of system-level behaviour. This Workplace of Well-being (WoW) framework is responsive and adaptive to local settings and allows a shared understanding of the enablers and barriers to behaviour change by capturing local information for each of the eight domains. We use the results of applying the WoW framework to one workplace, a UK National Health Service ward, to describe the utility of this approach in informing design of setting-appropriate healthy workplace interventions that create workplaces conducive to healthy behaviour change.

  19. A randomised trial of a psychosocial intervention for cancer patients integrated into routine care: the PROMPT study (promoting optimal outcomes in mood through tailored psychosocial therapies

    Directory of Open Access Journals (Sweden)

    Jolley Damien

    2011-02-01

    Full Text Available Abstract Background Despite evidence that up to 35% of patients with cancer experience significant distress, access to effective psychosocial care is limited by lack of systematic approaches to assessment, a paucity of psychosocial services, and patient reluctance to accept treatment either because of perceived stigma or difficulties with access to specialist psycho-oncology services due to isolation or disease burden. This paper presents an overview of a randomised study to evaluate the effectiveness of a brief tailored psychosocial Intervention delivered by health professionals in cancer care who undergo focused training and participate in clinical supervision. Methods/design Health professionals from the disciplines of nursing, occupational therapy, speech pathology, dietetics, physiotherapy or radiation therapy will participate in training to deliver the psychosocial Intervention focusing on core concepts of supportive-expressive, cognitive and dignity-conserving care. Health professional training will consist of completion of a self-directed manual and participation in a skills development session. Participating health professionals will be supported through structured clinical supervision whilst delivering the Intervention. In the stepped wedge design each of the 5 participating clinical sites will be allocated in random order from Control condition to Training then delivery of the Intervention. A total of 600 patients will be recruited across all sites. Based on level of distress or risk factors eligible patients will receive up to 4 sessions, each of up to 30 minutes in length, delivered face-to-face or by telephone. Participants will be assessed at baseline and 10-week follow-up. Patient outcome measures include anxiety and depression, quality of life, unmet psychological and supportive care needs. Health professional measures include psychological morbidity, stress and burnout. Process evaluation will be conducted to assess perceptions

  20. Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care

    Directory of Open Access Journals (Sweden)

    Westert Gert P

    2011-10-01

    Full Text Available Abstract Background Feedback is potentially effective in improving the quality of care. However, merely sending reports is no guarantee that performance data are used as input for systematic quality improvement (QI. Therefore, we developed a multifaceted intervention tailored to prospectively analyzed barriers to using indicators: the Information Feedback on Quality Indicators (InFoQI program. This program aims to promote the use of performance indicator data as input for local systematic QI. We will conduct a study to assess the impact of the InFoQI program on patient outcome and organizational process measures of care, and to gain insight into barriers and success factors that affected the program's impact. The study will be executed in the context of intensive care. This paper presents the study's protocol. Methods/design We will conduct a cluster randomized controlled trial with intensive care units (ICUs in the Netherlands. We will include ICUs that submit indicator data to the Dutch National Intensive Care Evaluation (NICE quality registry and that agree to allocate at least one intensivist and one ICU nurse for implementation of the intervention. Eligible ICUs (clusters will be randomized to receive basic NICE registry feedback (control arm or to participate in the InFoQI program (intervention arm. The InFoQI program consists of comprehensive feedback, establishing a local, multidisciplinary QI team, and educational outreach visits. The primary outcome measures will be length of ICU stay and the proportion of shifts with a bed occupancy rate above 80%. We will also conduct a process evaluation involving ICUs in the intervention arm to investigate their actual exposure to and experiences with the InFoQI program. Discussion The results of this study will inform those involved in providing ICU care on the feasibility of a tailored multifaceted performance feedback intervention and its ability to accelerate systematic and local quality

  1. Efficacy of a Web-Based, Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

    Science.gov (United States)

    Bingham, C. Raymond; Barretto, Andrea Ippel; Walton, Maureen A.; Bryant, Christopher M.; Shope, Jean T.; Raghunathan, Trivellore E.

    2010-01-01

    Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called "Michigan Prevention and Alcohol Safety for Students" (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1…

  2. Cultural adaptation of a cognitive-behavioural intervention to improve adherence to antiretroviral therapy among people living with HIV/AIDS in Zimbabwe: Nzira Itsva.

    Science.gov (United States)

    Bere, Tarisai; Nyamayaro, Primrose; Magidson, Jessica F; Chibanda, Dixon; Chingono, Alfred; Munjoma, Ronald; Macpherson, Kirsty; Ndhlovu, Chiratidzo Ellen; O'Cleirigh, Conall; Kidia, Khameer; Safren, Steven A; Abas, Melanie

    2016-02-18

    Few evidence-based interventions to improve adherence to antiretroviral therapy have been adapted for use in Africa. We selected, culturally adapted and tested the feasibility of a cognitive-behavioural intervention for adherence and for delivery in a clinic setting in Harare, Zimbabwe. The intervention consisted of a single, 50-minute problem-solving cognitive-behavioural intervention session with four skill-based booster sessions, delivered by four lay adherence counsellors in the context of HIV care. Adaptation followed a theoretically driven approach to intervention adaptation, Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT), and included modifications to language, session length, tailoring content for delivery by lay counsellors and inclusion of culturally competent probes. The feasibility of the intervention was evaluated using a mixed-methods assessment, including ratings of provider fidelity of intervention delivery, and qualitative assessments of feasibility using individual semi-structured interviews with counsellors (n = 4) and patients (n = 15). The intervention was feasible and acceptable when administered to 42 patients and resulted in improved self-reported adherence in a subset of 15 patients who were followed up after 6 months. Next steps from this study include conducting a randomised control trial to evaluate the adapted intervention compared to standard of care in a larger sample over a long-term follow-up.

  3. Comparison of use and appreciation of a print-delivered versus CD-ROM-delivered, computer-tailored intervention targeting saturated fat intake: randomized controlled trial.

    Science.gov (United States)

    Kroeze, Willemieke; Oenema, Anke; Campbell, Marci; Brug, Johannes

    2008-04-29

    Computer-tailored health education, a promising health education technique, is increasingly being delivered interactively, for example, over the Internet. It has been suggested that there may be differences in use and appreciation between print and interactive delivery of computer-tailored interventions, which may influence information processing. This may especially be the case for women, older people, and people of lower socioeconomic status. Knowledge about differences in use and appreciation could help in choosing the appropriate delivery mode for a particular target audience. The study investigates a content-identical, computer-tailored intervention addressing saturated fat intake delivered via print or CD-ROM. We analyzed consumer use and appreciation of the feedback information and explored whether possible differences exist among gender, age, and education subgroups. Healthy Dutch adults (18-65 years), none of whom were under treatment for hypercholesterolemia, were randomly allocated to receive a computer-tailored program on CD-ROM (n = 151) or in print (n = 141). At baseline, data were collected on gender, age, and education level. One month post-intervention, data were collected on the use (feedback information read, saved, discussed) and appreciation (trustworthiness, perceived individualization, perceived personal relevance, and user-friendliness) of the feedback. Statistical analyses on the use and appreciation items were performed using chi-square tests and independent-samples t tests. After exclusion of individuals with missing values, a total of 257 and 240 respondents were included in the analyses of the use outcomes of feedback read and saved, respectively. The results indicate that among the total population, the print feedback was read more often than the CD-ROM feedback (95% vs 81%; P = .001) and saved more often than the CD-ROM feedback (97% vs 77%; P values, a total of 208-223 respondents were included in the analyses of the use outcome of

  4. Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems

    DEFF Research Database (Denmark)

    Martin, Marie H. T.; D. Nielsen, Maj Britt; Pedersen, Jacob

    2015-01-01

    PURPOSE: Mental health problems (MHPs) are increasingly common as reasons for long-term sickness absence. However, the knowledge of how to promote a stable return to work (RTW) after sickness absence due to MHPs is limited. The purpose of this study was to assess the effects of a multidisciplinary......) and of conventional case management (n = 80) for 2 years to compare their risk of recurrent sickness absence and unemployment after RTW, their cumulative sickness absence and their labour market status after 2 years. RESULTS: We found no statistically significant intervention effect in terms of the risk of recurrent...... showed no benefits in terms of improved stability of RTW, reduced sickness absence or improved labour market status after 2 years when compared to conventional case management. IMPLICATIONS FOR REHABILITATION: Evidence for effective return-to-work (RTW) interventions for people with mental health...

  5. Cancer Health Empowerment for Living without Pain (Ca-HELP): effects of a tailored education and coaching intervention on pain and impairment.

    Science.gov (United States)

    Kravitz, Richard L; Tancredi, Daniel J; Grennan, Tim; Kalauokalani, Donna; Street, Richard L; Slee, Christina K; Wun, Ted; Oliver, Jennifer Wright; Lorig, Kate; Franks, Peter

    2011-07-01

    We aimed to determine the effectiveness of a lay-administered tailored education and coaching (TEC) intervention (aimed at reducing pain misconceptions and enhancing self-efficacy for communicating with physicians) on cancer pain severity, pain-related impairment, and quality of life. Cancer patients with baseline "worst pain" of ≥4 on a 0-10 scale or at least moderate functional impairment due to pain were randomly assigned to TEC or enhanced usual care (EUC) during a telephone interview conducted in advance of a planned oncology office visit (265 patients randomized to TEC or EUC; 258 completed at least one follow-up). Patients completed questionnaires before and after the visit and were interviewed by telephone at 2, 6, and 12 weeks. Mixed effects regressions were used to evaluate the intervention adjusting for patient, practice, and site characteristics. Compared to EUC, TEC was associated with increased pain communication self-efficacy after the intervention (Ppain misconceptions. At 2 weeks, assignment to TEC was associated with improvement in pain-related impairment (-0.25 points on a 5-point scale, 95% confidence interval -0.43 to -0.06, P=.01) but not in pain severity (-0.21 points on an 11-point scale, -0.60 to 0.17, P=.27). The improvement in pain-related impairment was not sustained at 6 and 12 weeks. There were no significant intervention by subgroup interactions (P>.10). We conclude that TEC, compared with EUC, resulted in improved pain communication self-efficacy and temporary improvement in pain-related impairment, but no improvement in pain severity.

  6. "Championing GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

    Science.gov (United States)

    Karame, P., Sr.

    2016-12-01

    "GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health sector

  7. "GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

    Science.gov (United States)

    Karame, P., Sr.; Dushimiyimana, V.

    2016-12-01

    " Championing GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health

  8. Acceptability of a Web-Based and Tailored Intervention for the Self-Management of Pain After Cardiac Surgery: The Perception of Women and Men

    Science.gov (United States)

    2014-01-01

    Background Approximately two thirds of adults undergoing cardiac surgery suffer from moderate to severe postoperative pain. Assisting patients with pain management is therefore critical to prevent its negative consequences. Information technologies have become part of our lifestyle and can facilitate the implementation of interventions to manage pain in a busy care setting. A computer-tailored and Web-based intervention—referred to as SOUtien à L’AutoGEstion-Traitement-Assistance Virtuelle Infirmière-Enseignement (SOULAGE-TAVIE)—for the self-management of pain was developed. Findings from a previous pilot randomized controlled trial (RCT) provided some evidence of the feasibility and preliminary effectiveness of this intervention in decreasing pain interference with a few postoperative activities and by modulating pain beliefs and analgesic intake. However, its acceptability from the patient’s perspective remains unclear. Moreover, the proportion of women is much lower in the cardiac surgical population, making it difficult to detect differences in experiences between men and women. Objective The objectives were (1) to describe SOULAGE-TAVIE’s acceptability from the perspective of adults experiencing pain after cardiac surgery and (2) to compare the perceptions of men and women. Methods A mixed-method approach was used to capture the various attributes of patients’ perceptions of the intervention’s acceptability and to compare the perceptions of men and women. Quota samples of men (n=10; mean age 62.5 years, SD 7.3) and women (n=10; mean age 64.3 years, SD 10.7) who had cardiac surgery in the past month were invited to view the intervention, complete a brief questionnaire rating its acceptability, and then to discuss each component in a 60-minute, semistructured interview. Mann-Whitney U tests were used to compare groups. The transcripts were content analyzed to generate themes based on patients’ experiences with the intervention and reports of

  9. C-C3-02: Developing a Culturally Appropriate Weight-Loss Intervention Program for Spanish-Speaking Mexican-American Women

    Science.gov (United States)

    Lindberg, Nangel; Stevens, Victor; Calderon, Mariana Rosales; Cervantes, Mayan; Gullion, Christina

    2011-01-01

    Background In the USA, 77% of Hispanic women age 20 and older are classified as overweight or obese. There is evidence that Hispanics tend to be less successful than non-Hispanic whites in standard weight-loss interventions. This study assessed the feasibility of a culturally-tailored behavioral weight-loss intervention specifically designed for Spanish-speaking women of Mexican origin. Methods This 6-month intervention consisting of weekly sessions was based on approaches previously used successfully with English-speaking participants in the PREMIER and Weight Loss Maintenance trials. Cultural adaptations were implemented throughout the program based on information derived from focus groups, available literature, and a multidisciplinary team that included Mexican experts in behavioral interventions and nutritional anthropology. The intervention was conducted entirely in Spanish. Beyond language, specific cultural adaptations included: “Grupos de mujeres” (“women-only” groups) of a wide range of age—covering topics central to the immigration experience (e.g., the loss of social networks, differing body-shape ideals in Mexican and American cultures, and the pressure of maintaining Mexican traditions while adopting “American ways”). Focusing on staple foods in the Mexican diet: returning to a traditional diet, how to make healthy choices. Providing basic instruction on nutrition, and hands-on training on standard food measurement for portion control. Addressing Mexican folk remedies and traditional beliefs regarding food and diet (e.g. “hot” and “cold” foods, “empacho,” etc.). Developing food-intake journals for people of limited literacy. Results The recruitment strategies used resulted in a significantly larger-than-expected response. There were 47 participants in the study. Thirty-one participants completed the intervention and had main outcome data available. Participants did not complete the intervention because they became pregnant (2

  10. Effects of a tailored lifestyle self-management intervention (TALENT study on weight reduction: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Melchart D

    2017-06-01

    Full Text Available Dieter Melchart,1,2 Peter Löw,3 Erich Wühr,4 Victoria Kehl,5 Wolfgang Weidenhammer1 1Competence Center for Complementary Medicine and Naturopathy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany; 2Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; 3Medical Practice for Internal Medicine, Treuchtlingen, 4Faculty for Applied Health Care Science, Deggendorf Institute of Technology, Deggendorf, 5Institute for Medical Statistics and Epidemiology, Munich Trial Centre, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Objective: Overweight and obesity are globally increasing risk factors for diseases in the context of metabolic syndrome. A randomized controlled trial was conducted to investigate whether there are any existing differences between two lifestyle intervention strategies with respect to weight reduction after 1 year.Subjects and methods: A total of 166 subjects with a body mass index of 28–35 kg/m2 were enrolled in this trial at seven study centers; 109 were randomly allocated to the intervention group (comprehensive lifestyle modification program: web-based Individual Health Management [IHM] with 3-month reduction phase plus 9-month maintenance phase, and 57 were allocated to the control group (written information with advice for healthy food habits: usual care [UC]. Body weight, waist circumference, blood pressure, laboratory findings, and bioimpedance analysis used to determine body composition were measured at baseline and after 3, 6, 9, and 12 months. The primary outcome parameter was body weight at month 12 compared to baseline.Results: With respect to baseline status there were no statistically significant differences between the groups. Based on the intent-to-treat population, body weight showed a mean decrease of 8.7 kg (SD 6.1 in the intervention group (IHM and 4.2 kg (SD 5 in the control group (UC at

  11. A randomised controlled trial testing a web-based, computer-tailored self-management intervention for people with or at risk for chronic obstructive pulmonary disease: a study protocol

    NARCIS (Netherlands)

    Voncken-Brewster, V.; Tange, H.; Vries, H. de; Nagykaldi, Z.; Winkens, B.; Weijden, T.T. van der

    2013-01-01

    BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality. Effective self-management support interventions are needed to improve the health and functional status of people with COPD or at risk for COPD. Computer-tailored technology could be an effective way

  12. Building a Tailored, Patient-Guided, Web-Based Self-Management Intervention 'ReumaUitgedaagd!' for Adults With a Rheumatic Disease : Results of a Usability Study and Design for a Randomized Control Trail

    NARCIS (Netherlands)

    Ammerlaan, Judy W; Mulder, Olga K; de Boer-Nijhof, Nienke C; Maat, Bertha; Kruize, Aike A; van Laar, Jaap; van Os-Medendorp, Harmieke; Geenen, Rinie

    2016-01-01

    BACKGROUND: The chronic nature of rheumatic diseases imposes daily challenges upon those affected and causes patients to make daily decisions about the way they self-manage their illness. Although there is attention to self-management and evidence for the desirability of tailored interventions to su

  13. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians

    DEFF Research Database (Denmark)

    Jay, Kenneth; Petersen, Mikkel Brandt; Sundstrup, Emil

    2014-01-01

    biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark. METHODS/DESIGN: In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants...... by questionnaire (modified visual analogue scale 0-10). DISCUSSION: This study will provide experimental evidence to guide workplace initiatives designed towards reducing chronic musculoskeletal pain and stress. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT02047669.......BACKGROUND: Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor...

  14. Effects of a Culturally Adapted Social-Emotional Learning Intervention Program on Students' Mental Health

    Science.gov (United States)

    Cramer, Kristine M.; Castro-Olivo, Sara

    2016-01-01

    Student self-reports of resiliency and social-emotional internalizing problems were examined to determine intervention effects of a culturally adapted social and emotional learning (SEL) program. Data were analyzed from 20 culturally and linguistically diverse high school students who participated in a school-based 12-lesson SEL intervention and…

  15. A pilot evaluation of the efficacy of a couple-tailored print intervention on colorectal cancer screening practices among non-adherent couples.

    Science.gov (United States)

    Manne, Sharon L; Kashy, Deborah A; Weinberg, David S; Boscarino, Joseph A; Bowen, Deborah J; Worhach, Sara

    2013-01-01

    The objective of this study was to evaluate the efficacy of a couple-tailored print (CTP) intervention on colorectal cancer screening (CRCS), CRCS intentions, and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS. A total of 168 married couples with both members non-adherent with CRCS were randomly assigned to receive either a CTP pamphlet accompanied by a generic print (GP) pamphlet or a GP pamphlet only. Couples completed measures of CRCS, intentions, relational perspective on CRCS, discussions about CRCS, spouse support for CRCS, spouse influence strategies, CRC knowledge, perceived CRC risk, and CRCS benefits and barriers. Results indicated there was no significant benefit of CTP vs. GP on CRCS, but there was a significant increase in CRCS intentions in CTP compared with GP. There was also a significant increase in relationship perspective on CRCS, a significant increase in husbands' support of their wives' CRCS, and a significant increase in CRCS benefits in CTP. In summary, CTP did not increase CRCS practices but increased intentions and perceived benefits of CRCS as well as improving couples' ability to view CRCS as having benefit for the marital relationship.

  16. Improving Health and Reducing Comorbidity Associated with HIV: The Development of TAVIE en santé, a Web-Based Tailored Intervention to Support the Adoption of Health Promoting Behaviors among People Living with HIV

    Directory of Open Access Journals (Sweden)

    José Côté

    2017-01-01

    Full Text Available Background. In the domain of health behavior change, the deployment and utilization of information and communications technologies as a way to deliver interventions appear to be promising. This article describes the development of a web-based tailored intervention, TAVIE en santé, to support people living with HIV in the adoption of healthy behaviors. Methods. This intervention was developed through an Intervention Mapping (IM framework and is based on the theory of planned behavior. Results. Crucial steps of IM are the selection of key determinants of behavior and the selection of useful theory-based intervention methods to change the targeted determinants (active ingredients. The content and the sequence of the intervention are then created based on these parameters. TAVIE en santé is composed of 7 interactive web sessions hosted by a virtual nurse. It aims to develop and strengthen skills required for behavior change. Based on an algorithm using individual cognitive data (attitude, perceived behavioral control, and intention, the number of sessions, theory-based intervention methods, and messages contents are tailored to each user. Conclusion. TAVIE en santé is currently being evaluated. The use of IM allows developing intervention with a systematic approach based on theory, empirical evidence, and clinical and experiential knowledge.

  17. Culturally Based Intervention Development: The Case of Latino Families Dealing With Schizophrenia.

    Science.gov (United States)

    Barrio, Concepción; Yamada, Ann-Marie

    2010-09-01

    OBJECTIVES: This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. METHOD: Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this multifamily group 16-session intervention with 59 Latino families in a randomized control trial. Data were collected on family- and client-level outcomes, and poststudy focus groups were conducted with intervention participants. RESULTS: Preliminary evidence indicates that the intervention is effective by increasing illness knowledge and reducing family burden. CONCLUSIONS: This work can provide a model for how to integrate cultural factors into psychosocial services and enhance interventions in real-world settings for culturally diverse populations.

  18. Individualized tailor-made dietetic intervention program at schools enhances eating behaviors and dietary habits in obese Hispanic children of low socioeconomic status.

    Science.gov (United States)

    Elizondo-Montemayor, Leticia; Moreno-Sànchez, Diana; Gutierrez, Norma G; Monsivais-Rodriguez, Fabiola; Martinez, Ubaldo; Lamadrid-Zertuche, Ana C; Hernandez-Torre, Martin M

    2014-01-01

    Hispanic children and those from low-socioeconomic status are predisposed to unhealthy eating habits and obesity. to implement an individualized, face-to-face, parent supported, and school-partnership dietetic intervention to promote healthy eating habits and decrease body mass index. Prospective school year dietetic intervention of 101 obese, Hispanic, low-socioeconomic school-age children representative of Monterrey, Mexico, consisted of anthropometrics, dietetic assessment, energy-restriction tailor-made daily menus, and parental education every three weeks. Student's t-test was used for means comparison. A significant decrease was found in body mass index percentile (96.43 ± 3.32 to 93.42 ± 8.12/P = 0.00) and energy intake/day of -755.7 kcal/day (P = 0.00). Among other energy dense foods with significant decline in servings/day and servings/week were processed meats (3.13 ± 1.43 to 2.19 ± 1.04/P = 0.00 and 5.60 ± 1.75 to 4.37 ± 2.10/P = 0.00, resp.), saturated fat (1.47 ± 1.08 to 0.78 ± 0.79/P = 0.00 and 2.19 ± 2.18 to 1.1 ± 1.36/P = 0.00), sweetened beverages (2.79 ± 1.99 to 1.42 ± 1.21 and 6.21 ± 1.72 to 3.89 ± 2.80/P = 0.00), and desserts and refined-grain bakery (1.99 ± 1.54 to 1.32 ± 1.59 and 2.85 ± 2.54 to 1.57 ± 2.20/P = 0.00). There was a significant increase in servings/day and servings/week of water (2.98 ± 2.02 to 4.91 ± 2.37 and 6.62 ± 2.03 to 6.87 ± 0.91/P = 0.00, resp.) and nutrient dense foods such as fruits (1.31 ± 0.89 to 1.66 ± 0.96 and 3.34 ± 2.24 to 4.28 ± 2.43/P = 0.00) and fish and poultry (3.76 ± 2.15 to 4.54 ± 2.25/P = 0.00). This intervention created healthy eating habits and decreased body mass index in a high risk population. NCT01925976.

  19. A tailored-guided internet-based cognitive-behavioral intervention for patients with rheumatoid arthritis as an adjunct to standard rheumatological care: results of a randomized controlled trial.

    Science.gov (United States)

    Ferwerda, Maaike; van Beugen, Sylvia; van Middendorp, Henriët; Spillekom-van Koulil, Saskia; Donders, A Rogier T; Visser, Henk; Taal, Erik; Creemers, Marjonne C W; van Riel, Piet C L M; Evers, Andrea W M

    2017-05-01

    For patients with chronic pain conditions such as rheumatoid arthritis (RA), who experience elevated levels of distress, tailored-guided internet-based cognitive-behavioral treatment may be effective in improving psychological and physical functioning, and reducing the impact of RA on daily life. A multicenter, randomized controlled trial was conducted for RA patients with elevated levels of distress as assessed by a disease-specific measure. The control group (n = 71) received standard care and the intervention group (n = 62) additionally received an internet-based tailored cognitive-behavioral intervention. Main analyses were performed using a linear mixed model estimating differences between the intervention and control groups in scores of psychological functioning, physical functioning, and impact of RA on daily life at preassesment and postassessment, and at 3, 6, 9, and 12 months. Patients who received the internet-based intervention reported a larger improvement in psychological functioning compared with the control group, indicating less depressed mood (P physical functioning, a trend was found for the intervention group reporting less fatigue than the control group (P = 0.06, d = 0.24), whereas no effect was found on pain. No effects were found for the impact of RA on daily life, except for the intervention group experiencing fewer role limitations due to emotional problems (P therapy is a promising development to aid patients with psychological distress particularly in improving psychological functioning. Further research on adherence and specific intervention ingredients is warranted.

  20. Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial.

    NARCIS (Netherlands)

    Verbakel, N.J.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.

    2015-01-01

    Background A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting A three-arm cluster randomised trial was

  1. Effectiveness of different methods for delivering tailored nutrition education to low income, ethnically diverse adults.

    Science.gov (United States)

    Gans, Kim M; Risica, Patricia M; Strolla, Leslie O; Fournier, Leanne; Kirtania, Usree; Upegui, David; Zhao, Julie; George, Tiffiney; Acharyya, Suddhasatta

    2009-05-05

    improve effectiveness. Future studies should determine which variables are mediators of dietary change and whether these differ by participant demographics. Moreover, future research should differentiate the effects of tailoring vs. cultural adaptation in ethnically diverse populations and study the dissemination of tailored interventions into community-based settings. Current Controlled Trials # NCT00301691.

  2. Exploring why junk foods are 'essential' foods and how culturally tailored recommendations improved feeding in Egyptian children.

    Science.gov (United States)

    Kavle, Justine A; Mehanna, Sohair; Saleh, Gulsen; Fouad, Mervat A; Ramzy, Magda; Hamed, Doaa; Hassan, Mohamed; Khan, Ghada; Galloway, Rae

    2015-07-01

    In Egypt, the double burden of malnutrition and rising overweight and obesity in adults mirrors the transition to westernized diets and a growing reliance on energy-dense, low-nutrient foods. This study utilized the trials of improved practices (TIPs) methodology to gain an understanding of the cultural beliefs and perceptions related to feeding practices of infants and young children 0-23 months of age and used this information to work in tandem with 150 mothers to implement feasible solutions to feeding problems in Lower and Upper Egypt. The study triangulated in-depth interviews (IDIs) with mothers participating in TIPs, with IDIs with 40 health providers, 40 fathers and 40 grandmothers to gain an understanding of the influence and importance of the role of other caretakers and health providers in supporting these feeding practices. Study findings reveal high consumption of junk foods among toddlers, increasing in age and peaking at 12-23 months of age. Sponge cakes and sugary biscuits are not perceived as harmful and considered 'ideal' common complementary foods. Junk foods and beverages often compensate for trivial amounts of food given. Mothers are cautious about introducing nutritious foods to young children because of fears of illness and inability to digest food. Although challenges in feeding nutritious foods exist, mothers were able to substitute junk foods with locally available and affordable foods. Future programming should build upon cultural considerations learned in TIPs to address sustainable, meaningful changes in infant and young child feeding to reduce junk foods and increase dietary quality, quantity and frequency.

  3. Individualized Tailor-Made Dietetic Intervention Program at Schools Enhances Eating Behaviors and Dietary Habits in Obese Hispanic Children of Low Socioeconomic Status

    Directory of Open Access Journals (Sweden)

    Leticia Elizondo-Montemayor

    2014-01-01

    Full Text Available Hispanic children and those from low-socioeconomic status are predisposed to unhealthy eating habits and obesity. Aim. to implement an individualized, face-to-face, parent supported, and school-partnership dietetic intervention to promote healthy eating habits and decrease body mass index. Prospective school year dietetic intervention of 101 obese, Hispanic, low-socioeconomic school-age children representative of Monterrey, Mexico, consisted of anthropometrics, dietetic assessment, energy-restriction tailor-made daily menus, and parental education every three weeks. Student’s t-test was used for means comparison. A significant decrease was found in body mass index percentile (96.43±3.32 to 93.42±8.12/P=0.00 and energy intake/day of −755.7 kcal/day (P=0.00. Among other energy dense foods with significant decline in servings/day and servings/week were processed meats (3.13 ± 1.43 to 2.19 ± 1.04/P=0.00 and 5.60 ± 1.75 to 4.37 ± 2.10/P=0.00, resp., saturated fat (1.47 ± 1.08 to 0.78 ± 0.79/P=0.00 and 2.19±2.18 to 1.1±1.36/P=0.00, sweetened beverages (2.79±1.99 to 1.42±1.21 and 6.21±1.72 to 3.89±2.80/P=0.00, and desserts and refined-grain bakery (1.99±1.54 to 1.32±1.59 and 2.85 ± 2.54 to 1.57 ± 2.20/P=0.00. There was a significant increase in servings/day and servings/week of water (2.98 ± 2.02 to 4.91 ± 2.37 and 6.62 ± 2.03 to 6.87 ± 0.91/P=0.00, resp. and nutrient dense foods such as fruits (1.31 ± 0.89 to 1.66 ± 0.96 and 3.34 ± 2.24 to 4.28 ± 2.43/P=0.00 and fish and poultry (3.76 ± 2.15 to 4.54 ± 2.25/P=0.00. This intervention created healthy eating habits and decreased body mass index in a high risk population. Trial registration number: NCT01925976.

  4. Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project.

    Science.gov (United States)

    Blegen, M A; Sehgal, N L; Alldredge, B K; Gearhart, S; Auerbach, A A; Wachter, R M

    2010-08-01

    The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used to determine the impact of the training with a before-after design. Surveys were returned from 454 healthcare staff before the training and 368 staff 1 year later. Five of eleven safety culture subscales showed significant improvement. Nurses perceived a stronger safety culture than physicians or pharmacists. While it is difficult to isolate the effects of the team training intervention from other events occurring during the year between training and postevaluation, overall the intervention seems to have improved the safety culture on these medical units.

  5. Tailored information about cancer risk and screening: a systematic review.

    NARCIS (Netherlands)

    Albada, A.; Ausems, M.G.E.M.; Bensing, J.M.; Dulmen, S. van

    2009-01-01

    OBJECTIVE: To study interventions that provide people with information about cancer risk and about screening that is tailored to their personal characteristics. We assess the tailoring characteristics, theory base and effects on risk perception, knowledge and screening behavior of these

  6. Evaluation of a Cultural Competence Intervention with Implications for the Nurse-Patient Encounter

    Science.gov (United States)

    Bradford, Althea Betty

    2012-01-01

    A short-term intervention on participants' knowledge of cultural competence was provided to 38 students in a baccalaureate nursing program at Winston-Salem State University (WSSU). The study examined the effectiveness of this intervention. Although WSSU is a Historically Black University, the majority of students in this program were White. Six…

  7. The Influence of National and Organizational Culture on the Use of Performance Improvement Interventions

    Science.gov (United States)

    Vadivelu, Ramaswamy N.; Klein, James D.

    2011-01-01

    This exploratory study examined the influence of national and organizational culture on the use of various performance improvement interventions. Data on intervention use were collected from practitioners in the United States and South Asia. Results revealed that orientation programs, organizational communication, instructor-led training, and…

  8. The effect of a cultural competence educational intervention for first-year nursing students in Israel.

    Science.gov (United States)

    Noble, Anita; Nuszen, Evelyn; Rom, Miriam; Noble, Lawrence M

    2014-01-01

    To evaluate the effectiveness of an educational intervention to increase general cultural competence of first-year nursing students. This was a quasi-experimental study that used a convenience sample with an experimental group and a control group and pre- and posttesting. The sample comprised 146 first-year nursing students enrolled in the Introduction to Nursing course divided into an intervention group (n = 58) of students from one school and a control group (n = 88) including students from two schools. The intervention group received a 2-hour faculty lecture on cultural competence, and students prepared and delivered a student group presentation about a cultural group in Israel, basing the presentation on Campinha-Bacote's five constructs. A demographic data instrument and Campinha-Bacote's Inventory for Assessing the Process of Cultural Competence Among Healthcare Professional-Revised© were used for pre- and posttesting. Students who received the educational intervention increased scores significantly (68 ± 6 to 73 ± 6, p = .000), students who did not receive the educational intervention had no significant increase (67 ± 6 to 66 ± 6). Introducing the topic of cultural competence for nursing students in the first-year Introduction to Nursing course as an integrative learning strategy revealed significant increases in cultural competence scores. Recommendations are to include evidence-based cultural competence teaching strategies into the nursing curriculum.

  9. Assessment of diabetic distress and disease related factors in patients with type 2 diabetes in Isfahan: A way to tailor an effective intervention planning in Isfahan-Iran

    Directory of Open Access Journals (Sweden)

    Tol Azar

    2012-10-01

    Full Text Available Abstract Background The purpose of this study was to assess diabetes distress and its related factors among type 2 diabetic patients to better tailor intervention planning in Isfahan-Iran. Methods A cross-sectional study was conducted in 2011. Study population was patients with type 2 diabetes referring to Omolbanin, an outpatient diabetic center in Isfahan. 140 diabetic patients met the inclusion criteria and were all included in the study. Patient’s diabetes distress was measured by DDS. A 17-item self-report diabetes distress scale was used with subscales reflecting 5 domains: 1 Emotional burden (5 items, 2 Physician distress (4 items, 3 Regimen distress (5 items and 4 Interpersonal distress (3 items. The responses to each item were rated between 1 and 6 (1 = not a problem, 2 = a slight problem, 3 = a moderate problem, 4 = somewhat serious problem, 5 = a serious problem, 6 = a very serious problem. The minimum and the maximum of score in the scale were 17 and 114 respectively. Collected data was analyzed by using SPSS software version 11.5. Results Mean age of participants were 53.23 years (SD = 7.82. 54.3% was female, 97.1% was married, and 57.1% had education lower than diploma. The average score of total diabetes distress was 2.96 ± 0.83. The average score of each domain was (3.40 ± 1.18, (2.57 ± 0.88, (2.97 ± 0.90, (2.76 ± 0.91 respectively. ‘Emotional Burden’ was considered as the most important domain in measuring diabetes distress. Total diabetes distress had significant association with age (p = 0.02, duration of diabetes (plc (r = 0.63, p Conclusion It seems some keywords have a main role in diabetes distress such as emotional support, communication with patient and physician, self-efficacy and social support. All of these points are achievable through empowerment approach in diabetes care plan.

  10. Building a Tailored, Patient-Guided, Web-Based Self-Management Intervention 'ReumaUitgedaagd!' for Adults With a Rheumatic Disease: Results of a Usability Study and Design for a Randomized Control Trail.

    Science.gov (United States)

    Ammerlaan, Judy W; Mulder, Olga K; de Boer-Nijhof, Nienke C; Maat, Bertha; Kruize, Aike A; van Laar, Jaap; van Os-Medendorp, Harmieke; Geenen, Rinie

    2016-06-23

    The chronic nature of rheumatic diseases imposes daily challenges upon those affected and causes patients to make daily decisions about the way they self-manage their illness. Although there is attention to self-management and evidence for the desirability of tailored interventions to support people with a rheumatic disease, interventions based on individual needs and preferences are scarce. To provide a systematic and comprehensive description of the theoretical considerations for building a Web-based, expert, patient-guided, and tailored intervention for adult patients with a rheumatic disease. Also, to present the results of a usability study on the feasibility of this intervention, and its study design in order to measure the effectiveness. To fit the intervention closely to the autonomy, needs, and preferences of the individual patient, a research team comprising patient representatives, health professionals, Web technicians, and communication experts was formed. The research team followed the new guidance by the Medical Research Council (MRC) for developing and evaluating complex interventions as a guide for the design of the intervention. Considerations from self-determination theory and a comprehensive assessment of preferences and needs in patients with a rheumatic disease guided the development of the Web-based intervention. The usability study showed that the intervention was useful, easy to use, and accepted and appreciated by the target group of patients. The planned randomized controlled trial is designed to be conducted among 120 adults with a rheumatic disease, who are assigned to the self-management intervention or a self-help control group. Both groups will be asked to formulate personal goals they want to achieve concerning their self-management. Progress toward the personal goal is the primary outcome measure of this study. Self-reported Web-based measures will be assessed before randomization at baseline, and 3 and 6 months after randomization

  11. Contemplative interventions or cultures of awareness in school

    DEFF Research Database (Denmark)

    Nielsen, Anne Maj; Kolmos, Marie

    contextual constraints, opportunities and interactions in which experience happen. We have used sensory-based interviews with children in order to obtain their sensuous experiences of contemplative activities. The theoretical approach is informed by phenomenology, cultural psychology and materiality studies...

  12. Unidas por la Vida (United for Life): implementing a culturally-tailored, community-based, family-oriented lifestyle intervention.

    Science.gov (United States)

    Sorkin, Dara H; Biegler, Kelly A; Peyreda, Margarita; Kilgore, David; Dow, Emily; Ngo-Metzger, Quyen

    2013-01-01

    Unidas por la Vida, a behavioral weight-loss program, was developed for use among low-income, Mexican-American women with diabetes and their overweight/obese adult daughters. The program leverages community resources in a partnership between primary care and community-based organizations. This paper describes the program's implementation, lessons learned, and implications for sustainability.

  13. Effects of a team-based assessment and intervention on patient safety culture in general practice

    DEFF Research Database (Denmark)

    Hoffmann, B; Müller, V; Rochon, J

    2014-01-01

    culture and decided on about 10 actions per practice to improve it. After 12 months, no significant differences were found between intervention and control groups in terms of error management (competing probability = 0.48, 95% CI 0.34 to 0.63, p = 0.823), 11 further patient safety culture indicators...

  14. The Relationship between Organizational Culture and the Implementation of Response to Intervention in One Elementary School

    Science.gov (United States)

    Methner, Lynn M.

    2013-01-01

    This study investigated the relationship between organizational culture and the implementation of Response to Intervention in one elementary school. It examined issues corresponding to change within a system, with particular attention to those relating to school culture. An ethnographic approach was used to gather data, including the collection of…

  15. Effects of a Culture-Adaptive Forgiveness Intervention for Chinese College Students

    Science.gov (United States)

    Ji, Mingxia; Hui, Eadaoin; Fu, Hong; Watkins, David; Tao, Linjin; Lo, Sing Kai

    2016-01-01

    The understanding and application of forgiveness varies across cultures. The current study aimed to examine the effect of a culture-adaptive Forgiveness Intervention on forgiveness attitude, self-esteem, empathy and anxiety of Mainland Chinese college students. Thirty-six participants were randomly allocated to either experimental groups or a…

  16. A Systematic Review of Literature on Culturally Adapted Obesity Prevention Interventions for African American Youth

    Science.gov (United States)

    Lofton, Saria; Julion, Wrenetha A.; McNaughton, Diane B.; Bergren, Martha Dewey; Keim, Kathryn S.

    2016-01-01

    Obesity and overweight prevalence in African American (AA) youth continues to be one of the highest of all major ethnic groups, which has led researchers to pursue culturally based approaches as a means to improve obesity prevention interventions. The purpose of this systematic review was to evaluate culturally adapted obesity prevention…

  17. Teamwork, communication and safety climate: a systematic review of interventions to improve surgical culture.

    Science.gov (United States)

    Sacks, Greg D; Shannon, Evan M; Dawes, Aaron J; Rollo, Johnathon C; Nguyen, David K; Russell, Marcia M; Ko, Clifford Y; Maggard-Gibbons, Melinda A

    2015-07-01

    To define the target domains of culture-improvement interventions, to assess the impact of these interventions on surgical culture and to determine whether culture improvements lead to better patient outcomes and improved healthcare efficiency. Healthcare systems are investing considerable resources in improving workplace culture. It remains unclear whether these interventions, when aimed at surgical care, are successful and whether they are associated with changes in patient outcomes. PubMed, Cochrane, Web of Science and Scopus databases were searched from January 1980 to January 2015. We included studies on interventions that aimed to improve surgical culture, defined as the interpersonal, social and organisational factors that affect the healthcare environment and patient care. The quality of studies was assessed using an adapted tool to focus the review on higher-quality studies. Due to study heterogeneity, findings were narratively reviewed. The 47 studies meeting inclusion criteria (4 randomised trials and 10 moderate-quality observational studies) reported on interventions that targeted three domains of culture: teamwork (n=28), communication (n=26) and safety climate (n=19); several targeted more than one domain. All moderate-quality studies showed improvements in at least one of these domains. Two studies also demonstrated improvements in patient outcomes, such as reduced postoperative complications and even reduced postoperative mortality (absolute risk reduction 1.7%). Two studies reported improvements in healthcare efficiency, including fewer operating room delays. These findings were supported by similar results from low-quality studies. The literature provides promising evidence for various strategies to improve surgical culture, although these approaches differ in terms of the interventions employed as well as the techniques used to measure culture. Nevertheless, culture improvement appears to be associated with other positive effects, including

  18. Maternity care services and culture: a systematic global mapping of interventions.

    Directory of Open Access Journals (Sweden)

    Ernestina Coast

    Full Text Available BACKGROUND: A vast body of global research shows that cultural factors affect the use of skilled maternity care services in diverse contexts. While interventions have sought to address this issue, the literature on these efforts has not been synthesised. This paper presents a systematic mapping of interventions that have been implemented to address cultural factors that affect women's use of skilled maternity care. It identifies and develops a map of the literature; describes the range of interventions, types of literature and study designs; and identifies knowledge gaps. METHODS AND FINDINGS: Searches conducted systematically in ten electronic databases and two websites for literature published between 01/01/1990 and 28/02/2013 were combined with expert-recommended references. Potentially eligible literature included journal articles and grey literature published in English, French or Spanish. Items were screened against inclusion and exclusion criteria, yielding 96 items in the final map. Data extracted from the full text documents are presented in tables and a narrative synthesis. The results show that a diverse range of interventions has been implemented in 35 countries to address cultural factors that affect the use of skilled maternity care. Items are classified as follows: (1 service delivery models; (2 service provider interventions; (3 health education interventions; (4 participatory approaches; and (5 mental health interventions. CONCLUSIONS: The map provides a rich source of information on interventions attempted in diverse settings that might have relevance elsewhere. A range of literature was identified, from narrative descriptions of interventions to studies using randomised controlled trials to evaluate impact. Only 23 items describe studies that aim to measure intervention impact through the use of experimental or observational-analytic designs. Based on the findings, we identify avenues for further research in order to better

  19. "Can you keep it real?" : Practical, and culturally tailored lifestyle recommendations by Mexican American women diagnosed with type 2 diabetes: A qualitative study.

    Science.gov (United States)

    Benavides-Vaello, Sandra; Brown, Sharon A; Vandermause, Roxanne

    2017-01-01

    The purpose of this article is to engage clinicians in a dialogue about ideas on how to provide more specific, contextually relevant, practical and culturally tailored diabetes self-management recommendations as suggested by Mexican-American women diagnosed with type 2 diabetes. Current diabetes self-management recommendations, targeting Mexican Americans in particular, remain largely broad ("reduce your calorie intake" or "cut back on carbs"), overly ambitious ("stop eating tortillas"), and relatively ineffective (Svedbo Engström et al., BMJ Open 6(3):e010249, 2016; Johansson et al., Int J Qual Stud Health Well-being 11, 2016; Oomen et al., The Diabetes Educ 25:220-225, 1999; Franek, Ont Health Technol Assess Ser 13(9):1-60, 2013; Purnell et al. Patient 9:349, 2016). A secondary and focused analysis (N = 12) was performed on data gathered from a larger qualitative study (N = 16), which explored diabetes among Mexican-American women residing in rural South Texas. Findings from the secondary analysis were that study informants elicited more realistic or contextually relevant, specific self-management strategies that reflected the cognitive, emotive, and behavioral areas but were reframed within the context of the Mexican-American culture. Self-management strategies fell into the categories of: (a) environmental controls, (b) avoiding overeating, (c) lifestyle changes, (d) cooking tips, and (e) active self-management. Diabetes remains a serious health threat to Mexican Americans, women in particular. Few individuals attain glycemic control, likely due in part to the disconnect between global and non-contextual self-management recommendations offered by health care providers and the need for more detailed and realistic guidance required for the day-to-day self-management of diabetes.

  20. Tailored multifactorial intervention to improve dizziness symptoms and quality of life, balance and gait in dizziness sufferers aged over 50 years: protocol for a randomised controlled trial.

    Science.gov (United States)

    Menant, Jasmine C; Migliaccio, Americo A; Hicks, Cameron; Lo, Joanne; Meinrath, Daniela; Ratanapongleka, Mayna; Turner, Jessica; Sturnieks, Daina L; Delbaere, Kim; Titov, Nickolai; McVeigh, Catherine; Close, Jacqueline C T; Lord, Stephen R

    2017-02-15

    Dizziness is a frequently reported symptom in older people that can markedly impair quality of life. This manuscript presents the protocol for a randomised controlled trial, which has the main objective of determining the impact of comprehensive assessment followed by a tailored multifaceted intervention in reducing dizziness episodes and symptoms, improving associated impairments to balance and gait and enhancing quality of life in older people with self-reported significant dizziness. Three hundred people aged 50 years or older, reporting significant dizziness in the past year will be recruited to participate in the trial. Participants allocated to the intervention group will receive a tailored, multifaceted intervention aimed at treating their dizziness symptoms over a 6 month trial period. Control participants will receive usual care. The primary outcome measures will be the frequency and duration of dizziness episodes, dizziness symptoms assessed with the Dizziness Handicap Inventory, choice-stepping reaction time and step time variability. Secondary outcomes will include health-related quality of life measures, depression and anxiety symptoms, concern about falling, balance and risk of falls assessed with the physiological fall risk assessment. Analyses will be by intention-to-treat. The study will determine the effectiveness of comprehensive assessment, combined with a tailored, multifaceted intervention on dizziness episodes and symptoms, balance and gait control and quality of life in older people experiencing dizziness. Clinical implications will be evident for the older population for the diagnosis and treatment of dizziness. The study is registered with the Australia New Zealand Clinical Trials Registry ACTRN12612000379819 .

  1. Weight-loss interventions for Hispanic populations: the role of culture.

    Science.gov (United States)

    Lindberg, Nangel M; Stevens, Victor J; Halperin, Ruben O

    2013-01-01

    In the United States, ethnic minorities are overrepresented among the overweight and obese population, with Hispanic individuals being among the groups most at risk for obesity and obesity-related disease and disability. Most weight-loss interventions designed for the general population have been less successful with individuals from ethnic minorities and there is a pressing need to develop more effective interventions for these groups. This paper examines the importance of culture in the development of "culturally competent" weight-loss interventions for ethnic minority populations, and discusses specific culturally mediated factors that should be considered in the design and implementation of treatment interventions. While specifically focusing on Hispanic populations, we also address issues of relevance to other multiethnic societies.

  2. Community engagement approach: developing a culturally appropriate intervention for Hispanic mother-child dyads.

    Science.gov (United States)

    Bender, Melinda S; Clark, Mary Jo; Gahagan, Sheila

    2014-10-01

    Childhood obesity affects approximately 20% of U.S. preschool children. Early prevention is needed to reduce young children's risks for obesity, especially among Hispanic preschool children who have one of the highest rates of obesity. Vida Saludable was an early childhood obesity intervention designed to be culturally appropriate for low-income Hispanic mothers with preschool children to improve maternal physical activity and reduce children's sugar-sweetened beverage consumption. It was conducted at a large southwestern United States urban health center. Presented here are the methods and rationale employed to develop and culturally adapt Vida Saludable, followed by scoring and ranking of the intervention's cultural adaptations. An empowered community helped design the customized, culturally relevant program via a collaborative partnership between two academic research institutions, a community health center, and stakeholders. Improved health behaviors in the participants may be attributed in part to this community-engagement approach. The intervention's cultural adaptations were scored and received a high comprehensive rank. Postprogram evaluation of the intervention indicated participant satisfaction. The information presented provides investigators with guidelines, a template, and a scoring tool for developing, implementing, and evaluating culturally adapted interventions for ethnically diverse populations. © The Author(s) 2014.

  3. Developing a Culturally Appropriate HIV and Hepatitis C Prevention Intervention for Latino Criminal Justice Clients.

    Science.gov (United States)

    Ibañez, Gladys E; Whitt, Elaine; Rosa, Mario de la; Martin, Steve; O'Connell, Daniel; Castro, Jose

    2016-07-01

    The population within the criminal justice system suffers from various health disparities including HIV and hepatitis C virus (HCV). African American and Latino offenders represent the majority of the offender population. Evidence-based interventions to prevent HIV and HCV among criminal justice clients are scant and usually do not take cultural differences into account. Toward this end, this study describes the process of culturally adapting an HIV/HCV prevention intervention for Latino criminal justice clients in Miami, Florida, by using the ecological validity model. Recommendations for culturally adapting an intervention for Latinos include an emphasis on language and integrating cultural themes such as familism and machismo. © The Author(s) 2016.

  4. Gaining Cultural Intelligence through Second Life Learning Interventions

    Directory of Open Access Journals (Sweden)

    Sarah Ellin Siegel

    2010-08-01

    Full Text Available Companies’ investment in international assignments remains essential, but is affordable for only relatively few employees. In today’s global economy, many employees must gain cultural intelligence. Encyclopedic web sites and smart game simulations are ill-equipped to offer the live, authentic immersive experience of Virtual World environments; learning from colleagues who are country-natives through interacting with them in a Virtual World like Second Life is the next best thing to being there, and it requires no travel. Virtual world learning sessions with local ambassadors are affordable on a massive scale compared with international assignments. In addition, through Virtual World experiences, international assignees can be more effective with colleagues from their assigned countries prior to boarding planes, even prior to Day 1 of the assignment. This research proposal, including a literature review and a research design, asks, and begins to answer: What can cultural intelligence learning in Second Life achieve or advance that cultural intelligence learning in real-life within the cultures, smart game simulations and encyclopedic, self-service web sites cannot as readily?

  5. Tough love: A brief cultural history of the addiction intervention.

    Science.gov (United States)

    Clark, Claire D

    2012-08-01

    Popular media depictions of intervention and associated confrontational therapies often implicitly reference-and sometimes explicitly present-dated and discredited therapeutic practices. Furthermore, rather than reenacting these practices, contemporary televised interventions revive them. Drawing on a range of literature in family history, psychology, and media studies that covers the course of the last 3 decades, this paper argues that competing discourses about the nuclear family enabled this revival. Historians such as Stephanie Coontz, Elaine Tyler May, and Natasha Zaretsky have demonstrated that the ideal nuclear family in the post-WWII United States was defined by strictly gendered roles for parents and appropriate levels of parental engagement with children. These qualities were supposedly strongly associated with middle-class decorum and material comfort. By the 1970s, this familial ideal was subjected to a variety of criticisms, most notably from mental health practitioners who studied-or attempted to remedy-the problematic family dynamics that arose from, for example, anxious mothers or absent fathers. After psychological professionals began to question the logic of treating maladjusted individuals for the sake of preserving the nuclear family, a therapeutic process for doing exactly that was popularized: the addiction intervention. The delayed prevalence of therapeutic interventions arises from a tension between the psychological establishment that increasingly viewed the nuclear family as the primary site and source of social and psychological ills, and the producers of popular media, who relied on the redemptive myth of the nuclear family as a source of drama. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  6. Influence of Recruitment Strategy on the Reach and Effect of a Web-Based Multiple Tailored Smoking Cessation Intervention among Dutch Adult Smokers

    Science.gov (United States)

    Smit, Eline Suzanne; Hoving, Ciska; Cox, Vincent Cornelis Maria; de Vries, Hein

    2012-01-01

    This study investigated the influence of two different recruitment strategies on the reach and effect of a web-based multiple tailored smoking cessation program. From May 2009 until June 2010, Dutch adult smokers were recruited via mass media or general practices. Those who completed the baseline questionnaire were followed up during 6 weeks (two…

  7. Comparison of use and appreciation of a print-delivered versus CD-ROM-delivered, computer-tailored intervention targeting saturated fat intake: Randomized controlled trial

    NARCIS (Netherlands)

    W. Kroeze (Willemieke); A. Oenema (Anke); M.K. Campbell (Marci); J. Brug (Hans)

    2008-01-01

    textabstractBackground: Computer-tailored health education, a promising health education technique, is increasingly being delivered interactively, for example, over the Internet. It has been suggested that there may be differences in use and appreciation between print and interactive delivery of com

  8. Comparison of use and appreciation of a print-delivered versus CD-ROM-delivered, computer-tailored intervention targeting saturated fat intake: Randomized controlled trial

    NARCIS (Netherlands)

    W. Kroeze (Willemieke); A. Oenema (Anke); M.K. Campbell (Marci); J. Brug (Hans)

    2008-01-01

    textabstractBackground: Computer-tailored health education, a promising health education technique, is increasingly being delivered interactively, for example, over the Internet. It has been suggested that there may be differences in use and appreciation between print and interactive delivery of

  9. The contribution of qualitative research to the development of tailor-made community-based interventions in primary care: a review

    NARCIS (Netherlands)

    Y.J.F.M. Jansen (Yvonne); M.M.E. Foets (Marleen); A.A. de Bont (Antoinette)

    2009-01-01

    textabstractBACKGROUND: In recent years, a trend in the use of tailor-made approaches and pragmatic trial methodology for evaluating effectiveness has been visible in programs ranging from large-scale national health prevention campaigns to community-based initiatives. Qualitative research is used m

  10. Impact of a continuing professional development intervention on midwifery academics' awareness of cultural safety.

    Science.gov (United States)

    Fleming, Tania; Creedy, Debra K; West, Roianne

    2017-06-01

    Cultural safety in higher education learning and teaching environments is paramount to positive educational outcomes for Aboriginal and/or Torres Strait Islander (hereafter called First Peoples) students. There is a lack of research evaluating the impact of continuing professional development on midwifery academics' awareness of cultural safety. To implement and evaluate a continuing professional development intervention to improve midwifery academics' awareness of cultural safety in supporting First Peoples midwifery students success. A pre-post intervention mixed methods design was used. Academics (n=13) teaching into a Bachelor of Midwifery program agreed to participate. The intervention consisted of two workshops and five yarning circles across a semester. Data included the Awareness of Cultural Safety Scale, self-assessment on cultural safety and perceptions of racism, evaluation of the intervention, participants' journal entries, and researcher's reflections. Responses on the Awareness of Cultural Safety Scale revealed significant improvement in participants' awareness of cultural safety. There was an upward trend in self-assessment ratings. Participants reported high levels of satisfaction with the intervention or workshops and yarning circles. Participants' journal entries revealed themes willingness to participate and learn, confidence as well as anger and distress. Increased awareness of cultural safety can be transformative for midwifery academics. Workshops and yarning circles can support academics in moving beyond a 'sense of paralysis' and engage in challenging conversations to transform their learning and teaching and in turn foster a culturally safe learning and teaching environment for First Peoples midwifery students towards success. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  11. Usability of a Culturally Informed mHealth Intervention for Symptoms of Anxiety and Depression: Feedback From Young Sexual Minority Men

    Science.gov (United States)

    Hill, Yvette N; Burns, Michelle Nicole

    2017-01-01

    Background To date, we are aware of no interventions for anxiety and depression developed as mobile phone apps and tailored to young sexual minority men, a group especially at risk of anxiety and depression. We developed TODAY!, a culturally informed mobile phone intervention for young men who are attracted to men and who have clinically significant symptoms of anxiety or depression. The core of the intervention consists of daily psychoeducation informed by transdiagnostic cognitive behavioral therapy (CBT) and a set of tools to facilitate putting these concepts into action, with regular mood ratings that result in tailored feedback (eg, tips for current distress and visualizations of mood by context). Objective The aim of this study was to conduct usability testing to understand how young sexual minority men interact with the app, to inform later stages of intervention development. Methods Participants (n=9) were young sexual minority men aged 18-20 years (Mean=19.00, standard deviation [SD]=0.71; 44% black, 44% white, and 11.1% Latino), who endorsed at least mild depression and anxiety symptoms. Participants were recruited via flyers, emails to college lesbian, gay, bisexual, and transgender (LGBT) organizations, Web-based advertisements, another researcher’s database of sexual minority youth interested in research participation, and word of mouth. During recorded interviews, participants were asked to think out loud while interacting with the TODAY! app on a mobile phone or with paper prototypes. Feedback identified from these recordings and from associated field notes were subjected to thematic analysis using a general inductive approach. To aid interpretation of results, methods and results are reported according to the consolidated criteria for reporting qualitative research (COREQ). Results Thematic analysis of usability feedback revealed a theme of general positive feedback, as well as six recurring themes that informed continued development: (1

  12. Organizational culture change in U.S. hospitals: a mixed methods longitudinal intervention study.

    Science.gov (United States)

    Curry, Leslie A; Linnander, Erika L; Brewster, Amanda L; Ting, Henry; Krumholz, Harlan M; Bradley, Elizabeth H

    2015-03-07

    Improving outcomes for patients with acute myocardial infarction (AMI) is a priority for hospital leadership, clinicians, and policymakers. Evidence suggests links between hospital organizational culture and hospital performance; however, few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with AMI. We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL). This manuscript describes the methodology of LSL, a 2-year intervention study using a concurrent mixed methods design, guided by open systems theory and the Assess, Innovate, Develop, Engage, Devolve (AIDED) model of diffusion, implemented in 10 U.S. hospitals and their peer hospital networks. The intervention has three primary components: 1) annual convenings of the ten intervention hospitals; 2) semiannual workshops with guiding coalitions at each hospital; and 3) continuous remote support across all intervention hospitals through a web-based platform. Primary outcomes include 1) shifts in key dimensions of hospital organizational culture associated with lower mortality rates for patients with AMI; 2) use of targeted evidence-based practices associated with lower mortality rates for patients with AMI; and 3) in-hospital AMI mortality. Quantitative data include annual surveys of guiding coalition members in the intervention hospitals and peer network hospitals. Qualitative data include in-person, in-depth interviews with all guiding coalition members and selective observations of key interactions in care for patients with AMI, collected at three time points. Data integration will identify patterns and major themes in change processes across all intervention hospitals over time. LSL is novel in its use of a longitudinal mixed methods approach in a diverse sample of hospitals, its focus on objective outcome measures of mortality, and its

  13. A pilot study: the development of a culturally tailored Malaysian Diabetes Education Module (MY-DEMO) based on the Health Belief Model

    National Research Council Canada - National Science Library

    Ahmad, Badariah; Ramadas, Amutha; Kia Fatt, Quek; Md Zain, Anuar Zaini

    2014-01-01

    .... Contrastingly, few structured and validated diabetes modules are available in Malaysia. This pilot study aims to develop and validate diabetes education material suitable and tailored for a multicultural society like Malaysia...

  14. American Indian culture as substance abuse treatment: pursuing evidence for a local intervention.

    Science.gov (United States)

    Gone, Joseph P; Looking, Patrick E Calf

    2011-01-01

    Contemporary tribal commitments to traditional cultural reclamation and revitalization find continued expression by recent generational cohorts of American Indians who, when it comes to matters of recovery, healing, and wellness in the context of substance abuse, routinely assert that "our culture is our treatment." And yet, empirical investigations of this culture-as-treatment hypothesis--namely, that a (post)colonial return to indigenous cultural orientations and practices is sufficient for effecting abstinence and recovery from substance use disorders for many American Indians--have yet to appear in the scientific literature. Preliminary activities of a research partnership dedicated to the empirical exploration of this hypothesis for reducing Native American substance use disorders are summarized. Specifically, collaboration between a university-based research psychologist and a reservation-based substance abuse treatment program staff has thus far resulted in a detailed blueprint for a radically alternative, culturally-grounded intervention developed for reservation residents. This proposed alternative intervention--a seasonal cultural immersion camp designed to approximate the day-to-day experiences of prereservation ancestors--was designed for eventual implementation and evaluation with adult clients referred for residential treatment on the Blackfeet Indian reservation. It is anticipated that the proposed intervention will eventually afford empirical evaluation of the culture-as-treatment hypothesis.

  15. An economic evaluation alongside a randomized controlled trial evaluating an individually tailored lifestyle intervention compared with usual care in people with Familial Hypercholesterolemia

    NARCIS (Netherlands)

    Broekhuizen, K.; Wier, M.F. van; Koppes, L.L.J.; Brug, J.; Mechelen, W. van; Bosmans, J.E.; Poppel, M.N.

    2015-01-01

    Background: Cost-effectiveness analyses provide insight in the use of lifestyle interventions. To evaluate the cost-effectiveness of a lifestyle intervention compared to usual care in people with Familial Hypercholesterolemia, 340 people with FH were randomized to the intervention or control group.

  16. An economic evaluation alongside a randomized controlled trial evaluating an individually tailored lifestyle intervention compared with usual care in people with Familial Hypercholesterolemia.

    NARCIS (Netherlands)

    Broekhuizen, K.; Wier, M.F. van; Koppes, L.L.J.; Brug, J.; Mechelen, W. van; Bosmans, J.E.; Poppel, M.N.M. van

    2015-01-01

    Background: Cost-effectiveness analyses provide insight in the use of lifestyle interventions. To evaluate the cost-effectiveness of a lifestyle intervention compared to usual care in people with Familial Hypercholesterolemia, 340 people with FH were randomized to the intervention or control group.

  17. An economic evaluation alongside a randomized controlled trial evaluating an individually tailored lifestyle intervention compared with usual care in people with Familial Hypercholesterolemia

    NARCIS (Netherlands)

    Broekhuizen, K.; Wier, M.F. van; Koppes, L.L.J.; Brug, J.; Mechelen, W. van; Bosmans, J.E.; Poppel, M.N.

    2015-01-01

    Background: Cost-effectiveness analyses provide insight in the use of lifestyle interventions. To evaluate the cost-effectiveness of a lifestyle intervention compared to usual care in people with Familial Hypercholesterolemia, 340 people with FH were randomized to the intervention or control group.

  18. Evaluation of an intervention to improve blood culture practices: a cluster randomised trial.

    Science.gov (United States)

    Pavese, P; Maillet, M; Vitrat-Hincky, V; Recule, C; Vittoz, J-P; Guyomard, A; Seigneurin, A; François, P

    2014-12-01

    This study aimed to evaluate an intervention to improve blood culture practices. A cluster randomised trial in two parallel groups was performed at the Grenoble University Hospital, France. In October 2009, the results of a practices audit and the guidelines for the optimal use of blood cultures were disseminated to clinical departments. We compared two types of information dissemination: simple presentation or presentation associated with an infectious diseases (ID) specialist intervention. The principal endpoint was blood culture performance measured by the rate of patients having one positive blood culture and the rate of positive blood cultures. The cases of 130 patients in the "ID" group and 119 patients in the "simple presentation" group were audited during the second audit in April 2010. The rate of patients with one positive blood culture increased in both groups (13.62 % vs 9.89 % for the ID group, p = 0.002, 15.90 % vs 13.47 % for the simple presentation group, p = 0.009). The rate of positive blood cultures improved in both groups (6.68 % vs 5.96 % for the ID group, p = 0.003, 6.52 % vs 6.21 % for the simple presentation group, p = 0.017). The blood culture indication was significantly less often specified in the request form in the simple presentation group, while it remained stable in the ID group (p = 0.04). The rate of positive blood cultures and the rate of patients having one positive blood culture improved in both groups. The ID specialist intervention did not have more of an impact on practices than a simple presentation of audit feedback and guidelines.

  19. Intervention in Multi-cultural Organizatioons - Prevention of accidents as political change processes

    DEFF Research Database (Denmark)

    Dyhrberg, Mette Bang

    1999-01-01

    workplaces and the contribution communicates ongoing work with such a method, including political, cultural and structural elements. A selective study of literature within safety culture, corporate culture and organisational theory has shown that the safety culture approach can benefit from...... the organisational culture approaches of Alvesson and Geertz and organisational theory dealing with political processes (Pettigrew, Knights). The implicit models of organisation and man within mainstream safety culture approaches seems to be too rationalistic compared with day to day life of organisations....... The concept of a multicultural organisation thus aims at encompassing the multitude of actor positions within an organisation with a possible influence on the preventive work. The planning of the intervention is furthermore not made once in the beginning but should rather be anticipated as an ongoing...

  20. Intervention in Multi-cultural Organizatioons - Prevention of accidents as political change processes

    DEFF Research Database (Denmark)

    Dyhrberg, Mette Bang

    1999-01-01

    workplaces and the contribution communicates ongoing work with such a method, including political, cultural and structural elements. A selective study of literature within safety culture, corporate culture and organisational theory has shown that the safety culture approach can benefit from...... the organisational culture approaches of Alvesson and Geertz and organisational theory dealing with political processes (Pettigrew, Knights). The implicit models of organisation and man within mainstream safety culture approaches seems to be too rationalistic compared with day to day life of organisations....... The concept of a multicultural organisation thus aims at encompassing the multitude of actor positions within an organisation with a possible influence on the preventive work. The planning of the intervention is furthermore not made once in the beginning but should rather be anticipated as an ongoing...

  1. Was cultural deprivation in fact sensory deprivation? Deprivation, retardation and intervention in the USA.

    Science.gov (United States)

    Raz, Mical

    2011-01-01

    In the 1950s, the term "deprivation" entered American psychiatric discourse. This article examines how the concept of deprivation permeated the field of mental retardation, and became an accepted theory of etiology. It focuses on sensory deprivation and cultural deprivation, and analyzes the interventions developed, based on these theories. It argues that the controversial theory of cultural deprivation derived its scientific legitimization from the theory of sensory deprivation, and was a highly politicized concept that took part in the nature-nurture debate.

  2. Interventions to nurture excellence in the nursing home culture.

    Science.gov (United States)

    Deutschman, M

    2001-08-01

    There is no one formula for culcure change. A joint steering committee of staff members can develop plans that will build trust, address each other as equals, and drive out fear as they move the process of change. Training and sharing information help staff recognize this is a process, not an event. New well-screened team members need training to integrate them into the culture. It is important to identify the knowledge and expertise of team members to maximize their energies and talents. Recruitment and retention of those who share the values of this culture are of paramount importance. It is worth the time and effort to secure commitment to these values. One example of this effort is a facility in Pennsylvania that, at its worst, had two thirds of its staff turnover in a year. The national average was 82% in 1995, an increase from 71.5% the year before. They were able to reduce their turnover rate to 27% by examining the hiring records and finding that workers with certain personality traits and attitudes were less likely to leave. They looked for compassion and communication skills, perceptions of older adults, ability to cope with death and dying, and ability to handle the unpleasant tasks of residene hygiene and bathroom visits. Current staff members determined and voted on best fit of candidates (Montague, 1997). Although training and evaluation are an important component of retention and commitment to values in any organization, training and evaluation of nursing home employees may be quite different from other employment. A nurse in a nursing home needs to be evaluated not only on clinical skills, but on communication skills, attitude, and leadership (Meyer, 1995). Then training and employee development programs can be targeted to specific areas for corrective action. What is taught in training and what occurs on the job should correspond, or role conflict occurs increasing the likelihood of turnover (Steffen, Nystrom, O'Connor, 1996). Although occasional

  3. The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review

    Directory of Open Access Journals (Sweden)

    Zahra Salmani

    2015-07-01

    Full Text Available Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. Results: The majority of interventions (90% related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well

  4. Are Early Intervention Services Placing Home Languages and Cultures "At Risk"?

    Science.gov (United States)

    Puig, Victoria I.

    2010-01-01

    This position statement considers family languages, family cultures, and partnerships between family members and early intervention (EI) professionals as intimately interconnected and resources to be accessed when serving young children with special needs and their families. It presents theory and an overview of works that examine the impact of…

  5. The Ububele Baby Mat intervention: facilitating meaning in a multi-cultural context.

    Science.gov (United States)

    Nortje, Michelle

    2016-07-01

    This paper expands on the continuing understanding of the Ububele Baby Mat Project - a community-based parent-infant mental health intervention now offered at six primary healthcare clinics in Alexandra, Johannesburg. This paper describes the influence of cultural diversity and the complex layers of meaning-making involved in the Baby Mat intervention. Meaning-making is a collaborative process between the caregiver-infant dyad's cultural beliefs and experiences, the Baby Mat couple's relationship, knowledge and skills, and the additional minds of the multicultural supervision group. This paper aims to clarify these three layers of co-constructed meaning-making involved in the Baby Mat intervention. Three central themes are thus presented to discuss the impact of multi-cultural, multi-racial and multi-lingual therapeutic dyads on the process of the Baby Mat intervention. These core themes are the verbal and non-verbal meanings of presenting problems brought by caregiver-infant dyads; the value and obstacles involved within a cross-cultural baby mat couple; and the significance of a reflective group supervision space. Case extracts are used to illustrate these processes of multiple minds at play during a Baby Mat session.

  6. Suicidal, Abused African American Women's Response to a Culturally Informed Intervention

    Science.gov (United States)

    Kaslow, Nadine J.; Leiner, Amy S.; Reviere, Susan; Jackson, Emily; Bethea, Kafi; Bhaju, Jeshmin; Rhodes, Miesha; Gantt, Min-Jung; Senter, Herman; Thompson, Martie P.

    2010-01-01

    Objective: This study examined (a) the efficacy of a manualized, culturally informed, empowerment-focused psychoeducational group intervention (Nia) designed in accord with the theory of triadic influence or treatment as usual (TAU) for reducing psychological symptomatology (suicidal ideation, depressive symptoms, posttraumatic stress symptoms,…

  7. Cultural Competence in a Group Intervention Designed for Latino Patients Living with HIV/AIDS

    Science.gov (United States)

    Acevedo, Vanessa

    2008-01-01

    Although the trajectory of the HIV/AIDS epidemic has changed dramatically over the past 25 years, addressing the psychosocial needs of patients living with HIV/AIDS remains vital. Ensuring the effective delivery of services demands that interventions be rooted in cultural competence and aimed at vulnerable populations. This article describes a…

  8. 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

    Directory of Open Access Journals (Sweden)

    Fanshawe Tom

    2011-04-01

    Full Text Available Abstract Background The increasing prevalence of type 2 diabetes poses both clinical and public health challenges. Cost-effective approaches to prevent progression of the disease in primary care are needed. Evidence suggests that intensive multifactorial interventions including medication and behaviour change can significantly reduce cardiovascular morbidity and mortality among patients with established type 2 diabetes, and that patient education in self-management can improve short-term outcomes. However, existing studies cannot isolate the effects of behavioural interventions promoting self-care from other aspects of intensive primary care management. The ADDITION-Plus trial was designed to address these issues among recently diagnosed patients in primary care over one year. Methods/Design ADDITION-Plus is an explanatory randomised controlled trial of a facilitator-led, theory-based behaviour change intervention tailored to individuals with recently diagnosed type 2 diabetes. 34 practices in the East Anglia region participated. 478 patients with diabetes were individually randomised to receive (i intensive treatment alone (n = 239, or (ii intensive treatment plus the facilitator-led individual behaviour change intervention (n = 239. Facilitators taught patients key skills to facilitate change and maintenance of key behaviours (physical activity, dietary change, medication adherence and smoking, including goal setting, action planning, self-monitoring and building habits. The intervention was delivered over one year at the participant's surgery and included a one-hour introductory meeting followed by six 30-minute meetings and four brief telephone calls. Primary endpoints are physical activity energy expenditure (assessed by individually calibrated heart rate monitoring and movement sensing, change in objectively measured dietary intake (plasma vitamin C, medication adherence (plasma drug levels, and smoking status (plasma cotinine levels at

  9. A culturally adapted depression intervention for African American adults experiencing depression: Oh Happy Day.

    Science.gov (United States)

    Ward, Earlise C; Brown, Roger L

    2015-01-01

    The purpose of this article is to describe development of a culturally adapted depression intervention (Oh Happy Day Class, OHDC) designed for African American adults experiencing major depressive disorder (MDD). This project included 2 pilot studies testing the feasibility and acceptability of the OHDC and examining short-term effects of the OHDC in reducing symptoms of MDD. The OHDC is a 2.5-hr weekly, culturally specific, cognitive behavioral, group counseling intervention for 12 weeks. Cultural adaptations of the OHDC are based on the ecological validity and culturally sensitive framework, along with an Afrocentric paradigm. Fifty African American participants with MDD were enrolled (15 in Pilot I and 35 in Pilot II). All participants in Pilots I and II received the 12-week intervention and completed assessments at baseline, mid-intervention, end-intervention, and 3 months postintervention. General linear mixed modeling for assessment of pre-post longitudinal data analysis was conducted. Results for Pilot I showed 73% of participants completed the full OHDC, a statistically significant decline in depression symptoms from pre- to postintervention, and a 0.38 effect size. Participants were very satisfied with the OHDC. In Pilot II, 66% of participants completed the full OHDC, and there was a significant pre-post intervention decrease in depression symptoms. For men, the OHDC showed a 1.01 effect size and for women, a 0.41 effect size. Both men and women were very satisfied with the OHDC based on the satisfaction measure. These promising findings are discussed with a focus on future plans for examining efficacy of the OHDC in a large-scale, randomized, control trial.

  10. Translation of a tailored nutrition and resistance exercise intervention for elderly people to a real-life setting: adaptation process and pilot study.

    Science.gov (United States)

    van Dongen, Ellen Ji; Leerlooijer, Joanne N; Steijns, Jan M; Tieland, Michael; de Groot, Lisette Cpgm; Haveman-Nies, Annemien

    2017-01-18

    Combining increased dietary protein intake and resistance exercise training for elderly people is a promising strategy to prevent or counteract the loss of muscle mass and decrease the risk of disabilities. Using findings from controlled interventions in a real-life setting requires adaptations to the intervention and working procedures of healthcare professionals (HCPs). The aim of this study is to adapt an efficacious intervention for elderly people to a real-life setting (phase one) and test the feasibility and potential impact of this prototype intervention in practice in a pilot study (phase two). The Intervention Mapping approach was used to guide the adaptation in phase one. Qualitative data were collected from the original researchers, target group, and HCPs, and information was used to decide whether and how specified intervention elements needed to be adapted. In phase two, a one-group pre-test post-test pilot study was conducted (n = 25 community-dwelling elderly), to elicit further improvements to the prototype intervention. The evaluation included participant questionnaires and measurements at baseline (T0) and follow-up (T1), registration forms, interviews, and focus group discussions (T1). Qualitative data for both phases were analysed using an inductive approach. Outcome measures included physical functioning, strength, body composition, and dietary intake. Change in outcomes was assessed using Wilcoxon signed-rank tests. The most important adaptations to the original intervention were the design of HCP training and extending the original protein supplementation with a broader nutrition programme aimed at increasing protein intake, facilitated by a dietician. Although the prototype intervention was appreciated by participants and professionals, and perceived applicable for implementation, the pilot study process evaluation resulted in further adaptations, mostly concerning recruitment, training session guidance, and the nutrition programme

  11. Evaluation of a Cultural Competence Intervention with Implications for the Nurse-Patient Encounter

    Science.gov (United States)

    Bradford, Althea Betty

    A short-term intervention on participants' knowledge of cultural competence was provided to 38 students in a baccalaureate nursing program at Winston-Salem State University (WSSU). The study examined the effectiveness of this intervention. Although WSSU is a Historically Black University, the majority of students in this program were White. Six tools were used for data collection. The Cultural Competence Survey consisted of 19 Likert Scale items that also gave participants an opportunity to elaborate on each response. Four tools allowed participants to provide written answers to prompts related to cultural competence. The final tool made it possible for the investigator to record impressions and reflections regarding various aspects of the study. Results showed that the students are familiar with cultural competence and want to avoid stereotypical behavior in their nurse-patient encounters. The study suggests a need for education in cultural competence in three areas: 1) accepting that cultural competence is a lifelong endeavor, 2) understanding patients from a holistic perspective, and 3) recognizing that all people have biases; however, the competent nurse is self-aware and has been educated to recognize biased behavior.

  12. A Mobile Phone App Intervention Targeting Fruit and Vegetable Consumption : The Efficacy of Textual and Auditory Tailored Health Information Tested in a Randomized Controlled Trial

    NARCIS (Netherlands)

    Elbert, Sarah Pietertje; Dijkstra, Arie; Oenema, Anke

    2016-01-01

    Background: Mobile phone apps are increasingly used to deliver health interventions, which provide the opportunity to present health information via different communication modes. However, scientific evidence regarding the effects of such health apps is scarce. Objective: In a randomized controlled

  13. Social marketing: approach to cultural and contextual relevance in a community-based physical activity intervention.

    Science.gov (United States)

    Keller, Colleen; Vega-López, Sonia; Ainsworth, Barbara; Nagle-Williams, Allison; Records, Kathie; Permana, Paska; Coonrod, Dean

    2014-03-01

    We report the social marketing strategies used for the design, recruitment and retention of participants in a community-based physical activity (PA) intervention, Madres para la Salud (Mothers for Health). The study example used to illustrate the use of social marketing is a 48-week prescribed walking program, Madres para la Salud (Mothers for Health), which tests a social support intervention to explore the effectiveness of a culturally specific program using 'bouts' of PA to effect the changes in body fat, fat tissue inflammation and postpartum depression symptoms in sedentary Hispanic women. Using the guidelines from the National Benchmark Criteria, we developed intervention, recruitment and retention strategies that reflect efforts to draw on community values, traditions and customs in intervention design, through partnership with community members. Most of the women enrolled in Madres para la Salud were born in Mexico, largely never or unemployed and resided among the highest crime neighborhoods with poor access to resources. We developed recruitment and retention strategies that characterized social marketing strategies that employed a culturally relevant, consumer driven and problem-specific design. Cost and benefit of program participation, consumer-derived motivation and segmentation strategies considered the development transition of the young Latinas as well as cultural and neighborhood barriers that impacted retention are described.

  14. Social marketing: approach to cultural and contextual relevance in a community-based physical activity intervention

    Science.gov (United States)

    Keller, Colleen; Vega-López, Sonia; Ainsworth, Barbara; Nagle-Williams, Allison; Records, Kathie; Permana, Paska; Coonrod, Dean

    2014-01-01

    We report the social marketing strategies used for the design, recruitment and retention of participants in a community-based physical activity (PA) intervention, Madres para la Salud (Mothers for Health). The study example used to illustrate the use of social marketing is a 48-week prescribed walking program, Madres para la Salud (Mothers for Health), which tests a social support intervention to explore the effectiveness of a culturally specific program using ‘bouts’ of PA to effect the changes in body fat, fat tissue inflammation and postpartum depression symptoms in sedentary Hispanic women. Using the guidelines from the National Benchmark Criteria, we developed intervention, recruitment and retention strategies that reflect efforts to draw on community values, traditions and customs in intervention design, through partnership with community members. Most of the women enrolled in Madres para la Salud were born in Mexico, largely never or unemployed and resided among the highest crime neighborhoods with poor access to resources. We developed recruitment and retention strategies that characterized social marketing strategies that employed a culturally relevant, consumer driven and problem-specific design. Cost and benefit of program participation, consumer-derived motivation and segmentation strategies considered the development transition of the young Latinas as well as cultural and neighborhood barriers that impacted retention are described. PMID:23002252

  15. [Effectiveness of intervention by the infection control team for cancer patients with a positive blood culture].

    Science.gov (United States)

    Yamada, Tomoyuki; Suzuki, Kaoru; Ohi, Yukimasa; Kawanishi, Fumiko; Shibata, Yuriko; Hosomi, Makoto; Goto, Emi; Nishihara, Masami; Katsumata, Takahiro; Ukimura, Akira

    2013-11-01

    Cancer patients at a high risk of acquiring infectious diseases should be maintained in a facility where good infection control practices are followed. At our hospital, the infection control team(ICT)provides expertise, education, and support to the staff, helping them maintain proper standards, thereby minimizing the risks of infection. The ICT(established in 2004)has implemented infection control programs by employing an appropriate number of staff members after the revision of medical treatment fees in 2011. Our intervention program includes 2 general policies, namely, ordering and collection of blood cultures and intervention for the medical care of patients with positive blood cultures. In this study, we evaluated the effectiveness of our intervention for cancer patients with a positive blood culture. During the surveillance period(April 2011 to July 2012), 42 positive cases were determined to be infectious. ICT intervention was required in 37 cases. Our suggestions were accepted in 92%(34/37)of the cases, and improved outcome was estimated in 65%(22/34)of the cases. The results of our study contribute to the scientific bases on which routine clinical practices could be promoted in the future.

  16. mHealth or eHealth? Efficacy, Use, and Appreciation of a Web-Based Computer-Tailored Physical Activity Intervention for Dutch Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Gomez Quiñonez, Stefanie; Walthouwer, Michel Jean Louis; Schulz, Daniela Nadine; de Vries, Hein

    2016-11-09

    Until a few years ago, Web-based computer-tailored interventions were almost exclusively delivered via computer (eHealth). However, nowadays, interventions delivered via mobile phones (mHealth) are an interesting alternative for health promotion, as they may more easily reach people 24/7. The first aim of this study was to compare the efficacy of an mHealth and an eHealth version of a Web-based computer-tailored physical activity intervention with a control group. The second aim was to assess potential differences in use and appreciation between the 2 versions. We collected data among 373 Dutch adults at 5 points in time (baseline, after 1 week, after 2 weeks, after 3 weeks, and after 6 months). We recruited participants from a Dutch online research panel and randomly assigned them to 1 of 3 conditions: eHealth (n=138), mHealth (n=108), or control condition (n=127). All participants were asked to complete questionnaires at the 5 points in time. Participants in the eHealth and mHealth group received fully automated tailored feedback messages about their current level of physical activity. Furthermore, they received personal feedback aimed at increasing their amount of physical activity when needed. We used analysis of variance and linear regression analyses to examine differences between the 2 study groups and the control group with regard to efficacy, use, and appreciation. Participants receiving feedback messages (eHealth and mHealth together) were significantly more physically active after 6 months than participants in the control group (B=8.48, df=2, P=.03, Cohen d=0.27). We found a small effect size favoring the eHealth condition over the control group (B=6.13, df=2, P=.09, Cohen d=0.21). The eHealth condition had lower dropout rates (117/138, 84.8%) than the mHealth condition (81/108, 75.0%) and the control group (91/127, 71.7%). Furthermore, in terms of usability and appreciation, the eHealth condition outperformed the mHealth condition with regard to

  17. Tailored information about cancer risk and screening: a systematic review.

    NARCIS (Netherlands)

    Albada, A.; Ausems, M.G.E.M.; Bensing, J.M.; Dulmen, S. van

    2009-01-01

    OBJECTIVE: To study interventions that provide people with information about cancer risk and about screening that is tailored to their personal characteristics. We assess the tailoring characteristics, theory base and effects on risk perception, knowledge and screening behavior of these intervention

  18. Nurses' competency in drawing blood cultures and educational intervention to reduce the contamination rate.

    Science.gov (United States)

    Al-Hamad, Arif; Al-Ibrahim, Maha; Alhajhouj, Eman; Al-Alshaikh Jaffer, Waseelah; Altowaileb, Jaffar; Alfaraj, Hassan

    2016-01-01

    Compared with truly negative cultures, false positive blood cultures (BCs) not only increase laboratory work but also prolong the lengths of patient stays, which are likely to increase patient morbidity and costs. The present study aimed to evaluate the effectiveness of a hospital-wide educational intervention on BC contamination rates. Nurses performed all phlebotomies; therefore, educational workshops were offered to all nurses twice a week over a 3-month period. The workshops consisted of a questionnaire, PowerPoint presentation, video show, demonstration of the different materials used to collect BCs, and question session. Data from the questionnaires and laboratory culture results were compared between the 6-month pre- and post-intervention periods. Of the 503 eligible nurses, 216 (42.9%) attended the workshops. The survey identified areas for improvement, which included time of disinfectant application, volume of blood to be cultured, and disinfection of BC bottle tops. Of the 9903 BC sets that were drawn from 3649 patients during the study period, 676 (6.8%) were contaminated. The monthly BC contamination rates for the 6-month pre- and post-intervention periods were 8.1% and 5.2%, respectively, representing a 36% reduction (P=0.008). Only three wards had an acceptable contamination rate of ≤3% before the intervention, compared with eight wards after the intervention. While contamination of BCs can never be completely eliminated, there is evidence that adherence to best practice BC collection techniques can minimize BC contamination, which might be best achieved with a dedicated phlebotomy team.

  19. Qualitative feedback from a text messaging intervention for depression: benefits, drawbacks, and cultural differences.

    Science.gov (United States)

    Aguilera, Adrian; Berridge, Clara

    2014-11-05

    Mobile health interventions are often standardized and assumed to work the same for all users; however, we may be missing cultural differences in the experiences of interventions that may impact how and if an intervention is effective. The objective of the study was to assess qualitative feedback from participants to determine if there were differences between Spanish speakers and English speakers. Daily text messages were sent to patients as an adjunct to group Cognitive Behavioral Therapy (CBT) for depression. Messages inquired about mood and about specific themes (thoughts, activities, social interactions) of a manualized group CBT intervention. There were thirty-nine patients who participated in the text messaging pilot study. The average age of the participants was 53 years (SD 10.4; range of 23-72). Qualitative feedback from Spanish speakers highlighted feelings of social support, whereas English speakers noted increased introspection and self-awareness of their mood state. These cultural differences should be explored further, as they may impact the effect of supportive mobile health interventions. Clinicaltrials.gov NCT01083628; http://clinicaltrials.gov/ct2/show/study/NCT01083628 (Archived by WebCite at http://www.webcitation.org/6StpbdHuq).

  20. Development and preliminary evaluation of culturally specific web-based intervention for parents of adolescents.

    Science.gov (United States)

    Choi, H; Kim, S; Ko, H; Kim, Y; Park, C G

    2016-10-01

    WHAT IS KNOWN ON THE SUBJECT?: Problematic parent-child relationships have been identified as one of the main predictors of adolescents' mental health problems, but there are few existing interventions that address this issue. The format and delivery method of existing interventions for parents are relatively inaccessible for parents with full-time jobs and families living in rural areas. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The newly developed 'Stepping Stone' culturally specific web-based intervention, which is intended to help Korean parents of adolescents to acquire both knowledge and communication and conflict management skills, was found to be feasible and well-accepted by parents. This study enabled us to identify areas for improvement in the content and format of the intervention and strategies. This will potentially increase effect sizes for the outcome variables of parents' perception and behaviours. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This web-based intervention could be delivered across diverse settings, such as schools and community mental health centers, to increase parents' knowledge of adolescent's mental health and allow for early detection of mental health problems. Mental health nurses working in schools may spend a significant amount of time addressing students' mental health issues; thus, this web-based intervention could be a useful resource to share with parents and children. In this way, the mental health nurses could facilitate parental engagement in the intervention and then help them to continue to apply and practice the knowledge and skills obtained through the program. Introduction There is a need for accessible, culturally specific web-based interventions to address parent-child relationships and adolescents' mental health. Aims This study developed and conducted a preliminary evaluation of a 4-week web-based intervention for parents of adolescents aged 11 to 16 years in Korea. Methods We used a two-group, repeated

  1. Cultural Adaptation of Minimally Guided Interventions for Common Mental Disorders: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Heim, Eva; Chowdhary, Neerja; Maercker, Andreas; Albanese, Emiliano

    2016-01-01

    Background Cultural adaptation of mental health care interventions is key, particularly when there is little or no therapist interaction. There is little published information on the methods of adaptation of bibliotherapy and e-mental health interventions. Objective To systematically search for evidence of the effectiveness of minimally guided interventions for the treatment of common mental disorders among culturally diverse people with common mental disorders; to analyze the extent and effects of cultural adaptation of minimally guided interventions for the treatment of common mental disorders. Methods We searched Embase, PubMed, the Cochrane Library, and PsycINFO for randomized controlled trials that tested the efficacy of minimally guided or self-help interventions for depression or anxiety among culturally diverse populations. We calculated pooled standardized mean differences using a random-effects model. In addition, we administered a questionnaire to the authors of primary studies to assess the cultural adaptation methods used in the included primary studies. We entered this information into a meta-regression to investigate effects of the extent of adaptation on intervention efficacy. Results We included eight randomized controlled trials (RCTs) out of the 4911 potentially eligible records identified by the search: four on e-mental health and four on bibliotherapy. The extent of cultural adaptation varied across the studies, with language translation and use of metaphors being the most frequently applied elements of adaptation. The pooled standardized mean difference for primary outcome measures of depression and anxiety was -0.81 (95% CI -0.10 to -0.62). Higher cultural adaptation scores were significantly associated with greater effect sizes (P=.04). Conclusions Our results support the results of previous systematic reviews on the cultural adaptation of face-to-face interventions: the extent of cultural adaptation has an effect on intervention efficacy

  2. Effects of patient safety culture interventions on incident reporting in general practice : A cluster randomised trial a cluster randomised trial

    NARCIS (Netherlands)

    Verbakel, Natasha J.; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M

    2015-01-01

    Background: A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim: To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting: A three-arm cluster randomised trial

  3. Evaluation of an intervention on socio cultural communication skills of international nurses.

    Science.gov (United States)

    Xu, Yu; Shen, Jay; Bolstad, Anne L; Covelli, Margaret; Torpey, Miriam

    2010-01-01

    International nurses face a myriad of challenges in their transition, adaptation, and integration into the U.S. health care environment. This pilot intervention study examined socio-cultural competence regarding communication in a sample of international nurses working in two community hospitals in southern Nevada. Significant improvement in communication behaviors of the sampled international nurses with regard to socio-cultural skills of communication after the workshop intervention were not found. Similarly, there were no remarkable differences in standardized patient comments for most items on the checklist. However, the sampled international nurses demonstrated some highly desirable qualities such as being very personable, caring, and compassion that appeared to lay a foundation for an effective nurse-patient relationship.

  4. Translation of a tailored nutrition and resistance exercise intervention for elderly people to a real-life setting: adaptation process and pilot study

    NARCIS (Netherlands)

    Dongen, van E.J.I.; Leerlooijer, J.N.; Steijns, J.M.; Tieland, C.A.B.; Groot, de C.P.G.M.; Haveman-Nies, A.

    2017-01-01

    Background
    Combining increased dietary protein intake and resistance exercise training for elderly people is a promising strategy to prevent or counteract the loss of muscle mass and decrease the risk of disabilities. Using findings from controlled interventions in a real-life setting requires a

  5. Community Engagement Approach: Developing a Culturally Appropriate Intervention for Hispanic Mother–Child Dyads

    OpenAIRE

    Bender, MS; Clark, MJ; Gahagan, S

    2014-01-01

    Childhood obesity affects approximately 20% of U.S. preschool children. Early prevention is needed to reduce young children's risks for obesity, especially among Hispanic preschool children who have one of the highest rates of obesity. Vida Saludable was an early childhood obesity intervention designed to be culturally appropriate for low-income Hispanic mothers with preschool children to improve maternal physical activity and reduce children's sugar-sweetened beverage consumption. It was con...

  6. The Healthy Migrant Families Initiative: development of a culturally competent obesity prevention intervention for African migrants

    OpenAIRE

    2015-01-01

    Background Although obesity among immigrants remains an important area of study given the increasing migrant population in Australia and other developed countries, research on factors amenable to intervention is sparse. The aim of the study was to develop a culturally-competent obesity prevention program for sub-Saharan African (SSA) families with children aged 12–17 years using a community-partnered participatory approach. Methods A community-partnered participatory approach that allowed the...

  7. A weight-loss intervention program designed for Mexican-American women: Cultural adaptations and results

    Science.gov (United States)

    Lindberg, Nangel M.; Stevens, Victor J.; Vega-López, Sonia; Kauffman, Tia; Calderón, Mariana Rosales; Cervantes, María Antonieta

    2013-01-01

    Background This study assessed the feasibility of a culturally-appropriate weight-loss intervention targeting obese Spanish-speaking Mexican women. Methods This 12-month weight-loss program was based on behavioral interventions previously used successfully with English-speaking participants. Cultural adaptations included: female interventionists, minimal written materials, emphasis on group activities, focus on Mexican traditions and beliefs, and skill-building approach to food measurement. All sessions were conducted in Spanish. The study had few exclusionary criteria, which allowed participation of women with a wide range of literacy levels. Results Recruitment exceeded expectations, with 47 participants enrolling in the program. Not counting participants who became pregnant during the study, attendance at 6 and 12 months was 62% and 50% respectively. Mean weight loss at 6 and 12 months was 5.3 kg and 7.2 kg, respectively, with a mean reduction in BMI of 4.0 kg/m2 and 5.5 kg/m2 from baseline to 6 and 12 months, respectively. Discussion This pilot study shows that it is feasible to develop and implement culturally-appropriate behavioral lifestyle interventions for obesity treatment in Mexican-American women. PMID:22460538

  8. Effectiveness of tailored lifestyle interventions, using web-based and print-mail, for reducing blood pressure among rural women with prehypertension: main results of the Wellness for Women: DASHing towards Health clinical trial.

    Science.gov (United States)

    Hageman, Patricia A; Pullen, Carol H; Hertzog, Melody; Boeckner, Linda S

    2014-12-06

    Lifestyle modification is recommended for management of prehypertension, yet finding effective interventions to reach rural women is a public health challenge. This community-based clinical trial compared the effectiveness of standard advice to two multi-component theory-based tailored interventions, using web-based or print-mailed delivery, in reducing blood pressure among rural women, ages 40-69, with prehypertension. 289 women with prehypertension enrolled in the Wellness for Women: DASHing towards Health trial, a 12-month intervention with 12-month follow-up. Women were randomly assigned to groups using a 1:2:2 ratio, comparing standard advice (30-minute counseling session) to two interventions (two 2-hour counseling sessions, 5 phone goal-setting sessions, strength-training video, and 16 tailored newsletters, web-based or print-mailed). Linear mixed model methods were used to test planned pairwise comparisons of marginal mean change in blood pressure, healthy eating and activity, adjusted for age and baseline level. General estimating equations were used to examine the proportion of women achieving normotensive status and meeting health outcome criteria for eating and activity. Mean blood pressure reduction ranged from 3.8 (SD = 9.8) mm Hg to 8.1 (SD = 10.4) mm Hg. The 24-month estimated marginal proportions of women achieving normotensive status were 47% for web-based, and 39% for both print-mailed and standard advice groups, with no group differences (p = .11 and p = .09, respectively). Web-based and print-mailed groups improved more than standard advice group for waist circumference (p = .017 and p = .016, respectively); % daily calories from fat (p = .018 and p = .030) and saturated fat (p = .049 and p = .013); daily servings of fruit and vegetables (p = .008 and p theory-based lifestyle modifications can achieve a reduction of blood pressure and attainment of normotensive status. ClinicalTrials.gov NCT00580528.

  9. Development of a theory-based (PEN-3 and Health Belief Model), culturally relevant intervention on cervical cancer prevention among Latina immigrants using intervention mapping.

    Science.gov (United States)

    Scarinci, Isabel C; Bandura, Lisa; Hidalgo, Bertha; Cherrington, Andrea

    2012-01-01

    The development of efficacious theory-based, culturally relevant interventions to promote cervical cancer prevention among underserved populations is crucial to the elimination of cancer disparities. The purpose of this article is to describe the development of a theory-based, culturally relevant intervention focusing on primary (sexual risk reduction) and secondary (Pap smear) prevention of cervical cancer among Latina immigrants using intervention mapping (IM). The PEN-3 and Health Belief Model provided theoretical guidance for the intervention development and implementation. IM provides a logical five-step framework in intervention development: delineating proximal program objectives, selecting theory-based intervention methods and strategies, developing a program plan, planning for adoption in implementation, and creating evaluation plans and instruments. We first conducted an extensive literature review and qualitatively examined the sociocultural factors associated with primary and secondary prevention of cervical cancer. We then proceeded to quantitatively validate the qualitative findings, which led to development matrices linking the theoretical constructs with intervention objectives and strategies as well as evaluation. IM was a helpful tool in the development of a theory-based, culturally relevant intervention addressing primary and secondary prevention among Latina immigrants.

  10. Online Pestkoppenstoppen: systematic and theory-based development of a web-based tailored intervention for adolescent cyberbully victims to combat and prevent cyberbullying

    OpenAIRE

    Jacobs, Niels CL; Völlink, Trijntje; Dehue, Francine; Lechner, Lilian

    2014-01-01

    Background The purpose of this article is to give an integrative insight into the theoretical and empirical-based development of the Online Pestkoppenstoppen (Stop Bullies Online/Stop Online Bullies). This intervention aims to reduce the number of cyberbully victims and their symptoms of depression and anxiety (program goal), by teaching cyberbully victims how to cope in an adequate and effective manner with cyberbully incidents (program’s outcomes). Method/Design In developing the program th...

  11. Breast feeding practices as cultural interventions for early childhood caries in Cree communities.

    Science.gov (United States)

    Cidro, Jaime; Zahayko, Lynelle; Lawrence, Herenia P; Folster, Samantha; McGregor, Margaret; McKay, Kristen

    2015-04-09

    Breastfeeding is a gift from mother to child and has a wide range of positive health, social and cultural impacts on infants. The link between bottle feeding and the prevalence of early childhood caries (ECC) is well documented. In Aboriginal communities, the higher rates of ECC are linked with low rates of breast feeding and inappropriate infant feeding of high sugar content liquids. The Baby Teeth Talk Study (BTT) is one project that is exploring the use of four interventions (motivational interviewing, anticipatory guidance, fluoride varnish and dental care to expectant mothers) for reducing the prevalence of ECC in infants within Aboriginal communities. This research explored cultural based practices through individual interviews and focus groups with older First Nations women in the community. Participants in a First Nations community identified cultural based practices that have also been used to promote healthy infant feeding and good oral health. A wide range of themes related to oral health and infant feeding emerged. However, this paper focuses on three themes including: breastfeeding attitudes, social support for mothers and birthing and supporting healthy infant feeding through community programs. The importance of understanding cultural health traditions is essential for those working in oral public health capacities to ensure there is community acceptance of the interventions.

  12. Why culture matters in health interventions: lessons from HIV/AIDS stigma and NCDs.

    Science.gov (United States)

    Airhihenbuwa, Collins O; Ford, Chandra L; Iwelunmor, Juliet I

    2014-02-01

    Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for strategies to reduce the global disease burden of noncommunicable diseases like diabetes requires a reassessment of individual-based approaches to behavior change. We argue that public health and health behavior intervention should focus more on culture than behavior to achieve meaningful and sustainable change resulting in positive health outcomes. To change negative health behaviors, one must first identify and promote positive health behaviors within the cultural logic of its contexts. To illustrate these points, we discuss stigma associated with obesity and human immunodeficiency virus and acquired immune deficiency syndrome. We conclude that focusing on positive behaviors and sustaining cultural and personal transformations requires a culturally grounded approach to public health interventions, such as that provided by the PEN-3 model.

  13. Effectiveness of a tailor-made intervention for pregnancy-related pelvic girdle and/or low back pain after delivery: Short-term results of a randomized clinical trial [ISRCTN08477490

    Directory of Open Access Journals (Sweden)

    Bastiaanssen Janneke M

    2006-02-01

    Full Text Available Abstract Background For the moment, scientific evaluation of programs on treatment of pregnancy-related pelvic girdle and/or low back pain after delivery is hardly available with only one study with a positive result, suggesting uncertainty about the optimal approach. Investigators draw particular attention to biomedical factors but there is growing evidence that biopsychosocial factors appear to be even more important as a basis of an intervention program. Methods We studied the effectiveness of a tailor-made program with respect to biopsychosocial factors (intervention group in women with pregnancy-related pelvic girdle and/ or low back pain versus usual care based on a pain contingent basis (control group shortly after delivery in a randomized controlled trial. Women with severe complaints shortly after delivery were selected from a longitudinal prospective cohort study (n = 7526, aimed at pregnancy-related pelvic girdle and/or low back pain in the Netherlands. A concealed block randomization was performed after collecting baseline data. Researchers were blinded to treatment assignment. Outcomes were evaluated within the domains of the biopsychosocial approach. Primary outcome concerned limitations in activities (RDQ. Follow-up measurements were performed 12 weeks after delivery. Results Since May 2001 until July 2003, 869 women out of the cohort made a request for treatment by a physiotherapist, 10 days after delivery. Because of a quick recovery in two weeks time, we included only 126 women three weeks after delivery. There was a statistically significant and clinically relevant difference in improvement on the primary outcome (RDQ between the two groups in favor of the experimental intervention. Conclusion The results favored the hypotheses. Women's worries about their condition were major targets in the experimental intervention. The prognosis after delivery, especially in de first weeks, turned out to be favorable.

  14. Hospital cultural competency as a systematic organizational intervention: Key findings from the national center for healthcare leadership diversity demonstration project.

    Science.gov (United States)

    Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne

    2016-10-25

    Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective

  15. “Queremos Aprender”: Latino Immigrants’ Call to Integrate Cultural Adaptation with Best Practice Knowledge in a Parenting Intervention

    Science.gov (United States)

    Parra Cardona, José; Holtrop, Kendal; Córdova, David; Escobar-Chew, Ana Rocio; Horsford, Sheena; Tams, Lisa; Villarruel, Francisco A.; Villalobos, Graciela; Dates, Brian; Anthony, James C.; Fitzgerald, Hiram E.

    2015-01-01

    Despite the unique and challenging circumstances confronting Latino immigrant families, debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Following the grounded theory approach, the current qualitative investigation utilized focus group interviews with 83 Latino immigrant parents to explore the relevance of culturally adapting an evidence-based parenting intervention to be disseminated within this population. Findings from this study indicate that Latino immigrant parents want to participate in a culturally adapted parenting intervention as long as it is culturally relevant, respectful, and responsive to their life experiences. Research results also suggest that the parenting skills participants seek to enhance are among those commonly targeted by evidence-based parenting interventions. This study contributes to the cultural adaptation/fidelity balance debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance, as well as high fidelity to the core components that have established efficacy for evidence-based parenting interventions. PMID:19579906

  16. "Queremos aprender": Latino immigrants' call to integrate cultural adaptation with best practice knowledge in a parenting intervention.

    Science.gov (United States)

    Cardona, José Parra; Holtrop, Kendal; Córdova, David; Escobar-Chew, Ana Rocio; Horsford, Sheena; Tams, Lisa; Villarruel, Francisco A; Villalobos, Graciela; Dates, Brian; Anthony, James C; Fitzgerald, Hiram E

    2009-06-01

    Despite the unique and challenging circumstances confronting Latino immigrant families, debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Following the grounded theory approach, the current qualitative investigation utilized focus group interviews with 83 Latino immigrant parents to explore the relevance of culturally adapting an evidence-based parenting intervention to be disseminated within this population. Findings from this study indicate that Latino immigrant parents want to participate in a culturally adapted parenting intervention as long as it is culturally relevant, respectful, and responsive to their life experiences. Research results also suggest that the parenting skills participants seek to enhance are among those commonly targeted by evidence-based parenting interventions. This study contributes to the cultural adaptation/fidelity balance debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance, as well as high fidelity to the core components that have established efficacy for evidence-based parenting interventions.

  17. Beyond bone mineral density, FRAX-based tailor-made intervention thresholds for therapeutic decision in subjects on glucocorticoid: A nationwide osteoporosis survey.

    Science.gov (United States)

    Yu, Shan-Fu; Chen, Jia-Feng; Chen, Yin-Chou; Lai, Han-Ming; Ko, Chi-Hua; Chiu, Wen-Chan; Su, Fu-Mei; Hsu, Chung-Yuan; Su, Ben Yu-Jih; Wu, Chih-Hsing; Cheng, Tien-Tsai

    2017-02-01

    Glucocorticoid-induced osteoporosis (GIOP) is the most common cause of secondary osteoporosis and confers a substantial risk for future fractures. Several recent guidelines for GIOP management have recommended the use of intervention thresholds to direct pharmacological therapy in those at high risk of fracture. The aim of this study was to analyze the characteristics of subjects on a glucocorticoid (GC) and to implement the Fracture Risk Assessment Tool (FRAX)-based intervention threshold for therapeutic decision-making.This was a cohort substudy of a nationwide osteoporosis screening program conducted in Taiwan from 2008 to 2011. All participants were requested to complete a questionnaire including FRAX elements, and antiosteoporosis medication (AOM) history was assessed before bone mineral density (BMD) measurement. GC users were recruited as the study group. Controls comprised randomly selected age- and sex-matched non-GC users. Individual intervention threshold (IIT) was set at individual-specific FRAX probability of a major osteoporotic fracture, relative to subjects with prior fractures. The characteristics and calculated IIT of all participants were analyzed.A total of 8704 participants were enrolled, including GC users (n = 807) and controls (n = 7897). There was no significant difference in BMD between GC users and controls. Clinical fracture risks, including previous fracture, parental hip fracture, rheumatoid arthritis, and secondary osteoporosis were higher in GC users than in controls. GC users had a higher 10-year probability of either major or hip fracture than controls. The proportion of GC users with a 10-year probability of major osteoporotic fracture above IIT was higher than in controls (75.0% vs 10.6%; P controls whose fracture risk was above IIT reported taking AOM.These findings suggest that more GC users should receive active intervention based on IIT, regardless of BMD. However, less than one-fourth of GC users whose fracture

  18. An economic evaluation of a video- and text-based computer-tailored intervention for smoking cessation: a cost-effectiveness and cost-utility analysis of a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Nicola E Stanczyk

    Full Text Available BACKGROUND: Although evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited. OBJECTIVE: The study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored (CT smoking cessation interventions (video- vs. text-based CT compared to a control condition that received general text-based advice. METHODS: In a randomized controlled trial, respondents were allocated to the video-based condition (N = 670, the text-based condition (N = 708 or the control condition (N = 721. Societal costs, smoking status, and quality-adjusted life years (QALYs; EQ-5D-3L were assessed at baseline, six-and twelve-month follow-up. The incremental costs per abstinent respondent and per QALYs gained were calculated. To account for uncertainty, bootstrapping techniques and sensitivity analyses were carried out. RESULTS: No significant differences were found in the three conditions regarding demographics, baseline values of outcomes and societal costs over the three months prior to baseline. Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of €1,500, the video-based intervention was likely to be the most cost-effective treatment, whereas from a willingness to pay of €50,400, the text-based intervention was likely to be the most cost-effective. With regard to cost-utilities, when quality of life was used as outcome measure, the control condition had the highest probability of being the most preferable treatment. Sensitivity analyses yielded comparable results. CONCLUSION: The video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months, varying the willingness to pay per abstinent respondent from €0 up to €80,000. With regard to cost-utility, the control condition seemed to be the most preferable treatment. Probably

  19. An economic evaluation of a video- and text-based computer-tailored intervention for smoking cessation: a cost-effectiveness and cost-utility analysis of a randomized controlled trial.

    Science.gov (United States)

    Stanczyk, Nicola E; Smit, Eline S; Schulz, Daniela N; de Vries, Hein; Bolman, Catherine; Muris, Jean W M; Evers, Silvia M A A

    2014-01-01

    Although evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited. The study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored (CT) smoking cessation interventions (video- vs. text-based CT) compared to a control condition that received general text-based advice. In a randomized controlled trial, respondents were allocated to the video-based condition (N = 670), the text-based condition (N = 708) or the control condition (N = 721). Societal costs, smoking status, and quality-adjusted life years (QALYs; EQ-5D-3L) were assessed at baseline, six-and twelve-month follow-up. The incremental costs per abstinent respondent and per QALYs gained were calculated. To account for uncertainty, bootstrapping techniques and sensitivity analyses were carried out. No significant differences were found in the three conditions regarding demographics, baseline values of outcomes and societal costs over the three months prior to baseline. Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of €1,500, the video-based intervention was likely to be the most cost-effective treatment, whereas from a willingness to pay of €50,400, the text-based intervention was likely to be the most cost-effective. With regard to cost-utilities, when quality of life was used as outcome measure, the control condition had the highest probability of being the most preferable treatment. Sensitivity analyses yielded comparable results. The video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months, varying the willingness to pay per abstinent respondent from €0 up to €80,000. With regard to cost-utility, the control condition seemed to be the most preferable treatment. Probably, more time will be required to assess changes in quality of life

  20. Using a tailored health information technology- driven intervention to improve health literacy and medication adherence in a Pakistani population with vascular disease (Talking Rx) - study protocol for a randomized controlled trial.

    Science.gov (United States)

    Kamal, Ayeesha Kamran; Muqeet, Abdul; Farhat, Kashfa; Khalid, Wardah; Jamil, Anum; Gowani, Ambreen; Muhammad, Aliya Amin; Zaidi, Fabiha; Khan, Danyal; Elahi, Touseef; Sharif, Shahrukh; Raz, Sibtain; Zafar, Taha; Bokhari, Syedah Saira; Rahman, Nasir; Sultan, Fateh Ali Tipoo; Sayani, Saleem; Virani, Salim S

    2016-03-05

    Vascular disease, manifesting as myocardial infarction and stroke, is a major cause of morbidity and mortality, especially in low- and middle-income countries. Current estimates are that only one in six patients have good adherence to medications and very few have sufficient health literacy. Our aim is to explore the effectiveness and acceptability of Prescription Interactive Voice Response (IVR) Talking Prescriptions (Talking Rx) and SMS reminders in increasing medication adherence and health literacy in Pakistani patients with vascular disease. This is a randomized, controlled, single center trial. Adult participants, with access to a cell phone and a history of vascular disease, taking multiple risk-modifying medications (inclusive of anti-platelets and statins) will be selected from cerebrovascular and cardiovascular clinics. They will be randomized in a 1:1 ratio via a block design to the intervention or the control arm with both groups having access to a helpline number to address their queries in addition to standard of care as per institutional guidelines. Participants in the intervention group will also have access to Interactive Voice Response (IVR) technology tailored to their respective prescriptions in the native language (Urdu) and will have the ability to hear information about their medication dosage, correct use, side effects, mechanism of action and how and why they should use their medication, as many times as they like. Participants in the intervention arm will also receive scheduled SMS messages reminding them to take their medications. The primary outcome measure will be the comparison of the difference in adherence to anti-platelet and statin medication between baseline and at 3-month follow-up in each group measured by the Morisky Medication Adherence Scale. To ascertain the impact of our intervention on health literacy, we will also compare a local content-validated and modified version of Test of Health Literacy in Adults (TOFHLA) between

  1. Republished paper: Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project.

    Science.gov (United States)

    Blegen, M A; Sehgal, N L; Alldredge, B K; Gearhart, S; Auerbach, A A; Wachter, R M

    2010-12-01

    The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used to determine the impact of the training with a before-after design. Surveys were returned from 454 healthcare staff before the training and 368 staff 1 year later. Five of eleven safety culture subscales showed significant improvement. Nurses perceived a stronger safety culture than physicians or pharmacists. While it is difficult to isolate the effects of the team training intervention from other events occurring during the year between training and postevaluation, overall the intervention seems to have improved the safety culture on these medical units.

  2. Tailored Porous Materials

    Energy Technology Data Exchange (ETDEWEB)

    BARTON,THOMAS J.; BULL,LUCY M.; KLEMPERER,WALTER G.; LOY,DOUGLAS A.; MCENANEY,BRIAN; MISONO,MAKOTO; MONSON,PETER A.; PEZ,GUIDO; SCHERER,GEORGE W.; VARTULI,JAMES C.; YAGHI,OMAR M.

    1999-11-09

    Tailoring of porous materials involves not only chemical synthetic techniques for tailoring microscopic properties such as pore size, pore shape, pore connectivity, and pore surface reactivity, but also materials processing techniques for tailoring the meso- and the macroscopic properties of bulk materials in the form of fibers, thin films and monoliths. These issues are addressed in the context of five specific classes of porous materials: oxide molecular sieves, porous coordination solids, porous carbons, sol-gel derived oxides, and porous heteropolyanion salts. Reviews of these specific areas are preceded by a presentation of background material and review of current theoretical approaches to adsorption phenomena. A concluding section outlines current research needs and opportunities.

  3. Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a Home-based, Individually-tailored Physical activity Print intervention for African American women in the Deep South

    Science.gov (United States)

    Pekmezi, Dori; Ainsworth, Cole; Joseph, Rodney; Bray, Molly S.; Kvale, Elizabeth; Isaac, Shiney; Desmond, Renee; Meneses, Karen; Marcus, Bess; Demark-Wahnefried, Wendy

    2016-01-01

    African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD= 4.7), a BMI of 32.1 kg/m2 (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5 minutes/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health. PMID:26944022

  4. Vida PURA: A Cultural Adaptation of Screening and Brief Intervention to Reduce Unhealthy Drinking Among Latino Day Laborers.

    Science.gov (United States)

    Ornelas, India J; Allen, Claire; Vaughan, Catalina; Williams, Emily C; Negi, Nalini

    2015-01-01

    Brief intervention is known to reduce drinking in primary care; however, because health care access is limited for Latino immigrants, traditional brief interventions are unlikely to reach this population. Using Barrera and Castro's framework, our study aims to culturally adapt a screening and brief intervention program to reduce unhealthy alcohol use among Latino day laborers, a particularly vulnerable group of Latino immigrant men. We conducted 18 interviews with Latino day laborers and 13 interviews with mental health and substance use providers that serve Latino immigrant men. Interviews were conducted until saturation of themes was reached. Themes from interviews were used to identify sources of mismatch between traditional screening and brief intervention in our target population. Unhealthy alcohol use was common, culturally accepted, and helped relieve immigration-related stressors. Men had limited knowledge about how to change their behavior. Men preferred to receive information from trusted providers in Spanish. Men faced significant barriers to accessing health and social services but were open to receiving brief interventions in community settings. Findings were used to design Vida PURA, a preliminary adaptation design of brief intervention for Latino day laborers. Key adaptations include brief intervention at a day labor worker center provided by promotores trained to incorporate the social and cultural context of drinking for Latino immigrant men. Culturally adapted brief intervention may help reduce unhealthy drinking in this underserved population.

  5. Interventions to improve cultural competency in healthcare: a systematic review of reviews

    Science.gov (United States)

    2014-01-01

    Background Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area. Methods A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong. Results Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes. Conclusion This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more

  6. Acoustic Intervention in a Cultural Heritage: The Chapel of the Royal Palace in Caserta, Italy

    Directory of Open Access Journals (Sweden)

    Umberto Berardi

    2015-12-01

    Full Text Available The modern use of ancient heritage sites can be, to say the least, challenging from an acoustical perspective. In fact, modern needs may require acoustical interventions in contrast with the preservation issues of the cultural heritage. This paper deals with this topic in an UNESCO designated world heritage site, the Palatine Chapel of the Royal Palace in Caserta, Italy. Since this chapel is currently being used for meetings and music chamber concerts, the acoustical characteristics of the chapel, originally used for religious purposes, are investigated. Field measurements were undertaken to evaluate the acoustical performance of the empty chapel. The measurements were then used to calibrate and validate a computer simulation model. Different acoustical treatments are then considered and simulations are used to determine the related acoustical improvements. Finally, the benefits of different acoustical treatments which are respectful of the aesthetic and historical value of this cultural heritage are discussed.

  7. Reduced bone resorption by intake of dietary vitamin D and K from tailor-made Atlantic salmon: a randomized intervention trial

    Science.gov (United States)

    Graff, Ingvild Eide; Øyen, Jannike; Kjellevold, Marian; Frøyland, Livar; Gjesdal, Clara Gram; Almås, Bjørg; Rosenlund, Grethe; Lie, Øyvind

    2016-01-01

    Suboptimal vitamin D status is common among humans, and might increase bone resorption with subsequent negative effects on bone health. Fatty fish, including Atlantic salmon, is an important dietary vitamin D source. However, due to a considerable change in fish feed composition, the contribution of vitamin D from salmon fillet has been reduced. The main objective was to investigate if intake of vitamin D3 enriched salmon or vitamin D3 tablets decreased bone biomarkers (urinary N-telopeptides, deoxypyridinoline, serum bone-specific alkaline phosphatase, and osteocalcin) compared to a low vitamin D3 intake. The 122 healthy postmenopausal women included in this 12 weeks intervention trial were randomized into four groups: three salmon groups (150 grams/two times/week) and one tablet group (800 IU vitamin D and 1000 mg calcium/day). The salmon groups also received calcium supplements. The salmon had three different vitamin D3/vitamin K1 combinations: high D3+high K1, low D3+high K1, or high D3+low K1. Increased intake of salmon containing high levels of vitamin D3 (0.35-0.38 mg/kg/fillet) and supplements with the same weekly contribution had a positive influence on bone health as measured by bone biomarkers in postmenopausal women. Consequently, an increased level of vitamin D3 at least to original level in feed for salmonids will contribute to an improved vitamin D3 status and may improve human bone health. PMID:27542236

  8. Cultural perspectives of interventions for managing diabetes and asthma in children and adolescents from ethnic minority groups.

    Science.gov (United States)

    Mc Manus, V; Savage, E

    2010-09-01

    Both diabetes and asthma are increasingly being recognized as health problems for ethnic groups. Because of cultural differences, ethnicity is reported to be a risk factor for poorer quality in health care, disease management and disease control. Ethnic groups are at risk for poorer quality of life and increased disease complications when compared with non-ethnic counterparts living in the same country. There is little known about how culture is addressed in interventions developed for ethnic groups. The aim of this paper is to systematically review the cultural perspectives of interventions for managing diabetes and asthma in children, adolescents and/or their families from ethnic minority groups. A total of 92 records were identified that were potentially relevant to this review following which, 61 papers were excluded. The full texts of remaining papers (n= 31) were then read independently by both authors, and agreement was reached to exclude a further 27 papers that did not meet inclusion criteria. A total of four papers were eligible for inclusion in this review. Findings indicate that despite growing concerns about health disparities between ethnic and non-ethnic groups in relation to both asthma and diabetes in childhood, there has been little effort to develop cultural specific interventions for ethnic groups. By systematically reviewing asthma and diabetes interventions we have highlighted that few interventions have been developed from a cultural perspective. There are a limited number of interventions published that add knowledge on the specific elements of intervention that is needed to effectively and sensitively educate other cultures. More work is required into identifying which strategies or components of cultural interventions are most effective in achieving positive health outcomes for children, adolescents and/or their families from ethnic groups.

  9. A Framework for the Study of Complex mHealth Interventions in Diverse Cultural Settings.

    Science.gov (United States)

    Maar, Marion A; Yeates, Karen; Perkins, Nancy; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Sleeth, Jessica; Tobe, Sheldon W

    2017-04-20

    To facilitate decision-making capacity between options of care under real-life service conditions, clinical trials must be pragmatic to evaluate mobile health (mHealth) interventions under the variable conditions of health care settings with a wide range of participants. The mHealth interventions require changes in the behavior of patients and providers, creating considerable complexity and ambiguity related to causal chains. Process evaluations of the implementation are necessary to shed light on the range of unanticipated effects an intervention may have, what the active ingredients in everyday practice are, how they exert their effect, and how these may vary among recipients or between sites. Building on the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth) statement and participatory evaluation theory, we present a framework for the process evaluations for mHealth interventions in multiple cultural settings. We also describe the application of this evaluation framework to the implementation of DREAM-GLOBAL (Diagnosing hypertension-Engaging Action and Management in Getting Lower BP in Indigenous and LMIC [low- and middle-income countries]), a pragmatic randomized controlled trial (RCT), and mHealth intervention designed to improve hypertension management in low-resource environments. We describe the evaluation questions and the data collection processes developed by us. Our literature review revealed that there is a significant knowledge gap related to the development of a process evaluation framework for mHealth interventions. We used community-based participatory research (CBPR) methods and formative research data to develop a process evaluation framework nested within a pragmatic RCT. Four human organizational levels of participants impacted by the mHealth intervention were identified that included patients, providers, community and organizations actors, and health systems and

  10. Framing the impact of culture on health: a systematic review of the PEN-3 cultural model and its application in public health research and interventions.

    Science.gov (United States)

    Iwelunmor, Juliet; Newsome, Valerie; Airhihenbuwa, Collins O

    2014-02-01

    This paper reviews available studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. We search electronic databases and conducted a thematic analysis of empirical studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. Studies were mapped to describe their methods, target population and the health behaviors or health outcomes studied. Forty-five studies met the inclusion criteria. The studies reviewed used the PEN-3 model as a theoretical framework to centralize culture in the study of health behaviors and to integrate culturally relevant factors in the development of interventions. The model was also used as an analysis tool, to sift through text and data in order to separate, define and delineate emerging themes. PEN-3 model was also significant with exploring not only how cultural context shapes health beliefs and practices, but also how family systems play a critical role in enabling or nurturing positive health behaviors and health outcomes. Finally, the studies reviewed highlighted the utility of the model with examining cultural practices that are critical to positive health behaviors, unique practices that have a neutral impact on health and the negative factors that are likely to have an adverse influence on health. The limitations of model and the role for future studies are discussed relative to the importance of using PEN-3 cultural model to explore the influence of culture in promoting positive health behaviors, eliminating health disparities and designing and implementing sustainable public health interventions.

  11. The Impact of Educational Interventions on Organizational Culture at an Urban Federal Agency. Ph.D. Thesis - Old Dominion Univ.

    Science.gov (United States)

    Mckenzie, Janet Myrick

    1994-01-01

    This study on the impact of educational interventions on organizational culture is an evaluation of a major educational initiative undertaken by an urban federal agency, namely the National Aeronautics and Space Administration's Langley Research Center (NASA-LaRC). The design of this educational evaluation captures the essence of NASA-LaRC's efforts to continue its distinguished and international stature in the aeronautical research community following the Challenger tragedy. More specifically, this study is an evaluation of the educational initiative designed to ameliorate organizational culture via educational interventions, with emphasis on communications, rewards and recognition, and career development. After completing a review of the related literature, chronicling the educational initiative, interviewing senior managers and employees, and critically examining thousands of free responses on employee perceptions of organizational culture, it is found that previous definitions of organizational culture are more accurately classified as manifestations of organizational culture. This research has endeared to redefine 'organizational culture' by offering a more accurate and diagnostic perspective.

  12. Culturally adaptive storytelling intervention versus didactic intervention to improve hypertension control in Vietnam: a cluster-randomized controlled feasibility trial

    National Research Council Canada - National Science Library

    Hoa L Nguyen; Jeroan J Allison; Duc A Ha; German Chiriboga; Ha N Ly; Hanh T Tran; Cuong K Nguyen; Diem M Dang; Ngoc T Phan; Nguyen C Vu; Quang P Nguyen; Robert J Goldberg

    2017-01-01

    ...,” and a didactic intervention. Methods The storytelling intervention included stories about strategies for coping with hypertension, with patients speaking in their own words, and didactic content about the importance of healthy...

  13. The value of tailored communication in promoting medication intake behavior

    NARCIS (Netherlands)

    Linn, A.J.

    2013-01-01

    Little is known about appropriate methods to address medication intake behavior in individual patients and how content should be tailored to the needs of these patients. This dissertation aims to develop a theoretical and evidence-based tailored multimedia intervention to improve medication intake b

  14. Pilot study of a culturally adapted psychoeducation (CaPE) intervention for bipolar disorder in Pakistan.

    Science.gov (United States)

    Husain, Muhammad Ishrat; Chaudhry, Imran B; Rahman, Raza R; Hamirani, Munir M; Mehmood, Nasir; Haddad, Peter M; Hodsoll, John; Young, Allan H; Naeem, Farooq; Husain, Nusrat

    2017-12-01

    Despite the use of maintenance medication, recurrence rates in bipolar affective disorder (BPAD) are high. To date, there are no clinical trials that have investigated the use of psychological interventions in bipolar disorder in Pakistan. The purpose of the study was to assess the feasibility and acceptability of a culturally adapted bipolar psychoeducation programme (CaPE) in Pakistan. Thirty-four euthymic bipolar I and II outpatients were randomized to either 12 weekly sessions of individual psychoeducation plus Treatment As Usual (Intervention) or Treatment As Usual (TAU) (Control). Outcomes were assessed using the Young Mania Rating Scale (YMRS), Beck Depression Inventory (BDI), EuroQoL (EQ-5D), Bipolar Knowledge and Attitudes and Questionnaire (BKAQ), and a self-reported measure of medication adherence (Morisky Medication Adherence Scale-4 items, MMAS-4). Effect sizes were derived from baseline adjusted standardized regression coefficients. Retention in the study was good, 80% of patients in the TAU follow-up assessment and 100% of patients in the CaPE group attended all 12 sessions. Patient satisfaction was higher in the CaPE group relative to control (ES = 1.41). Further, there were large effect sizes shown for CaPE versus TAU for medication adherence (MMAS-4: ES = 0.81), knowledge and attitudes towards bipolar (BKAQ: ES = 0.68), mania (YMRS: ES = 1.18), depression (BDI: ES = 1.17) and quality of life measures (EQ-5D: ES ⇒ 0.88). Culturally adapted psychoeducation intervention is acceptable and feasible, and can be effective in improving mood symptoms and knowledge and attitudes to BPAD when compared with TAU. Larger scale studies are needed to confirm our findings. Clinicaltrials.gov identifier NCT02210390.

  15. Designing and evaluating culturally specific smoking cessation interventions for American Indian communities.

    Science.gov (United States)

    Fu, Steven S; Rhodes, Kristine L; Robert, Christina; Widome, Rachel; Forster, Jean L; Joseph, Anne M

    2014-01-01

    American Indians have the highest smoking rates in the United States, yet few randomized controlled trials of culturally specific interventions exist. This study assessed American Indians' opinions about evidence-based treatment and attitudes toward participating in clinical trials. Six focus groups were conducted based on smoking status (current/former smoker), sex, and elder status (55 years and older or younger). Meetings were held at local American Indian community organizations. This project was accomplished in partnership with the American Indian Community Tobacco Projects, a community-academic research partnership at the University of Minnesota. Thematic qualitative data analyses were conducted. Participants desired the following: (a) programs led by trained American Indian community members, (b) the opportunity to connect with other American Indian smokers interested in quitting, and (c) programs promoting healthy lifestyles. Strategies desired for treatment included (a) free pharmacotherapy, including nicotine replacement therapy (NRT); (b) nominal incentives, e.g., gift cards for groceries; and (c) culturally specific program components such as American Indian images, education on traditional tobacco use, and quit-smoking messages that target the value of family and include narratives or story telling in recruitment and program materials. Biochemical verification of smoking abstinence, such as salivary cotinine or carbon monoxide breathalyzers, is likely acceptable. Standard treatment or delayed treatment control groups were viewed as potentially acceptable for randomized study designs. Rigorously conducted randomized controlled trials of culturally specific smoking cessation interventions are sorely needed but will only be accomplished with the commitment of funders, researchers, and collaborative trusting relationships with the community.

  16. Cultural theories of postpartum bleeding in Matlab, Bangladesh: implications for community health intervention.

    Science.gov (United States)

    Sibley, Lynn M; Hruschka, Daniel; Kalim, Nahid; Khan, Jasmin; Paul, Moni; Edmonds, Joyce K; Koblinsky, Marjorie A

    2009-06-01

    Early recognition can reduce maternal disability and deaths due to postpartum haemorrhage. This study identified cultural theories of postpartum bleeding that may lead to inappropriate recognition and delayed care-seeking. Qualitative and quantitative data obtained through structured interviews with 149 participants living in Matlab, Bangladesh, including women aged 18-49 years, women aged 50+ years, traditional birth attendants (TBAs), and skilled birth attendants (SBAs), were subjected to cultural domain. General consensus existed among the TBAs and lay women regarding signs, causes, and treatments of postpartum bleeding (eigenvalue ratio 5.9, mean competence 0.59, and standard deviation 0.15). Excessive bleeding appeared to be distinguished by flow characteristics, not colour or quantity. Yet, the TBAs and lay women differed significantly from the SBAs in beliefs about normalcy of blood loss, causal role of the retained placenta and malevolent spirits, and care practices critical to survival. Cultural domain analysis captures variation in theories with specificity and representativeness necessary to inform community health intervention.

  17. The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans

    Science.gov (United States)

    Woods-Giscombé, Cheryl L.; Gaylord, Susan A.

    2014-01-01

    African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, “buddy system,” etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. PMID:24442592

  18. Resistance to Cultural Intervention: Formation of Inhibitory Collective and children's Self-Defensive Regulation in a Chinese School.

    Science.gov (United States)

    Wu, Aruna; Li, Xiao-Wen; Zhou, Lihua; Zhang, Qian

    2016-11-28

    A sequel to the previous article "Roots of Excellence: The Releasing Effect of Individual Potentials through Educational Cultural Intervention in a Chinese School" (in press), the present study is on the unexpected reversal phenomena in the process of cultural intervention. The goal of the intervention is to construct the dynamics of Jiti (well-organized collective in Chinese) through creative activities to promote students' development. In the intervention, the releasing effect (Wu et al. 2016) emerged as well, but the teacher's concern about worsening discipline and academic performance evoked and reinforced his habitual notions and practices of education, turning the joint activities into a way of strengthening discipline. The energy that had been discharging at the beginning of the intervention was inhibited, so that many more problematic behaviors took shape. The whole class formed an inhibitory atmosphere, within which pupils formed self-defensive regulation strategies. By comparing with the productive collective in which intervention was effective and analyzing this unexpected reversal process, we can not only see pupils' self-construction status in the inhibitory culture but illuminate the formation of the teacher's resistance to educational and cultural transformation as well. Resistance is originated from teachers not being able to interpret pupils' inner developmental needs but instead anxious about the ongoing problems.

  19. A study of a culturally enhanced EatRight dietary intervention in a predominately African American workplace.

    Science.gov (United States)

    Ard, Jamy D; Cox, Tiffany L; Zunker, Christie; Wingo, Brooks C; Jefferson, Wendy K; Brakhage, Cora

    2010-01-01

    The workplace may be an ideal venue for engaging African American women in behavioral interventions for weight reduction. To examine the effectiveness of a culturally enhanced EatRight dietary intervention among a group of predominately African American women in a workplace setting. Crossover design study. Workplace. A total of 39 women volunteered for this study, of whom 27 completed it. The control period involved observation of participants for 22 weeks after receiving standard counseling on lifestyle methods to achieve a healthy weight; following the control period, participants crossed over to the 22-week intervention period. The intervention was culturally enhanced using feedback derived from formative assessment and delivered as 15 group sessions. The primary outcome measure was the difference in weight change between the control and intervention periods; changes in waist circumference and quality of life were secondary outcomes. Most participants were obese, with a mean baseline body mass index of 36 kg/m², weight of 97.9 kg, and waist circumference of 111 cm. Weight increased during the control period by 0.7 kg but decreased by 2.6 kg during the intervention (net difference = -3.4 kg, P culturally enhanced behavioral weight loss intervention in a predominately African American workplace setting. The workplace may be conducive for targeting African American women who are disproportionately affected by obesity.

  20. An examination of cross-cultural systems implementing evidence-based assessment and intervention approaches

    Directory of Open Access Journals (Sweden)

    Murray Laura K

    2006-01-01

    Full Text Available Implementation of evidence-based assessment and intervention approaches for youth with behavioral and/or emotional problems is rising to recognition worldwide. Feasibility research is critical to examine what characteristics of systems allow for success or barriers to the implementation of evidence-based practices into real-world settings, especially when working cross-culturally. This paper briefly reviews the experience of 4 international sites to understand how the overall structure and specific site variables directed the implementation of the World Health Organization and the World Psychiatry Association project. Discussion includes a thematic summary of the successes and challenges experienced by the sites, and future directions of feasibility studies.

  1. A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students.

    Science.gov (United States)

    Gallagher, Ruth W; Polanin, Joshua R

    2015-02-01

    Increasing professional nurses' and nursing students cultural competence has been identified as one way to decrease the disparity of care for vulnerable and minority groups, but effectiveness of training programs to increase competence remains equivocal. The purpose of this project is to synthesize educational interventions designed to increase cultural competence in professional nurses and nursing students. A systematic review and meta-analysis was conducted to synthesize all existing studies on increasing cultural competence. A comprehensive search and screen procedures was conducted to locate all cultural competence interventions implemented with professional nurses and nursing students. Two independent researchers screened and coded the included studies. Effect sizes were calculated for each study and a random-effects meta-analysis was conducted. A total of 25 studies were included in the review. Two independent syntheses were conducted given the disparate nature of the effect size metrics. For the synthesis of treatment-control designed studies, the results revealed a non-statistically significant increase in cultural competence (g¯=.38, 95% CI: -.05, .79, p=.08). Moderator analyses indicated significant variation as a function of the measurements, participant types, and funding source. The pretest-posttest effect size synthesis revealed a significant increase in overall cultural competence (g¯=.45, 95% CI: .24, .66, pcultural competence have shown varied effectiveness. Greater research is required to improve these interventions and promote cultural competence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. From "Water Boiling in a Peruvian Town" to "Letting them Die": culture, community intervention, and the metabolic balance between patience and zeal.

    Science.gov (United States)

    Trickett, Edison J

    2011-03-01

    While the concept of culture has long been central to community psychology research and intervention, it has most frequently referred to the communities in which such work occurs. The purpose of this paper is to reframe this discussion by viewing community interventions as instances of intercultural contact between the culture of science, reflected in community intervention research, and the culture of the communities in which those interventions occur. Following a brief discussion of the complexities of culture as a concept, two illustrative stories of failed community interventions are provided to highlight the centrality of cultural and contextual understanding as prelude to community intervention. These stories, set 50 years apart, reflect the depth and pervasive influence of both the culture of science and the culture of communities. Next, a series of propositions about the culture of social science as a partial reflection of the broader culture of the United States are offered, and their implications for the conduct of community interventions drawn. The paper concludes with a series of recommendations which, together, provide an ecological mind-set for taking culture seriously in community interventions. Central to this mind set are the importance of focusing on communities rather than programs and emphasizing the intervention goal of choice over change.

  3. Cultural adaptation of a brief motivational intervention for heavy drinking among Hispanics in a medical setting.

    Science.gov (United States)

    Field, Craig A; Cabriales, José Alonso; Woolard, Robert H; Tyroch, Alan H; Caetano, Raul; Castro, Yessenia

    2015-07-30

    Hispanics, particularly men of Mexican origin, are more likely to engage in heavy drinking and experience alcohol-related problems, but less likely to obtain treatment for alcohol problems than non-Hispanic men. Our previous research indicates that heavy-drinking Hispanics who received a brief motivational intervention (BMI) were significantly more likely than Hispanics receiving standard care to reduce subsequent alcohol use. Among Hispanics who drink heavily the BMI effectively reduced alcohol use but did not impact alcohol-related problems or treatment utilization. We hypothesized that an adapted BMI that integrates cultural values and addresses acculturative stress among Hispanics would be more effective. We describe here the protocol for the design and implementation of a randomized (approximately 300 patients per condition) controlled trial evaluating the comparative effectiveness of a culturally adapted (CA) BMI in contrast to a non-adapted BMI (NA-BMI) in a community hospital setting among men of Mexican origin. Study participants will include men who were hospitalized due to an alcohol related injury or screened positive for heavy drinking. By accounting for risk and protective factors of heavy drinking among Hispanics, we hypothesize that CA-BMI will significantly decrease alcohol use and alcohol problems, and increase help-seeking and treatment utilization. This is likely the first study to directly address alcohol related health disparities among non-treatment seeking men of Mexican origin by comparing the benefits of a CA-BMI to a NA-BMI. This study stands to not only inform interventions used in medical settings to reduce alcohol-related health disparities, but may also help reduce the public health burden of heavy alcohol use in the United States. Trial registration clinicaltrials.gov identifier NCT02429401; Registration date: April 28, 2015.

  4. Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review

    Science.gov (United States)

    Coast, Ernestina; Jones, Eleri; Lattof, Samantha R; Portela, Anayda

    2016-01-01

    Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were considered. Fifteen studies describing a range of interventions met the inclusion criteria. Data were extracted on population and intervention characteristics; study design; definitions and data for relevant outcomes; and the contexts and conditions in which interventions occurred. Because most of the included studies focus on antenatal care outcomes, evidence of impact is particularly limited for care seeking for birth and after birth. Evidence in this review is clustered within a small number of countries, and evidence from low- and middle-income countries is notably lacking. Interventions largely had positive effects on uptake of skilled maternity care. Cultural factors are often not the sole factor affecting populations’ use of maternity care services. Broader social, economic, geographical and political factors interacted with cultural factors to affect targeted populations’ access to services in included studies. Programmes and policies should seek to establish an enabling environment and support respectful dialogue with communities to improve use of skilled maternity care. Whilst issues of culture are being recognized by programmes and researchers as being important, interventions that explicitly incorporate issues of culture are rarely evaluated. PMID:27190222

  5. Impact of a learning circle intervention across academic and service contexts on developing a learning culture.

    Science.gov (United States)

    Walker, Rachel; Henderson, Amanda; Cooke, Marie; Creedy, Debra

    2011-05-01

    Partnerships between university schools of nursing and health services lead to successful learning experiences for students and staff. A purposive sample of academics and students from a university school of nursing and clinicians from three health institutions involved in clinical learning (n=73) actively participated in a learning circles intervention conducted over 5 months in south east Queensland. Learning circle discussions resulted in enhanced communication and shared understanding regarding: (1) staff attitudes towards students, expectations and student assessment; (2) strategies enhancing preparation of students, mechanisms for greater support of and recognition of clinicians; (3) challenges faced by staff in the complex processes of leadership in clinical nursing education; (4) construction of learning, ideas for improving communication, networking and sharing; and (5) questioning routine practices that may not enhance student learning. Pre-post surveys of hospital staff (n=310) revealed significant differences across three sub-scales of 'accomplishment' (t=-3.98, pLearning circles can positively enhance organisational learning culture. The intervention enabled participants to recognise mutual goals. Further investigation around staff perception of their influence on their workplace is required. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Do not forget culture when implementing mental health interventions for violence survivors.

    Science.gov (United States)

    Bonilla-Escobar, Francisco Javier; Osorio-Cuellar, Gisel Viviana; Pacichana-Quinayáz, Sara Gabriela; Sánchez-Rentería, Gabriela; Fandiño-Losada, Andrés; Gutiérrez, Maria Isabel

    2017-09-01

    Armed conflict has positioned Colombia as the country with the second highest internal displacement of citizens. This situation has forced government projects and international cooperation agencies to intervene to mitigate the impact of violence; however, the coping strategies implemented by the country's minorities are still unknown. The study objective is to describe the coping strategies and their relation with mental health within Afro-descendant culture in Colombia and the effects that armed conflict has on these coping mechanisms, through a phenomenological study involving focus groups and interviews with experts. Rituals and orality have a healing function that allow Afro-Colombian communities to express their pain and support each other, enabling them to cope with loss. Since the forced displacement, these traditions have been in jeopardy. Armed conflict prevents groups from mourning, generating a form of latent pain. Afro-Colombians require community interventions that create similar spaces for emotional support for the bereaved persons in the pre-conflict period. Thus, it is essential to understand the impact of this spiritual and ritualistic approach on mental health issues and the relevance of narrative and community interventions for survivors.

  7. Project Salud: Using community-based participatory research to culturally adapt an HIV prevention intervention in the Latino migrant worker community.

    Science.gov (United States)

    Sánchez, Jesús; Serna, Claudia A; de La Rosa, Mario

    2012-01-01

    Despite the unique and challenging circumstances confronting Latino migrant worker communities in the U.S., debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Project Salud adopted a community-based participatory research model and utilized focus group methodology with 83 Latino migrant workers to explore the relevance of culturally adapting an evidence-based HIV prevention intervention to be disseminated within this population. Findings from this study indicate that, despite early reservations, Latino migrant workers wanted to participate in the cultural adaptation that would result in an intervention that was culturally relevant, respectful, responsive to their life experiences, and aligned with their needs. This study contributes to the cultural adaptation/fidelity debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance without sacrificing high fidelity to the core components that have established efficacy for evidence-based HIV prevention interventions.

  8. Tailored antiplatelet therapy to improve prognosis in patients exhibiting clopidogrel low-response prior to percutaneous coronary intervention for stable angina or non-ST elevation acute coronary syndrome.

    Science.gov (United States)

    Paarup Dridi, Nadia; Johansson, Pär I; Lønborg, Jacob T; Clemmensen, Peter; Radu, Maria D; Qayyum, Abbas; Pedersen, Frants; Kollslid, Rudi; Helqvist, Steffen; Saunamäki, Kari; Kelbæk, Henning; Jørgensen, Erik; Engstrøm, Thomas; Holmvang, Lene

    2015-01-01

    To investigate whether an intensified antiplatelet regimen could improve prognosis in stable or non-ST elevation in acute coronary syndrome (ACS) patients exhibiting high on-treatment platelet reactivity (HTPR) on clopidogrel and treated with percutaneous coronary intervention (PCI). There is a wide variability in the platelet reactivity to clopidogrel and HTPR has been associated with a poor prognosis. In this observational study, 923 consecutive patients without ST-elevation myocardial infarction (STEMI) and adequately pre-treated with clopidogrel were screened for HTPR with multiple electrode aggregometry after assessment of the coronary anatomy. Patients were grouped based on their response to clopidogrel and the assigned antiplatelet strategy. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, or stent thrombosis. HTPR was demonstrated in 237 patients (25.7%). Of these, 114 continued on conventional clopidogrel therapy, while the remaining 123 received intensified antiplatelet therapy with either double-dose clopidogrel (150 mg daily, n = 55) or the newer P2Y12-inhibitors, prasugrel or ticagrelor (n = 68) for at least 30 days after the index procedure. The median follow-up was 571 days (interquartile range, 373-746). Intensifying antiplatelet therapy reduced the rate of the composite endpoint (p therapy remained independently associated with an increased risk of cardiovascular events (hazard ratio (HR), 2.92; 95% CI, 1.90-4.48), whereas intensified treatment reduced the risk to a level equivalent to that of patients exhibiting normal platelet reactivity (HR, 1.08; 95% CI, 0.59-1.99). Tailored antiplatelet therapy significantly reduced the event rate in patients exhibiting HTPR prior to PCI.

  9. Tailoring of onboard system software

    Institute of Scientific and Technical Information of China (English)

    彭俊杰; 洪炳镕; 魏振华; 乔永强

    2003-01-01

    Tailoring of an operating system and an in embedded real-time operating system in particular is es-sential for both, kernel and operation. But many of current embedded real-time operating systems provide somebasic tailoring at the cost of depleting the flexibility of hardware, which causes the lack of flexibility, and de-grades their tailors. A layered modular tailoring model has been proposed together with some tailoring operationsto improve the flexibility of the systems, and algorithms have been proposed for verification of tailoring opera-tions with the current operating system.

  10. [Effectiveness of an intervention to improve safety culture. Less is more?

    Science.gov (United States)

    López-Picazo, J J; Ferrer-Bas, P; Garrido-Corro, B; Pujalte-Ródenas, V; de la Cruz Murie, P; Blázquez-Pedrero, M; Sánchez-Lorca, S; Soler-Gallego, P; Albacete-Moreno, C; Alcaraz-Pérez, T; Pérez-Romero, S

    To assess the impact of a long-term initiative to improve safety culture among professionals working in a Health Area, and to know their perceived usefulness. An uncontrolled intervention study was designed in a public health care organization including a 3rd level hospital and 5,000 professionals. To measure the impact, the AHRQ Survey was conducted by telephone. A total of 7 dimensions of culture were measured, before starting the project (2012, n=100) and 3 years later (2015, n=207). Variations between 2012 and the respondents aware of the project in 2015 (RAP) were compared, as also between this last group and the rest of respondents (RNAP). The utility was assessed using a 5-item Likert scale, defining higher utility by medians 4 or higher. The response rates were above 80%. In 2015, the 41.5% of respondents were RAP (95%CI: 34.8-48.3), which was perceived as of high utility. Negative variations were detected in "sense of security" (-9.9%, P<.01, vs. 2012, and -4.2% between 2015 groups) and "feedback and communication errors" (-10.0% vs. 2012, and -8.9% between 2015 groups, P<.05). There was a not-significant positive variation in "openness in communication" (1.3% vs. 2012, and 6.9% between 2015 groups). The "management support" showed a not-significant improve in 2015 (37.0%, 95%CI: 30.9-43.1, in RAP; and 38.3%, 95%CI: 33.1-43.4, in RANP) in comparison to 2012 (31.4%, 95%CI: 28.4-39.7). A paradoxical worsening is detected in several dimensions, this probably due to immaturity of the organization and the instrument used. Thus, tools explicitly considering the degree of maturity may be more appropriate to measure cultural changes, although more studies are needed. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Success for All? The Role of the School Counselor in Creating and Sustaining Culturally Responsive Positive Behavior Interventions and Supports Programs

    Science.gov (United States)

    Betters-Bubon, Jennifer; Brunner, Todd; Kansteiner, Avery

    2016-01-01

    Successful implementation of Positive Behavior Interventions and Supports (PBIS) programs should include culturally responsive practices to reduce disproportionality in school discipline referrals and create effective learning environments for all students. Sustaining culturally responsive PBIS programs requires attention to student demographics…

  12. Effectiveness of Cultural Adaptations of Interventions Aimed at Smoking Cessation, Diet, and/or Physical Activity in Ethnic Minorities. A Systematic Review

    Science.gov (United States)

    Nierkens, Vera; Hartman, Marieke A.; Nicolaou, Mary; Vissenberg, Charlotte; Beune, Erik J. A. J.; Hosper, Karen; van Valkengoed, Irene G.; Stronks, Karien

    2013-01-01

    Background The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. Aim To systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness. Methods Systematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997–2009). Inclusion criteria: a) effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b) interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c) primary outcome measures included smoking cessation, diet, or physical activity. Results Out of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity. Conclusion This review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a higher intensity of the

  13. Clinical and economic impact of antimicrobial stewardship interventions with the FilmArray blood culture identification panel.

    Science.gov (United States)

    Pardo, Joe; Klinker, Kenneth P; Borgert, Samuel J; Butler, Brittany M; Giglio, Patricia G; Rand, Kenneth H

    2016-02-01

    The purpose of this study was to evaluate the impact of the FilmArray Blood Culture Identification (BCID) Panel on the management of patients with blood cultures growing gram positive cocci and Candida. We retrospectively compared clinical and economic outcomes between patients during the BCID testing period and a matched historical control group before BCID testing was introduced. A total of 84 BCID patients were matched to 252 historical controls. BCID identification of coagulase negative staphylococci contaminants resulted in shorter post-culture length of stay (P historical controls (P = 0.047). The BCID, coupled with antimicrobial stewardship intervention, was a cost effective tool to improve patient care.

  14. Building Social and Cultural Capital among Young People in Disadvantaged Communities: Lessons from a Brazilian Sport-Based Intervention Program

    Science.gov (United States)

    Spaaij, Ramon

    2012-01-01

    This article explores the concepts of social and cultural capital as analytical tools for investigating the capacity of sport-based intervention programs to contribute to the personal, social and professional development of disadvantaged young people. It draws on survey data (n = 129) and qualitative interviews (n = 53) with participants of the…

  15. Impact of a Multiyear Professional Development Intervention on Science Achievement of Culturally and Linguistically Diverse Elementary Students

    Science.gov (United States)

    Lee, Okhee; Deaktor, Rachael; Enders, Craig; Lambert, Julie

    2008-01-01

    This study examined the impact of the 3-year implementation of a professional development intervention on science achievement of culturally and linguistically diverse elementary students. Teachers were provided with instructional units and workshops that were designed to improve teaching practices and foster positive beliefs about science and…

  16. Effects of Explicit and Non-Explicit Versions of an Early Intervention Program Incorporating Indigenous Culture into Kindergarten Literacy Instruction

    Science.gov (United States)

    MacKay, Leslie D.; McIntosh, Kent

    2012-01-01

    Low literacy is a challenge facing Indigenous communities across North America and is an identified barrier to school success. Early literacy intervention is an important target to reduce the discrepancies in literacy outcomes. The Moe the Mouse® Speech and Language Development Program (Gardner & Chesterman, 2006) is a cultural curriculum…

  17. Rhythm experience and Africana culture trial (REACT!): A culturally salient intervention to promote neurocognitive health, mood, and well-being in older African Americans

    Science.gov (United States)

    Lukach, Alexis J.; Jedrziewski, M. Kathryn; Grove, George A.; Mechanic-Hamilton, Dawn J.; Williams, Shardae S.; Wollam, Mariegold E.; Erickson, Kirk I.

    2017-01-01

    The Rhythm Experience and Africana Culture Trial (REACT!) is a multi-site randomized controlled intervention study designed to examine the efficacy of using African Dance as a form of moderate-intensity physical activity to improve cognitive function in older African Americans. African Americans are almost two times more likely than Caucasians to experience cognitive impairment in late adulthood. This increased risk may be attributed to lower level and quality of education, lower socioeconomic status, and higher prevalence of vascular diseases, type 2 diabetes, hypertension, and obesity, all of which are recognized as risk factors for dementia. Fortunately, interventions targeting cardiovascular health (i.e., physical activity) are associated with improved neurocognitive function and a reduced risk for dementia, so African Americans may be particularly suited for interventions targeting cardiovascular health and cognitive function. Here, we describe a randomized intervention protocol for increasing physical activity in older (65–75 years) African Americans. Participants (n = 80) at two study locations will be randomized into one of two groups. The treatment group will participate in African Dance three times per week for six months and the control group will receive educational training on Africana history and culture, as well as information about health behaviors, three times per week for six months. If successful, the REACT! study may transform community interventions and serve as a platform and model for testing other populations, age groups, and health outcomes, potentially identifying novel and creative methods for reducing or eliminating health disparities. PMID:27033674

  18. Rhythm experience and Africana culture trial (REACT!): A culturally salient intervention to promote neurocognitive health, mood, and well-being in older African Americans.

    Science.gov (United States)

    Lukach, Alexis J; Jedrziewski, M Kathryn; Grove, George A; Mechanic-Hamilton, Dawn J; Williams, Shardae S; Wollam, Mariegold E; Erickson, Kirk I

    2016-05-01

    The Rhythm Experience and Africana Culture Trial (REACT!) is a multi-site randomized controlled intervention study designed to examine the efficacy of using African Dance as a form of moderate-intensity physical activity to improve cognitive function in older African Americans. African Americans are almost two times more likely than Caucasians to experience cognitive impairment in late adulthood. This increased risk may be attributed to lower level and quality of education, lower socioeconomic status, and higher prevalence of vascular diseases, type 2 diabetes, hypertension, and obesity, all of which are recognized as risk factors for dementia. Fortunately, interventions targeting cardiovascular health (i.e., physical activity) are associated with improved neurocognitive function and a reduced risk for dementia, so African Americans may be particularly suited for interventions targeting cardiovascular health and cognitive function. Here, we describe a randomized intervention protocol for increasing physical activity in older (65-75years) African Americans. Participants (n=80) at two study locations will be randomized into one of two groups. The treatment group will participate in African Dance three times per week for six months and the control group will receive educational training on Africana history and culture, as well as information about health behaviors, three times per week for six months. If successful, the REACT! study may transform community interventions and serve as a platform and model for testing other populations, age groups, and health outcomes, potentially identifying novel and creative methods for reducing or eliminating health disparities. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. 商务广告翻译中的文化介入%Culture Intervention in Translation of Business Advertisement

    Institute of Scientific and Technical Information of China (English)

    吴粉华

    2011-01-01

    商务广告翻译与文化密切相关,对商务广告翻译中的文化因素及文化差异进行了分析,阐释商务广告翻译中存在的文化性,提出在进行商务广告翻译时应做到从翻译手法、语言审美及文化转换三个方面进行文化介入。%The author of this paper has made a deep analysis of the cultural factors and cultural differences,illustrated the cultural phenomena in the translation of business advertisements and suggested making culture intervention from the method of translation,language aesthetic appreciation and cultural conversion.

  20. Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness.

    Science.gov (United States)

    Wainberg, Milton L; Alfredo González, M; McKinnon, Karen; Elkington, Katherine S; Pinto, Diana; Gruber Mann, Claudio; Mattos, Paulo E

    2007-07-01

    As in other countries worldwide, adults with severe mental illness (SMI) in Brazil are disproportionately infected with HIV relative to the general population. Brazilian psychiatric facilities lack tested HIV prevention interventions. To adapt existing interventions, developed only in the US, we conducted targeted ethnography with adults with SMI and staff from two psychiatric institutions in Brazil. We sought to characterize individual, institutional, and interpersonal factors that may affect HIV risk behavior in this population. We conducted 350 hours of ethnographic field observations in two mental health service settings in Rio de Janeiro, and 9 focus groups (n=72) and 16 key-informant interviews with patients and staff in these settings. Data comprised field notes and audiotapes of all exchanges, which were transcribed, coded, and systematically analyzed. The ethnography identified and/or characterized the institutional culture: (1) patients' risk behaviors; (2) the institutional setting; (3) intervention content; and (4) intervention format and delivery strategies. Targeted ethnography also illuminated broader contextual issues for development and implementation of HIV prevention interventions for adults with SMI in Brazil, including an institutional culture that did not systematically address patients' sexual behavior, sexual health, or HIV sexual risk, yet strongly impacted the structure of patients' sexual networks. Further, ethnography identified the Brazilian concept of "social responsibility" as important to prevention work with psychiatric patients. Targeted ethnography with adults with SMI and institutional staff provided information critical to the adaptation of tested US HIV prevention interventions for Brazilians with SMI.

  1. Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study.

    Science.gov (United States)

    Taylor, Natalie J; Sahota, Pinki; Sargent, Judith; Barber, Sally; Loach, Jackie; Louch, Gemma; Wright, John

    2013-12-28

    Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother's diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.

  2. Self-related neural response to tailored smoking-cessation messages predicts quitting

    Science.gov (United States)

    Chua, Hannah Faye; Ho, S. Shaun; Jasinska, Agnes J.; Polk, Thad A.; Welsh, Robert C.; Liberzon, Israel; Strecher, Victor J.

    2011-01-01

    Although tailored health interventions can be more effective in eliciting positive behavior change then generic interventions, the underlying neural mechanisms are not yet understood. Ninety-one smokers participated in a functional magnetic resonance imaging (fMRI) session and a tailored smoking-cessation program. We found that increases in activations in self-related processing regions, particularly dorsomedial prefrontal cortex, to tailored messages predicted quitting during a 4-month follow-up. PMID:21358641

  3. International Cultural Immersion: Assessing the Influence of a Group Intervention on Intercultural Sensitivity for Counselor Trainees

    Science.gov (United States)

    Barden, Sejal M.; Shannonhouse, Laura; Mobley, Keith

    2015-01-01

    Scholars (e.g., Bemak & Chung, 2004) underscore the need for group workers to be culturally sensitive. One group training strategy, cultural immersion, is often employed to develop cultural sensitivity. However, no studies have utilized quasi-experimental methodologies to assess differences in cultural sensitivity between trainees that immerse…

  4. Engaging Parents in Preventive Interventions for Young Children: Working with Cultural Diversity Within Low-Income, Urban Neighborhoods.

    Science.gov (United States)

    Dawson-McClure, Spring; Calzada, Esther J; Brotman, Laurie M

    2017-08-01

    A robust literature documents the impact of poverty on child development and lifelong health, well-being and productivity. Racial and ethnic minority children continue to bear the burden of poverty disproportionately. Evidence-based parenting interventions in early childhood have the potential to attenuate risk attributable to poverty and stress. To reduce racial, ethnic, and socioeconomic disparities in the USA, parenting interventions must be accessible, engaging, and effective for low-income families of color living in large urban centers. This paper describes the initial development of ParentCorps and ongoing improvements to realize that vision. Initial development focused on creating a parenting intervention that places culture at the center and effectively embedding it in schools. ParentCorps includes core components found in nearly all effective parenting interventions with a culturally informed approach to engaging families and supporting behavior change. As the intervention is implemented at scale in increasingly diverse communities, improvement efforts include augmenting professional development to increase racial consciousness among all staff (evaluators, coaches, and school-based facilitators) and applying an implementation science framework to study and more fully support schools' use of a package of engagement strategies.

  5. Parenting in 2 Worlds: Effects of a Culturally Adapted Intervention for Urban American Indians on Parenting Skills and Family Functioning.

    Science.gov (United States)

    Kulis, Stephen S; Ayers, Stephanie L; Harthun, Mary L; Jager, Justin

    2016-08-01

    Parenting in 2 Worlds (P2W) is a culturally grounded parenting intervention that addresses the distinctive social and cultural worlds of urban American Indian (AI) families. P2W was culturally adapted through community-based participatory research in three urban AI communities with diverse tribal backgrounds. This paper reports the immediate outcomes of P2W in a randomized controlled trial, utilizing data from 575 parents of AI children (ages 10-17). Parents were assigned to P2W or to the comparison group, an informational family health curriculum, Healthy Families in 2 Worlds (HF2W). Both the P2W and HF2W curricula consisted of 10 workshops delivered weekly by AI community facilitators. Pretests were administered at the first workshop and a post-test at the last workshop. Tests of the efficacy of P2W versus HF2W on parenting skills and family functioning were analyzed with pairwise t tests, within intervention type, and by baseline adjusted path models using FIML estimation in Mplus. Intervention effect sizes were estimated with Cohen's d. Participants in P2W reported significant improvements in parental agency, parenting practices, supervision and family cohesion, and decreases in discipline problems and parent-child conflict. Compared to HF2W, P2W participants reported significantly larger increases in parental self-agency and positive parenting practices, and fewer child discipline problems. Most of these desired program effects for P2W approached medium size. Culturally adapted parenting interventions like P2W can effectively strengthen parenting practices and family functioning among urban AI families and help address their widespread need for targeted, culturally grounded programs.

  6. Intervention in Multi-cultural Organizations -Prevention of Accidents as political change processes

    DEFF Research Database (Denmark)

    Dyhrberg, Mette Bang; Kamp, Annette; Koch, Christian

    1999-01-01

    A selective study of literature within safety culture, corporate culture and organisational theory have shown that the safety culture approach can benefit from the corporate culture approaches and organisational theory dealing with political processes. The implicit models of organisation within m...... of an organisation as a Multi-cultural Organisation. Second on change processes as political processes where the needed change have to be negotiated and reshaped....... culture approaches.The Concept of a multicultural organisation thus aims at encompassing the multitude of actor positions within an organisation with possible influence on the prevention work. A case study within industry is used to demonstrate the benefits of mobilizing these additional approaches...

  7. Process and Product in Cross-Cultural Treatment Research: Development of a Culturally Sensitive Women-Centered Substance Use Intervention in Georgia

    Directory of Open Access Journals (Sweden)

    Hendrée E. Jones

    2014-01-01

    Full Text Available Women who inject drugs (WID are highly marginalized and stigmatized and experience ongoing discrimination in Georgia. Few opportunities exist for WID to receive publicly funded treatment for substance use disorders. The IMEDI (Investigating Methods for Enhancing Development in Individuals project was developed in response to the need for women-specific and women-centered treatment services. This paper described our approach to understanding the Georgian culture—and WID within that culture—so that we could integrate two interventions for substance use found effective in other Western and non-Western cultures and to outline how we refined and adapted our integrated intervention to yield a comprehensive women-centered intervention for substance use. Reinforcement Based Treatment (RBT and the Women’s CoOp (WC were adapted and refined based on in-depth interviews with WID (N=55 and providers of health services (N=34 to such women and focus groups [2 with WID (N=15 and 2 with health service providers (N=12]. The resulting comprehensive women-centered intervention, RBT+WC, was then pretested and further refined in a sample of 20 WID. Results indicated positive pre-post changes in urine screening results and perceived needs for both RBT+WC and a case management control condition. The approach to treatment adaptation and the revised elements of RBT+WC are presented and discussed.

  8. An Internet-based intervention for eating disorders consisting of automated computer-tailored feedback with or without supplemented frequent or infrequent support from a coach: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    J.J. Aardoom; A.E. Dingemans (Alexandra); P. Spinhoven (Philip); L. van Hakkaart-van Roijen (Leona); E.F. van Furth (Eric)

    2013-01-01

    textabstractSeveral Internet-based interventions for eating disorders have shown their effectiveness. Still, there is a need to refine such interventions given that most existing programs seem to be limited by their static ‘one-size-fits-all’ approach. ‘Featback’, an Internet-based intervention for

  9. Do cultural differences influence batterer intervention program outcomes? A studywith Spanish and Latin American offenders

    Directory of Open Access Journals (Sweden)

    Viviana Vargas

    2015-04-01

    Full Text Available This study analyzed, first, if there were any differences in attitudes towards partner violence (i.e., perceivedseverity, victim blaming, and acceptability, responsibility attributions, sexism, and risk of recidivismbetween Latin American immigrants and Spanish offenders convicted of intimate-partner violence at thebeginning of a batterer intervention program. Second, differences in the batterer intervention programoutcomes between Spanish and Latin American offenders were explored. The sample consisted of 278batterers (211 Spanish and 67 Latin American who participated in a community-based battererintervention program. Results showed significant differences between Spanish and Latin Americanoffenders in perceived severity, victim blaming, violence against women acceptability, and benevolentsexism. Regarding batterer intervention program outcomes, results showed that despite initial differencesbetween Spanish and Latin American offenders, both groups benefit equally from the intervention.

  10. Multi-Level Cultural Intervention for the Prevention of Suicide and Alcohol Use Risk with Alaska Native Youth: a Nonrandomized Comparison of Treatment Intensity.

    Science.gov (United States)

    Allen, James; Rasmus, Stacy M; Fok, Carlotta Ching Ting; Charles, Billy; Henry, David

    2017-08-07

    Suicide and alcohol use disorders are primary determinants of health disparity among Alaska Native people in contrast to the US general population. Qungasvik, a Yup'ik word for toolbox, is a strengths-based, multi-level, community/cultural intervention for rural Yup'ik youth ages 12-18. The intervention uses "culture as intervention" to promote reasons for life and sobriety in young people using local expertise, high levels of community direction, and community based staff. The intervention is grounded in local practices and adaptive to local cultural differences distinctive to rural Yup'ik communities. The current study compares the effectiveness of high-intensity intervention in one community (treatment), operationalized as a high number of intervention activities, or modules, implemented and attended by youth, contrasted to a lower intensity intervention in a second community (comparison) that implemented fewer modules. A Yup'ik Indigenous theory of change developed through previous qualitative and quantitative work guides intervention. In the model, direct intervention effects on proximal or intermediate variables constituting protective factors at the individual, family, community, and peer influences levels lead to later change on the ultimate prevention outcome variables of Reasons for Life protective from suicide risk and Reflective Processes about alcohol use consequences protective from alcohol risk. Mixed effects regression models contrasted treatment and comparison arms, and identified significant intervention effects on Reasons for Life (d = 0.27, p < .05) but not Reflective Processes.

  11. The effect of organisational context on organisational development (OD interventions

    Directory of Open Access Journals (Sweden)

    Sanjana Brijball Parumasur

    2012-01-01

    Full Text Available Orientation: Systematic and congruent organisational structures, systems, strategies and designs are necessary for the successful implementation of organisational development (OD interventions.Research purpose: This article examines national and international OD practices. It assesses the effect of diverse cultures and cultural values for determining the effectiveness of OD interventions.Motivation for the study: Most organisational change and development programmes fail and only a few result in increased competitiveness, improvements and profitability. This emphasises the need for change interventions to give sufficient attention to leadership, cultures, managing change and adopting context-based OD interventions.Research design, approach and method: This article is a literature review of the current trends and research in the area of OD interventions. It synthesises the influence that cultures and cultural orientations have on determining which OD intervention strategies organisations should adopt in different cultures.Main findings: The analysis emphasises how important it is to achieve congruence between the OD interventions organisations select and their local cultures.Practical/managerial implications: It is important to note the evolving nature of the political and economic climates that influence national cultures and that they emphasise that interventions that reflect OD values, which are tailor-made and shaped to the needs of local cultures, are necessary.Contribution/value-add: This study links various OD interventions to Hofstede’s dimensions for differentiating national cultures. It provides guidelines for aligning the practices and techniques of OD to the values and cultures of the organisations and societies in which they are to be implemented.

  12. Towards tailored radiopeptide therapy

    Energy Technology Data Exchange (ETDEWEB)

    Radojewski, Piotr [University Hospital Bern, Institute of Nuclear Medicine, Bern (Switzerland); Dumont, Rebecca [University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); UCLA, Department of Radiology, David Geffen School of Medicine, Los Angeles, CA (United States); Marincek, Nicolas; Walter, Martin A. [University Hospital Bern, Institute of Nuclear Medicine, Bern (Switzerland); University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Brunner, Philippe; Mueller-Brand, Jan [University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Maecke, Helmut R. [University Hospital Basel, Division of Radiological Chemistry, Basel (Switzerland); Briel, Matthias [University Hospital Basel, Basel Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland)

    2015-07-15

    Somatostatin receptor-targeted radiopeptide therapy is commonly performed using single radioisotopes. We evaluated the benefits and harms of combining radioisotopes in radiopeptide therapy in patients with neuroendocrine tumor. Using multivariable-adjusted survival analyses and competing risk analyses we evaluated outcomes in patients with neuroendocrine tumor receiving {sup 90}Y-DOTATOC, {sup 177}Lu-DOTATOC or their combination. {sup 90}Y-DOTATOC plus {sup 177}Lu-DOTATOC treatment was associated with longer survival than {sup 90}Y-DOTATOC (66.1 vs. 47.5 months; n = 1,358; p < 0.001) or {sup 177}Lu-DOTATOC alone (66.1 vs. 45.5 months; n = 390; p < 0.001). {sup 177}Lu-DOTATOC was associated with longer survival than {sup 90}Y-DOTATOC in patients with solitary lesions (HR 0.3, range 0.1 - 0.7; n = 153; p = 0.005), extrahepatic metastases (HR 0.5, range 0.3 - 0.9; n = 256; p = 0.029) and metastases with low uptake (HR 0.1, range 0.05 - 0.4; n = 113; p = 0.001). {sup 90}Y-DOTATOC induced higher hematotoxicity rates than combined treatment (9.5 % vs. 4.0 %, p = 0.005) or {sup 177}Lu-DOTATOC (9.5 % vs. 1.4 %, p = 0.002). Renal toxicity was similar among the treatments. Using {sup 90}Y and {sup 177}Lu might facilitate tailoring radiopeptide therapy and improve survival in patients with neuroendocrine tumors. (orig.)

  13. Implementing a Culturally and Linguistically Responsive Phonics Curriculum That Incorporates Music to Meet the Needs of English Language Learners in the Response to Intervention Process

    Science.gov (United States)

    Miller, Danielle Denise

    2013-01-01

    The purpose of this study is to investigate the effect of the Sing, Spell, Read, Write (SSRW) phonics curriculum that uses explicit and systematic methods and incorporates music to teach literacy skills implemented as a tier-two reading intervention in the Response to Intervention process to meet the cultural and linguistic needs of English…

  14. ¡Cocinar Para Su Salud!: Randomized Controlled Trial of a Culturally Based Dietary Intervention among Hispanic Breast Cancer Survivors.

    Science.gov (United States)

    Greenlee, Heather; Gaffney, Ann Ogden; Aycinena, A Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M; Lim, Emerson; Tsai, Wei-Yann; Crew, Katherine; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L

    2015-05-01

    There is a need for culturally relevant nutrition programs targeted to underserved cancer survivors. Our aim was to examine the effect of a culturally based approach to dietary change on increasing fruit/vegetable (F/V) intake and decreasing fat intake among Hispanic breast cancer survivors. Participants were randomized to Intervention and Control groups. Diet recalls, detailed interviews, fasting blood, and anthropometric measures were collected at baseline, 3, 6, and 12 months. Hispanic women (n=70) with stage 0 to III breast cancer who completed adjuvant treatment and lived in New York City were randomized between April 2011 and March 2012. The Intervention group (n=34) participated in ¡Cocinar Para Su Salud!, a culturally based nine-session (24 hours over 12 weeks) intervention including nutrition education, cooking classes, and food-shopping field trips. The Control group (n=36) received written dietary recommendations for breast cancer survivors. Change at 6 months in daily F/V servings and percent calories from total fat were the main outcome measures. Linear regression models adjusted for stratification factors and estimated marginal means were used to compare changes in diet from baseline to 3 and 6 months. Baseline characteristics were the following: mean age 56.6 years (standard deviation 9.7 years), mean time since diagnosis 3.4 years (standard deviation 2.7 years), mean body mass index (calculated as kg/m²) 30.9 (standard deviation 6.0), 62.9% with annual household income ≤$15,000, mean daily servings of all F/V was 5.3 (targeted F/V 3.7 servings excluding legumes/juices/starchy vegetables/fried foods), and 27.7% of daily calories from fat. More than 60% in the Intervention group attended seven or more of nine classes, with overall study retention of 87% retention at 6 months. At month 6, the Intervention group compared with Control group reported an increase in mean servings of F/V from baseline (all F/V: +2.0 vs -0.1; P=0.005; targeted F/V: +2

  15. Mediators and Moderators of the Effectiveness of a Community Health Worker Intervention That Improved Dietary Outcomes in Pregnant Latino Women

    Science.gov (United States)

    Shah, Megha K.; Kieffer, Edith C.; Choi, Hwajung; Schumann, Christina; Heisler, Michele

    2015-01-01

    Background. Pregnancy is an opportune time to initiate diabetes prevention strategies for minority and underserved women, using culturally tailored interventions delivered by community health workers. A community-partnered randomized controlled trial (RCT) with pregnant Latino women resulted in significantly improved vegetable, fiber, added sugar,…

  16. An Internet-based intervention for eating disorders consisting of automated computer-tailored feedback with or without supplemented frequent or infrequent support from a coach: Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    J.J. Aardoom; A.E. Dingemans (Alexandra); P. Spinhoven (Philip); L. van Hakkaart-van Roijen (Leona); E.F. van Furth (Eric)

    2013-01-01

    textabstractBackground: Several Internet-based interventions for eating disorders have shown their effectiveness. Still, there is a need to refine such interventions given that most existing programs seem to be limited by their static 'one-size-fits-all' approach. 'Featback', an Internet-based

  17. An Internet-based intervention for eating disorders consisting of automated computer-tailored feedback with or without supplemented frequent or infrequent support from a coach: Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    J.J. Aardoom; A.E. Dingemans (Alexandra); P. Spinhoven (Philip); L. van Hakkaart-van Roijen (Leona); E.F. van Furth (Eric)

    2013-01-01

    textabstractBackground: Several Internet-based interventions for eating disorders have shown their effectiveness. Still, there is a need to refine such interventions given that most existing programs seem to be limited by their static 'one-size-fits-all' approach. 'Featback', an Internet-based inter

  18. "En el grupo tomas conciencia (in group you become aware)": Latino immigrants' satisfaction with a culturally informed intervention for men who batter.

    Science.gov (United States)

    Parra-Cardona, José Rubén; Escobar-Chew, Ana Rocío; Holtrop, Kendal; Carpenter, Georgia; Guzmán, Ricardo; Hernández, Dolores; Zamudio, Efraín; González Ramírez, Dolores

    2013-01-01

    Qualitative interviews were conducted with 21 Latino immigrant men who participated in a culturally informed batterer intervention. The objectives of this investigation were twofold. First, to identify the treatment components that facilitated the participants' willingness to engage in a process of change aimed at terminating their abusive behaviors. Second, to describe the treatment components that led to their satisfaction with the intervention. Research findings confirm that the Spanish version of the Duluth curriculum can be beneficial for Latino immigrant batterers. Results also demonstrate the critical role of culture as it refers to content of the intervention and method of delivery.

  19. Tactical Utility of Tailored Systems

    Science.gov (United States)

    2015-07-10

    www.popsci.com/ cars /article/2011-06/how-first- crowdsourced-military- car -can-remake-future-defense- manufacturing Tactical Utility of Tailored Systems...year lead time to develop a piece of equipment, if we were able to collapse the pace of which that manufacturing takes place, that would save taxpayers...within budget. This paper hopes to explore the idea of combining virtual environments and rapid manufacturing to create tailored materiel specific

  20. A systematic review of assessment and intervention strategies for effective clinical communication in culturally and linguistically diverse students.

    Science.gov (United States)

    Chan, Annie; Purcell, Alison; Power, Emma

    2016-09-01

    Culturally and linguistically diverse (CALD) students often experience difficulties with the clinical communication skills that are essential for successful interactions in the workplace. However, there is little evidence on the effectiveness of assessment and intervention strategies for this population. The two aims of this study were: to evaluate the effectiveness of assessment tools in identifying and describing the clinical communication difficulties of CALD health care students; and to determine whether communication programmes improved their clinical communication skills. Systematic review based on the Cochrane protocol. Articles were identified through a search of established databases using MeSH and key search terms. Studies published in English from 1990 to March 2015 were included if they described assessment strategies or a training programme for communication skills of CALD students. Studies were excluded if they did not describe implementation of a specific assessment or intervention programme. Data were extracted independently by the first author and verified by the second author. Quality was measured by the Best Evidence Medical Education guide and the Educational Interventions Critical Appraisal Tool. The Kirkpatrick hierarchy was used to measure impact. Meta-analysis was not conducted because of the heterogeneity of programme design and outcome measures. One hundred and twenty-nine articles met the criteria for full text review. Eighty-six articles were excluded. Thirteen articles addressing assessment and 30 articles reporting on communication training programmes were included in this review. Assessment tools used rubrics and rating scales effectively. Intervention studies focused on speech and language skills (n = 20), interpersonal skills (n = 7) and faculty-level support (n = 5). Although 17 studies reported positive findings on student satisfaction, only eight reported improved skills post-training. The development of effective

  1. Providing Early Intervention within Natural Environments: A Cross-Cultural Comparison

    Science.gov (United States)

    Rantala, Anja; Uotinen, Sanna; McWilliam, R. A.

    2009-01-01

    The purposes of this study were to determine the state of current practice in early intervention in Finland and to compare them to American data. Professional women (N = 52), representing child care, elementary school, healthcare, and social work, completed the Families in Natural Environments Scale of Service Evaluation, a 34-item questionnaire…

  2. The Impact of Multicultural Trade Books and an Intervention on Fourth Graders' Cultural Attitudes

    Science.gov (United States)

    Whitcomb, Susan Herberger

    2009-01-01

    As the United States population has become more diverse and the civil rights movement of the 1960s increased attentiveness to the change in population, the need for multicultural awareness has grown (Perry & Fraser, 1993). This study examined if teacher read alouds of multicultural trade books and a scripted instructional intervention could impact…

  3. The Ethical Implications of Cultural Intervention by Space-faring Civilizations -- What Science Fiction Has to Say

    Science.gov (United States)

    Ciupa, M.

    Science fiction (Scifi) plays out the concerns of our possible scientistic futures; it is a source for exploring the deep rooted psychological concerns of mankind with science and the humanities. In this paper it is proposed Scifi is a valid source of hypotheses to examine, not as "evidence", but as candidate ­ often cautionary ­ notions, i.e., scenarios to be studied. Scifi represents a kind of Jungian mythological based story-telling, putting forward tales that express our conscious/unconscious concerns. Thus, when looking into ethical questions like, "where will techno-progressive futures take us?", we import into them these archetypes, hopes and fears, as a result they frequently reappear as familiar tropes. In this respect it is appropriate not to ignore them, but to openly challenge/appreciate them: to see what scenarios are indeed likely and how they may impact us reciprocally. This paper examines some of these aspects, and provides examples of how they are represented in the Scifi genre, in particular with consideration of the ethical implications of cultural intervention by space-faring civilizations. Given the specific analysis/examples provided, it concludes with an ethical scenario analysis (a dialectic argument), within the limiting conditions of the Drake Equation, Fermi Paradox and Cultural History. It comments on the potential existential risk of the Active SETI programmes recently initiated, indeed the need for an ethical exosociological review of all proposed Interstellar projects that express an "Intervention-Propensity".

  4. Reducing cultural and psychological barriers to Latino enrollment in HIV-prevention counseling: initial data on an enrollment meta-intervention.

    Science.gov (United States)

    Wilson, Kristina; Durantini, Marta R; Albarracín, Julia; Crause, Candi; Albarracín, Dolores

    2013-01-01

    Aspects of Latino culture (e.g., machismo, marianism) can act as barriers to enrollment in HIV-prevention programs. To lift these barriers, a culturally appropriate meta-intervention was designed to increase intentions to enroll in HIV-prevention counseling by Latinos. Latino participants (N=41) were recruited from the community and randomly assigned to either an experimental or control meta-intervention condition that varied the introduction to a HIV-prevention counseling program. Following the meta-intervention, participants were issued an invitation to take part in HIV-prevention counseling. The outcome measure was the intention to enroll in a HIV-prevention counseling session. Findings indicated that enrollment intentions were higher in the experimental meta-intervention condition (96%) than in the control meta-intervention condition (53%). In addition, the effects of the meta-intervention were comparable across genders and participant ages. Findings suggest that the use of a culturally appropriate meta-intervention may be an effective strategy for increasing Latino enrollment in HIV-prevention programs. These promising findings warrant further investigation into the efficacy and effectiveness of this meta-intervention.

  5. Culture-Based Considerations in Programming for Stuttering Intervention with African American Clients and Their Families.

    Science.gov (United States)

    Robinson, Tommie L., Jr.; Crowe, Thomas A.

    1998-01-01

    Describes a clinical service delivery model for use with African-American children who stutter and their families. The model emphasizes the clinical importance of culture-based factors such as myths, oral presentation styles, narrative discourse styles, and cognitive learning styles, as well as rules for interaction and turn-taking. (Author/DB)

  6. Devising and Investigating Benefits of Interconnected Interventions to Promote Education Majors' Culturally Responsive Teaching

    Science.gov (United States)

    Richards, Janet C.

    2011-01-01

    For five years I have supervised a summer literacy camp that connects graduate education majors with students from diverse ethnicities. Each summer I noted I inadequately challenged the education majors to extend their knowledge, examine their attitudes, and expand their abilities to offer culturally responsive literacy instruction to students in…

  7. Using Relational-Cultural Theory to Conceptualize Couple Interventions in the Treatment of Sex Addiction

    Science.gov (United States)

    Vogel, Joanne E.

    2007-01-01

    Sex addictions have become an increasing concern since the growth of the sex industry, sex in advertising, and the ease of Internet access to sex. This article uses the foundational principles of Relational-Cultural Theory (RCT) to conceptualize sexual addiction and its relational impact. Particular attention is paid to the principles of…

  8. Routine in vitro culture of P. falciparum gametocytes to evaluate novel transmission-blocking interventions.

    Science.gov (United States)

    Delves, Michael J; Straschil, Ursula; Ruecker, Andrea; Miguel-Blanco, Celia; Marques, Sara; Baum, Jake; Sinden, Robert E

    2016-09-01

    The prevention of parasite transmission from the human host to the mosquito has been recognized as a vital tool for malaria eradication campaigns. However, transmission-blocking antimalarial drug and/or vaccine discovery and development is currently hampered by the expense and difficulty of producing mature Plasmodium falciparum gametocytes in vitro-the parasite stage responsible for mosquito infection. Current protocols for P. falciparum gametocyte culture usually require complex parasite synchronization and addition of stimulating and/or inhibitory factors, and they may not have demonstrated the essential property of mosquito infectivity. This protocol details all the steps required for reliable P. falciparum gametocyte production and highlights common factors that influence culture success. The protocol can be completed in 15 d, and particular emphasis is placed upon operating a gametocyte culture facility on a continuous cycle. In addition, we show how functionally viable gametocytes can be used to evaluate transmission-blocking drugs both in a field setting and at high throughput (HTP) for drug discovery.

  9. Neural correlates of message tailoring and self-relatedness in smoking cessation programming

    Science.gov (United States)

    Chua, Hannah Faye; Liberzon, Israel; Welsh, Robert C.; Strecher, Victor J.

    2011-01-01

    BACKGROUND Smoking leads to illnesses including addiction, cancer, and cardiovascular and respiratory diseases. Different intervention programs have become available. In the past decade, providing tailored smoking cessation messages has been shown to be more effective in inducing smoking cessation than one-size-fits-all interventions. However, little is known about the brain responses of smokers when they receive tailored smoking cessation messages. METHODS A neuroimaging study using blocked and event-related designs examined neural activity in 24 smokers exposed to high-tailored and low-tailored smoking cessation messages. RESULTS: In both blocked and event-related conditions, rostral medial prefrontal cortex and precuneus/posterior cingulate were engaged more during the processing of high-tailored smoking cessation messages than low-tailored smoking cessation messages. CONCLUSION The activation patterns of smokers to tailored cessation messages show involvement of brain areas commonly implicated in self-related processing. Results seem to add support to the suggested role of self-relevance in tailored cessation programs, where previous studies have shown a potential mediating role of self-relevance on smoking abstinence. The findings are relevant to understanding the cognitive mechanisms underlying tailored message processing and may point to new directions for testing response to health communications programming. PMID:18926523

  10. Qualitative study among African American parents to inform an intervention to promote adoption of the dietary guidelines for Americans food and phyical activity recommendations

    Science.gov (United States)

    This qualitative study was conducted to enable the research team to culturally tailor an intervention to increase adherence to the dietary guidelines for Americans (DGA) in African American parents and their children living in Lower Mississippi Delta (LMD) Communities. Focus group results guided the...

  11. ¡Cocinar Para Su Salud!: Randomized Controlled Trial of a Culturally Based Dietary Intervention among Hispanic Breast Cancer Survivors.

    Science.gov (United States)

    Greenlee, Heather; Gaffney, Ann Ogden; Aycinena, A Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M; Lim, Emerson; Tsai, Wei-Yann; Crew, Katherine; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L

    2015-05-01

    There is a need for culturally relevant nutrition programs targeted to underserved cancer survivors. Our aim was to examine the effect of a culturally based approach to dietary change on increasing fruit/vegetable (F/V) intake and decreasing fat intake among Hispanic breast cancer survivors. Participants were randomized to Intervention and Control groups. Diet recalls, detailed interviews, fasting blood, and anthropometric measures were collected at baseline, 3, 6, and 12 months. Hispanic women (n=70) with stage 0 to III breast cancer who completed adjuvant treatment and lived in New York City were randomized between April 2011 and March 2012. The Intervention group (n=34) participated in ¡Cocinar Para Su Salud!, a culturally based nine-session (24 hours over 12 weeks) intervention including nutrition education, cooking classes, and food-shopping field trips. The Control group (n=36) received written dietary recommendations for breast cancer survivors. Change at 6 months in daily F/V servings and percent calories from total fat were the main outcome measures. Linear regression models adjusted for stratification factors and estimated marginal means were used to compare changes in diet from baseline to 3 and 6 months. Baseline characteristics were the following: mean age 56.6 years (standard deviation 9.7 years), mean time since diagnosis 3.4 years (standard deviation 2.7 years), mean body mass index (calculated as kg/m(2)) 30.9 (standard deviation 6.0), 62.9% with annual household income ≤$15,000, mean daily servings of all F/V was 5.3 (targeted F/V 3.7 servings excluding legumes/juices/starchy vegetables/fried foods), and 27.7% of daily calories from fat. More than 60% in the Intervention group attended seven or more of nine classes, with overall study retention of 87% retention at 6 months. At month 6, the Intervention group compared with Control group reported an increase in mean servings of F/V from baseline (all F/V: +2.0 vs -0.1; P=0.005; targeted F

  12. Tailored antiplatelet therapy to improve prognosis in patients exhibiting clopidogrel low-response prior to percutaneous coronary intervention for stable angina or non-ST elevation acute coronary syndrome

    DEFF Research Database (Denmark)

    Paarup Dridi, Nadia; Johansson, Pär I; Lønborg, Jacob T

    2015-01-01

    Abstract Aim: To investigate whether an intensified antiplatelet regimen could improve prognosis in stable or non-ST elevation in acute coronary syndrome (ACS) patients exhibiting high on-treatment platelet reactivity (HTPR) on clopidogrel and treated with percutaneous coronary intervention (PCI...

  13. Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review.

    Science.gov (United States)

    Chaet, Alexis V; Morshedi, Bijan; Wells, Kristen J; Barnes, Laura E; Valdez, Rupa

    2016-08-10

    As consumer health information technology (IT) becomes more thoroughly integrated into patient care, it is critical that these tools are appropriate for the diverse patient populations whom they are intended to serve. Cultural differences associated with ethnicity are one aspect of diversity that may play a role in user-technology interactions. Our aim was to evaluate the current scope of consumer health IT interventions targeted to the US Spanish-speaking Latino population and to characterize these interventions in terms of technological attributes, health domains, cultural tailoring, and evaluation metrics. A narrative synthesis was conducted of existing Spanish-language consumer health IT interventions indexed within health and computer science databases. Database searches were limited to English-language articles published between January 1990 and September 2015. Studies were included if they detailed an assessment of a patient-centered electronic technology intervention targeting health within the US Spanish-speaking Latino population. Included studies were required to have a majority Latino population sample. The following were extracted from articles: first author's last name, publication year, population characteristics, journal domain, health domain, technology platform and functionality, available languages of intervention, US region, cultural tailoring, intervention delivery location, study design, and evaluation metrics. We included 42 studies in the review. Most of the studies were published between 2009 and 2015 and had a majority percentage of female study participants. The mean age of participants ranged from 15 to 68. Interventions most commonly focused on urban population centers and within the western region of the United States. Of articles specifying a technology domain, computer was found to be most common; however, a fairly even distribution across all technologies was noted. Cancer, diabetes, and child, infant, or maternal health were the

  14. Cross-cultural aspects of depression management in primary care.

    Science.gov (United States)

    Hails, Katherine; Brill, Charlotte D; Chang, Trina; Yeung, Albert; Fava, Maurizio; Trinh, Nhi-Ha

    2012-08-01

    Major depressive disorder (MDD) is a prevalent illness in minority populations. Minority patients with MDD are often unrecognized and untreated. This review examines promising interventions to address MDD in primary care settings, where minority groups are more likely to seek care. Since 2010, eleven interventions have been developed to address patient-specific and provider-specific barriers, many of which are adaptations of the collaborative care model. Other promising interventions include cultural tailoring of the collaborative care model, as well as the addition of telepsychiatry, motivational interviewing, cultural consultation, and innovations in interpreting. Overall, collaborative care was found feasible and improved satisfaction and treatment engagement of depressed minority patients in primary care. It remains inconclusive whether these newer intervention models improve MDD treatment outcomes. Future research will be needed to establish the effectiveness of these intervention models in improving the treatment outcomes of minority populations with MDD.

  15. ARTISTIC INTERVENTION PROJECTS AND CULTURAL MEMORY: EXPERIENCES FROM PORTUGAL’S CENTRE REGION

    Directory of Open Access Journals (Sweden)

    Claudia Pato Carvalho

    2015-03-01

    Full Text Available In July and August 2013, O Teatrão, a Coimbra-based theatre company, presented the project Arruin-ados, comprising three theatre performances in three abandoned spaces (‘ruins’, one in each of three cities in the Centre region of Portugal located along the Mondego River: Coimbra, Montemor-o-Velho, and Figueira da Foz. Developed through a community the atre approach, the artistic presentations were based on the collection of local memories, including local testimonies and other types of local materials from local, social, and economic history. The objectives of the project were to bring un-der reflection how different types of urban and rural ruins, understood as scars and tattoos of a country, may speak about the history of that country and, at the same time, may inspire the possible future transformations and possibilities of change. In parallel with this reflec-tion, the artistic production embodies a strong commit-ment to build collective projects; a sense of a shared, common territory; and a network of people and things to explore and articulate, in a localized, concrete way, the history of Portugal between 1890 and 2020. The paper assesses the role and significance of Arruinados in the context of collective memory, community-based artistic interventions in public space, and the potential for local mobilization through the arts.

  16. Effects of tailoring health messages on physical activity.

    Science.gov (United States)

    Smeets, Tamara; Brug, J; de Vries, H

    2008-06-01

    Computer-tailored printed education can be a promising way of promoting physical activity. The present study tested whether computer-tailored feedback on physical activity is effective and whether there are differences between respondents with low and high motivation to change. Respondents (n = 487) were randomly assigned to a tailored intervention group or a no information control group. Physical activity and determinants were measured at baseline and after 3 months. At post-test, the motivated respondents in the control group were more likely not to meet the recommendation for physical activity than to meet it, and motivated respondents in the experimental group were more likely to engage in transport-related activities and showed more improvement over time for the total activity score than respondents in the control group (beta = 0.24, P = 0.02). Both groups improved their behaviour over time. No group differences in physical activity were found for the unmotivated respondents. The results showed that the effects of the tailored feedback were restricted to respondents who had a positive motivation to change at baseline. Possible explanations could be that unmotivated respondents were unwilling to read and process the information because they felt 'no need to change'. Alternatively, one tailored feedback letter may not have been sufficient for this unmotivated group.

  17. Culturally specific adaptation of a prevention intervention: an international collaborative research project.

    Science.gov (United States)

    Tsarouk, Tatiana; Thompson, Elaine A; Herting, Jerald R; Walsh, Elaine; Randell, Brooke

    2007-08-01

    This study adapted a U.S. drug use prevention program for use with Russian at-risk adolescents, and explored directions for further development of programs addressing prevention of substance abuse and other health risk behaviors including risk of HIV infection. The adaptation process was conducted in phases, initially carried out in Seattle with 23 bilingual (English-Russian) youth and then further adapted in two Moscow schools with 44 "typical" youth. In the final phase, program adaptation for the Russian at-risk adolescents was achieved by conducting a pilot test of the adapted program lessons with Moscow at-risk adolescents (n=10), who met criteria of poor school performance and/or truancy. Observations and experience were used throughout to adapt and refine the program for at-risk youth. Modifications were made to represent more accurately colloquial Russian and to capture teen experiences common to Russian culture. Both U.S. and Russian youth characterized the lessons as engaging and valuable. They also expressed a need to learn about sexuality, drug use, and health; peer and romantic relationships; and problem-solving strategies.

  18. The effects of tailoring knowledge acquisition on colorectal cancer screening self-efficacy.

    Science.gov (United States)

    Jerant, Anthony; To, Patricia; Franks, Peter

    2015-01-01

    Interventions tailored to psychological factors such as personal and vicarious behavioral experiences can enhance behavioral self-efficacy but are complex to develop and implement. Information seeking theory suggests tailoring acquisition of health knowledge (without concurrent psychological factor tailoring) could enhance self-efficacy, simplifying the design of tailored behavior change interventions. To begin to examine this issue, the authors conducted exploratory analyses of data from a randomized controlled trial, comparing the effects of an experimental colorectal cancer screening intervention tailoring knowledge acquisition with the effects of a nontailored control on colorectal cancer screening knowledge and self-efficacy in 1159 patients comprising three ethnicity/language strata (Hispanic/Spanish, 23.4%, Hispanic/English, 27.2%, non-Hispanic/English, 49.3%) and 5 recruitment center strata. Adjusted for study strata, the mean postintervention knowledge score was significantly higher in the experimental group than in the control group. Adjusted experimental intervention exposure (B = 0.22, 95% CI [0.14, 0.30]), preintervention knowledge (B = 0.11, 95% CI [0.05, 0.16]), and postintervention knowledge (B = 0.03, 95% CI [0.01, 0.05]) were independently associated with subsequent colorectal cancer screening self-efficacy (p self-efficacy, with potential implications for tailored intervention design, but this implication requires confirmation in studies specifically designed to examine this issue.

  19. Culture in Ibero-America: A neglected issue in behavioral and cognitive randomized control trial interventions

    Directory of Open Access Journals (Sweden)

    Juan Preciado

    2012-01-01

    Full Text Available El propósito de este estudio de revisión interpretativo es determinar si los investigadores iberoamericanos son conscientes de la cultura y adaptaciones culturales a tratamientos y programas de intervención psicológica. Como una primera aproximación para estudiar estos aspectos, se realizaron búsquedas de las palabras "cultura", "factores culturales" o "adaptaciones culturales" en cualquier parte del texto de artículos cognitivo-conductuales de tipo ensayo controlado aleatorio (ECA sobre temas clínicos, y de la salud en niños y adultos de países iberoamericanos. Se realizaron búsquedas en bases de datos norteamericanas y regionales sobre ECAs que cumplieran con los criterios de inclusión. Los resultados muestran que las palabras cultura y adaptaciones culturales están ausentes en la mayor parte de las descripciones de los estudios tipo ECA de Iberoamérica. A pesar de las limitaciones de este estudio exploratorio, los investigadores ibero-americanos están probablemente ajustando sus intervenciones a los contextos particulares, sin explícitamente identificarlos como adaptaciones culturales. Se propone el concepto Efecto de Alianza Cultural para explicar porque la cultura es reconocida en la literatura Norteamericana y desatendida en la iberoamericana. Se recomienda que las adaptaciones a manuales y protocolos clínicos iberoamericanos sean ampliamente descritas para facilitar su aplicación por otros investigadores, particularmente de los países en desarrollo.

  20. Culturally focused wellness intervention for American Indian women of a small southwest community: associations with alcohol use, abstinence self-efficacy, symptoms of depression, and self-esteem.

    Science.gov (United States)

    Gray, Norma; Mays, Mary Z; Wolf, Denise; Jirsak, Janice

    2010-01-01

    This study examined the influence of a culturally focused wellness intervention on alcohol consumption, alcohol abstinence self-efficacy, depression, and self-esteem among women of a small American Indian community in the southwestern United States. Participation in two intervention approaches was compared: a curriculum-based health promotion–only approach and health promotion combined with cognitive-behavioral skills building (CBSB). The wellness intervention was tested in a prospective, randomized, two-group design with repeated measures. There was no control group. An American Indian community in the Southwest. American Indian women, ages 18 to 50 (N = 268). A 10-session culturally focused curriculum-based health promotion intervention, with a CBSB component, was developed using a community-based participatory research process. Comparisons were made between those who attended the health promotion plus CBSB intervention and those who attended the intervention without the CBSB component. Information regarding demographics, substance use, alcohol consumption, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem was collected through a structured interview. Regression was used to evaluate the effect of the intervention on alcohol consumption, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem in CBSB and non-CBSB groups. Although there were no significant differences between the CBSB and non-CBSB groups, the results indicate a significant decrease in alcohol consumption and symptoms of depression, and a significant increase in alcohol abstinence self-efficacy and self-esteem, from baseline to the 6-month follow-up for both groups. Evidence suggests that this culturally focused health promotion intervention has a positive impact on alcohol use, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem among American Indian women.

  1. Feasibility, Acceptability, and Initial Findings from a Community-Based Cultural Mental Health Intervention for American Indian Youth and Their Families

    Science.gov (United States)

    Goodkind, Jessica; LaNoue, Marianna; Lee, Christopher; Freeland, Lance; Freund, Rachel

    2012-01-01

    Through a CBPR partnership, university and American Indian (AI) tribal members developed and tested "Our Life" intervention to promote mental health of AI youth and their families by addressing root causes of violence, trauma, and substance abuse. Based on premises that well-being is built on a foundation of traditional cultural beliefs and…

  2. Towards tailor-made participation

    DEFF Research Database (Denmark)

    Agger, Annika

    2012-01-01

    Public participation has become an important element of governance in many Western European countries. However, among scholars and practitioners there is a recognition that participatory governance processes tend to produce systematic exclusions. Knowledge about 'who' participates and 'how......' they participate can enhance our understanding of participatory processes. This paper presents some characterisations of citizens based on a review of the literature on participation. In addition, examples of how to tailor participation for different type of citizens are provided based on studies of urban...... regeneration programmes and local environmental initiatives in Denmark. The paper concludes that in order to broaden the inclusion of affected citizens, public authorities need to be tailor participation processes by applying distinct approaches to different types of citizens...

  3. Tailored Ceramics for Laser Applications

    Energy Technology Data Exchange (ETDEWEB)

    Hollingsworth, Joel [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2007-12-10

    Transparent ceramics match or exceed the performance of single-crystal materials in laser applications, with a more-robust fabrication process. Controlling the distribution of optical dopants in transparent ceramics would allow qualitative improvements in amplifier slab design by allowing gain and loss to be varied within the material. My work aims to achieve a controlled pattern or gradient of dopant prior to sintering, in order to produce tailored ceramics.

  4. ZERODUR TAILORED for cryogenic application

    Science.gov (United States)

    Jedamzik, R.; Westerhoff, T.

    2014-07-01

    ZERODUR® glass ceramic from SCHOTT is known for its very low thermal expansion coefficient (CTE) at room temperature and its excellent CTE homogeneity. It is widely used for ground-based astronomical mirrors but also for satellite applications. Many reference application demonstrate the excellent and long lasting performance of ZERODUR® components in orbit. For space application a low CTE of the mirror material is required at cryogenic temperatures together with a good match of the thermal expansion to the supporting structure material. It is possible to optimize the coefficient of thermal expansion of ZERODUR® for cryogenic applications. This paper reports on measurements of thermal expansion of ZERODUR® down to cryogenic temperatures of 10 K performed by the PTB (Physikalisch Technische Bundesanstallt, Braunschweig, Germany, the national metrology laboratory). The ZERODUR® TAILORED CRYO presented in this paper has a very low coefficient of thermal expansion down to 70 K. The maximum absolute integrated thermal expansion down to 10 K is only about 20 ppm. Mirror blanks made from ZERODUR® TAILORED CRYO can be light weighted to almost 90% with our modern processing technologies. With ZERODUR® TAILORED CRYO, SCHOTT offers the mirror blank material for the next generation of space telescope applications.

  5. Innovative Sexually Transmitted Infection Prevention-Intervention for African-American Adolescent Girls

    Directory of Open Access Journals (Sweden)

    Ringer, Brialle D.

    2014-09-01

    Full Text Available The purpose of this study is to determine whether implementation of an innovative STI prevention intervention design affects participants’ knowledge of sexually transmitted infections and sexual self-efficacy. The population this research focuses on is African-American adolescent girls. The participants included in this study are aged 13-19. This particular population is disproportionately infected by sexually transmitted diseases, so it is vital that intervention programs be tailored to fit their culture and gender-specific needs in order to achieve maximum results. However, current interventions for African-American girls could be improved. The researcher has designed an innovative STI prevention intervention that draws from current, best evidence interventions. The researcher has hypothesized that: (1 participants that complete the intervention will have increased STI knowledge; and, (2 upon completion of the intervention, participants will have greater sexual self-efficacy.

  6. A comparison of family interventions to address adolescent risky behaviors: a literature review.

    Science.gov (United States)

    Kao, Tsui-Sui; Gibbs, Marilyn Beth; Clemen-Stone, Susan; Duffy, Sonia

    2013-05-01

    The purpose of this integrative review is to describe, compare, and synthesize traditional and computer-based family interventions that aim to change adolescents' risky sexual behaviors and substance abuse. Family interventions have been shown to generate protective effects for preventing adolescents from risky behaviors. It is not clear, however, whether there are significant differences or similarities in the designs and effects of traditional and computer-based family interventions. An integrative literature review was conducted to describe and compare the designs and effects of traditional and computer-based family interventions. Both interventions have generated significant effects on reducing risky behavior among adolescents. Interventions guided by theory, tailored to participants' culture/gender, and which included sufficient boosting dosages in their designs demonstrated significant short- or long-term effects in terms of reducing adolescents' risky behaviors. Regardless of delivery method, well-designed family interventions are noted to maximize familial protective effects and reduce risky behaviors.

  7. Tailored, interactive soap operas for breast cancer education of high-risk Hispanic women.

    Science.gov (United States)

    Jibaja, M L; Kingery, P; Neff, N E; Smith, Q; Bowman, J; Holcomb, J D

    2000-01-01

    While Hispanic women have lower rates of breast cancer than do women of other ethnic groups, they are the least likely to undergo screening examinations. This study evaluated a culturally sensitive and linguistically appropriate, tailored, computer-based, educational program for early detection of breast cancer aimed at high-risk Hispanic women. Spanish-speaking Hispanic women from an inner-city community health clinic were recruited and randomly assigned either to a computer intervention with an interactive soap-opera format (n = 118) or to a comparison group (n = 60). Pre- and posttests were used to identify any change in breast-cancer-related knowledge and beliefs. Both younger (18-40 years old) and older (41-65 years old) women in the intervention group demonstrated significant increases in their breast cancer screening knowledge and beliefs as compared with the younger and older women in the comparison group (n soap operas that are linguistically and culturally appropriate are effective in increasing breast cancer screening knowledge and beliefs among underserved Spanish-speaking Hispanic women.

  8. Deep drawing simulation of Tailored Blanks

    NARCIS (Netherlands)

    Berg, van den A.; Meinders, V.T.; Stokman, B.

    1998-01-01

    Tailored blanks are increasingly used in the automotive industry. A tailored blank consists of different metal parts, which are joined by a welding process. These metal parts usually have different material properties. Hence, the main advantage of using a tailored blank is to provide the right mater

  9. Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples.

    Directory of Open Access Journals (Sweden)

    Omar Martinez

    Full Text Available Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM, who face a disproportionately high risk of HIV acquisition.We collaborated with Latino male couples and providers to adapt Connect 'n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention.The majority (N = 37 of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP; pre-exposure prophylaxis (PrEP; and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be

  10. Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples.

    Science.gov (United States)

    Martinez, Omar; Wu, Elwin; Levine, Ethan C; Muñoz-Laboy, Miguel; Fernandez, M Isabel; Bass, Sarah Bauerle; Moya, Eva M; Frasca, Timothy; Chavez-Baray, Silvia; Icard, Larry D; Ovejero, Hugo; Carballo-Diéguez, Alex; Rhodes, Scott D

    2016-01-01

    Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. We collaborated with Latino male couples and providers to adapt Connect 'n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be offered after

  11. Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review.

    Science.gov (United States)

    Clifford, Anton; McCalman, Janya; Bainbridge, Roxanne; Tsey, Komla

    2015-04-01

    This article describes the characteristics and reviews the methodological quality of interventions designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA. A total of 17 electronic databases and 13 websites for the period of 2002-13. Studies were included if they evaluated an intervention strategy designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, the USA or Canada. Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools. Sixteen published evaluations of interventions to improve cultural competency in health care for Indigenous peoples were identified: 11 for Indigenous peoples of the USA and 5 for Indigenous Australians. The main types of intervention strategies were education and training of the health workforce, culturally specific health programs and recruitment of an Indigenous health workforce. Main positive outcomes reported were improvements in health professionals' confidence, and patients' satisfaction with and access to health care. The methodological quality of evaluations and the reporting of key methodological criteria were variable. Particular problems included weak study designs, low or no reporting of consent rates, confounding and non-validated measurement instruments. There is a lack of evidence from rigorous evaluations on the effectiveness of interventions for improving cultural competency in health care for Indigenous peoples. Future evaluations should employ more rigorous study designs and extend their measurement of outcomes beyond those relating to health professionals, to those relating to the health of Indigenous peoples. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  12. Time Series with Tailored Nonlinearities

    CERN Document Server

    Raeth, C

    2015-01-01

    It is demonstrated how to generate time series with tailored nonlinearities by inducing well- defined constraints on the Fourier phases. Correlations between the phase information of adjacent phases and (static and dynamic) measures of nonlinearities are established and their origin is explained. By applying a set of simple constraints on the phases of an originally linear and uncor- related Gaussian time series, the observed scaling behavior of the intensity distribution of empirical time series can be reproduced. The power law character of the intensity distributions being typical for e.g. turbulence and financial data can thus be explained in terms of phase correlations.

  13. A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors

    NARCIS (Netherlands)

    Kroeze, W.; Werkman, A.M.; Brug, J.

    2006-01-01

    Although computer-tailored promotion of dietary change and physical activity has been identified as a promising intervention strategy, there is a need for a more systematic evaluation of the evidence. Purpose: This study systematically reviews the scientific literature on computer-tailored physical

  14. Tailored Interactive Multimedia Computer Programs to Reduce Health Disparities: Opportunities and Challenges

    Science.gov (United States)

    Jerant, Anthony; Sohler, Nancy; Fiscella, Kevin; Franks, Becca; Franks, Peter

    2010-01-01

    Objective To review the theory and research evidence suggesting that tailored interactive multimedia computer programs (IMCPs) aimed at optimizing patient health behaviors could lessen socio-demographic health disparities. Methods Selective critical review of research regarding IMCPs tailored to psychological mediators of behavior and their effects on health behavior and outcomes among socio-demographically disadvantaged patients. Results Tailored IMCPs can address patient factors (e.g. language barriers, low self-efficacy) and buffer provider (e.g. cognitive bias) and health system (e.g. office visit time constraints) factors that contribute to poor provider-patient communication and, thereby, suboptimal health behaviors. Research indicates disadvantaged individuals' interactions with providers are disproportionately affected by such factors, and that their behaviors respond favorably to tailored information, thus suggesting tailored IMCPs could mitigate disparities. However, no randomized controlled trials (RCTs) have examined this question. The optimal design and deployment of tailored IMCPs for disadvantaged patients also requires further study. Conclusion Preliminary research suggests tailored IMCPs have the potential to reduce health disparities. RCTs designed expressly to examine this issue are warranted. Practice Implications Many socio-demographic health disparities exist, and there is a dearth of proven disparity-reducing interventions. Thus, if tailored IMCPs were shown to lessen disparities, the public health implications would be considerable. PMID:21146950

  15. Ecological Momentary Assessments and Automated Time Series Analysis to Promote Tailored Health Care : A Proof-of-Principle Study

    NARCIS (Netherlands)

    van der Krieke, Lian; Emerencia, Ando C; Bos, Elisabeth H; Rosmalen, Judith Gm; Riese, Harriëtte; Aiello, Marco; Sytema, Sjoerd; de Jonge, Peter

    2015-01-01

    BACKGROUND: Health promotion can be tailored by combining ecological momentary assessments (EMA) with time series analysis. This combined method allows for studying the temporal order of dynamic relationships among variables, which may provide concrete indications for intervention. However,

  16. Ecological Momentary Assessments and Automated Time Series Analysis to Promote Tailored Health Care : A Proof-of-Principle Study

    NARCIS (Netherlands)

    van der Krieke, Lian; Emerencia, Ando C; Bos, Elisabeth H; Rosmalen, Judith Gm; Riese, Harriëtte; Aiello, Marco; Sytema, Sjoerd; de Jonge, Peter

    2015-01-01

    BACKGROUND: Health promotion can be tailored by combining ecological momentary assessments (EMA) with time series analysis. This combined method allows for studying the temporal order of dynamic relationships among variables, which may provide concrete indications for intervention. However, applicat

  17. Effects of a culturally adapted lifestyle intervention on cardio-metabolic outcomes: a randomized controlled trial in Iraqi immigrants to Sweden at high risk for Type 2 diabetes.

    Science.gov (United States)

    Siddiqui, Faiza; Kurbasic, Azra; Lindblad, Ulf; Nilsson, Peter M; Bennet, Louise

    2017-01-01

    Middle-Eastern immigrants constitute a growing proportion of the Swedish population and are at high risk for Type 2 diabetes. This calls for a more proactive preventive approach for dealing with diabetes risk in this target group. The aim was to test the effect of a culturally adapted lifestyle intervention programme on changes in lifestyle habits and cardio-metabolic outcomes comparing an intervention group with a control group receiving usual care. Citizens of Malmö, Sweden born in Iraq and at high risk for Type 2 diabetes (n=636) were invited. Participation rate was 15.1%. In all, 96 participants were randomized to the intervention group (n=50) or to the control group (n=46). The intervention group was offered seven group sessions addressing healthy diet and physical activity including one cooking class. Changes in body weight, physical activity levels and cardio-metabolic outcomes were evaluated using linear mixed-effects models. The mean follow-up time was 3.9 and 3.5months in the intervention and control groups, respectively. The drop-out rate from baseline to the last visit was 30.0% in the intervention group (n=15) and 30.4% in the control group (n=14). The mean insulin sensitivity index increased significantly at follow-up in the intervention group compared to the control group (10.9% per month, p=0.005). The intervention group also reached a significant reduction in body weight (0.4% per month, p=0.004), body mass index (0.4% per month, p=0.004) and LDL-cholesterol (2.1% per month, p=0.036) compared to the control group. In total, 14.3% in the intervention group reached the goal to lose ≥5% of body weight versus none in the control group. This culturally adapted lifestyle intervention programme shows a beneficial effect on insulin action, body weight reduction, as well as LDL-cholesterol reduction, in Middle-Eastern immigrants. The programme adapted to resources in primary health care provides tools for improved primary prevention and reduced cardio

  18. cultural

    Directory of Open Access Journals (Sweden)

    Irene Kreutz

    2006-01-01

    Full Text Available Es un estudio cualitativo que adoptó como referencial teorico-motodológico la antropología y la etnografía. Presenta las experiencias vivenciadas por mujeres de una comunidad en el proceso salud-enfermedad, con el objetivo de comprender los determinantes sócio-culturales e históricos de las prácticas de prevención y tratamiento adoptados por el grupo cultural por medio de la entrevista semi-estructurada. Los temas que emergieron fueron: la relación entre la alimentación y lo proceso salud-enfermedad, las relaciones con el sistema de salud oficial y el proceso salud-enfermedad y lo sobrenatural. Los dados revelaron que los moradores de la comunidad investigada tienen un modo particular de explicar sus procedimientos terapéuticos. Consideramos que es papel de los profesionales de la salud en sus prácticas, la adopción de abordajes o enfoques que consideren al individuo en su dimensión sócio-cultural e histórica, considerando la enorme diversidad cultural en nuestro país.

  19. The effect of oppressed group behaviours on the culture of the nursing workplace: a review of the evidence and interventions for change.

    Science.gov (United States)

    Roberts, Susan J O; Demarco, Rosanna; Griffin, Martha

    2009-04-01

    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.

  20. Taming Parasites by Tailoring Them

    Directory of Open Access Journals (Sweden)

    Bingjian Ren

    2017-07-01

    Full Text Available The next-generation gene editing based on CRISPR (clustered regularly interspaced short palindromic repeats has been successfully implemented in a wide range of organisms including some protozoan parasites. However, application of such a versatile game-changing technology in molecular parasitology remains fairly underexplored. Here, we briefly introduce state-of-the-art in human and mouse research and usher new directions to drive the parasitology research in the years to come. In precise, we outline contemporary ways to embolden existing apicomplexan and kinetoplastid parasite models by commissioning front-line gene-tailoring methods, and illustrate how we can break the enduring gridlock of gene manipulation in non-model parasitic protists to tackle intriguing questions that remain long unresolved otherwise. We show how a judicious solicitation of the CRISPR technology can eventually balance out the two facets of pathogen-host interplay.

  1. Molecular tailoring of solid surfaces

    CERN Document Server

    Evenson, S A

    1997-01-01

    The overall performance of a material can be dramatically improved by tailoring its surface at the molecular level. The aim of this project was to develop a universal technique for attaching dendrimers (well-defined, nanoscale, functional polymers) and Jeffamines (high molecular weight polymer chains) to the surface of any shaped solid substrate. This desire for controlled functionalization is ultimately driven by the need to improve material compatibility in various biomedical applications. Atomic force microscopy (AFM) was used initially to study the packing and structure of Langmuir-Blodgett films on surfaces, and subsequently resulted in the first visualization of individual, spherically shaped, nanoscopic polyamidoamine dendrimers. The next goal was to develop a methodology for attaching such macromolecules to inert surfaces. Thin copolymer films were deposited onto solid substrates to produce materials with a fixed concentration of surface anhydride groups. Vapor-phase functionalization reactions were t...

  2. Targeted therapy: tailoring cancer treatment

    Institute of Scientific and Technical Information of China (English)

    Min Yan; Quentin Qiang Liu

    2013-01-01

    Targeted therapies include small-molecule inhibitors and monoclonal antibodies,have made treatment more tumor-specific and less toxic,and have opened new possibilities for tailoring cancer treatment.Nevertheless,there remain several challenges to targeted therapies,including molecular identification,drug resistance,and exploring reliable biomarkers.Here,we present several selected signaling pathways and molecular targets involved in human cancers including Aurora kinases,PI3K/mTOR signaling,FOXO-FOXM1 axis,and MDM2/MDM4-p53 interaction.Understanding the molecular mechanisms for tumorigenesis and development of drug resistance will provide new insights into drug discovery and design of therapeutic strategies for targeted therapies.

  3. Tailoring Magnetism in Quantum Dots

    Science.gov (United States)

    Zutic, Igor; Abolfath, Ramin; Hawrylak, Pawel

    2007-03-01

    We study magnetism in magnetically doped quantum dots as a function of particle numbers, temperature, confining potential, and the strength of Coulomb interaction screening. We show that magnetism can be tailored by controlling the electron-electron Coulomb interaction, even without changing the number of particles. The interplay of strong Coulomb interactions and quantum confinement leads to enhanced inhomogeneous magnetization which persists at substantially higher temperatures than in the non-interacting case or in the bulk-like dilute magnetic semiconductors. We predict a series of electronic spin transitions which arise from the competition between the many-body gap and magnetic thermal fluctuations. Cond-mat/0612489. [1] R. Abolfath, P. Hawrylak, I. Zuti'c, preprint.

  4. Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): A randomized controlled trial.

    Science.gov (United States)

    Rosas, Lisa G; Lv, Nan; Xiao, Lan; Lewis, Megan A; Zavella, Patricia; Kramer, M Kaye; Luna, Veronica; Ma, Jun

    2016-05-01

    Latinos bear a disproportionate burden of the dual pandemic of obesity and diabetes. However, successful interventions addressing this disparity through primary care are lacking. To address this gap, the 5-year Vida Sana (Healthy Life) study tests a culturally adapted and technology-enhanced group-based Diabetes Prevention Program intervention in a randomized controlled trial with overweight/obese Latino adults who have metabolic syndrome and/or pre-diabetes. Eligible, consenting patients (n=186) from a large community-based multispecialty group practice in Northern California will be randomly assigned to receive the culturally-adapted intervention or usual care. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework guided the planned evaluations. The primary aim is to determine the effectiveness of the intervention (the "E" in RE-AIM). We hypothesize that the intervention will lead to a greater mean reduction in weight at 24months (primary endpoint) vs. usual care. Secondary outcomes will include measures of cardiometabolic risk factors (e.g., blood pressure), psychosocial well-being (e.g., health-related quality of life), and behavior change (e.g., physical activity). The secondary aim is to evaluate the other RE-AIM dimensions using mixed methods: reach (e.g., participation rate of the target population), adoption (e.g., participating clinic and provider characteristics), implementation (e.g., intervention fidelity), and maintenance (e.g., sustainability in the practice setting). These findings have real word applicability with value to clinicians, patients, and other decision makers considering effective diabetes prevention programs for primary care that would support the millions of Latino adults who experience a disproportionate burden of diabetes. NCT02459691. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Computer tailored nutrition education: Mediterranean diet.

    Science.gov (United States)

    del Balzo, V; Vitiello, V; Dernini, S; Zicari, S; Giusti, A M; Donini, L M; Pinto, A; Cannella, C

    2012-01-01

    Goal of this work is to promote via on-line applications the knowledge of the Italian Weekly Pyramid, which is based on the concept of WI (Well Being Index) as a unit for a correct lifestyle. On the website www.piramideitaliana.it the user can verify his/her weekly lifestyle by participating in a "game" based on the introduction, for seven consecutive days, of food and beverages consumption and time assigned to physical activity. At the end of the seven days it is possible to access the page with an evaluation of dietary habits together with the possible suggestions for a correct lifestyle. On the basis of the data collected through this web game, a statistical analysis has been developed to evaluate the food habits and the level of physical activity. In the period between September 2005-January 2010 16,546 participants have completed the game. The data collected compare actual WI consumption for each food group with the one suggested by the Pyramid. The sample eating pattern appears almost varied; all the food groups were consumed daily, albeit in much lower quantities with regard to the suggested portions. It is pointed out that some differences in the nutritional habits are related to differences in age groups and in the school degree of the sample analyzed. This work highlights the importance of web-based tailored interventions on population food habits: many people can be reached to promote the knowledge of the guidelines leading to a healthy lifestyle.

  6. Tailored logistics: the next advantage.

    Science.gov (United States)

    Fuller, J B; O'Conor, J; Rawlinson, R

    1993-01-01

    How many top executives have ever visited with managers who move materials from the factory to the store? How many still reduce the costs of logistics to the rent of warehouses and the fees charged by common carriers? To judge by hours of senior management attention, logistics problems do not rank high. But logistics have the potential to become the next governing element of strategy. Whether they know it or not, senior managers of every retail store and diversified manufacturing company compete in logistically distinct businesses. Customer needs vary, and companies can tailor their logistics systems to serve their customers better and more profitably. Companies do not create value for customers and sustainable advantage for themselves merely by offering varieties of goods. Rather, they offer goods in distinct ways. A particular can of Coca-Cola, for example, might be a can of Coca-Cola going to a vending machine, or a can of Coca-Cola that comes with billing services. There is a fortune buried in this distinction. The goal of logistics strategy is building distinct approaches to distinct groups of customers. The first step is organizing a cross-functional team to proceed through the following steps: segmenting customers according to purchase criteria, establishing different standards of service for different customer segments, tailoring logistics pipelines to support each segment, and creating economics of scale to determine which assets can be shared among various pipelines. The goal of establishing logistically distinct businesses is familiar: improved knowledge of customers and improved means of satisfying them.

  7. Tailor-made ionic liquids

    Energy Technology Data Exchange (ETDEWEB)

    Jork, C. [Technische Universitaet Berlin, Strasse des 17. Juni 135, Institut fuer Verfahrenstechnik, Fachgebiet Thermodynamik und Thermische Verfahrenstechnik, 10623 Berlin (Germany); Kristen, C. [Technische Universitaet Berlin, Strasse des 17. Juni 135, Institut fuer Verfahrenstechnik, Fachgebiet Thermodynamik und Thermische Verfahrenstechnik, 10623 Berlin (Germany); Pieraccini, D. [University of Pisa, Dipartimento di Chimica Bioorganica e Biofarmacia, via Bonanno 33, 56126 Pisa (Italy); Stark, A. [Friedrich-Schiller-Universitaet Jena, Institut fuer Technische Chemie und Umweltchemie, Lessingstrasse 12, 07743 Jena (Germany); Chiappe, C. [University of Pisa, Dipartimento di Chimica Bioorganica e Biofarmacia, via Bonanno 33, 56126 Pisa (Italy); Beste, Y.A. [BASF AG, GCT/A-L540, 67056 Ludwigshafen (Germany); Arlt, W. [Universitaet Erlangen/Nuernberg, Lehrstuhl fuer Thermische Verfahrenstechnik, Egerlandstrasse 3, 91058 Erlangen (Germany)]. E-mail: wolfgang.arlt@cbi.uni-erlangen.de

    2005-06-15

    This article presents a first consequent thermodynamic optimization of ionic liquids (IL) as entrainers in the distillative separation of both an azeotropic aqueous (tetrahydrofuran + water) and a close-boiling aromatic test system (methylcyclohexane + toluene) on the basis of COSMO-RS predictions. The use of this method allows for the preselection from the large pool of available IL. Thus, favorable structural variations were identified and used for tailoring IL entrainers. For the prediction of activity coefficients with COSMO-RS, the use of different conformations of the components, derived from conformational analyses, leads to varying results. The simulations showed that the influence of conformations of the volatile components and the ionic liquids depends largely on the type of the phase equilibrium, which is investigated. The approach to tailor ionic liquids as additives for separation science starts with the prediction of the activity coefficients at infinite dilution. The simulation indicated that a higher degree of branching or longer alkyl substituents on the cation, as well as a low nucleophilicity of the anion decreases both selectivity and capacity in the polar test mixture. However, COSMO-RS calculations for the non-polar mixture showed that the selection of an entrainer for this system is more complicated, because - contrarily to (tetrahydrofuran + water) - structural variations of the IL entrainer cause converse changes in selectivity and capacity: while the selectivity for toluene increases with a lower degree of branching and a shorter alkyl substituent of the cation as well as with a lower nucleophilicity of the anion, these properties decrease the capacity. In this work, the most favorable IL entrainers were synthesized and the separation factors of the test systems were experimentally validated at finite dilution.

  8. Fatherhood Education from a Cultural Perspective: Evolving Roles and Identities after a Fatherhood Intervention for Latinos in South Florida

    Science.gov (United States)

    Concha, Maritza; Villar, Maria Elena; Tafur-Salgado, Rocio; Ibanez, Sandra; Azevedo, Lauren

    2016-01-01

    This article uses gender-role theory to consider the involvement of Latino fathers in their children's lives as a result of participating in a fatherhood educational intervention. Open-ended interviews (n = 48) were conducted with participants of the program. Findings revealed that the content of the group intervention encouraged fathers to…

  9. Formability of stainless steel tailored blanks

    DEFF Research Database (Denmark)

    Bagger, Claus; Gong, Hui; Olsen, Flemming Ove

    2004-01-01

    In a number of systematic tests, the formability of tailored blanks consisting of even and different combinations of AISI304 and AISI316 in thickness of 0.8 mm and 1.5 mm have been investigated. In order to analyse the formability of tailored blanks with different sheet thickness, a method based ...

  10. From traditional to patient-centered learning: curriculum change as an intervention for changing institutional culture and promoting professionalism in undergraduate medical education.

    Science.gov (United States)

    Christianson, Charles E; McBride, Rosanne B; Vari, Richard C; Olson, Linda; Wilson, H David

    2007-11-01

    The authors reframe a curriculum change from a traditional lecture-based to an integrated patient-centered approach as an intervention for changing the culture and hidden curriculum of an institution in ways that promote professionalism. Within this context, the authors articulate some of the inherent process and relational factors brought about by these curricular changes that are essential elements of this intervention process. In 1998 the University of North Dakota School of Medicine and Health Sciences (UNDSMHS) introduced a new preclinical patient-centered learning (PCL) curriculum for first- and second-year medical students. Case-based, small-group learning forms the critical foundation of the PCL process, and an integrated basic and clinical science didactic component supports this process. At the student level, the case-based PCL process generates innovative opportunities for professionalism education from the explicitly articulated formal content that arises naturally from the cases, but more importantly from the implicit values inherent to the PCL small-group process itself--humanism, accountability, pursuit of excellence, and altruism. Further, the organizational changes necessary for the transformation to the PCL curriculum required process changes at student, faculty, and administrative levels that have resulted in a cultural shift toward relationship centeredness within the institution. The authors describe the evolution and structure of the PCL curriculum at UNDSMHS and how this curricular transformation has served as an intervention that promotes professionalism and institutional culture change through (1) processes at the student level that present new opportunities for professionalism education, and (2) processes at student, faculty, administrative, and institutional levels that have created an institutional culture that supports, models, and promotes relationship-centered professional values.

  11. A tailored multimedia nutrition education pilot program for low-income women receiving food assistance.

    Science.gov (United States)

    Campbell, M K; Honess-Morreale, L; Farrell, D; Carbone, E; Brasure, M

    1999-04-01

    This article describes the development and pilot evaluation of a tailored multimedia program to improve dietary behavior among 378 low-income women enrolled in the Food Stamp program in Durham, North Carolina. After randomization to intervention or control groups, participants completed a baseline survey and were resurveyed 1-3 months post-intervention. Measures included dietary fat intake assessed using a brief food-frequency questionnaire, stage of change, knowledge of low-fat foods, self-efficacy and eating behavior questions. The computer-based intervention consisted of a tailored soap opera and interactive 'info-mercials' that provided individualized feedback about dietary fat intake, knowledge and strategies for lowering fat based on stage of change. At follow-up, intervention group participants had improved significantly in knowledge (P educational interventions for lower income and minority populations.

  12. mHealth Pilot Study: Text Messaging Intervention to Promote HPV Vaccination.

    Science.gov (United States)

    Lee, Hee Yun; Koopmeiners, Joseph S; McHugh, Jennifer; Raveis, Victoria H; Ahluwalia, Jasjit S

    2016-01-01

    To test the feasibility and efficacy of a culturally-tailored mobile health intervention designed to increase knowledge about, intent to obtain, and receipt of the HPV vaccine. A 7-day text message HPV intervention was developed using a quasi-experimental research design for 30 Korean-American women. Participants demonstrated significant increases in knowledge of HPV with an intent to get vaccinated within one year, and 30% of participants received the first dose of the HPV vaccine. Mobile health technology could be a promising tool in reducing the cancer burden for underserved populations.

  13. Indigenous message tailoring increases consumption of fresh vegetables by clients of community pantries.

    Science.gov (United States)

    Clarke, Peter; Evans, Susan H; Hovy, Eduard H

    2011-09-01

    This study tested whether message tailoring of recipes and food-use tips for low-income households is superior to providing a generic version of the material. The field experiment was conducted in the busy conditions found at community food pantries, and included 10 food distributions at each of six sites. We analyzed the consumption of fresh vegetables 6 days following distributions, and retention of print materials 6 weeks later. Self-determination and reactance theories guided the development of tailoring in an indigenous fashion, allowing each pantry client to choose recipes and food tips thought personally useful. This contrasted against paternalistic tailoring, common in health communication, where a motivational theory is used to regulate the health messages given to recipients. Results demonstrated benefits of tailoring over both generic and control conditions and uncovered the degree of tailoring that produced the largest effects. As suggested by construal level theory, the intervention addressed recipients' immediate and concrete decisions about healthy eating, instead of distant or abstract goals like prevention of illnesses. We documented per-client costs of tailored information. Results also suggested that benefits from social capital at sites offering a health outreach may exceed the impact of message tailoring on outcomes of interest.

  14. Acculturative Dissonance and Risks for Proactive and Reactive Aggression Among Latino/a Adolescents: Implications for Culturally Relevant Prevention and Interventions.

    Science.gov (United States)

    Williford, Anne; Fite, Paula J; Johnson-Motoyama, Michelle; Frazer, Andrew L

    2015-12-01

    There is a dearth of studies concerning the functions of aggression among Latino/a youth despite the fact they are one of the fastest growing youth populations in the United States. We examined individual, peer, cultural, and community level indicators of reactive and proactive aggression and determined whether these relationships were moderated by acculturative dissonance (e.g., culturally specific family conflicts arising from the acculturation process) among a sample of Latino/a adolescents who were predominantly of Mexican heritage. Consistent with prior evidence, results revealed that peer delinquency was uniquely associated with proactive aggression, whereas impulsivity was uniquely associated with reactive aggression. Further, acculturative dissonance was uniquely associated with proactive but not reactive aggression. No moderating effects for acculturative dissonance were found, indicating that the significant risk factors in our study were associated with proactive and reactive aggression regardless of the level of acculturative dissonance experienced. Notably, acculturative dissonance was a unique risk factor for proactive aggression and thus may be an important target for prevention and interventions among Latino/a youth. Consequently, interventions designed to prevent culturally specific family conflicts and promote family functioning may be particularly useful in mitigating the risk of aggression intended to achieve social and material awards among in this population.

  15. Effects of a Web-Based Computer-Tailored Game to Reduce Binge Drinking Among Dutch Adolescents: A Cluster Randomized Controlled Trial

    OpenAIRE

    Jander, Astrid F; Crutzen, Rik; Mercken, Liesbeth; Candel, Math JJM; De Vries, Hein

    2016-01-01

    Background Binge drinking among Dutch adolescents is among the highest in Europe. Few interventions so far have focused on adolescents aged 15 to 19 years. Because binge drinking increases significantly during those years, it is important to develop binge drinking prevention programs for this group. Web-based computer-tailored interventions can be an effective tool for reducing this behavior in adolescents. Embedding the computer-tailored intervention in a serious game may make it more attrac...

  16. Quality control of laser tailor welded blanks

    Science.gov (United States)

    Yan, Qi

    2008-03-01

    Tailor welded blanks were widely used in the automobile industry for their special advantages. A combination of different materials, thickness, and coatings could be welded together to form a blank for stamping car body panels. With the gradually growing consciousness on safety requirement of auto body structural, the business of laser tailor welded blanks is developing rapidly in China. Laser tailor welded blanks were just the semi products between steel factory and automobile manufacturers. As to the laser welding defects such as convexity and concavity, automobile industry had the strict requirement. In this paper, quality standard on laser tailor welded blanks were discussed. As for the production of laser tailor welded blanks, online quality control of laser tailor welded blanks was introduced. The image processing system for welding laser positioning and weld seam monitoring were used in the production of laser tailor welded blanks. The system analyzes images from the individual cameras and transmits the results to the machine control system via a CAN bus.

  17. Transtheoretical Model-based Nursing Intervention on Lifestyle Change: A Review Focused on Intervention Delivery Methods

    Directory of Open Access Journals (Sweden)

    Joo Yun Lee, RN

    2015-06-01

    Conclusions: ICT is not yet actively used in the TTM-based nursing interventions. Stage-matched interventions and TTM concepts were shown to be in partial use also in the TTM-based interventions. Therefore, it is necessary to develop a variety of ways to use ICT in tailored nursing interventions and to use TTM frameworks and concepts.

  18. Rapid testing using the Verigene Gram-negative blood culture nucleic acid test in combination with antimicrobial stewardship intervention against Gram-negative bacteremia.

    Science.gov (United States)

    Bork, Jacqueline T; Leekha, Surbhi; Heil, Emily L; Zhao, LiCheng; Badamas, Rilwan; Johnson, J Kristie

    2015-03-01

    Rapid identification of microorganisms and antimicrobial resistance is paramount for targeted treatment in serious bloodstream infections (BSI). The Verigene Gram-negative blood culture nucleic acid test (BC-GN) is a multiplex, automated molecular diagnostic test for identification of eight Gram-negative (GN) organisms and resistance markers from blood culture with a turnaround time of approximately 2 h. Clinical isolates from adult patients at the University Maryland Medical Center with GN bacteremia from 1 January 2012 to 30 June 2012 were included in this study. Blood culture bottles were spiked with clinical isolates, allowed to incubate, and processed by BC-GN. A diagnostic evaluation was performed. In addition, a theoretical evaluation of time to effective and optimal antibiotic was performed, comparing actual antibiotic administration times from chart review ("control") to theoretical administration times based on BC-GN reporting and antimicrobial stewardship team (AST) review ("intervention"). For organisms detected by the assay, BC-GN correctly identified 95.6% (131/137), with a sensitivity of 97.1% (95% confidence interval [CI], 90.7 to 98.4%) and a specificity of 99.5% (95% CI, 98.8 to 99.8%). CTX-M and OXA resistance determinants were both detected. Allowing 12 h from Gram stain for antibiotic implementation, the intervention group had a significantly shorter duration to both effective (3.3 versus 7.0 h; P < 0.01) and optimal (23.5 versus 41.8 h; P < 0.01) antibiotic therapy. BC-GN with AST intervention can potentially decrease time to both effective and optimal antibiotic therapy in GN BSI.

  19. Creating a Nurse-Led Culture to Minimize Horizontal Violence in the Acute Care Setting: A Multi-Interventional Approach.

    Science.gov (United States)

    Parker, Karen M; Harrington, Ann; Smith, Charlene M; Sellers, Kathleen F; Millenbach, Linda

    2016-01-01

    Horizontal violence (HV) is prevalent in nursing. However, few strategies are identified to address this phenomenon that undermines communication and patient safety. Nurses at an acute care hospital implemented multiple interventions to address HV resulting in increased knowledge of hospital policies regarding HV, and significantly (p < .05) less HV prevalence than was reported by nurses in other organizations throughout New York State. With the aid and oversight of nursing professional development specialists, evidence-based interventions to address HV were developed including policies, behavioral performance reviews, and staff/manager educational programs.

  20. The DISC (Diabetes in Social Context Study-evaluation of a culturally sensitive social network intervention for diabetic patients in lower socioeconomic groups: a study protocol

    Directory of Open Access Journals (Sweden)

    Vissenberg Charlotte

    2012-03-01

    Full Text Available Abstract Background Compared to those in higher socioeconomic groups, diabetic patients in lower socioeconomic groups have less favourable metabolic control and experience more diabetes-related complications. They encounter specific barriers that hinder optimal diabetes self-management, including a lack of social support and other psychosocial mechanisms in their immediate social environments. Powerful Together with Diabetes is a culturally sensitive social network intervention specifically targeted to ethnic Dutch, Moroccan, Turkish, and Surinamese diabetic patients in lower socioeconomic groups. For ten months, patients will participate in peer support groups in which they will share experiences, support each other in maintaining healthy lifestyles, and learn skills to resist social pressure. At the same time, their significant others will also receive an intervention, aimed at maximizing support for and minimizing the negative social influences on diabetes self-management. This study aims to test the effectiveness of Powerful Together with Diabetes. Methods/Design We will use a quasi-experimental design with an intervention group (Group 1 and two comparison groups (Groups 2 and 3, N = 128 in each group. Group 1 will receive Powerful Together with Diabetes. Group 2 will receive Know your Sugar, a six-week group intervention that does not focus on the participants' social environments. Group 3 receives standard care only. Participants in Groups 1 and 2 will be interviewed and physically examined at baseline, 3, 10, and 16 months. We will compare their haemoglobin A1C levels with the haemoglobin A1C levels of Group 3. Main outcome measures are haemoglobin A1C, diabetes-related quality of life, diabetes self-management, health-related, and intermediate outcome measures. We will conduct a process evaluation and a qualitative study to gain more insights into the intervention fidelity, feasibility, and changes in the psychosocial mechanism in the

  1. MALDI-TOF alone versus MALDI-TOF combined with real-time antimicrobial stewardship interventions on time to optimal antimicrobial therapy in patients with positive blood cultures.

    Science.gov (United States)

    Beganovic, Maya; Costello, Michael; Wieczorkiewicz, Sarah M

    2017-02-22

    Introduction: Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) decreases time to organism identification and improves clinical and financial outcomes. The purpose of this study was to evaluate the impact of MALDI-TOF alone vs MALDI-TOF combined with real-time, pharmacist-driven, antimicrobial stewardship (AMS) intervention on patient outcomes.Methods: This single-center, pre-post quasi-experimental study evaluated hospitalized patients with positive blood cultures identified via MALDI-TOF combined with prospective AMS intervention, compared to a control cohort with MALDI-TOF identification without AMS intervention. AMS intervention included: real-time MALDI-TOF pharmacist notification, and prospective AMS provider feedback. The primary outcome was time to optimal antimicrobial therapy (TTOT).Results: A total of 252 blood cultures were included for final analysis: 126 in each group. MALDI-TOF + AMS intervention significantly reduced overall TTOT (75.17 vs 43.06 h, p <0.001), Gram + contaminant TTOT (48.21 vs 11.75 h, p <0.001), Gram - infection (GNI) TTOT (71.83 vs 35.98 h, p <0.001), and reduced overall hospital LOS (15.03 vs 9.02 days, p 0.021). TTOT for Gram + infection (GPI) was improved (64.04 vs 41.61 h, p 0.082). For GPI: reduced hospital LOS (14.64 vs 10.31 days, p 0.002) and length of antimicrobial therapy 24.30 vs 18.97 days, p 0.018). For GNI: reduced time to microbiologic clearance (51.13 vs 34.51 h, p <0.001), hospital LOS (15.40 vs 7.90 days, p 0.027), and ICU LOS (5.55 vs 1.19 days, p 0.035).Conclusion: In order to achieve optimal outcomes, rapid identification with MALDI-TOF combined with real-time AMS interventions is more impactful than MALDI-TOF alone.

  2. Macromolecular crowding for tailoring tissue-derived fibrillated matrices.

    Science.gov (United States)

    Magno, Valentina; Friedrichs, Jens; Weber, Heather M; Prewitz, Marina C; Tsurkan, Mikhail V; Werner, Carsten

    2017-06-01

    Tissue-derived fibrillated matrices can be instrumental for the in vitro reconstitution of multiphasic extracellular microenvironments. However, despite of several advantages, the obtained scaffolds so far offer a rather narrow range of materials characteristics only. In this work, we demonstrate how macromolecular crowding (MMC) - the supplementation of matrix reconstitution media with synthetic or natural macromolecules in ways to create excluded volume effects (EVE) - can be employed for tailoring important structural and biophysical characteristics of kidney-derived fibrillated matrices. Porcine kidneys were decellularized, ground and the obtained extracellular matrix (ECM) preparations were reconstituted under varied MMC conditions. We show that MMC strongly influences the fibrillogenesis kinetics and impacts the architecture and the elastic modulus of the reconstituted matrices, with diameters and relative alignment of fibrils increasing at elevated concentrations of the crowding agent Ficoll400, a nonionic synthetic polymer of sucrose. Furthermore, we demonstrate how MMC modulates the distribution of key ECM molecules within the reconstituted matrix scaffolds. As a proof of concept, we compared different variants of kidney-derived fibrillated matrices in cell culture experiments referring to specific requirements of kidney tissue engineering approaches. The results revealed that MMC-tailored matrices support the morphogenesis of human umbilical vein endothelial cells (HUVECs) into capillary networks and of murine kidney stem cells (KSCs) into highly branched aggregates. The established methodology is concluded to provide generally applicable new options for tailoring tissue-specific multiphasic matrices in vitro. Tissue-derived fibrillated matrices can be instrumental for the in vitro reconstitution of multiphasic extracellular microenvironments. However, despite of several advantages, the obtained scaffolds so far offer a rather narrow range of materials

  3. Comparing and Contrasting Three Cultural Food Customs from Nigeria and Analyzing the Nutrient Content of Diets from These Cultures with the Aim of Proffering Nutritional Intervention.

    Science.gov (United States)

    Adegboye, Omoyemi Roseline; Smith, Chris; Anang, Daniel; Musa, Haruna

    2016-11-17

    Nigeria is a multicultural country with a diverse cultural food. Most Nigerians' cultural diet is based on staple food accompanied by stew. In the South West and Eastern region (where Yorubas and Igbos are the dominant ethnic groups), staple foods are yam and cassava by-product (garri, fufu and lafun) with vegetables prepared as stew, often over cooked, thereby losing essential micronutrients. In Northern Nigeria (where the Hausas and Fulanis are the dominant ethnic groups), grains such as sorghum, millet form the main diet; these are served with palm oil based soup made with tomatoes and okra. Meat is sometimes added. Among the Hausas, meat is usually reserved for special occasions. Various types of malnutrition prevalent in developing countries such as Nigeria are iron deficiency anemia (ID/A), protein-energy malnutrition (PEM), Vitamin A deficiency (VAD), iodine deficiency disorder (IDD). The proposed long-term measure by the Federal government of Nigeria for the resolution of these various types of malnutrition is dietary diversification. A review of the literature on Nigerian cultural diets identified gaps in knowledge with respect to the nutritional values of Nigerian ethnic diets.

  4. Testing a Dutch web-based tailored lifestyle programme among adults: a study protocol

    Directory of Open Access Journals (Sweden)

    van Osch Liesbeth ADM

    2011-02-01

    Full Text Available Abstract Background Smoking, high alcohol consumption, unhealthy eating habits and physical inactivity often lead to (chronic diseases, such as cardiovascular diseases and cancer. Tailored online interventions have been proven to be effective in changing health behaviours. The aim of this study is to test and compare the effectiveness of two different tailoring strategies for changing lifestyle compared to a control group using a multiple health behaviour web-based approach. Methods In our Internet-based tailored programme, the five lifestyle behaviours of smoking, alcohol intake, fruit consumption, vegetable consumption, and physical activity are addressed. This randomized controlled trial, conducted among Dutch adults, includes two experimental groups (i.e., a sequential behaviour tailoring condition and a simultaneous behaviour tailoring condition and a control group. People in the sequential behaviour tailoring condition obtain feedback on whether their lifestyle behaviours meet the Dutch recommendations. Using a step-by-step approach, they are stimulated to continue with a computer tailored module to change only one unhealthy behaviour first. In the course of the study, they can proceed to change a second behaviour. People in the simultaneous behaviour tailoring condition receive computer tailored feedback about all their unhealthy behaviours during their first visit as a stimulation to change all unhealthy behaviours. The experimental groups can re-visit the website and can then receive ipsative feedback (i.e., current scores are compared to previous scores in order to give feedback about potential changes. The (difference in effectiveness of the different versions of the programme will be tested and compared to a control group, in which respondents only receive a short health risk appraisal. Programme evaluations will assess satisfaction with and appreciation and personal relevance of the intervention among the respondents. Finally

  5. Project Exhale: preliminary evaluation of a tailored smoking cessation treatment for HIV-positive African American smokers.

    Science.gov (United States)

    Matthews, Alicia K; Conrad, Megan; Kuhns, Lisa; Vargas, Maria; King, Andrea C

    2013-01-01

    This study examined the feasibility, acceptability, and outcomes of a culturally tailored smoking cessation intervention for HIV-positive African American male smokers. Eligible smokers were enrolled in a seven-session group-based treatment combined with nicotine patch. The mean age of participants was M=46 years. The majority were daily smokers (71%), smoked a mentholated brand (80%), and averaged 8.6 (standard deviation [SD]=8.1) cigarettes per day. Baseline nicotine dependency scores (M=5.8) indicated a moderate to high degree of physical dependence. Of the 31 participants enrolled, the majority completed treatment (≥3 sessions; 68%), 1-month follow-up (74%), and 3-month follow-up (87%) interviews. Program acceptability scores were strong. However, adherence to the patch was low, with 39% reporting daily patch use. The majority of participants (80%, n=24) made a quit attempt. Furthermore, over the course of the intervention, smoking urge, cigarettes smoked, nicotine dependence, withdrawal symptoms, and depression scores all significantly decreased. Follow-up quit rates at 1 and 3 months ranged from 6% to 24%, with treatment completers having better outcomes. This first of its kind intervention for HIV-positive African American male smokers was feasible, acceptable, and showed benefit for reducing smoking behaviors and depression scores. Smoking cessation outcomes were on par with other similar programs. A larger trial is needed to address limitations and to confirm benefits.

  6. Tailor made preservation strategies : Food Innovation Concepts

    NARCIS (Netherlands)

    Blankestijn, J.

    2013-01-01

    High quality, long shelf life, clean label, less salt: food must comply with many requirements. From genomics and mild preservation to a ‘Quick Scan’ for process hygiene, TNO helps manufacturers to develop a tailor made preservation strategy.

  7. User-tailored Inter-Widget Communication

    NARCIS (Netherlands)

    Drachsler, Hendrik; Hoisl, Bernhard; Waglecher, Christoph

    2010-01-01

    Drachsler, H., Hoisl, B., & Wagenlecher, C. (2010, 16 September). User-tailored Inter-Widget Communication. Extending the Shared Data Interface for the Apache Wookie Engine, International Conference on Interactive Computer Aided Learning 2010, Hasselt, Belgium.

  8. Promoting Psychological Well-Being in an Urban School Using the Participatory Culture-Specific Intervention Model

    Science.gov (United States)

    Bell, Patrick B.; Summerville, Meredith A.; Nastasi, Bonnie K.; Patterson, Julie; Earnshaw, Elizabeth

    2015-01-01

    School psychology has recently reconceptualized its service provision model to include multitiered systems of academic and psychosocial promotion, prevention, and intervention. The availability of evidence-based programs and advances in school consultation theory accompany the paradigm shift of the field. Despite these advances, implementing…

  9. Promoting Psychological Well-Being in an Urban School Using the Participatory Culture-Specific Intervention Model

    Science.gov (United States)

    Bell, Patrick B.; Summerville, Meredith A.; Nastasi, Bonnie K.; Patterson, Julie; Earnshaw, Elizabeth

    2015-01-01

    School psychology has recently reconceptualized its service provision model to include multitiered systems of academic and psychosocial promotion, prevention, and intervention. The availability of evidence-based programs and advances in school consultation theory accompany the paradigm shift of the field. Despite these advances, implementing…

  10. The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

    Science.gov (United States)

    Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin

    2013-01-01

    China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence--favorably evaluated in the West--for Chinese HIV-positive patients. The…

  11. Basic Needs, Stress and the Effects of Tailored Health Communication in Vulnerable Populations

    Science.gov (United States)

    Cappelletti, Erika R.; Kreuter, Matthew W.; Boyum, Sonia; Thompson, Tess

    2015-01-01

    This study examined whether unmet basic needs (food, housing, personal and neighborhood safety, money for necessities) and perceived stress affect recall of and response to a tailored print intervention one month later. Participants (N = 372) were adults who had called 2-1-1 Missouri between June 2010 and June 2012. A series of path analyses using…

  12. Basic Needs, Stress and the Effects of Tailored Health Communication in Vulnerable Populations

    Science.gov (United States)

    Cappelletti, Erika R.; Kreuter, Matthew W.; Boyum, Sonia; Thompson, Tess

    2015-01-01

    This study examined whether unmet basic needs (food, housing, personal and neighborhood safety, money for necessities) and perceived stress affect recall of and response to a tailored print intervention one month later. Participants (N = 372) were adults who had called 2-1-1 Missouri between June 2010 and June 2012. A series of path analyses using…

  13. Personalization and perceived personal relevance in computer-tailored persuasion in smoking cessation

    NARCIS (Netherlands)

    Dijkstra, Arie; Ballast, Karien

    Objectives. In most computer-tailored interventions, the recipient's name is used to personalize the information. This is done to increase the process of persuasion but few empirical data exist that support this notion. yDesign. An experimental laboratory study was conducted to test the effects of

  14. Incredible Years Program Tailored to Parents of Preschoolers with Autism: Pilot Results

    Science.gov (United States)

    Dababnah, Sarah; Parish, Susan L.

    2016-01-01

    Objective: This article reports on the acceptability and results from an evaluation of an empirically supported practice, The Incredible Years, tailored to parents of children with autism spectrum disorder (ASD). Methods: Two groups of parents (N = 17) participated in a mixed methods test with no comparison group of the 15-week intervention. Data…

  15. Biomarker Evaluation Does Not Confirm Efficacy of Computer-Tailored Nutrition Education

    Science.gov (United States)

    Kroeze, Willemieke; Dagnelie, Pieter C.; Heymans, Martijn W.; Oenema, Anke; Brug, Johannes

    2011-01-01

    Objective: To evaluate the efficacy of computer-tailored nutrition education with objective outcome measures. Design: A 3-group randomized, controlled trial with posttests at 1 and 6 months post-intervention. Setting: Worksites and 2 neighborhoods in the urban area of Rotterdam. Participants: A convenience sample of healthy Dutch adults (n = 442).…

  16. Tailoring thermal interfaces with nanomaterials

    Science.gov (United States)

    Seshadri, Indira

    mobility via pre-cure gelation, and hinder crosslinking. This thesis also demonstrates novel techniques to create tailored nanowires and networks for high k nanocomposites. Branched Ag nanowires are synthesized via controlled interruptions to microwave-stimulated polyvinylpyrrolidone-directed polyol-reduction of silver nitrate. Microwave exposure results in micrometer-long nanowires passivated with polyvinylpyrrolidone. Cooling the reaction mixture by interrupting microwave exposure promotes nanocrystal nucleation at low-surfactant coverage sites. The nascent nuclei grow into nanowire branches upon further microwave exposure. Dispersions of low fractions of the branched nanowires in polydimethylsiloxane yield up to 60 % higher thermal conductivity than that obtained using unbranched nanowire fillers. A forty-fold thermal conductivity increase is obtained by in situ welding of silver nanowire fillers inside polydimethylsiloxane using microwaves. Even for ≤ 0.04 filler volume fractions, welding facilitates nanowire networking that counteracts thermal transport bottlenecks associated with the low polymer thermal conductivity and high polymer-filler interface thermal resistances. The transparency of the polymer to microwaves precludes thermal degradation, and the composites retain high mechanical compliance as indicated by thesis further explores the use of external stimuli in the form of magnetic fields to reversibly induce nanoparticle networking and gate heat transport at interfaces, a requirement in many emerging applications. It is demonstrated that magnetic field actuation of ~ 3 - 16 vol. % of magnetite or cobalt-ferrite nanoparticles in a fluid matrix yields ~16 times enhancement of the no field effective thermal conductivity, but only in a gradient magnetic field. Heat transfer modeling shows that the enhancement arises from magnetic field gradient driven bulk convection, rather than the expected nanoparticle network formation.

  17. Achieving Cultural Congruency in Weight Loss Interventions: Can a Spirituality-Based Program Attract and Retain an Inner-City Community Sample?

    Directory of Open Access Journals (Sweden)

    Chad Davis

    2014-01-01

    Full Text Available Ethnic minorities continue to be disproportionately affected by obesity and are less likely to access healthcare than Caucasians. It is therefore imperative that researchers develop novel methods that will attract these difficult-to-reach groups. The purpose of the present study is to describe characteristics of an urban community sample attracted to a spiritually based, weight loss intervention. Methods. Thirteen participants enrolled in a pilot version of Spiritual Self-Schema Therapy (3S applied to disordered eating behavior and obesity. Treatment consisted of 12 one-hour sessions in a group therapy format. At baseline, participants were measured for height and weight and completed a battery of self-report measures. Results. The sample was predominantly African-American and Hispanic and a large percentage of the sample was male. Mean baseline scores of the EDE-Q, YFAS, and the CES-D revealed clinically meaningful levels of eating disordered pathology and depression, respectively. The overall attrition rate was quite low for interventions targeting obesity. Discussion. This application of a spiritually centered intervention seemed to attract and retain a predominantly African-American and Hispanic sample. By incorporating a culturally congruent focus, this approach may have been acceptable to individuals who are traditionally more difficult to reach.

  18. Social Skills Instruction for Urban Learners with Emotional and Behavioral Disorders: A Culturally Responsive and Computer-Based Intervention

    Science.gov (United States)

    Robinson-Ervin, Porsha; Cartledge, Gwendolyn; Musti-Rao, Shobana; Gibson, Lenwood, Jr.; Keyes, Starr E.

    2016-01-01

    This study examined the effects of culturally relevant/responsive, computer-based social skills instruction on the social skill acquisition and generalization of 6 urban African American sixth graders with emotional and behavioral disorders (EBD). A multiple-probe across participants design was used to evaluate the effects of the social skills…

  19. Energy conservation through behavioral change. Examining the effectiveness of a tailor-made approach

    Energy Technology Data Exchange (ETDEWEB)

    Abrahamse, W.

    2007-12-06

    Households constitute an important target group when it comes to encouraging energy conservation. This dissertation provides an overview of the effectiveness of interventions aimed at encouraging households to reduce their energy use through behavioral changes. It also provides more insight into the factors related to household energy use and conservation. Tailored interventions in particular appear to be effective in reducing energy consumption. Households were given tailored information about energy saving measures they could apply. They were asked to try and save 5% energy and the website indicated how much energy they could save with each measure to attain that goal. Households also received feedback about their energy savings. Households who received the combination of tailored information, goal setting and tailored feedback via the Internet saved 5%, while households in a control group used more energy. Households had adopted more energy-saving measures and had more knowledge of energy conservation, compared to the control group. Also, household energy consumption appeared to be mainly related to socio-demographic variables, such as income and household size. Energy savings appeared to be mainly related to individual factors like perceived behavioral control. If the aim is to encourage households to adopt more sustainable lifestyles, it is important to provide them with more insight into which energy saving options are most effective for them to conserve energy. In view of the annual energy reduction targets set by the Dutch government, a tailor-made approach via the Internet can be an important step in that direction.

  20. A scoping study of cultural interventions to treat addictions in Indigenous populations: methods, strategies and insights from a Two-Eyed Seeing approach.

    Science.gov (United States)

    Rowan, Margo; Poole, Nancy; Shea, Beverley; Mykota, David; Farag, Marwa; Hopkins, Carol; Hall, Laura; Mushquash, Christopher; Fornssler, Barbara; Dell, Colleen Anne

    2015-07-04

    This paper describes the methods, strategies and insights gained from a scoping study using a "Two-Eyed Seeing" approach. An evolving technique, Two-Eyed Seeing respects and integrates the strengths of Indigenous knowledge and Western sciences, often "weaving back and forth" between the two worldviews. The scoping study was used to inform a tool for measuring the impact of culturally based addictions treatment services on wellness in Indigenous populations. It formed part of a three-year study, Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment. The scoping study identified and mapped literature on cultural interventions in addictions treatment, and described the nature, extent and gaps in literature. Using a Two-Eyed Seeing approach, we adapted, applied and enhanced a common framework of scoping studies. In the end stage of the scoping review process, an Ad Hoc Review Group, led by our project Elder, reviewed and interpreted Indigenous and Western understandings within the mapped information. Elements of the scoping study were joined with results from community focus groups with staff at treatment centres. Two-Eyed Seeing contributed differently at each stage of the scoping study. In early stages, it clarified team expertise and potential contributions. At the mid-point, it influenced our shift from a systematic to a scoping review. Near the end, it incorporated Western and Indigenous knowledge to interpret and synthesize evidence from multiple sources. This paper adds to the collective work on augmenting the methodology of scoping studies. Despite the challenges of a Two-Eyed Seeing approach, it enables researchers using scoping studies to develop knowledge that is better able to translate into meaningful findings for Indigenous communities.

  1. The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans: Implications for Reducing Stress-Related Health Disparities.

    Science.gov (United States)

    Woods-Giscombé, Cheryl L; Gaylord, Susan A

    2014-09-01

    African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, "buddy system," etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population.

  2. Lessons learned in developing a culturally adapted intervention for African-American families coping with parental cancer.

    Science.gov (United States)

    Davey, Maureen P; Kissil, Karni; Lynch, Laura; Harmon, La-Rhonda; Hodgson, Nancy

    2012-12-01

    Prior clinical research supports the effectiveness of cancer support groups for cancer patients and their families, yet African-American families continue to be underrepresented in cancer support groups and in cancer clinical research studies. In order to fill this gap, we developed and evaluated a culturally adapted family support group for African-American families coping with parental cancer. We encountered unexpected challenges in overcoming barriers to recruitment, partnering with oncology providers, and building trust with the African-American community and African-American families coping with parental cancer. We describe actions taken during the two phases of this study and lessons learned along the way about recruiting and engaging African-American families in cancer support group studies, partnering with oncology providers, networking with the African-American community, and the importance of demonstrating cultural sensitivity to overcome the understandable historical legacy of mistrust.

  3. Interventions to Enhance Breast Cancer Screening, Diagnosis, and Treatment among Racial and Ethnic Minority Women

    Science.gov (United States)

    Masi, Christopher M.; Blackman, Dionne J.; Peek, Monica E.

    2009-01-01

    The authors conduct a systematic review of the literature to identify interventions designed to enhance breast cancer screening, diagnosis, and treatment among minority women. Most trials in this area have focused on breast cancer screening, while relatively few have addressed diagnostic testing or breast cancer treatment. Among patient-targeted screening interventions, those that are culturally tailored or addressed financial or logistical barriers are generally more effective than reminder-based interventions, especially among women with fewer financial resources and those without previous mammography. Chart-based reminders increase physician adherence to mammography guidelines but are less effective at increasing clinical breast examination. Several trials demonstrate that case management is an effective strategy for expediting diagnostic testing after screening abnormalities have been found. Additional support for these and other proven health care organization-based interventions appears justified and may be necessary to eliminate racial and ethnic breast cancer disparities. PMID:17881627

  4. ¡Cocinar Para Su Salud!: Randomized controlled trial of a culturally-based dietary intervention among Hispanic breast cancer survivors

    Science.gov (United States)

    Greenlee, Heather; Gaffney, Ann Ogden; Aycinena, A. Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M.; Lim, Emerson; Tsai, Wei-Yann; Crew, Katherine; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L.

    2015-01-01

    BACKGROUND There is a need for culturally-relevant nutrition programs targeted to underserved cancer survivors. OBJECTIVE To examine the effect of a culturally-based approach to dietary change on increasing fruit/vegetable intake and decreasing fat intake among Hispanic breast cancer (BC) survivors. DESIGN Participants were randomized to intervention (IG) and control (CG) groups. Diet recalls, detailed interviews, fasting blood, and anthropometric measures were collected at baseline, 3-, 6- and 12-months. PARTICIPANTS/SETTING Hispanic women (n=70) with stage 0-III BC who completed adjuvant treatment and lived in New York City were randomized between April 2011 and March 2012. INTERVENTION The IG (n=34) participated in ¡Cocinar Para Su Salud! (¡CPSS!), a culturally-based 9-session (24-hours over 12 weeks) intervention including nutrition education, cooking classes and food shopping field trips. The CG (n=36) received written dietary recommendations for BC survivors. MAIN OUTCOME MEASURES Change at 6 months in daily fruit/vegetable servings and % calories from total fat. STATISTICAL ANALYSES Linear regression models adjusted for stratification factors and estimated marginal means were used to compare changes in diet from baseline to 3- and 6-months. RESULTS Baseline characteristics: mean age 56.6 years (SD 9.7), mean time since diagnosis 3.4 years (SD 2.7), mean BMI 30.9 kg/m2 (SD 6.0), 62.9% with annual household income ≤$15,000, average daily servings of all fruits/vegetables 5.3 (targeted fruits/vegetables 3.7 servings excluding legumes/juices/starchy vegetables/fried foods) and 27.7% of daily calories from fat. Over 60% in the IG attended ≥7/9 classes with overall study retention of 87% retention at 6 months. At month 6, the IG compared to CG reported an increase in mean servings of fruits/vegetables from baseline (all fruits/vegetables: +2.0 vs. −0.1, P=0.005; targeted fruits/vegetables: +2.7 vs. +0.5, P=0.002) and a non-significant decrease in

  5. Using computer technology for HIV prevention among African-Americans: development of a tailored information program for safer sex (TIPSS)

    Science.gov (United States)

    Noar, Seth M.; Webb, Elizabeth M.; Van Stee, Stephanie K.; Redding, Colleen A.; Feist-Price, Sonja; Crosby, Richard; Troutman, Adewale

    2011-01-01

    New prevention options are urgently needed for African-Americans in the United States given the disproportionate impact of HIV/AIDS on this group. This combined with recent evidence supporting the efficacy of computer technology-based interventions in HIV prevention led our research group to pursue the development of a computer-delivered individually tailored intervention for heterosexually active African-Americans—the tailored information program for safer sex (TIPSS). In the current article, we discuss the development of the TIPSS program, including (i) the targeted population and behavior, (ii) theoretical basis for the intervention, (iii) design of the intervention, (iv) formative research, (v) technical development and testing and (vi) intervention delivery and ongoing randomized controlled trial. Given the many advantages of computer-based interventions, including low-cost delivery once developed, they offer much promise for the future of HIV prevention among African-Americans and other at-risk groups. PMID:21257676

  6. Challenges in treatment of posttraumatic stress disorder in refugees: towards integration of evidence-based treatments with contextual and culture-sensitive perspectives

    Directory of Open Access Journals (Sweden)

    Boris Drožđek

    2015-01-01

    Full Text Available Background: Research shows that trauma-focused therapy and multimodal interventions are the two most often used strategies in treatment of refugees suffering from posttraumatic stress disorder (PTSD. While preliminary evidence suggests that trauma-focused approaches may have some efficacy, this could not be established for multimodal interventions. However, it may be that multimodal interventions have been studied in more treatment-resistant refugees with very high levels of psychopathology, disability, and chronicity. In the past decades, various models for understanding of the complex relationship between mental health problems and well-being have emerged. They aim at framing mental health problems in individualized, contextual, epigenetic, and culturally sensitive ways, and may be useful in tailoring content and timing of multimodal interventions. Objective: To draw clinicians’ attention to the possibility of using the Integrative Contextual Model for understanding and assessment of posttrauma mental health sequelae while tailoring multimodal interventions; to present a possible way of combining multimodal with evidence-based trauma-focused approaches; and to improve the understanding and treatment of PTSD and other mental health problems in refugee survivors of prolonged and repeated trauma. Method: Based on literature, clinical experience, and presentation of a fictional case, the use of the Integrative Contextual Model in tailoring the treatment of severe PTSD in a refugee patient is presented and discussed. Results: The Integrative Contextual Model for understanding and assessing factors, which may play a role in causing and maintaining of PTSD and comorbidity in refugees, may help tailoring of multimodal interventions. These interventions can be combined with evidence-based trauma-focused treatments. Conclusion: The field of refugee mental health intervention and clinical practice with traumatized refugees may be enriched with the use

  7. Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions.

    Science.gov (United States)

    Maar, Marion A; Yeates, Karen; Toth, Zsolt; Barron, Marcia; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Perkins, Nancy; Sleeth, Jessica; Wabano, Mary Jo; Williamson, Pamela; Tobe, Sheldon W

    2016-01-22

    evidence-based text message created by researchers and the message received by the recipient in mobile health interventions. These discrepancies were primarily generated by six mediators of meaning in SMS messages: (1) negative or non-affirming framing of advocacies, (2) fear- or stress-inducing content, (3) oppressive or authoritarian content, (4) incongruity with cultural and traditional practices, (5) disconnect with the reality of the social determinants of health and the diversity of cultures within a population, and (6) lack of clarity and/or practicality of content. These 6 mediators of meaning provide the basis for sound strategies for message development because they impact directly on the target populations' capability, opportunity, and motivation for behavior change. The quality of text messages impacts significantly on the effectiveness of a mobile health intervention. Our research underscores the urgent need for interventions to incorporate and evaluate the quality of SMS messages and to examine the mediators of meaning within each targeted cultural and demographic group. Reporting on this aspect of mobile health intervention research will allow researchers to move away from the current black box of SMS text message development, thus improving the transparency of the process as well as the quality of the outcomes.

  8. Effects of dietary interventions on incidence and progression of CKD.

    Science.gov (United States)

    Jain, Nishank; Reilly, Robert F

    2014-12-01

    Traditional strategies for management of patients with chronic kidney disease (CKD) have not resulted in any change in the growing prevalence of CKD worldwide. A historic belief that eating healthily might ameliorate kidney disease still holds credibility in the 21(st) century. Dietary sodium restriction to dietary net acid load could be beneficial in patients with CKD, but the supremacy of any particular diet has yet to be established. More trials of dietary interventions are needed, especially in diabetic nephropathy, before evidence-based recommendations can be made. In the meantime, nephrologists should discuss healthy dietary habits with their patients and provide individualized care aimed at maximizing the potential benefits of dietary intervention, reducing the incidence of CKD and delaying its progression to end-stage renal disease. Keeping in mind the lack of data on hard outcomes, dietary recommendations should take into account barriers to adherence and be tailored to different cultures, ethnicities and geographical locations.

  9. Clinicians' views of an intervention to reduce racial disparities in diabetes outcomes.

    Science.gov (United States)

    Thorlby, Ruth; Jorgensen, Selena; Ayanian, John Z; Sequist, Thomas D

    2011-01-01

    Interventions that improve clinicians' awareness of racial disparities and improve their communication skills are considered promising strategies for reducing disparities in health care. We report clinicians' views of an intervention involving cultural competency training and race-stratified performance reports designed to reduce racial disparities in diabetes outcomes. Semistructured interviews were conducted with 12 physicians and 5 nurse practitioners who recently participated in a randomized intervention to reduce racial disparities in diabetes outcomes. Clinicians were asked open-ended questions about their attitudes towards the intervention, the causes of disparities, and potential solutions to them. Thematic analysis of the interviews showed that most clinicians acknowledged the presence of racial disparities in diabetes control among their patients. They described a complex set of causes, including socioeconomic factors, but perceived only some causes to be within their power to change, such as switching patients to less-expensive generic drugs. The performance reports and training were generally well received but some clinicians did not feel empowered to act on the information. All clinicians identified additional services that would help them address disparities; for example, culturally tailored nutrition advice. Some clinicians challenged the premise of the intervention, focusing instead on socioeconomic factors as the primary cause of disparities rather than on patients' race. The cultural competency training and performance reports were well received by many but not all of the clinicians. Clinicians reported the intervention alone had not empowered them to address the complex, root causes of racial disparities in diabetes outcomes.

  10. Self-confidence for emergency intervention: adaptation and cultural validation of the Self-confidence Scale in nursing students

    Directory of Open Access Journals (Sweden)

    José Carlos Amado Martins

    2014-08-01

    Full Text Available Objective: develop the cultural adaptation and validation of a Portuguese version of the Self-confidence Scale.Method: descriptive and exploratory methodological research for the adaptation and validation of a measuring instrument. The translation, synthesis, back-translation, revision, pretest and semantic evaluation phases were accomplished. The evaluation involving 178 students from a Teaching Diploma Program in Nursing. The ethical principles were complied with.Results: the internal consistency analysis of the scale reveals good Alpha coefficients (0.92 for the global scale and superior to 0.83 for the different dimensions. The factor analysis presents a three-factor solution with rational meaning.Conclusion: The scale is easy to answer and understand. Based on the obtained results, it can be affirmed that the scale reveals good psychometric properties, with great potential to be used in future research.

  11. Understanding tailoring in communicating about health

    NARCIS (Netherlands)

    Hawkins, Robert P.; Kreuter, Matthew; Resnicow, Kenneth; Fishbein, Martin; Dijkstra, Arie

    2008-01-01

    'Tailoring' refers to any of a number of methods for creating communications individualized for their receivers, with the expectation that this individualization will lead to larger intended effects of these communications. Results so far have been generally positive but not consistently so, and thi

  12. LIFE-STYLE SEGMENTATION WITH TAILORED INTERVIEWING

    NARCIS (Netherlands)

    KAMAKURA, WA; WEDEL, M

    1995-01-01

    The authors present a tailored interviewing procedure for life-style segmentation. The procedure assumes that a life-style measurement instrument has been designed. A classification of a sample of consumers into life-style segments is obtained using a latent-class model. With these segments, the tai

  13. Tailoring endocrine treatment for early breast cancer

    NARCIS (Netherlands)

    Fontein, Duveken Berthe Yvonne

    2014-01-01

    This thesis describes several important aspects of adjuvant endocrine therapy for postmenopausal women with endocrine-sensitive, early-stage breast cancer. In our ongoing efforts to tailor treatment so as to provide the best possible care to each of our patients, we studied the influence of various

  14. Tailoring endocrine treatment for early breast cancer

    NARCIS (Netherlands)

    Fontein, Duveken Berthe Yvonne

    2014-01-01

    This thesis describes several important aspects of adjuvant endocrine therapy for postmenopausal women with endocrine-sensitive, early-stage breast cancer. In our ongoing efforts to tailor treatment so as to provide the best possible care to each of our patients, we studied the influence of various

  15. User-tailored E-health services

    NARCIS (Netherlands)

    van 't Klooster, J.W.J.R.

    2013-01-01

    This thesis describes a method to offer personalised healthcare. It is motivated by a desire for more efficient healthcare, as population ages and care demand and costs increase. Developing and testing individually tailored health services using ICT fits in this motivation, as it leads to more

  16. Tailoring group velocity by topology optimization

    DEFF Research Database (Denmark)

    Stainko, Roman; Sigmund, Ole

    2007-01-01

    The paper describes a systematic method for the tailoring of dispersion properties of slab-based photonic crystal waveguides. The method is based on the topology optimization method which consists in repeated finite element frequency domain analyses. The goal of the optimization process is to come...

  17. Space and Missile Systems Center Tailoring: Tailoring Instructions for MIL-STD-882E

    Science.gov (United States)

    2012-11-30

    Space Command SPACE AND MISSILE SYSTEMS CENTER TAILORING TAILORING INSTRUCTIONS FOR MIL- STD -882E APPROVED FOR PUBLIC RELEASE...for MIL- STD -882E 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT...THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 SMC Tailoring of MIL- STD -882E, System Safety FOREWORD This

  18. Creative Learning Through the Use of Simulation to Teach Nursing Students Screening, Brief Intervention, and Referral to Treatment for Alcohol and Other Drug Use in a Culturally Competent Manner.

    Science.gov (United States)

    Fioravanti, Marie A; Hagle, Holly; Puskar, Kathy; Knapp, Emily; Kane, Irene; Lindsay, Dawn; Terhorst, Lauren; Mitchell, Ann M

    2017-08-01

    Cultural competency is an integral component in undergraduate nursing education to provide patient-centered care and addressing patients' cultural differences. Students need to consider the prevalence of alcohol and other drug use/misuse in patients from all cultures. This project combines cultural competency education, simulation, and educating students to use screening, brief intervention, and referral to treatment for alcohol and other drug use. Culturally diverse simulation scenarios were developed and used in the simulation lab with students to reduce stigma surrounding other cultures while learning an evidence-based practice to screen and intervene with patients who use/misuse substances. Results show students value simulation and 91% of the students felt that they were able to apply culturally competent knowledge after the simulation experience. Cultural competency principles can be embedded in teaching the broader evidence-based practice of screening, brief intervention, and referral to treatment with undergraduate students. This is a replicable teaching methodology that could be adapted in other schools of nursing.

  19. A personalized and control systems engineering conceptual approach to target childhood anxiety in the contexts of cultural diversity.

    Science.gov (United States)

    Pina, Armando A; Holly, Lindsay E; Zerr, Argero A; Rivera, Daniel E

    2014-01-01

    In the child and adolescent anxiety area, some progress has been made to develop evidence-based prevention protocols, but less is known about how to best target these problems in children and families of color. In general, data show differential program effects with some minority children benefiting significantly less. Our preliminary data, however, show promise and suggest cultural parameters to consider in the tailoring process beyond language and cultural symbols. It appears that a more focused approach to culture might help activate intervention components and its intended effects by focusing, for example, on the various facets of familismo when working with some Mexican parents. However, testing the effects and nuances of cultural adaption vis-à-vis a focused personalized approach is methodologically challenging. For this reason, we identify control systems engineering design methods and provide example scenarios relevant to our data and recent intervention work.

  20. Tailoring Hydrogel Viscoelasticity with Physical and Chemical Crosslinking

    Directory of Open Access Journals (Sweden)

    Michal Bartnikowski

    2015-12-01

    Full Text Available Biological tissues are viscoelastic, demonstrating a mixture of fluid and solid responses to mechanical strain. Whilst viscoelasticity is critical for native tissue function, it is rarely used as a design criterion in biomaterials science or tissue engineering. We propose that viscoelasticity may be tailored to specific levels through manipulation of the hydrogel type, or more specifically the proportion of physical and chemical crosslinks present in a construct. This theory was assessed by comparing the mechanical properties of various hydrogel blends, comprising elastic, equilibrium, storage and loss moduli, as well as the loss tangent. These properties were also assessed in human articular cartilage explants. It was found that whilst very low in elastic modulus, the physical crosslinks found in gellan gum-only provided the closest approximation of loss tangent levels found in cartilage. Blends of physical and chemical crosslinks (gelatin methacrylamide (GelMA combined with gellan gum gave highest values for elastic response. However, a greater proportion of gellan gum to GelMA than investigated may be required to achieve native cartilage viscoelasticity in this case. Human articular chondrocytes encapsulated in hydrogels remained viable over one week of culture. Overall, it was shown that viscoelasticity may be tailored similarly to other mechanical properties and may prove a new criterion to be included in the design of biomaterial structures for tissue engineering.

  1. Adaptation of a culturally relevant nutrition and physical activity program for low-income, Mexican-origin parents with young children.

    Science.gov (United States)

    Kaiser, Lucia; Martinez, Judith; Horowitz, Marcel; Lamp, Catherine; Johns, Margaret; Espinoza, Dorina; Byrnes, Michele; Gomez, Mayra Muñoz; Aguilera, Alberto; de la Torre, Adela

    2015-05-14

    Latino children experience higher rates of obesity than do non-Latino white children. Family-centered nutrition interventions can slow the rate of weight gain in this population. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a 5-year, community-based, participatory research study that targets rural Mexican-origin farmworker families with children aged 2 to 8 years in California's Central Valley. Adaptation of a culturally relevant obesity prevention program involved qualitative research to tailor key obesity prevention messages, pilot testing and implementation of key messages and activities at family nights, and continual modification to incorporate culturally innovative elements. Of the 238 families enrolled, 53% (125) attended the recommended minimum of 5 (of 10 possible) classes during the first year. A university and community partnership can guide development of a culturally tailored obesity prevention program that is suitable for reaching a high-risk Mexican-origin audience through cooperative extension and other public health programs.

  2. Predictors of unprotected sex among young sexually active African American, Hispanic, and White MSM: the importance of ethnicity and culture.

    Science.gov (United States)

    Warren, Jacob C; Fernández, M Isabel; Harper, Gary W; Hidalgo, Marco A; Jamil, Omar B; Torres, Rodrigo Sebastián

    2008-05-01

    Despite the recognized need for culturally tailored HIV prevention interventions for gay, bisexual, and questioning youth, few studies have examined if predictors of unprotected sex vary for youth from different ethnic groups. This study reports on a sample of 189 gay, bisexual, and questioning youth (age 15-22) from three racial/ethnic backgrounds (African American, Hispanic, and White) recruited in Chicago, IL and Miami-Dade and Broward Counties, Florida. For African American youth, being in a long-term relationship, having been kicked out of the home for having sex with men, and younger age at initiation of sexual behavior were associated with unprotected sex. For Hispanic youth, higher ethnic identification and older age at initiation of sexual behavior were associated with unprotected sex. For White youth, no predictors were associated with unprotected sex. Our findings point to the importance of understanding the varying predictors of unprotected sex and integrating them into tailored prevention interventions.

  3. Pasos Hacia La Salud: a randomized controlled trial of an internet-delivered physical activity intervention for Latinas.

    Science.gov (United States)

    Marcus, Bess H; Hartman, Sheri J; Larsen, Britta A; Pekmezi, Dori; Dunsiger, Shira I; Linke, Sarah; Marquez, Becky; Gans, Kim M; Bock, Beth C; Mendoza-Vasconez, Andrea S; Noble, Madison L; Rojas, Carlos

    2016-05-28

    Internet access has grown markedly in Latinos during the past decade. However, there have been no Internet-based physical activity interventions designed for Latinos, despite large disparities in lifestyle-related conditions, such as obesity and diabetes, particularly in Latina women. The current study tested the efficacy of a 6-month culturally adapted, individually tailored, Spanish-language Internet-based physical activity intervention. Inactive Latinas (N = 205) were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. Participants in both groups received emails on a tapered schedule over 6 months to alert them to new content on the website. The primary outcome was minutes/week of moderate to vigorous physical activity (MVPA) at 6 months as measured by the 7-Day Physical Activity Recall; activity was also measured by accelerometers. Data were collected between 2011 and 2014 and analyzed in 2015 at the University of California, San Diego. Increases in minutes/week of MVPA were significantly greater in the Intervention Group compared to the Control Group (mean difference = 50.00, SE = 9.5, p < 0.01). Increases in objectively measured MVPA were also significantly larger in the Intervention Group (mean differences = 31.0, SE = 10.7, p < .01). The Intervention Group was also significantly more likely to meet national physical activity guidelines at 6 months (OR = 3.12, 95% CI 1.46-6.66, p < .05). Findings from the current study suggest that this Internet-delivered individually tailored intervention successfully increased MVPA in Latinas compared to a Wellness Contact Control Internet Group. NCT01834287.

  4. Use of Media Technologies by Native American Teens and Young Adults: Evaluating Their Utility for Designing Culturally-Appropriate Sexual Health Interventions Targeting Native Youth in the Pacific Northwest

    Science.gov (United States)

    Craig Rushing, Stephanie Nicole

    2010-01-01

    American Indian and Alaska Native (AI/AN) youth are disproportionally burdened by high rates of sexually transmitted infections and teen pregnancy, heightening their need for sexual health interventions that are aligned to their unique culture and social context. Media technologies, including the Internet, cell phones, and video games, offer new…

  5. Use of Media Technologies by Native American Teens and Young Adults: Evaluating Their Utility for Designing Culturally-Appropriate Sexual Health Interventions Targeting Native Youth in the Pacific Northwest

    Science.gov (United States)

    Craig Rushing, Stephanie Nicole

    2010-01-01

    American Indian and Alaska Native (AI/AN) youth are disproportionally burdened by high rates of sexually transmitted infections and teen pregnancy, heightening their need for sexual health interventions that are aligned to their unique culture and social context. Media technologies, including the Internet, cell phones, and video games, offer new…

  6. Tailored Trustworthy Spaces: Solutions for the Smart Grid

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — The NITRD workshop on Tailored Trustworthy Spaces: Solutions for the Smart Grid was conceived by the Federal government to probe deeper into how Tailored Trustworthy...

  7. Systematic identification and intervention for reading difficulty: case studies of children with EAL.

    Science.gov (United States)

    Fawcett, A J; Lynch, L

    2000-01-01

    Literacy underpins education. There is now very widespread concern over standards of literacy for children from multi-cultural backgrounds, who are learning English as a second or subsequent language, and who may have special educational needs. Research evidence suggests that the earlier children's difficulties can be identified, the more effective (and cost-effective) intervention will be, provided that the intervention is tailored to the child's abilities and skills. Nicolson and Fawcett have developed systematic procedures for identifying children at risk for reading difficulty, together with systematic teaching strategies to overcome reading difficulty. In this paper we present case studies of children with EAL (English as an additional language) drawn from a controlled study using computer interventions with secondary school children. Our findings indicate that children with EAL may be more resistant to remediation than some children with learning difficulties. The prognosis is more problematic for children with both EAL and dyslexia.

  8. All-optical bandwidth-tailorable radar

    CERN Document Server

    Zou, Weiwen; Long, Xin; Zhang, Siteng; Cui, Yuanjun; Chen, Jianping

    2015-01-01

    Radar has been widely used in military, security, and rescue. Metamaterial cloak is employed in stealth targets to evade radar detection. Hence modern radar should be reconfigurable at multi-bands for detecting stealth targets, which might be realized based on microwave photonics. Here, we demonstrate an all-optical bandwidth-tailorable radar architecture. It is a coherent system utilizing one mode-locked laser for both signal generation and reception. Heterodyning of two individually filtered optical pulses that are pre-chirped via wavelength-to-time mapping generates wideband linearly-chirped radar signal. The working bands can be flexibly tailored with desired bandwidth at user-preferred carrier frequency. After modulated onto the pre-chirped optical pulse, radar echoes are time-stretched and frequency-compressed by several times. The digitization becomes much easier without loss of detection ability. We believe that the demonstration can innovate the radar's architecture with ultra-high range resolution.

  9. Gust response of aeroelastically tailored wind turbines

    Science.gov (United States)

    Scott, S.; Capuzzi, M.; Langston, D.; Bossanyi, E.; McCann, G.; Weaver, PM; Pirrera, A.

    2016-09-01

    Some interesting challenges arise from the drive to build larger, more durable rotors that produce cheaper energy. The rationale is that, with current wind turbine designs, the power generated is theoretically proportional to the square of blade length. One enabling technology is aeroelastic tailoring that offers enhanced combined energy capture and system durability. The design of two adaptive, aeroelastically tailored blade configurations is considered here. One uses material bend-twist coupling; the other combines both material and geometric coupling. Each structural design meets a predefined coupling distribution, whilst approximately matching the stiffness of an uncoupled baseline blade. A gust analysis shows beneficial flapwise load alleviation for both adaptive blades, with the additional benefits of smoothing variations in electrical power and rotational speed.

  10. Metamaterials with tailored nonlinear optical response.

    Science.gov (United States)

    Husu, Hannu; Siikanen, Roope; Mäkitalo, Jouni; Lehtolahti, Joonas; Laukkanen, Janne; Kuittinen, Markku; Kauranen, Martti

    2012-02-08

    We demonstrate that the second-order nonlinear optical response of noncentrosymmetric metal nanoparticles (metamolecules) can be efficiently controlled by their mutual ordering in an array. Two samples with minor change in ordering have nonlinear responses differing by a factor of up to 50. The results arise from polarization-dependent plasmonic resonances modified by long-range coupling associated with metamolecular ordering. The approach opens new ways for tailoring the nonlinear responses of metamaterials and their tensorial properties.

  11. Tailored Training in Vehicle Maintenance Courses

    Science.gov (United States)

    2014-07-01

    G. A., Wampler, R. L., & Dyer, J. L. (2007). Techniques and practices in the training of digital operator skills . (Research Report 1878...occur in technical, functional courses where graduates must be proficient in clearly defined skills , based on specified performance standards, upon...tailored training in the Army is most likely to occur in technical, functional courses where graduates must be proficient in clearly defined skills

  12. Development of patient-centric linguistically tailored psychoeducational messages to support nutrition and medication self-management in type 2 diabetes: a feasibility study

    Science.gov (United States)

    Ellis, Rebecca J Bartlett; Connor, Ulla; Marshall, James

    2014-01-01

    with the ultimate goal to design intervention studies to investigate if linguistically tailoring communication within the context of patient education influences patient knowledge, motivation, and activation toward making healthy behavior changes in T2DM self-management. PMID:25336928

  13. Outcomes of a type 2 diabetes education program adapted to the cultural contexts of Saudi women

    Science.gov (United States)

    Al-Bannay, Hana R.; Jongbloed, Lyn E.; Jarus, Tal; Alabdulwahab, Sami S.; Khoja, Tawfik A.; Dean, Elizabeth

    2015-01-01

    Objective: To explore the outcomes of a pilot intervention of a type 2 diabetes (T2D) education program, based on international standards, and adapted to the cultural and religious contexts of Saudi women. Methods: This study is an experiment of a pilot intervention carried out between August 2011 and January 2012 at the primary health clinics in Dammam. Women at risk of or diagnosed with T2D (N=35 including dropouts) were assigned to one of 2 groups; an intervention group participated in a pilot intervention of T2D education program, based on international standards and tailored to their cultural and religious contexts; and a usual care group received the usual care for diabetes in Saudi Arabia. Outcomes included blood glucose, body composition, 6-minute walk distance, life satisfaction, quality of life, and diabetes knowledge. The intervention group participated in a focus group of their program experience. Data analysis was based on mixed methods. Results: Based on 95% confidence interval comparisons, improvements were noted in blood sugar, 6-minute walk distance, quality of life, and diabetes knowledge in participants of the intervention group. They also reported improvements in lifestyle-related health behaviors after the education program. Conclusion: Saudi women may benefit from a T2D education program based on international standards and adapted to their cultural and religious contexts. PMID:26108595

  14. Long-term effectiveness of computer-generated tailored patient education on benzodiazepines : a randomized controlled trial

    NARCIS (Netherlands)

    Ten Wolde, Geeske Brecht; Dijkstra, Arie; Van Empelen, Pepijn; van den Hout, Wilbert; Neven, Arie Knuistingh; Zitman, Frans

    Aims Chronic benzodiazepine use is highly prevalent and is associated with a variety of negative health consequences. The present study examined the long-term effectiveness of a tailored patient education intervention on benzodiazepine use. Participants A randomized controlled trial was conducted

  15. Tailored support for type 2 diabetes patients after an acute coronary event : The Diacourse-ACE study

    NARCIS (Netherlands)

    Kasteleyn, M.J.

    2015-01-01

    Aims: The aims of this thesis were to define the clinical profile and difficulties encountered by type 2 diabetes patients with a first acute coronary event (ACE), to develop and evaluate a tailored supportive intervention for type 2 diabetes patients with a first ACE and to examine diabetes-related

  16. Tailored support for type 2 diabetes patients after an acute coronary event : The Diacourse-ACE study

    NARCIS (Netherlands)

    Kasteleyn, M.J.

    2015-01-01

    Aims: The aims of this thesis were to define the clinical profile and difficulties encountered by type 2 diabetes patients with a first acute coronary event (ACE), to develop and evaluate a tailored supportive intervention for type 2 diabetes patients with a first ACE and to examine diabetes-related

  17. Long-term effectiveness of computer-generated tailored patient education on benzodiazepines : a randomized controlled trial

    NARCIS (Netherlands)

    Ten Wolde, Geeske Brecht; Dijkstra, Arie; Van Empelen, Pepijn; van den Hout, Wilbert; Neven, Arie Knuistingh; Zitman, Frans

    2008-01-01

    Aims Chronic benzodiazepine use is highly prevalent and is associated with a variety of negative health consequences. The present study examined the long-term effectiveness of a tailored patient education intervention on benzodiazepine use. Participants A randomized controlled trial was conducted co

  18. The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation.

    Science.gov (United States)

    Wight, Daniel; Plummer, Mary; Ross, David

    2012-09-14

    Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief), economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action - but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change.

  19. The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

    Directory of Open Access Journals (Sweden)

    Wight Daniel

    2012-09-01

    Full Text Available Abstract Background Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief, economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change.

  20. Culture, threat, and mental illness stigma: identifying culture-specific threat among Chinese-American groups.

    Science.gov (United States)

    Yang, Lawrence H; Purdie-Vaughns, Valerie; Kotabe, Hiroki; Link, Bruce G; Saw, Anne; Wong, Gloria; Phelan, Jo C

    2013-07-01

    We incorporate anthropological insights into a stigma framework to elucidate the role of culture in threat perception and stigma among Chinese groups. Prior work suggests that genetic contamination that jeopardizes the extension of one's family lineage may comprise a culture-specific threat among Chinese groups. In Study 1, a national survey conducted from 2002 to 2003 assessed cultural differences in mental illness stigma and perceptions of threat in 56 Chinese-Americans and 589 European-Americans. Study 2 sought to empirically test this culture-specific threat of genetic contamination to lineage via a memory paradigm. Conducted from June to August 2010, 48 Chinese-American and 37 European-American university students in New York City read vignettes containing content referring to lineage or non-lineage concerns. Half the participants in each ethnic group were assigned to a condition in which the illness was likely to be inherited (genetic condition) and the rest read that the illness was unlikely to be inherited (non-genetic condition). Findings from Study 1 and 2 were convergent. In Study 1, culture-specific threat to lineage predicted cultural variation in stigma independently and after accounting for other forms of threat. In Study 2, Chinese-Americans in the genetic condition were more likely to accurately recall and recognize lineage content than the Chinese-Americans in the non-genetic condition, but that memorial pattern was not found for non-lineage content. The identification of this culture-specific threat among Chinese groups has direct implications for culturally-tailored anti-stigma interventions. Further, this framework might be implemented across other conditions and cultural groups to reduce stigma across cultures. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Protocol of a Randomized Controlled Trial of Culturally Sensitive Interventions to Improve African Americans' and Non-African Americans' Early, Shared, and Informed Consideration of Live Kidney Transplantation: The talking about Live Kidney Donation (TALK study

    Directory of Open Access Journals (Sweden)

    Senga Mikiko

    2011-07-01

    Full Text Available Abstract Background Live kidney transplantation (LKT is underutilized, particularly among ethnic/racial minorities. The effectiveness of culturally sensitive educational and behavioral interventions to encourage patients' early, shared (with family and health care providers and informed consideration of LKT and ameliorate disparities in consideration of LKT is unknown. Methods/Design We report the protocol of the Talking About Live Kidney Donation (TALK Study, a two-phase study utilizing qualitative and quantitative research methods to design and test culturally sensitive interventions to improve patients' shared and informed consideration of LKT. Study Phase 1 involved the evidence-based development of culturally sensitive written and audiovisual educational materials as well as a social worker intervention to encourage patients' engagement in shared and informed consideration of LKT. In Study Phase 2, we are currently conducting a randomized controlled trial in which participants with progressing chronic kidney disease receive: 1 usual care by their nephrologists, 2 usual care plus the educational materials, or 3 usual care plus the educational materials and the social worker intervention. The primary outcome of the randomized controlled trial will include patients' self-reported rates of consideration of LKT (including family discussions of LKT, patient-physician discussions of LKT, and identification of an LKT donor. We will also assess differences in rates of consideration of LKT among African Americans and non-African Americans. Discussion The TALK Study rigorously developed and is currently testing the effectiveness of culturally sensitive interventions to improve patients' and families' consideration of LKT. Results from TALK will provide needed evidence on ways to enhance consideration of this optimal treatment for patients with end stage renal disease. Trial Registration ClinicalTrials.gov number, NCT00932334

  2. Individually Tailored Dietary Counseling among Old Home Care Clients - Effects on Nutritional Status.

    Science.gov (United States)

    Pölönen, S; Tiihonen, M; Hartikainen, S; Nykänen, I

    2017-01-01

    To evaluate the effect of individually tailored dietary counseling on nutritional status among home care clients aged 75 years or older. Non-randomised controlled study. The study sample consisted of 224 home care clients (≥ 75 years) (intervention group, n = 127; control group, n = 100) who were at protein-energy malnutrition (PEM) or risk of PEM (MNA score Nutritional Assessment (MNA), Body Mass Index (BMI) and plasma albumin were used to determine nutritional status at the baseline and after the six-month intervention. The mean age of the home care clients was 84.3 (SD 5.5) in the intervention group and 84.4 (SD 5.3) in the control group, and 70 percent were women in both groups. After the six-month nutritional intervention, the MNA score increased 2.3 points and plasma albumin 1.6 g/L in the intervention group, against MNA score decreased -0.2 points and plasma albumin -0.1 g/L in the control group. Individually tailored dietary counseling may improve nutritional status among older home care clients.

  3. Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial.

    Science.gov (United States)

    Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark

    2016-01-01

    Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (Pmanage a COPD exacerbation (Pmanaging COPD (Peducational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies.

  4. Tailored antireflective biomimetic nanostructures for UV applications

    Energy Technology Data Exchange (ETDEWEB)

    Morhard, Christoph; Pacholski, Claudia; Spatz, Joachim P [Department of New Materials and Biosystems, Max Planck Institute for Metals Research, Heisenbergstrasse 3, D-70569 Stuttgart (Germany); Lehr, Dennis; Brunner, Robert; Helgert, Michael [Carl Zeiss Jena GmbH, Technology Center, Carl-Zeiss-Promenade 10, D-07745 Jena (Germany); Sundermann, Michael, E-mail: Pacholski@mf.mpg.de [Carl Zeiss Jena GmbH, Technology Center, Carl-Zeiss-Strasse 56, D-73447 Oberkochen (Germany)

    2010-10-22

    Antireflective surfaces composed of biomimetic sub-wavelength structures that employ the 'moth eye principle' for reflectance reduction are highly desirable in many optical applications such as solar cells, photodetectors and laser optics. We report an efficient approach for the fabrication of antireflective surfaces based on a two-step process consisting of gold nanoparticle mask generation by micellar block copolymer nanolithography and a multi-step reactive ion etching process. Depending on the RIE process parameters nanostructured surfaces with tailored antireflective properties can easily be fabricated that show optimum performance for specific applications.

  5. Which intervention characteristics are related to more exposure to internet-delivered healthy lifestyle promotion interventions? A systematic review

    NARCIS (Netherlands)

    W. Brouwer (Wendy); W. Kroeze (Willemieke); R. Crutzen (Rik); J. de Nooijer (Jascha); N.K. de Vries (Nanne); J. Brug (Hans); A. Oenema (Anke)

    2011-01-01

    textabstractBackground: The Internet has become a popular medium for the delivery of tailored healthy lifestyle promoting interventions. The actual reach of Internet-delivered interventions seems, however, lower than expected, and attrition from interventions is generally high. Characteristics of an

  6. A counselor in your pocket: feasibility of mobile health tailored messages to support HIV medication adherence

    Directory of Open Access Journals (Sweden)

    Cook PF

    2015-09-01

    Full Text Available Paul F Cook,1 Jane M Carrington,2 Sarah J Schmiege,1 Whitney Starr,3 Blaine Reeder11University of Colorado College of Nursing, Aurora, CO, USA; 2University of Arizona College of Nursing, Tucson, AZ, USA; 3University of Colorado School of Medicine, Aurora, CO, USAPurpose: Medication adherence is a major challenge in HIV treatment. New mobile technologies such as smartphones facilitate the delivery of brief tailored messages to promote adherence. However, the best approach for tailoring messages is unknown. Persons living with HIV (PLWH might be more receptive to some messages than others based on their current psychological state.Methods: We recruited 37 PLWH from a parent study of motivational states and adherence. Participants completed smartphone-based surveys at a random time every day for 2 weeks, then immediately received intervention or control tailored messages, depending on random assignment. After 2 weeks in the initial condition, participants received the other condition in a crossover design. Intervention messages were tailored to match PLWH’s current psychological state based on five variables – control beliefs, mood, stress, coping, and social support. Control messages were tailored to create a mismatch between message framing and participants’ current psychological state. We evaluated intervention feasibility based on acceptance, ease of use, and usefulness measures. We also used pilot randomized controlled trial methods to test the intervention’s effect on adherence, which was measured using electronic caps that recorded pill-bottle openings.Results: Acceptance was high based on 76% enrollment and 85% satisfaction. Participants found the hardware and software easy to use. However, attrition was high at 59%, and usefulness ratings were slightly lower. The most common complaint was boredom. Unexpectedly, there was no difference between mismatched and matched messages’ effects, but each group showed a 10%–15% improvement

  7. Laser cutting of sheets for Tailored Blanks

    DEFF Research Database (Denmark)

    Bagger, Claus; Olsen, Flemming Ove

    1999-01-01

    Over the past few years there has been an enormous increase in the use of tailored blanks, especially in the automotive industry. Often the sheets for tailored blanks are shear cut, but results have been reported that the allowable sheet gap distance should not exceed 0.1 mm in order to obtain...... sound welds. Laser cutting the sheets may therefore be an alternative to shear cutting, if the cut kerf squareness can be kept below 0.05 mm.In a number of systematic laboratory experiments the effects of the major process parameters in laser cutting have been investigated. Each cut was quantified...... by the squareness, the surface roughness and the burr height. Mild steel as well as high strength steel with and with out galvanisation with thickness' of 0.7(5) and 1.25 were used.In the tests the difference in cut quality between a 5" and a 7.5" focusing lens were tested and the effect of using pulsed mode laser...

  8. Video-Based Grocery Shopping Intervention Effect on Purchasing Behaviors Among Latina Shoppers.

    Science.gov (United States)

    Amaro, Hortensia; Cortés, Dharma E; Garcia, Samantha; Duan, Lei; Black, David S

    2017-05-01

    To compare changes in food-purchasing knowledge, self-efficacy, and behavior after viewing nutrition education videos among Los Angeles, California Latinas responsible for household grocery shopping. From February to May 2015, a convenience sample of 113 Latinas watched 1 video (El Carrito Saludable) featuring MyPlate guidelines applied to grocery shopping (1-video intervention) and another convenience sample of 105 Latinas watched 2 videos (El Carrito Saludable and Ser Consciente), the latter featuring mindfulness to support attention and overcome distractions while grocery shopping (2-video intervention). We administered questionnaires before and after intervention. A preselected sample in each intervention condition (n = 72) completed questionnaires at 2-months after intervention and provided grocery receipts (before and 2-months after intervention). Knowledge improved in both intervention groups (P shopping list (both P < .05) and purchased more healthy foods (d = 0.60; P < .05) at 2 months than did the 1-video group. Culturally tailored videos that model food-purchasing behavior and mindfulness show promise for improving the quality of foods that Latinas bring into the home.

  9. Deep Drawing of High-Strength Tailored Blanks by Using Tailored Tools

    Directory of Open Access Journals (Sweden)

    Thomas Mennecart

    2016-01-01

    Full Text Available In most forming processes based on tailored blanks, the tool material remains the same as that of sheet metal blanks without tailored properties. A novel concept of lightweight construction for deep drawing tools is presented in this work to improve the forming behavior of tailored blanks. The investigations presented here deal with the forming of tailored blanks of dissimilar strengths using tailored dies made of two different materials. In the area of the steel blank with higher strength, typical tool steel is used. In the area of the low-strength steel, a hybrid tool made out of a polymer and a fiber-reinforced surface replaces the steel half. Cylindrical cups of DP600/HX300LAD are formed and analyzed regarding their formability. The use of two different halves of tool materials shows improved blank thickness distribution, weld-line movement and pressure distribution compared to the use of two steel halves. An improvement in strain distribution is also observed by the inclusion of springs in the polymer side of tools, which is implemented to control the material flow in the die. Furthermore, a reduction in tool weight of approximately 75% can be achieved by using this technique. An accurate finite element modeling strategy is developed to analyze the problem numerically and is verified experimentally for the cylindrical cup. This strategy is then applied to investigate the thickness distribution and weld-line movement for a complex geometry, and its transferability is validated. The inclusion of springs in the hybrid tool leads to better material flow, which results in reduction of weld-line movement by around 60%, leading to more uniform thickness distribution.

  10. Protocol of a Randomized Controlled Trial of Culturally Sensitive Interventions to Improve African Americans' and Non-African Americans' Early, Shared, and Informed Consideration of Live Kidney Transplantation: The talking about Live Kidney Donation (TALK) study

    OpenAIRE

    2011-01-01

    Abstract Background Live kidney transplantation (LKT) is underutilized, particularly among ethnic/racial minorities. The effectiveness of culturally sensitive educational and behavioral interventions to encourage patients' early, shared (with family and health care providers) and informed consideration of LKT and ameliorate disparities in consideration of LKT is unknown. Methods/Design We report the protocol of the Talking About Live Kidney Donation (TALK) Study, a two-phase study utilizing q...

  11. Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial

    Science.gov (United States)

    Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark

    2016-01-01

    Background Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Methods Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Results Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05). Conclusion Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. Clinical implication A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment

  12. Evaluating a Hospitalist-Based Intervention to Decrease Unnecessary Antimicrobial Use in Patients With Asymptomatic Bacteriuria.

    Science.gov (United States)

    Hartley, Sarah E; Kuhn, Latoya; Valley, Staci; Washer, Laraine L; Gandhi, Tejal; Meddings, Jennifer; Robida, Michelle; Sabnis, Salas; Chenoweth, Carol; Malani, Anurag N; Saint, Sanjay; Flanders, Scott A

    2016-09-01

    OBJECTIVE Inappropriate treatment of asymptomatic bacteriuria (ASB) in the hospital setting is common. We sought to evaluate the treatment rate of ASB at the 3 hospitals and assess the impact of a hospitalist-focused improvement intervention. DESIGN Prospective, interventional trial. SETTING Two community hospitals and a tertiary-care academic center. PATIENTS Adult patients with a positive urine culture admitted to hospitalist services were included in this study. Exclusions included pregnancy, intensive care unit admission, history of a major urinary procedure, and actively being treated for a urinary tract infection (UTI) at the time of admission or >48 hours prior to urine collection. INTERVENTIONS An educational intervention using a pocket card was implemented at all sites followed by a pharmacist-based intervention at the academic center. Medical records of the first 50 eligible patients at each site were reviewed at baseline and after each intervention for signs and symptoms of UTI, microbiological results, antimicrobials used, and duration of treatment for positive urine cultures. Diagnosis of ASB was determined through adjudication by 2 hospitalists and 2 infectious diseases physicians. RESULTS Treatment rates of ASB decreased (23.5%; P=.001) after the educational intervention. Reductions in treatment rates for ASB differed by site and were greatest in patients without classic signs and symptoms of UTI (34.1%; P<.001) or urinary catheters (31.2%; P<.001). The pharmacist-based intervention was most effective at reducing ASB treatment rates in catheterized patients. CONCLUSIONS A hospitalist-focused educational intervention significantly reduced ASB treatment rates. The impact varied across sites and by patient characteristics, suggesting that a tailored approach may be useful. Infect Control Hosp Epidemiol 2016;37:1044-1051.

  13. Hypertension Improvement Project (HIP) Latino: results of a pilot study of lifestyle intervention for lowering blood pressure in Latino adults

    Science.gov (United States)

    del Pilar Rocha-Goldberg, María; Corsino, Leonor; Batch, Bryan; Voils, Corrine I.; Thorpe, Carolyn T.; Bosworth, Hayden B.; Svetkey, Laura P.

    2010-01-01

    Objectives To assess the feasibility of a culturally tailored behavioral intervention for improving hypertension-related health behaviors in Hispanic/Latino adults. Design Feasibility pilot study in a community health center and a Latino organization in Durham, North Carolina (NC). Intervention The culturally adapted behavioral intervention consisted of 6 weekly group sessions incorporating motivational interviewing techniques. Goals included weight loss if overweight, adoption of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern, and increased physical activity. Participants were also encouraged to monitor their daily intake of fruits, vegetables, dairy and fat, and to record physical activity. Cultural adaptations included conducting the study in familiar places, using Spanish-speaking interventionist, culturally-appropriate food choices, and physical activity. Main outcomes Systolic blood pressure, weight, body mass index (BMI), exercise, and dietary pattern were measured at baseline and at 6 weeks follow-up. Qualitative evaluations of the recruitment process and the intervention were also conducted. Results There were 64 potential participants identified via health care provider referrals (33%), printed media (23%), and direct contact (44%). Seventeen participants completed the intervention and had main outcome data available. Participants “strongly agreed/ agreed” that the group sessions provided them with the tools they needed to achieve weight loss, blood pressure control, and the possibility of sustaining the lifestyle changes after completing the intervention. At the end of the intervention, all physiological, diet, and exercise outcomes were more favorable, with the exception of fat. After 6 weeks, systolic blood pressure decreased an average of −10.4 ± 10.6 mmHg, weight decreased 1.5 ± 3.2 lbs, BMI decreased 0.3 ± 0.5, and physical activity increased 40 minutes per week. Conclusion Our findings suggest that lifestyle

  14. Physical activity maintenance among Spanish-speaking Latinas in a randomized controlled trial of an Internet-based intervention.

    Science.gov (United States)

    Hartman, Sheri J; Dunsiger, Shira I; Bock, Beth C; Larsen, Britta A; Linke, Sarah; Pekmezi, Dori; Marquez, Becky; Gans, Kim M; Mendoza-Vasconez, Andrea S; Marcus, Bess H

    2017-06-01

    Spanish-speaking Latinas have some of the lowest rates of meeting physical activity guidelines in the U.S. and are at high risk for many related chronic diseases. The purpose of the current study was to examine the maintenance of a culturally and individually-tailored Internet-based physical activity intervention for Spanish-speaking Latinas. Inactive Latinas (N  =  205) were randomly assigned to a 6-month Tailored Physical Activity Internet Intervention or a Wellness Contact Control Internet Group, with a 6-month follow-up. Maintenance was measured by assessing group differences in minutes per week of self-reported and accelerometer measured moderate to vigorous physical activity (MVPA) at 12 months after baseline and changes in MVPA between the end of the active intervention (month 6) and the end of the study (month 12). Potential moderators of the intervention were also examined. Data were collected between 2011 and 2014, and were analyzed in 2015 at the University of California, San Diego. The Intervention Group engaged in significantly more minutes of MVPA per week than the Control Group at the end of the maintenance period for both self-reported (mean diff. = 30.68, SE = 11.27, p = .007) and accelerometer measured (mean diff. = 11.47, SE = 3.19, p = .01) MVPA. There were no significant between- or within-group changes in MVPA from month 6 to 12. Greater intervention effects were seen for those with lower BMI (BMI × intervention = -6.67, SE = 2.88, p = .02) and lower perceived places to walk to in their neighborhood (access × intervention = -43.25, SE = 19.07, p = .02), with a trend for less family support (social support × intervention = -3.49, SE = 2.05, p = .08). Acculturation, health literacy, and physical activity related psychosocial variables were not significant moderators of the intervention effect during the maintenance period. Findings from the current study support the efficacy of an Internet

  15. Sociopsychological tailoring to address colorectal cancer screening disparities: a randomized controlled trial.

    Science.gov (United States)

    Jerant, Anthony; Kravitz, Richard L; Sohler, Nancy; Fiscella, Kevin; Romero, Raquel L; Parnes, Bennett; Tancredi, Daniel J; Aguilar-Gaxiola, Sergio; Slee, Christina; Dvorak, Simon; Turner, Charles; Hudnut, Andrew; Prieto, Francisco; Franks, Peter

    2014-01-01

    Interventions tailored to sociopsychological factors associated with health behaviors have promise for reducing colorectal cancer screening disparities, but limited research has assessed their impact in multiethnic populations. We examined whether an interactive multimedia computer program (IMCP) tailored to expanded health belief model sociopsychological factors could promote colorectal cancer screening in a multiethnic sample. We undertook a randomized controlled trial, comparing an IMCP tailored to colorectal cancer screening self-efficacy, knowledge, barriers, readiness, test preference, and experiences with a nontailored informational program, both delivered before office visits. The primary outcome was record-documented colorectal cancer screening during a 12-month follow-up period. Secondary outcomes included postvisit sociopsychological factor status and discussion, as well as clinician recommendation of screening during office visits. We enrolled 1,164 patients stratified by ethnicity and language (49.3% non-Hispanic, 27.2% Hispanic/English, 23.4% Hispanic/Spanish) from 26 offices around 5 centers (Sacramento, California; Rochester and the Bronx, New York; Denver, Colorado; and San Antonio, Texas). Adjusting for ethnicity/language, study center, and the previsit value of the dependent variable, compared with control patients, the IMCP led to significantly greater colorectal cancer screening knowledge, self-efficacy, readiness, test preference specificity, discussion, and recommendation. During the followup period, 132 (23%) IMCP and 123 (22%) control patients received screening (adjusted difference = 0.5 percentage points, 95% CI -4.3 to 5.3). IMCP effects did not differ significantly by ethnicity/language. Sociopsychological factor tailoring was no more effective than nontailored information in encouraging colorectal cancer screening in a multiethnic sample, despite enhancing sociopsychological factors and visit behaviors associated with screening. The

  16. Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families.

    Science.gov (United States)

    Hilliard, Marisa E; Powell, Priscilla W; Anderson, Barbara J

    2016-10-01

    As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals' and families' unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. (PsycINFO Database Record

  17. Tailoring Accelerating Beams in Phase Space

    CERN Document Server

    Wen, Yuanhui; Zhang, Yanfeng; Chen, Hui; Yu, Siyuan

    2016-01-01

    An appropriate design of wavefront will enable light fields propagating along arbitrary trajectories thus forming accelerating beams in free space. Previous ways of designing such accelerating beams mainly rely on caustic methods, which start from diffraction integrals and only deal with two-dimensional fields. Here we introduce a new perspective to construct accelerating beams in phase space by designing the corresponding Wigner distribution function (WDF). We find such a WDF-based method is capable of providing both the initial field distribution and the angular spectrum in need by projecting the WDF into the real space and the Fourier space respectively. Moreover, this approach applies to the construction of both two- and three-dimensional fields, greatly generalizing previous caustic methods. It may therefore open up a new route to construct highly-tailored accelerating beams and facilitate applications ranging from particle manipulation and trapping to optical routing as well as material processing.

  18. Tailoring the multipoles in THz toroidal metamaterials

    Science.gov (United States)

    Cong, Longqing; Srivastava, Yogesh Kumar; Singh, Ranjan

    2017-08-01

    The multipoles play a significant role in determining the resonant behavior of subwavelength resonators that form the basis of metamaterial and plasmonic systems. Here, we study the impact of multipoles including toroidal dipole on the resonance intensity and linewidth of the fundamental inductive-capacitance (LC) resonance of a metamaterial array. The dominant multipoles that strongly contribute to the resonances are tailored by spatial rearrangement of the neighboring resonators such that the mutual interactions between the magnetic, electric, and toroidal configurations lead to enormous change in the linewidth as well as the resonance intensity of the LC mode. Manipulation of the multipoles in a metamaterial array provides a general strategy for the optimization of the quality factor of metamaterial resonances, which is fundamental to its applications in broad areas of sensing, lasing and nonlinear optics where stronger field confinement plays a significant role.

  19. Tailored Patient Information Some Issues and Questions

    CERN Document Server

    Reiter, E R; Reiter, Ehud; Osman, Liesl

    1997-01-01

    Tailored patient information (TPI) systems are computer programs which produce personalised heath-information material for patients. TPI systems are of growing interest to the natural-language generation (NLG) community; many TPI systems have also been developed in the medical community, usually with mail-merge technology. No matter what technology is used, experience shows that it is not easy to field a TPI system, even if it is shown to be effective in clinical trials. In this paper we discuss some of the difficulties in fielding TPI systems. This is based on our experiences with 2 TPI systems, one for generating asthma-information booklets and one for generating smoking-cessation letters.

  20. Tailored nanoporous gold for ultrahigh fluorescence enhancement.

    Science.gov (United States)

    Lang, X Y; Guan, P F; Fujita, T; Chen, M W

    2011-03-07

    We report molecular fluorescence enhancement of free-standing nanoporous gold in which the nanoporosity can be arbitrarily tailored by the combination of dealloying and electroless gold plating. The nanoporous gold fabricated by this facile method possesses unique porous structures with large gold ligaments and very small pores, and exhibits significant improvements in surface enhanced fluorescence as well as structure rigidity. It demonstrates that the confluence effect of improved quantum yield and excitation of fluorophores is responsible for the large fluorescence enhancement due to the near-field enhancement of nanoporous gold, which arises from the strong electromagnetic coupling between neighboring ligaments and the weakening of plasmon damping of the large ligaments because of the small pore size and large ligament size, respectively.

  1. [Tailor-made strategy in HCV treatment].

    Science.gov (United States)

    Watanabe, Tsunamasa; Tanaka, Yasuhito

    2012-04-01

    Hepatitis C virus (HCV) infection is a global health problem and a leading cause of end-stage liver disease and hepatocellular carcinoma. Treatment of HCV infection with pegylated interferon-alpha and ribavirin can eradicate chronic HCV infection in approximately 50% of patients infected with high viremia of HCV genotype 1, and spontaneous viral clearance was observed in approximately 30% of individuals with acute infection. These findings were strongly expected to reflect variations of the host genome. Significant breakthrough by the genome-wide association study (GWAS) approach led to the discovery of genetic polymorphisms playing a major role in the evolution of infection, as well as on treatment response and adverse effects. Herein, we present current evidence with regard to the relationship between host variations and clinical outcome of hepatitis C, and focus on the potential clinical implications with respect to tailor-made therapy for chronic hepatitis C.

  2. Tailoring quantum structures for active photonic crystals

    DEFF Research Database (Denmark)

    Kuznetsova, Nadezda

    This work is dedicated to the tailoring of quantum structures, with particular attention to the integration of selective area grown (SAG) active material into photonic crystal (PhC) slabs. The platform based on active PhC is vital to the realization of highly efficient elements with low energy...... consumption for on-chip and chip-to-chip optical communication. In order to develop metal-organic vapor phase epitaxial selective area etching and growth, a mask was fabricated in the HSQ e-beam resist including optimization of exposure and development conditions. By use of CBr4 as an etchant, in situ etching...... area and between the structures oriented along the [0-1-1] and [0-11] directions. Strong wavelength dependence with variations of the mask width of a few μm and opening sizes of hundreds of nanometers was observed. Incorporation of an active medium into PhC structures has showed promising results...

  3. Tailoring superradiance to design artificial quantum systems

    Science.gov (United States)

    Longo, Paolo; Keitel, Christoph H.; Evers, Jörg

    2016-03-01

    Cooperative phenomena arising due to the coupling of individual atoms via the radiation field are a cornerstone of modern quantum and optical physics. Recent experiments on x-ray quantum optics added a new twist to this line of research by exploiting superradiance in order to construct artificial quantum systems. However, so far, systematic approaches to deliberately design superradiance properties are lacking, impeding the desired implementation of more advanced quantum optical schemes. Here, we develop an analytical framework for the engineering of single-photon superradiance in extended media applicable across the entire electromagnetic spectrum, and show how it can be used to tailor the properties of an artificial quantum system. This “reverse engineering” of superradiance not only provides an avenue towards non-linear and quantum mechanical phenomena at x-ray energies, but also leads to a unified view on and a better understanding of superradiance across different physical systems.

  4. Tailoring superradiance to design artificial quantum systems.

    Science.gov (United States)

    Longo, Paolo; Keitel, Christoph H; Evers, Jörg

    2016-03-24

    Cooperative phenomena arising due to the coupling of individual atoms via the radiation field are a cornerstone of modern quantum and optical physics. Recent experiments on x-ray quantum optics added a new twist to this line of research by exploiting superradiance in order to construct artificial quantum systems. However, so far, systematic approaches to deliberately design superradiance properties are lacking, impeding the desired implementation of more advanced quantum optical schemes. Here, we develop an analytical framework for the engineering of single-photon superradiance in extended media applicable across the entire electromagnetic spectrum, and show how it can be used to tailor the properties of an artificial quantum system. This "reverse engineering" of superradiance not only provides an avenue towards non-linear and quantum mechanical phenomena at x-ray energies, but also leads to a unified view on and a better understanding of superradiance across different physical systems.

  5. Cultural Adaptation of a U.S. Evidence-Based Parenting Intervention for Rural Western Kenya: From Parents Matter! to Families Matter!

    Science.gov (United States)

    Poulsen, Melissa N.; Vandenhoudt, Hilde; Wyckoff, Sarah C.; Obong'o, Christopher O.; Ochura, Juliet; Njika, Gillian; Otwoma, Nelson Juma; Miller, Kim S.

    2010-01-01

    Evidence-based interventions (EBIs) are critical for effective HIV prevention, but time and resources required to develop and evaluate new interventions are limited. Alternatively, existing EBIs can be adapted for new settings if core elements remain intact. We describe the process of adapting the Parents Matter! Program, an EBI originally…

  6. Familias Unidas for high risk adolescents: Study design of a cultural adaptation and randomized controlled trial of a U.S. drug and sexual risk behavior intervention in Ecuador.

    Science.gov (United States)

    Jacobs, Petra; Estrada, Yannine A; Tapia, Maria I; Quevedo Terán, Ana M; Condo Tamayo, Cecilia; Albán García, Mónica; Valenzuela Triviño, Gilda M; Pantin, Hilda; Velazquez, Maria R; Horigian, Viviana E; Alonso, Elizabeth; Prado, Guillermo

    2016-03-01

    Developing, testing and implementing evidence-based prevention interventions are important in decreasing substance use and sexual risk behavior among adolescents. This process requires research expertise, infrastructure, resources and decades of research testing, which might not always be feasible for low resource countries. Adapting and testing interventions proven to be efficacious in similar cultures might circumvent the time and costs of implementing evidence-based interventions in new settings. This paper describes the two-phase study, including training and development of the research infrastructure in the Ecuadorian university necessary to implement a randomized controlled trial. Familias Unidas is a multilevel parent-centered intervention designed in the U.S. to prevent drug use and sexual risk behaviors in Hispanic adolescents. The current study consisted of Phase 1 feasibility study (n=38) which adapted the intervention and study procedures within a single-site school setting in an area with a high prevalence of drug use and unprotected sexual behavior among adolescents in Ecuador, and Phase 2 randomized controlled trial of the adapted intervention in two public high schools with a target population of families with adolescents from 12 to 14 years old. The trial is currently in Phase 2. Study recruitment was completed with 239 parent-youth dyads enrolling. The intervention phase and the first follow-up assessment have been completed. The second and third follow-up assessments will be completed in 2016. This project has the potential of benefitting a large population of families in areas of Ecuador that are disproportionally affected by drug trafficking and its consequences. MSP-DIS-2015-0055-0, Ministry of Public Health (MSP), Quito, Ecuador. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Tailored cognitive-behavioral therapy for fibromyalgia: two case studies.

    NARCIS (Netherlands)

    Koulil, S. van; Lankveld, W. van; Kraaimaat, F.W.; Helmond, T. van; Vedder, A.; Hoorn, H. van; Cats, H.; Riel, P.L.C.M. van; Evers, A.W.

    2008-01-01

    OBJECTIVE: To illustrate a multidisciplinary group treatment for patients with fibromyalgia (FM) tailored to the patient's cognitive-behavioral pattern. METHOD: In a case-study design the tailored treatment approaches of two FM patients were described. One patient characterized by avoidance behavior

  8. Effects of tailoring health messages on physical activity

    NARCIS (Netherlands)

    T. Smeets (Tamara); J. Brug (Hans); H. de Vries (Hein)

    2008-01-01

    textabstractComputer-tailored printed education can be a promising way of promoting physical activity. The present study tested whether computer-tailored feedback on physical activity is effective and whether there are differences between respondents with low and high motivation to change. Responden

  9. Transtheoretical Model-based Nursing Intervention on Lifestyle Change: A Review Focused on Intervention Delivery Methods.

    Science.gov (United States)

    Lee, Joo Yun; Park, Hyeoun-Ae; Min, Yul Ha

    2015-06-01

    The transtheoretical model (TTM) was used to provide tailored nursing for lifestyle management such as diet, physical activity, and smoking cessation. The present study aims to assess the provision of intervention delivery methods, intervention elements, and stage-matched interventions, in order to identify ways in which information technology is used in the TTM-based research. The relevant literature was selected by two researchers using inclusion criteria after searching for "TTM (transtheoretical or stage of change)" and "nursing" from the databases PubMed and CINAHL. The selected studies were categorized in terms of study characteristics, intervention delivery method, intervention element, and use and level of stage-matched intervention. A total of 35 studies were selected including eight studies that used information communication technology (ICT). Nine different intervention delivery methods were used, of which "face-to-face" was the most common at 24 times. Of the 35 studies, 26 provided stage-matched interventions. Seven different intervention elements were used, of which "counseling" was the most common at 27 times. Of all the intervention elements, tailored feedback used ICT the most at seven instances out of nine, and there was a significant difference in the rate of ICT usage among intervention elements. ICT is not yet actively used in the TTM-based nursing interventions. Stage-matched interventions and TTM concepts were shown to be in partial use also in the TTM-based interventions. Therefore, it is necessary to develop a variety of ways to use ICT in tailored nursing interventions and to use TTM frameworks and concepts. Copyright © 2015. Published by Elsevier B.V.

  10. Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy?

    Science.gov (United States)

    Slobodin, Ortal; de Jong, Joop T V M

    2015-02-01

    The prevalence of trauma-related problems among refugees and asylum seekers is extremely high due to adverse experiences associated with forced migration. Although the literature presents a considerable number of guidelines and theoretical frameworks for working with traumatized refugees and asylum seekers, the efficacy, feasibility and applicability of these interventions have little empirical evidence. The purpose of this article is to critically review the literature to provide a rationale for developing culturally sensitive, evidence-based interventions for refugees and asylum seekers. A literature review integrating research findings on interventions designed especially for traumatized asylum seekers and refugees was conducted. Retained studies had to use some quantitative measurements of post-traumatic stress and to have pre- and post-measurements to evaluate the efficacy of the intervention. Studies included in this review cover a wide variety of interventions, including trauma-focused interventions, group therapy, multidisciplinary interventions and pharmacological treatments. The majority of studies with traumatized refugees and asylum seekers reported positive outcomes of the intervention in reducing trauma-related symptoms. There is evidence to support the suitability of cognitive-behavioral therapy (CBT) and narrative exposure therapy (NET) in certain populations of refugees. Other intervention studies are limited by methodological considerations, such as lack of randomization, absence of control group and small samples. This review has again highlighted the shortage of guiding frameworks available to investigators and clinicians who are interested in tailoring interventions to work with refugees and asylum seekers. Theoretical, ethical and methodological considerations for future research are discussed. © The Author(s) 2014.

  11. Tailoring enzyme-rich environmental DNA clones: a source of enzymes for generating libraries of unnatural natural products.

    Science.gov (United States)

    Banik, Jacob J; Craig, Jeffrey W; Calle, Paula Y; Brady, Sean F

    2010-11-10

    A detailed bioinformatics analysis of six glycopeptide biosynthetic gene clusters isolated from soil environmental DNA (eDNA) megalibraries indicates that a subset of these gene clusters contains collections of tailoring enzymes that are predicted to result in the production of new glycopeptide congeners. In particular, sulfotransferases appear in eDNA-derived gene clusters at a much higher frequency than would be predicted from the characterization of glycopeptides from cultured Actinomycetes . Enzymes found on tailoring-enzyme-rich eDNA clones associated with these six gene clusters were used to produce a series of new sulfated glycopeptide derivatives in both in vitro and in vivo derivatization studies. The derivatization of known natural products with eDNA-derived tailoring enzymes is likely to be a broadly applicable strategy for generating libraries of new natural product variants.

  12. Tailoring the volatility and stability of oligopeptides

    Science.gov (United States)

    Schätti, J.; Sezer, U.; Pedalino, S.; Cotter, J. P.; Mayor, M.

    2017-01-01

    Amino acids are essential building blocks of life, and fluorinated derivatives have gained interest in chemistry and medici