WorldWideScience

Sample records for delivering constructive interventions

  1. Delivering construction projects using innovative building technologies

    CSIR Research Space (South Africa)

    Ampofo-Anti, Naalamkai

    2017-07-01

    Full Text Available . Figure 1: IBT delivery flowchart Proceedings 11th Built Environment Conference 6 th August – 8 th August 2017 Delivering construction projects using innovative building technologies Durban, South Africa 5. REFERENCES Ampofo-Anti, N...

  2. Portable devices for delivering imagery and modelling interventions ...

    African Journals Online (AJOL)

    The main objective of this study was to investigate the effectiveness of portable devices (MP4) and a stationary device (DVD and fixed point stationary computer) in delivering imagery and modelling training among female netball players, examining the effect on imagery adherence, performance, self-efficacy, and the relative ...

  3. Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability.

    Science.gov (United States)

    Stapleton, Jerod L; Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

    2018-02-20

    There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within an interactive social media format. The findings

  4. Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability

    Science.gov (United States)

    Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

    2018-01-01

    Background There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. Objective To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Methods Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. Results The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). Conclusions This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within

  5. Initial Progress Toward Development of a Voice-Based Computer-Delivered Motivational Intervention for Heavy Drinking College Students: An Experimental Study

    Science.gov (United States)

    Lechner, William J; MacGlashan, James; Wray, Tyler B; Littman, Michael L

    2017-01-01

    perceived importance of changing drinking behaviors. In comparison to the text-based computer-delivered intervention condition, those assigned to voice-based computer-delivered intervention reported significantly fewer alcohol-related problems at the 1-month follow-up (incident rate ratio 0.60, 95% CI 0.44-0.83, P=.002). The conditions did not differ significantly on perceived importance of changing drinking or on measures of drinking quantity and frequency of heavy drinking. Conclusions Results indicate that it is feasible to construct a series of open-ended questions and a bank of responses and follow-up prompts that can be used in a future fully automated voice-based computer-delivered intervention that may mirror more closely human-delivered motivational interventions to reduce drinking. Such efforts will require using advanced speech recognition capabilities and machine-learning approaches to train a program to mirror the decisions made by human controllers in the voice-based computer-delivered intervention used in this study. In addition, future studies should examine enhancements that can increase the perceived warmth and empathy of voice-based computer-delivered intervention, possibly through greater personalization, improvements in the speech generation software, and embodying the computer-delivered intervention in a physical form. PMID:28659259

  6. Initial Progress Toward Development of a Voice-Based Computer-Delivered Motivational Intervention for Heavy Drinking College Students: An Experimental Study.

    Science.gov (United States)

    Kahler, Christopher W; Lechner, William J; MacGlashan, James; Wray, Tyler B; Littman, Michael L

    2017-06-28

    behaviors. In comparison to the text-based computer-delivered intervention condition, those assigned to voice-based computer-delivered intervention reported significantly fewer alcohol-related problems at the 1-month follow-up (incident rate ratio 0.60, 95% CI 0.44-0.83, P=.002). The conditions did not differ significantly on perceived importance of changing drinking or on measures of drinking quantity and frequency of heavy drinking. Results indicate that it is feasible to construct a series of open-ended questions and a bank of responses and follow-up prompts that can be used in a future fully automated voice-based computer-delivered intervention that may mirror more closely human-delivered motivational interventions to reduce drinking. Such efforts will require using advanced speech recognition capabilities and machine-learning approaches to train a program to mirror the decisions made by human controllers in the voice-based computer-delivered intervention used in this study. In addition, future studies should examine enhancements that can increase the perceived warmth and empathy of voice-based computer-delivered intervention, possibly through greater personalization, improvements in the speech generation software, and embodying the computer-delivered intervention in a physical form. ©Christopher W Kahler, William J Lechner, James MacGlashan, Tyler B Wray, Michael L Littman. Originally published in JMIR Mental Health (http://mental.jmir.org), 28.06.2017.

  7. Training radiographers to deliver an intervention to promote early presentation of breast cancer

    International Nuclear Information System (INIS)

    Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

    2012-01-01

    Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

  8. Interventions to prevent injuries in construction workers.

    Science.gov (United States)

    van der Molen, Henk F; Basnet, Prativa; Hoonakker, Peter Lt; Lehtola, Marika M; Lappalainen, Jorma; Frings-Dresen, Monique Hw; Haslam, Roger; Verbeek, Jos H

    2018-02-05

    Construction workers are frequently exposed to various types of injury-inducing hazards. There are a number of injury prevention interventions, yet their effectiveness is uncertain. To assess the effects of interventions for preventing injuries in construction workers. We searched the Cochrane Injuries Group's specialised register, CENTRAL (issue 3), MEDLINE, Embase and PsycINFO up to April 2017. The searches were not restricted by language or publication status. We also handsearched the reference lists of relevant papers and reviews. Randomised controlled trials, controlled before-after (CBA) studies and interrupted time-series (ITS) of all types of interventions for preventing fatal and non-fatal injuries among workers at construction sites. Two review authors independently selected studies, extracted data and assessed their risk of bias. For ITS studies, we re-analysed the studies and used an initial effect, measured as the change in injury rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention. Seventeen studies (14 ITS and 3 CBA studies) met the inclusion criteria in this updated version of the review. The ITS studies evaluated the effects of: introducing or changing regulations that laid down safety and health requirements for the construction sites (nine studies), a safety campaign (two studies), a drug-free workplace programme (one study), a training programme (one study), and safety inspections (one study) on fatal and non-fatal occupational injuries. One CBA study evaluated the introduction of occupational health services such as risk assessment and health surveillance, one evaluated a training programme and one evaluated the effect of a subsidy for upgrading to safer scaffoldings. The overall risk of bias of most of the included studies was high, as it was uncertain for the ITS studies whether the intervention was independent from other changes and thus could be

  9. Development and Feasibility of a COPD Self-Management Intervention Delivered with Motivational Interviewing Strategies

    Science.gov (United States)

    Benzo, Roberto; Vickers, Kristin; Ernst, Denise; Tucker, Sharon; McEvoy, Charlene; Lorig, Kate

    2013-01-01

    BACKGROUND Self-management (SM) is proposed as the standard of care in chronic obstructive pulmonary disease (COPD) but details of the process and training required to deliver effective SM are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This manuscript carefully describes a self-management intervention using Motivational Interviewing skills, aimed to increase engagement and commitment in severe COPD patients. METHODS The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback (qualitative) and effect on quality of life. Engagement between patient and interventionists was measured by the Working Alliance Inventory. The intervention was refined based in the results of the pilot study and delivered in the active arm of a prospective randomized study. RESULTS The pilot study suggested improvements in quality of life, fidelity to theory and patient acceptability. The refined self-management intervention was delivered 540 times in the active arm of a randomized study. We observed a retention rate of 86% (patients missing or not available for only 14% the scheduled encounters). CONCLUSIONS A self-management intervention, that includes motivational interviewing as the way if guiding patient into behavior change, is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the SM process for (the specifics of training and delivering the intervention) that facilitates replicability in other settings and could be translated to cardiac rehabilitation. PMID:23434613

  10. Designing and delivering facilitated storytelling interventions for chronic disease self-management: a scoping review.

    Science.gov (United States)

    Gucciardi, Enza; Jean-Pierre, Nicole; Karam, Grace; Sidani, Souraya

    2016-07-11

    Little is known about how to develop and deliver storytelling as an intervention to support those managing chronic illnesses. This scoping review aims to describe the core elements of storytelling interventions in order to help facilitate its implementation. A scoping review was conducted in seven databases for articles published up to May 2014 to identify interventions that describe in detail how storytelling was used to support people in disease self-management interventions. Ten articles met all inclusion criteria. Core elements consistently observed across the storytelling interventions were: reflection and interactive meaning-making of experiences; principles of informality and spontaneity; non-directional and non-hierarchical facilitation; development of group norms and conduct to create a community among participants; and both an individual and collective role for participants. Differences were also observed across interventions, such as: the conceptual frameworks that directed the design of the intervention; the type and training of facilitators; intervention duration; and how session topics were selected and stories delivered. Furthermore, evaluation of the intervention and outcome assessment varied greatly across studies. The use of storytelling can be a novel intervention to enhance chronic disease self-management. The core elements identified in the review inform the development of the intervention to be more patient-centred by guiding participants to take ownership of and lead the intervention, which differs significantly from traditional support groups. Storytelling has the potential to provide patients with a more active role in their health care by identifying their specific needs as well as gaps in knowledge and skills, while allowing them to form strong bonds with peers who share similar disease-related experiences. However, measures of impact differed across interventions given the variation in chronic conditions. Our findings can guide future

  11. Effectiveness of online word of mouth on exposure to an Internet-delivered intervention.

    Science.gov (United States)

    Crutzen, Rik; de Nooijer, Jascha; Brouwer, Wendy; Oenema, Anke; Brug, Johannes; de Vries, Nanne

    2009-07-01

    The use of online word of mouth (WOM) seems a promising strategy to motivate young people to visit Internet-delivered interventions. An Internet-delivered intervention aimed at changing implicit attitudes related to alcohol was used in two experiments to test effectiveness of e-mail invitations on a first visit to the intervention. The results of the first experiment (N = 196) showed that an invitation by e-mail from a friend was more effective to attract young adults (aged 18-24 years) to the intervention website than an invitation from an institution. A 2 x 2 design was used in the second experiment (N = 236) to test manipulations of argument strength and the use of peripheral cues in invitations. Results showed that weak arguments were more effective to attract young adults to the intervention website when an incentive was withheld. These results need to be taken into account when using online WOM as a strategy to improve exposure to Internet-delivered interventions.

  12. Qualitative assessment of adolescents' views about improving exposure to internet-delivered interventions

    NARCIS (Netherlands)

    Crutzen, R.; de Nooijer, J.; Brouwer, W.; Oenema, A.; Brug, J.

    2008-01-01

    Purpose - The purpose of this paper is to gain first insight into factors which might be associated with exposure to internet-delivered interventions. Design/methodology/approach - Semi-structured focus group interviews were conducted with five groups of Dutch adolescents (n=54), aged 12-17 years.

  13. Feasibility and Acceptability of Delivering a Postpartum Weight Loss Intervention via Facebook: A Pilot Study.

    Science.gov (United States)

    Waring, Molly E; Moore Simas, Tiffany A; Oleski, Jessica; Xiao, Rui S; Mulcahy, Julie A; May, Christine N; Pagoto, Sherry L

    2018-01-01

    To evaluate the feasibility and acceptability of a Facebook-delivered postpartum weight loss intervention. Overweight and obese postpartum women received a 12-week weight loss intervention via Facebook. Feasibility outcomes were recruitment, retention, engagement, and acceptability. Weight loss was an exploratory outcome. Participants (n = 19) were 3.5 (SD 2.2) months postpartum with a baseline body mass index of 30.1 (SD 4.2) kg/m 2 . Retention was 95%. Forty-two percent of participants visibly engaged on the last day of the intervention, and 100% in the last 4 weeks; 88% were likely or very likely to participate again and 82% were likely or very likely to recommend the program to a postpartum friend. Average 12-week weight loss was 4.8% (SD 4.2%); 58% lost ≥5%. Findings suggested that this Facebook-delivered intervention is feasible and acceptable and supports research to test efficacy for weight loss. Research is needed to determine how best to engage participants in social network-delivered weight loss interventions. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  14. Information Processing Versus Social Cognitive Mediators of Weight Loss in a Podcast-Delivered Health Intervention

    Science.gov (United States)

    Ko, Linda K.; Turner-McGrievy, Gabrielle M.; Campbell, Marci K.

    2014-01-01

    Podcasting is an emerging technology, and previous interventions have shown promising results using theory-based podcast for weight loss among overweight and obese individuals. This study investigated whether constructs of social cognitive theory and information processing theories (IPTs) mediate the effect of a podcast intervention on weight loss…

  15. A cluster randomised controlled trial of the efficacy of a brief walking intervention delivered in primary care: Study protocol

    Directory of Open Access Journals (Sweden)

    Szczepura Ala

    2011-06-01

    Full Text Available Abstract Background The aim of the present research is to conduct a fully powered explanatory trial to evaluate the efficacy of a brief self-regulation intervention to increase walking. The intervention will be delivered in primary care by practice nurses (PNs and Healthcare Assistants (HCAs to patients for whom increasing physical activity is a particular priority. The intervention has previously demonstrated efficacy with a volunteer population, and subsequently went through an iterative process of refinement in primary care, to maximise acceptability to both providers and recipients. Methods/ Design This two arm cluster randomised controlled trial set in UK general practices will compare two strategies for increasing walking, assessed by pedometer, over six months. Patients attending practices randomised to the self-regulation intervention arm will receive an intervention consisting of behaviour change techniques designed to increase walking self-efficacy (confidence in ability to perform the behaviour, and to help people translate their "good" intentions into behaviour change by making plans. Patients attending practices randomised to the information provision arm will receive written materials promoting walking, and a short unstructured discussion about increasing their walking. The trial will recruit 20 PN/HCAs (10 per arm, who will be trained by the research team to deliver the self-regulation intervention or information provision control intervention, to 400 patients registered at their practices (20 patients per PN/HCA. This will provide 85% power to detect a mean difference of five minutes/day walking between the self-regulation intervention group and the information provision control group. Secondary outcomes include health services costs, and intervention effects in sub-groups defined by age, ethnicity, gender, socio-economic status, and clinical condition. A mediation analysis will investigate the extent to which changes in

  16. Can radiographers be trained to deliver an intervention to raise breast cancer awareness, and thereby promote early presentation of breast cancer, in older women?

    International Nuclear Information System (INIS)

    Omar, L.; Burgess, C.C.; Tucker, L.D.; Whelehan, P.; Ramirez, A.J.

    2010-01-01

    Aims: To assess the feasibility of training radiographers to deliver a one-to-one intervention to raise breast cancer awareness among older women. The ultimate aim is to increase the likelihood of early presentation of breast cancer by older women and improve survival from the disease. Method: Four radiographers were trained to deliver a 10-min scripted one-to-one intervention. Key elements of training included rehearsal of the intervention using role-play with actors and colleagues and practice interviews with women attending NHS breast screening clinics. All practice interventions were videotaped to facilitate positive, constructive feedback on performance. Competence to deliver the intervention was assessed on delivery of the key messages and the style of delivery. Radiographers' experiences of training and intervention delivery were collated from reflective diaries. Results: Three radiographers were assessed as competent after training and all four increased in confidence to deliver the intervention. Reported benefits to radiographers included increased awareness of communication skills and enhanced interaction with women attending breast screening. Radiographers reported challenges relating to mastering the prescriptive nature of the intervention and to delivering complex health messages within time constraints. Discussion: It was feasible but challenging for radiographers to be trained to deliver a one-to-one intervention designed to raise breast cancer awareness and thereby to promote early presentation of breast cancer. If the intervention is found to be cost-effective it may be implemented across the NHS Breast Screening Programme with diagnostic radiographers playing a key role in promoting early presentation of breast cancer.

  17. Evaluation of active transition, a website-delivered physical activity intervention for university students: pilot study.

    Science.gov (United States)

    Kwan, Matthew; Faulkner, Guy; Bray, Steven

    2013-04-29

    While physical activity in individuals tends to decline steadily with age, there are certain periods where this decline occurs more rapidly, such as during early adulthood. Interventions aimed at attenuating the declines in physical activity during this transition period appear warranted. The purpose of the study was to test the feasibility and efficacy of a theoretically informed, website-delivered physical activity intervention aimed at students entering university. Using a quasi-experimental design, 65 participants (44 females; mean age 18.51, SD 0.91) were assigned to either an intervention (receiving website access plus weekly prompts) or comparison condition (receiving unprompted website access only), completing questionnaires at baseline and follow-up 8 weeks later. The intervention website, "Active Transition", was specifically designed to target students' physical activity cognitions and self-regulatory skills. Intervention usage was low, with only 47% (18/38) of participants assigned to the intervention condition logging into the website 2 or more times. Among the broader student sample, there were significant declines in students' physical activity behaviors (F1,63=18.10, Pusers (29/65, individuals logging in 2 or more times) and non-users (36/65, individuals logging in once or not at all), there was a significant interaction effect for intervention usage and time on perceived behavioral control (F1,62=5.13, P=.03). Poor intervention usage suggests that future efforts need to incorporate innovative strategies to increase intervention uptake and better engage the student population. The findings, however, suggest that a website-delivered intervention aimed at this critical life stage may have positive impact on students' physical activity cognitions. Future studies with more rigorous sampling designs are required.

  18. Feasibility of Delivering a Dance Intervention for SubAcute Stroke in a Rehabilitation Hospital Setting

    Science.gov (United States)

    Demers, Marika; McKinley, Patricia

    2015-01-01

    Dance can be a promising treatment intervention used in rehabilitation for individuals with disabilities to address physical, cognitive and psychological impairments. The aim of this pilot study was to determine the feasibility of a modified dance intervention as an adjunct therapy designed for people with subacute stroke, in a rehabilitation setting. Using a descriptive qualitative study design, a biweekly 45-min dance intervention was offered to individuals with a subacute stroke followed in a rehabilitation hospital, over 4 weeks. The dance intervention followed the structure of an usual dance class, but the exercises were modified and progressed to meet each individual’s needs. The dance intervention, delivered in a group format, was feasible in a rehabilitation setting. A 45-min dance class of moderate intensity was of appropriate duration and intensity for individuals with subacute stroke to avoid excessive fatigue and to deliver the appropriate level of challenge. The overall satisfaction of the participants towards the dance class, the availability of space and equipment, and the low level of risks contributed to the feasibility of a dance intervention designed for individuals in the subacute stage of post-stroke recovery. PMID:25785497

  19. Feasibility of Delivering a Dance Intervention for SubAcute Stroke in a Rehabilitation Hospital Setting

    Directory of Open Access Journals (Sweden)

    Marika Demers

    2015-03-01

    Full Text Available Dance can be a promising treatment intervention used in rehabilitation for individuals with disabilities to address physical, cognitive and psychological impairments. The aim of this pilot study was to determine the feasibility of a modified dance intervention as an adjunct therapy designed for people with subacute stroke, in a rehabilitation setting. Using a descriptive qualitative study design, a biweekly 45-min dance intervention was offered to individuals with a subacute stroke followed in a rehabilitation hospital, over 4 weeks. The dance intervention followed the structure of an usual dance class, but the exercises were modified and progressed to meet each individual’s needs. The dance intervention, delivered in a group format, was feasible in a rehabilitation setting. A 45-min dance class of moderate intensity was of appropriate duration and intensity for individuals with subacute stroke to avoid excessive fatigue and to deliver the appropriate level of challenge. The overall satisfaction of the participants towards the dance class, the availability of space and equipment, and the low level of risks contributed to the feasibility of a dance intervention designed for individuals in the subacute stage of post-stroke recovery.

  20. Efficacy of an experiential, dissonance-based smoking intervention for college students delivered via the internet.

    Science.gov (United States)

    Simmons, Vani Nath; Heckman, Bryan W; Fink, Angelina C; Small, Brent J; Brandon, Thomas H

    2013-10-01

    College represents a window of opportunity to reach the sizeable number of cigarette smokers who are vulnerable to lifelong smoking. The underutilization of typical cessation programs suggests the need for novel and more engaging approaches for reaching college smokers. The aim of the present study was to test the efficacy of a dissonance-enhancing, Web-based experiential intervention for increasing smoking cessation motivation and behavior. We used a 4-arm, randomized design to examine the efficacy of a Web-based, experiential smoking intervention (Web-Smoke). The control conditions included a didactic smoking intervention (Didactic), a group-based experiential intervention (Group), and a Web-based nutrition experiential intervention (Web-Nutrition). We recruited 341 college smokers. Primary outcomes were motivation to quit, assessed immediately postintervention, and smoking abstinence at 1 and 6 months following the intervention. As hypothesized, the Web-Smoke intervention was more effective than control groups in increasing motivation to quit. At 6-month follow-up, the Web-Smoke intervention produced higher rates of smoking cessation than the Web-Nutrition control intervention. Daily smoking moderated intervention outcomes. Among daily smokers, the Web-Smoke intervention produced greater abstinence rates than both the Web-Nutrition and Didactic control conditions. Findings demonstrate the efficacy of a theory-based intervention delivered over the Internet for increasing motivation to quit and smoking abstinence among college smokers. The intervention has potential for translation and implementation as a secondary prevention strategy for college-aged smokers. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  1. Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone.

    Science.gov (United States)

    Crombie, Iain K; Irvine, Linda; Falconer, Donald W; Williams, Brian; Ricketts, Ian W; Jones, Claire; Humphris, Gerry; Norrie, John; Slane, Peter; Rice, Peter

    2017-07-01

    Disadvantaged men suffer substantial harm from heavy drinking. This feasibility study developed and evaluated the methods for a trial of a brief intervention delivered by text messages to disadvantaged men. It aimed to test the methods for recruitment and retention, to monitor engagement with the intervention and assess the overall acceptability of study methods. Disadvantaged men aged 25-44 years who had ≥2 episodes of binge drinking (≥8 units in one session) in the preceding month were recruited. Two recruitment strategies were assessed: recruitment from general practice registers and by a community outreach strategy. Theoretically and empirically based text messages were tailored to the target group. The study recruited 67 disadvantaged men at high risk of alcohol-related harm, exceeding the target of 60. Evaluation showed that 95% of text messages were delivered, and the men engaged enthusiastically with the intervention. Retention at follow up was 96%. Outcomes were successfully measured on all men followed up. This provided data for the sample size calculation for the full trial. Post-study evaluation showed high levels of satisfaction with the study. This study has shown that disadvantaged men can be recruited and follow-up data obtained in an alcohol intervention study. The study methods were acceptable to the participants. The men recruited were at high risk of alcohol-related harms. It also clarified ways in which the recruitment strategy, the baseline questionnaire and the intervention could be improved. The full trial is currently underway. [Crombie IK, Irvine L, Falconer DW, Williams B, Ricketts IW, Jones C, Humphris G, Norrie J, Slane P, Rice P. Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone. Drug Alcohol Rev 2017;36:468-476]. © 2017 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

  2. A Pilot Investigation of Speech Sound Disorder Intervention Delivered by Telehealth to School-Age Children

    Directory of Open Access Journals (Sweden)

    Sue Grogan-Johnson

    2011-05-01

    Full Text Available This article describes a school-based telehealth service delivery model and reports outcomes made by school-age students with speech sound disorders in a rural Ohio school district. Speech therapy using computer-based speech sound intervention materials was provided either by live interactive videoconferencing (telehealth, or conventional side-by-side intervention.  Progress was measured using pre- and post-intervention scores on the Goldman Fristoe Test of Articulation-2 (Goldman & Fristoe, 2002. Students in both service delivery models made significant improvements in speech sound production, with students in the telehealth condition demonstrating greater mastery of their Individual Education Plan (IEP goals. Live interactive videoconferencing thus appears to be a viable method for delivering intervention for speech sound disorders to children in a rural, public school setting. Keywords:  Telehealth, telerehabilitation, videoconferencing, speech sound disorder, speech therapy, speech-language pathology; E-Helper

  3. Effects of narrator empathy in a computer delivered brief intervention for alcohol use.

    Science.gov (United States)

    Ellis, Jennifer D; Grekin, Emily R; Beatty, Jessica R; McGoron, Lucy; LaLiberte, Benjamin V; Pop, Damaris E; Kostecki, Anthony P; Ondersma, Steven J

    2017-10-01

    Computer-delivered, brief interventions (CDBIs) have been an increasingly popular way to treat alcohol use disorders; however, very few studies have examined which characteristics of CDBIs maximize intervention effectiveness. The literature has consistently demonstrated that therapist empathy is associated with reduced substance use in in-person therapy; however, it is unclear whether this principle applies to CDBIs. Therefore, the study aimed to examine whether the presence of an empathic narrator increased intentions to reduce heavy drinking in a CDBI. Results suggest that the presence of empathy increases motivation to reduce drinking, and makes participants feel more supported and less criticized. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Using Facebook to deliver a social norm intervention to reduce problem drinking at university.

    Science.gov (United States)

    Ridout, Brad; Campbell, Andrew

    2014-11-01

    University students usually overestimate peer alcohol use, resulting in them 'drinking up' to perceived norms. Social norms theory suggests correcting these inflated perceptions can reduce alcohol consumption. Recent findings by the current authors show portraying oneself as 'a drinker' is considered by many students to be a socially desirable component of their Facebook identity, perpetuating an online culture that normalises binge drinking. However, social networking sites have yet to be utilised in social norms interventions. Actual and perceived descriptive and injunctive drinking norms were collected from 244 university students. Ninety-five students screened positive for hazardous drinking and were randomly allocated to a control group or intervention group that received social norms feedback via personalised Facebook private messages over three sessions. At 1 month post-intervention, the quantity and frequency of alcohol consumed by intervention group during the previous month had significantly reduced compared with baseline and controls. Reductions were maintained 3 months post-intervention. Intervention group perceived drinking norms were significantly more accurate post-intervention. This is the first study to test the feasibility of using Facebook to deliver social norms interventions. Correcting misperceptions of peer drinking norms resulted in clinically significant reductions in alcohol use. Facebook has many advantages over traditional social norms delivery, providing an innovative method for tackling problem drinking at university. These results have implications for the use of Facebook to deliver positive messages about safe alcohol use to students, which may counter the negative messages regarding alcohol normally seen on Facebook. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  5. An efficacy trial of brief lifestyle intervention delivered by generalist community nurses (CN SNAP trial

    Directory of Open Access Journals (Sweden)

    Fanaian Mahnaz

    2010-02-01

    Full Text Available Abstract Background Lifestyle risk factors, in particular smoking, nutrition, alcohol consumption and physical inactivity (SNAP are the main behavioural risk factors for chronic disease. Primary health care (PHC has been shown to be an effective setting to address lifestyle risk factors at the individual level. However much of the focus of research to date has been in general practice. Relatively little attention has been paid to the role of nurses working in the PHC setting. Community health nurses are well placed to provide lifestyle intervention as they often see clients in their own homes over an extended period of time, providing the opportunity to offer intervention and enhance motivation through repeated contacts. The overall aim of this study is to evaluate the impact of a brief lifestyle intervention delivered by community nurses in routine practice on changes in clients' SNAP risk factors. Methods/Design The trial uses a quasi-experimental design involving four generalist community nursing services in NSW Australia. Services have been randomly allocated to an 'early intervention' group or 'late intervention' (comparison group. 'Early intervention' sites are provided with training and support for nurses in identifying and offering brief lifestyle intervention for clients during routine consultations. 'Late intervention site' provide usual care and will be offered the study intervention following the final data collection point. A total of 720 generalist community nursing clients will be recruited at the time of referral from participating sites. Data collection consists of 1 telephone surveys with clients at baseline, three months and six months to examine change in SNAP risk factors and readiness to change 2 nurse survey at baseline, six and 12 months to examine changes in nurse confidence, attitudes and practices in the assessment and management of SNAP risk factors 3 semi-structured interviews/focus with nurses, managers and clients

  6. Brief alcohol interventions for mandated college students: comparison of face-to-face counseling and computer-delivered interventions.

    Science.gov (United States)

    Carey, Kate B; Carey, Michael P; Henson, James M; Maisto, Stephen A; DeMartini, Kelly S

    2011-03-01

    College students who violate alcohol policies are often mandated to participate in alcohol-related interventions. This study investigated (i) whether such interventions reduced drinking beyond the sanction alone, (ii) whether a brief motivational intervention (BMI) was more efficacious than two computer-delivered interventions (CDIs) and (iii) whether intervention response differed by gender. Randomized controlled trial with four conditions [brief motivation interventions (BMI), Alcohol 101 Plus™, Alcohol Edu for Sanctions(®), delayed control] and four assessments (baseline, 1, 6 and 12 months). Private residential university in the United States. Students (n = 677; 64% male) who had violated campus alcohol policies and were sanctioned to participate in a risk reduction program. Consumption (drinks per heaviest and typical week, heavy drinking frequency, peak and typical blood alcohol concentration), alcohol problems and recidivism. Piecewise latent growth models characterized short-term (1-month) and longer-term (1-12 months) change. Female but not male students reduced drinking and problems in the control condition. Males reduced drinking and problems after all interventions relative to control, but did not maintain these gains. Females reduced drinking to a greater extent after a BMI than after either CDI, and maintained reductions relative to baseline across the follow-up year. No differences in recidivism were found. Male and female students responded differently to sanctions for alcohol violations and to risk reduction interventions. BMIs optimized outcomes for both genders. Male students improved after all interventions, but female students improved less after CDIs than after BMI. Intervention effects decayed over time, especially for males. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  7. Telephone delivered interventions for reducing morbidity and mortality in people with HIV infection.

    Science.gov (United States)

    Gentry, Sarah; van-Velthoven, Michelle H M M T; Tudor Car, Lorainne; Car, Josip

    2013-05-31

    This is one of three Cochrane reviews examining the role of the telephone in HIV/AIDS services. Telephone interventions, delivered either by landline or mobile phone, may be useful in the management of people living with HIV (PLHIV) in many situations. Telephone delivered interventions have the potential to reduce costs, save time and facilitate more support for PLHIV. To assess the effectiveness of voice landline and mobile telephone delivered interventions for reducing morbidity and mortality in people with HIV infection. We searched The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed Central, EMBASE, PsycINFO, ISI Web of Science, Cumulative Index to Nursing & Allied Health, World Health Organisation's The Global Health Library and Current Controlled Trials from 1980 to June 2011. We searched the following grey literature sources: Dissertation Abstracts International, Centre for Agriculture Bioscience International Direct Global Health database, The System for Information on Grey Literature Europe, The Healthcare Management Information Consortium database, Google Scholar, Conference on Retroviruses and Opportunistic Infections, International AIDS Society, AIDS Educational Global Information System and reference lists of articles. Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series studies comparing the effectiveness of telephone delivered interventions for reducing morbidity and mortality in persons with HIV infection versus in-person interventions or usual care, regardless of demographic characteristics and in all settings. Both mobile and landline telephone interventions were included, but mobile phone messaging interventions were excluded. Two reviewers independently searched, screened, assessed study quality and extracted data. Primary outcomes were change in behaviour, healthcare uptake or clinical outcomes. Secondary outcomes were appropriateness of the

  8. Interventional radiology delivers high-value health care and is an Imaging 3.0 vanguard.

    Science.gov (United States)

    Charalel, Resmi A; McGinty, Geraldine; Brant-Zawadzki, Michael; Goodwin, Scott C; Khilnani, Neil M; Matsumoto, Alan H; Min, Robert J; Soares, Gregory M; Cook, Philip S

    2015-05-01

    Given the changing climate of health care and the imperative to add value, radiologists must join forces with the rest of medicine to deliver better patient care in a more cost-effective, evidence-based manner. For several decades, interventional radiology has added value to the health care system through innovation and the provision of alternative and effective minimally invasive treatments, which have decreased morbidity, mortality, and overall cost. The clinical practice of interventional radiology embodies many of the features of Imaging 3.0, the program recently launched by the ACR. We provide a review of some of the major contributions made by interventional radiology and offer general principles from that experience, which are applicable to all radiologists. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  9. Rationale and design: telephone-delivered behavioral skills interventions for Blacks with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Strom Joni L

    2010-03-01

    Full Text Available Abstract Background African Americans with Type 2 diabetes (T2DM have higher prevalence of diabetes, poorer metabolic control, and greater risk for complications and death compared to American Whites. Poor outcomes in African Americans with T2DM can be attributed to patient, provider, and health systems level factors. Provider and health system factors account for Methods/Design We describe an ongoing four-year randomized clinical trial, using a 2 × 2 factorial design, which will test the efficacy of separate and combined telephone-delivered, diabetes knowledge/information and motivation/behavioral skills training interventions in high risk African Americans with poorly controlled T2DM (HbA1c ≥ 9%. Two-hundred thirty-two (232 male and female African-American participants, 18 years of age or older and with an HbA1c ≥ 9%, will be randomized into one of four groups for 12-weeks of phone interventions: (1 an education group, (2 a motivation/skills group, (3 a combined group or (4 a usual care/general health education group. Participants will be followed for 12-months to ascertain the effect of the interventions on glycemic control. Our primary hypothesis is that among African Americans with poorly controlled T2DM, patients randomized to the combined diabetes knowledge/information and motivation/behavioral skills training intervention will have significantly greater reduction in HbA1c at 12 months of follow-up compared to the usual care/general health education group. Discussion Results from this study will provide important insight into how best to deliver diabetes education and skills training in ethnic minorities and whether combined knowledge/information and motivation/behavioral skills training is superior to the usual method of delivering diabetes education for African Americans with poorly controlled T2DM. Trial registration National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00929838.

  10. Bringing loyalty to e-Health: theory validation using three internet-delivered interventions.

    Science.gov (United States)

    Crutzen, Rik; Cyr, Dianne; de Vries, Nanne K

    2011-09-24

    Internet-delivered interventions can effectively change health risk behaviors, but the actual use of these interventions by the target group once they access the website is often very low (high attrition, low adherence). Therefore, it is relevant and necessary to focus on factors related to use of an intervention once people arrive at the intervention website. We focused on user perceptions resulting in e-loyalty (ie, intention to visit an intervention again and to recommend it to others). A background theory for e-loyalty, however, is still lacking for Internet-delivered interventions. The objective of our study was to propose and validate a conceptual model regarding user perceptions and e-loyalty within the field of eHealth. We presented at random 3 primary prevention interventions aimed at the general public and, subsequently, participants completed validated measures regarding user perceptions and e-loyalty. Time on each intervention website was assessed by means of server registrations. Of the 592 people who were invited to participate, 397 initiated the study (response rate: 67%) and 351 (48% female, mean age 43 years, varying in educational level) finished the study (retention rate: 88%). Internal consistency of all measures was high (Cronbach alpha > .87). The findings demonstrate that the user perceptions regarding effectiveness (beta(range) .21-.41) and enjoyment (beta(range) .14-.24) both had a positive effect on e-loyalty, which was mediated by active trust (beta(range) .27-.60). User perceptions and e-loyalty had low correlations with time on the website (r(range) .04-.18). The consistent pattern of findings speaks in favor of their robustness and contributes to theory validation regarding e-loyalty. The importance of a theory-driven solution to a practice-based problem (ie, low actual use) needs to be stressed in view of the importance of the Internet in terms of intervention development. Longitudinal studies are needed to investigate whether people

  11. Adapting a computer-delivered brief alcohol intervention for veterans with Hepatitis C.

    Science.gov (United States)

    Cucciare, Michael A; Jamison, Andrea L; Combs, Ann S; Joshi, Gauri; Cheung, Ramsey C; Rongey, Catherine; Huggins, Joe; Humphreys, Keith

    2017-12-01

    This study adapted an existing computer-delivered brief alcohol intervention (cBAI) for use in Veterans with the hepatitis C virus (HCV) and examined its acceptability and feasibility in this patient population. A four-stage model consisting of initial pilot testing, qualitative interviews with key stakeholders, development of a beta version of the cBAI, and usability testing was used to achieve the study objectives. In-depth interviews gathered feedback for modifying the cBAI, including adding HCV-related content such as the health effects of alcohol on liver functioning, immune system functioning, and management of HCV, a preference for concepts to be displayed through "newer looking" graphics, and limiting the use of text to convey key concepts. Results from usability testing indicated that the modified cBAI was acceptable and feasible for use in this patient population. The development model used in this study is effective for gathering actionable feedback that can inform the development of a cBAI and can result in the development of an acceptable and feasible intervention for use in this population. Findings also have implications for developing computer-delivered interventions targeting behavior change more broadly.

  12. Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania.

    Science.gov (United States)

    Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

    2016-07-01

    Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual's area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  13. Acceptability of Interventions Delivered Online and Through Mobile Phones for People Who Experience Severe Mental Health Problems: A Systematic Review.

    Science.gov (United States)

    Berry, Natalie; Lobban, Fiona; Emsley, Richard; Bucci, Sandra

    2016-05-31

    Psychological interventions are recommended for people with severe mental health problems (SMI). However, barriers exist in the provision of these services and access is limited. Therefore, researchers are beginning to develop and deliver interventions online and via mobile phones. Previous research has indicated that interventions delivered in this format are acceptable for people with SMI. However, a comprehensive systematic review is needed to investigate the acceptability of online and mobile phone-delivered interventions for SMI in depth. This systematic review aimed to 1) identify the hypothetical acceptability (acceptability prior to or without the delivery of an intervention) and actual acceptability (acceptability where an intervention was delivered) of online and mobile phone-delivered interventions for SMI, 2) investigate the impact of factors such as demographic and clinical characteristics on acceptability, and 3) identify common participant views in qualitative studies that pinpoint factors influencing acceptability. We conducted a systematic search of the databases PubMed, Embase, PsycINFO, CINAHL, and Web of Science in April 2015, which yielded a total of 8017 search results, with 49 studies meeting the full inclusion criteria. Studies were included if they measured acceptability through participant views, module completion rates, or intervention use. Studies delivering interventions were included if the delivery method was online or via mobile phones. The hypothetical acceptability of online and mobile phone-delivered interventions for SMI was relatively low, while actual acceptability tended to be high. Hypothetical acceptability was higher for interventions delivered via text messages than by emails. The majority of studies that assessed the impact of demographic characteristics on acceptability reported no significant relationships between the two. Additionally, actual acceptability was higher when participants were provided remote online

  14. Delivering interventions to reduce the global burden of stillbirths: improving service supply and community demand

    Science.gov (United States)

    Bhutta, Zulfiqar A; Darmstadt, Gary L; Haws, Rachel A; Yakoob, Mohammad Yawar; Lawn, Joy E

    2009-01-01

    Background Although a number of antenatal and intrapartum interventions have shown some evidence of impact on stillbirth incidence, much confusion surrounds ideal strategies for delivering these interventions within health systems, particularly in low-/middle-income countries where 98% of the world's stillbirths occur. Improving the uptake of quality antenatal and intrapartum care is critical for evidence-based interventions to generate an impact at the population level. This concluding paper of a series of papers reviewing the evidence for stillbirth interventions examines the evidence for community and health systems approaches to improve uptake and quality of antenatal and intrapartum care, and synthesises programme and policy recommendations for how best to deliver evidence-based interventions at community and facility levels, across the continuum of care, to reduce stillbirths. Methods We systematically searched PubMed and the Cochrane Library for abstracts pertaining to community-based and health-systems strategies to increase uptake and quality of antenatal and intrapartum care services. We also sought abstracts which reported impact on stillbirths or perinatal mortality. Searches used multiple combinations of broad and specific search terms and prioritised rigorous randomised controlled trials and meta-analyses where available. Wherever eligible randomised controlled trials were identified after a Cochrane review had been published, we conducted new meta-analyses based on the original Cochrane criteria. Results In low-resource settings, cost, distance and the time needed to access care are major barriers for effective uptake of antenatal and particularly intrapartum services. A number of innovative strategies to surmount cost, distance, and time barriers to accessing care were identified and evaluated; of these, community financial incentives, loan/insurance schemes, and maternity waiting homes seem promising, but few studies have reported or evaluated the

  15. A randomised controlled trial of a smoking cessation intervention delivered by dental hygienists: a feasibility study

    Directory of Open Access Journals (Sweden)

    Jenkins William

    2007-05-01

    Full Text Available Abstract Background Tobacco use continues to be a global public health problem. Helping patients to quit is part of the preventive role of all health professionals. There is now increasing interest in the role that the dental team can play in helping their patients to quit smoking. The aim of this study was to determine the feasibility of undertaking a randomised controlled smoking cessation intervention, utilising dental hygienists to deliver tobacco cessation advice to a cohort of periodontal patients. Methods One hundred and eighteen patients who attended consultant clinics in an outpatient dental hospital department (Periodontology were recruited into a trial. Data were available for 116 participants, 59 intervention and 57 control, and were analysed on an intention-to-treat basis. The intervention group received smoking cessation advice based on the 5As (ask, advise, assess, assist, arrange follow-up and were offered nicotine replacement therapy (NRT, whereas the control group received 'usual care'. Outcome measures included self-reported smoking cessation, verified by salivary cotinine measurement and CO measurements. Self-reported measures in those trial participants who did not quit included number and length of quit attempts and reduction in smoking. Results At 3 months, 9/59 (15% of the intervention group had quit compared to 5/57 (9% of the controls. At 6 months, 6/59 (10% of the intervention group quit compared to 3/57 (5% of the controls. At one year, there were 4/59 (7% intervention quitters, compared to 2/59 (4% control quitters. In participants who described themselves as smokers, at 3 and 6 months, a statistically higher percentage of intervention participants reported that they had had a quit attempt of at least one week in the preceding 3 months (37% and 47%, for the intervention group respectively, compared with 18% and 16% for the control group. Conclusion This study has shown the potential that trained dental hygienists

  16. A systematic review of randomised control trials of sexual health interventions delivered by mobile technologies.

    Science.gov (United States)

    Burns, Kara; Keating, Patrick; Free, Caroline

    2016-08-12

    use. Finally, one trial showed that collection of sexual health information using mobile technology was acceptable. The findings suggest interventions delivered by SMS interventions can increase uptake of sexual health services and STI testing. High quality trials of interventions using standardised objective measures and employing a wider range of behavioural change techniques are needed to assess if interventions delivered by mobile phone can alter safer sex behaviours carried out between couples and reduce STIs.

  17. Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series.

    Science.gov (United States)

    Pagoto, Sherry L; Waring, Molly E; Schneider, Kristin L; Oleski, Jessica L; Olendzki, Effie; Hayes, Rashelle B; Appelhans, Bradley M; Whited, Matthew C; Busch, Andrew M; Lemon, Stephenie C

    2015-10-23

    Lifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden. Online social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss. We conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention. In Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2% (SD 3.6) of baseline weight. A total of 67% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0% (SD 3.4) of baseline weight, and 100% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0% (SD 3.1) of baseline weight, and 90% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media. Future research should evaluate the efficacy and cost-effectiveness of online

  18. Voice Over the Internet Protocol as a Medium for Delivering Reading Intervention

    Directory of Open Access Journals (Sweden)

    Craig Wright

    2011-10-01

    Full Text Available Voice Over the Internet Protocol (VoIP holds promise as a platform by which services can be delivered to students in rural and remote regions who have reading difficulties. VoIP is an Internet-based protocol that allows two or more individuals to videoconference from remote locations. This study used a single-case research design to investigate whether VoIP would produce significant gains in reading ability in BM, a 10-year-old with long-standing word-level reading problems. BM was provided with a theoretically motivated reading intervention 4 times weekly. The intervention was delivered remotely using the Apple iChat software. Substantial growth in regular- and nonword reading covaried with onset and removal of treatment. Treatment gains were maintained at 10-week follow-up. Meaningful gains were also seen in text-reading accuracy and reading comprehension. VoIP-based instruction represents an important avenue for future research and is a teaching method that holds much promise for rural and remote students.

  19. Randomized trial of a population-based, home-delivered intervention for preschool language delay.

    Science.gov (United States)

    Wake, Melissa; Tobin, Sherryn; Levickis, Penny; Gold, Lisa; Ukoumunne, Obioha C; Zens, Naomi; Goldfeld, Sharon; Le, Ha; Law, James; Reilly, Sheena

    2013-10-01

    Population approaches to lessen the adverse impacts of preschool language delay remain elusive. We aimed to determine whether systematic ascertainment of language delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves language and related outcomes at age 5 years. A randomized trial nested within a cross-sectional ascertainment of language delay. Children with expressive and/or receptive language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive language (Clinical Evaluation of Language Fundamentals - Preschool, 2(nd) Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life. A total of 1464 children were assessed for language delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention - control, 2.0; 95% confidence interval [CI] -0.5 to 4.4; P = .12) but not receptive (0.6; 95% CI -2.5 to 3.8; P = .69) language. The intervention improved phonological awareness skills (5.0; 95% CI 2.2 to 7.8; P language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early language delay within a public health framework.

  20. Heat stress intervention research in construction: gaps and recommendations.

    Science.gov (United States)

    Yang, Yang; Chan, Albert Ping-Chuen

    2017-06-08

    Developing heat stress interventions for construction workers has received mounting concerns in recent years. However, limited efforts have been exerted to elaborate the rationale, methodology, and practicality of heat stress intervention in the construction industry. This study aims to review previous heat stress intervention research in construction, to identify the major research gaps in methodological issues, and to offer detailed recommendations for future studies. A total of 35 peer-reviewed journal papers have been identified to develop administrative, environmental or personal engineering interventions to safeguard construction workers. It was found that methodological limitations, such as arbitrary sampling methods and unreliable instruments, could be the major obstacle in undertaking heat stress intervention research. To bridge the identified research gaps, this study then refined a research framework for conducting heat stress intervention studies in the construction industry. The proposed research strategy provides researchers and practitioners with fresh insights into expanding multidisciplinary research areas and solving practical problems in the management of heat stress. The proposed research framework may foster the development of heat stress intervention research in construction, which further aids researchers, practitioners, and policymakers in formulating proper intervention strategies.

  1. Improving uptake and engagement with child body image interventions delivered to mothers: Understanding mother and daughter preferences for intervention content.

    Science.gov (United States)

    Garbett, Kirsty M; Diedrichs, Phillippa C

    2016-12-01

    Mothers are a key influence on adolescent girls' body image. This study aimed to improve understanding of mothers' and daughters' preferences for content in body image interventions designed to assist mothers to promote positive body image among their daughters. British mother-daughter dyads (N=190) viewed descriptions of five evidence-based influences on body image (family, friends, and relationships; appearance-based teasing; media and celebrities; appearance conversations; body acceptance and care). Mothers and daughters each selected the two most important influences to learn about in these interventions. Overall, both mothers and daughters most frequently opted for family, friends, and relationships and body acceptance and care, whereas media and celebrities was their least preferred topic. While the overall sample of mothers and daughters agreed on preferences, Fisher's exact tests showed that within-dyad agreement was low. Recommendations for improving parent and child engagement with, and effectiveness of, child body image interventions delivered to parents are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. The Usability of Diabetes MAP: A Web-delivered Intervention for Improving Medication Adherence.

    Science.gov (United States)

    Nelson, Lyndsay A; Bethune, Magaela C; Lagotte, Andrea E; Osborn, Chandra Y

    2016-05-12

    Web-delivered interventions are a feasible approach to health promotion. However, if a website is poorly designed, difficult to navigate, and has technical bugs, it will not be used as intended. Usability testing prior to evaluating a website's benefits can identify barriers to user engagement and maximize future use. We developed a Web-delivered intervention called Diabetes Medication Adherence Promotion (Diabetes MAP) and used a mixed-methods approach to test its usability prior to evaluating its efficacy on medication adherence and glycemic control in a randomized controlled trial. We recruited English-speaking adults with type 2 diabetes mellitus (T2DM) from an academic medical center who were prescribed diabetes medications. A trained research assistant administered a baseline survey, collected medical record information, and instructed participants on how to access Diabetes MAP. Participants were asked to use the site independently for 2 weeks and to provide survey and/or focus group feedback on their experience. We analyzed survey data descriptively and qualitative data thematically to identify participants' favorable and unfavorable experiences, characterize usability concerns, and solicit recommendations for improving Diabetes MAP. Enrolled participants (N=32) were an average of 51.7 ± 11.8 years old, 66% (21/32) female, 60% (19/32) non-Hispanic White, 88% (28/32) had more than 12 years of education, half had household incomes over $50,000, and 78% (25/32) were privately insured. Average duration of diagnosed diabetes was 7.8 ± 6.3 years, average A1c was 7.4 ± 2.0, and 38% (12/32) were prescribed insulin. Of enrolled participants, 91% (29/32) provided survey and/or focus group feedback about Diabetes MAP. On the survey, participants agreed website information was clear and easy to understand, but in focus groups they reported navigational challenges and difficulty overcoming user errors (eg, entering data in an unspecified format). Participants also

  3. Negative effects of internet interventions: a qualitative content analysis of patients' experiences with treatments delivered online.

    Science.gov (United States)

    Rozental, Alexander; Boettcher, Johanna; Andersson, Gerhard; Schmidt, Brad; Carlbring, Per

    2015-01-01

    Internet interventions are defined as the delivery of health care-related treatments via an online or a smartphone interface, and have been shown to be a viable alternative to face-to-face treatments. However, not all patients benefit from such treatments, and it is possible that some may experience negative effects. Investigations of face-to-face treatments indicate that deterioration occurs in 5-10% of all patients. The nature and scope of other negative effects of Internet interventions is, however, largely unknown. Hence, the current study explored patients' reported negative experiences while undergoing treatments delivered via the Internet. Data from four large clinical trials (total N = 558) revealed that 9.3% of patients reported some type of negative effects. Qualitative content analysis was used to explore the patients' responses to open-ended questions regarding their negative experiences. Results yielded two broad categories and four subcategories of negative effects: patient-related negative effects (insight and symptom) and treatment-related negative effects (implementation and format). Results emphasize the importance of always considering negative effects in Internet-based interventions, and point to several ways of preventing such experiences, including regular assessment of negative events, increasing the flexibility of treatment schedules and therapist contact, as well as prolonging the treatment duration.

  4. Estimating the cost of delivering direct nutrition interventions at scale: national and subnational level insights from India.

    Science.gov (United States)

    Menon, Purnima; McDonald, Christine M; Chakrabarti, Suman

    2016-05-01

    India's national nutrition and health programmes are largely designed to provide evidence-based nutrition-specific interventions, but intervention coverage is low due to a combination of implementation challenges, capacity and financing gaps. Global cost estimates for nutrition are available but national and subnational costs are not. We estimated national and subnational costs of delivering recommended nutrition-specific interventions using the Scaling Up Nutrition (SUN) costing approach. We compared costs of delivering the SUN interventions at 100% scale with those of nationally recommended interventions. Target populations (TP) for interventions were estimated using national population and nutrition data. Unit costs (UC) were derived from programmatic data. The cost of delivering an intervention at 100% coverage was calculated as (UC*projected TP). Cost estimates varied; estimates for SUN interventions were lower than estimates for nationally recommended interventions because of differences in choice of intervention, target group or unit cost. US$5.9bn/year are required to deliver a set of nationally recommended nutrition interventions at scale in India, while US$4.2bn are required for the SUN interventions. Cash transfers (49%) and food supplements (40%) contribute most to costs of nationally recommended interventions, while food supplements to prevent and treat malnutrition contribute most to the SUN costs. We conclude that although such costing is useful to generate broad estimates, there is an urgent need for further costing studies on the true unit costs of the delivery of nutrition-specific interventions in different local contexts to be able to project accurate national and subnational budgets for nutrition in India. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

  5. Sun safety in construction: a U.K. intervention study.

    Science.gov (United States)

    Houdmont, J; Madgwick, P; Randall, R

    2016-01-01

    Interventions to promote sun safety in the U.K. construction sector are warranted given the high incidence of skin cancer attributable to sun exposure relative to other occupational groups. To evaluate change in sun safety knowledge and practices among construction workers in response to an educational intervention. A baseline questionnaire was administered, followed by a bespoke sector-specific DVD-based intervention. At 12-month follow-up, participants completed a further questionnaire. Analyses were conducted on a sample of 120 workers (intervention group, n = 70; comparison group, n = 50). At follow-up, the proportion of intervention group participants that reported correct sun safety knowledge was not significantly greater than at baseline. However, the intervention group demonstrated significant positive change on 9 out of 10 behavioural measures, the greatest change being use of a shade/cover when working in the sun followed by regularly checking skin for moles or unusual changes. Exposure to this intervention was linked to some specific positive changes in construction workers' self-reported sun safety practices. These findings highlight the potential for educational interventions to contribute to tackling skin cancer in the UK construction sector. The findings support the development of bespoke educational interventions for other high-risk outdoor worker groups. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Technology-Enhanced Maintenance of Treatment Gains in Eating Disorders: Efficacy of an Intervention Delivered via Text Messaging

    Science.gov (United States)

    Bauer, Stephanie; Okon, Eberhard; Meermann, Rolf; Kordy, Hans

    2012-01-01

    Objective: Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment. Method: The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on…

  7. Implementation of participatory ergonomics intervention in construction companies

    NARCIS (Netherlands)

    van der Molen, Henk F.; Sluiter, Judith K.; Hulshof, Carel T. J.; Vink, Peter; van Duivenbooden, Cor; Holman, Rebecca; Frings-Dresen, Monique H. W.

    2005-01-01

    Objectives The effectiveness of the implementation of participatory ergonomics intervention to reduce physical work demands in construction work was studied. Methods in a cluster randomized controlled trial, 10 bricklaying companies were randomly assigned either to an intervention group (N=5) or a

  8. Implementation of participatory ergonomics intervention in construction companies

    NARCIS (Netherlands)

    Molen, H.F. van der; Sluiter, J.K.; Vink, P.; Hulshof, C.T.J.; Duivenbooden, C. van; Holman, R.; Frings-Dresen, M.H.W.

    2005-01-01

    Objectives The effectiveness of the implementation of participatory ergonomics intervention to reduce physical work demands in construction work was studied. Methods In a cluster randomized controlled trial, 10 bricklaying companies were randomly assigned either to an intervention group (N=5) or a

  9. Culture, context and therapeutic processes: delivering a parent-child intervention in a remote Aboriginal community.

    Science.gov (United States)

    Mares, Sarah; Robinson, Gary

    2012-04-01

    Little is written about the process of delivering mainstream, evidence-based therapeutic interventions for Aboriginal children and families in remote communities. Patterns of interaction between parents and children and expectations about parenting and professional roles and responsibilities vary across cultural contexts. This can be a challenging experience for professionals accustomed to work in urban settings. Language is only a part of cultural difference, and the outsider in a therapeutic group in an Aboriginal community is outside not only in language but also in access to community relationships and a place within those relationships. This paper uses examples from Let's Start, a therapeutic parent-child intervention to describe the impact of distance, culture and relationships in a remote Aboriginal community, on the therapeutic framework, group processes and relationships. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Program adaptation, evaluation and staff training and support need to take these factors into account to ensure cultural accessibility without loss of therapeutic fidelity and efficacy.

  10. Social media-delivered sexual health intervention: a cluster randomized controlled trial.

    Science.gov (United States)

    Bull, Sheana S; Levine, Deborah K; Black, Sandra R; Schmiege, Sarah J; Santelli, John

    2012-11-01

    Youth are using social media regularly and represent a group facing substantial risk for sexually transmitted infection (STI). Although there is evidence that the Internet can be used effectively in supporting healthy sexual behavior, this has not yet extended to social networking sites. To determine whether STI prevention messages delivered via Facebook are efficacious in preventing increases in sexual risk behavior at 2 and 6 months. Cluster RCT, October 2010-May 2011. Individuals (seeds) recruited in multiple settings (online, via newspaper ads and face-to-face) were asked to recruit three friends, who in turn recruited additional friends, extending three waves from the seed. Seeds and waves of friends were considered networks and exposed to either the intervention or control condition. Exposure to Just/Us, a Facebook page developed with youth input, or to control content on 18-24 News, a Facebook page with current events for 2 months. Condom use at last sex and proportion of sex acts protected by condoms. Repeated measures of nested data were used to model main effects of exposure to Just/Us and time by treatment interaction. A total of 1578 participants enrolled, with 14% Latino and 35% African-American; 75% of participants completed at least one study follow-up. Time by treatment effects were observed at 2 months for condom use (intervention 68% vs control 56%, p=0.04) and proportion of sex acts protected by condoms (intervention 63% vs control 57%, p=0.03) where intervention participation reduced the tendency for condom use to decrease over time. No effects were seen at 6 months. Social networking sites may be venues for efficacious health education interventions. More work is needed to understand what elements of social media are compelling, how network membership influences effects, and whether linking social media to clinical and social services can be beneficial. This study is registered at www.clinicaltrials.govNCT00725959. Copyright © 2012 American

  11. Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams

    Directory of Open Access Journals (Sweden)

    Middleton Sandy

    2010-01-01

    Full Text Available Abstract Background Transferring knowledge from research into practice can be challenging, partly because the process involves a change in attitudes, roles and behaviour by individuals and teams. Helping teams to identify then target potential barriers may aid the knowledge transfer process. The aim of this study was to identify barriers and enablers, as perceived by allied health professionals, to delivering an evidence-based (Level 1 outdoor journey intervention for people with stroke. Methods A qualitative design and semi-structured interviews were used. Allied health professionals (n = 13 from two community rehabilitation teams were interviewed, before and after receiving feedback from a medical record audit and attending a training workshop. Interviews allowed participants to identify potential and actual barriers, as well as enablers to delivering the intervention. Qualitative data were analysed using theoretical domains described by Michie and colleagues. Results Two barriers to delivery of the intervention were the social influence of people with stroke and their family, and professionals' beliefs about their capabilities. Other barriers included professionals' knowledge and skills, their role identity, availability of resources, whether professionals remembered to provide the intervention, and how they felt about delivering the intervention. Enablers to delivering the intervention included a belief that they could deliver the intervention, a willingness to expand and share professional roles, procedures that reminded them what to do, and feeling good about helping people with stroke to participate. Conclusions This study represents one step in the quality improvement process. The interviews encouraged reflection by staff. We obtained valuable data which have been used to plan behaviour change interventions addressing identified barriers. Our methods may assist other researchers who need to design similar behaviour change interventions.

  12. A Meta-Analysis of the Impact of Universal and Indicated Preventive Technology-Delivered Interventions for Higher Education Students.

    Science.gov (United States)

    Conley, Colleen S; Durlak, Joseph A; Shapiro, Jenna B; Kirsch, Alexandra C; Zahniser, Evan

    2016-08-01

    The uses of technology-delivered mental health treatment options, such as interventions delivered via computer, smart phone, or other communication or information devices, as opposed to primarily face-to-face interventions, are proliferating. However, the literature is unclear about their effectiveness as preventive interventions for higher education students, a population for whom technology-delivered interventions (TDIs) might be particularly fitting and beneficial. This meta-analytic review examines technological mental health prevention programs targeting higher education students either without any presenting problems (universal prevention) or with mild to moderate subclinical problems (indicated prevention). A systematic literature search identified 22 universal and 26 indicated controlled interventions, both published and unpublished, involving 4763 college, graduate, or professional students. As hypothesized, the overall mean effect sizes (ESs) for both universal (0.19) and indicated interventions (0.37) were statistically significant and differed significantly from each other favoring indicated interventions. Skill-training interventions, both universal (0.21) and indicated (0.31), were significant, whereas non-skill-training interventions were only significant among indicated (0.25) programs. For indicated interventions, better outcomes were obtained in those cases in which participants had access to support during the course of the intervention, either in person or through technology (e.g., email, online contact). The positive findings for both universal and indicated prevention are qualified by limitations of the current literature. To improve experimental rigor, future research should provide detailed information on the level of achieved implementation, describe participant characteristics and intervention content, explore the impact of potential moderators and mechanisms of success, collect post-intervention and follow-up data regardless of

  13. Intervention Mapping as a framework for developing an intervention at the worksite for older construction workers.

    Science.gov (United States)

    Oude Hengel, Karen M; Joling, Catelijne I; Proper, Karin I; van der Molen, Henk F; Bongers, Paulien M

    2011-01-01

    The purpose of this study was to apply the Intervention Mapping approach as a framework in the development of a worksite intervention to improve the work ability of construction workers. Development of an intervention by using the Intervention Mapping approach. Construction worksite. Construction workers aged 45 years and older. According to the principles of Intervention Mapping, evidence from the literature was combined with data collected from stakeholders (e.g., construction workers, managers, providers). The Intervention Mapping approach resulted in an intervention with the following components: (1) two individual visits of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the range of influence at the worksite. Application of Intervention Mapping in the development of a worksite prevention program was useful in the construction industry to obtain a positive attitude and commitment. Stakeholders could give input regarding the program components as well as provide specific leads for the practical intervention strategy. Moreover, it also gives insight in the current theoretical and empirical knowledge in the field of improving the work ability of older workers in the construction industry.

  14. Effects of healthcare professional delivered early feeding interventions on feeding practices and dietary intake: A systematic review.

    Science.gov (United States)

    Matvienko-Sikar, Karen; Toomey, Elaine; Delaney, Lisa; Harrington, Janas; Byrne, Molly; Kearney, Patricia M

    2018-04-01

    Childhood obesity is a global public health challenge. Parental feeding practices, such as responsive feeding, are implicated in the etiology of childhood obesity. This systematic review aimed to examine of effects of healthcare professional-delivered early feeding interventions, on parental feeding practices, dietary intake, and weight outcomes for children up to 2 years. The role of responsive feeding interventions was also specifically examined. Databases searched included: CINAHL, the Cochrane Library, EMBASE, Medline, PubMed, PsycINFO, and Maternity and Infant Care. participants are parents of children ≤2 years; intervention includes focus on early child feeding to prevent overweight and obesity; intervention delivered by healthcare professionals. Sixteen papers, representing 10 trials, met inclusion criteria for review. Six interventions included responsive feeding components. Interventions demonstrated inconsistent effects on feeding practices, dietary intake, and weight outcomes. Findings suggest some reductions in pressure to eat and infant consumption of non-core beverages. Responsive feeding based interventions demonstrate greater improvements in feeding approaches, and weight outcomes. The findings of this review highlight the importance of incorporating responsive feeding in healthcare professional delivered early feeding interventions to prevent childhood obesity. Observed inconsistencies across trials may be explained by methodological limitations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review.

    Science.gov (United States)

    Banbury, Annie; Nancarrow, Susan; Dart, Jared; Gray, Leonard; Parkinson, Lynne

    2018-02-02

    replicate group processes such as bonding and cohesiveness. Similar outcomes were reported for those comparing face-to-face groups and videoconference groups. Groups delivered by videoconference are feasible and potentially can improve the accessibility of group interventions. This may be particularly useful for those who live in rural areas, have limited mobility, are socially isolated, or fear meeting new people. Outcomes are similar to in-person groups, but future research on facilitation process in videoconferencing-mediated groups and large-scale studies are required to develop the evidence base. ©Annie Banbury, Susan Nancarrow, Jared Dart, Leonard Gray, Lynne Parkinson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.02.2018.

  16. The feasibility and impact of delivering a mind-body intervention in a virtual world.

    Directory of Open Access Journals (Sweden)

    Daniel B Hoch

    Full Text Available INTRODUCTION: Mind-body medical approaches may ameliorate chronic disease. Stress reduction is particularly helpful, but face-to-face delivery systems cannot reach all those who might benefit. An online, 3-dimensional virtual world may be able to support the rich interpersonal interactions required of this approach. In this pilot study, we explore the feasibility of translating a face-to-face stress reduction program into an online virtual setting and estimate the effect size of the intervention. METHODS AND FINDINGS: Domain experts in virtual world technology joined with mind body practitioners to translate an existing 8 week relaxation response-based resiliency program into an 8-week virtual world-based program in Second Life™ (SL. Twenty-four healthy volunteers with at least one month's experience in SL completed the program. Each subject filled out the Perceived Stress Scale (PSS and the Symptom Checklist 90- Revised (SCL-90-R before and after taking part. Participants took part in one of 3 groups of about 10 subjects. The participants found the program to be helpful and enjoyable. Many reported that the virtual environment was an excellent substitute for the preferred face-to-face approach. On quantitative measures, there was a general trend toward decreased perceived stress, (15.7 to 15.0, symptoms of depression, (57.6 to 57.0 and anxiety (56.8 to 54.8. There was a significant decrease of 2.8 points on the SCL-90-R Global Severity Index (p<0.05. CONCLUSIONS: This pilot project showed that it is feasible to deliver a typical mind-body medical intervention through a virtual environment and that it is well received. Moreover, the small reduction in psychological distress suggests further research is warranted. Based on the data collected for this project, a randomized trial with less than 50 subjects would be appropriately powered if perceived stress is the primary outcome.

  17. Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

    Science.gov (United States)

    Mauriello, Leanne M; Van Marter, Deborah F; Umanzor, Cindy D; Castle, Patricia H; de Aguiar, Emma L

    2016-09-01

    To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. Women were recruited from six locations of federally funded health centers across three states. Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors. © 2016 by American Journal of Health Promotion, Inc.

  18. Lifestyle behavior interventions delivered using technology in childhood, adolescent, and young adult cancer survivors: A systematic review.

    Science.gov (United States)

    Kopp, Lisa M; Gastelum, Zachary; Guerrero, Christian H; Howe, Carol L; Hingorani, Pooja; Hingle, Melanie

    2017-01-01

    Childhood, adolescent, and young adult cancer survivors demonstrate increased cardio-metabolic risk factors, which are amenable to lifestyle changes. The use of technology to impact lifestyle change expands previously limited intervention access, yet little is known about its use. We summarized lifestyle interventions for survivors delivered using technology, finding six studies, primarily targeting physical activity. Study samples were small and durations ranged from 5 to 16 weeks and outcomes modest. Participants were older, white, survivors of leukemia or brain tumors, and the majority received Web-based interventions. Study quality was moderate. Few technology-based interventions have been developed, suggesting an area of opportunity for survivors. © 2016 Wiley Periodicals, Inc.

  19. Developments in Technology-Delivered Psychological Interventions / Desarrollos en Intervenciones Psicológicas utilizando la Tecnología

    Directory of Open Access Journals (Sweden)

    Derek Richards

    2013-06-01

    Full Text Available The worldwide penetration of the Internet and its related technologies, the rapid developments of new technologies and the pervasive use of technology in people’s lives, are indicators that we live in a technological age. New technologies and their potential for use in psychological interventions and mental health services have not gone unnoticed. The last 15 years or so have witnessed the employment of new technologies in developing and delivering a variety of psychological interventions, these include information WebPages, internet-based computer programs that are addressed to treatment of specific problems, the use of mobile phones and games to help psychological practice, among others. However, while a broad range of technology-delivered psychological interventions have demonstrated success in high-income countries, little is known of their potential for countries such as Colombia. The paper begins with a brief history, followed by an overview of the field of technology-delivered psychological interventions. Lastly, the paper seeks to present a justification for the potential use of technology delivered psychological interventions in Colombia.

  20. Effectiveness of recruitment to a smartphone-delivered nutrition intervention in New Zealand: analysis of a randomised controlled trial

    OpenAIRE

    Volkova, Ekaterina; Michie, Jo; Corrigan, Callie; Sundborn, Gerhard; Eyles, Helen; Jiang, Yannan; Mhurchu, Cliona Ni

    2017-01-01

    Objectives Delivery of interventions via smartphone is a relatively new initiative in public health, and limited evidence exists regarding optimal strategies for recruitment. We describe the effectiveness of approaches used to recruit participants to a smartphone-enabled nutrition intervention trial. Methods Internet and social media advertising, mainstream media advertising and research team networks were used to recruit New Zealand adults to a fully automated smartphone-delivered nutrition ...

  1. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India

    OpenAIRE

    Balaji, Madhumitha; Chatterjee, Sudipto; Koschorke, Mirja; Rangaswamy, Thara; Chavan, Animish; Dabholkar, Hamid; Dakshin, Lilly; Kumar, Pratheesh; John, Sujit; Thornicroft, Graham; Patel, Vikram

    2012-01-01

    Abstract Background Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community...

  2. Computer and telephone delivered interventions to support caregivers of people with dementia: a systematic review of research output and quality

    Directory of Open Access Journals (Sweden)

    Amy Waller

    2017-11-01

    Full Text Available Abstract Background To assess the scope, volume and quality of research on the acceptability, utilisation and effectiveness of telephone- and computer-delivered interventions for caregivers of people living with dementia. Methods Medline, EMBASE, CINAHL and Cochrane databases were searched (Jan 1990 – Dec 2016. Eligible papers were classified as data-based descriptive, measurement or intervention studies. Intervention studies were first categorised according to mode of delivery (e.g. telephone, computer; then assessed against the Effective Practice and Organisation of Care (EPOC methodological criteria for research design. Impact on health-related outcomes; and the acceptability, feasibility and utilisation of interventions were also assessed. Results The number of publications increased by 13% each year (p < 0.001. Half were descriptive studies (n = 92, 50% describing caregiver views on acceptability, access or utilization of technology. The remainder (n = 89, 48% reported on interventions designed to improve caregiver outcomes. Only 34 met EPOC design criteria. Interventions were delivered via computer (n = 10, multiple modalities (n = 9 or telephone (n = 15. Interventions that incorporated various elements of psycho-education, peer support, skills training and health assessments led to improvements in caregiver wellbeing. While largely acceptable, utilisation of computer-based interventions was variable, with use often decreasing over time. Conclusion Interventions delivered via telephone and computer have the potential to augment existing dementia care. High-quality trials are required to make clear recommendations about the types of interventions that are most effective. Those that provide caregivers with: access to practical strategies to manage care of the person with dementia and their own wellbeing, advice and support from peers and/or clinicians; and that target the dyad should be explored.

  3. Family Generated and Delivered Social Story Intervention: Acquisition, Maintenance, and Generalization of Social Skills in Youths with ASD

    Science.gov (United States)

    Olcay-Gül, Seray; Tekin-Iftar, Elif

    2016-01-01

    The purpose of this study was to examine whether (a) family members were able to learn to write a social story and deliver social story intervention to teach social skills to their children (age 12 to 16) with ASD, (b) youths with ASD acquired and maintained the targeted social skills and generalized these skills across novel situations. Multiple…

  4. Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: a systematic review.

    Science.gov (United States)

    Loo Gee, Brendan; Griffiths, Kathleen M; Gulliver, Amelia

    2016-01-01

    Mobile technologies may be suitable for delivering Ecological Momentary Interventions (EMI) to treat anxiety in real-time. This review aims to synthesize evidence on the effectiveness of EMI for treating anxiety conditions. Four databases and the reference lists of previous studies were searched. A total of 1949 abstracts were double screened for inclusion. Sufficient studies were available to undertake a quantitative meta-analysis on EMIs on generalized anxiety symptoms. The 15 randomized trials and randomized controlled trials examined anxiety (n = 7), stress (n = 3), anxiety and stress (n = 2), panic disorder (n = 2), and social phobia (n = 1). Eight EMIs comprised self-monitoring integrated with therapy modules, seven comprised multimedia content, and three comprised self-monitoring only. The quality of studies presented high risk of biases. Meta-analysis (n = 7) demonstrated that EMIs reduced generalized anxiety compared to control and/or comparison groups (Effect Size (ES) = 0.32, 95% CI, 0.12-0.53). Most EMIs targeting stress were reported effective relative to control as were the two EMIs targeting panic disorders. The EMI targeting social phobia was not effective. EMIs have potential in treating both anxiety and stress. However, few high-quality trials have been conducted for specific anxiety disorders. Further trials are needed to assess the value of EMI technologies for anxiety in enhancing existing treatments. This study found a small significant effect of EMI studies on reducing generalized anxiety. Studies on stress demonstrated EMI was effective compared to control, with the small number of studies on panic and social phobia demonstrating mixed results. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. An Open Trial of the Anxiety Action Plan (AxAP): A Brief Pediatrician-Delivered Intervention for Anxious Youth

    Science.gov (United States)

    Ginsburg, Golda S.; Drake, Kelly; Winegrad, Heather; Fothergill, Kate; Wissow, Larry

    2016-01-01

    Background Anxiety disorders in youth are among the most common psychiatric disorders, yet the majority of affected youth do not receive treatment. One approach to improving access to care is identification and intervention within the primary care setting. Objective This manuscript presents data from a single group pre-post open trial of the Anxiety Action Plan (AxAP), a brief pediatrician-delivered intervention to reduce anxiety in youth who present in the primary care setting. Methods Eleven pediatricians conducted the intervention with 25 youth (mean age 11.16 years; range 6-18 years) with elevated levels of anxiety in their primary care practice setting. Results Pediatricians’ ratings of the AxAP training were positive (mean overall satisfaction was 4.82 on 5 point scale). Pediatricians and parents also reported high levels of intervention satisfaction and acceptability. Parents (but not children) who completed the intervention reported significant reductions from pre- to post-intervention on measures of child anxiety severity, impairment, and caregiver burden (Cohen's d 1.06, .75, .60, respectively). Conclusions Findings suggest that a brief, pediatrician-delivered intervention in primary care settings appears feasible and beneficial to patients. Additional controlled evaluation of the intervention's efficacy is needed. PMID:27403041

  6. Process evaluation of a technology-delivered screening and brief intervention for substance use in primary care.

    Science.gov (United States)

    Ondersma, Steven J; Gryczynski, Jan; Mitchell, Shannon Gwin; O'Grady, Kevin E; Schwartz, Robert P

    2016-05-01

    Psychotherapy process research examines the content of treatment sessions and their association with outcomes in an attempt to better understand the interactions between therapists and clients, and to elucidate mechanisms of behavior change. A similar approach is possible in technology-delivered interventions, which have an interaction process that is always perfectly preserved and rigorously definable. The present study sought to examine the process of participants' interactions with a computer-delivered brief intervention for drug use, from a study comparing computer- and therapist-delivered brief interventions among adults at two primary health care centers in New Mexico. Specifically, we sought to describe the pattern of participants' ( N =178) choices and reactions throughout the computer-delivered brief intervention, and to examine associations between that process and intervention response at 3-month follow-up. Participants were most likely to choose marijuana as the first substance they wished to discuss ( n = 114, 64.0%). Most participants indicated that they had not experienced any problems as a result of their drug use ( n = 108, 60.7%), but nearly a third of these ( n = 32, 29.6%) nevertheless indicated a desire to stop or reduce its use; participants who did report negative consequences were most likely to endorse financial or relationship concerns. However, participant ratings of the importance of change or of the helpfulness of personalized normed feedback were unrelated to changes in substance use frequency. Design of future e-interventions should consider emphasizing possible benefits of quitting rather than the negative consequences of drug use, and-when addressing consequences-should consider focusing on the impacts of substance use on relationship and financial aspects. These findings are an early but important step toward using process evaluation to optimize e-intervention content.

  7. Process evaluation of a technology-delivered screening and brief intervention for substance use in primary care

    Directory of Open Access Journals (Sweden)

    Steven J. Ondersma

    2016-05-01

    Full Text Available Psychotherapy process research examines the content of treatment sessions and their association with outcomes in an attempt to better understand the interactions between therapists and clients, and to elucidate mechanisms of behavior change. A similar approach is possible in technology-delivered interventions, which have an interaction process that is always perfectly preserved and rigorously definable. The present study sought to examine the process of participants' interactions with a computer-delivered brief intervention for drug use, from a study comparing computer- and therapist-delivered brief interventions among adults at two primary health care centers in New Mexico. Specifically, we sought to describe the pattern of participants' (N = 178 choices and reactions throughout the computer-delivered brief intervention, and to examine associations between that process and intervention response at 3-month follow-up. Participants were most likely to choose marijuana as the first substance they wished to discuss (n = 114, 64.0%. Most participants indicated that they had not experienced any problems as a result of their drug use (n = 108, 60.7%, but nearly a third of these (n = 32, 29.6% nevertheless indicated a desire to stop or reduce its use; participants who did report negative consequences were most likely to endorse financial or relationship concerns. However, participant ratings of the importance of change or of the helpfulness of personalized normed feedback were unrelated to changes in substance use frequency. Design of future e-interventions should consider emphasizing possible benefits of quitting rather than the negative consequences of drug use, and—when addressing consequences—should consider focusing on the impacts of substance use on relationship and financial aspects. These findings are an early but important step toward using process evaluation to optimize e-intervention content.

  8. An Intervention Model of Constructive Conflict Resolution and Cooperative Learning.

    Science.gov (United States)

    Zhang, Quanwu

    1994-01-01

    Tests an intervention model of constructive conflict resolution (CCR) and cooperative learning in three urban high schools. Findings show that improvements in CCR increased social support and decreased victimization for the students. These changes improved student's attitudes, self-esteem, interpersonal relations, and academic achievement. (GLR)

  9. A systematic review evaluating the role of nurses and processes for delivering early mobility interventions in the intensive care unit.

    Science.gov (United States)

    Krupp, Anna; Steege, Linsey; King, Barbara

    2018-04-19

    To investigate processes for delivering early mobility interventions in adult intensive care unit patients used in research and quality improvement studies and the role of nurses in early mobility interventions. A systematic review was conducted. Electronic databases PubMED, CINAHL, PEDro, and Cochrane were searched for studies published from 2000 to June 2017 that implemented an early mobility intervention in adult intensive care units. Included studies involved progression to ambulation as a component of the intervention, included the role of the nurse in preparing for or delivering the intervention, and reported at least one patient or organisational outcome measure. The System Engineering Initiative for Patient Safety (SEIPS) model, a framework for understanding structure, processes, and healthcare outcomes, was used to evaluate studies. 25 studies were included in the final review. Studies consisted of randomised control trials, prospective, retrospective, or mixed designs. A range of processes to support the delivery of early mobility were found. These processes include forming interdisciplinary teams, increasing mobility staff, mobility protocols, interdisciplinary education, champions, communication, and feedback. Variation exists in the process of delivering early mobility in the intensive care unit. In particular, further rigorous studies are needed to better understand the role of nurses in implementing early mobility to maintain a patient's functional status. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. The process evaluation of two alternative participatory ergonomics intervention strategies for construction companies.

    Science.gov (United States)

    Visser, Steven; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2018-03-26

    To gain insight into the process of applying two guidance strategies - face-to-face (F2F) or e-guidance strategy (EC) - of a Participatory Ergonomics (PE) intervention and whether differences between these guidance strategies occur, 12 construction companies were randomly assigned to a strategy. The process evaluation contained reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change of individual workers. Data were assessed by logbooks, and questionnaires and interviews at baseline and/or after six months. Reach was low (1%). Dose delivered (F2F: 63%; EC: 44%), received (F2F: 42%; EC: 16%) were not sufficient. The precision and competence were sufficient for both strategies and satisfaction was strongly affected by dose received. For behavioural change, knowledge (F2F) and culture (EC) changed positively within companies. Neither strategy was delivered as intended. Compliance to the intervention was low, especially for EC. Starting with a face-to-face meeting might lead to higher compliance, especially in the EC group. Practitioner Summary: This study showed that compliance to a face-to-face and an e-guidance strategy is low. To improve the compliance, it is advised to start with a face-to-face meeting to see which parts of the intervention are needed and which guidance strategy can be used for these parts. ISRCTN73075751.

  11. Effectiveness of psychological interventions delivered by non-psychologists on low back pain and disability: a qualitative systematic review.

    Science.gov (United States)

    Bostick, Geoff P

    2017-11-01

    Psychological treatments delivered by non-psychologists have been proposed as a way to increase access to care to address important psychological barriers to recovery in people with low back pain (LBP). This review aimed to synthesize randomized controlled trials (RCTs) that assess the effectiveness of psychological interventions delivered by non-psychologists in reducing pain intensity and disability in adults with LBP, compared with usual care. A systematic review without meta-analysis was carried out. Randomized controlled trials including adult patients with all types of musculoskeletal LBP were eligible. Interventions included those based on psychological principles and delivered by non-psychologists. The primary outcomes of interest were self-reported pain intensity and disability. Information sources included Medline, EMBASE, and the Cochrane Central Registrar for Controlled Trials. The Cochrane Collaboration's tool for assessing risk of bias was used for the evaluation of internal validity. There were 1,101 records identified, 159 were assessed for eligibility, 16 were critically appraised, and 11 studies were included. Mild to moderate risk of bias was present in the included studies, with personnel and patient blinding, treatment fidelity, and attrition being the most common sources of bias. Considerable heterogeneity existed for patient population, intervention components, and comparison groups. Although most studies demonstrated statistical and clinical improvements in pain and disability, few were statistically superior to the comparison group. Consistent with the broader psychological literature, psychological interventions delivered by non-psychologists have modest effects on low back pain and disability. Additional high quality research is needed to understand what patients are likely to respond to psychological interventions, the appropriate dose to achieve the desired outcome, the amount of training required to implement psychological

  12. Using a Virtual Environment to Deliver Evidence-Based Interventions: The Facilitator's Experience

    Science.gov (United States)

    Villarruel, Antonia; Tschannen, Dana; Valladares, Angel; Yaksich, Joseph; Yeagley, Emily; Hawes, Armani

    2015-01-01

    Background Evidence-based interventions (EBIs) have the potential to maximize positive impact on communities. However, despite the quantity and quality of EBIs for prevention, the need for formalized training and associated training-related expenses, such as travel costs, program materials, and input of personnel hours, pose implementation challenges for many community-based organizations. In this study, the community of inquiry (CoI) framework was used to develop the virtual learning environment to support the adaptation of the ¡Cuídate! (Take Care of Yourself!) Training of Facilitators curriculum (an EBI) to train facilitators from community-based organizations. Objective The purpose of this study was to examine the feasibility of adapting a traditional face-to-face facilitator training program for ¡Cuídate!, a sexual risk reduction EBI for Latino youth, for use in a multi-user virtual environment (MUVE). Additionally, two aims of the study were explored: the acceptability of the facilitator training and the level of the facilitators’ knowledge and self-efficacy to implement the training. Methods A total of 35 facilitators were trained in the virtual environment. We evaluated the facilitators' experience in the virtual training environment and determined if the learning environment was acceptable and supported the acquisition of learning outcomes. To this end, the facilitators were surveyed using a modified community of inquiry survey, with questions specific to the Second Life environment and an open-ended questionnaire. In addition, a comparison to face-to-face training was conducted using survey methods. Results Results of the community of inquiry survey demonstrated a subscale mean of 23.11 (SD 4.12) out of a possible 30 on social presence, a subscale mean of 8.74 (SD 1.01) out of a possible 10 on teaching presence, and a subscale mean of 16.69 (SD 1.97) out of a possible 20 on cognitive presence. The comparison to face-to-face training showed no

  13. The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention

    Science.gov (United States)

    2013-01-01

    Background The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. Methods The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants’ characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. Results A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. Conclusions With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle

  14. The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention.

    Science.gov (United States)

    Schneider, Francine; Schulz, Daniela N; Pouwels, Loes H L; de Vries, Hein; van Osch, Liesbeth A D M

    2013-08-05

    The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants' characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive

  15. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India

    Directory of Open Access Journals (Sweden)

    Balaji Madhumitha

    2012-02-01

    Full Text Available Abstract Background Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. Methods We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Results Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and

  16. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India.

    Science.gov (United States)

    Balaji, Madhumitha; Chatterjee, Sudipto; Koschorke, Mirja; Rangaswamy, Thara; Chavan, Animish; Dabholkar, Hamid; Dakshin, Lilly; Kumar, Pratheesh; John, Sujit; Thornicroft, Graham; Patel, Vikram

    2012-02-16

    Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion) to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and expected them to have knowledge about the subject matter

  17. Diabetes self-management education and support delivered by mobile health (m-health) interventions for adults with type 2 diabetes mellitus

    NARCIS (Netherlands)

    Boels, Anne Meike; Vos, Rimke C.; Metzendorf, Maria-Inti; Rutten, Guy E.H.M.

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of diabetes self-management education and support delivered by mobile health interventions in adults with type 2 diabetes mellitus.

  18. Integrated package approach in delivering interventions during immunisation campaigns in a complex environment in Papua New Guinea: a case study.

    Science.gov (United States)

    Vince, John David; Datta, Siddhartha Sankar; Toikilik, Steven; Lagani, William

    2014-08-06

    Papua New Guinea's difficult and varied topography, poor transport infrastructure, changing dynamics of population and economy in recent times and understaffed and poorly financed health service present major challenges for successful delivery of vaccination and other preventative health interventions to both the rural majority and urban populations, thereby posing risks for vaccine preventable disease outbreaks in the country. The country has struggled to meet the vaccination coverage targets required for the eradication of poliomyelitis and elimination of measles. Escalation of inter and intra country migration resulting from major industrial developments, particularly in extraction industries, has substantially increased the risk of infectious disease importation. This case study documents the evolution of immunisation programmes since the introduction of supplementary immunisation activities (SIAs). Single antigen SIAs have advantages and disadvantages. In situations in which the delivery of preventative health interventions is difficult, it is likely that the cost benefit is greater for multiple than for single intervention. The lessons learned from the conduct of single antigen SIAs can be effectively used for programmes delivering multiple SIA antigens, routine immunisations, and other health interventions. This paper describes a successful and cost effective multiple intervention programme in Papua New Guinea. The review of the last SIA in Papua New Guinea showed relatively high coverage of all the interventions and demonstrated the operational feasibility of delivering multiple interventions in resource constrained settings. Studies in other developing countries such as Lesotho and Ethiopia have also successfully integrated health interventions with SIA. In settings such as Papua New Guinea there is a strong case for integrating supplementary immunisation activity with routine immunisation and other health interventions through a comprehensive outreach

  19. An exploratory trial of the effectiveness of an enhanced consultative approach to delivering speech and language intervention in schools.

    Science.gov (United States)

    Mecrow, Carol; Beckwith, Jennie; Klee, Thomas

    2010-01-01

    Increased demand for access to specialist services for providing support to children with speech, language and communication needs prompted a local service review of how best to allocate limited resources. This study arose as a consequence of a wish to evaluate the effectiveness of an enhanced consultative approach to delivering speech and language intervention in local schools. The purpose was to evaluate an intensive speech and language intervention for children in mainstream schools delivered by specialist teaching assistants. A within-subjects, quasi-experimental exploratory trial was conducted, with each child serving as his or her own control with respect to the primary outcome measure. Thirty-five children between the ages of 4;2 and 6;10 (years; months) received speech and/or language intervention for an average of four 1-hour sessions per week over 10 weeks. The primary outcome measure consisted of change between pre- and post-intervention scores on probe tasks of treated and untreated behaviours summed across the group of children, and maintenance probes of treated behaviours. Secondary outcome measures included standardized tests (Clinical Evaluation of Language Fundamentals - Preschool(UK) (CELF-P(UK)); Diagnostic Evaluation of Articulation and Phonology (DEAP)) and questionnaires completed by parents/carers and school staff before and after the intervention period. The primary outcome measure showed improvement over the intervention period, with target behaviours showing a significantly larger increase than control behaviours. The gains made on the target behaviours as a result of intervention were sustained when reassessed 3-12 months later. These findings were replicated on a second set of targets and controls. Significant gains were also observed on CELF-Preschool(UK) receptive and expressive language standard scores from pre- to post-intervention. However, DEAP standard scores of speech ability did not increase over the intervention period

  20. Virtual peer-delivered memory intervention: a single-case experimental design in an adolescent with chronic memory impairment.

    Science.gov (United States)

    Cooper, Janine M; Lockett, Stephen; McIlroy, Alissandra; Gonzalez, Linda

    2018-01-01

    Children and adolescents with chronic memory impairment may develop coping strategies that enable functioning, yet these often remain undetectable using traditional psychometric measures. Personalized intervention studies that promote the use of such strategies designed specifically for use by this young cohort are scarce. To investigate the effect of a novel virtual reality peer-delivered memory intervention on the everyday functioning and well-being of SE, a 17-year-old female with a history of chronic verbal memory issues, impaired autobiographical event recall and elevated mood symptoms. A single-case ABA experimental design study was used to assess change. Following initial baseline assessment using objective neuropsychological and subjective functional questionnaires and intervention training, case SE used the intervention daily for 3 weeks before repeating key outcome measures. Using non-overlap of all pairs and qualitative feedback analysis, the results revealed a significant increase in event recall and self-reported positive changes to levels of everyday functioning. Supporting autobiographical event recall and prospective memory via a virtual peer-delivered intervention may lead to reduction in cognitive load, and benefit overall well-being and everyday functioning.

  1. Development of a mobile solution for delivering price quotes in the construction industry

    OpenAIRE

    Andersson, Filip; Pantzar, Anders

    2013-01-01

    The rapid growth of the mobile consumer market has influenced companies to make their workplace digital and mobile, with the goal to remove ties to a physical workplace, increase productivity, and trivialize tedious tasks. The construction industry is in need of modernization; it is a competitive market and to get a contract it is vital to provide a reasonable price quote fast.This bachelor thesis was performed together with Byggwalle AB in Västerås with the objective to create a mobile solut...

  2. Evaluating the Benefits of Aphasia Intervention Delivered in Virtual Reality: Results of a Quasi-Randomised Study.

    Science.gov (United States)

    Marshall, Jane; Booth, Tracey; Devane, Niamh; Galliers, Julia; Greenwood, Helen; Hilari, Katerina; Talbot, Richard; Wilson, Stephanie; Woolf, Celia

    2016-01-01

    This study evaluated an intervention for people with aphasia delivered in a novel virtual reality platform called EVA Park. EVA Park contains a number of functional and fantastic locations and allows for interactive communication between multiple users. Twenty people with aphasia had 5 weeks' intervention, during which they received daily language stimulation sessions in EVA Park from a support worker. The study employed a quasi randomised design, which compared a group that received immediate intervention with a waitlist control group. Outcome measures explored the effects of intervention on communication and language skills, communicative confidence and feelings of social isolation. Compliance with the intervention was also explored through attrition and usage data. There was excellent compliance with the intervention, with no participants lost to follow up and most (18/20) receiving at least 88% of the intended treatment dose. Intervention brought about significant gains on a measure of functional communication. Gains were achieved by both groups of participants, once intervention was received, and were well maintained. Changes on the measures of communicative confidence and feelings of social isolation were not achieved. Results are discussed with reference to previous aphasia therapy findings.

  3. Computer-delivered indirect screening and brief intervention for drug use in the perinatal period: A randomized trial.

    Science.gov (United States)

    Ondersma, Steven J; Svikis, Dace S; Thacker, Casey; Resnicow, Ken; Beatty, Jessica R; Janisse, James; Puder, Karoline

    2018-04-01

    Under-reporting of drug use in the perinatal period is well-documented, and significantly limits the reach of proactive intervention approaches. The Wayne Indirect Drug Use Screener (WIDUS) focuses on correlates of drug use rather than use itself. This trial tested a computer-delivered, brief intervention designed for use with indirect screen-positive cases, seeking to motivate reductions in drug use without presuming its presence. Randomized clinical trial with 500 WIDUS-positive postpartum women recruited between August 14, 2012 and November 19, 2014. Participants were randomly assigned to either a time control condition or a single-session, tailored, indirect brief intervention. The primary outcome was days of drug use over the 6-month follow-up period; secondary outcomes included urine and hair analyses results at 3- and 6-month follow-up. All outcomes were measured by blinded evaluators. Of the 500 participants (252 intervention and 248 control), 36.1% of participants acknowledged drug use in the 3 months prior to pregnancy, but 89% tested positive at the 6-month follow-up. Participants rated the intervention as easy to use (4.9/5) and helpful (4.4/5). Analyses revealed no between-group differences in drug use (52% in the intervention group, vs. 53% among controls; OR 1.03). Exploratory analyses also showed that intervention effects were not moderated by baseline severity, WIDUS score, or readiness to change. The present trial showed no evidence of efficacy for an indirect, single-session, computer-delivered, brief intervention designed as a complement to indirect screening. More direct approaches that still do not presume active drug use may be possible and appropriate. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Constructing Learning-by-Doing Pedagogical Model for Delivering 21st Century Engineering Education

    Directory of Open Access Journals (Sweden)

    Ghassan Frache

    2018-01-01

    Full Text Available The United Arab Emirates (UAE is dedicated to establishing the best teaching and learning environment for students and staff across all higher education institutions. To heed this call, the engineering division adopted the Learning-by-Doing (LBD pedagogical philosophy for 21st Century education at the heart of its strategic directions. This study intends to explore how LBD is understood and practiced in UAE colleges and how 21st Century skills can be explicitly incorporated into its engineering curriculum by using constructive alignment as a pattern for instructional design. This work intends to investigate the general question: “What constructively aligned Learning-by-Doing pedagogical model, with the incorporation of 21st Century skills, needs to be developed to effectively teach and prepare engineering students at the Higher College of Technology, UAE for successful long-term employment in the global working economy?”. Using mixed method research design and input from its major stakeholders, student survey questionnaires, engineering instructors and dean structured interviews, overt class observation and syllabi examination have all been utilized for data triangulation. In conclusion, the study developed a collaborative LBD model tailor-fitted to the institution’s engineering program and to UAE’s culture.

  5. Effects of a Guided Internet-Delivered Self-Help Intervention for Adolescents With Chronic Pain.

    NARCIS (Netherlands)

    Voerman, J.S.; Remerie, S.; Westendorp, T.; Timman, R.; Busschbach, J.J.V.; Passchier, J.; de Klerk, C.

    2015-01-01

    Cognitive-behavioral therapy (CBT) is effective in reducing the frequency and intensity of chronic pain in adolescents. However, CBT seems not to be considered acceptable by all adolescents. The main aim of our study was therefore to evaluate the effects of guided Internet-delivered self-help for

  6. A Peer-Led, Social Media-Delivered, Safer Sex Intervention for Chinese College Students: Randomized Controlled Trial.

    Science.gov (United States)

    Sun, Wai Han; Wong, Carlos King Ho; Wong, William Chi Wai

    2017-08-09

    The peer-led, social media-delivered intervention is an emerging method in sexual health promotion. However, no research has yet investigated its effectiveness as compared with other online channels or in an Asian population. The objective of this study is to compare a peer-led, social media-delivered, safer sex intervention with a sexual health website. Both conditions target Chinese college students in Hong Kong. A randomized controlled trial was conducted with a peer-led, safer sex Facebook group as the intervention and an existing online sexual health website as the control. The intervention materials were developed with peer input and followed the information-motivation-behavioral skills model; the intervention was moderated by peer educators. The participants filled out the online questionnaires before and after the 6-week intervention period. Outcome evaluations included safer sex attitudes, behavioral skills, and behaviors, while process evaluation focused on online experience, online-visiting frequency, and online engagement. The effect of online-visiting frequency and online engagement on outcome variables was investigated. Of 196 eligible participants-100 in the control group and 96 in the intervention group-who joined the study, 2 (1.0%) control participants joined the Facebook group and 24 of the remaining 194 participants (12.4%) were lost to follow-up. For the process evaluation, participants in the intervention group reported more satisfying online experiences (Psocial media-delivered, safer sex intervention was found to be feasible and effective in improving attitudes toward condom use and behavioral skills, but was not significantly more effective than a website. Future research may focus on the long-term effectiveness and cost-effectiveness of this popular method, as well as the potential cultural differences of using social media between different countries. Chinese Clinical Trial Registry (ChiCTR): ChiCTR-IOR-16009495; http

  7. Lifestyle interventions based on the diabetes prevention program delivered via eHealth: A systematic review and meta-analysis.

    Science.gov (United States)

    Joiner, Kevin L; Nam, Soohyun; Whittemore, Robin

    2017-07-01

    The objective was to describe Diabetes Prevention Program (DPP)-based lifestyle interventions delivered via electronic, mobile, and certain types of telehealth (eHealth) and estimate the magnitude of the effect on weight loss. A systematic review was conducted. PubMed and EMBASE were searched for studies published between January 2003 and February 2016 that met inclusion and exclusion criteria. An overall estimate of the effect on mean percentage weight loss across all the interventions was initially conducted. A stratified meta-analysis was also conducted to determine estimates of the effect across the interventions classified according to whether behavioral support by counselors post-baseline was not provided, provided remotely with communication technology, or face-to-face. Twenty-two studies met the inclusion/exclusion criteria, in which 26 interventions were evaluated. Samples were primarily white and college educated. Interventions included Web-based applications, mobile phone applications, text messages, DVDs, interactive voice response telephone calls, telehealth video conferencing, and video on-demand programing. Nine interventions were stand-alone, delivered post-baseline exclusively via eHealth. Seventeen interventions included additional behavioral support provided by counselors post-baseline remotely with communication technology or face-to-face. The estimated overall effect on mean percentage weight loss from baseline to up to 15months of follow-up across all the interventions was -3.98%. The subtotal estimate across the stand-alone eHealth interventions (-3.34%) was less than the estimate across interventions with behavioral support given by a counselor remotely (-4.31%), and the estimate across interventions with behavioral support given by a counselor in-person (-4.65%). There is promising evidence of the efficacy of DPP-based eHealth interventions on weight loss. Further studies are needed particularly in racially and ethnically diverse

  8. Development of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries.

    Science.gov (United States)

    McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; López Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; Makleff, Shelly; Vandewiele, Marieka; Standaert, Sarah; Free, Caroline

    2018-05-02

    Unintended pregnancies can result in poorer health outcomes for women, children and families. Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions. There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours. This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan, Bolivia and Palestine, where unmet need for contraception is high among this group. Guided by Intervention Mapping, the following steps contributed to the development of the interventions: (1) needs assessment; (2) specifying behavioural change to result from the intervention; (3) selecting behaviour change methods to include in the intervention; (4) producing and refining the intervention content. The results of the needs assessment produced similar interventions across the countries. The interventions consist of short daily messages delivered over 4 months (delivered by text messaging in Palestine and mobile phone application instant messages in Bolivia and Tajikistan). The messages provide information about contraception, target attitudes that are barriers to contraceptive uptake and support young people in feeling that they can influence their reproductive health. The interventions each contain the same ten behaviour change methods, adapted for delivery by mobile phone. The development resulted in a well-specified, theory-based intervention, tailored to each country. It is feasible to develop an intervention delivered by mobile phone for young people in resource-limited settings.

  9. Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service.

    Science.gov (United States)

    Devescovi, Raffaella; Monasta, Lorenzo; Mancini, Alice; Bin, Maura; Vellante, Valerio; Carrozzi, Marco; Colombi, Costanza

    2016-01-01

    Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System. Twenty-one toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents' and teachers' active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and post-intervention (Time 1 [T1]; mean age =42 months). Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment. Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.

  10. Nurse-delivered counselling intervention for parental HIV disclosure: Results from a pilot randomized controlled trial in China

    Science.gov (United States)

    Simoni, Jane M.; Yang, Joyce P.; Shiu, Cheng-Shi; Chen, Wei-ti; Udell, Wadiya; Bao, Meijuan; Zhang, Lin; Lu, Hongzhou

    2016-01-01

    Objective The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. Design This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. Setting The study occurred at an outpatient HIV primary care centre in Shanghai, China. Participants Participants were 20 HIV-positive outpatients with at least one child (13–25 years old) who was unaware of the parent’s HIV diagnosis. Intervention The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. Main outcome measure(s) Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. Results In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a ‘large’ effect size. Conclusion Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy. PMID:26049544

  11. Translation of associative learning models into extinction reminders delivered via mobile phones during cue exposure interventions for substance use.

    Science.gov (United States)

    Rosenthal, M Zachary; Kutlu, Munir G

    2014-09-01

    Despite experimental findings and some treatment research supporting the use of cues as a means to induce and extinguish cravings, interventions using cue exposure have not been well integrated into contemporary substance abuse treatments. A primary problem with exposure-based interventions for addiction is that after learning not to use substances in the presence of addiction cues inside the clinic (i.e., extinction), stimuli in the naturalistic setting outside the clinic may continue to elicit craving, drug use, or other maladaptive conditioned responses. For exposure-based substance use interventions to be efficacious, new approaches are needed that can prevent relapse by directly generalizing learning from the therapeutic setting into naturalistic settings associated with a high risk for relapse. Basic research suggests that extinction reminders (ERs) can be paired with the context of learning new and more adaptive conditioned responses to substance abuse cues in exposure therapies for addiction. Using mobile phones and automated dialing and data collection software, ERs can be delivered in everyday high-risk settings to inhibit conditioned responses to substance-use-related stimuli. In this review, we describe how associative learning mechanisms (e.g., conditioned inhibition) can inform how ERs are conceptualized, learned, and implemented to prevent substance use when delivered via mobile phones. This approach, exposure with portable reminders of extinction, is introduced as an adjunctive intervention that uses brief automated ERs between clinic visits when individuals are in high-risk settings for drug use.

  12. Analysis of health behaviour change interventions for preventing dental caries delivered in primary schools.

    Science.gov (United States)

    Adair, P M; Burnside, G; Pine, C M

    2013-01-01

    To improve oral health in children, the key behaviours (tooth brushing and sugar control) responsible for development of dental caries need to be better understood, as well as how to promote these behaviours effectively so they become habitual; and, the specific, optimal techniques to use in interventions. The aim of this paper is to describe and analyse the behaviour change techniques that have been used in primary school-based interventions to prevent dental caries (utilizing a Cochrane systematic review that we have undertaken) and to identify opportunities for improving future interventions by incorporating a comprehensive range of behaviour change techniques. Papers of five interventions were reviewed and data were independently extracted. Results indicate that behaviour change techniques were limited to information-behaviour links, information on consequences, instruction and demonstration of behaviours. None of the interventions were based on behaviour change theory. We conclude that behaviour change techniques used in school interventions to reduce dental caries were limited and focused around providing information about how behaviour impacts on health and the consequences of not developing the correct health behaviours as well as providing oral hygiene instruction. Establishing which techniques are effective is difficult due to poor reporting of interventions in studies. Future design of oral health promotion interventions using behaviour change theory for development and evaluation (and reporting results in academic journals) could strengthen the potential for efficacy and provide a framework to use a much wider range of behaviour change techniques. Future studies should include development and publication of intervention manuals which is becoming standard practice in other health promoting programmes. © 2013 S. Karger AG, Basel.

  13. Telephone-delivered psychoeducational intervention for Hong Kong Chinese dementia caregivers: a single-blinded randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kwok T

    2013-09-01

    Full Text Available Timothy Kwok,1,2 Bel Wong,2 Isaac Ip,2 Kenny Chui,2 Daniel Young,2 Florence Ho2 1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region; 2Jockey Club Centre for Positive Ageing, Hong Kong, Special Administrative Region Purpose: Many family caregivers of persons with dementia (PWD are unable to participate in community center-based caregiver support services because of logistical constraints. This study evaluated the effectiveness of a telephone-delivered psychoeducational intervention for family caregivers of PWD in alleviating caregiver burden and enhancing caregiving self-efficacy. Subjects and methods: In a single-blinded randomized controlled trial, 38 family caregivers of PWD were randomly allocated into an intervention group or a control group. The intervention group received psychoeducation from a registered social worker over the phone for 12 sessions. Caregivers in the control group were given a DVD containing educational information about dementia caregiving. Outcomes of the intervention were measured by the Chinese versions of the Zarit Burden Interview and the Revised Scale for Caregiving Self-efficacy. Mann–Whitney U tests were used to compare the differences between the intervention and control groups. Results: The level of burden of caregivers in the intervention group reduced significantly compared with caregivers in the control group. Caregivers in the intervention group also reported significantly more gain in self-efficacy in obtaining respite than the control group. Conclusion: A structured telephone intervention can benefit dementia caregivers in terms of self-efficacy and caregiving burden. The limitations of the research and recommendations for intervention are discussed. Keywords: telephone intervention, psychoeducation, dementia caregivers

  14. The Development of a Design and Construction Process Protocol to Support the Home Modification Process Delivered by Occupational Therapists

    Directory of Open Access Journals (Sweden)

    Rachel Russell

    2018-01-01

    Full Text Available Modifying the home environments of older people as they age in place is a well-established health and social care intervention. Using design and construction methods to redress any imbalance caused by the ageing process or disability within the home environment, occupational therapists are seen as the experts in this field of practice. However, the process used by occupational therapists when modifying home environments has been criticised for being disorganised and not founded on theoretical principles and concepts underpinning the profession. To address this issue, research was conducted to develop a design and construction process protocol specifically for home modifications. A three-stage approach was taken for the analysis of qualitative data generated from an online survey, completed by 135 occupational therapists in the UK. Using both the existing occupational therapy intervention process model and the design and construction process protocol as the theoretical frameworks, a 4-phase, 9-subphase design and construction process protocol for home modifications was developed. Overall, the study is innovative in developing the first process protocol for home modifications, potentially providing occupational therapists with a systematic and effective approach to the design and delivery of home modification services for older and disabled people.

  15. The Development of a Design and Construction Process Protocol to Support the Home Modification Process Delivered by Occupational Therapists.

    Science.gov (United States)

    Russell, Rachel; Ormerod, Marcus; Newton, Rita

    2018-01-01

    Modifying the home environments of older people as they age in place is a well-established health and social care intervention. Using design and construction methods to redress any imbalance caused by the ageing process or disability within the home environment, occupational therapists are seen as the experts in this field of practice. However, the process used by occupational therapists when modifying home environments has been criticised for being disorganised and not founded on theoretical principles and concepts underpinning the profession. To address this issue, research was conducted to develop a design and construction process protocol specifically for home modifications. A three-stage approach was taken for the analysis of qualitative data generated from an online survey, completed by 135 occupational therapists in the UK. Using both the existing occupational therapy intervention process model and the design and construction process protocol as the theoretical frameworks, a 4-phase, 9-subphase design and construction process protocol for home modifications was developed. Overall, the study is innovative in developing the first process protocol for home modifications, potentially providing occupational therapists with a systematic and effective approach to the design and delivery of home modification services for older and disabled people.

  16. Overcoming recruitment challenges in construction safety intervention research.

    Science.gov (United States)

    Kidd, Pamela; Parshall, Mark; Wojcik, Susan; Struttmann, Tim

    2004-03-01

    Recruiting workers in small construction companies and securing their participation in voluntary safety programs or safety research poses unique challenges. Worker turnover and worksite changes contribute to difficulties in locating and enrolling participants. Economic pressures and time demands potentially threaten ongoing participation. Six simulation exercises designed to reduce back and fall injuries in small construction companies were developed based on data from focus groups of workers and company owners. Working with a workers' compensation insurer, we had access to owner-operators of general, heavy, and special trade construction companies reporting less than $10,000 in payroll expenses. Recruitment methods included a participation incentive, mailed invitations followed by phone contacts, and follow-up reminders. Despite using recruitment methods recommended in the literature, participation rates were low over a 2-year intervention period. Because of these difficulties, factors affecting participation or nonparticipation became an additional research focus. Owners' perceptions of already having a good safety record and of the time demands of participation were the most commonly cited reasons for not participating. Literature on recruitment emphasizes processes and procedures under investigator control rather than understanding potential participants' judgments about the adequacy of their existing practices and the potential benefits of intervention participation relative to potential time and productivity trade-offs. Greater attention to such judgments may enhance recruitment and participation in under-studied and difficult to access populations. Copyright 2004 Wiley-Liss, Inc.

  17. The Impact of Parent-Delivered Intervention on Parents of Very Young Children with Autism

    Science.gov (United States)

    Estes, Annette; Vismara, Laurie; Mercado, Carla; Fitzpatrick, Annette; Elder, Lauren; Greenson, Jessica; Lord, Catherine; Munson, Jeffrey; Winter, Jamie; Young, Gregory; Dawson, Geraldine; Rogers, Sally

    2014-01-01

    This study investigated the impact of a parent-coaching intervention based on the Early Start Denver Model (P-ESDM) on parenting-related stress and sense of competence. This was part of a multisite, randomized trial comparing P-ESDM (n = 49) with community intervention (n = 49) for children aged 12 and 24 months. The P-ESDM group reported no…

  18. Nurse-delivered counselling intervention for parental HIV disclosure: results from a pilot randomized controlled trial in China.

    Science.gov (United States)

    Simoni, Jane M; Yang, Joyce P; Shiu, Cheng-Shi; Chen, Wei-Ti; Udell, Wadiya; Bao, Meijuan; Zhang, Lin; Lu, Hongzhou

    2015-06-01

    The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. The study occurred at an outpatient HIV primary care centre in Shanghai, China. Participants were 20 HIV-positive outpatients with at least one child (13-25 years old) who was unaware of the parent's HIV diagnosis. The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy, and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a 'large' effect size. Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy.

  19. Randomized Controlled Trial of Nurse-Delivered Cognitive Behavioral Therapy Versus Supportive Psychotherapy Telehealth Interventions for Chronic Back Pain.

    Science.gov (United States)

    Rutledge, Thomas; Atkinson, J Hampton; Holloway, Rachael; Chircop-Rollick, Tatiana; D'Andrea, John; Garfin, Steven R; Patel, Shetal; Penzien, Donald B; Wallace, Mark; Weickgenant, Anne L; Slater, Mark

    2018-04-16

    This study evaluated a nurse-delivered, telehealth intervention of cognitive behavioral therapy versus supportive psychotherapy for chronic back pain. Participants (N=61) had chronic back pain (pain "daily" ≥ 6 months at an intensity ≥4/10 scale) and were randomized to an 8-week, 12-session, Cognitive Behavioral Therapy (CBT) or to Supportive Care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ). Secondary outcomes included the Numerical Rating Scale (NRS) and the Patient Global Impressions Scale (CGI). CBT participants (n=30) showed significant improvements on the RMDQ (means=11.4[5.9] vs. 9.4[6.1] at baseline and post-treatment, respectively, p.10). The results suggest that telehealth, nurse-delivered CBT and SC treatments for chronic back pain can offer significant and relatively comparable benefits. ClinicalTrials.gov: NCT00608530. This article describes the benefits of training primary care nurses to deliver evidence-based behavioral therapies for low back pain. Due to the high prevalence of chronic pain and the growing emphasis on non-opioid therapies, training nurses to provide behavior therapies could be a cost-effective way to improve pain management. Copyright © 2018. Published by Elsevier Inc.

  20. Parent-Mediated Intervention Training Delivered Remotely for Children With Autism Spectrum Disorder Living Outside of Urban Areas: Systematic Review.

    Science.gov (United States)

    Parsons, Dave; Cordier, Reinie; Vaz, Sharmila; Lee, Hoe C

    2017-08-14

    Parent training programs for families living outside of urban areas can be used to improve the social behavior and communication skills in children with autism spectrum disorder (ASD). However, no review has been conducted to investigate these programs. The aim of this study was to (1) systematically review the existing evidence presented by studies on parent-mediated intervention training, delivered remotely for parents having children with ASD and living outside of urban areas; (2) provide an overview of current parent training interventions used with this population; (3) and provide an overview of the method of delivery of the parent training interventions used with this population. Guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, we conducted a comprehensive review across 5 electronic databases (CINAHL, Embase, ERIC, PsycINFO, and Pubmed) on July 4, 2016, searching for studies investigating parent-mediated intervention training for families living outside of urban centers who have a child diagnosed with ASD. Two independent researchers reviewed the articles for inclusion, and assessment of methodological quality was based on the Kmet appraisal checklist. Seven studies met the eligibility criteria, including 2 prepost cohort studies, 3 multiple baseline studies, and 2 randomized controlled trials (RCTs). Interventions included mostly self-guided websites: with and without therapist assistance (n=6), with training videos, written training manuals, and videoconferencing. Post intervention, studies reported significant improvements (P<.05) in parent knowledge (n=4), parent intervention fidelity (n=6), and improvements in children's social behavior and communication skills (n=3). A high risk of bias existed within all of the studies because of a range of factors including small sample sizes, limited use of standardized outcome measures, and a lack of control groups to negate confounding factors. There is

  1. Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

    Science.gov (United States)

    Macpherson, Eleanor E; Adams, Emily R; Bockarie, Moses J; Hollingsworth, T Deirdre; Kelly-Hope, Louise A; Lehane, Mike; Kovacic, Vanja; Harrison, Robert A; Paine, Mark Ji; Reimer, Lisa J; Torr, Stephen J

    2015-01-01

    Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs.

  2. Training pharmacists to deliver a complex information technology intervention (PINCER) using the principles of educational outreach and root cause analysis.

    Science.gov (United States)

    Sadler, Stacey; Rodgers, Sarah; Howard, Rachel; Morris, Caroline J; Avery, Anthony J

    2014-02-01

    To describe the training undertaken by pharmacists employed in a pharmacist-led information technology-based intervention study to reduce medication errors in primary care (PINCER Trial), evaluate pharmacists' assessment of the training, and the time implications of undertaking the training. Six pharmacists received training, which included training on root cause analysis and educational outreach, to enable them to deliver the PINCER Trial intervention. This was evaluated using self-report questionnaires at the end of each training session. The time taken to complete each session was recorded. Data from the evaluation forms were entered onto a Microsoft Excel spreadsheet, independently checked and the summary of results further verified. Frequencies were calculated for responses to the three-point Likert scale questions. Free-text comments from the evaluation forms and pharmacists' diaries were analysed thematically. All six pharmacists received 22 h of training over five sessions. In four out of the five sessions, the pharmacists who completed an evaluation form (27 out of 30 were completed) stated they were satisfied or very satisfied with the various elements of the training package. Analysis of free-text comments and the pharmacists' diaries showed that the principles of root cause analysis and educational outreach were viewed as useful tools to help pharmacists conduct pharmaceutical interventions in both the study and other pharmacy roles that they undertook. The opportunity to undertake role play was a valuable part of the training received. Findings presented in this paper suggest that providing the PINCER pharmacists with training in root cause analysis and educational outreach contributed to the successful delivery of PINCER interventions and could potentially be utilised by other pharmacists based in general practice to deliver pharmaceutical interventions to improve patient safety. © 2013 The Authors. IJPP © 2013 Royal Pharmaceutical Society.

  3. Primary Care Provider-Delivered Smoking Cessation Interventions and Smoking Cessation Among Participants in the National Lung Screening Trial.

    Science.gov (United States)

    Park, Elyse R; Gareen, Ilana F; Japuntich, Sandra; Lennes, Inga; Hyland, Kelly; DeMello, Sarah; Sicks, JoRean D; Rigotti, Nancy A

    2015-09-01

    The National Lung Screening Trial (NLST) found a reduction in lung cancer mortality among participants screened with low-dose computed tomography vs chest radiography. In February 2015, Medicare announced its decision to cover annual lung screening for patients with a significant smoking history. These guidelines promote smoking cessation treatment as an adjunct to screening, but the frequency and effectiveness of clinician-delivered smoking cessation interventions delivered after lung screening are unknown. To determine the association between the reported clinician-delivered 5As (ask, advise, assess, assist [talk about quitting or recommend stop-smoking medications or recommend counseling], and arrange follow-up) after lung screening and smoking behavior changes. A matched case-control study (cases were quitters and controls were continued smokers) of 3336 NLST participants who were smokers at enrollment examined participants' rates and patterns of 5A delivery after a lung screen and reported smoking cessation behaviors. Prevalence of the clinician-delivered 5As and associated smoking cessation after lung screening. Delivery of the 5As 1 year after screening were as follows: ask, 77.2%; advise, 75.6%; assess, 63.4%; assist, 56.4%; and arrange follow-up, 10.4%. Receipt of ask, advise, and assess was not significantly associated with quitting in multivariate models that adjusted for sociodemographic characteristics, medical history, screening results, nicotine dependence, and motivation to quit. Assist was associated with a 40% increase in the odds of quitting (odds ratio, 1.40; 95% CI, 1.21-1.63), and arrange was associated with a 46% increase in the odds of quitting (odds ratio, 1.46; 95% CI, 1.19-1.79). Assist and arrange follow-up delivered by primary care providers to smokers who were participating in the NLST were associated with increased quitting; less intensive interventions (ask, advise, and assess) were not. However, rates of assist and arrange

  4. A Peer-Delivered Social Interaction Intervention for High School Students with Autism

    Science.gov (United States)

    Hughes, Carolyn; Harvey, Michelle; Cosgriff, Joseph; Reilly, Caitlin; Heilingoetter, Jamie; Brigham, Nicolette; Kaplan, Lauren; Bernstein, Rebekah

    2013-01-01

    Limited social interaction typically occurs between high school students with autism and their general education peers unless programming is introduced to promote interaction. However, few published social interaction interventions have been conducted among high school students with autism and their general education classmates. Such studies…

  5. Employment and Satisfaction Outcomes From a Job Retention Intervention Delivered to Persons with Chronic Diseases

    Science.gov (United States)

    Allaire, Saralynn H.; Niu, Jingbo; LaValley, Michael P.

    2005-01-01

    Job retention services are recommended for people with chronic diseases based on their high risk for work disability. This randomized trial tested the effectiveness of a job retention intervention in a sample of employed persons with rheumatic diseases at risk for work disability. One hundred and twenty-two experimental participants received the…

  6. Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service

    Directory of Open Access Journals (Sweden)

    Devescovi R

    2016-06-01

    Full Text Available Raffaella Devescovi,1 Lorenzo Monasta,2 Alice Mancini,3 Maura Bin,1 Valerio Vellante,1 Marco Carrozzi,1 Costanza Colombi4 1Division of Child Neurology and Psychiatry, 2Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, 3Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 4Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA Background: Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM, can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System.Methods: Twenty-one toddlers at risk for autism spectrum disorders, aged 20–36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents’ and teachers’ active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months and post-intervention (Time 1 [T1]; mean age =42 months.Results: Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment.Conclusion: Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children

  7. Using mobile phones and short message service to deliver self-management interventions for chronic conditions: a meta-review.

    Science.gov (United States)

    Jones, Katherine R; Lekhak, Nirmala; Kaewluang, Napatsawan

    2014-04-01

    The worldwide burden of chronic disease is widespread and growing. This shift from acute to chronic care requires rethinking how resources are invested in managing these conditions. One response has been to create programs and interventions that have the goal of helping patients better manage their own conditions. Over time, these self-management interventions and strategies have increasingly relied on various technologies for their implementation, with the newest technology being mobile phones and short message service (SMS). The objective of this meta-review was to evaluate the current evidence on the use of mobile phones and SMS to deliver self-management interventions for chronic conditions. A meta-review was conducted of the 11 systematic reviews (SRs) that were identified and retrieved after an extensive search of electronic databases covering the years 2000-2012. Relevant information was abstracted from each systematic review and a quality assessment carried out using the AMSTAR ("A Measurement Tool to Assess Systematic Reviews") criteria. The number and types of included studies and total number of subjects varied significantly across the systematic reviews. Mobile phone text messaging was reported to significantly improve adherence to appointments and antiretroviral therapy, short-term smoking quit rates, and selected clinical and behavioral outcomes. AMSTAR scores ranged from 11 to 3, reflecting substantial variation in SR quality. Mobile phones and SMS show promise as a technology to deliver self-management interventions to improve outcomes of chronic care management. However, the quality of future studies and systematic reviews needs to be improved. There also are unresolved issues about the technology itself. © 2014 Sigma Theta Tau International.

  8. Understanding reactions to an internet-delivered health-care intervention: accommodating user preferences for information provision.

    Science.gov (United States)

    Yardley, Lucy; Morrison, Leanne G; Andreou, Panayiota; Joseph, Judith; Little, Paul

    2010-09-17

    It is recognised as good practice to use qualitative methods to elicit users' views of internet-delivered health-care interventions during their development. This paper seeks to illustrate the advantages of combining usability testing with 'theoretical modelling', i.e. analyses that relate the findings of qualitative studies during intervention development to social science theory, in order to gain deeper insights into the reasons and context for how people respond to the intervention. This paper illustrates how usability testing may be enriched by theoretical modelling by means of two qualitative studies of users' views of the delivery of information in an internet-delivered intervention to help users decide whether they needed to seek medical care for their cold or flu symptoms. In Study 1, 21 participants recruited from a city in southern England were asked to 'think aloud' while viewing draft web-pages presented in paper format. In Study 2, views of our prototype website were elicited, again using think aloud methods, in a sample of 26 participants purposively sampled for diversity in education levels. Both data-sets were analysed by thematic analysis. Study 1 revealed that although the information provided by the draft web-pages had many of the intended empowering benefits, users often felt overwhelmed by the quantity of information. Relating these findings to theory and research on factors influencing preferences for information-seeking we hypothesised that to meet the needs of different users (especially those with lower literacy levels) our website should be designed to provide only essential personalised advice, but with options to access further information. Study 2 showed that our website design did prove accessible to users with different literacy levels. However, some users seemed to want still greater control over how information was accessed. Educational level need not be an insuperable barrier to appreciating web-based access to detailed health

  9. Efficacy of a Nurse-Delivered Intervention to Prevent and Delay Postpartum Return to Smoking: The Quit for Two Trial.

    Science.gov (United States)

    Pollak, Kathryn I; Fish, Laura J; Lyna, Pauline; Peterson, Bercedis L; Myers, Evan R; Gao, Xiaomei; Swamy, Geeta K; Brown-Johnson, Angela; Whitecar, Paul; Bilheimer, Alicia K; Pletsch, Pamela K

    2016-10-01

    Most pregnant women who quit smoking return to smoking postpartum. Trials to prevent this return have been unsuccessful. We tested the efficacy of a nurse-delivered intervention in maintaining smoking abstinence after delivery among pregnant women who quit smoking that was tailored on their high risk of relapse (eg, had strong intentions to return). We recruited 382 English-speaking spontaneous pregnant quitters from 14 prenatal clinics and randomized them to receive either a smoking abstinence booklet plus newsletters about parenting and stress (control) or a nurse-delivered smoking abstinence intervention that differed in intensity for the high and low risk groups. Our primary outcome was smoking abstinence at 12 months postpartum. Using intent-to-treat analyses, there was a high rate of biochemically validated smoking abstinence at 12 months postpartum but no arm differences ( 36% [95% confidence interval [CI]: 29-43] vs. 35% [95% CI: 28-43], P = .81). Among women at low risk of returning to smoking, the crude abstinence rate was significantly higher in the control arm (46%) than in the intervention arm (33%); among women at high risk of returning to smoking, the crude abstinence rate was slightly lower but not different in the control arm (31%) than in the intervention arm (37%). Low-risk women fared better with a minimal intervention that focused on parenting skills and stress than when they received an intensive smoking abstinence intervention. The opposite was true for women who were at high risk of returning to smoking. Clinicians might need to tailor their approach based on whether women are at high or low risk of returning to smoking. Results suggest that high-risk and low-risk women might benefit from different types of smoking relapse interventions. Those who are lower risk of returning to smoking might benefit from stress reduction that is devoid of smoking content, whereas those who are higher risk might benefit from smoking relapse prevention. © The

  10. The Effects of a Peer-Delivered Social Skills Intervention for Adults with Comorbid Down Syndrome and Autism Spectrum Disorder.

    Science.gov (United States)

    Davis, Matthew A Cody; Spriggs, Amy; Rodgers, Alexis; Campbell, Jonathan

    2018-06-01

    Deficits in social skills are often exhibited in individuals with comorbid Down syndrome (DS) and autism spectrum disorder (ASD), and there is a paucity of research to help guide intervention for this population. In the present study, a multiple probe study across behaviors, replicated across participants, assessed the effectiveness of peer-delivered simultaneous prompting in teaching socials skills to adults with DS-ASD using visual analysis techniques and Tau-U statistics to measure effect. Peer-mediators with DS and intellectual disability (ID) delivered simultaneous prompting sessions reliably (i.e., > 80% reliability) to teach social skills to adults with ID and a dual-diagnoses of DS-ASD with small (Tau Weighted  = .55, 90% CI [.29, .82]) to medium effects (Tau Weighted  = .75, 90% CI [.44, 1]). Statistical and visual analysis findings suggest a promising social skills intervention for individuals with DS-ASD as well as reliable delivery of simultaneous prompting procedures by individuals with DS.

  11. Long-term Outcomes of a Cell Phone–Delivered Intervention for Smokers Living With HIV/AIDS

    Science.gov (United States)

    Gritz, Ellen R.; Danysh, Heather E.; Fletcher, Faith E.; Tami-Maury, Irene; Fingeret, Michelle Cororve; King, Rachel Marks; Arduino, Roberto C.; Vidrine, Damon J.

    2013-01-01

    Background. People living with human immunodeficiency virus (HIV)/AIDS (PLWHA) have a substantially higher prevalence of cigarette smoking compared to the general population. In addition, PLWHA are particularly susceptible to the adverse health effects of smoking. Our primary objective was to design and test the efficacy over 12 months of a smoking cessation intervention targeting PLWHA. Methods. Participants were enrolled from an urban HIV clinic with a multiethnic and economically disadvantaged patient population. Participants received smoking cessation treatment either through usual care (UC) or counseling delivered by a cell phone intervention (CPI). The 7-day point prevalence abstinence was evaluated at 3, 6, and 12 months using logistic regression and generalized linear mixed models. Results. We randomized 474 HIV-positive smokers to either the UC or CPI group. When evaluating the overall treatment effect (7-day abstinence outcomes from 3-, 6-, and 12-month follow-ups), participants in the CPI group were 2.41 times (P = .049) more likely to demonstrate abstinence compared to the UC group. The treatment effect was strongest at the 3-month follow-up (odds ratio = 4.3, P .05). Conclusions. Cell phone–delivered smoking cessation treatment has a positive impact on abstinence rates compared to a usual care approach. Future research should focus on strategies for sustaining the treatment effect in the long term. PMID:23704120

  12. Long-term outcomes of a cell phone-delivered intervention for smokers living with HIV/AIDS.

    Science.gov (United States)

    Gritz, Ellen R; Danysh, Heather E; Fletcher, Faith E; Tami-Maury, Irene; Fingeret, Michelle Cororve; King, Rachel Marks; Arduino, Roberto C; Vidrine, Damon J

    2013-08-01

    People living with human immunodeficiency virus (HIV)/AIDS (PLWHA) have a substantially higher prevalence of cigarette smoking compared to the general population. In addition, PLWHA are particularly susceptible to the adverse health effects of smoking. Our primary objective was to design and test the efficacy over 12 months of a smoking cessation intervention targeting PLWHA. Participants were enrolled from an urban HIV clinic with a multiethnic and economically disadvantaged patient population. Participants received smoking cessation treatment either through usual care (UC) or counseling delivered by a cell phone intervention (CPI). The 7-day point prevalence abstinence was evaluated at 3, 6, and 12 months using logistic regression and generalized linear mixed models. We randomized 474 HIV-positive smokers to either the UC or CPI group. When evaluating the overall treatment effect (7-day abstinence outcomes from 3-, 6-, and 12-month follow-ups), participants in the CPI group were 2.41 times (P = .049) more likely to demonstrate abstinence compared to the UC group. The treatment effect was strongest at the 3-month follow-up (odds ratio = 4.3, P .05). Cell phone-delivered smoking cessation treatment has a positive impact on abstinence rates compared to a usual care approach. Future research should focus on strategies for sustaining the treatment effect in the long term.

  13. Enhancing Intervention for Residual Rhotic Errors Via App-Delivered Biofeedback: A Case Study.

    Science.gov (United States)

    Byun, Tara McAllister; Campbell, Heather; Carey, Helen; Liang, Wendy; Park, Tae Hong; Svirsky, Mario

    2017-06-22

    Recent research suggests that visual-acoustic biofeedback can be an effective treatment for residual speech errors, but adoption remains limited due to barriers including high cost and lack of familiarity with the technology. This case study reports results from the first participant to complete a course of visual-acoustic biofeedback using a not-for-profit iOS app, Speech Therapist's App for /r/ Treatment. App-based biofeedback treatment for rhotic misarticulation was provided in weekly 30-min sessions for 20 weeks. Within-treatment progress was documented using clinician perceptual ratings and acoustic measures. Generalization gains were assessed using acoustic measures of word probes elicited during baseline, treatment, and maintenance sessions. Both clinician ratings and acoustic measures indicated that the participant significantly improved her rhotic production accuracy in trials elicited during treatment sessions. However, these gains did not transfer to generalization probes. This study provides a proof-of-concept demonstration that app-based biofeedback is a viable alternative to costlier dedicated systems. Generalization of gains to contexts without biofeedback remains a challenge that requires further study. App-delivered biofeedback could enable clinician-research partnerships that would strengthen the evidence base while providing enhanced treatment for children with residual rhotic errors. https://doi.org/10.23641/asha.5116318.

  14. Using Videoconferencing to Deliver Individual Therapy and Pediatric Psychology Interventions with Children and Adolescents.

    Science.gov (United States)

    Nelson, Eve-Lynn; Patton, Susana

    2016-04-01

    Because of the widening access gap between need for individual and pediatric psychology services and child specialist availability, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. The authors summarize real-time videoconferencing evidence to date across individual therapy with children and pediatric psychology interventions using videoconferencing. The authors summarize emerging guidelines that inform best practices for individual child therapy over videoconferencing. The authors present three case examples to illustrate best practices. The first behavioral pediatrics case summarizes evidence-based approaches in treating a rural young adolescent with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and hearing impairment. The second pediatric psychology case describes similarities and difference between on-site and videoconferencing services in treating a rural child with toileting concerns. The third adolescent case describes treatment of an urban honors student with depression. Videoconferencing is an effective approach to improving access to individual and pediatric psychology interventions for children and adolescents. Videoconferencing approaches are well accepted by families and show promise for disseminating evidence-based treatments to underserved communities.

  15. Evaluating a complex system-wide intervention using the difference in differences method: the Delivering Choice Programme.

    Science.gov (United States)

    Round, Jeff; Drake, Robyn; Kendall, Edward; Addicott, Rachael; Agelopoulos, Nicky; Jones, Louise

    2015-03-01

    We report the use of difference in differences (DiD) methodology to evaluate a complex, system-wide healthcare intervention. We use the worked example of evaluating the Marie Curie Delivering Choice Programme (DCP) for advanced illness in a large urban healthcare economy. DiD was selected because a randomised controlled trial was not feasible. The method allows for before and after comparison of changes that occur in an intervention site with a matched control site. This enables analysts to control for the effect of the intervention in the absence of a local control. Any policy, seasonal or other confounding effects over the test period are assumed to have occurred in a balanced way at both sites. Data were obtained from primary care trusts. Outcomes were place of death, inpatient admissions, length of stay and costs. Small changes were identified between pre- and post-DCP outputs in the intervention site. The proportion of home deaths and median cost increased slightly, while the number of admissions per patient and the average length of stay per admission decreased slightly. None of these changes was statistically significant. Effects estimates were limited by small numbers accessing new services and selection bias in sample population and comparator site. In evaluating the effect of a complex healthcare intervention, the choice of analysis method and output measures is crucial. Alternatives to randomised controlled trials may be required for evaluating large scale complex interventions and the DiD approach is suitable, subject to careful selection of measured outputs and control population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Parent-delivered early intervention in infants at risk for ASD: Effects on electrophysiological and habituation measures of social attention.

    Science.gov (United States)

    Jones, Emily J H; Dawson, Geraldine; Kelly, Jean; Estes, Annette; Jane Webb, Sara

    2017-05-01

    Prospective longitudinal studies of infants with older siblings with autism spectrum disorder (ASD) have indicated that differences in the neurocognitive systems underlying social attention may emerge prior to the child meeting ASD diagnostic criteria. Thus, targeting social attention with early intervention might have the potential to alter developmental trajectories for infants at high risk for ASD. Electrophysiological and habituation measures of social attention were collected at 6, 12, and 18 months in a group of high-risk infant siblings of children with ASD (N = 33). Between 9 and 11 months of age, infant siblings received a parent-delivered intervention, promoting first relationships (PFR), (n = 19) or on-going assessment without intervention (n = 14). PFR has been previously shown to increase parental responsivity to infant social communicative cues and infant contingent responding. Compared to infants who only received assessment and monitoring, infants who received the intervention showed improvements in neurocognitive metrics of social attention, as reflected in a greater reduction in habituation times to face versus object stimuli between 6 and 12 months, maintained at 18 months; a greater increase in frontal EEG theta power between 6 and 12 months; and a more comparable P400 response to faces and objects at 12 months. The high-risk infants who received the intervention showed a pattern of responses that appeared closer to the normative responses of two groups of age-matched low-risk control participants. Though replication is necessary, these results suggest that early parent-mediated intervention has the potential to impact the brain systems underpinning social attention in infants at familial risk for ASD. Autism Res 2017, 10: 961-972. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

  17. A cluster randomized pilot trial of a tailored worksite smoking cessation intervention targeting Hispanic/Latino construction workers: Intervention development and research design.

    Science.gov (United States)

    Asfar, Taghrid; Caban-Martinez, Alberto J; McClure, Laura A; Ruano-Herreria, Estefania C; Sierra, Danielle; Gilford Clark, G; Samano, Daniel; Dietz, Noella A; Ward, Kenneth D; Arheart, Kristopher L; Lee, David J

    2018-04-01

    Construction workers have the highest smoking rate among all occupations (39%). Hispanic/Latino workers constitute a large and increasing group in the US construction industry (over 2.6 million; 23% of all workers). These minority workers have lower cessation rates compared to other groups due to their limited access to cessation services, and lack of smoking cessation interventions adapted to their culture and work/life circumstances. Formative research was conducted to create an intervention targeting Hispanic/Latino construction workers. This paper describes the intervention development and the design, methods, and data analysis plans for an ongoing cluster pilot two-arm randomized controlled trial comparing an Enhanced Care worksite cessation program to Standard Care. Fourteen construction sites will be randomized to either Enhanced Care or Standard Care and 126 participants (63/arm) will be recruited. In both arms, recruitment and intervention delivery occur around "food trucks" that regularly visit the construction sites. Participants at Enhanced Care sites will receive the developed intervention consisting of a single face-to-face group counseling session, 2 phone calls, and a fax referral to Florida tobacco quitline (QL). Participants at Standard Care sites will receive a fax referral to the QL. Both groups will receive eight weeks of nicotine replacement treatment and two follow-up assessments at three and six months. Feasibility outcomes are estimated recruitment yield, barriers to delivering the intervention onsite, and rates of adherence/compliance to the intervention, follow-ups, and QL enrollment. Efficacy outcomes are point-prevalence and prolonged abstinence rates at six month follow-up confirmed by saliva cotinine <15 ng/ml. Copyright © 2018. Published by Elsevier Inc.

  18. Economic evaluation of a Child Health Days strategy to deliver multiple maternal and child health interventions in Somalia.

    Science.gov (United States)

    Vijayaraghavan, Maya; Wallace, Aaron; Mirza, Imran Raza; Kamadjeu, Raoul; Nandy, Robin; Durry, Elias; Everard, Marthe

    2012-03-01

    Child Health Days (CHDs) are increasingly used by countries to periodically deliver multiple maternal and child health interventions as time-limited events, particularly to populations not reached by routine health services. In countries with a weak health infrastructure, this strategy could be used to reach many underserved populations with an integrated package of services. In this study, we estimate the incremental costs, impact, cost-effectiveness, and return on investment of 2 rounds of CHDs that were conducted in Somalia in 2009 and 2010. We use program costs and population estimates reported by the World Health Organization and United Nations Children's Fund to estimate the average cost per beneficiary for each of 9 interventions delivered during 2 rounds of CHDs implemented during the periods of December 2008 to May 2009 and August 2009 to April 2010. Because unstable areas were unreachable, we calculated costs for targeted and accessible beneficiaries. We model the impact of the CHDs on child mortality using the Lives Saved Tool, convert these estimates of mortality reduction to life years saved, and derive the cost-effectiveness ratio and the return on investment. The estimated average incremental cost per intervention for each targeted beneficiary was $0.63, with the cost increasing to $0.77 per accessible beneficiary. The CHDs were estimated to save the lives of at least 10,000, or 500,000 life years for both rounds combined. The CHDs were cost-effective at $34.00/life year saved. For every $1 million invested in the strategy, an estimated 615 children's lives, or 29,500 life years, were saved. If the pentavalent vaccine had been delivered during the CHDs instead of diphtheria-pertussis-tetanus vaccine, an additional 5000 children's lives could have been saved. Despite high operational costs, CHDs are a very cost-effective service delivery strategy for addressing the leading causes of child mortality in a conflict setting like Somalia and compare

  19. Training Teachers to Deliver Mindfulness-Based Interventions: Learning from the UK Experience.

    Science.gov (United States)

    Crane, Rebecca S; Kuyken, Willem; Hastings, Richard P; Rothwell, Neil; Williams, J Mark G

    2010-06-01

    Several randomised controlled trials suggest that mindfulness-based approaches are helpful in preventing depressive relapse and recurrence, and the UK Government's National Institute for Health and Clinical Excellence has recommended these interventions for use in the National Health Service. There are good grounds to suggest that mindfulness-based approaches are also helpful with anxiety disorders and a range of chronic physical health problems, and there is much clinical and research interest in applying mindfulness approaches to other populations and problems such as people with personality disorders, substance abuse, and eating disorders. We review the UK context for developments in mindfulness-based approaches and set out criteria for mindfulness teacher competence and training steps, as well as some of the challenges and future directions that can be anticipated in ensuring that evidence-based mindfulness approaches are available in health care and other settings.

  20. The feasibility and impact of delivering a mind-body intervention in a virtual world.

    Science.gov (United States)

    Hoch, Daniel B; Watson, Alice J; Linton, Deborah A; Bello, Heather E; Senelly, Marco; Milik, Mariola T; Baim, Margaret A; Jethwani, Kamal; Fricchione, Gregory L; Benson, Herbert; Kvedar, Joseph C

    2012-01-01

    Mind-body medical approaches may ameliorate chronic disease. Stress reduction is particularly helpful, but face-to-face delivery systems cannot reach all those who might benefit. An online, 3-dimensional virtual world may be able to support the rich interpersonal interactions required of this approach. In this pilot study, we explore the feasibility of translating a face-to-face stress reduction program into an online virtual setting and estimate the effect size of the intervention. Domain experts in virtual world technology joined with mind body practitioners to translate an existing 8 week relaxation response-based resiliency program into an 8-week virtual world-based program in Second Life™ (SL). Twenty-four healthy volunteers with at least one month's experience in SL completed the program. Each subject filled out the Perceived Stress Scale (PSS) and the Symptom Checklist 90- Revised (SCL-90-R) before and after taking part. Participants took part in one of 3 groups of about 10 subjects. The participants found the program to be helpful and enjoyable. Many reported that the virtual environment was an excellent substitute for the preferred face-to-face approach. On quantitative measures, there was a general trend toward decreased perceived stress, (15.7 to 15.0), symptoms of depression, (57.6 to 57.0) and anxiety (56.8 to 54.8). There was a significant decrease of 2.8 points on the SCL-90-R Global Severity Index (pmind-body medical intervention through a virtual environment and that it is well received. Moreover, the small reduction in psychological distress suggests further research is warranted. Based on the data collected for this project, a randomized trial with less than 50 subjects would be appropriately powered if perceived stress is the primary outcome.

  1. Cost-effectiveness of peer-delivered interventions for cocaine and alcohol abuse among women: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Jennifer Prah Ruger

    Full Text Available To determine whether the additional interventions to standard care are cost-effective in addressing cocaine and alcohol abuse at 4 months (4 M and 12 months (12 M from baseline.We conducted a cost-effectiveness analysis of a randomized controlled trial with three arms: (1 NIDA's Standard intervention (SI; (2 SI plus a Well Woman Exam (WWE; and, (3 SI, WWE, plus four Educational Sessions (4ES.To obtain an additional cocaine abstainer, WWE compared to SI cost $7,223 at 4 M and $3,611 at 12 M. Per additional alcohol abstainer, WWE compared to SI cost $3,611 and $7,223 at 4 M and 12 M, respectively. At 12 M, 4ES was dominated (more costly and less effective by WWE for abstinence outcomes.To our knowledge, this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women. Depending on primary outcomes sought and priorities of policy makers, peer-delivered interventions can be a cost-effective way to address the needs of this growing, underserved population.ClinicalTrials.gov NCT01235091.

  2. A Randomized Educational Intervention Trial to Determine the Effect of Online Education on the Quality of Resident-Delivered Care.

    Science.gov (United States)

    Dolan, Brigid M; Yialamas, Maria A; McMahon, Graham T

    2015-09-01

    There is limited research on whether online formative self-assessment and learning can change the behavior of medical professionals. We sought to determine if an adaptive longitudinal online curriculum in bone health would improve resident physicians' knowledge, and change their behavior regarding prevention of fragility fractures in women. We used a randomized control trial design in which 50 internal medicine resident physicians at a large academic practice were randomized to either receive a standard curriculum in bone health care alone, or to receive it augmented with an adaptive, longitudinal, online formative self-assessment curriculum delivered via multiple-choice questions. Outcomes were assessed 10 months after the start of the intervention. Knowledge outcomes were measured by a multiple-choice question examination. Clinical outcomes were measured by chart review, including bone density screening rate, calculation of the fracture risk assessment tool (FRAX) score, and rate of appropriate bisphosphonate prescription. Compared to the control group, residents participating in the intervention had higher scores on the knowledge test at the end of the study. Bone density screening rates and appropriate use of bisphosphonates were significantly higher in the intervention group compared with the control group. FRAX score reporting did not differ between the groups. Residents participating in a novel adaptive online curriculum outperformed peers in knowledge of fragility fracture prevention and care practices to prevent fracture. Online adaptive education can change behavior to improve patient care.

  3. 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

  4. Who will deliver comprehensive healthy lifestyle interventions to combat non-communicable disease? Introducing the healthy lifestyle practitioner discipline.

    Science.gov (United States)

    Arena, Ross; Lavie, Carl J; Hivert, Marie-France; Williams, Mark A; Briggs, Paige D; Guazzi, Marco

    2016-01-01

    Unhealthy lifestyle characteristics (i.e., physical inactivity, excess body mass, poor diet, and smoking) as well as associated poor health metrics (i.e., dyslipidemia, hyperglycemia, and hypertension) are the primary reasons for the current non-communicable disease crisis. Compared to those with the poorest of lifestyles and associated health metrics, any movement toward improving lifestyle and associated health metrics improves health outcomes. To address the non-communicable disease crisis we must: 1) acknowledge that healthy lifestyle (HL) interventions are a potent medicine; and 2) move toward a healthcare system that embraces primordial as much as, if not more than, secondary prevention with a heavy focus on HL medicine. This article introduces the Healthy Lifestyle Practitioner, focused on training health professionals to deliver HL medicine.

  5. Teacher-delivered resilience-focused intervention in schools with traumatized children following the second Lebanon War.

    Science.gov (United States)

    Wolmer, Leo; Hamiel, Daniel; Barchas, Jack D; Slone, Michelle; Laor, Nathaniel

    2011-06-01

    The 2006 Lebanon War exposed children in the north of Israel to daily rocket attacks. To cope with the massive psychological needs, a teacher-delivered protocol focusing on enhancing personal resilience was implemented. Children were assessed for risk factors, symptoms, and adaptation before the 16-week program (Time 1; n = 983) and after its completion (Time 2; n = 563). At a 3-month follow-up (Time 3; n = 754) children were assessed together with a waiting-list comparison group (n = 1,152). Participating children showed a significant symptom decrease at Time 2 and significantly fewer symptoms than the control group at Time 3. Six or more risk factors were associated with greater symptoms and parental concern about the child's adaptive functioning. Teachers are valuable cost-effective providers for clinically informed interventions after mass trauma and disaster. Copyright © 2011 International Society for Traumatic Stress Studies.

  6. A Web-Based, Social Networking Physical Activity Intervention for Insufficiently Active Adults Delivered via Facebook App: Randomized Controlled Trial.

    Science.gov (United States)

    Maher, Carol; Ferguson, Monika; Vandelanotte, Corneel; Plotnikoff, Ron; De Bourdeaudhuij, Ilse; Thomas, Samantha; Nelson-Field, Karen; Olds, Tim

    2015-07-13

    Online social networks offer considerable potential for delivery of socially influential health behavior change interventions. To determine the efficacy, engagement, and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app. A total of 110 adults with a mean age of 35.6 years (SD 12.4) were recruited online in teams of 3 to 8 friends. Teams were randomly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring, social elements, and pedometers ("Active Team" Facebook app; n=51 individuals, 12 teams) or a wait-listed control condition (n=59 individuals, 13 teams). Assessments were undertaken online at baseline, 8 weeks, and 20 weeks. The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity (MVPA). Secondary outcomes were weekly walking, vigorous physical activity time, moderate physical activity time, overall quality of life, and mental health quality of life. Analyses were undertaken using random-effects mixed modeling, accounting for potential clustering at the team level. Usage statistics were reported descriptively to determine engagement and feasibility. At the 8-week follow-up, the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group (P=.03), due primarily to increases in walking time (155 min/week increase relative to controls, Plife or mental health quality of life at either time point. High levels of engagement with the intervention, and particularly the self-monitoring features, were observed. An online, social networking physical activity intervention with pedometers can produce sizable short-term physical activity changes. Future work is needed to determine how to maintain behavior change in the longer term, how to reach at-need populations, and how to disseminate such interventions on a mass scale. Australian New Zealand

  7. CanPrevent: a telephone-delivered intervention to reduce multiple behavioural risk factors for colorectal cancer

    Directory of Open Access Journals (Sweden)

    Hawkes Anna L

    2012-11-01

    Full Text Available Abstract Background This pilot study aimed to test the acceptability and short-term effectiveness of a telephone-delivered multiple health behaviour change intervention for relatives of colorectal cancer survivors. Methods A community-based sample of 22 first-degree relatives of colorectal cancer survivors were recruited via a media release. Data were collected at baseline and at six weeks (post-intervention. Outcome measures included health behaviours (physical activity, television viewing, diet, alcohol, body mass index, waist circumference and smoking, health-related quality of life (Short Form-36 and perceived colorectal cancer risk. Intervention satisfaction levels were also measured. The intervention included six telephone health coaching sessions, a participant handbook and a pedometer. It focused on behavioural risk factors for colorectal cancer [physical activity, diet (red and processed meat consumption, fruit and vegetable intake, alcohol, weight management and smoking], and colorectal cancer risk. Results From baseline to six weeks, improvements were observed for minutes moderate-vigorous physical activity (150.7 minutes, processed meat intake (−1.2 serves/week, vegetable intake (1 serve/day, alcohol intake (−0.4 standard drinks/day, body mass index (−1.4 kg/m2, and waist circumference (−5.1 cm. Improvements were also observed for physical (3.3 and mental (4.4 health-related quality of life. Further, compared with baseline, participants were more likely to meet Australian recommendations post-intervention for: moderate-vigorous physical activity (27.3 vs 59.1%; fruit intake (68.2 vs 81.8%; vegetable intake (4.6 vs 18.2%; alcohol consumption (59.1 vs 72.7%; body mass index (31.8 vs 45.5% and waist circumference (18.2 vs 27.3%. At six weeks participants were more likely to believe a diagnosis of CRC was related to family history, and there was a decrease in their perceived risk of developing CRC in their lifetime following

  8. Understanding reactions to an internet-delivered health-care intervention: accommodating user preferences for information provision

    Directory of Open Access Journals (Sweden)

    Yardley Lucy

    2010-09-01

    Full Text Available Abstract Background It is recognised as good practice to use qualitative methods to elicit users' views of internet-delivered health-care interventions during their development. This paper seeks to illustrate the advantages of combining usability testing with 'theoretical modelling', i.e. analyses that relate the findings of qualitative studies during intervention development to social science theory, in order to gain deeper insights into the reasons and context for how people respond to the intervention. This paper illustrates how usability testing may be enriched by theoretical modelling by means of two qualitative studies of users' views of the delivery of information in an internet-delivered intervention to help users decide whether they needed to seek medical care for their cold or flu symptoms. Methods In Study 1, 21 participants recruited from a city in southern England were asked to 'think aloud' while viewing draft web-pages presented in paper format. In Study 2, views of our prototype website were elicited, again using think aloud methods, in a sample of 26 participants purposively sampled for diversity in education levels. Both data-sets were analysed by thematic analysis. Results Study 1 revealed that although the information provided by the draft web-pages had many of the intended empowering benefits, users often felt overwhelmed by the quantity of information. Relating these findings to theory and research on factors influencing preferences for information-seeking we hypothesised that to meet the needs of different users (especially those with lower literacy levels our website should be designed to provide only essential personalised advice, but with options to access further information. Study 2 showed that our website design did prove accessible to users with different literacy levels. However, some users seemed to want still greater control over how information was accessed. Conclusions Educational level need not be an

  9. The effects of Young Adults Eating and Active for Health (YEAH): a theory-based Web-delivered intervention.

    Science.gov (United States)

    Kattelmann, Kendra K; Bredbenner, Carol Byrd; White, Adrienne A; Greene, Geoffrey W; Hoerr, Sharon L; Kidd, Tandalayo; Colby, Sarah; Horacek, Tanya M; Phillips, Beatrice W; Koenings, Mallory M; Brown, Onikia N; Olfert, Melissa D; Shelnutt, Karla P; Morrell, Jesse Stabile

    2014-01-01

    To assess the effectiveness of a tailored theory-based, Web-delivered intervention (Young Adults Eating and Active for Health) developed using community-based participatory research process. A 15-month (10-week intensive intervention with a 12-month follow-up) randomized, controlled trial delivered via Internet and e-mail. Thirteen college campuses. A total of 1,639 college students. Twenty-one mini-educational lessons and e-mail messages (called nudges) developed with the non-diet approach and focusing on eating behavior, physical activity, stress management, and healthy weight management. Nudges were short, frequent, entertaining, and stage-tailored to each behavior, and reinforced lesson content. All participants were assessed at baseline, postintervention (3 months from baseline), and follow-up (15 months from baseline) for primary outcomes of weight, body mass index (BMI), fruit and vegetable intake (FVI), physical activity (PA), and perceived stress; and secondary outcomes of waist circumference, percent dietary fat, energy from sugar-sweetened beverages, servings of whole grains, self-instruction and regulation for mealtime behavior, hours of sleep, and stage of readiness for change for consuming 5 cups of FVI, completing 150 minutes of PA/wk, and managing stress on most days of the week. Demographics were collected at baseline. Chi-square analysis and mixed-models repeated measures analysis were performed to determine differences between experimental and control outcomes. There were no differences between experimental and control participants in BMI, weight, and waist circumference. There were small improvements in FVI (P = .001), vigorous PA in females (P = .05), fat intake (P = .002), self-instruction (P = .001), and regulation (P = .004) for mealtime behavior, and hours of sleep (P = .05) at postintervention, but improvements were not maintained at follow-up. At postintervention, a greater proportion of experimental participants were in the action

  10. Effectiveness of recruitment to a smartphone-delivered nutrition intervention in New Zealand: analysis of a randomised controlled trial.

    Science.gov (United States)

    Volkova, Ekaterina; Michie, Jo; Corrigan, Callie; Sundborn, Gerhard; Eyles, Helen; Jiang, Yannan; Mhurchu, Cliona Ni

    2017-07-02

    Delivery of interventions via smartphone is a relatively new initiative in public health, and limited evidence exists regarding optimal strategies for recruitment. We describe the effectiveness of approaches used to recruit participants to a smartphone-enabled nutrition intervention trial. Internet and social media advertising, mainstream media advertising and research team networks were used to recruit New Zealand adults to a fully automated smartphone-delivered nutrition labelling trial (no face-to-face visits were required). Recruitment of Māori and Pacific participants was a key focus and ethically relevant recruitment materials and approaches were used where possible. The effectiveness of recruitment strategies was evaluated using Google Analytics, monitoring of study website registrations and randomisations, and self-reported participant data. The cost of the various strategies and associations with participant demographics were assessed. Over a period of 13 months, there were 2448 registrations on the study website, and 1357 eligible individuals were randomised into the study (55%). Facebook campaigns were the most successful recruitment strategy overall (43% of all randomised participants) and for all ethnic groups (Māori 44%, Pacific 44% and other 43%). Significant associations were observed between recruitment strategy and age (psmartphone-delivered trial. These approaches also reached diverse ethnic groups. However, more culturally appropriate recruitment strategies are likely to be necessary in studies where large numbers of participants from specific ethnic groups are sought. ACTRN12614000644662; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.

    Science.gov (United States)

    Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes

    2013-10-24

    Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was

  12. Internet-Delivered Parenting Program for Prevention and Early Intervention of Anxiety Problems in Young Children: Randomized Controlled Trial.

    Science.gov (United States)

    Morgan, Amy J; Rapee, Ronald M; Salim, Agus; Goharpey, Nahal; Tamir, Elli; McLellan, Lauren F; Bayer, Jordana K

    2017-05-01

    The Cool Little Kids parenting group program is an effective intervention for preventing anxiety disorders in young children who are at risk because of inhibited temperament. The program has six group sessions delivered by trained psychologists to parents of 3- to 6-year-old children. An online adaptation (Cool Little Kids Online) has been developed to overcome barriers to its wide dissemination in the community. This study tested the efficacy of Cool Little Kids Online in a randomized controlled trial. A total of 433 parents of a child aged 3 to 6 years with an inhibited temperament were randomized to the online parenting program or to a 24-week waitlist. The online program has 8 interactive modules providing strategies that parents can implement with their child to manage their child's avoidant coping, reduce parental overprotection, and encourage child independence. Parents were provided telephone consultation support with a psychologist when requested. Parents completed self-report questionnaires at baseline and at 12 and 24 weeks after baseline. The intervention group showed significantly greater improvement over time in child anxiety symptoms compared to the control group (d = 0.38). The intervention group also showed greater reductions in anxiety life interference (ds = 0.33-0.35) and lower rates of anxiety disorders than the control group (40% versus 54%), but there were minimal effects on broader internalizing symptoms or overprotective parenting. Results provide empirical support for the efficacy of online delivery of the Cool Little Kids program. Online dissemination may improve access to an evidence-based prevention program for child anxiety disorders. Clinical trial registration information-Randomised Controlled Trial of Cool Little Kids Online: A Parenting Program to Prevent Anxiety Problems in Young Children; http://www.anzctr.org.au/; 12615000217505. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc

  13. Effectiveness of a facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol.

    Science.gov (United States)

    Kernot, Jocelyn; Olds, Tim; Lewis, Lucy K; Maher, Carol

    2013-05-29

    Physical activity is reduced during the post-partum period. Facebook is frequently used by Australian mothers, and offers flexibility, high levels of engagement and the ability to disseminate information and advice via social contacts. The Mums Step it Up Program is a newly developed 50 day team-based physical activity intervention delivered via a Facebook app. The program involves post-partum women working in teams of 4-8 friends aiming to achieve 10,000 steps per day measured by a pedometer. Women are encouraged to use the app to log their daily steps and undertake social and supportive interactions with their friends and other participants. This study aims to determine the effectiveness of the Mums Step it Up Program. A sample of 126 women up to 12 months post-partum will be recruited through community-based health and family services. Participants will be randomly allocated into one of three groups: control, pedometer only and the Mums Step it Up Program. Assessments will be completed at baseline, 6 weeks and 6 months. The primary outcome (objective physical activity) and the secondary outcomes (sleep quality and quantity, depressive symptoms, weight and quality of life) will be used to determine the effectiveness of the Mums Step it Up Program compared with the control and pedometer only groups. Analyses will be undertaken on an intention-to-treat-basis using random effects mixed modeling. The effect of theorized mediators (physical activity attitudes, subjective norms and perceived behavioral control) will also be examined. This study will provide information about the potential of a Facebook app for the delivery of health behavior interventions. If this intervention proves to be effective it will be released on a mass scale and promoted to the general public. Australia and New Zealand Clinical Trials Register: ACTRN12613000069752.

  14. Health on the web: randomised controlled trial of online screening and brief alcohol intervention delivered in a workplace setting.

    Directory of Open Access Journals (Sweden)

    Zarnie Khadjesari

    Full Text Available BACKGROUND: Alcohol misuse in England costs around £7.3 billion (US$12.2 billion annually from lost productivity and absenteeism. Delivering brief alcohol interventions to employees as part of a health check may be acceptable, particularly with online delivery which can provide privacy for this stigmatised behaviour. Research to support this approach is limited and methodologically weak. The aim was to determine the effectiveness of online screening and personalised feedback on alcohol consumption, delivered in a workplace as part of a health check. METHODS AND FINDINGS: This two-group online individually randomised controlled trial recruited employees from a UK-based private sector organisation (approx. 100,000 employees. 3,375 employees completed the online health check in the three week recruitment period. Of these, 1,330 (39% scored five or more on the AUDIT-C (indicating alcohol misuse and were randomised to receive personalised feedback on their alcohol intake, alongside feedback on other health behaviours (n = 659, or to receive feedback on all health behaviours except alcohol intake (n = 671. Participants were mostly male (75%, with a median age of 48 years and half were in managerial positions (55%. Median Body Mass Index was 26, 12% were smokers, median time undertaking moderate/vigorous physical activity a week was 173 minutes and median fruit and vegetable consumption was three portions a day. Eighty percent (n = 1,066 of participants completed follow-up questionnaires at three months. An intention to treat analysis found no difference between experimental groups for past week drinking (primary outcome (5.6% increase associated with the intervention (95% CI -4.7% to 16.9%; p = .30, AUDIT (measure of alcohol-related harm and health utility (EQ-5D. CONCLUSIONS: There was no evidence to support the use of personalised feedback within an online health check for reducing alcohol consumption among employees in this

  15. Health on the Web: Randomised Controlled Trial of Online Screening and Brief Alcohol Intervention Delivered in a Workplace Setting

    Science.gov (United States)

    Khadjesari, Zarnie; Freemantle, Nick; Linke, Stuart; Hunter, Rachael; Murray, Elizabeth

    2014-01-01

    Background Alcohol misuse in England costs around £7.3 billion (US$12.2 billion) annually from lost productivity and absenteeism. Delivering brief alcohol interventions to employees as part of a health check may be acceptable, particularly with online delivery which can provide privacy for this stigmatised behaviour. Research to support this approach is limited and methodologically weak. The aim was to determine the effectiveness of online screening and personalised feedback on alcohol consumption, delivered in a workplace as part of a health check. Methods and Findings This two-group online individually randomised controlled trial recruited employees from a UK-based private sector organisation (approx. 100,000 employees). 3,375 employees completed the online health check in the three week recruitment period. Of these, 1,330 (39%) scored five or more on the AUDIT-C (indicating alcohol misuse) and were randomised to receive personalised feedback on their alcohol intake, alongside feedback on other health behaviours (n = 659), or to receive feedback on all health behaviours except alcohol intake (n = 671). Participants were mostly male (75%), with a median age of 48 years and half were in managerial positions (55%). Median Body Mass Index was 26, 12% were smokers, median time undertaking moderate/vigorous physical activity a week was 173 minutes and median fruit and vegetable consumption was three portions a day. Eighty percent (n = 1,066) of participants completed follow-up questionnaires at three months. An intention to treat analysis found no difference between experimental groups for past week drinking (primary outcome) (5.6% increase associated with the intervention (95% CI −4.7% to 16.9%; p = .30)), AUDIT (measure of alcohol-related harm) and health utility (EQ-5D). Conclusions There was no evidence to support the use of personalised feedback within an online health check for reducing alcohol consumption among employees in this organisation

  16. The effects of a brief intervention to promote walking on Theory of Planned Behavior constructs: a cluster randomized controlled trial in general practice.

    Science.gov (United States)

    Williams, Stefanie L; Michie, Susan; Dale, Jeremy; Stallard, Nigel; French, David P

    2015-05-01

    Perceived behavioral control (PBC) is a consistent predictor of intentions to walk more. A previously successful intervention to promote walking by altering PBC has been adapted for delivery in general practice. This study aimed to evaluate the effect of this intervention on Theory of Planned Behavior (TPB) constructs in this context. Cluster randomized controlled trial, with n = 315 general practice patients. Practice nurses and Healthcare Assistants delivered a self-regulation intervention or information provision (control). Questionnaires assessed TPB variables at baseline, post-intervention, 6 weeks and 6 months. Walking was measured by pedometer. The control group reported significantly higher subjective norm at all follow-up time points. There were no significant differences between the two groups in PBC, intention, attitude or walking behavior. TPB variables significantly predicted intentions to walk more, but not objective walking behavior, after accounting for clustering. The lack of effect of the intervention was probably due to a failure to maintain intervention fidelity, and the unsuitability of the behavior change techniques included in the intervention for the population investigated. This previously successful intervention was not successful when delivered in this context, calling into question whether practice nurses are best placed to deliver such interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Reducing physical risk factors in construction work through a participatory intervention

    DEFF Research Database (Denmark)

    Ajslev, Jeppe; Brandt, Mikkel; Møller, Jeppe Lykke

    2016-01-01

    , video documentation of working tasks, and a 3-phased workshop program. METHODS: The evaluation is designed in an adapted process evaluation framework, addressing recruitment, reach, fidelity, satisfaction, intervention delivery, intervention received, and context of the intervention companies......: Intervention studies are challenging to conduct and evaluate in the construction industry, often because of narrow time frames and ever-changing contexts. The mixed-methods design presents opportunities for obtaining detailed knowledge of the practices intra-acting with the intervention, while offering...

  18. A process evaluation exploring the lay counsellor experience of delivering a task shared psycho-social intervention for perinatal depression in Khayelitsha, South Africa.

    Science.gov (United States)

    Munodawafa, Memory; Lund, Crick; Schneider, Marguerite

    2017-07-01

    Task sharing of psycho-social interventions for perinatal depression has been shown to be feasible, acceptable and effective in low and middle-income countries. This study conducted a process evaluation exploring the perceptions of counsellors who delivered a task shared psycho-social counselling intervention for perinatal depression in Khayelitsha, Cape Town together with independent fidelity ratings. Post intervention qualitative semi-structured interviews were conducted with six counsellors from the AFrica Focus on Intervention Research for Mental health (AFFIRM-SA) randomised controlled trial on their perceptions of delivering a task shared psycho-social intervention for perinatal depression. Themes were identified using the framework approach and were coded and analysed using Nvivo v11. These interviews were supplemented with fidelity ratings for each counsellor and supervision notes. Facilitating factors in the delivery of the intervention included intervention related factors such as: the content of the intervention, ongoing training and supervision, using a counselling manual, conducting counselling sessions in the local language (isiXhosa) and fidelity to the manual; counsellor factors included counsellors' confidence and motivation to conduct the sessions; participant factors included older age, commitment and a desire to be helped. Barriers included contextual factors such as poverty, crime and lack of space to conduct counselling sessions and participant factors such as the nature of the participant's problem, young age, and avoidance of contact with counsellors. Fidelity ratings and dropout rates varied substantially between counsellors. These findings show that a variety of intervention, counsellor, participant and contextual factors need to be considered in the delivery of task sharing counselling interventions. Careful attention needs to be paid to ongoing supervision and quality of care if lay counsellors are to deliver good quality task shared

  19. Differences in reach and attrition between Web-based and print-delivered tailored interventions among adults over 50 years of age: clustered randomized trial.

    Science.gov (United States)

    Peels, Denise Astrid; Bolman, Catherine; Golsteijn, Rianne Henrica Johanna; De Vries, Hein; Mudde, Aart Nicolaas; van Stralen, Maartje Marieke; Lechner, Lilian

    2012-12-17

    The Internet has the potential to provide large populations with individual health promotion advice at a relatively low cost. Despite the high rates of Internet access, actual reach by Web-based interventions is often disappointingly low, and differences in use between demographic subgroups are present. Furthermore, Web-based interventions often have to deal with high rates of attrition. This study aims to assess user characteristics related to participation and attrition when comparing Web-based and print-delivered tailored interventions containing similar content and thereby to provide recommendations in choosing the appropriate delivery mode for a particular target audience. We studied the distribution of a Web-based and a print-delivered version of the Active Plus intervention in a clustered randomized controlled trial (RCT). Participants were recruited via direct mailing within the participating Municipal Health Council regions and randomized to the printed or Web-based intervention by their region. Based on the answers given in a prior assessment, participants received tailored advice on 3 occasions: (1) within 2 weeks after the baseline, (2) 2 months after the baseline, and (3) within 4 months after the baseline (based on a second assessment at 3 months). The baseline (printed or Web-based) results were analyzed using ANOVA and chi-square tests to establish the differences in user characteristics between both intervention groups. We used logistic regression analyses to study the interaction between the user characteristics and the delivery mode in the prediction of dropout rate within the intervention period. The printed intervention resulted in a higher participation rate (19%) than the Web-based intervention (12%). Participants of the Web-based intervention were significantly younger (PWeb-based intervention group (53%) compared to the print-delivered intervention (39%, PWeb-based and the printed intervention was not explained by user characteristics. The

  20. Can text messages reach the parts other process measures cannot reach: an evaluation of a behavior change intervention delivered by mobile phone?

    Directory of Open Access Journals (Sweden)

    Linda Irvine

    Full Text Available BACKGROUND: Process evaluation is essential in developing, piloting and evaluating complex interventions. This often involves observation of intervention delivery and interviews with study participants. Mobile telephone interventions involve no face to face contact, making conventional process evaluation difficult. This study assesses the utility of novel techniques for process evaluation involving no face to face contact. METHODS: Text messages were delivered to 34 disadvantaged men as part of a feasibility study of a brief alcohol intervention. Process evaluation focused on delivery of the text messages and responses received from study participants. The computerized delivery system captured data on receipt of the messages. The text messages, delivered over 28 days, included nine which asked questions. Responses to these questions served as one technique for process evaluation by ascertaining the nature of engagement with the study and with steps on the causal chain to behavior change. RESULTS: A total of 646 SMS text messages were sent to participants. Of these, 613 messages (95% were recorded as delivered to participants' telephones. 88% of participants responded to messages that asked questions. There was little attenuation in responses to the questions across the intervention period. Content analysis of the responses revealed that participants engaged with text messages, thought deeply about their content and provided carefully considered personal responses to the questions. CONCLUSIONS: Socially disadvantaged men, a hard to reach population, engaged in a meaningful way over a sustained period with an interactive intervention delivered by text message. The novel process measures used in the study are unobtrusive, low cost and collect real-time data on all participants. They assessed the fidelity of delivery of the intervention and monitored retention in the study. They measured levels of engagement and identified participants' reactions to

  1. An exploration of factors related to dissemination of and exposure to internet-delivered behavior change interventions aimed at adults: A Delphi study approach

    NARCIS (Netherlands)

    W. Brouwer (Wendy); A. Oenema (Anke); R. Crutzen (Rik); J. de Nooijer (Jascha); N.K. de Vries (Nanne); J. Brug (Hans)

    2008-01-01

    textabstractBackground: The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of

  2. Contact & connect--an intervention to reduce depression stigma and symptoms in construction workers: protocol for a randomised controlled trial.

    Science.gov (United States)

    Milner, Allison; Witt, Katrina; Burnside, Lewis; Wilson, Caitlyn; LaMontagne, Anthony D

    2015-10-16

    Males employed in the construction industry have high rates of suicide. Although reasons underpinning this risk are multifaceted, poor help-seeking and stigma are represent major contributors. Males in the construction industry are also exposed to other risk factors for mental ill health and suicide, including unemployment. Sigma-reducing interventions that are accessible and attractive to recently unemployed males in the construction industry could therefore improve help-seeking, and address depression and suicidal behaviour in this population. Contact&Connect will use a parallel individual randomized design to evaluate the effectiveness of a multimedia-based intervention aimed at reducing stigma. The intervention consists of a package of 12 brief contact interventions (BCIs) delivered over a six month period. BCIs will direct participants to informational programs and microsites. Content will address three major themes: debunking depression myths and stereotypes, normalisation, and empowerment. Target enrollment is 630 (315 in each arm), each to be followed for 12 months. Eligible participants will be males, between 30 and 64 years, unemployed at the time of recruitment, registered with Incolink (a social welfare trustee company for unemployed members of the construction industry), and own a smart phone with enabled internet connectivity. At present, there are no programs that have been shown to be effective in reducing stigma in the blue-collar male population. Contact&Connect promises to provide a tailored, efficient, and scalable approach to reducing stigma, depressive symptoms and suicidality among unemployed males. Australian New Zealand Clinical Trials Register ACTRN12615000792527 (date of registration: 30 July, 2015).

  3. Social Analysis in Development Interventions: Policy Artefact or Constructive Transformation?

    Directory of Open Access Journals (Sweden)

    SUSANNA PRICE

    2012-02-01

    Full Text Available Recently attention has focused on the role of social researchers in the processes of construction and transmission of knowledge about global poverty and its reduction. This paper examines some of the formative efforts by pioneering social researchers in development institutions to step into the realm of policy making to construct processes for project preparation and management through social analysis. Before 1970 development planners invoked ‘social' or ‘human' factors only as an excuse to explain away project failures - they designed and implemented development projects in the absence of any strategies or regulatory frameworks for managing their social impacts. Recognizing that project investments represent induced change and constitute a social process in themselves, pioneering social researchers constructed policies and procedures to introduce sociological content and method into the project cycle and so re-order social outcomes. Were such constructs merely policy artefacts? Even as the constructs helped to shift the statements of the development discourse towards ‘people oriented' poverty reduction, new modalities appeared which tested the limits of the agreed methods. Institutions may forget, neglect, contest or re-write the documents if in perceived conflict with the institutional ‘core business'. Yet those pioneering efforts created institutional space for, and understanding of, social analysis, with a measure of flow-on international recognition. Tracking social analysis in several international institutions and in a significant emerging economy, China, this paper highlights not only a history full of lessons to be learned where social analysis is not practiced systematically but also outlines some future challenges.

  4. Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial.

    Science.gov (United States)

    Hawkes, Anna L; Chambers, Suzanne K; Pakenham, Kenneth I; Patrao, Tania A; Baade, Peter D; Lynch, Brigid M; Aitken, Joanne F; Meng, Xingqiong; Courneya, Kerry S

    2013-06-20

    Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form-36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m(2)], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months. At 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (-0.9 kg/m(2); P = .001), energy from total fat (-7.0%; P = .006), and energy from saturated fat (-2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.

  5. Theoretical constructs for early intervention programs in mathematics:

    DEFF Research Database (Denmark)

    Lindenskov, Lena; Kirsted, Katrine

    2017-01-01

    . It is not a straightforward endeavour. One reason is that the term theory as well as the term practice may very well be given different meanings by different agents. This variation is in our view to be considered in “implementation research” and Lewin’s statement ought to be qualified by two questions “Who cares for a good...... theory?” and “What makes a good theory good for whom?” This paper explores this variation of how theory is perceived by mathematics teachers and by mathematics researchers involved in a developmental project on early intervention in mathematics education in Denmark. The paper exemplifies how agents...

  6. An evaluation of a body image intervention in adolescent girls delivered in single-sex versus co-educational classroom settings.

    Science.gov (United States)

    Dunstan, Candice J; Paxton, Susan J; McLean, Siân A

    2017-04-01

    Body dissatisfaction is now recognized as having considerable negative impact on social, psychological, and physical health, particularly in adolescent girls. Consequently, we have developed a six-session co-educational body image intervention (Happy Being Me Co-educational) designed to reduce body dissatisfaction and its risk factors in Grade 7 girls. In addition to evaluating the program's efficacy, we aimed to identify whether girls would benefit equally when it was delivered as a universal intervention to a whole class including both boys and girls (co-educational delivery), or delivered as a selective intervention to girls only (single-sex delivery). Participants were 200 Grade 7 girls from five schools in Melbourne, Australia. Schools were randomly allocated to receive the intervention in single-sex classes (n=74), co-educational classes (n=73), or participate as a no-intervention control (n=53). Girls completed self-report assessments of body dissatisfaction, psychological (internalization of the thin ideal, appearance comparison, and self-esteem) and peer environment (weight-related teasing and appearance conversations) risk factors for body dissatisfaction, and dietary restraint, at baseline, post-intervention, and at 6-month follow-up. Significant improvements in body dissatisfaction and psychological risk factors were observed in the intervention group at post-intervention and these were maintained at follow-up for psychological risk factors. Importantly, no significant differences between universal and selective delivery were observed, suggesting that the intervention is appropriate for dissemination in both modes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Development of a Program Logic Model and Evaluation Plan for a Participatory Ergonomics Intervention in Construction

    Science.gov (United States)

    Jaegers, Lisa; Dale, Ann Marie; Weaver, Nancy; Buchholz, Bryan; Welch, Laura; Evanoff, Bradley

    2013-01-01

    Background Intervention studies in participatory ergonomics (PE) are often difficult to interpret due to limited descriptions of program planning and evaluation. Methods In an ongoing PE program with floor layers, we developed a logic model to describe our program plan, and process and summative evaluations designed to describe the efficacy of the program. Results The logic model was a useful tool for describing the program elements and subsequent modifications. The process evaluation measured how well the program was delivered as intended, and revealed the need for program modifications. The summative evaluation provided early measures of the efficacy of the program as delivered. Conclusions Inadequate information on program delivery may lead to erroneous conclusions about intervention efficacy due to Type III error. A logic model guided the delivery and evaluation of our intervention and provides useful information to aid interpretation of results. PMID:24006097

  8. Development of a program logic model and evaluation plan for a participatory ergonomics intervention in construction.

    Science.gov (United States)

    Jaegers, Lisa; Dale, Ann Marie; Weaver, Nancy; Buchholz, Bryan; Welch, Laura; Evanoff, Bradley

    2014-03-01

    Intervention studies in participatory ergonomics (PE) are often difficult to interpret due to limited descriptions of program planning and evaluation. In an ongoing PE program with floor layers, we developed a logic model to describe our program plan, and process and summative evaluations designed to describe the efficacy of the program. The logic model was a useful tool for describing the program elements and subsequent modifications. The process evaluation measured how well the program was delivered as intended, and revealed the need for program modifications. The summative evaluation provided early measures of the efficacy of the program as delivered. Inadequate information on program delivery may lead to erroneous conclusions about intervention efficacy due to Type III error. A logic model guided the delivery and evaluation of our intervention and provides useful information to aid interpretation of results. © 2013 Wiley Periodicals, Inc.

  9. Participating in and delivering the ATEAM trial (Alexander technique lessons, exercise, and massage) interventions for chronic back pain: A qualitative study of professional perspectives.

    Science.gov (United States)

    Beattie, Angela; Shaw, Alison; Yardley, Lucy; Little, Paul; Sharp, Debbie

    2010-01-01

    To outline professionals' experiences of participation, perceived benefits and acceptability of the interventions delivered in the ATEAM trial (Alexander technique lessons, exercise, and massage), for patients with chronic or recurrent back pain. Qualitative study using in-depth interviews was conducted with a purposeful sample of twenty professionals (general practitioners (GPs), nurses, Alexander technique teachers, and massage therapists). Data were recorded, transcribed, and analysed thematically using the constant comparison method. Evidence of effectiveness GPs wanted an evidence base for the interventions, whilst nurses, Alexander technique teachers and massage therapists perceived patient reports of benefit as evidence. Professionals' perception of the acceptability of the intervention: professional perspectives differed, with GPs and nurses viewing the structured nature of exercise prescription and Alexander technique lessons as more beneficial and acceptable than massage in alleviating patients' back pain. Economic cost: the cost to patients pursuing Alexander technique lessons and massage was perceived to be a barrier outside the trial. Inter-professional communication: there was little communication between the professionals groups within the trial. Valuable insights have been gained into the perceived benefits and acceptability of exercise, Alexander technique lessons and massage as interventions for chronic back pain. Lessons in the Alexander technique with or without exercise, was perceived as more beneficial and acceptable than massage by professionals who participated and delivered the ATEAM trial interventions. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. Process evaluation determines the pathway of success for a health center-delivered, nutrition education intervention for infants in Trujillo, Peru.

    Science.gov (United States)

    Robert, Rebecca C; Gittelsohn, Joel; Creed-Kanashiro, Hilary M; Penny, Mary E; Caulfield, Laura E; Narro, M Rocio; Black, Robert E

    2006-03-01

    Process evaluation was used to explain the success of a randomized, controlled trial of an educational intervention to improve the feeding behaviors of caregivers and the nutritional status of infants in Trujillo, Peru. Health personnel delivered a multicomponent intervention within the environment of usual care at government health centers. We created a model of the expected intervention pathway to successful outcomes. Process data were then collected on health center implementation of the intervention and caregiver reception to it. Using multivariate models, we found that variables of health center implementation, caregiver exposure, and caregiver message recall were all significant determinants in the pathway leading to improved feeding behaviors. These outcomes were consistent with our original intervention model. Further support for our model arose from the differences in caregiver reception between intervention and control centers. Process data allowed us to characterize the pathway through which an effective nutrition intervention operated. This study underscores the importance of including process evaluation, which will lead to the development and implementation of more effective nutrition interventions.

  11. Computer-Assisted, Counselor-Delivered Smoking Cessation Counseling for Community College Students: Intervention Approach and Sample Characteristics

    Science.gov (United States)

    Prokhorov, Alexander V.; Fouladi, Rachel T.; de Moor, Carl; Warneke, Carla L.; Luca, Mario; Jones, Mary Mullin; Rosenblum, Carol; Emmons, Karen M.; Hudmon, Karen Suchanek; Yost, Tracey E.; Gritz, Ellen R.

    2007-01-01

    This report presents the experimental approach and baseline findings from "Look at Your Health," an ongoing study to develop and evaluate a computer-assisted, counselor-delivered smoking cessation program for community college students. It describes the expert system software program used for data collection and for provision of tailored feedback,…

  12. Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

    Science.gov (United States)

    Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

    2015-01-01

    Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…

  13. Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: a systematic review and meta-analysis.

    Science.gov (United States)

    Davies, E Bethan; Morriss, Richard; Glazebrook, Cris

    2014-05-16

    Depression and anxiety are common mental health difficulties experienced by university students and can impair academic and social functioning. Students are limited in seeking help from professionals. As university students are highly connected to digital technologies, Web-based and computer-delivered interventions could be used to improve students' mental health. The effectiveness of these intervention types requires investigation to identify whether these are viable prevention strategies for university students. The intent of the study was to systematically review and analyze trials of Web-based and computer-delivered interventions to improve depression, anxiety, psychological distress, and stress in university students. Several databases were searched using keywords relating to higher education students, mental health, and eHealth interventions. The eligibility criteria for studies included in the review were: (1) the study aimed to improve symptoms relating to depression, anxiety, psychological distress, and stress, (2) the study involved computer-delivered or Web-based interventions accessed via computer, laptop, or tablet, (3) the study was a randomized controlled trial, and (4) the study was trialed on higher education students. Trials were reviewed and outcome data analyzed through random effects meta-analyses for each outcome and each type of trial arm comparison. Cochrane Collaboration risk of bias tool was used to assess study quality. A total of 17 trials were identified, in which seven were the same three interventions on separate samples; 14 reported sufficient information for meta-analysis. The majority (n=13) were website-delivered and nine interventions were based on cognitive behavioral therapy (CBT). A total of 1795 participants were randomized and 1480 analyzed. Risk of bias was considered moderate, as many publications did not sufficiently report their methods and seven explicitly conducted completers' analyses. In comparison to the inactive

  14. A physiotherapist-delivered integrated exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2012-07-01

    Full Text Available Abstract Background Knee osteoarthritis (OA is a prevalent chronic musculoskeletal condition with no cure. Pain is the primary symptom and results from a complex interaction between structural changes, physical impairments and psychological factors. Much evidence supports the use of strengthening exercises to improve pain and physical function in this patient population. There is also a growing body of research examining the effects of psychologist-delivered pain coping skills training (PCST particularly in other chronic pain conditions. Though typically provided separately, there are symptom, resource and personnel advantages of exercise and PCST being delivered together by a single healthcare professional. Physiotherapists are a logical choice to be trained to deliver a PCST intervention as they already have expertise in administering exercise for knee OA and are cognisant of the need for a biopsychosocial approach to management. No studies to date have examined the effects of an integrated exercise and PCST program delivered solely by physiotherapists in this population. The primary aim of this multisite randomised controlled trial is to investigate whether an integrated 12-week PCST and exercise treatment program delivered by physiotherapists is more efficacious than either program alone in treating pain and physical function in individuals with knee OA. Methods/design This will be an assessor-blinded, 3-arm randomised controlled trial of a 12-week intervention involving 10 physiotherapy visits together with home practice. Participants with symptomatic and radiographic knee OA will be recruited from the community in two cities in Australia and randomized into one of three groups: exercise alone, PCST alone, or integrated PCST and exercise. Randomisation will be stratified by city (Melbourne or Brisbane and gender. Primary outcomes are overall average pain in the past week measured by a Visual Analogue Scale and physical function measured by

  15. General practitioners' perceptions of the effectiveness of medical interventions: an exploration of underlying constructs

    Directory of Open Access Journals (Sweden)

    Marteau Theresa M

    2010-02-01

    Full Text Available Abstract Background Many interventions shown to be effective through clinical trials are not readily implemented in clinical practice. Unfortunately, little is known regarding how clinicians construct their perceptions of the effectiveness of medical interventions. This study aims to explore general practitioners' perceptions of the nature of 'effectiveness'. Methods The design was qualitative in nature using the repertory grid technique to elicit the constructs underlying the perceived effectiveness of a range of medical interventions. Eight medical interventions were used as stimuli (diclophenac to reduce acute pain, cognitive behaviour therapy to treat depression, weight loss surgery to achieve weight loss, diet and exercise to prevent type 2 diabetes, statins to prevent heart disease, stopping smoking to prevent heart disease, nicotine replacement therapy to stop smoking, and stop smoking groups to stop smoking. The setting involved face-to-face interviews followed by questionnaires in London Primary Care Trusts. Participants included a random sample of 13 general practitioners. Results Analysis of the ratings showed that the constructs clustered around two dimensions: low patient effort versus high patient effort (dimension one, and small impact versus large impact (dimension two. Dimension one represented constructs such as 'success requires little motivation', 'not a lifestyle intervention', and 'health-care professional led intervention'. Dimension two represented constructs such as 'weak and/or minimal evidence of effectiveness', 'small treatment effect for users', 'a small proportion of users will benefit' and 'not cost-effective'. Constructs within each dimension were closely related. Conclusions General practitioners judged the effectiveness of medical interventions by considering two broad dimensions: the extent to which interventions involve patient effort, and the size of their impact. The latter is informed by trial evidence, but

  16. Cell-type specific oxytocin gene expression from AAV delivered promoter deletion constructs into the rat supraoptic nucleus in vivo.

    Directory of Open Access Journals (Sweden)

    Raymond L Fields

    Full Text Available The magnocellular neurons (MCNs in the hypothalamus selectively express either oxytocin (OXT or vasopressin (AVP neuropeptide genes, a property that defines their phenotypes. Here we examine the molecular basis of this selectivity in the OXT MCNs by stereotaxic microinjections of adeno-associated virus (AAV vectors that contain various OXT gene promoter deletion constructs using EGFP as the reporter into the rat supraoptic nucleus (SON. Two weeks following injection of the AAVs, immunohistochemical assays of EGFP expression from these constructs were done to determine whether the EGFP reporter co-localizes with either the OXT- or AVP-immunoreactivity in the MCNs. The results show that the key elements in the OT gene promoter that regulate the cell-type specific expression the SON are located -216 to -100 bp upstream of the transcription start site. We hypothesize that within this 116 bp domain a repressor exists that inhibits expression specifically in AVP MCNs, thereby leading to the cell-type specific expression of the OXT gene only in the OXT MCNs.

  17. Brief Computer-Delivered Intervention to Increase Parental Monitoring in Families of African American Adolescents with Type 1 Diabetes: A Randomized Controlled Trial.

    Science.gov (United States)

    Ellis, Deborah A; Idalski Carcone, April; Ondersma, Steven J; Naar-King, Sylvie; Dekelbab, Bassem; Moltz, Kathleen

    2017-06-01

    African American adolescents with type 1 diabetes (T1D) are at elevated risk for poor diabetes management and metabolic control. Parental supervision and monitoring of adolescent diabetes management have been shown to promote better diabetes management among adolescents, but parents typically decrease their oversight during the transition to independent diabetes care. The purpose of the study was to conduct a randomized clinical trial to test the feasibility and efficacy of a three-session, computer-delivered motivational intervention (The 3Ms) to promote increased parental monitoring among primary caregivers of young African American adolescents with T1D. The intervention was brief and optimized for delivery during routine diabetes clinic visits. Sixty-seven adolescents with T1D aged 11-14 and their primary caregiver were randomly assigned to one of three arms: adolescent and parent motivational intervention (Arm 1), adolescent control and parent motivational intervention (Arm 2), or adolescent and parent control (Arm 3). Intervention effects were assessed 1 month after intervention completion. Parents in Arm 1 and Arm 2 had significant increases in knowledge of the importance of monitoring adolescents' diabetes care. Parents in Arm 2 also had trend to significant increases in direct observation and monitoring of adolescent diabetes care, and adolescents in Arm 2 had significant improvements in glycemic control. Findings from the present study provide preliminary support for the efficacy of a brief, computer-delivered parenting intervention for improving family management practices and adolescent health outcomes among African American adolescents with T1D and their caregivers.

  18. Pilot Trial of a Social Cognitive Theory-Based Physical Activity Intervention Delivered by Nonsupervised Technology in Persons With Multiple Sclerosis.

    Science.gov (United States)

    Suh, Yoojin; Motl, Robert W; Olsen, Connor; Joshi, Ina

    2015-07-01

    Physical inactivity is prevalent in people with multiple sclerosis (MS) and this highlights the importance of developing behavioral interventions for increasing physical activity (PA) in MS. This pilot trial examined the efficacy of a 6-week, behavioral intervention based on social cognitive theory (SCT) delivered by newsletters and phone calls for increasing PA in persons with MS who were physically inactive and had middle levels of self-efficacy. The sample included 68 persons with relapsing-remitting MS who were randomly assigned into intervention and control groups. The intervention group received SCT-based information by newsletters and phone calls, whereas the controls received information regarding topics such as stress management over 6 weeks. Participants completed self-report of PA and social cognitive variables. The intervention group had a significant increase in self-reported PA (d = 0.56, P = .02) over the 6 weeks, but the controls had a nonsignificant change (d = -0.13, P = .45). Goal setting was changed in the intervention group (d = 0.68, P ≤ .01) and identified as a significant mediator of change in self-reported PA. This study provides initial evidence for the benefit of a theory-based behavioral intervention for increasing PA in MS.

  19. Determining who responds better to a computer- vs. human-delivered physical activity intervention: results from the community health advice by telephone (CHAT) trial

    Science.gov (United States)

    2013-01-01

    Background Little research has explored who responds better to an automated vs. human advisor for health behaviors in general, and for physical activity (PA) promotion in particular. The purpose of this study was to explore baseline factors (i.e., demographics, motivation, interpersonal style, and external resources) that moderate intervention efficacy delivered by either a human or automated advisor. Methods Data were from the CHAT Trial, a 12-month randomized controlled trial to increase PA among underactive older adults (full trial N = 218) via a human advisor or automated interactive voice response advisor. Trial results indicated significant increases in PA in both interventions by 12 months that were maintained at 18-months. Regression was used to explore moderation of the two interventions. Results Results indicated amotivation (i.e., lack of intent in PA) moderated 12-month PA (d = 0.55, p  0.12). Conclusions Results provide preliminary evidence for generating hypotheses about pathways for supporting later clinical decision-making with regard to the use of either human- vs. computer-delivered interventions for PA promotion. PMID:24053756

  20. Design and Methods for a Pilot Study of a Phone-Delivered, Mindfulness-Based Intervention in Patients with Implantable Cardioverter Defibrillators

    Directory of Open Access Journals (Sweden)

    Elena Salmoirago-Blotcher

    2012-01-01

    Full Text Available Background. Meditation practices are associated with a reduction in adrenergic activity that may benefit patients with severe cardiac arrhythmias. This paper describes the design and methods of a pilot study testing the feasibility of a phone-delivered mindfulness-based intervention (MBI for treatment of anxiety in patients with implantable cardioverter defibrillators (ICDs. Design and Methods. Consecutive, clinically stable outpatients (n=52 will be screened for study eligibility within a month of an ICD-related procedure or ICD shock and will be randomly assigned to MBI or to usual care. MBI patients will receive eight weekly individual phone sessions based on two mindfulness practices (awareness of breath and body scan plus home practice with a CD for 20 minutes daily. Patients assigned to usual care will be offered the standard care planned by the hospital. Assessments will occur at baseline and at the completion of the intervention (between 9 and 12 weeks after randomization. The primary study outcome is feasibility; secondary outcomes include anxiety, mindfulness, and number of administered shocks during the intervention period. Conclusions. If proven feasible and effective, phone-delivered mindfulness-based interventions could improve psychological distress in ICD outpatients with serious cardiovascular conditions.

  1. An exploration of factors related to dissemination of and exposure to internet-delivered behavior change interventions aimed at adults: a Delphi study approach.

    Science.gov (United States)

    Brouwer, Wendy; Oenema, Anke; Crutzen, Rik; de Nooijer, Jascha; de Vries, Nanne K; Brug, Johannes

    2008-04-16

    The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure. The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention. A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD word-of-mouth by family and friends, a publicity campaign with simultaneous use of various mass media, and recommendation by health professionals, were indicated as effective ways to encourage adults to visit an Internet intervention. This systematic study identified important factors related to the dissemination of and exposure to Internet interventions aimed at adults. In order to improve optimal use of and exposure to Internet interventions, potential users may

  2. An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies: a randomised controlled trial.

    Science.gov (United States)

    Armstrong, G; Blashki, G; Joubert, L; Bland, R; Moulding, R; Gunn, J; Naccarella, L

    2010-11-05

    Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy). A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. 40 Melbourne-based (Australia) social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97%) completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group). The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02) on the 66 point Cognitive Therapy Scale) and in subjective confidence (mean improvement of 1.28 (0.84-1.72) on a 5 point Likert scale). On average, the intervention group improved from below to above the base competency threshold on the Cognitive

  3. An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies: A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Moulding R

    2010-11-01

    Full Text Available Abstract Background Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy. Methods A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. Results 40 Melbourne-based (Australia social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97% completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group. The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02 on the 66 point Cognitive Therapy Scale and in subjective confidence (mean improvement of 1.28 (0.84-1.72 on a 5 point Likert scale. On average, the intervention group improved from below to above

  4. An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies: A randomised controlled trial

    Science.gov (United States)

    2010-01-01

    Background Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy). Methods A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. Results 40 Melbourne-based (Australia) social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97%) completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group). The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02) on the 66 point Cognitive Therapy Scale) and in subjective confidence (mean improvement of 1.28 (0.84-1.72) on a 5 point Likert scale). On average, the intervention group improved from below to above the base competency

  5. Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Ørner Roderick

    2009-01-01

    Full Text Available Abstract Background Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for managing sleep problems, including cognitive behavioural therapy for insomnia (CBTi have been shown to be effective and cost effective but have not been widely implemented or evaluated in a general practice setting where they are most likely to be needed and most appropriately delivered. This paper outlines the protocol for a pilot study designed to evaluate the effectiveness and cost-effectiveness of an educational intervention for general practitioners, primary care nurses and other members of the primary care team to deliver problem focused therapy to adult patients presenting with sleep problems due to lifestyle causes, pain or mild to moderate depression or anxiety. Methods and design This will be a pilot cluster randomised controlled trial of a complex intervention. General practices will be randomised to an educational intervention for problem focused therapy which includes a consultation approach comprising careful assessment (using assessment of secondary causes, sleep diaries and severity and use of modified CBTi for insomnia in the consultation compared with usual care (general advice on sleep hygiene and pharmacotherapy with hypnotic drugs. Clinicians randomised to the intervention will receive an educational intervention (2 × 2 hours to implement a complex intervention of problem focused therapy. Clinicians randomised to the control group will receive reinforcement of usual care with sleep hygiene advice. Outcomes will be assessed via self-completion questionnaires and telephone interviews of patients and staff as well as clinical records for interventions and prescribing. Discussion Previous studies in adults

  6. Resilience Training for Work-related Stress Among Health Care Workers: Results of a Randomized Clinical Trial Comparing In-person and Smartphone-delivered Interventions.

    Science.gov (United States)

    Mistretta, Erin G; Davis, Mary C; Temkit, M'hamed; Lorenz, Christopher; Darby, Betty; Stonnington, Cynthia M

    2018-01-24

    The aim of this study was to assess whether an in-person mindfulness-based resilience training (MBRT) program or a smartphone-delivered resiliency-based intervention improved stress, well-being, and burnout in employees at a major tertiary health care institution. Sixty participants were randomized to a 6-week MBRT, a resiliency-based smartphone intervention, or an active control group. Stress, well-being, and burnout were assessed at baseline, at program completion, and 3 months postintervention. Both the MBRT and the smartphone groups showed improvements in well-being, whereas only the MBRT group showed improvements in stress and emotional burnout over time. The control group did not demonstrate sustained improvement on any outcome. Findings suggest that brief, targeted interventions improve psychological outcomes and point to the need for larger scale studies comparing the individual and combined treatments that can inform development of tailored, effective, and low-cost programs for health care workers.

  7. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial

    NARCIS (Netherlands)

    Sluijs, van E.M.F.; Poppel - Bruinvels, van M.N.M.; Twisk, J.W.R.; Paw, M.J.M. Chin A; Calfas, K.J.; Mechelen, van W.

    2005-01-01

    OBJECTIVES: We evaluated the effectiveness of a minimal intervention physical activity strategy (physician-based assessment and counseling for exercise [PACE]) applied in general practice settings in the Netherlands. METHODS: Randomization took place at the general practice level. Participants were

  8. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial

    NARCIS (Netherlands)

    van Sluijs, E.M.F.; van Poppel-Bruinvels, M.N.M.; Twisk, J.W.R.; Chin A Paw, M.J.M.; Calfas, K.J.; van Mechelen, W.

    2005-01-01

    Objectives. We evaluated the effectiveness of a minimal intervention physical activity strategy (physician-based assessment and counseling for exercise [PACE]) applied in general practice settings in the Netherlands. Methods. Randomization took place at the general practice level. Participants were

  9. Building theories of knowledge translation interventions: Use the entire menu of constructs

    Directory of Open Access Journals (Sweden)

    Brehaut Jamie C

    2012-11-01

    Full Text Available Abstract Background In the ongoing effort to develop and advance the science of knowledge translation (KT, an important question has emerged around how theory should inform the development of KT interventions. Discussion Efforts to employ theory to better understand and improve KT interventions have until recently mostly involved examining whether existing theories can be usefully applied to the KT context in question. In contrast to this general theory application approach, we propose a ‘menu of constructs’ approach, where individual constructs from any number of theories may be used to construct a new theory. By considering the entire menu of available constructs, rather than limiting choice to the broader level of theories, we can leverage knowledge from theories that would never on their own provide a complete picture of a KT intervention, but that nevertheless describe components or mechanisms relevant to it. We can also avoid being forced to adopt every construct from a particular theory in a one-size-fits-all manner, and instead tailor theory application efforts to the specifics of the situation. Using audit and feedback as an example KT intervention strategy, we describe a variety of constructs (two modes of reasoning, cognitive dissonance, feed forward, desirable difficulties and cognitive load, communities of practice, and adaptive expertise from cognitive and educational psychology that make concrete suggestions about ways to improve this class of intervention. Summary The ‘menu of constructs’ notion suggests an approach whereby a wider range of theoretical constructs, including constructs from cognitive theories with scope that makes the immediate application to the new context challenging, may be employed to facilitate development of more effective KT interventions.

  10. Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review.

    Science.gov (United States)

    D'Egidio, V; Sestili, C; Mancino, M; Sciarra, I; Cocchiara, R; Backhaus, I; Mannocci, A; De Luca, Alessandro; Frusone, Federico; Monti, Massimo; La Torre, G

    2017-10-01

    Higher survival rates for breast cancer patients have led to concerns in dealing with short- and long-term side effects. The most common complications are impairment of shoulder functions, pain, lymphedema, and dysesthesia of the injured arm; psychological consequences concern: emotional distress, anxiety, and depression, thereby, deeply impacting/affecting daily living activity, and health-related quality of life. To perform a systematic review for assessing the efficacy or effectiveness of interventions aiming at improving health-related quality of life, return to daily activity, and correct lifestyles among breast cancer patients. A literature search was conducted in December 2016 using the databases PubMed and Scopus. Search terms included: (counseling) AND (breast cancer) AND (quality of life). Articles on counseling interventions to improve quality of life, physical and psychological outcomes were included. Thirty-five articles met the inclusion criteria. The interventions were grouped in five main areas: concerning lifestyle counseling interventions, related to combined interventions (physical activity and nutritional counseling), physical therapy, peer counseling, multidisciplinary approach, included psychological, psycho-educational interventions, and cognitive-behavior therapy (CBT). Exercise counseling as well as physical therapy are effective to improve shoulder mobility, healing wounds, and limb strength. Psychological therapies such as psychoeducation and CBT may help to realize a social and psychological rehabilitation. A multidisciplinary approach can help in sustaining and restoring impaired physical, psychosocial, and occupational outcomes of breast cancer patients.

  11. Internet-delivered eating disorder prevention: A randomized controlled trial of dissonance-based and cognitive-behavioral interventions.

    Science.gov (United States)

    Chithambo, Taona P; Huey, Stanley J

    2017-10-01

    The current study evaluated two web-based programs for eating disorder prevention in high-risk, predominantly ethnic minority women. Two hundred and seventy-one women with elevated weight concerns were randomized to Internet dissonance-based intervention (DBI-I), Internet cognitive-behavioral intervention (CBI-I), or no intervention (NI). Both interventions consisted of four weekly online sessions. Participants were assessed at pre- and post intervention. Outcome measures included eating pathology, body dissatisfaction, dieting, thin-ideal internalization, and depression. At postintervention, DBI-I and CBI-I led to greater reductions in body dissatisfaction, thin-ideal internalization, and depression than NI. In addition, CBI-I was effective at reducing dieting and composite eating pathology relative to NI. No outcome differences were found between the active conditions. Moderation analyses suggested that both active conditions were more effective for ethnic minorities than Whites relative to NI. Results suggest that both DBI-I and CBI-I are effective at reducing eating disorder risk factors in a high-risk, predominantly minority population relative to no intervention. © 2017 Wiley Periodicals, Inc.

  12. Living well after breast cancer randomized controlled trial protocol: evaluating a telephone-delivered weight loss intervention versus usual care in women following treatment for breast cancer.

    Science.gov (United States)

    Reeves, Marina M; Terranova, Caroline O; Erickson, Jane M; Job, Jennifer R; Brookes, Denise S K; McCarthy, Nicole; Hickman, Ingrid J; Lawler, Sheleigh P; Fjeldsoe, Brianna S; Healy, Genevieve N; Winkler, Elisabeth A H; Janda, Monika; Veerman, J Lennert; Ware, Robert S; Prins, Johannes B; Vos, Theo; Demark-Wahnefried, Wendy; Eakin, Elizabeth G

    2016-10-28

    Obesity, physical inactivity and poor diet quality have been associated with increased risk of breast cancer-specific and all-cause mortality as well as treatment-related side-effects in breast cancer survivors. Weight loss intervention trials in breast cancer survivors have shown that weight loss is safe and achievable; however, few studies have examined the benefits of such interventions on a broad range of outcomes and few have examined factors important to translation (e.g. feasible delivery method for scaling up, assessment of sustained changes, cost-effectiveness). The Living Well after Breast Cancer randomized controlled trial aims to evaluate a 12-month telephone-delivered weight loss intervention (versus usual care) on weight change and a range of secondary outcomes including cost-effectiveness. Women (18-75 years; body mass index 25-45 kg/m 2 ) diagnosed with stage I-III breast cancer in the previous 2 years are recruited from public and private hospitals and through the state-based cancer registry (target n = 156). Following baseline assessment, participants are randomized 1:1 to either a 12-month telephone-delivered weight loss intervention (targeting diet and physical activity) or usual care. Data are collected at baseline, 6-months (mid-intervention), 12-months (end-of-intervention) and 18-months (maintenance). The primary outcome is change in weight at 12-months. Secondary outcomes are changes in body composition, bone mineral density, cardio-metabolic and cancer-related biomarkers, metabolic health and chronic disease risk, physical function, patient-reported outcomes (quality of life, fatigue, menopausal symptoms, body image, fear of cancer recurrence) and behaviors (dietary intake, physical activity, sitting time). Data collected at 18-months will be used to assess whether outcomes achieved at end-of-intervention are sustained six months after intervention completion. Cost-effectiveness will be assessed, as will mediators and moderators of

  13. Improving Employee Well-Being and Effectiveness: Systematic Review and Meta-Analysis of Web-Based Psychological Interventions Delivered in the Workplace.

    Science.gov (United States)

    Carolan, Stephany; Harris, Peter R; Cavanagh, Kate

    2017-07-26

    Stress, depression, and anxiety among working populations can result in reduced work performance and increased absenteeism. Although there is evidence that these common mental health problems are preventable and treatable in the workplace, uptake of psychological treatments among the working population is low. One way to address this may be the delivery of occupational digital mental health interventions. While there is convincing evidence for delivering digital psychological interventions within a health and community context, there is no systematic review or meta-analysis of these interventions in an occupational setting. The aim of this study was to identify the effectiveness of occupational digital mental health interventions in enhancing employee psychological well-being and increasing work effectiveness and to identify intervention features associated with the highest rates of engagement and adherence. A systematic review of the literature was conducted using Cochrane guidelines. Papers published from January 2000 to May 2016 were searched in the PsychINFO, MEDLINE, PubMed, Science Direct, and the Cochrane databases, as well as the databases of the researchers and relevant websites. Unpublished data was sought using the Conference Proceedings Citation Index and the Clinical Trials and International Standard Randomized Controlled Trial Number (ISRCTN) research registers. A meta-analysis was conducted by applying a random-effects model to assess the pooled effect size for psychological well-being and the work effectiveness outcomes. A positive deviance approach was used to identify those intervention features associated with the highest rates of engagement and adherence. In total, 21 randomized controlled trials (RCTs) met the search criteria. Occupational digital mental health interventions had a statistically significant effect post intervention on both psychological well-being (g=0.37, 95% CI 0.23-0.50) and work effectiveness (g=0.25, 95% CI 0

  14. Are rehabilitation and/or care co-ordination interventions delivered in the community effective in reducing depression, facilitating participation and improving quality of life after stroke?

    Science.gov (United States)

    Graven, Christine; Brock, Kim; Hill, Keith; Joubert, Lynette

    2011-01-01

    To conduct a systematic review to explore the effectiveness of community-based rehabilitation interventions delivered by allied health professionals and/or nursing staff in reducing depression, facilitating participation and improving health-related quality of life (HRQoL) post-inpatient stroke rehabilitation. A search was conducted in the databases of MEDLINE, PEDro, CINAHL and the Cochrane Library. Publications were classified into categories based on the type of the interventions. Best evidence synthesis and meta-analysis were utilised to determine the level of evidence. Fifty-four studies were included in the review, and divided into nine broad intervention categories. Meta-analysis demonstrated significant reduction in depression with exercise interventions (n = 137; effect estimate SMD: -2.03, 95%CI: -3.22, -0.85). Community-based interventions targeting participation and leisure domains showed moderate evidence for improvement in global participation measures and HRQoL. Comprehensive rehabilitation demonstrated limited evidence for depression and participation, and strong evidence for HRQoL. There is limited to moderate evidence supporting some rehabilitation interventions in affecting the outcomes of depression, participation and HRQoL post-stroke. Heterogeneity of the studies made evidence synthesis difficult. Further consideration needs to be given to the type and timing of outcome measures selected to represent the domains of participation and HRQoL.

  15. Attitudes and Learning through Practice Are Key to Delivering Brief Interventions for Heavy Drinking in Primary Health Care: Analyses from the ODHIN Five Country Cluster Randomized Factorial Trial

    Directory of Open Access Journals (Sweden)

    Peter Anderson

    2017-01-01

    Full Text Available In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years who screened positive and were given advice to reduce their alcohol consumption (intervention activity. We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers’ screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity.

  16. Ethical issues in using social media to deliver an HIV prevention intervention: Results from the HOPE Peru Study

    Science.gov (United States)

    Garett, Renee; Menacho, Luis; Young, Sean D.

    2017-01-01

    Social media technologies have become increasingly useful tools for research-based interventions. However, participants and social media users have expressed ethical concerns with these studies, such as risks and benefits of participation, as well as privacy, confidentiality, and informed consent issues. This study was designed to follow up with and assess experiences and perceptions of ethics-related issues among a sample of 211 men who have sex with men who participated in the Harnessing Online Peer Education (HOPE) Peru study, a randomized controlled HIV prevention intervention conducted in Peru. We found that after adjusting for age, highest educational attainment, race, sexual orientation, and prior HIV research experience, participants in the intervention group were more likely than those in the control group to have safe sex (p = 0.0051) and get tested for HIV regularly (p = 0.0051). As a result of their participation, those in the intervention group benefited more positively than participants in the control group in improving HIV care (p = 0.0077) and learning where to receive sexual health services (p = 0.0021). Participants in the intervention group expressed higher levels of comfort than those in the control group in joining and seeing other people in the Facebook group (p = 0.039), seeing other people’s posts (p = 0.038), and having other group members talk to them online (p = 0.040). We discuss the implications of these results as they relate to social media–based HIV research. PMID:27933425

  17. iSocial: delivering the Social Competence Intervention for Adolescents (SCI-A) in a 3D virtual learning environment for youth with high functioning autism.

    Science.gov (United States)

    Stichter, Janine P; Laffey, James; Galyen, Krista; Herzog, Melissa

    2014-02-01

    One consistent area of need for students with autism spectrum disorders is in the area of social competence. However, the increasing need to provide qualified teachers to deliver evidence-based practices in areas like social competence leave schools, such as those found in rural areas, in need of support. Distance education and in particular, 3D Virtual Learning, holds great promise for supporting schools and youth to gain social competence through knowledge and social practice in context. iSocial, a distance education, 3D virtual learning environment implemented the 31-lesson social competence intervention for adolescents across three small cohorts totaling 11 students over a period of 4 months. Results demonstrated that the social competence curriculum was delivered with fidelity in the 3D virtual learning environment. Moreover, learning outcomes suggest that the iSocial approach shows promise for social competence benefits for youth.

  18. Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

    Science.gov (United States)

    Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

    2016-09-06

    Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change

  19. Evolutionary Game Model Study of Construction Green Supply Chain Management under the Government Intervention

    Science.gov (United States)

    Xing, Yuanzhi; Deng, Xiaoyi

    2017-11-01

    The paper first has defined the concepts of green supply chain management and evolution game theory, and pointed out the characteristics of green supply chain management in construction. The main participants and key links of the construction green supply chain management are determined by constructing the organization framework. This paper established the evolutionary game model between construction enterprises and recycling enterprises for the green supply chain closed-loop structure. The waste recycling evolutionary stability equilibrium solution is obtained to explore the principle and effective scope of government policy intervention. This paper put forward the relevant countermeasures to the green supply chain management in construction recycling stage from the government point of view. The conclusion has reference value and guidance to the final product construction enterprises, recycling enterprises and the government during green supply chain.

  20. A Healthy Lifestyle Intervention Delivered by Aspiring Physical Education Teachers to Children from Social Disadvantage: Study Protocol and Preliminary Findings

    Science.gov (United States)

    Breslin, Gavin; Brennan, Deirdre

    2012-01-01

    We describe the design of a school-based healthy lifestyle intervention for eight-year-old to nine-year-old school children from lower socio-economic backgrounds, intended to increase physical activity, decrease sedentary behaviours, reduce screen-time behaviours, encourage healthy attitudes and behaviours to nutrition, and reduce body mass index.…

  1. Ethical Issues in Using Social Media to Deliver an HIV Prevention Intervention: Results from the HOPE Peru Study.

    Science.gov (United States)

    Garett, Renee; Menacho, Luis; Young, Sean D

    2017-02-01

    Social media technologies have become increasingly useful tools for research-based interventions. However, participants and social media users have expressed ethical concerns with these studies, such as risks and benefits of participation, as well as privacy, confidentiality, and informed consent issues. This study was designed to follow up with and assess experiences and perceptions of ethics-related issues among a sample of 211 men who have sex with men who participated in the Harnessing Online Peer Education (HOPE) Peru study, a randomized controlled HIV prevention intervention conducted in Peru. We found that after adjusting for age, highest educational attainment, race, sexual orientation, and prior HIV research experience, participants in the intervention group were more likely than those in the control group to have safe sex (p = 0.0051) and get tested for HIV regularly (p = 0.0051). As a result of their participation, those in the intervention group benefited more positively than participants in the control group in improving HIV care (p = 0.0077) and learning where to receive sexual health services (p = 0.0021). Participants in the intervention group expressed higher levels of comfort than those in the control group in joining and seeing other people in the Facebook group (p = 0.039), seeing other people's posts (p = 0.038) and having other group members talk to them online (p = 0.040). We discuss the implications of these results as they relate to social media-based HIV research.

  2. Efficacy of a health educator-delivered HIV prevention intervention for Latina women: a randomized controlled trial.

    Science.gov (United States)

    Wingood, Gina M; DiClemente, Ralph J; Villamizar, Kira; Er, Deja L; DeVarona, Martina; Taveras, Janelle; Painter, Thomas M; Lang, Delia L; Hardin, James W; Ullah, Evelyn; Stallworth, JoAna; Purcell, David W; Jean, Reynald

    2011-12-01

    We developed and assessed AMIGAS (Amigas, Mujeres Latinas, Inform andonos, Gui andonos, y Apoy andonos contra el SIDA [friends, Latina women, informing each other, guiding each other, and supporting each other against AIDS]), a culturally congruent HIV prevention intervention for Latina women adapted from SiSTA (Sistas Informing Sistas about Topics on AIDS), an intervention for African American women. We recruited 252 Latina women aged 18 to 35 years in Miami, Florida, in 2008 to 2009 and randomized them to the 4-session AMIGAS intervention or a 1-session health intervention. Participants completed audio computer-assisted self-interviews at baseline and follow-up. Over the 6-month follow-up, AMIGAS participants reported more consistent condom use during the past 90 (adjusted odds ratio [AOR] = 4.81; P < .001) and 30 (AOR = 3.14; P < .001) days and at last sexual encounter (AOR = 2.76; P < .001), and a higher mean percentage condom use during the past 90 (relative change = 55.7%; P < .001) and 30 (relative change = 43.8%; P < .001) days than did comparison participants. AMIGAS participants reported fewer traditional views of gender roles (P = .008), greater self-efficacy for negotiating safer sex (P < .001), greater feelings of power in relationships (P = .02), greater self-efficacy for using condoms (P < .001), and greater HIV knowledge (P = .009) and perceived fewer barriers to using condoms (P < .001). Our results support the efficacy of this linguistically and culturally adapted HIV intervention among ethnically diverse, predominantly foreign-born Latina women.

  3. Impacts of cooling intervention on the heat strain attenuation of construction workers.

    Science.gov (United States)

    Zhao, Yijie; Yi, Wen; Chan, Albert P C; Wong, Del P

    2018-05-25

    This study aimed to evaluate the effectiveness and practicality of a cooling intervention with a newly designed cooling vest on heat strain attenuation in the construction industry. Fourteen construction workers volunteered to participate in the field study. Each participant took part in two trials, i.e., cooling and control. Construction work included morning and afternoon sessions. Cooling intervention was implemented for 15 and 30 min during the morning and afternoon rest periods, respectively, between repeated bouts of work. Micrometeorological (wet-bulb globe temperature [WBGT]), physiological (tympanic temperature and heart rate), and perceptual (ratings of perceived exertion [RPE] and thermal sensation) measurements were taken during the test. Heat strain indices, including physiological strain index (PSI HR ) and perceptual strain index (PeSI), were estimated accordingly. During the study, construction workers were exposed to a hot environment with a mean WBGT of 31.56 ± 1.87 °C. Compared with the control, physiological and perceptual strain were significantly reduced in the cooling condition during rest and subsequent work periods (p construction industry. The effectiveness and practicality of a proposed cooling intervention were tested in a field study. Results provide a reference for setting guidelines and promoting application on a range of construction sites.

  4. Gender based violence and psychosocial intervention at Quito. Weaving narratives to construct new meanings

    Directory of Open Access Journals (Sweden)

    Paz Guarderas

    2014-11-01

    Full Text Available Very few studies have been done in Ecuador on psychosocial interventions involving gender violence. This article, based on research carried out in Quito with people who have experienced this type of violence, is intended to contribute to the debate on the subject. Through narrative production methodology, we hope to construct new meanings of psychosocial intervention and gender violence. The participants offer conceptions of gender violence that go beyond aspects usually taken into account in the creation of laws and services. They point out that current psychosocial intervention in response to gender violence tends to homogenize women, providing services that reduce these situations to woman/victim-man/perpetrator scenarios.

  5. Delivering an empowerment intervention to a remote Indigenous child safety workforce: Its economic cost from an agency perspective.

    Science.gov (United States)

    Kinchin, Irina; Doran, Christopher M; McCalman, Janya; Jacups, Susan; Tsey, Komla; Lines, Katrina; Smith, Kieran; Searles, Andrew

    2017-10-01

    The Family Wellbeing (FWB) program applies culturally appropriate community led empowerment training to enhance the personal development of Aboriginal and Torres Strait Islander people in life skills. This study sought to estimate the economic cost required to deliver the FWB program to a child safety workforce in remote Australian communities. This study was designed as a retrospective cost description taken from the perspective of a non-government child safety agency. The target population were child protection residential care workers aged 24 or older, who worked in safe houses in five remote Indigenous communities and a regional office during the study year (2013). Resource utilization included direct costs (personnel and administrative) and indirect or opportunity costs of participants, regarded as absence from work. The total cost of delivering the FWB program for 66 participants was $182,588 ($2766 per participant), with 45% ($82,995) of costs classified as indirect (i.e., opportunity cost of participants time). Training cost could be further mitigated (∼30%) if offered on-site, in the community. The costs for offering the FWB program to a remotely located workforce were high, but not substantial when compared to the recruitment cost required to substitute a worker in remote settings. An investment of $2766 per participant created an opportunity to improve social and emotional wellbeing of remotely located workforce. This cost study provided policy relevant information by identifying the resources required to transfer the FWB program to other remote locations. It also can be used to support future comparative cost and outcome analyses and add to the evidence base around the cost-effectiveness of empowerment programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: priorities for implementation and research.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Lassi, Zohra S; Bergeron, Gilles; Koletzko, Berthold; Salam, Rehana; Diaz, Angela; McLean, Mireille; Black, Robert E; De-Regil, Luz Maria; Christian, Parul; Prentice, Andrew M; Klein, Jonathan D; Keenan, William; Hanson, Mark

    2017-04-01

    Adolescent nutritional behaviors are assuming considerable importance in nutrition interventions given their important relationships with medium- and long-term outcomes. This is the period when young people undergo major anatomical and physiological maturational changes in preparation for adulthood. Nutritional requirements during puberty are higher during adolescence than during the prepubertal stage and during adulthood. A significant proportion of adolescents also become parents, and hence the importance of their health and nutritional status before as well as during pregnancy has its impact on their own health, fetal well-being, and newborn health. In this paper, we describe the evidence-based nutrition recommendations and the current global guidance for nutrition actions for adolescents. Despite the limitations of available information, we believe that a range of interventions are feasible to address outcomes in this age group, although some would need to start earlier in childhood. We propose packages of preventive care and management comprising nutrition-specific and nutrition-sensitive interventions to address adolescent undernutrition, overnutrition, and micronutrient deficiencies. We discuss potential delivery platforms and strategies relevant to low- and middle-income countries. Beyond the evidence synthesis, there is a clear need to translate evidence into policy and for implementation of key recommendations and addressing knowledge gaps through prioritized research. © 2017 New York Academy of Sciences.

  7. TRAK App Suite: A Web-Based Intervention for Delivering Standard Care for the Rehabilitation of Knee Conditions.

    Science.gov (United States)

    Spasić, Irena; Button, Kate; Divoli, Anna; Gupta, Satyam; Pataky, Tamas; Pizzocaro, Diego; Preece, Alun; van Deursen, Robert; Wilson, Chris

    2015-10-16

    Standard care for the rehabilitation of knee conditions involves exercise programs and information provision. Current methods of rehabilitation delivery struggle to keep up with large volumes of patients and the length of treatment required to maximize the recovery. Therefore, the development of novel interventions to support self-management is strongly recommended. Such interventions need to include information provision, goal setting, monitoring, feedback, and support groups, but the most effective methods of their delivery are poorly understood. The Internet provides a medium for intervention delivery with considerable potential for meeting these needs. The objective of this study was to demonstrate the feasibility of a Web-based app and to conduct a preliminary review of its practicability as part of a complex medical intervention in the rehabilitation of knee disorders. This paper describes the development, implementation, and usability of such an app. An interdisciplinary team of health care professionals and researchers, computer scientists, and app developers developed the TRAK app suite. The key functionality of the app includes information provision, a three-step exercise program based on a standard care for the rehabilitation of knee conditions, self-monitoring with visual feedback, and a virtual support group. There were two types of stakeholders (patients and physiotherapists) that were recruited for the usability study. The usability questionnaire was used to collect both qualitative and quantitative information on computer and Internet usage, task completion, and subjective user preferences. A total of 16 patients and 15 physiotherapists participated in the usability study. Based on the System Usability Scale, the TRAK app has higher perceived usability than 70% of systems. Both patients and physiotherapists agreed that the given Web-based approach would facilitate communication, provide information, help recall information, improve understanding

  8. Feasibility of a computer-delivered driver safety behavior screening and intervention program initiated during an emergency department visit.

    Science.gov (United States)

    Murphy, Mary; Smith, Lucia; Palma, Anton; Lounsbury, David; Bijur, Polly; Chambers, Paul; Gallagher, E John

    2013-01-01

    Injuries from motor vehicle crashes are a significant public health problem. The emergency department (ED) provides a setting that may be used to screen for behaviors that increase risk for motor vehicle crashes and provide brief interventions to people who might otherwise not have access to screening and intervention. The purpose of the present study was to (1) assess the feasibility of using a computer-assisted screening program to educate ED patients about risky driving behaviors, (2) evaluate patient acceptance of the computer-based traffic safety educational intervention during an ED visit, and (3) assess postintervention changes in risky driving behaviors. Pre/posteducational intervention involving medically stable adult ED patients in a large urban academic ED serving over 100,000 patients annually. Patients completed a self-administered, computer-based program that queried patients on risky driving behaviors (texting, talking, and other forms of distracted driving) and alcohol use. The computer provided patients with educational information on the dangers of these behaviors and data were collected on patient satisfaction with the program. Staff called patients 1 month post-ED visit for a repeat query. One hundred forty-nine patients participated, and 111 completed 1-month follow up (75%); the mean age was 39 (range: 21-70), 59 percent were Hispanic, and 52 percent were male. Ninety-seven percent of patients reported that the program was easy to use and that they were comfortable receiving this education via computer during their ED visit. All driving behaviors significantly decreased in comparison to baseline with the following reductions reported: talking on the phone, 30 percent; aggressive driving, 30 percent; texting while driving, 19 percent; drowsy driving, 16 percent; driving while multitasking, 12 percent; and drinking and driving, 9 percent. Overall, patients were very satisfied receiving educational information about these behaviors via computer

  9. Constructing a Theory- and Evidence-Based Treatment Rationale for Complex eHealth Interventions: Development of an Online Alcohol Intervention Using an Intervention Mapping Approach.

    Science.gov (United States)

    Brendryen, Håvar; Johansen, Ayna; Nesvåg, Sverre; Kok, Gerjo; Duckert, Fanny

    2013-01-23

    Due to limited reporting of intervention rationale, little is known about what distinguishes a good intervention from a poor one. To support improved design, there is a need for comprehensive reports on novel and complex theory-based interventions. Specifically, the emerging trend of just-in-time tailoring of content in response to change in target behavior or emotional state is promising. The objective of this study was to give a systematic and comprehensive description of the treatment rationale of an online alcohol intervention called Balance. We used the intervention mapping protocol to describe the treatment rationale of Balance. The intervention targets at-risk drinking, and it is delivered by email, mobile phone text messaging, and tailored interactive webpages combining text, pictures, and prerecorded audio. The rationale of the current treatment was derived from a self-regulation perspective, and the overarching idea was to support continued self-regulation throughout the behavior change process. Maintaining the change efforts over time and coping adaptively during critical moments (eg, immediately before and after a lapse) are key factors to successful behavior change. Important elements of the treatment rationale to achieving these elements were: (1) emotion regulation as an inoculation strategy against self-regulation failure, (2) avoiding lapses by adaptive coping, and (3) avoiding relapse by resuming the change efforts after a lapse. Two distinct and complementary delivery strategies were used, including a day-to-day tunnel approach in combination with just-in-time therapy. The tunnel strategy was in accordance with the need for continuous self-regulation and it functions as a platform from which just-in-time therapy was launched. Just-in-time therapy was used to support coping during critical moments, and started when the client reports either low self-efficacy or that they were drinking above target levels. The descriptions of the treatment

  10. Evidence supporting a promotora-delivered entertainment education intervention for improving mothers' dietary intake: the Entre Familia: Reflejos de Salud Study.

    Science.gov (United States)

    Ayala, Guadalupe X; Ibarra, Leticia; Horton, Lucy; Arredondo, Elva M; Slymen, Donald J; Engelberg, Moshe; Rock, Cheryl L; Hernandez, Erika; Parada, Humberto; Elder, John P

    2015-01-01

    Entertainment education and the promotora model are 2 evidence-based health communication strategies. This study examined their combined effect on promoting healthy eating among mothers in a family-based intervention. Participants were 361 Mexican-origin families living in Imperial County, California, who were randomly assigned to an intervention or delayed treatment condition. The intervention involved promotoras (community health workers) who delivered 11 home visits and 4 telephone calls. Home visits included a 12-minute episode of a 9-part situation comedy depicting a family struggling with making healthy eating choices; an accompanying family workbook was reviewed to build skills and left with the family. Baseline and immediate postintervention data were collected from the mothers, including the primary outcome of daily servings of fruits and vegetables. Other dietary and psychosocial factors related to healthy eating were examined. At postintervention, mothers in the intervention reported increases in daily vegetable servings (p ≤ .05); however, no changes were observed in fruit consumption. Improvements were observed in behavioral strategies to increase fiber (p ≤ .001) and to decrease fat intake (p ≤ .001), unhealthy eating behaviors (p ≤ .001), and individual (p ≤ .05) and family-related (p ≤ .01) perceived barriers to healthy eating. Entertainment education and promotoras engaged families and improved mothers' diets. Further research should examine the dose needed for greater changes.

  11. Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review.

    Science.gov (United States)

    Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Washburn, Richard A; Donnelly, Joseph E

    2017-02-01

    Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

  12. Supportive monitoring and disease management through the internet: an internet-delivered intervention strategy for recurrent depression.

    Science.gov (United States)

    Kordy, Hans; Backenstrass, Matthias; Hüsing, Johannes; Wolf, Markus; Aulich, Kai; Bürgy, Martin; Puschner, Bernd; Rummel-Kluge, Christine; Vedder, Helmut

    2013-11-01

    Major depression is a highly prevalent, disabling disorder associated with loss of quality of life and large economic burden for the society. Depressive disorders often follow a chronic or recurrent course. The risk of relapses increases with each additional episode. The internet-deliverable intervention strategy SUMMIT (SUpportive Monitoring and Disease Management over the InTernet) for patients with recurrent depression has been developed with the main objectives to prolong symptom-free phases and to shorten symptom-loaden phases. This paper describes the study design of a six-sites, three-arm, randomized clinical trial intended to evaluate the efficacy of this novel strategy compared to treatment as usual (TAU). Two hundred thirty six patients who had been treated for their (at least) third depressive episode in one of the six participating psychiatric centers were randomized into one of three groups: 1) TAU plus a twelve-month SUMMIT program participation with personal support or 2) TAU plus a twelve-month SUMMIT program participation without personal support, or 3) TAU alone. Primary outcome of this study is defined as the number of "well weeks" over 24months after index treatment assessed by blind evaluators based on the Longitudinal Interval Follow-Up Evaluation. If efficacious, the low monetary and nonmonetary expenditures of this automated, yet individualized intervention may open new avenues for providing an acceptable, convenient, and affordable long-term disease management strategy to people with a chronic mental condition such as recurrent depression. © 2013.

  13. A pilot trial of body weight reduction for nonalcoholic fatty liver disease with a home-based lifestyle modification intervention delivered in collaboration with interdisciplinary medical staff

    International Nuclear Information System (INIS)

    Oza, Noriko; Eguchi, Yuichiro; Mizuta, Toshihiko

    2009-01-01

    Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome. The aim of this study was to evaluate a 6-month home-based lifestyle modification intervention delivered in collaboration with physicians, hygienists, registered dietitians, and nurses. Outpatients with NAFLD diagnosed by abdominal ultrasonography were eligible for this study. Abdominal computed tomography (CT) scan evaluated liver fat deposition by the liver-spleen ratio (L/S ratio) and visceral fat accumulation as the visceral fat area (VFA; cm 2 ). During the 6-month home-based lifestyle modification intervention, each patient was examined by physicians, nurses, hygienists, and registered dietitians, who provided individualized advice to the patients. Patients recorded their daily weight for self-control of weight with recommended diet and exercise regimens. Sixty-seven NAFLD patients were enrolled in this study and 22 patients (32.8%) completed the 6-month intervention. Nineteen of the 22 patients achieved significant improvements in body weight, body mass index (BMI), waist circumference, VFA, L/S ratio, and systolic blood pressure, with improved laboratory data. Overall, 39 patients withdrew from the intervention. The mean age of the patients who withdrew was 50.0±11.0 years, which was significantly younger than that of the patients who were followed up (60.1±10.1 years; P<0.01). The reduction in body weight achieved by NAFLD patients during the 6-month intervention was associated with improved fat deposition and liver function. This intervention offers a practical approach for treating a large number of NAFLD patients with lifestyle modification therapy. (author)

  14. Paraprofessional-delivered home-visiting intervention for American Indian teen mothers and children: 3-year outcomes from a randomized controlled trial.

    Science.gov (United States)

    Barlow, Allison; Mullany, Britta; Neault, Nicole; Goklish, Novalene; Billy, Trudy; Hastings, Ranelda; Lorenzo, Sherilynn; Kee, Crystal; Lake, Kristin; Redmond, Cleve; Carter, Alice; Walkup, John T

    2015-02-01

    The Affordable Care Act provides funding for home-visiting programs to reduce health care disparities, despite limited evidence that existing programs can overcome implementation and evaluation challenges with at-risk populations. The authors report 36-month outcomes of the paraprofessional-delivered Family Spirit home-visiting intervention for American Indian teen mothers and children. Expectant American Indian teens (N=322, mean age=18.1 years) from four southwestern reservation communities were randomly assigned to the Family Spirit intervention plus optimized standard care or optimized standard care alone. Maternal and child outcomes were evaluated at 28 and 36 weeks gestation and 2, 6, 12, 18, 24, 30, and 36 months postpartum. At baseline the mothers had high rates of substance use (>84%), depressive symptoms (>32%), dropping out of school (>57%), and residential instability (51%). Study retention was ≥83%. From pregnancy to 36 months postpartum, mothers in the intervention group had significantly greater parenting knowledge (effect size=0.42) and parental locus of control (effect size=0.17), fewer depressive symptoms (effect size=0.16) and externalizing problems (effect size=0.14), and lower past month use of marijuana (odds ratio=0.65) and illegal drugs (odds ratio=0.67). Children in the intervention group had fewer externalizing (effect size=0.23), internalizing (effect size=0.23), and dysregulation (effect size=0.27) problems. The paraprofessional home-visiting intervention promoted effective parenting, reduced maternal risks, and improved child developmental outcomes in the U.S. population subgroup with the fewest resources and highest behavioral health disparities. The methods and results can inform federal efforts to disseminate and sustain evidence-based home-visiting interventions in at-risk populations.

  15. Development of a culturally appropriate computer-delivered tailored Internet-based health literacy intervention for Spanish-dominant Hispanics living with HIV.

    Science.gov (United States)

    Jacobs, Robin J; Caballero, Joshua; Ownby, Raymond L; Kane, Michael N

    2014-11-30

    Low health literacy is associated with poor medication adherence in persons with human immunodeficiency virus (HIV), which can lead to poor health outcomes. As linguistic minorities, Spanish-dominant Hispanics (SDH) face challenges such as difficulties in obtaining and understanding accurate information about HIV and its treatment. Traditional health educational methods (e.g., pamphlets, talking) may not be as effective as delivering through alternate venues. Technology-based health information interventions have the potential for being readily available on desktop computers or over the Internet. The purpose of this research was to adapt a theoretically-based computer application (initially developed for English-speaking HIV-positive persons) that will provide linguistically and culturally appropriate tailored health education to Spanish-dominant Hispanics with HIV (HIV + SDH). A mixed methods approach using quantitative and qualitative interviews with 25 HIV + SDH and 5 key informants guided by the Information-Motivation-Behavioral (IMB) Skills model was used to investigate cultural factors influencing medication adherence in HIV + SDH. We used a triangulation approach to identify major themes within cultural contexts relevant to understanding factors related to motivation to adhere to treatment. From this data we adapted an automated computer-based health literacy intervention to be delivered in Spanish. Culture-specific motivational factors for treatment adherence in HIV + SDH persons that emerged from the data were stigma, familismo (family), mood, and social support. Using this data, we developed a culturally and linguistically adapted a tailored intervention that provides information about HIV infection, treatment, and medication related problem solving skills (proven effective in English-speaking populations) that can be delivered using touch-screen computers, tablets, and smartphones to be tested in a future study. Using a theoretically

  16. Protocol for a systematic review with network meta-analysis of the modalities used to deliver eHealth interventions for chronic pain.

    Science.gov (United States)

    Slattery, Brian W; Haugh, Stephanie; Francis, Kady; O'Connor, Laura; Barrett, Katie; Dwyer, Christopher P; O'Higgins, Siobhan; Egan, Jonathan; McGuire, Brian E

    2017-03-03

    As eHealth interventions prove both efficacious and practical, and as they arguably overcome certain barriers encountered by traditional face-to-face treatment for chronic pain, their number has increased dramatically in recent times. However, there is a dearth of research that focuses on evaluating and comparing the different types of technology-assisted interventions. This is a protocol for a systematic review that aims to evaluate the eHealth modalities in the context of psychological and non-psychological (other than non-drug) interventions for chronic pain. We will search the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase and PsycINFO. Randomised controlled trials (RCTs) with more than 20 participants per trial arm that have evaluated non-drug psychological or non-psychological interventions delivered via an eHealth modality and have pain as an outcome measure will be included. Two review authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one outcome variable in accordance with the IMMPACT guidelines (i.e. pain severity, pain interference, physical functioning, symptoms, emotional functioning, global improvement and disposition). Secondary outcomes will be measures of depression and health-related quality of life (HRQoL). A network meta-analysis will be conducted based on direct comparisons to generate indirect comparisons of modalities across treatment trials, which will return rankings for the eHealth modalities in terms of their effectiveness. Most trials that use an eHealth intervention to manage chronic pain typically use one modality. As a result, little evidence exists to support which modality type is the most effective. The current review will address this gap in the literature and compare the different eHealth modalities used for technology-assisted interventions for

  17. Delivering Reading Intervention to the Poorest Children: The Case of Liberia and EGRA-Plus, a Primary Grade Reading Assessment and Intervention

    Science.gov (United States)

    Davidson, Marcia; Hobbs, Jenny

    2013-01-01

    As governments, donors and implementation organisations re-focus Education for All Goals in terms of quality of education, increasing concerns have been raised over low literacy levels in developing countries. This paper provides key learning from the application of an early reading intervention applied in post-conflict Liberia, which included a…

  18. Delivering services to incarcerated teen fathers: a pilot intervention to increase the quality of father-infant interactions during visitation.

    Science.gov (United States)

    Barr, Rachel; Morin, Marisa; Brito, Natalie; Richeda, Benjamin; Rodriguez, Jennifer; Shauffer, Carole

    2014-02-01

    The absence of a father figure has been linked to very poor developmental outcomes for the child. During incarceration, there are limited opportunities for visitation between fathers and their children. The Baby Elmo Program provides incarcerated teen fathers with parenting training and visitation with their children with the stated goal of enhancing father-child interactional quality. Forty-one incarcerated teen fathers and their infants ranging from 1 to 15 months of age participated in the present study. During individual sessions, a trained facilitator prepared fathers for visits with their children by introducing key concepts such as following the child's lead, using developmentally appropriate media to illustrate those concepts. After each training session, the incarcerated teen father interacted with his infant and the visit was video recorded. Analysis of the visit sessions focused on father's time use on different activities, the quality of father-infant interactions, and father's integration of target skills introduced in the intervention. The time-use analysis revealed that time use changed as a function of infant age. Growth linear modeling indicated that there were significant positive increases in the amount of parent support and infant engagement as a function of the number of sessions. Follow-up analyses indicated that changes between specific sessions mapped onto the target skills discussed during specific training sessions. This study's preliminary findings suggest that an intervention integrating visitation and appropriate media may be effective for incarcerated teen fathers. Due to the lack of a randomized control group, the present findings are exploratory and are discussed with a focus on further program development. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  19. A smoking prevention photoageing intervention for secondary schools in Brazil delivered by medical students: protocol for a randomised trial.

    Science.gov (United States)

    Faria, Bianca Lisa; Brieske, Christian M; Cosgarea, Ioana; Omlor, Albert J; Fries, Fabian N; de Faria, Christian Olber Moreira; Lino, Henrique Augusto; Oliveira, Ana Carla Cruz; Lisboa, Oscar Campos; Klode, Joachim; Schadendorf, Dirk; Bernardes-Souza, Breno; Brinker, Titus J

    2017-12-10

    Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous; the dramatic health consequences are too far in the future to fathom. We recently designed and tested an intervention that takes advantage of the broad availability of mobile phones as well as adolescents' interest in their appearance. A free photoageing mobile app (Smokerface) was implemented by medical students in secondary schools via a novel method called mirroring. The pupils' altered three-dimensional selfies on tablets were 'mirrored' via a projector in front of their whole grade. This is the first randomised trial to measure the effectiveness of the mirroring approach on smoking behaviour in secondary schools. The mirroring intervention, which lasts 45 min, is implemented by Brazilian medical students in at least 35 secondary school classes with 21 participants each (at least 35 classes with 21 participants for control) in February 2018 in the city of Itauna, Brazil. External block randomisation via computer is performed on the class level with a 1:1 allocation. In addition to sociodemographic data, smoking behaviour is measured via a paper-pencil questionnaire before, 3 and 6 months postintervention plus a random carbon monoxide breathing test at baseline and end line. The primary outcome is cigarette smoking in the past week at 6 months follow-up. Smoking behaviour (smoking onset, quitting) and effects on the different genders are studied as secondary outcomes. Analysis is by intention to treat. Ethical approval is obtained from the ethics committee of the University of Itauna in Brazil. Results will be disseminated at conferences, in peer-reviewed journals, throughout the Education Against Tobacco network social media channels and on our websites. NCT03178227. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research.

    Science.gov (United States)

    Richardson, Michelle; Moore, Darren A; Gwernan-Jones, Ruth; Thompson-Coon, Jo; Ukoumunne, Obioha; Rogers, Morwenna; Whear, Rebecca; Newlove-Delgado, Tamsin V; Logan, Stuart; Morris, Christopher; Taylor, Eric; Cooper, Paul; Stein, Ken; Garside, Ruth; Ford, Tamsin J

    2015-01-01

    BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by age-inappropriate levels of inattention, impulsivity and hyperactivity. School can be particularly challenging for children with ADHD. Few reviews have considered non-pharmacological interventions in school settings. OBJECTIVES To assess the effectiveness of non-pharmacological interventions delivered in school settings for pupils with, or at risk of, ADHD and to explore the factors that may enhance, or limit, their delivery. DATA SOURCES Twenty electronic databases (including PsycINFO, MEDLINE, EMBASE, Education Resources Information Centre, The Cochrane Library and Education Research Complete) were searched from 1980 to February-August 2013. Three separate searches were conducted for four systematic reviews; they were supplemented with forward and backwards citation chasing, website searching, author recommendations and hand-searches of key journals. REVIEW METHODS The systematic reviews focused on (1) the effectiveness of school-based interventions for children with or at risk of ADHD; (2) quantitative research that explores attitudes towards school-based non-pharmacological interventions for pupils with ADHD; (3) qualitative research investigating the attitudes and experiences of children, teachers, parents and others using ADHD interventions in school settings; and (4) qualitative research exploring the experience of ADHD in school among pupils, their parents and teachers more generally. Methods of synthesis included a random-effects meta-analysis, meta-regression and narrative synthesis for review 1, narrative synthesis for review 2 and meta-ethnography and thematic analysis for reviews 3 and 4. RESULTS For review 1, 54 controlled trials met the inclusion criteria. For the 36 meta-analysed randomised controlled trials, beneficial effects (p views about the impact of interventions, although it was clear that interventions both influence and are

  1. Implementation evaluation of steering teens safe: engaging parents to deliver a new parent-based teen driving intervention to their teens.

    Science.gov (United States)

    Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

    2013-08-01

    Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. Steering Teens Safe is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills with their teens. This implementation evaluation focuses on a sample of 83 parents who delivered Steering Teens Safe to their teens. One-, 2- and 3-month follow-up assessments were conducted with intervention parents to evaluate the self-reported quantity and quality of talking about, demonstrating, and practicing safe driving goals with teens; perceived success and benefit of the program; and barriers to implementation. Over 3 months of follow-up, parents discussed driving goals with their teens for a median of 101.5 minutes. The most frequently addressed topics were general safety principles, including distracted driving, driving in bad weather, wearing a seat belt, and being a safe passenger. Parents spent a median of 30 minutes practicing safe driving skills such as changing lanes. Sixty-seven percent of parents talked to their children about rural road safety, but just 36% demonstrated and half practiced these skills with their teens. Barriers to implementation include time and opportunity barriers and resistant attitudes of their teens. However, barriers neither affected frequency of engagement nor parents' perceived benefit and comfort in delivering the program. Parents with time/opportunity barriers also had higher practice and demonstration times than parents without these barriers. Findings indicate high acceptability among parent implementers and promise for real-world delivery. Future studies are needed to assess intervention impact.

  2. The QUIT-PRIMO provider-patient Internet-delivered smoking cessation referral intervention: a cluster-randomized comparative effectiveness trial: study protocol

    Directory of Open Access Journals (Sweden)

    Ford Daniel E

    2010-11-01

    Full Text Available Abstract Background Although screening for tobacco use is increasing with electronic health records and standard protocols, other tobacco-control activities, such as referral of patients to cessation resources, is quite low. In the QUIT-PRIMO study, an online referral portal will allow providers to enter smokers' email addresses into the system. Upon returning home, the smokers will receive automated emails providing education about tobacco cessation and encouragement to use the patient smoking cessation website (with interactive tools, educational resources, motivational email messages, secure messaging with a tobacco treatment specialist, and online support group. Methods The informatics system will be evaluated in a comparative effectiveness trial of 160 community-based primary care practices, cluster-randomized at the practice level. In the QUIT-PRIMO intervention, patients will be provided a paper information-prescription referral and then "e-referred" to the system. In the comparison group, patients will receive only the paper-based information-prescription referral with the website address. Once patients go to the website, they are subsequently randomized within practices to either a standard patient smoking cessation website or an augmented version with access to a tobacco treatment specialist online, motivational emails, and an online support group. We will compare intervention and control practice participation (referral rates and patient participation (proportion referred who go to the website. We will then compare the effectiveness of the standard and augmented patient websites. Discussion Our goal is to evaluate an integrated informatics solution to increase access to web-delivered smoking cessation support. We will analyze the impact of this integrated system in terms of process (provider e-referral and patient login and patient outcomes (six-month smoking cessation. Trial Registration Web-delivered Provider Intervention for

  3. The effect of an outdoor activities' intervention delivered by older volunteers on the quality of life of older people with severe mobility limitations: a randomized controlled trial.

    Science.gov (United States)

    Rantanen, Taina; Äyräväinen, Irma; Eronen, Johanna; Lyyra, Tiinamari; Törmäkangas, Timo; Vaarama, Marja; Rantakokko, Merja

    2015-04-01

    Older community-living disabled people often have unmet activity needs and participation restrictions potentially reducing their quality of life (QoL). We examined the effects of an individualized out-of-home activity intervention delivered by volunteers on QoL among community-living older people, who have difficulty accessing the outdoors independently. Volunteering, Access to Outdoor Activities and Wellbeing in Older People (VOW; ISRCTN56847832) was a two-arm randomized single-blinded, controlled effectiveness trial (RCT) in Jyväskylä, Finland. The inclusion criteria were: age 65 or over, severe mobility limitation, able to communicate, and agree to participate in a RCT. Each intervention group member was assigned a trained volunteer with whom out-of-home activities were done once a week for 3 months (e.g., running errands or recreational activities). The primary outcome was the environmental subscore of QoL assessed with WHOQOL-BREF. Secondary outcomes were the overall QoL, physical capacity, psychological well-being, and social relationships assessed with WHOQOL_BREF and lower-extremity performance assessed with Short Physical Performance Battery (SPPB). 121 people aged 67-92 years (mean age 81.9 years, SD 5.9, 90 % women) were randomized. No treatment effect on the environmental QoL subscore was observed, but for physical capacity subscore a significant treatment effect was observed (General Linear Model, Group by Time p = 0.001). No effects were observed for the other QoL subscores or for SPPB score. This study suggests that individualized out-of-home activity intervention delivered by volunteers may influence the QoL of old severely mobility-limited community-living people in a positive way. Further studies are needed to better understand how to improve QoL of older disabled community-living people and potentially buffer them against more severe care needs and institutionalization.

  4. The Effect of a Leisure Time Physical Activity Intervention Delivered via a Workplace: 15-Month Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Marit Skogstad

    2018-02-01

    Full Text Available In line with recommendations from both the World Health Organization and the European Union some employers encourage workplace health promotion through physical activity (PA facilities and leisure time PA-initiatives. The current study describes a 15-month follow-up after an 8-week workplace delivered PA-initiative, investigates if improvements in cardiovascular risk status are sustainable, and elucidates differences according to educational level. One hundred and twenty one employees (43 women were examined before and after the 8-week PA-initiative and 94 at the 15-month follow-up. PA-levels, blood pressure, resting heart rate, lipids, glycosylated hemoglobin (HbA1c, C-reactive protein (CRP, and selected markers of inflammation were registered at baseline, immediately after the 8-week PA-initiative, and 15 months after baseline. At the end of follow-up (15-month, PA-levels—increased during the 8-week intervention—had returned to baseline values. None of the five improvements in cardiovascular markers (total cholesterol, low density lipoprotein (LDL, P-selectin, CD40Ligand (CD40L and Monocyte chemoattractant protein-1 (MCP-1 seen at the 8-week follow-up were sustained. At the 15-month follow-up as compared to baseline HbA1c, CRP (log and interleukin-6 (IL-6 were reduced by 0.06 mmol/L (95% CI −0.11,−0.01, 0.25 mg/L (95% CI −0.46,−0.04 and 0.39 pg/mL (95% CI −0.75, −0.04, respectively. At baseline, there were differences in cardiovascular risk factors comparing men with low versus high levels of education. No differences in changes in outcomes between these groups of men were found during follow-up. In this study highly educated men generally have lower levels of cardiovascular risk factors, but the effect of PA on such markers in this group do not differ from the effects seen in less educated men.

  5. A web delivered intervention for depression combining Behavioural Activation with physical activity promotion: study protocol for a pilot randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Jeffrey David Lambert

    2015-10-01

    Full Text Available Background: Physical activity (PA yields moderate effect sizes for treating depression (Cooney et al., 2013. PA may also help reduce depressive relapse, providing additional psychological benefits such as positive self-regard and a sense of competence (Babyak et al., 2000. Behavioural Activation (BA is an evidence-based psychological therapy for depression, which aims to get people more engaged with activities that provide positive reinforcement for non-depressed behaviours (Hopko, Lejuez, LePage, Hopko, & McNeil, 2003. The structured nature of BA is consistent with the use of good behaviour change techniques (specific goal-setting, self-regulation offering a potential platform for promoting PA alongside depression treatment. BA may also be useful for gradually increasing PA in people who are more sedentary than the general population. Aims: This pilot randomised controlled trial aims to assess the feasibility, acceptability, and fidelity of a web-delivered intervention combining BA and PA (eBAcPAc to enhance mental and physical health, and assess the trial methods. Method: A community sample of 120 people exhibiting symptoms of depression and who are participating in less than 150 minutes of moderate to vigorous physical activity per week will be randomized to receive eBAcPAc or be put on a wait list control group. eBAcPAc is informed by previous work (Farrand et al., 2014; Pentecost et al., 2015 and further developed using the Centre for eHealth Research and Disease management Roadmap (CeHReS (van Gemert-Pijnen et al., 2011 in order to be applied in an web-based setting. A platform hosted by the University of Glasgow which has been used to deliver a wide range of successful web-delivered interventions for mental health, will be used to deliver eBAcPAc. Feasibility measures will include data on recruitment, attrition and acceptability. Pre-post outcome measures will include the PHQ-9, and self-reported and accelerometer measured PA. Process and

  6. Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Gilmore, Brynne; McAuliffe, Eilish

    2013-09-13

    Community Health Workers are widely utilised in low- and middle-income countries and may be an important tool in reducing maternal and child mortality; however, evidence is lacking on their effectiveness for specific types of programmes, specifically programmes of a preventive nature. This review reports findings on a systematic review analysing effectiveness of preventive interventions delivered by Community Health Workers for Maternal and Child Health in low- and middle-income countries. A search strategy was developed according to the Evidence for Policy and Practice Information and Co-ordinating Centre's (EPPI-Centre) guidelines and systematic searching of the following databases occurred between June 8-11th, 2012: CINAHL, Embase, Ovid Nursing Database, PubMed, Scopus, Web of Science and POPLINE. Google, Google Scholar and WHO search engines, as well as relevant systematic reviews and reference lists from included articles were also searched. Inclusion criteria were: i) Target beneficiaries should be pregnant or recently pregnant women and/or children under-5 and/or caregivers of children under-5; ii) Interventions were required to be preventive and delivered by Community Health Workers at the household level. No exclusion criteria were stipulated for comparisons/controls or outcomes. Study characteristics of included articles were extracted using a data sheet and a peer tested quality assessment. A narrative synthesis of included studies was compiled with articles being coded descriptively to synthesise results and draw conclusions. A total of 10,281 studies were initially identified and through the screening process a total of 17 articles detailing 19 studies were included in the review. Studies came from ten different countries and consisted of randomized controlled trials, cluster randomized controlled trials, before and after, case control and cross sectional studies. Overall quality of evidence was found to be moderate. Five main preventive intervention

  7. A Web-Based, Social Networking Beginners’ Running Intervention for Adults Aged 18 to 50 Years Delivered via a Facebook Group: Randomized Controlled Trial

    Science.gov (United States)

    Boshoff, Kobie; Maher, Carol

    2018-01-01

    Background Online social networks continue to grow in popularity, with 1.7 billion users worldwide accessing Facebook each month. The use of social networking sites such as Facebook for the delivery of health behavior programs is relatively new. Objective The primary aim of this study was to determine the effectiveness of a Web-based beginners’ running program for adults aged 18 to 50 years, delivered via a Facebook group, in increasing physical activity (PA) and cardiorespiratory fitness. Methods A total of 89 adults with a mean age of 35.2 years (SD 10.9) were recruited online and via print media. Participants were randomly allocated to receive the UniSA Run Free program, an 8-week Web-based beginners’ running intervention, delivered via a closed Facebook group (n=41) that included daily interactive posts (information with links, motivational quotes, opinion polls, or questions) and details of the running sessions; or to the control group who received a hard copy of the running program (n=48). Assessments were completed online at baseline, 2 months, and 5 months. The primary outcome measures were self-reported weekly moderate to vigorous physical activity (MVPA) and objectively measured cardiorespiratory fitness. Secondary outcomes were social support, exercise attitudes, and self-efficacy. Analyses were undertaken using random effects mixed modeling. Compliance with the running program and engagement with the Facebook group were analyzed descriptively. Results Both groups significantly increased MVPA across the study period (P=.004); however, this was significantly higher in the Facebook group (P=.04). The Facebook group increased their MVPA from baseline by 140 min/week versus 91 min for the control at 2 months. MVPA remained elevated for the Facebook group (from baseline) by 129 min/week versus a 50 min/week decrease for the control at 5 months. Both groups had significant increases in social support scores at 2 months (P=.02); however, there were no group

  8. Effects of a Brief Psychoeducational Intervention for Family Conflict: Constructive Conflict, Emotional Insecurity and Child Adjustment.

    Science.gov (United States)

    Miller-Graff, Laura E; Cummings, E Mark; Bergman, Kathleen N

    2016-10-01

    The role of emotional security in promoting positive adjustment following exposure to marital conflict has been identified in a large number of empirical investigations, yet to date, no interventions have explicitly addressed the processes that predict child adjustment after marital conflict. The current study evaluated a randomized controlled trial of a family intervention program aimed at promoting constructive marital conflict behaviors thereby increasing adolescent emotional security and adjustment. Families (n = 225) were randomized into 1 of 4 conditions: Parent-Adolescent (n = 75), Parent-Only (n = 75), Self-Study (n = 38) and No Treatment (n = 37). Multi-informant and multi-method assessments were conducted at baseline, post-treatment and 6-month follow-up. Effects of treatment on destructive and constructive conflict behaviors were evaluated using multilevel models where observations were nested within individuals over time. Process models assessing the impact of constructive and destructive conflict behaviors on emotional insecurity and adolescent adjustment were evaluated using path modeling. Results indicated that the treatment was effective in increasing constructive conflict behaviors (d = 0.89) and decreasing destructive conflict behaviors (d = -0.30). For the Parent-Only Group, post-test constructive conflict behaviors directly predicted lower levels of adolescent externalizing behaviors at 6-month follow-up. Post-test constructive conflict skills also indirectly affected adolescent internalizing behaviors through adolescent emotional security. These findings support the use of a brief psychoeducational intervention in improving post-treatment conflict and emotional security about interparental relationships.

  9. Using the Medical Research Council framework for development and evaluation of complex interventions in a low resource setting to develop a theory-based treatment support intervention delivered via SMS text message to improve blood pressure control.

    Science.gov (United States)

    Bobrow, Kirsten; Farmer, Andrew; Cishe, Nomazizi; Nwagi, Ntobeko; Namane, Mosedi; Brennan, Thomas P; Springer, David; Tarassenko, Lionel; Levitt, Naomi

    2018-01-23

    Several frameworks now exist to guide intervention development but there remains only limited evidence of their application to health interventions based around use of mobile phones or devices, particularly in a low-resource setting. We aimed to describe our experience of using the Medical Research Council (MRC) Framework on complex interventions to develop and evaluate an adherence support intervention for high blood pressure delivered by SMS text message. We further aimed to describe the developed intervention in line with reporting guidelines for a structured and systematic description. We used a non-sequential and flexible approach guided by the 2008 MRC Framework for the development and evaluation of complex interventions. We reviewed published literature and established a multi-disciplinary expert group to guide the development process. We selected health psychology theory and behaviour change techniques that have been shown to be important in adherence and persistence with chronic medications. Semi-structured interviews and focus groups with various stakeholders identified ways in which treatment adherence could be supported and also identified key features of well-regarded messages: polite tone, credible information, contextualised, and endorsed by identifiable member of primary care facility staff. Direct and indirect user testing enabled us to refine the intervention including refining use of language and testing of interactive components. Our experience shows that using a formal intervention development process is feasible in a low-resource multi-lingual setting. The process enabled us to pre-test assumptions about the intervention and the evaluation process, allowing the improvement of both. Describing how a multi-component intervention was developed including standardised descriptions of content aimed to support behaviour change will enable comparison with other similar interventions and support development of new interventions. Even in low

  10. Evaluation of a Participatory Ergonomics Intervention in Small Commercial Construction Firms

    Science.gov (United States)

    Dale, Ann Marie; Jaegers, Lisa; Welch, Laura; Gardner, Bethany T.; Buchholz, Bryan; Weaver, Nancy; Evanoff, Bradley A.

    2017-01-01

    Background Work-related musculoskeletal disorders (WMSD) among construction workers remain high. Participatory ergonomics (PE) interventions that engage workers and employers in reducing work injury risks have shown mixed results. Methods Eight-six workers from seven contractors participated in a PE program. A logic model guided the process evaluation and summative evaluation of short term and intermediate impacts and long term outcomes from surveys and field records. Results Process measures showed good delivery of training, high worker engagement, and low contractor participation. Workers’ knowledge improved and workers reported changes to work practices and tools used; contractor provision of appropriate equipment was low (33%). No changes were seen in symptoms or reported physical effort. Conclusions The PE program produced many worker-identified ergonomic solutions, but lacked needed support from contractors. Future interventions should engage higher levels of the construction organizational system to improve contractor involvement for reducing WMSD. PMID:27094450

  11. Using mobile technology to deliver a cognitive behaviour therapy-informed intervention in early psychosis (Actissist): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bucci, Sandra; Barrowclough, Christine; Ainsworth, John; Morris, Rohan; Berry, Katherine; Machin, Matthew; Emsley, Richard; Lewis, Shon; Edge, Dawn; Buchan, Iain; Haddock, Gillian

    2015-09-10

    Cognitive behaviour therapy (CBT) is recommended for the treatment of psychosis; however, only a small proportion of service users have access to this intervention. Smartphone technology using software applications (apps) could increase access to psychological approaches for psychosis. This paper reports the protocol development for a clinical trial of smartphone-based CBT. We present a study protocol that describes a single-blind randomised controlled trial comparing a cognitive behaviour therapy-informed software application (Actissist) plus Treatment As Usual (TAU) with a symptom monitoring software application (ClinTouch) plus TAU in early psychosis. The study consists of a 12-week intervention period. We aim to recruit and randomly assign 36 participants registered with early intervention services (EIS) across the North West of England, UK in a 2:1 ratio to each arm of the trial. Our primary objective is to determine whether in people with early psychosis the Actissist app is feasible to deliver and acceptable to use. Secondary aims are to determine whether Actissist impacts on predictors of first episode psychosis (FEP) relapse and enhances user empowerment, functioning and quality of life. Assessments will take place at baseline, 12 weeks (post-treatment) and 22-weeks (10 weeks post-treatment) by assessors blind to treatment condition. The trial will report on the feasibility and acceptability of Actissist and compare outcomes between the randomised arms. The study also incorporates semi-structured interviews about the experience of participating in the Actissist trial that will be qualitatively analysed to inform future developments of the Actissist protocol and app. To our knowledge, this is the first controlled trial to test the feasibility, acceptability, uptake, attrition and potential efficacy of a CBT-informed smartphone app for early psychosis. Mobile applications designed to deliver a psychologically-informed intervention offer new possibilities to

  12. Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial.

    Science.gov (United States)

    Joseph, Rodney P; Keller, Colleen; Adams, Marc A; Ainsworth, Barbara E

    2015-03-27

    African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women. Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction. All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = -74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = -34 minutes/week) in comparison to PI participants (all P's  .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P program to a friend

  13. Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research.

    Science.gov (United States)

    Richardson, Michelle; Moore, Darren A; Gwernan-Jones, Ruth; Thompson-Coon, Jo; Ukoumunne, Obioha; Rogers, Morwenna; Whear, Rebecca; Newlove-Delgado, Tamsin V; Logan, Stuart; Morris, Christopher; Taylor, Eric; Cooper, Paul; Stein, Ken; Garside, Ruth; Ford, Tamsin J

    2015-06-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by age-inappropriate levels of inattention, impulsivity and hyperactivity. School can be particularly challenging for children with ADHD. Few reviews have considered non-pharmacological interventions in school settings. To assess the effectiveness of non-pharmacological interventions delivered in school settings for pupils with, or at risk of, ADHD and to explore the factors that may enhance, or limit, their delivery. Twenty electronic databases (including PsycINFO, MEDLINE, EMBASE, Education Resources Information Centre, The Cochrane Library and Education Research Complete) were searched from 1980 to February-August 2013. Three separate searches were conducted for four systematic reviews; they were supplemented with forward and backwards citation chasing, website searching, author recommendations and hand-searches of key journals. The systematic reviews focused on (1) the effectiveness of school-based interventions for children with or at risk of ADHD; (2) quantitative research that explores attitudes towards school-based non-pharmacological interventions for pupils with ADHD; (3) qualitative research investigating the attitudes and experiences of children, teachers, parents and others using ADHD interventions in school settings; and (4) qualitative research exploring the experience of ADHD in school among pupils, their parents and teachers more generally. Methods of synthesis included a random-effects meta-analysis, meta-regression and narrative synthesis for review 1, narrative synthesis for review 2 and meta-ethnography and thematic analysis for reviews 3 and 4. For review 1, 54 controlled trials met the inclusion criteria. For the 36 meta-analysed randomised controlled trials, beneficial effects (p intervention features were linked with effectiveness. For review 2, 28 included studies revealed that educators' attitudes towards interventions ranged in positivity

  14. Acceptability of woman-delivered HIV self-testing to the male partner, and additional interventions: a qualitative study of antenatal care participants in Malawi.

    Science.gov (United States)

    Choko, Augustine Talumba; Kumwenda, Moses Kelly; Johnson, Cheryl Case; Sakala, Doreen Wongera; Chikalipo, Maria Chifuniro; Fielding, Katherine; Chikovore, Jeremiah; Desmond, Nicola; Corbett, Elizabeth Lucy

    2017-06-26

    In the era of ambitious HIV targets, novel HIV testing models are required for hard-to-reach groups such as men, who remain underserved by existing services. Pregnancy presents a unique opportunity for partners to test for HIV, as many pregnant women will attend antenatal care (ANC). We describe the views of pregnant women and their male partners on HIV self-test kits that are woman-delivered, alone or with an additional intervention. A formative qualitative study to inform the design of a multi-arm multi-stage cluster-randomized trial, comprised of six focus group discussions and 20 in-depth interviews, was conducted. ANC attendees were purposively sampled on the day of initial clinic visit, while men were recruited after obtaining their contact information from their female partners. Data were analysed using content analysis, and our interpretation is hypothetical as participants were not offered self-test kits. Providing HIV self-test kits to pregnant women to deliver to their male partners was highly acceptable to both women and men. Men preferred this approach compared with standard facility-based testing, as self-testing fits into their lifestyles which were characterized by extreme day-to-day economic pressures, including the need to raise money for food for their household daily. Men and women emphasized the need for careful communication before and after collection of the self-test kits in order to minimize the potential for intimate partner violence although physical violence was perceived as less likely to occur. Most men stated a preference to first self-test alone, followed by testing as a couple. Regarding interventions for optimizing linkage following self-testing, both men and women felt that a fixed financial incentive of approximately USD$2 would increase linkage. However, there were concerns that financial incentives of greater value may lead to multiple pregnancies and lack of child spacing. In this low-income setting, a lottery incentive was

  15. Improving physical functional and quality of life in older adults with multiple sclerosis via a DVD-delivered exercise intervention: a study protocol.

    Science.gov (United States)

    Wójcicki, Thomas R; Roberts, Sarah A; Learmonth, Yvonne C; Hubbard, Elizabeth A; Kinnett-Hopkins, Dominque; Motl, Robert W; McAuley, Edward

    2014-12-01

    There is a need to identify innovative, low-cost and broad-reaching strategies for promoting exercise and improving physical function in older adults with multiple sclerosis (MS). This randomised controlled pilot trial will test the efficacy of a 6-month, DVD-delivered exercise intervention to improve functional performance and quality of life in older adults with MS. Participants will be randomised either into a DVD-delivered exercise condition or an attentional control condition. This novel approach to programme delivery provides participants with detailed exercise instructions which are presented in a progressive manner and includes a variety of modifications to better meet varying levels of physical abilities. The targeted exercises focus on three critical elements of functional fitness: flexibility, strength and balance. It is hypothesised that participants who are randomised to the exercise DVD condition will demonstrate improvements in physical function compared with participants assigned to the attentional control condition. Data analysis will include a 2 (condition)×2 (time) mixed factor analysis of variance (ANOVA) that follows intent-to-treat principles, as well as an examination of effect sizes. Participants will take part in qualitative interviews about perspectives on physical activity and programme participation. The study protocol was approved by a university institutional review board and registered with a federal database. Participants will be asked to read and sign a detailed informed consent document and will be required to provide a physician's approval to participate in the study. The exercise DVDs include an overview of safety-related concerns and recommendations relative to exercise participation, as well as detailed instructions highlighting the proper execution of each exercise presented on screen. Following completion of this trial, data will be immediately analysed and results will be presented at scientific meetings and published in

  16. A Web-Based, Social Networking Beginners' Running Intervention for Adults Aged 18 to 50 Years Delivered via a Facebook Group: Randomized Controlled Trial.

    Science.gov (United States)

    Looyestyn, Jemma; Kernot, Jocelyn; Boshoff, Kobie; Maher, Carol

    2018-02-26

    Online social networks continue to grow in popularity, with 1.7 billion users worldwide accessing Facebook each month. The use of social networking sites such as Facebook for the delivery of health behavior programs is relatively new. The primary aim of this study was to determine the effectiveness of a Web-based beginners' running program for adults aged 18 to 50 years, delivered via a Facebook group, in increasing physical activity (PA) and cardiorespiratory fitness. A total of 89 adults with a mean age of 35.2 years (SD 10.9) were recruited online and via print media. Participants were randomly allocated to receive the UniSA Run Free program, an 8-week Web-based beginners' running intervention, delivered via a closed Facebook group (n=41) that included daily interactive posts (information with links, motivational quotes, opinion polls, or questions) and details of the running sessions; or to the control group who received a hard copy of the running program (n=48). Assessments were completed online at baseline, 2 months, and 5 months. The primary outcome measures were self-reported weekly moderate to vigorous physical activity (MVPA) and objectively measured cardiorespiratory fitness. Secondary outcomes were social support, exercise attitudes, and self-efficacy. Analyses were undertaken using random effects mixed modeling. Compliance with the running program and engagement with the Facebook group were analyzed descriptively. Both groups significantly increased MVPA across the study period (P=.004); however, this was significantly higher in the Facebook group (P=.04). The Facebook group increased their MVPA from baseline by 140 min/week versus 91 min for the control at 2 months. MVPA remained elevated for the Facebook group (from baseline) by 129 min/week versus a 50 min/week decrease for the control at 5 months. Both groups had significant increases in social support scores at 2 months (P=.02); however, there were no group by time differences (P=.16). There were

  17. Improving quit rates of web-delivered interventions for smoking cessation: full-scale randomized trial of WebQuit.org versus Smokefree.gov.

    Science.gov (United States)

    Bricker, Jonathan B; Mull, Kristin E; McClure, Jennifer B; Watson, Noreen L; Heffner, Jaimee L

    2018-05-01

    Millions of people world-wide use websites to help them quit smoking, but effectiveness trials have an average 34% follow-up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; WebQuit.org) with the current standard of the National Cancer Institute's (NCI) Smokefree.gov website. A two-arm stratified double-blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for Smokefree.gov) with 12-month follow-up. United States. Adults (n = 2637) who currently smoked at least five cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean [standard deviation (SD)] age 46.2 years (13.4), 79% women and 73% white. WebQuit.org website (experimental) provided ACT for smoking cessation; Smokefree.gov website (comparison) followed US Clinical Practice Guidelines for smoking cessation. The primary outcome was self-reported 30-day point prevalence abstinence at 12 months. The 12-month follow-up data retention rate was 88% (2309 of 2637). The 30-day point prevalence abstinence rates at the 12-month follow-up were 24% (278 of 1141) for WebQuit.org and 26% (305 of 1168) for Smokefree.gov [odds ratio (OR) = 0.91; 95% confidence interval (CI) = 0.76, 1.10; P = 0.334] in the a priori complete case analysis. Abstinence rates were 21% (278 of 1319) for WebQuit.org and 23% (305 of 1318) for Smokefree.gov (OR = 0.89 (0.74, 1.07; P = 0.200) when missing cases were imputed as smokers. The Bayes factor comparing the primary abstinence outcome was 0.17, indicating 'substantial' evidence of no difference between groups. WebQuit.org and Smokefree.gov had similar 30-day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website-delivered interventions and telephone counselor-delivered interventions. © 2017 Society for the Study of Addiction.

  18. Short and long term effects of a lifestyle intervention for construction workers at risk for cardiovascular disease: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Groeneveld Iris F

    2011-10-01

    Full Text Available Abstract Background The prevalence of overweight and elevated cardiovascular disease (CVD risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity (PA, diet, and smoking of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease (CVD. Methods In a randomized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD, usual care was compared to a 6-month lifestyle intervention. The intervention consisted of individual counseling using motivational interviewing techniques, and was delivered by an occupational physician or occupational nurse. In three face to face and four telephone contacts, the participant's risk profile, personal determinants, and barriers for behavior change were discussed, and personal goals were set. Participants chose to aim at either diet and PA, or smoking. Data were collected at baseline and after six and 12 months, by means of a questionnaire. To analyse the data, linear and logistic regression analyses were performed. Results The intervention had a statistically significant beneficial effect on snack intake (β-1.9, 95%CI -3.7; -0.02 and fruit intake (β 1.7, 95%CI 0.6; 2.9 at 6 months. The effect on snack intake was sustained until 12 months; 6 months after the intervention had ended (β -1.9, 95%CI -3.6; -0.2. The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant. The beneficial effect on smoking was statistically significant at 6 (OR smoking 0.3, 95%CI 0.1;0.7, but not at 12 months (OR 0.8, 95%CI 0.4; 1.6. Conclusions Beneficial effects on smoking, fruit, and snack intake can be achieved by an individual-based lifestyle intervention among

  19. A randomised control crossover trial of a theory based intervention to improve sun-safe and healthy behaviours in construction workers: study protocol.

    Science.gov (United States)

    Nioi, Amanda; Wendelboe-Nelson, Charlotte; Cowan, Sue; Cowie, Hilary; Rashid, Shahzad; Ritchie, Peter; Cherrie, Mark; Lansdown, Terry C; Cherrie, John W

    2018-02-15

    Exposure to sunlight can have both positive and negative health impacts. Excessive exposure to ultra-violet (UV) radiation from the sun can cause skin cancer, however insufficient exposure to sunlight has a detrimental effect on production of Vitamin D. In the construction industry there are onsite proactive behaviours for safety, but sun-safety remains a low priority. There is limited research on understanding the barriers to adopting sun-safe behaviours and the association this may have with Vitamin D production. This paper reports a protocol for an intervention study, using text messaging in combination with a supportive smartphone App. The intervention aims to both reduce UV exposure during months with higher UV levels and promote appropriate dietary changes to boost Vitamin D levels during months with low UV levels. Approximately 60 construction workers will be recruited across the United Kingdom. A randomised control crossover trial (RCCT) will be used to test the intervention, with randomisation at site level - i.e. participants will receive both the control (no text messages or supportive App support) and intervention (daily text messages and supportive App). Using the Theory of Planned Behaviour (TPB) the intervention focuses on supporting sun-safety and healthy dietary decisions in relation to Vitamin D intake. The intervention emphasises cultivating the perception of normative support in the workplace, increasing awareness of control and self-efficacy in taking sun-protective behaviours, making healthier eating choices to boost Vitamin D, and tackling stigmas attached to image and group norms. Each study epoch will last 21 days with intervention text messages delivered on workdays only. The supportive App will provide supplementary information about sun protective behaviours and healthy dietary choices. The primary outcome measure is 25-hydroxy-Vitamin D [25(OH)D] level (obtained using blood spot sampling), which will be taken pre and post control and

  20. A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis

    OpenAIRE

    Hillier-Brown, Frances C.; Summerbell, Carolyn D.; Moore, Helen J.; Wrieden, Wendy L.; Adams, Jean; Abraham, Charles; Adamson, Ashley; Ara?jo-Soares, Vera; White, Martin; Lake, Amelia A.

    2017-01-01

    $\\textbf{Background:}$ Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. $\\...

  1. A cluster randomised controlled trial of a manualised cognitive behavioural anger management intervention delivered by supervised lay therapists to people with intellectual disabilities.

    Science.gov (United States)

    Willner, P; Rose, J; Jahoda, A; Stenfert Kroese, B; Felce, D; MacMahon, P; Stimpson, A; Rose, N; Gillespie, D; Shead, J; Lammie, C; Woodgate, C; Townson, J K; Nuttall, J; Cohen, D; Hood, K

    2013-05-01

    Anger is a frequent problem for many people with intellectual disabilities, and is often expressed as verbal and/or physical aggression. Cognitive-behaviour therapy (CBT) is the treatment of choice for common mental health problems, but CBT has only recently been adapted for people with intellectual disabilities. Anger is the main psychological presentation in which controlled trials have been used to evaluate CBT interventions for people with intellectual disabilities but these do not include rigorous randomised studies. To evaluate (1) the impact of a staff-delivered manualised CBT anger management intervention on (a) reported anger among people with mild to moderate intellectual disabilities, and (b) anger coping skills, aggression, mental health, quality of life and costs of health and social care; (2) factors that influence outcome; and (3) the experience of service users, lay therapists and service managers. A cluster randomised controlled trial based on 30 day centres (15 intervention and 15 control). Intention-to-treat comparisons of outcomes used a two-level linear regression model to allow for clustering within centres with baseline outcome levels as a covariate. Comparison of cost data used non-parametric bootstrapping. Qualitative analysis used interpretative phenomenological analysis and thematic analysis. Recruited day centres had four-plus service users with problem anger who were prepared to participate, two-plus staff willing to be lay therapists, a supportive manager and facilities for group work, and no current anger interventions. A total of 212 service users with problem anger were recruited. Thirty-three were deemed ineligible (30 could not complete assessments and three withdrew before randomisation). Retention at follow-up was 81%, with 17 withdrawals in each arm. Two to four staff per centre were recruited as lay therapists. Eleven service users, nine lay therapists and eight managers were interviewed. The manualised intervention comprised

  2. Evaluation of a participatory ergonomics intervention in small commercial construction firms.

    Science.gov (United States)

    Dale, Ann Marie; Jaegers, Lisa; Welch, Laura; Gardner, Bethany T; Buchholz, Bryan; Weaver, Nancy; Evanoff, Bradley A

    2016-06-01

    Work-related musculoskeletal disorders (WMSD) among construction workers remain high. Participatory ergonomics (PE) interventions that engage workers and employers in reducing work injury risks have shown mixed results. Eight-six workers from seven contractors participated in a PE program. A logic model guided the process evaluation and summative evaluation of short-term and intermediate impacts and long-term outcomes from surveys and field records. Process measures showed good delivery of training, high worker engagement, and low contractor participation. Workers' knowledge improved and workers reported changes to work practices and tools used; contractor provision of appropriate equipment was low (33%). No changes were seen in symptoms or reported physical effort. The PE program produced many worker-identified ergonomic solutions, but lacked needed support from contractors. Future interventions should engage higher levels of the construction organizational system to improve contractor involvement for reducing WMSD. Am. J. Ind. Med. 59:465-475, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Psychosocial constructs and postintervention changes in physical activity and dietary outcomes in a lifestyle intervention, HUB City Steps, 2010

    Science.gov (United States)

    Purpose: To examine relationships among psychosocial constructs (PSC) of behavior change and post-intervention changes in physical activity (PA) and dietary outcomes. Design: Non-controlled, pre- post-experimental intervention. Setting: Midsized, southern United States city. Subjects: 269 prima...

  4. Relieved Working study: systematic development and design of an intervention to decrease occupational quartz exposure at construction worksites

    NARCIS (Netherlands)

    Oude Hengel, K.M.; Deurssen, E. van; Meijster, T.; Tielemans, E.; Heederik, D.; Pronk, A.

    2014-01-01

    Background: Occupational quartz exposure continues to be a serious hazard in the construction industry. Until now, evidence-based interventions aimed at reducing quartz exposure are scarce. The aim of this study was to systematically develop an intervention and to describe the study to evaluate its

  5. Feasibility of Training Physical Therapists to Deliver the Theory-Based Self-Management of Osteoarthritis and Low Back Pain Through Activity and Skills (SOLAS) Intervention Within a Trial.

    Science.gov (United States)

    Keogh, Alison; Matthews, James; Segurado, Ricardo; Hurley, Deirdre A

    2018-02-01

    Provider training programs are frequently underevaluated, leading to ambiguity surrounding effective intervention components. The purpose of this study was to assess the effectiveness of a training program in guiding physical therapists to deliver the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) group education and exercise intervention (ISRCTN49875385), using a communication style underpinned by self-determination theory (SDT). This was an assessment of the intervention arm training program using quantitative methods. Thirteen physical therapists were trained using mixed methods to deliver the SOLAS intervention. Training was evaluated using the Kirkpatrick model: (1) Reaction-physical therapists' satisfaction with training, (2) Learning-therapists' confidence in and knowledge of the SDT-based communication strategies and intervention content and their skills in applying the strategies during training, and (3) Behavior-8 therapists were audio-recorded delivering all 6 SOLAS intervention classes (n = 48), and 2 raters independently coded 50% of recordings (n = 24) using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention-specific measure. Reaction: Physical therapists reacted well to training (median [IRQ]; min-max = 4.7; [0.5]; 3.7-5.0). Learning: Physical therapists' confidence in the SDT-based communication strategies and knowledge of some intervention content components significantly improved. Behavior: Therapists delivered the intervention in a needs-supportive manner (median HCCQ = 5.3 [1.4]; 3.9-6.0; median CCBS = 6.6 ([0.5]; 6.1-6.8; median intervention specific measure = 4.0 [1.2]; 3.2-4.9). However, "goal setting" was delivered below acceptable levels by all therapists (median 2.9 [0.9]; 2.0-4.0). The intervention group only was assessed as part of the process evaluation of the feasibility trial. Training effectively guided physical therapists to be needs

  6. Can a community health worker and a trained traditional birth attendant work as a team to deliver child health interventions in rural Zambia?

    Science.gov (United States)

    Yeboah-Antwi, Kojo; Hamer, Davidson H; Semrau, Katherine; Waltensperger, Karen Z; Snetro-Plewman, Gail; Kambikambi, Chilobe; Sakala, Amon; Filumba, Stephen; Sichamba, Bias; Marsh, David R

    2014-10-27

    Teaming is an accepted approach in health care settings but rarely practiced at the community level in developing countries. Save the Children trained and deployed teams of volunteer community health workers (CHWs) and trained traditional birth attendants (TBAs) to provide essential newborn and curative care for children aged 0-59 months in rural Zambia. This paper assessed whether CHWs and trained TBAs can work as teams to deliver interventions and ensure a continuum of care for all children under-five, including newborns. We trained CHW-TBA teams in teaming concepts and assessed their level of teaming prospectively every six months for two years. The overall score was a function of both teamwork and taskwork. We also assessed personal, community and service factors likely to influence the level of teaming. We created forty-seven teams of predominantly younger, male CHWs and older, female trained TBAs. After two years of deployment, twenty-one teams scored "high", twelve scored "low," and fourteen were inactive. Teamwork was high for mutual trust, team cohesion, comprehension of team goals and objectives, and communication, but not for decision making/planning. Taskwork was high for joint behavior change communication and outreach services with local health workers, but not for intra-team referral. Teams with members residing within one hour's walking distance were more likely to score high. It is feasible for a CHW and a trained TBA to work as a team. This may be an approach to provide a continuum of care for children under-five including newborns.

  7. Towards Clinically Optimized MRI-guided Surgical Manipulator for Minimally Invasive Prostate Percutaneous Interventions: Constructive Design*

    Science.gov (United States)

    Eslami, Sohrab; Fischer, Gregory S.; Song, Sang-Eun; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Iordachita, Iulian

    2013-01-01

    This paper undertakes the modular design and development of a minimally invasive surgical manipulator for MRI-guided transperineal prostate interventions. Severe constraints for the MRI-compatibility to hold the minimum artifact on the image quality and dimensions restraint of the bore scanner shadow the design procedure. Regarding the constructive design, the manipulator kinematics has been optimized and the effective analytical needle workspace is developed and followed by proposing the workflow for the manual needle insertion. A study of the finite element analysis is established and utilized to improve the mechanism weaknesses under some inevitable external forces to ensure the minimum structure deformation. The procedure for attaching a sterile plastic drape on the robot manipulator is discussed. The introduced robotic manipulator herein is aimed for the clinically prostate biopsy and brachytherapy applications. PMID:24683502

  8. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students, Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Directory of Open Access Journals (Sweden)

    Stanislaw Gorski

    2017-01-01

    Full Text Available Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students, targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards. Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization, received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

  9. An eighteen-month follow-up of a pilot parent-delivered play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder and their playmates.

    Science.gov (United States)

    Cantrill, Alycia; Wilkes-Gillan, Sarah; Bundy, Anita; Cordier, Reinie; Wilson, Nathan J

    2015-06-01

    Children with attention deficit hyperactivity disorder (ADHD) experience significant ongoing social difficulties which occur in multiple contexts. Interventions designed to improve these social difficulties have demonstrated minimal effectiveness. Thus, there is a clear need to establish interventions that are effective in addressing the social difficulties of children with ADHD across contexts and in the long term. To examine the long-term effectiveness and appropriateness of a pilot parent-delivered intervention designed to improve the social play skills of children with ADHD and their playmates. Participants included five children with ADHD who had completed the intervention 18-months prior, their typically developing playmates and mothers of children with ADHD. Blinded ratings from the Test of Playfulness were used to measure children's social play: post-intervention and 18-months following the intervention in the home and clinic. Wilcoxon signed-ranks and Cohen's-d calculations were used to measure effectiveness. Parents' perspectives of the appropriateness of the intervention were explored through semi-structured interviews and data were analysed thematically. The social play skills of children with ADHD and their playmates were maintained following the intervention in the home and clinic. Thematic analysis revealed four core-themes against an intervention appropriateness framework: new parenting tools, a social shift, adapting strategies over time and the next developmental challenge. The parent-delivered intervention demonstrated long-term effectiveness and appropriateness for improving children's social play skills. These preliminary results are promising as maintaining treatment effects and achieving generalisation across contexts has remained an unachieved goal for most psycho-social interventions. © 2015 Occupational Therapy Australia.

  10. Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial

    Science.gov (United States)

    2014-01-01

    Background More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. Methods/Design The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. Discussion The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance

  11. Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial.

    Science.gov (United States)

    Visser, Steven; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2014-04-17

    More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance strategies. When these strategies are

  12. A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis.

    Science.gov (United States)

    Hillier-Brown, Frances C; Summerbell, Carolyn D; Moore, Helen J; Wrieden, Wendy L; Adams, Jean; Abraham, Charles; Adamson, Ashley; Araújo-Soares, Vera; White, Martin; Lake, Amelia A

    2017-01-19

    Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. A systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1) and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2). A total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business, sell ready-to-eat meals, can be engaged in implementing

  13. A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered sold by specific food outlets in England: a systematic mapping and evidence synthesis

    Directory of Open Access Journals (Sweden)

    Frances C. Hillier-Brown

    2017-01-01

    Full Text Available Abstract Background Ready-to-eat meals (to eat in, to take away or to be delivered sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered sold by specific food outlets in England. Methods A systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1 and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2. Results A total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. Conclusions Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business

  14. Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

    Science.gov (United States)

    Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

    2016-04-01

    Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  15. Anger management for people with mild to moderate learning disabilities: Study protocol for a multi-centre cluster randomized controlled trial of a manualized intervention delivered by day-service staff

    Directory of Open Access Journals (Sweden)

    Nuttall Jacqueline

    2011-02-01

    Full Text Available Abstract Background Cognitive behaviour therapy (CBT is the treatment of choice for common mental health problems, but this approach has only recently been adapted for people with learning disabilities, and there is a limited evidence base for the use of CBT with this client group. Anger treatment is the one area where there exists a reasonable number of small controlled trials. This study will evaluate the effectiveness of a manualized 12-week CBT intervention for anger. The intervention will be delivered by staff working in the day services that the participants attend, following training to act as 'lay therapists' by a Clinical Psychologist, who will also provide supervision. Methods/Design This is a multi-centre cluster randomized controlled trial of a group intervention versus a 'support as usual' waiting-list control group, with randomization at the level of the group. Outcomes will be assessed at the end of the intervention and again 6-months later. After completion of the 6-month follow-up assessments, the intervention will also be delivered to the waiting-list groups. The study will include a range of anger/aggression and mental health measures, some of which will be completed by service users and also by their day service key-workers and by home carers. Qualitative data will be collected to assess the impact of the intervention on participants, lay therapists, and services, and the study will also include a service-utilization cost and consequences analysis. Discussion This will be the first trial to investigate formally how effectively staff working in services providing day activities for people with learning disabilities are able to use a therapy manual to deliver a CBT based anger management intervention, following brief training by a Clinical Psychologist. The demonstration that service staff can successfully deliver anger management to people with learning disabilities, by widening the pool of potential therapists, would have

  16. Effect of individualized worksite exercise training on aerobic capacity and muscle strength among construction workers - a randomized controlled intervention study

    DEFF Research Database (Denmark)

    Gram, Bibi; Holtermann, Andreas; Søgaard, Karen

    2012-01-01

    OBJECTIVES: The combination of high physical work demands and low physical capacity has been shown to increase the risk for cardiovascular disease and musculoskeletal disorders. The aim of this study was to assess the physical capacity of construction workers and evaluate the effect of individually...... tailored exercise programs on their physical fitness and muscular capacity. METHOD: The study was a randomized controlled trial of male constructions workers allocated to either an exercise or control group. The intervention lasted 12 weeks, and the exercise group trained 3 x 20 minutes a week....... The participants completed health checks before and after the intervention period. Data from the first health check were used to tailor the exercise in the interventions. RESULTS: At baseline, participants had maximal oxygen consumption (VO (2max)) of 2.9 [standard deviation (SD) 0.7L/min] and body mass index (BMI...

  17. iSocial: Delivering the Social Competence Intervention for Adolescents (SCI-A) in a 3D Virtual Learning Environment for Youth with High Functioning Autism

    Science.gov (United States)

    Stichter, Janine P.; Laffey, James; Galyen, Krista; Herzog, Melissa

    2014-01-01

    One consistent area of need for students with autism spectrum disorders is in the area of social competence. However, the increasing need to provide qualified teachers to deliver evidence-based practices in areas like social competence leave schools, such as those found in rural areas, in need of support. Distance education and in particular, 3D…

  18. The Preference for Internet-Based Psychological Interventions by Individuals Without Past or Current Use of Mental Health Treatment Delivered Online: A Survey Study With Mixed-Methods Analysis

    Science.gov (United States)

    Mattsson, Susanne; Olsson, Erik Martin Gustaf

    2016-01-01

    Background The use of the Internet has the potential to increase access to evidence-based mental health services for a far-reaching population at a low cost. However, low take-up rates in routine care indicate that barriers for implementing Internet-based interventions have not yet been fully identified. Objective The aim of this study was to evaluate the preference for Internet-based psychological interventions as compared to treatment delivered face to face among individuals without past or current use of mental health treatment delivered online. A further aim was to investigate predictors of treatment preference and to complement the quantitative analyses with qualitative data about the perceived advantages and disadvantages of Internet-based interventions. Methods Two convenience samples were used. Sample 1 was recruited in an occupational setting (n=231) and Sample 2 consisted of individuals previously treated for cancer (n=208). Data were collected using a paper-and-pencil survey and analyzed using mixed methods. Results The preference for Internet-based psychological interventions was low in both Sample 1 (6.5%) and Sample 2 (2.6%). Most participants preferred psychological interventions delivered face to face. Use of the Internet to search for and read health-related information was a significant predictor of treatment preference in both Sample 1 (odds ratio [OR] 2.82, 95% CI 1.18-6.75) and Sample 2 (OR 3.52, 95% CI 1.33-9.29). Being born outside of Sweden was a significant predictor of preference for Internet-based interventions, but only in Sample 2 (OR 6.24, 95% CI 1.29-30.16). Similar advantages and disadvantages were mentioned in both samples. Perceived advantages of Internet-based interventions included flexibility regarding time and location, low effort, accessibility, anonymity, credibility, user empowerment, and improved communication between therapist and client. Perceived disadvantages included anonymity, low credibility, impoverished

  19. Thirty years after Alma-Ata: a systematic review of the impact of community health workers delivering curative interventions against malaria, pneumonia and diarrhoea on child mortality and morbidity in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Lewin Simon

    2011-10-01

    Full Text Available Abstract Background Over thirty years have passed since the Alma-Ata Declaration on primary health care in 1978. Many governments in the first decade following the declaration responded by developing national programmes of community health workers (CHWs, but evaluations of these often demonstrated poor outcomes. As many CHW programmes have responded to the HIV/AIDS pandemic, international interest in them has returned and their role in the response to other diseases should be examined carefully so that lessons can be applied to their new roles. Over half of the deaths in African children under five years of age are due to malaria, diarrhoea and pneumonia - a situation which could be addressed through the use of cheap and effective interventions delivered by CHWs. However, to date there is very little evidence from randomised controlled trials of the impacts of CHW programmes on child mortality in Africa. Evidence from non-randomised controlled studies has not previously been reviewed systematically. Methods We searched databases of published and unpublished studies for RCTs and non-randomised studies evaluating CHW programmes delivering curative treatments, with or without preventive components, for malaria, diarrhoea or pneumonia, in children in sub-Saharan Africa from 1987 to 2007. The impact of these programmes on morbidity or mortality in children under six years of age was reviewed. A descriptive analysis of interventional and contextual factors associated with these impacts was attempted. Results The review identified seven studies evaluating CHWs, delivering a range of interventions. Limited descriptive data on programmes, contexts or process outcomes for these CHW programmes were available. CHWs in national programmes achieved large mortality reductions of 63% and 36% respectively, when insecticide-treated nets and anti-malarial chemoprophylaxis were delivered, in addition to curative interventions. Conclusions CHW programmes could

  20. Ethical considerations for the design and implementation of child injury prevention interventions: the example of delivering and installing safety equipment into the home.

    Science.gov (United States)

    Scholtes, Beatrice; Schröder-Bäck, Peter

    2017-12-11

    Public health ethics is a growing field of academic interest but ethical discussion of injury prevention seems to have received limited attention. Interventions that promise to be effective are not necessarily-without explicit justification-'good' and 'right' interventions in every sense. This paper explores public health ethics in the context of child injury prevention with the objective to initiate interdisciplinary dialogue on the ethics of child safety interventions. A framework of seven public health ethics principles (non-maleficence, health maximisation, beneficence, respect for autonomy, justice, efficiency and proportionality) were applied to an intervention to promote child safety in the home. Preventing child injury in the home is ethically challenging due to the requirement for the state to intervene in the private sphere. Non-maleficence and beneficence are difficult to judge within this intervention as these are likely to be highly dependent on the nature of intervention delivery, in particular, the quality of communication. Respect for autonomy is challenged by an intervention occurring in the home. The socioeconomic gradient in child injury risk is an important factor but a nuanced approach could help to avoid exacerbating inequalities or stigmatisation. Equally, a nuanced approach may be necessary to accommodate the principles of proportionality and efficiency within the local context. We conclude that this intervention is justifiable from an ethical perspective but that this type of reflection loop is helpful to identify the impact of interventions beyond effectiveness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. MENOS4 trial: a multicentre randomised controlled trial (RCT) of a breast care nurse delivered cognitive behavioural therapy (CBT) intervention to reduce the impact of hot flushes in women with breast cancer: Study Protocol.

    Science.gov (United States)

    Fenlon, Deborah; Nuttall, Jacqueline; May, Carl; Raftery, James; Fields, Jo; Kirkpatrick, Emma; Abab, Julia; Ellis, Mary; Rose, Taylor; Khambhaita, Priya; Galanopoulou, Angeliki; Maishman, Tom; Haviland, Jo; Griffiths, Gareth; Turner, Lesley; Hunter, Myra

    2018-05-08

    Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity. The research team will assess whether breast care nurses can effectively deliver a CBT intervention to alleviate hot flushes in women with breast cancer. This study is a multi-centre phase III individually randomised controlled trial of group CBT versus usual care to reduce the impact of hot flushes in women with breast cancer. 120-160 women with primary breast cancer experiencing seven or more problematic HFNS a week will be randomised to receive either treatment as usual (TAU) or participation in the group CBT intervention plus TAU (CBT Group). A process evaluation using May's Normalisation Process Theory will be conducted, as well as practical and organisational issues relating to the implementation of the intervention. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost effectiveness of the intervention will also be assessed. There is a need for studies that enable effective interventions to be implemented in practice. There is good evidence that CBT is helpful for women with breast cancer who experience HFNS, yet it is not widely available. It is not yet known whether the intervention can be effectively delivered by breast care nurses or implemented in practice. This study will provide information on both whether the intervention can effectively

  2. HABIT-an early phase study to explore an oral health intervention delivered by health visitors to parents with young children aged 9-12 months: study protocol.

    Science.gov (United States)

    Eskyte, Ieva; Gray-Burrows, Kara; Owen, Jenny; Sykes-Muskett, Bianca; Zoltie, Tim; Gill, Susanne; Smith, Victoria; McEachan, Rosemary; Marshman, Zoe; West, Robert; Pavitt, Sue; Day, Peter

    2018-01-01

    Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective home-based oral health habits thereby reducing the risk of dental caries. However, PSB is a complex behaviour with many barriers reported by parents hindering its effective implementation. Within the UK, oral health advice is delivered universally to parents by health visitors and their wider teams when children are aged between 9 and 12 months. Nevertheless, there is no standardised intervention or training upon which health visitors can base this advice, and they often lack the specialised knowledge needed to help parents overcome barriers to performing PSB and limiting sugary foods and drinks.Working with health visitors and parents of children aged 9-24 months, we have co-designed oral health training and resources (Health Visitors delivering Advice in Britain on Infant Toothbrushing (HABIT) intervention) to be used by health visitors and their wider teams when providing parents of children aged 9-12 months with oral health advice.The aim of the study is to explore the acceptability of the HABIT intervention to parents and health visitors, to examine the mechanism of action and develop suitable objective measures of PSB. Six health visitors working in a deprived city in the UK will be provided with training on how to use the HABIT intervention. Health visitors will then each deliver the intervention to five parents of children aged 9-12 months. The research team will collect measures of PSB and dietary behaviours before and at 2 weeks and 3 months after the HABIT intervention. Acceptability of the HABIT intervention to health visitors will be explored through semi-structured diaries completed after each visit and a focus group discussion after delivery to all parents. Acceptability of the HABIT intervention and mechanism of action will be explored briefly during each home visit with parents and in greater details in 20-25 qualitative interviews after the

  3. Impact of a computer-assisted, provider-delivered intervention on sexual risk behaviors in HIV-positive men who have sex with men (MSM) in a primary care setting.

    Science.gov (United States)

    Bachmann, Laura H; Grimley, Diane M; Gao, Hongjiang; Aban, Inmaculada; Chen, Huey; Raper, James L; Saag, Michael S; Rhodes, Scott D; Hook, Edward W

    2013-04-01

    Innovative strategies are needed to assist providers with delivering secondary HIV prevention in the primary care setting. This longitudinal HIV clinic-based study conducted from 2004-2007 in a Birmingham, Alabama HIV primary care clinic tested a computer-assisted, provider-delivered intervention designed to increase condom use with oral, anal and vaginal sex, decrease numbers of sexual partners and increase HIV disclosure among HIV-positive men-who-have-sex-with-men (MSM). Significant declines were found for the number of unprotected insertive anal intercourse acts with HIV+ male partners during the intervention period (p = 0.0003) and with HIV-/UK male partners (p = 0.0007), as well as a 47% reduction in the number of male sexual partners within the preceding 6 months compared with baseline (p = 0.0008). These findings confirm and extend prior reports by demonstrating the effectiveness of computer-assisted, provider-delivered messaging to accomplish risk reduction in patients in the HIV primary care setting.

  4. A realist synthesis of randomised control trials involving use of community health workers for delivering child health interventions in low and middle income countries

    Directory of Open Access Journals (Sweden)

    Dal Poz Mario

    2010-10-01

    Full Text Available Abstract Background A key constraint to saturating coverage of interventions for reducing the burden of childhood illnesses in Low and Middle Income Countries (LMIC is the lack of human resources. Community health workers (CHW are potentially important actors in bridging this gap. Evidence exists on effectiveness of CHW in management of some childhood illnesses (IMCI. However, we need to know how and when this comes to be. We examine evidence from randomized control trials (RCT on CHW interventions in IMCI in LMIC from a realist perspective with the aim to see if they can yield insight into the working of the interventions, when examined from a different perspective. Methods The realist approach involves educing the mechanisms through which an intervention produced an outcome in a particular context. 'Mechanisms' are reactions, triggered by the interaction of the intervention and a certain context, which lead to change. These are often only implicit and are actually hypothesized by the reviewer. This review is limited to unravelling these from the RCTs; it is thus a hypothesis generating exercise. Results Interventions to improve CHW performance included 'Skills based training of CHW', 'Supervision and referral support from public health services', 'Positioning of CHW in the community'. When interventions were applied in context of CHW programs embedded in local health services, with beneficiaries who valued services and had unmet needs, the interventions worked if following mechanisms were triggered: anticipation of being valued by the community; perception of improvement in social status; sense of relatedness with beneficiaries and public services; increase in self esteem; sense of self efficacy and enactive mastery of tasks; sense of credibility, legitimacy and assurance that there was a system for back-up support. Studies also showed that if context differed, even with similar interventions, negative mechanisms could be triggered

  5. The pragmatic language, communication skills, parent-child relationships, and symptoms of children with ADHD and their playmates 18-months after a parent-delivered play-based intervention.

    Science.gov (United States)

    Wilkes-Gillan, Sarah; Cantrill, Alycia; Parsons, Lauren; Smith, Cally; Cordier, Reinie

    2017-07-01

    This study examined the communication skills, pragmatic language, parent-child relationships, and attention deficit hyperactivity disorder (ADHD) symptoms of children with ADHD and their playmates 18-months after a pilot parent-delivered intervention for improving social play skills and pragmatic language. Participants were five children with ADHD, their parents, and five typically-developing playmates. Outcomes were measured immediately post and 18-months following the intervention. Parent-rated norm-based assessments and an observational measure were used. Differences within and between the ADHD and playmate groups were examined. Children maintained all skills gained 18-months following the intervention. Compared to a normative sample, children with ADHD remained below the average range on aspects of communication skills, parent-child relationships, and ADHD symptom levels 18-months following intervention. After intervention, children with ADHD still experienced pragmatic language skills below those of their peers on norm-based assessments that measure their skills across contexts. School-based interventions are needed to facilitate ongoing skill development and generalization.

  6. Fidelity considerations in translational research: Eating As Treatment - a stepped wedge, randomised controlled trial of a dietitian delivered behaviour change counselling intervention for head and neck cancer patients undergoing radiotherapy.

    Science.gov (United States)

    Beck, Alison Kate; Baker, Amanda; Britton, Ben; Wratten, Chris; Bauer, Judith; Wolfenden, Luke; Carter, Gregory

    2015-10-15

    The confidence with which researchers can comment on intervention efficacy relies on evaluation and consideration of intervention fidelity. Accordingly, there have been calls to increase the transparency with which fidelity methodology is reported. Despite this, consideration and/or reporting of fidelity methods remains poor. We seek to address this gap by describing the methodology for promoting and facilitating the evaluation of intervention fidelity in The EAT (Eating As Treatment) project: a multi-site stepped wedge randomised controlled trial of a dietitian delivered behaviour change counselling intervention to improve nutrition (primary outcome) in head and neck cancer patients undergoing radiotherapy. In accordance with recommendations from the National Institutes of Health Behaviour Change Consortium Treatment Fidelity Workgroup, we sought to maximise fidelity in this stepped wedge randomised controlled trial via strategies implemented from study design through to provider training, intervention delivery and receipt. As the EAT intervention is designed to be incorporated into standard dietetic consultations, we also address unique challenges for translational research. We offer a strong model for improving the quality of translational findings via real world application of National Institutes of Health Behaviour Change Consortium recommendations. Greater transparency in the reporting of behaviour change research is an important step in improving the progress and quality of behaviour change research. ACTRN12613000320752 (Date of registration 21 March 2013).

  7. Omani Girls' Conceptions of Gender Equality: Addressing Socially Constructed Sexist Attitudes through Educational Intervention

    Science.gov (United States)

    Al Sadi, Fatma H.; Basit, Tehmina N.

    2017-01-01

    This paper is based on a quasi-experimental study which examines the effects of a school-based intervention on Omani girls' attitudes towards the notion of gender equality. A questionnaire was administered before and after the intervention to 241 girls (116 in the experimental group; 125 in the control group). A semi-structured interview was…

  8. The effectiveness of smoking cessation, physical activity/diet and alcohol reduction interventions delivered by mobile phones for the prevention of non-communicable diseases: A systematic review of randomised controlled trials.

    Directory of Open Access Journals (Sweden)

    Melissa Palmer

    Full Text Available We conducted a systematic review to assess the effectiveness of smoking cessation, physical activity (PA, diet, and alcohol reduction interventions delivered by mobile technology to prevent non-communicable diseases (NCDs.We searched for randomised controlled trials (RCTs of mobile-based NCD prevention interventions using MEDLINE, EMBASE, Global Health, CINAHL (Jan 1990-Jan 2016. Two authors extracted data.71 trials were included: smoking cessation (n = 18; PA (n = 15, diet (n = 3, PA and diet (n = 25; PA, diet, and smoking cessation (n = 2; and harmful alcohol consumption (n = 8. 4 trials had low risk of bias. The effect of SMS-based smoking cessation support on biochemically verified continuous abstinence was pooled relative risk [RR] 2.19 [95% CI 1.80-2.68], I2 = 0% and on verified 7 day point prevalence of smoking cessation was pooled RR 1.51 [95% CI 1.06-2.15], I2 = 0%, with no reported adverse events. There was no difference in peak oxygen intake at 3 months in a trial of an SMS-based PA intervention. The effect of SMS-based diet and PA interventions on: incidence of diabetes was pooled RR 0.67 [95% CI 0.49, 0.90], I2 = 0.0%; end-point weight was pooled MD -0.99Kg [95% CI -3.63, 1.64] I2 = 29.4%; % change in weight was pooled MD -3.1 [95%CI -4.86- -1.3] I2 0.3%; and on triglyceride levels was pooled MD -0.19 mmol/L [95% CI -0.29, -0.08], I2 = 0.0%. The results of other pooled analyses of the effect of SMS-based diet and PA interventions were heterogenous (I2 59-90%. The effects of alcohol reduction interventions were inconclusive.Smoking cessation support delivered by SMS increases quitting rates. Trials of PA interventions reporting outcomes ≥3 months showed no benefits. There were at best modest benefits of diet and PA interventions. The effects of the most promising SMS-based smoking, diet and PA interventions on morbidity and mortality in high-risk groups should be established in adequately powered RCTs.

  9. The effectiveness of smoking cessation, physical activity/diet and alcohol reduction interventions delivered by mobile phones for the prevention of non-communicable diseases: A systematic review of randomised controlled trials.

    Science.gov (United States)

    Palmer, Melissa; Sutherland, Jennifer; Barnard, Sharmani; Wynne, Aileen; Rezel, Emma; Doel, Andrew; Grigsby-Duffy, Lily; Edwards, Suzanne; Russell, Sophie; Hotopf, Ellie; Perel, Pablo; Free, Caroline

    2018-01-01

    We conducted a systematic review to assess the effectiveness of smoking cessation, physical activity (PA), diet, and alcohol reduction interventions delivered by mobile technology to prevent non-communicable diseases (NCDs). We searched for randomised controlled trials (RCTs) of mobile-based NCD prevention interventions using MEDLINE, EMBASE, Global Health, CINAHL (Jan 1990-Jan 2016). Two authors extracted data. 71 trials were included: smoking cessation (n = 18); PA (n = 15), diet (n = 3), PA and diet (n = 25); PA, diet, and smoking cessation (n = 2); and harmful alcohol consumption (n = 8). 4 trials had low risk of bias. The effect of SMS-based smoking cessation support on biochemically verified continuous abstinence was pooled relative risk [RR] 2.19 [95% CI 1.80-2.68], I2 = 0%) and on verified 7 day point prevalence of smoking cessation was pooled RR 1.51 [95% CI 1.06-2.15], I2 = 0%, with no reported adverse events. There was no difference in peak oxygen intake at 3 months in a trial of an SMS-based PA intervention. The effect of SMS-based diet and PA interventions on: incidence of diabetes was pooled RR 0.67 [95% CI 0.49, 0.90], I2 = 0.0%; end-point weight was pooled MD -0.99Kg [95% CI -3.63, 1.64] I2 = 29.4%; % change in weight was pooled MD -3.1 [95%CI -4.86- -1.3] I2 0.3%; and on triglyceride levels was pooled MD -0.19 mmol/L [95% CI -0.29, -0.08], I2 = 0.0%. The results of other pooled analyses of the effect of SMS-based diet and PA interventions were heterogenous (I2 59-90%). The effects of alcohol reduction interventions were inconclusive. Smoking cessation support delivered by SMS increases quitting rates. Trials of PA interventions reporting outcomes ≥3 months showed no benefits. There were at best modest benefits of diet and PA interventions. The effects of the most promising SMS-based smoking, diet and PA interventions on morbidity and mortality in high-risk groups should be established in adequately powered RCTs.

  10. The effectiveness of smoking cessation, physical activity/diet and alcohol reduction interventions delivered by mobile phones for the prevention of non-communicable diseases: A systematic review of randomised controlled trials

    Science.gov (United States)

    Sutherland, Jennifer; Barnard, Sharmani; Wynne, Aileen; Rezel, Emma; Doel, Andrew; Grigsby-Duffy, Lily; Edwards, Suzanne; Russell, Sophie; Hotopf, Ellie; Perel, Pablo; Free, Caroline

    2018-01-01

    Background We conducted a systematic review to assess the effectiveness of smoking cessation, physical activity (PA), diet, and alcohol reduction interventions delivered by mobile technology to prevent non-communicable diseases (NCDs). Methods We searched for randomised controlled trials (RCTs) of mobile-based NCD prevention interventions using MEDLINE, EMBASE, Global Health, CINAHL (Jan 1990–Jan 2016). Two authors extracted data. Findings 71 trials were included: smoking cessation (n = 18); PA (n = 15), diet (n = 3), PA and diet (n = 25); PA, diet, and smoking cessation (n = 2); and harmful alcohol consumption (n = 8). 4 trials had low risk of bias. The effect of SMS-based smoking cessation support on biochemically verified continuous abstinence was pooled relative risk [RR] 2.19 [95% CI 1.80–2.68], I2 = 0%) and on verified 7 day point prevalence of smoking cessation was pooled RR 1.51 [95% CI 1.06–2.15], I2 = 0%, with no reported adverse events. There was no difference in peak oxygen intake at 3 months in a trial of an SMS-based PA intervention. The effect of SMS-based diet and PA interventions on: incidence of diabetes was pooled RR 0.67 [95% CI 0.49, 0.90], I2 = 0.0%; end-point weight was pooled MD -0.99Kg [95% CI -3.63, 1.64] I2 = 29.4%; % change in weight was pooled MD -3.1 [95%CI -4.86- -1.3] I2 0.3%; and on triglyceride levels was pooled MD -0.19 mmol/L [95% CI -0.29, -0.08], I2 = 0.0%. The results of other pooled analyses of the effect of SMS-based diet and PA interventions were heterogenous (I2 59–90%). The effects of alcohol reduction interventions were inconclusive. Conclusions Smoking cessation support delivered by SMS increases quitting rates. Trials of PA interventions reporting outcomes ≥3 months showed no benefits. There were at best modest benefits of diet and PA interventions. The effects of the most promising SMS-based smoking, diet and PA interventions on morbidity and mortality in high-risk groups should be established in adequately

  11. The study of KBP of road construction workers of highway AIDS prevention project before and after intervention.

    Science.gov (United States)

    Liu, Dan; Dong, Si-Ping; Gao, Guang-Ming; Fan, Ming-Yu; Zhang, Zong-Jiu; Fang, Peng-Qian

    2013-10-01

    To get scientific basis for further health education through the research of the road construction workers' KBP before and after the interventions of highway AIDS prevention project. Multi-stage random sampling method was employeed to select workers of 8 sites from 14 sites along highway to investigate their AIDS knowledge, belief and performance (KBP) before and after highway AIDS prevention project. Over 90% of the investigated workers had ever heard about AIDS, and the non-skilled workers of lower educational level improved more after intervention. The correct answer rate of the three transmitting ways of AIDS of drivers which is the focused group of highway before and after intervention had the obvious statistical significance (Proad construction workers is effective and further health education of HIV prevention should be carried out among the road construction workers to improve their knowledge and awareness of avoiding the high-risk behaviors. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  12. Implementation Evaluation of "Steering Teens Safe": Engaging Parents to Deliver a New Parent-Based Teen Driving Intervention to Their Teens

    Science.gov (United States)

    Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

    2013-01-01

    Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. "Steering Teens Safe" is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills…

  13. A realist synthesis of randomised control trials involving use of community health workers for delivering child health interventions in low and middle income countries

    NARCIS (Netherlands)

    Kane, Sumit; Gerretsen, Barend; Scherpbier, Robert; Dal Poz, Mario; Dieleman, Marjolein

    2010-01-01

    BACKGROUND: A key constraint to saturating coverage of interventions for reducing the burden of childhood illnesses in Low and Middle Income Countries (LMIC) is the lack of human resources. Community health workers (CHW) are potentially important actors in bridging this gap. Evidence exists on

  14. The UPBEAT Nurse-Delivered Personalized Care Intervention for People with Coronary Heart Disease Who Report Current Chest Pain and Depression: A Randomised Controlled Pilot Study

    NARCIS (Netherlands)

    Barley, E.A.; Walters, P.; Haddad, M.; Phillips, R.; Achilla, E.; McCrone, P.; van Marwijk, H.W.J.; Mann, A.; Tylee, A.

    2014-01-01

    Background: Depression is common in people with coronary heart disease (CHD) and associated with worse outcome. This study explored the acceptability and feasibility of procedures for a trial and for an intervention, including its potential costs, to inform a definitive randomized controlled trial

  15. Safe and effective use of medicines for patients with type 2 diabetes - A randomized controlled trial of two interventions delivered by local pharmacies

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Bjerrum, Lars; Dam, Pernille

    2015-01-01

    Poor management of chronic medical treatments may result in severe health consequences for patients as well as costs for society. Non-adherence is common among patients with type 2 diabetes. Interventions by community pharmacists may assist in improving adherence and consequently health outcomes...

  16. Cluster-Randomized Controlled Trial Evaluating the Effectiveness of Computer-Assisted Intervention Delivered by Educators for Children with Speech Sound Disorders

    Science.gov (United States)

    McLeod, Sharynne; Baker, Elise; McCormack, Jane; Wren, Yvonne; Roulstone, Sue; Crowe, Kathryn; Masso, Sarah; White, Paul; Howland, Charlotte

    2017-01-01

    Purpose: The aim was to evaluate the effectiveness of computer-assisted input-based intervention for children with speech sound disorders (SSD). Method: The Sound Start Study was a cluster-randomized controlled trial. Seventy-nine early childhood centers were invited to participate, 45 were recruited, and 1,205 parents and educators of 4- and…

  17. Changing adherence-related beliefs about ICS maintenance treatment for asthma: feasibility study of an intervention delivered by asthma nurse specialists.

    Science.gov (United States)

    Chapman, Sarah C E; Barnes, Neil; Barnes, Mari; Wilkinson, Andrea; Hartley, John; Piddock, Cher; Weinman, John; Horne, Rob

    2015-06-05

    The Necessity-Concerns Framework (NCF) posits that non-adherence to inhaled corticosteroids (ICS) in asthma is influenced by doubts about the necessity for ICS and concerns about their potential adverse effects. This feasibility study examined whether these beliefs could be changed by briefing asthma nurse specialists on ways of addressing necessity beliefs and concerns within consultations. Pre-post intervention study. Secondary care. Patients with a diagnosis of moderate to severe asthma who were prescribed daily ICS were recruited to either a hospital care group (n=79; 71.0% female) or intervention group (n=57; 66.7% female). Asthma nurse specialists attended a 1.5-day NCF briefing. Beliefs about ICS (primary outcome) and self-reported adherence were measured preconsultation and 1 month postconsultation. Participants also rated their satisfaction with their consultations immediately after the consultation. Consultation recordings were coded to assess intervention delivery. After the NCF briefing, nurse specialists elicited and addressed beliefs about medicine more frequently. The frequency of using the NCF remained low, for example, open questions eliciting adherence were used in 0/59 hospital care versus 14/49 (28.6%) intervention consultations. Doubts about personal necessity for, and concerns about, ICS were reduced at 1 month postbriefing (pchanged nurse consultations, but not sufficiently enough to fully address non-adherence or adherence-related ICS beliefs (necessity and concerns). More effective techniques are needed to support nurse specialists and other practitioners to apply the intervention in hospital asthma review consultations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. The Effectiveness of a Psychoeducation Intervention delivered via WhatsApp for mothers of children with Autism Spectrum Disorder (ASD) in the Kingdom of Saudi Arabia: A randomized controlled trial.

    Science.gov (United States)

    Hemdi, A; Daley, D

    2017-11-01

    Mothers of children with autism spectrum disorder (ASD) report high levels of stress and lower levels of well-being than parents of typically developing children. Current interventions for ASD typically focus on working with the child rather than delivering strategies to help support parents. To evaluate the effectiveness of a psychoeducation intervention developed to support mothers of children with ASD in Saudi Arabia. Sixty-two mothers (23-52 years) of children (26-78 months) were recruited to a multisite randomized controlled trials of the intervention. The intervention consisted of one face-to-face session (60 min) and four virtual sessions (30 min each) delivered using WhatsApp. Parenting stress was the primary outcome, with secondary outcomes focusing on maternal depression, anxiety, and happiness, and child behaviour problems and ASD symptoms. Data were collected at baseline T1, immediately postintervention T2 and 8-week follow-up T3. One-way analysis of covariance was used at T2 and T3 with T1 scores entered as a covariate. Improvements were found at T2 for stress (F = 234.34, p = .00, and d = -1.52) and depression (F = 195.70, p = .00, and d = -2.14) but not anxiety, and these results were maintained at T3. Changes in child behaviour problems were limited to improvements in hyperactivity at T2 (F = 133.66, p = .00, and d = -1.54). Although changes in stress and depression were statistically significant, change to clinically normal levels was limited to depression. None of the participants had recovered after the intervention (Parent Stress Index Short Form stress scores), whereas 23 mothers (71.87%) in the intervention group had recovered at T2 and 22 (68.75%) at T3 (Hospital Anxiety and Depression Scale depression scores). This intervention with WhatsApp support is beneficial but may need to be augmented with other forms of support for mothers of children with ASD including more condensed sessions on stress and interventions

  19. A four-session acceptance and commitment therapy based intervention for depressive symptoms delivered by masters degree level psychology students: a preliminary study.

    Science.gov (United States)

    Kohtala, Aino; Lappalainen, Raimo; Savonen, Laura; Timo, Elina; Tolvanen, Asko

    2015-05-01

    Depressive symptoms are one of the main reasons for seeking psychological help. Shorter interventions using briefly trained therapists could offer a solution to the ever-rising need for early and easily applicable psychological treatments. The current study examines the effectiveness of a four-session Acceptance and Commitment Therapy (ACT) based treatment for self-reported depressive symptoms administered by Masters level psychology students. This paper reports the effectiveness of a brief intervention compared to a waiting list control (WLC) group. Participants were randomized into two groups: ACT (n = 28) and waiting list (n = 29). Long-term effects were examined using a 6-month follow-up. The treatment group's level of depressive symptoms (Beck Depression Inventory) decreased by an average of 47%, compared to an average decrease of 4% in the WLC group. Changes in psychological well-being in the ACT group were better throughout, and treatment outcomes were maintained after 6 months. The posttreatment "between-group" and follow-up "with-in group" effect sizes (Cohen's d) were large to medium for depressive symptoms and psychological flexibility. The results support the brief ACT-based intervention for sub-clinical depressive symptoms when treatment was conducted by briefly trained psychology students. It also contributes to the growing body of evidence on brief ACT-based treatments and inexperienced therapists.

  20. Mediators effecting moderate-to-vigorous physical activity and inactivity for girls from an intervention program delivered in an organised youth sports setting.

    Science.gov (United States)

    Guagliano, Justin M; Lonsdale, Chris; Rosenkranz, Richard R; Parker, Philip D; Agho, Kingsley E; Kolt, Gregory S

    2015-11-01

    The objective of this study was to test whether coaches' physical activity levels, contextual variables, and coaches' behavioural variables mediated the effect of an intervention on female basketball players' moderate-to-vigorous physical activity (MVPA) and inactivity in an organised youth sport (OYS) setting. Randomised controlled trial Data for the current study were derived from a two-armed, parallel-group randomised controlled trial. This study ran over the course of a 5-day OYS basketball program in 2 sports centres in Sydney, Australia. A convenience sample of 76 female players and 8 coaches were recruited. Coaches allocated to the intervention condition attended 2 coach education sessions, where strategies to increase MVPA and decrease inactivity were taught. There was a significant effect between changes in coach MVPA and player MVPA (unstandardised regression coefficient [B] = 0.26, 95% CI = 0.14 to 0.38) which coincided with a significant indirect effect (B = 1.80, 95% CI = 0.85 to 2.85). There was also a significant effect between changes in coach inactivity and player inactivity (B = -0.23, 95% CI = -0.14 to -0.31), which coincided with a significant indirect effect (B = -3.20, 95% CI = -0.14 to -0.31). No significant indirect effects were found for lesson context and coaches' behaviours variables. Coaches' MVPA and inactivity significantly mediated the effect of the intervention on player MVPA and inactivity, respectively. Consequently, coaches' physical activity levels appear to be important for influencing their players' physical activity levels. Published by Elsevier Ltd.

  1. Nuevo Amanecer: results of a randomized controlled trial of a community-based, peer-delivered stress management intervention to improve quality of life in Latinas with breast cancer.

    Science.gov (United States)

    Nápoles, Anna María; Ortíz, Carmen; Santoyo-Olsson, Jasmine; Stewart, Anita L; Gregorich, Steven; Lee, Howard E; Durón, Ysabel; McGuire, Peggy; Luce, Judith

    2015-07-01

    We evaluated a community-based, translational stress management program to improve health-related quality of life in Spanish-speaking Latinas with breast cancer. We adapted a cognitive-behavioral stress management program integrating evidence-based and community best practices to address the needs of Latinas with breast cancer. Spanish-speaking Latinas with breast cancer were randomly assigned to an intervention or usual-care control group. Trained peers delivered the 8-week intervention between February 2011 and February 2014. Primary outcomes were breast cancer-specific quality of life and distress, and general symptoms of distress. Of 151 participants, 95% were retained at 6 months (between May 2011 and May 2014). Improvements in quality of life from baseline to 6 months were greater for the intervention than the control group on physical well-being, emotional well-being, breast cancer concerns, and overall quality of life. Decreases from baseline to 6 months were greater for the intervention group on depression and somatization. Results suggest that translation of evidence-based programs can reduce psychosocial health disparities in Latinas with breast cancer. Integration of this program into community-based organizations enhances its dissemination potential.

  2. A Pilot Randomized Controlled Trial of an Integrated In-person and Mobile Phone Delivered Counseling and Text Messaging Intervention to Reduce HIV Transmission Risk among Male Sex Workers in Chennai, India.

    Science.gov (United States)

    Mimiaga, Matthew J; Thomas, Beena; Biello, Katie; Johnson, Blake E; Swaminathan, Soumya; Navakodi, Pandiyaraja; Balaguru, S; Dhanalakshmi, A; Closson, Elizabeth F; Menon, Sunil; O'Cleirigh, Conall; Mayer, Kenneth H; Safren, Steven A

    2017-11-01

    Men who have sex with men (MSM) are at increased risk for HIV infection in India, particularly those who engage in transactional sex with other men (i.e., male sex workers; MSW). Despite the need, HIV prevention efforts for Indian MSW are lacking. As in other settings, MSW in India increasingly rely on the use of mobile phones for sex work solicitation. Integrating mobile phone technology into an HIV prevention intervention for Indian MSW may mitigate some of the challenges associated with face-to face approaches, such as implementation, lack of anonymity, and time consumption, while at the same time proving to be both feasible and useful. This is a pilot randomized controlled trial to examine participant acceptability, feasibility of study procedures, and preliminary efficacy for reducing sexual risk for HIV. MSW (N = 100) were equally randomized to: (1) a behavioral HIV prevention intervention integrating in-person and mobile phone delivered HIV risk reduction counseling, and daily, personalized text or voice messages as motivating "cognitive restructuring" cues for reducing condomless anal sex (CAS); or (2) a standard of care (SOC) comparison condition. Both groups received HIV counseling and testing at baseline and 6-months, and completed ACASI-based, behavioral and psychosocial assessments at baseline, 3, and 6 months. Mixed-effects regression procedures specifying a Poisson distribution and log link with a random intercept and slope for month of follow-up was estimated to assess the intervention effect on the primary outcomes: (1) CAS acts with male clients who paid them for sex, and (2) CAS acts with male non-paying sexual partners-both outcomes assessed over the past month. The intervention was both feasible (98% retention at 6-months) and acceptable (>96% of all intervention sessions attended); all intervention participants rated the intervention as "acceptable" or "very acceptable." A reduction in the reported number of CAS acts with male clients who

  3. Effects of a Whatsapp-delivered physical activity intervention to enhance health-related physical fitness components and cardiovascular disease risk factors in older adults.

    Science.gov (United States)

    Muntaner-Mas, Adrià; Vidal-Conti, Josep; Borràs, Pere A; Ortega, Francisco B; Palou, Pere

    2017-01-01

    This pilot study evaluated the feasibility and preliminary effectiveness of a 10-week WhatsApp-based intervention aimed at enhancing health-related physical fitness components and cardiovascular disease (CVD) risk factors compared with a face-to-face condition. Participants (N.=32) were assigned to one of three groups: training group (N.=16), mobile group (N.=7) and control group (N.=9). Training group and mobile group performed the same training program, based on strength training with elastics bands and aerobic exercise, during 10 weeks; only the delivery mode differed. The mobile group increased handgrip strength, aerobic capacity and decreased systolic blood pressure and heart rate after exercise though there were no significant differences respect to control group. The training group decreased significantly systolic blood pressure (P=0.038), diastolic blood pressure (P=0.005), mean arterial pressure (P=0.006) and heart rate after exercise (P=0.002), respect to control group. Comparison between training and mobile group showed that WhatsApp-based physical activity intervention was less effective than face-to-face condition. The results indicate that the use of an online social network produced slight changes in some health-related physical fitness components and CVD risk factors.

  4. Can an evidence-based book club intervention delivered via a tablet computer improve physical activity in middle-aged women?

    Science.gov (United States)

    Ehlers, Diane K; Huberty, Jennifer L; de Vreede, Gert-Jan

    2015-02-01

    Fewer than 50% of middle-aged women participate in regular physical activity (PA). Innovative approaches that engage women who may not otherwise participate in PA programs are warranted. The purpose of this study was to explore the acceptability and feasibility of a 12-week tablet-based book club for improving middle-aged women's PA. Thirty women (35-64 years of age) were randomized to the Fit Minded Tablet (n=15) and the Standard Fit Minded (i.e., face-to-face intervention) (n=15) groups. The Fit Minded Tablet was adapted from the Standard Fit Minded, a previously tested, theory-based book club intervention using books as a platform for discussion and group support to help women adopt regular PA. Both interventions met weekly for 3 months, for a total of 12 sessions. Tablet group participants accessed materials (e.g., e-books, workbook, live/recorded videoconferencing) via a tablet computer; Standard group participants received materials (e.g., printed books, workbook, live face-to-face meetings) in person. Feasibility (i.e., implementation and expansion) was assessed using process evaluation, qualitative interviews, satisfaction surveys, and quantitative outcome assessments. Women in the Tablet group attended fewer meetings (mean, 8.25) than women in the Standard group (mean, 9.9). Videoconferencing, digital literacy, and participant engagement limitations were observed in the Tablet group. Tablet participants enjoyed the e-books but thought technology barriers hindered their engagement during meetings. Women in both groups valued the support they received from other group members. Standard participants cited this support as a key contributor to their PA changes, whereas Tablet participants reported needing in-person contact to feel more connected. Given the popularity of tablet computers and the value that middle-aged women place on group interaction to support their PA behaviors, additional research is warranted to determine best strategies for optimizing

  5. A systematic review and meta-analysis of online versus alternative methods for training licensed health care professionals to deliver clinical interventions

    Directory of Open Access Journals (Sweden)

    Helen Richmond

    2017-11-01

    Full Text Available Abstract Background Online training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction. Methods Seven databases were searched for randomised controlled trials (RCTs from January 2000 to June 2015. Two independent reviewers rated trial quality and extracted trial data. Comparative effects were summarised as standardised mean differences (SMD and 95% confidence intervals. Pooled effect sizes were calculated using a random-effects model for three contrasts of online versus (i interactive workshops (ii taught lectures and (iii written/electronic manuals. Results We included 14 studies with a total of 1089 participants. Most trials studied medical professionals, used a workshop or lecture comparison, were of high risk of bias and had small sample sizes (range 21-183. Using the GRADE approach, we found low quality evidence that there was no difference between online training and an interactive workshop for clinical behaviour SMD 0.12 (95% CI -0.13 to 0.37. We found very low quality evidence of no difference between online methods and both a workshop and lecture for knowledge (workshop: SMD 0.04 (95% CI -0.28 to 0.36; lecture: SMD 0.22 (95% CI: -0.08, 0.51. Lastly, compared to a manual (n = 3/14, we found very low quality evidence that online methods were superior for knowledge SMD 0.99 (95% CI 0.02 to 1.96. There were too few studies to draw any conclusions on the effects of online training for practical skills, self-efficacy, and satisfaction across all contrasts. Conclusions It is likely that online methods may be as effective as alternative methods for training HCPs in

  6. The UPBEAT nurse-delivered personalized care intervention for people with coronary heart disease who report current chest pain and depression: a randomised controlled pilot study.

    Directory of Open Access Journals (Sweden)

    Elizabeth A Barley

    Full Text Available Depression is common in people with coronary heart disease (CHD and associated with worse outcome. This study explored the acceptability and feasibility of procedures for a trial and for an intervention, including its potential costs, to inform a definitive randomized controlled trial (RCT of a nurse-led personalised care intervention for primary care CHD patients with current chest pain and probable depression.Multi-centre, outcome assessor-blinded, randomized parallel group study. CHD patients reporting chest pain and scoring 8 or more on the HADS were randomized to personalized care (PC or treatment as usual (TAU for 6 months and followed for 1 year. Primary outcome was acceptability and feasibility of procedures; secondary outcomes included mood, chest pain, functional status, well being and psychological process variables.1001 people from 17 General Practice CHD registers in South London consented to be contacted; out of 126 who were potentially eligible, 81 (35% female, mean age = 65 SD11 years were randomized. PC participants (n = 41 identified wide ranging problems to work on with nurse-case managers. Good acceptability and feasibility was indicated by low attrition (9%, high engagement and minimal nurse time used (mean/SD = 78/19 mins assessment, 125/91 mins telephone follow up. Both groups improved on all outcomes. The largest between group difference was in the proportion no longer reporting chest pain (PC 37% vs TAU 18%; mixed effects model OR 2.21 95% CI 0.69, 7.03. Some evidence was seen that self efficacy (mean scale increase of 2.5 vs 0.9 and illness perceptions (mean scale increase of 7.8 vs 2.5 had improved in PC vs TAU participants at 1 year. PC appeared to be more cost effective up to a QALY threshold of approximately £3,000.Trial and intervention procedures appeared to be feasible and acceptable. PC allowed patients to work on unaddressed problems and appears cheaper than TAU.Controlled-Trials.com ISRCTN21615909.

  7. A systematic review and meta-analysis of online versus alternative methods for training licensed health care professionals to deliver clinical interventions.

    Science.gov (United States)

    Richmond, Helen; Copsey, Bethan; Hall, Amanda M; Davies, David; Lamb, Sarah E

    2017-11-23

    Online training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs) in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs) on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction. Seven databases were searched for randomised controlled trials (RCTs) from January 2000 to June 2015. Two independent reviewers rated trial quality and extracted trial data. Comparative effects were summarised as standardised mean differences (SMD) and 95% confidence intervals. Pooled effect sizes were calculated using a random-effects model for three contrasts of online versus (i) interactive workshops (ii) taught lectures and (iii) written/electronic manuals. We included 14 studies with a total of 1089 participants. Most trials studied medical professionals, used a workshop or lecture comparison, were of high risk of bias and had small sample sizes (range 21-183). Using the GRADE approach, we found low quality evidence that there was no difference between online training and an interactive workshop for clinical behaviour SMD 0.12 (95% CI -0.13 to 0.37). We found very low quality evidence of no difference between online methods and both a workshop and lecture for knowledge (workshop: SMD 0.04 (95% CI -0.28 to 0.36); lecture: SMD 0.22 (95% CI: -0.08, 0.51)). Lastly, compared to a manual (n = 3/14), we found very low quality evidence that online methods were superior for knowledge SMD 0.99 (95% CI 0.02 to 1.96). There were too few studies to draw any conclusions on the effects of online training for practical skills, self-efficacy, and satisfaction across all contrasts. It is likely that online methods may be as effective as alternative methods for training HCPs in clinical interventions for the outcomes of knowledge

  8. Disarming the Threat to Feminist Identification: An Application of Personal Construct Theory to Measurement and Intervention

    Science.gov (United States)

    Moradi, Bonnie; Martin, Annelise; Brewster, Melanie E.

    2012-01-01

    Many individuals endorse feminist values but do not identify as feminist. The present set of studies tests the concept of threat, grounded in G. A. Kelly's personal construct theory of personality, as a potential factor in feminist nonidentification. Study 1 introduces the theoretically grounded "Feminist Threat Index" and evaluates its…

  9. Construction contractors and healthcare delivery in South Africa: challenges and interventions

    CSIR Research Space (South Africa)

    Van Wyk, Llewellyn V

    2007-10-01

    Full Text Available This paper compares the demand side requirements of the National Department of Health with the supply-side capabilities of the construction industry as determined by the Register of Contractors. It finds that only a small percentage of registered...

  10. Reducing depressive or anxiety symptoms in post-stroke patients: Pilot trial of a constructive integrative psychosocial intervention

    Science.gov (United States)

    Fang, Yihong; Mpofu, Elias; Athanasou, James

    2017-01-01

    Background: About 30% of stroke survivors clinically have depressive symptoms at some point following stroke and anxiety prevalence is around 20-25%. Objective: The purpose of this brief report is to evaluate a pilot trial of a constructive integrative psychosocial intervention (CIPI) over standard care in post-stroke depression or anxiety. Methods: Patients were randomly assigned to either CIPI (n = 23) or standard care (n = 19). Patients were assessed using the Hospital Anxiety and Depression Scale at the 1st, 3rd, and 6th months to monitor changes of mood. Results: A Wilcoxon signed-rank test indicated that compared to admission baseline, patients with the intervention had significantly normal post-stroke depression symptom levels at the 1st, 3rd, and 6th months (P < 0.005). Conclusion: CIPI appears to be of incremental value in treating depression as well as anxiety in subacute care. PMID:29085269

  11. Effects of the Educational Intervention on some Health Belief Model Constructs regarding the Prevention of Obesity in Students

    Directory of Open Access Journals (Sweden)

    Ahmadreza Noorbakhsh

    2017-08-01

    Full Text Available Background Obesity causes depression and undermines mental health in adolescents. It is also related to adulthood diseases and mortality. The current study drew upon an educational intervention to modify some Health Belief Model constructs to preventing overweight and obesity among adolescents.  Materials and Methods: In this quasi-experimental study 100 boy students recruited from selected boys junior high schools in Isfahan. They were randomly assigned to intervention (n=50 and control (n=50 groups. In 4 training sessions, a nutritionist introduced different types of healthy foods and explained how to consume them. A sports coach also taught how to do physical exercises well in 4 sessions (each one 90 minutes in terms of nutrition and physical activity. Data of pretest and posttest gathered from demographic and a valid questionnaire were fed into the SPSS software, version 20.0 and analyzed using relevant statistical tests. Results: The independent t-test revealed that, before the intervention, there was no significant difference between the two groups in the mean scores of knowledge, perceived benefits, perceived barriers, physical activity, and nutrition behavior (P>0.05; but, after the intervention, this difference between the two groups was significant (P

  12. Intervention of French safety authorities during the design and construction phases of the Creys-Malville plant

    International Nuclear Information System (INIS)

    Orzoni, G.

    1985-01-01

    The intervention of French safety authorities during the design and construction phases of the Creys-Malville plant has been made by the different means of technical regulation, of several successive authorizations bound to different steps, and of numerous surveillance visits. Some safety-related problems have been met. Some of them are detailed, relating to the basis accident for containment design, decay heat removal, polar crane of reactor building, seismic resistance of main vessel internals, core cover plug, design and fabrication of steam generators. The main problems met during the design reviews and the construction phase of the plant have been solved in time; the safety level reached is provisionally judged acceptable by the French safety authorities

  13. Feasibility study of a randomized controlled trial of a telephone-delivered problem-solving-occupational therapy intervention to reduce participation restrictions in rural breast cancer survivors undergoing chemotherapy.

    Science.gov (United States)

    Hegel, Mark T; Lyons, Kathleen D; Hull, Jay G; Kaufman, Peter; Urquhart, Laura; Li, Zhongze; Ahles, Tim A

    2011-10-01

    Breast cancer patients receiving adjuvant chemotherapy often experience functional effects of treatment that limit participation in life activities. The purpose of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) of a novel intervention for these restrictions, determine acceptability of the intervention, and preliminarily assess its effects. A pilot RCT of a telephone-delivered Problem-solving and Occupational Therapy intervention (PST-OT) to improve participation restrictions in rural breast cancer patients undergoing chemotherapy. Thirty-one participants with Stages 1-3 breast cancer were randomized to 6 weekly sessions of PST-OT (n = 15) and usual care (n = 16). The primary study outcome was the feasibility of conducting the trial. Secondary outcomes were functional, quality of life and emotional status as assessed at baseline, 6 and 12 weeks. Of 46 patients referred 31 were enrolled (67% recruitment rate), of which 6 participants withdrew (81% retention rate). Twenty-four participants completed all study-related assessments (77%). Ninety-two percent of PST-OT participants were highly satisfied with the intervention, and 92% reported PST-OT to be helpful/very helpful for overcoming participation restrictions. Ninety-seven percent of planned PST-OT treatment sessions were completed. Completion rates for PST-OT homework tasks were high. Measures of functioning, quality of life, and emotional state favored the PST-OT condition. This pilot study suggests that an RCT of the PST-OT intervention is feasible to conduct with rural breast cancer patients undergoing adjuvant chemotherapy and that PST-OT may have positive effects on function, quality of life, and emotional state. 2010 John Wiley & Sons, Ltd.

  14. Project LifeSkills - a randomized controlled efficacy trial of a culturally tailored, empowerment-based, and group-delivered HIV prevention intervention for young transgender women: study protocol.

    Science.gov (United States)

    Kuhns, Lisa M; Mimiaga, Matthew J; Reisner, Sari L; Biello, Katie; Garofalo, Robert

    2017-09-16

    Transgender women in the U.S. have an alarmingly high incidence rate of HIV infection; condomless anal and vaginal sex is the primary risk behavior driving transmission. Young transgender women are the subpopulation at the highest risk for HIV. Despite this, there are no published randomized controlled efficacy trials testing interventions to reduce sexual risk for HIV among this group. This paper describes the design of a group-based intervention trial to reduce sexual risk for HIV acquisition and transmission in young transgender women. This study, funded by the National Institutes of Health, is a randomized controlled trial of a culturally-specific, empowerment-based, and group-delivered six-session HIV prevention intervention, Project LifeSkills, among sexually active young transgender women, ages 16-29 years in Boston and Chicago. Participants are randomized (2:2:1) to either the LifeSkills intervention, standard of care only, or a diet and nutrition time- and attention-matched control. At enrollment, all participants receive standardized HIV pre- and post-test counseling and screening for HIV and urogenital gonorrhea and chlamydia infections. The primary outcome is difference in the rate of change in the number of self-reported condomless anal or vaginal sex acts during the prior 4-months, assessed at baseline, 4-, 8-, and 12-month follow-up visits. Behavioral interventions to reduce sexual risk for HIV acquisition and transmission are sorely needed for young transgender women. This study will provide evidence to determine feasibility and efficacy in one of the first rigorously designed trials for this population. ClinicalTrials.gov number, NCT01575938 , registered March 29, 2012.

  15. Measuring teamwork and taskwork of community-based "teams" delivering life-saving health interventions in rural Zambia: a qualitative study.

    Science.gov (United States)

    Yeboah-Antwi, Kojo; Snetro-Plewman, Gail; Waltensperger, Karen Z; Hamer, Davidson H; Kambikambi, Chilobe; MacLeod, William; Filumba, Stephen; Sichamba, Bias; Marsh, David

    2013-06-27

    The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0-59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries.

  16. An Internet-supported Physical Activity Intervention Delivered in Secondary Schools Located in Low Socio-economic Status Communities: Study Protocol for the Activity and Motivation in Physical Education (AMPED) Cluster Randomized Controlled Trial.

    Science.gov (United States)

    Lonsdale, Chris; Lester, Aidan; Owen, Katherine B; White, Rhiannon L; Moyes, Ian; Peralta, Louisa; Kirwan, Morwenna; Maeder, Anthony; Bennie, Andrew; MacMillan, Freya; Kolt, Gregory S; Ntoumanis, Nikos; Gore, Jennifer M; Cerin, Ester; Diallo, Thierno M O; Cliff, Dylan P; Lubans, David R

    2016-01-06

    School-based physical education is an important public health initiative as it has the potential to provide students with regular opportunities to participate in moderate-to-vigorous physical activity (MVPA). Unfortunately, in many physical education lessons students do not engage in sufficient MVPA to achieve health benefits. In this trial we will test the efficacy of a teacher professional development intervention, delivered partially via the Internet, on secondary school students' MVPA during physical education lessons. Teaching strategies covered in this training are designed to (i) maximize opportunities for students to be physically active during lessons and (ii) enhance students' autonomous motivation towards physical activity. A two-arm cluster randomized controlled trial with allocation at the school level (intervention vs. usual care control). Teachers and Year 8 students in government-funded secondary schools in low socio-economic areas of the Western Sydney region of Australia will be eligible to participate. During the main portion of the intervention (6 months), teachers will participate in two workshops and complete two implementation tasks at their school. Implementation tasks will involve video-based self-reflection via the project's Web 2.0 platform and an individualized feedback meeting with a project mentor. Each intervention school will also complete two group peer-mentoring sessions at their school (one per term) in which they will discuss implementation with members of their school physical education staff. In the booster period (3 months), teachers will complete a half-day workshop at their school, plus one online implementation task, and a group mentoring session at their school. Throughout the entire intervention period (main intervention plus booster period), teachers will have access to online resources. Data collection will include baseline, post-intervention (7-8 months after baseline) and maintenance phase (14-15 months after baseline

  17. A smart-phone intervention to address mental health stigma in the construction industry: A two-arm randomised controlled trial

    OpenAIRE

    Milner, A.; Law, P.C.F.; Mann, C.; Cooper, T.; Witt, K.; LaMontagne, A.D.

    2017-01-01

    Background High levels of self-stigma are associated with a range of adverse mental health, treatment, and functional outcomes. This prospective study examined the effects of an electronic mental health stigma reduction intervention on self-stigma (self-blame, shame, and help-seeking inhibition) among male construction workers in Australia. Method Male construction workers (N = 682) were randomly assigned to receive either the intervention condition or the wait list control over a six-week pe...

  18. A smart-phone intervention to address mental health stigma in the construction industry: A two-arm randomised controlled trial

    OpenAIRE

    A. Milner; P.C.F. Law; C. Mann; T. Cooper; K. Witt; A.D. LaMontagne

    2018-01-01

    Background: High levels of self-stigma are associated with a range of adverse mental health, treatment, and functional outcomes. This prospective study examined the effects of an electronic mental health stigma reduction intervention on self-stigma (self-blame, shame, and help-seeking inhibition) among male construction workers in Australia. Method: Male construction workers (N = 682) were randomly assigned to receive either the intervention condition or the wait list control over a six-week ...

  19. Measuring teamwork and taskwork of community-based “teams” delivering life-saving health interventions in rural Zambia: a qualitative study

    Science.gov (United States)

    2013-01-01

    Background The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0–59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Methods Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. Results We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Conclusion Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries. PMID:23802766

  20. Serotonin transporter gene (SLC6A4) polymorphism and susceptibility to a home-visiting maternal-infant attachment intervention delivered by community health workers in South Africa: Reanalysis of a randomized controlled trial.

    Science.gov (United States)

    Morgan, Barak; Kumsta, Robert; Fearon, Pasco; Moser, Dirk; Skeen, Sarah; Cooper, Peter; Murray, Lynne; Moran, Greg; Tomlinson, Mark

    2017-02-01

    Clear recognition of the damaging effects of poverty on early childhood development has fueled an interest in interventions aimed at mitigating these harmful consequences. Psychosocial interventions aimed at alleviating the negative impacts of poverty on children are frequently shown to be of benefit, but effect sizes are typically small to moderate. However, averaging outcomes over an entire sample, as is typically done, could underestimate efficacy because weaker effects on less susceptible individuals would dilute estimation of effects on those more disposed to respond. This study investigates whether a genetic polymorphism of the serotonin transporter gene moderates susceptibility to a psychosocial intervention. We reanalyzed data from a randomized controlled trial of a home-visiting program delivered by community health workers in a black, isiXhosa-speaking population in Khayelitsha, South Africa. The intervention, designed to enhance maternal-infant attachment, began in the third trimester and continued until 6 mo postpartum. Implemented between April 1999 and February 2003, the intervention comprised 16 home visits delivered to 220 mother-infant dyads by specially trained community health workers. A control group of 229 mother-infant dyads did not receive the intervention. Security of maternal-infant attachment was the main outcome measured at infant age 18 mo. Compared to controls, infants in the intervention group were significantly more likely to be securely attached to their primary caregiver (odds ratio [OR] = 1.7, p = 0.029, 95% CI [1.06, 2.76], d = 0.29). After the trial, 162 intervention and 172 control group children were reenrolled in a follow-up study at 13 y of age (December 2012-June 2014). At this time, DNA collected from 279 children (134 intervention and 145 control) was genotyped for a common serotonin transporter polymorphism. There were both genetic data and attachment security data for 220 children (110 intervention and 110 control), of

  1. Serotonin transporter gene (SLC6A4 polymorphism and susceptibility to a home-visiting maternal-infant attachment intervention delivered by community health workers in South Africa: Reanalysis of a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Barak Morgan

    2017-02-01

    Full Text Available Clear recognition of the damaging effects of poverty on early childhood development has fueled an interest in interventions aimed at mitigating these harmful consequences. Psychosocial interventions aimed at alleviating the negative impacts of poverty on children are frequently shown to be of benefit, but effect sizes are typically small to moderate. However, averaging outcomes over an entire sample, as is typically done, could underestimate efficacy because weaker effects on less susceptible individuals would dilute estimation of effects on those more disposed to respond. This study investigates whether a genetic polymorphism of the serotonin transporter gene moderates susceptibility to a psychosocial intervention.We reanalyzed data from a randomized controlled trial of a home-visiting program delivered by community health workers in a black, isiXhosa-speaking population in Khayelitsha, South Africa. The intervention, designed to enhance maternal-infant attachment, began in the third trimester and continued until 6 mo postpartum. Implemented between April 1999 and February 2003, the intervention comprised 16 home visits delivered to 220 mother-infant dyads by specially trained community health workers. A control group of 229 mother-infant dyads did not receive the intervention. Security of maternal-infant attachment was the main outcome measured at infant age 18 mo. Compared to controls, infants in the intervention group were significantly more likely to be securely attached to their primary caregiver (odds ratio [OR] = 1.7, p = 0.029, 95% CI [1.06, 2.76], d = 0.29. After the trial, 162 intervention and 172 control group children were reenrolled in a follow-up study at 13 y of age (December 2012-June 2014. At this time, DNA collected from 279 children (134 intervention and 145 control was genotyped for a common serotonin transporter polymorphism. There were both genetic data and attachment security data for 220 children (110 intervention and

  2. Are we sure that Mobile Health is really mobile? An examination of mobile device use during two remotely-delivered weight loss interventions.

    Science.gov (United States)

    Turner-McGrievy, Gabrielle M; Tate, Deborah F

    2014-05-01

    The "m" in mHealth is often thought of as the ability to receive health information and monitor behaviors on the go. Little is known about how people actually use mobile vs. traditional access methods and if access method affects engagement and health outcomes. This study examines the 3-month outcomes of two mobile weight loss interventions (Pounds Off Digitally (POD) and mobile POD (mPOD)) where participants were required to own a mobile device for study entry and received weight loss information via podcast. Only participants in both studies who were randomized to receive the same theory-based podcast (TBP) were used in this analysis. In POD, 41 participants were randomized to the TBP condition (37 to a control not included in this analyses). In mPOD, 49 participants were randomized to the TBP (n=49) and 47 to the TBP+mobile group (a self-monitoring app and Twitter app for social support). The goal of this study is to examine how participants accessed study components and to examine how type of device impacts engagement and weight loss. Examining data from both studies in aggregate, despite a mobile delivery method, 58% of participants reported using a non-mobile device to access the majority of the podcasts (desktop computers), 76% accessed the podcasts mostly at their home or work, and 62% were mainly non-mobile (e.g., sitting at work) when listening. Examining objective download data for mPOD, 49% of downloads (2889/5944) originated from non-mobile delivery methods vs. mobile platforms (3055/5944). At 3 months, 55% of Twitter posts originated from the website (n=665 posts) vs. a mobile app (n=540; 45%). There was no difference in the number of podcasts participants reported listening to by device. There were more Twitter posts by mobile app users (51±11) than Twitter website users (23±6, p<0.05). There was a trend (p=0.055) in greater weight loss among mobile users for podcasts (-3.5±0.5%) as compared to non-mobile users (-2.5±0.5%). Weight loss was

  3. Construction of HMI Network System for Individualized Maternity Intervention Service against Birth Defects in Community

    Institute of Scientific and Technical Information of China (English)

    Xu-huai HU

    2007-01-01

    The paper expounds the community maternity service system against birth defects,from the viewpoint of individualized service in family planning. We have utilized modern information technology to develop health management information (HMI) network with individualized maternity, and to establish the community service system for intervention of birth defects. The service system applied the concept of modern health management information to implementing informational management for screening,treatment, following up, outcome monitoring, so as to provide a base for promotion of health, diagnosis, treatment as well as scientific research, with the prenatal screening of Down's syndrome as a model. The introduction to informational network during the processes of service has been carried out with regards to its composition, function and application, while introducing the effects of computerized case record individualized in prevention, management and research of Down's syndrome.

  4. "Real men don't": constructions of masculinity and inadvertent harm in public health interventions.

    Science.gov (United States)

    Fleming, Paul J; Lee, Joseph G L; Dworkin, Shari L

    2014-06-01

    Research shows that constraining aspects of male gender norms negatively influence both women's and men's health. Messaging that draws on norms of masculinity in health programming has been shown to improve both women's and men's health, but some types of public health messaging (e.g., Man Up Monday, a media campaign to prevent the spread of sexually transmitted infections) can reify harmful aspects of hegemonic masculinity that programs are working to change. We critically assess the deployment of hegemonic male norms in the Man Up Monday campaign. We draw on ethical paradigms in public health to challenge programs that reinforce harmful aspects of gender norms and suggest the use of gender-transformative interventions that challenge constraining masculine norms and have been shown to have a positive effect on health behaviors.

  5. [Assessment of risk of burden in construction: improvement interventions and contribution of the competent physician].

    Science.gov (United States)

    Martinelli, R; Tarquini, M

    2012-01-01

    Three construction companies in three years have changed the operating modes, making use of innovative carpentry, with little amount of equipment, improved usability of the site, reduced cleaning time, less manual handling and reduced risk of accidents. The Competent Doctor has participated in the review of the risk assessment of manual handling: data has been acquired on musculoskeletal disorders to compare, in terms of this innovation, the average trend and changes, with encouraging results in terms of incidence of musculoskeletal disorders, absenteeism due to illness by these causes, new cases of lumbar diseases. It remains difficult in building to assess manual handling risk, but the collaboration between the Employer, Prevention and Protection Service and Competent Doctor, thanks to the greater attention that the design subject to these issues, suggests improvements and further steps to extend to all phases of operation of building.

  6. Social Cognitive Constructs Did Not Mediate the BEAT Cancer Intervention Effects on Objective Physical Activity Behavior Based on Multivariable Path Analysis.

    Science.gov (United States)

    Rogers, Laura Q; Courneya, Kerry S; Anton, Phillip M; Hopkins-Price, Patricia; Verhulst, Steven; Robbs, Randall S; Vicari, Sandra K; McAuley, Edward

    2017-04-01

    Most breast cancer survivors do not meet physical activity recommendations. Understanding mediators of physical activity behavior change can improve interventions designed to increase physical activity in this at-risk population. Study aims were to determine the 3-month Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention effects on social cognitive theory constructs and the mediating role of any changes on the increase in accelerometer-measured physical activity previously reported. Post-treatment breast cancer survivors (N = 222) were randomized to BEAT Cancer or usual care. Assessments occurred at baseline, 3 months (M3), and 6 months (M6). Adjusted linear mixed model analysis of variance determined intervention effects on walking self-efficacy, outcome expectations, goal setting, and perceived barrier interference at M3. Path analysis determined mediation of intervention effects on physical activity at M6 by changes in social cognitive constructs during the intervention (i.e., baseline to M3). BEAT Cancer significantly improved self-efficacy, goals, negative outcome expectations, and barriers. Total path analysis model explained 24 % of the variance in M6 physical activity. There were significant paths from randomized intervention group to self-efficacy (β = 0.15, p social cognitive constructs, no significant indirect effects on physical activity improvements 3 months post-intervention were observed (NCT00929617).

  7. Randomised controlled trial of the clinical and cost-effectiveness of a peer-delivered self-management intervention to prevent relapse in crisis resolution team users: study protocol.

    Science.gov (United States)

    Johnson, Sonia; Mason, Oliver; Osborn, David; Milton, Alyssa; Henderson, Claire; Marston, Louise; Ambler, Gareth; Hunter, Rachael; Pilling, Stephen; Morant, Nicola; Gray, Richard; Weaver, Tim; Nolan, Fiona; Lloyd-Evans, Brynmor

    2017-10-27

    Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self-management interventions, involving supporting service users in recognising and managing signs of their own illness and in actively planning their recovery, have some supporting evidence, but have not been tested as a means of preventing readmission to acute care in people leaving community crisis care. We thus proposed the current study to test the effectiveness of such an intervention. We selected peer support workers as the preferred staff to deliver such an intervention, as they are well-placed to model and encourage active and autonomous recovery from mental health problems. The CORE (CRT Optimisation and Relapse Prevention) self-management trial compares the effectiveness of a peer-provided self-management intervention for people leaving CRT care, with treatment as usual supplemented by a booklet on self-management. The planned sample is 440 participants, including 40 participants in an internal pilot. The primary outcome measure is whether participants are readmitted to acute care over 1 year of follow-up following entry to the trial. Secondary outcomes include self-rated recovery at 4 and at 18 months following trial entry, measured using the Questionnaire on the Process of Recovery. Analysis will follow an intention to treatment principle. Random effects logistic regression modelling with adjustment for clustering by peer support worker will be used to test the primary hypothesis. The CORE self-management trial was approved

  8. [Study on interventions based on systematic ecological system construction to interrupt transmission of schistosomiasis in hilly endemic regions].

    Science.gov (United States)

    Jia, Xu; Xue-Xiang, Wan; Lin, Chen; Bo, Zhong; Yi, Zhang

    2016-10-13

    To study the effectiveness of comprehensive control measures based on systematic ecological system construction to interrupt the transmission of schistosomiasis in hilly endemic regions in Sichuan Province, so as to provide the evidence for adjustment of schistosomiasis prevention and control strategies. A high endemic area of schistosomiasis, Panao Township of Dongpo District in Meishan City, was selected as a demonstration area. The comprehensive measures for schistosomiasis control with focus on systematic ecological management were implemented, and the income of residents, indexes of schistosomiasis control effect and so on were investigated before and after the intervention and the results were compared. The project based on systematic ecological system construction started in 2009 and 317.351 million Yuan was put into the construction. The construction included economic forest plant base (1 866.68 hm 2 , 72.66% of the total farmland areas), ecological protection gardens (585.35 hm 2 ) and so on. Totally 97.04% of historical areas with Oncomelania hupensis snails were comprehensively improved. In 2015, the peasants´ pure income per capita increased 4 938 Yuan, with the average annual growth rate of 14.69%. All the farm cattle were replaced by the machine. The benefit rate of water improvement was increased by 52.84% and the coverage rate of harmless toilets increased by 18.30%. The positive rate of serological tests for schistosomiasis decreased from 7.69% to 3.50%, and the positive rate of parasitological tests decreased from 1.18% to 0. The area with snails was decreased from 23.33 hm 2 to 0. The awareness rate of schistosomiasis control knowledge and correct behavior rate of the residents increased from 85.50% and 82.60% to 95.70% and 93.90% respectively. The comprehensive schistosomiasis control measures based on systematic ecological management are conform to the currently actual schistosomiasis prevention and control work in hilly endemic regions, and

  9. A smart-phone intervention to address mental health stigma in the construction industry: A two-arm randomised controlled trial

    Directory of Open Access Journals (Sweden)

    A. Milner

    2018-04-01

    Full Text Available Background: High levels of self-stigma are associated with a range of adverse mental health, treatment, and functional outcomes. This prospective study examined the effects of an electronic mental health stigma reduction intervention on self-stigma (self-blame, shame, and help-seeking inhibition among male construction workers in Australia. Method: Male construction workers (N = 682 were randomly assigned to receive either the intervention condition or the wait list control over a six-week period. Self-stigma was assessed using the Self-Stigma of Depression Scale at post-intervention. We conducted linear regression to assess the effectiveness of the intervention on self-stigma, adjusting for relevant covariates. Results: Self-stigma was relatively low in the sample. The intervention had no significant effect on self-stigma, after adjusting for confounders. There were reductions in stigma in both the intervention and control groups at 6-week follow-up. Process evaluation indicated that participants generally enjoyed the program and felt that it was beneficial to their mental health. Conclusions: These observations underscore the need for further research to elucidate understanding of the experience of self-stigma among employed males. Keywords: Self-blame, shame, help-seeking inhibition, stigma, construction, mental health

  10. Constructions and experiences of motherhood in the context of an early intervention for Aboriginal mothers and their children: mother and healthcare worker perspectives.

    Science.gov (United States)

    Ussher, Jane M; Charter, Rosie; Parton, Chloe; Perz, Janette

    2016-07-22

    The colonisation of Australia has been associated with traumatic consequences for Aboriginal health and wellbeing, including the breakdown of the traditional family unit and negative consequences for the mother/child relationship. Early-intervention programs have been developed to assist families to overcome disadvantage and strengthen mother/child attachment. However, there is no research examining Aboriginal women's subjective experiences and constructions of motherhood in the context of such programs, and no research on the perceived impact of such programs, from the perspective of Aboriginal mothers and healthcare workers (HCWs), with previous research focusing on child outcomes. Researchers conducted participant observation of an early intervention program for Aboriginal mothers and young children over a 6 month period, one-to-one interviews and a focus group with 10 mothers, and interviews with nine HCWs, in order to examine their perspectives on motherhood and the intervention program. Thematic analysis identified 2 major themes under which subthemes were clustered. Constructions of motherhood: 'The resilient mother: Coping with life trauma and social stress' and 'The good mother: Transformation of self through motherhood'; Perspectives on the intervention: '"Mothers come to life": Transformation through therapy'; and '"I know I'm a good mum": The need for connections, skills and time for self'. The mothers constructed themselves as being resilient 'good mothers', whilst also acknowledging their own traumatic life experiences, predominantly valuing the peer support and time-out aspects of the program. HCWs positioned the mothers as 'traumatised', yet also strong, and expressed the view that in order to improve mother/child attachment a therapeutic transformation is required. These results suggest that early interventions for Aboriginal mothers should acknowledge and strengthen constructions of the good and resilient mother. The differing perspectives of

  11. A smart-phone intervention to address mental health stigma in the construction industry: A two-arm randomised controlled trial.

    Science.gov (United States)

    Milner, A; Law, P C F; Mann, C; Cooper, T; Witt, K; LaMontagne, A D

    2018-04-01

    High levels of self-stigma are associated with a range of adverse mental health, treatment, and functional outcomes. This prospective study examined the effects of an electronic mental health stigma reduction intervention on self-stigma (self-blame, shame, and help-seeking inhibition) among male construction workers in Australia. Male construction workers (N = 682) were randomly assigned to receive either the intervention condition or the wait list control over a six-week period. Self-stigma was assessed using the Self-Stigma of Depression Scale at post-intervention. We conducted linear regression to assess the effectiveness of the intervention on self-stigma, adjusting for relevant covariates. Self-stigma was relatively low in the sample. The intervention had no significant effect on self-stigma, after adjusting for confounders. There were reductions in stigma in both the intervention and control groups at 6-week follow-up. Process evaluation indicated that participants generally enjoyed the program and felt that it was beneficial to their mental health. These observations underscore the need for further research to elucidate understanding of the experience of self-stigma among employed males.

  12. The effect of a health promotion intervention for construction workers on work-related outcomes: results from a randomized controlled trial.

    Science.gov (United States)

    Viester, Laura; Verhagen, Evert A L M; Bongers, Paulien M; van der Beek, Allard J

    2015-08-01

    The objective of the present study is to investigate the effects of a worksite health promotion intervention on musculoskeletal symptoms, physical functioning, work ability, work-related vitality, work performance, and sickness absence. In a randomized controlled design, 314 construction workers were randomized into an intervention group (n = 162) receiving personal coaching, tailored information, and materials, and a control group (n = 152) receiving usual care. Sickness absence was recorded continuously in company records, and questionnaires were completed before, directly after the 6-month intervention period, and 12 months after baseline measurements. Linear and logistic regression analyses were performed to determine intervention effects. No significant changes at 6 or 12 months of follow-up were observed in musculoskeletal symptoms, physical functioning, work ability, work-related vitality, work performance, and sickness absence as a result of the intervention. This study shows that the intervention was not statistically significantly effective on secondary outcomes. Although the intervention improved physical activity, dietary, and weight-related outcomes, it was not successful in decreasing musculoskeletal symptoms and improving other work-related measures. Presumably, more multifaceted interventions are required to establish significant change in these outcomes.

  13. Does an Exercise Intervention Improving Aerobic Capacity Among Construction Workers Also Improve Musculoskeletal Pain, Work Ability, Productivity, Perceived Physical Exertion, and Sick Leave?

    DEFF Research Database (Denmark)

    Gram, Bibi; Holtermann, Andreas; Bültmann, Ute

    2012-01-01

    OBJECTIVE:: To investigate whether an exercise intervention shown to increase aerobic capacity, would also lead to less musculoskeletal pain; improved work ability, productivity, and perceived physical exertion; and less sick leave. METHODS:: Sixty-seven construction workers were randomized...... into an exercise group training 3 × 20 minutes per week and a control group. Questionnaires and text messages were completed before and after the 12-week intervention. RESULTS:: No significant changes were found in musculoskeletal pain, work ability, productivity, perceived physical exertion, and sick leave...... with the intervention. Questionnaires and text messages provided similar results of pain and work ability. CONCLUSIONS:: Although the intervention improved aerobic capacity, it was not successful in improving musculoskeletal pain and other work-related factors. A detectable improvement presumably requires a more...

  14. The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial.

    Science.gov (United States)

    LeBouthillier, Daniel M; Asmundson, Gordon J G

    2017-12-01

    Evidence supports exercise as an intervention for many mental health concerns; however, randomized controlled investigations of the efficacy of different exercise modalities and predictors of change are lacking. The purposes of the current trial were to: (1) quantify the effects of aerobic exercise and resistance training on anxiety-related disorder (including anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder) status, symptoms, and constructs, (2) evaluate whether both modalities of exercise were equivalent, and (3) to determine whether exercise enjoyment and physical fitness are associated with symptom reduction. A total of 48 individuals with anxiety-related disorders were randomized to aerobic exercise, resistance training, or a waitlist. Symptoms of anxiety-related disorders, related constructs, and exercise enjoyment were assessed at pre-intervention and weekly during the 4-week intervention. Participants were further assessed 1-week and 1-month post-intervention. Both exercise modalities were efficacious in improving disorder status. As well, aerobic exercise improved general psychological distress and anxiety, while resistance training improved disorder-specific symptoms, anxiety sensitivity, distress tolerance, and intolerance of uncertainty. Physical fitness predicted reductions in general psychological distress for both types of exercise and reductions in stress for aerobic exercise. Results highlight the efficacy of different exercise modalities in uniquely addressing anxiety-related disorder symptoms and constructs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Delivering migrant workers' remittances

    OpenAIRE

    Ballard, Roger

    2004-01-01

    As globalization has led to ever higher levels of labour mobility, so the volume of funds remitted to their families by workers employed in countries far distant from their homes has increased by leaps and bounds. The total volume of such transfers currently amounts to over $100 billion per annum, the greater part of which flows from economically advanced regions in the West and North to developing countries in the East and South. Delivering those funds swiftly, reliably and cheaply to relati...

  16. Promoting contraceptive use more effectively among unmarried male migrants in construction sites in China: a pilot intervention trial

    NARCIS (Netherlands)

    He, D.; Cheng, Y.-M.; Wu, S.-Z.; Decat, P.; Wang, Z.-J.; Minkauskiene, M.; Moyer, E.

    2012-01-01

    Poor sexual and reproductive health status has been reported among rural-to-urban migrants in China. Therefore, some effective and feasible interventions are urgently needed. The authors developed a workplace-based intervention to compare 2 young labor migrant service packages (A and B) on the

  17. Test-retest reliability and construct validity of the DOiT (Dutch Obesity Intervention in Teenagers) questionnaire: measuring energy balance-related behaviours in Dutch adolescents.

    Science.gov (United States)

    Janssen, Evelien H C; Singh, Amika S; van Nassau, Femke; Brug, Johannes; van Mechelen, Willem; Chinapaw, Mai J M

    2014-02-01

    Adequate assessment of energy balance-related behaviours in adolescents is essential to develop and evaluate effective obesity prevention programmes. The present study examined the test-retest reliability and construct validity of a questionnaire assessing energy balance-related behaviours in adolescents during the evaluation of the DOiT (Dutch Obesity Intervention in Teenagers) intervention. To assess test-retest reliability, adolescents filled in the questionnaire twice (n 111). To assess construct validity, the results from the first test were compared with data collected in a personal cognitive interview (n 20, independent from the reliability study). For both reliability and validity, intraclass correlation coefficients for continuous data or Cohen's kappa coefficients for categorical data were calculated as well as percentage agreement. Data were collected during school time from February to May 2010. Study participants were Dutch adolescents aged 12-14 years attending pre-vocational secondary schools. In more than three-quarters of the ninety-five questionnaire items the test-retest reliability appeared to be good to excellent. Moderate reliability was found for all other twenty-one items. Fifty-one items (of ninety-five items) showed good to excellent construct validity. Construct validity appeared moderate in twenty-three items and poor in twenty-one items. Most items with poor construct validity concerned consumption of sugar-containing beverages and high-energy snacks/sweets. Our study showed good test-retest reliability and largely moderate to good construct validity for the majority of items of the DOiT questionnaire. Items with poor construct validity (most of them found for items concerning energy intake-related behaviours) should be revised and tested again to improve the questionnaire for future use.

  18. Psychosocial constructs were not mediators of intervention effects for dietary and physical activity outcomes in a church-based,lifestyle intervention: Delta Body and Soul III

    Science.gov (United States)

    Background: While using theory-based methods when designing and implementing behavioral health interventions is essential, it also has become increasingly important to evaluate an intervention’s theoretical basis. Such evaluations can be accomplished through the use of mediation analysis which can ...

  19. Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention.

    Science.gov (United States)

    Zoellner, Jamie M; Porter, Kathleen J; Chen, Yvonnes; Hedrick, Valisa E; You, Wen; Hickman, Maja; Estabrooks, Paul A

    2017-05-01

    Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13-20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6-38%) and behaviour (average 30%, range 6-55%) were significant. Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases.

  20. Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention

    Science.gov (United States)

    Zoellner, Jamie M.; Porter, Kathleen J.; Chen, Yvonnes; Hedrick, Valisa E.; You, Wen; Hickman, Maja; Estabrooks, Paul A.

    2017-01-01

    Objective Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Design Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Main Outcome Measures Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. Results TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13–20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6–38%) and behaviour (average 30%, range 6–55%) were significant. Conclusion Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases. PMID:28165771

  1. Constructions and experiences of motherhood in the context of an early intervention for Aboriginal mothers and their children: mother and healthcare worker perspectives

    Directory of Open Access Journals (Sweden)

    Jane M. Ussher

    2016-07-01

    Full Text Available Abstract Background The colonisation of Australia has been associated with traumatic consequences for Aboriginal health and wellbeing, including the breakdown of the traditional family unit and negative consequences for the mother/child relationship. Early-intervention programs have been developed to assist families to overcome disadvantage and strengthen mother/child attachment. However, there is no research examining Aboriginal women’s subjective experiences and constructions of motherhood in the context of such programs, and no research on the perceived impact of such programs, from the perspective of Aboriginal mothers and healthcare workers (HCWs, with previous research focusing on child outcomes. Method Researchers conducted participant observation of an early intervention program for Aboriginal mothers and young children over a 6 month period, one-to-one interviews and a focus group with 10 mothers, and interviews with nine HCWs, in order to examine their perspectives on motherhood and the intervention program. Results Thematic analysis identified 2 major themes under which subthemes were clustered. Constructions of motherhood: ‘The resilient mother: Coping with life trauma and social stress’ and ‘The good mother: Transformation of self through motherhood’; Perspectives on the intervention: ‘“Mothers come to life”: Transformation through therapy’; and ‘“I know I’m a good mum”: The need for connections, skills and time for self’. Conclusions The mothers constructed themselves as being resilient ‘good mothers’, whilst also acknowledging their own traumatic life experiences, predominantly valuing the peer support and time-out aspects of the program. HCWs positioned the mothers as ‘traumatised’, yet also strong, and expressed the view that in order to improve mother/child attachment a therapeutic transformation is required. These results suggest that early interventions for Aboriginal mothers should

  2. [Study on interventions based on urban - rural integration system construction to consolidate achievements of schistosomiasis control in hilly schistosomiasis endemic areas].

    Science.gov (United States)

    Rong-Zhi, Li; Yang, Liu; Hui, Zhang; Yi, Zhang; Bo, Zhong; Jian-Jun, Wu; Chun-Xia, Yang

    2017-09-28

    To explore the effectiveness of comprehensive schistosomiasis control interventions based on urban-rural integration system construction to carry out the schistosomiasis control in hilly schistosomiasis endemic areas, so as to offer a new mode to consolidate the achievements of schistosomiasis control in the new situation. Shouan Town and Changqiu Township in Pujiang County in hilly schistosomiasis endemic regions were selected as demonstration areas. The comprehensive schistosomiasis control interventions based on urban-rural integration system construction were implemented, including the land consolidation, centralized residence and so on. The effectiveness the interventions was evaluated. In Shouan Town and Changqiu Township, the transformed environments with Oncomelania hupensis snail habitats were 1 330.61 hm 2 and 1 456.84 hm 2 , the areas with snails decreased from 94.31 hm 2 and 83.00 hm 2 in 2000 to both 0 in 2015, the positive rates of serological tests for schistosomiasis decreased from 11.8% and 7.53% in 2000 to 1.01% and 1.86% in 2015, and the positive rates of parasitological tests decreased from 0.18% and 0.15% in 2000 to both 0 in 2015 respectively. The numbers of cattle decreased from 358 and 368 in 2000 to 4 and 6 in 2015 respectively. In 2000, the schistosome infection rates of cattle were 3.63% and 6.51% in Shouan Town and Changqiu Township respectively, and from 2004, no infected cattle were found. The comprehensive schistosomiasis control interventions based on urban-rural integration system construction can decrease the schistosome infection rate and area with snails effectively, providing a new mode for schistosomiasis elimination.

  3. Contractor firm strategies in delivering green project: A review

    Science.gov (United States)

    Powmya, Ayisha; Abidin, Nazirah Zainul; Azizi, Nurul Sakina Mokhtar

    2017-10-01

    Building green requires effort from various parties, from those who plan, design, manage and construct the building. Contractors are responsible for converting the design on paper into a real building and their role at the construction site support environmental sustainability by implementing responsible construction practices. Inefficient or inexperienced contractor in green construction project may find that delivering this type of project is not an easy task due to added requirement in design, stringent practices at site and the use of green technology and materials. Adopting suitable strategies at firm level will assist in preparatory process and readiness of delivering the green project. This paper reviews the strategies at firm level to deliver green construction project. From extensive literature review, it was discovered that there are six strategies to be adopted by the contractor. Understanding these strategies is expected to promote more contractors to be proactive in delivering green projects.

  4. Delivering the right dose

    International Nuclear Information System (INIS)

    Shaw, A

    2004-01-01

    For treatment with high intensity focused ultrasound (HIFU), delivering the correct amount of energy to the patient is critical. This paper describes a novel design of sensor based on the pyroelectric principle for monitoring the output power from HIFU transducers of the type used for tissue ablation. The sensor is intended to be minimally perturbing to the ultrasound field, so that it can remain in the ultrasound field throughout treatment and provide a constant monitor of ultrasound power. The main advantages of the technique are: power can be measured or monitored without dismantling the HIFU system, thus reducing equipment downtime; power can be measured immediately before or during every patient treatment, thus ensuring accurate dosimetry; power can be measured at the output levels used for treatment (whereas a radiation force balance may be damaged by overheating); the method uses components which are robust and simple to use compared to radiation force balances or hydrophone scanning systems

  5. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35 tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which finished its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. "The production is proceeding well and we expect to be complete in October as previously foreseen," said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have been delivered.

  6. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35-tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which completed its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. 'The production is proceeding well and we expect to be complete in October as foreseen,' said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have already been delivered.

  7. Randomised controlled trial evaluating the effectiveness and cost-effectiveness of 'Families for Health', a family-based childhood obesity treatment intervention delivered in a community setting for ages 6 to 11 years.

    Science.gov (United States)

    Robertson, Wendy; Fleming, Joanna; Kamal, Atiya; Hamborg, Thomas; Khan, Kamran A; Griffiths, Frances; Stewart-Brown, Sarah; Stallard, Nigel; Petrou, Stavros; Simkiss, Douglas; Harrison, Elizabeth; Kim, Sung Wook; Thorogood, Margaret

    2017-01-01

    Effective programmes to help children manage their weight are required. 'Families for Health' focuses on a parenting approach, designed to help parents develop their parenting skills to support lifestyle change within the family. Families for Health version 1 showed sustained reductions in mean body mass index (BMI) z-score after 2 years in a pilot project. The aim was to evaluate its effectiveness and cost-effectiveness in a randomised controlled trial (RCT). The trial was a multicentre, investigator-blind RCT, with a parallel economic and process evaluation, with follow-up at 3 and 12 months. Randomisation was by family unit, using a 1 : 1 allocation by telephone registration, stratified by three sites, with a target of 120 families. Three sites in the West Midlands, England, UK. Children aged 6-11 years who were overweight (≥ 91st centile BMI) or obese (≥ 98th centile BMI), and their parents/carers. Recruitment was via referral or self-referral. Families for Health version 2 is a 10-week, family-based community programme with parallel groups for parents and children, addressing parenting, lifestyle, social and emotional development. Usual care was the treatment for childhood obesity provided within each locality. Joint primary outcome measures were change in children's BMI z-score and incremental cost per quality-adjusted life-year (QALY) gained at 12 months' follow-up (QALYs were calculated using the European Quality of Life-5 Dimensions Youth version). Secondary outcome measures included changes in children's waist circumference, percentage body fat, physical activity, fruit/vegetable consumption and quality of life. Parents' BMI and mental well-being, family eating/activity, parent-child relationships and parenting style were also assessed. The process evaluation documented recruitment, reach, dose delivered, dose received and fidelity, using mixed methods. The study recruited 115 families (128 children; 63 boys and 65 girls), with 56 families

  8. Principles for designing and delivering psychosocial and mental healthcare.

    Science.gov (United States)

    Williams, Richard; Kemp, V

    2018-03-08

    The development of the UK's military policy includes the potential for military organisations to deploy in support of humanitarian aid operations. This paper offers an overview of the risks to people's mental health of their exposure to emergencies, major incidents, disasters, terrorism, displacement, postconflict environments in which humanitarian aid is delivered, and deployments to conflict zones. It summarises the psychosocial approach recommended by many contemporary researchers and practitioners. It differentiates the extremely common experience of distress from the mental disorders that people who are affected may develop and introduces the construct of psychosocial resilience. The authors recognise the importance of trajectories of response in separating people who are distressed and require psychosocial care from those who require mental healthcare. Finally, this paper summarises a strategic approach to designing, planning and providing psychosocial and mental healthcare, provides a model of care and outlines the principles for early psychosocial interventions that do not require training in mental healthcare to deliver them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. The impact of interventions to promote healthier ready‐to‐eat meals (to eat in, to take away or to be delivered) sold by specific food outlets open to the general public: a systematic review

    Science.gov (United States)

    Summerbell, C. D.; Moore, H. J.; Routen, A.; Lake, A. A.; Adams, J.; White, M.; Araujo‐Soares, V.; Abraham, C.; Adamson, A. J.; Brown, T. J.

    2016-01-01

    Summary Introduction Ready‐to‐eat meals sold by food outlets that are accessible to the general public are an important target for public health intervention. We conducted a systematic review to assess the impact of such interventions. Methods Studies of any design and duration that included any consumer‐level or food‐outlet‐level before‐and‐after data were included. Results Thirty studies describing 34 interventions were categorized by type and coded against the Nuffield intervention ladder: restrict choice = trans fat law (n = 1), changing pre‐packed children's meal content (n = 1) and food outlet award schemes (n = 2); guide choice = price increases for unhealthier choices (n = 1), incentive (contingent reward) (n = 1) and price decreases for healthier choices (n = 2); enable choice = signposting (highlighting healthier/unhealthier options) (n = 10) and telemarketing (offering support for the provision of healthier options to businesses via telephone) (n = 2); and provide information = calorie labelling law (n = 12), voluntary nutrient labelling (n = 1) and personalized receipts (n = 1). Most interventions were aimed at adults in US fast food chains and assessed customer‐level outcomes. More ‘intrusive’ interventions that restricted or guided choice generally showed a positive impact on food‐outlet‐level and customer‐level outcomes. However, interventions that simply provided information or enabled choice had a negligible impact. Conclusion Interventions to promote healthier ready‐to‐eat meals sold by food outlets should restrict choice or guide choice through incentives/disincentives. Public health policies and practice that simply involve providing information are unlikely to be effective. PMID:27899007

  10. The impact of interventions to promote healthier ready-to-eat meals (to eat in, to take away or to be delivered) sold by specific food outlets open to the general public: a systematic review.

    Science.gov (United States)

    Hillier-Brown, F C; Summerbell, C D; Moore, H J; Routen, A; Lake, A A; Adams, J; White, M; Araujo-Soares, V; Abraham, C; Adamson, A J; Brown, T J

    2017-02-01

    Ready-to-eat meals sold by food outlets that are accessible to the general public are an important target for public health intervention. We conducted a systematic review to assess the impact of such interventions. Studies of any design and duration that included any consumer-level or food-outlet-level before-and-after data were included. Thirty studies describing 34 interventions were categorized by type and coded against the Nuffield intervention ladder: restrict choice = trans fat law (n = 1), changing pre-packed children's meal content (n = 1) and food outlet award schemes (n = 2); guide choice = price increases for unhealthier choices (n = 1), incentive (contingent reward) (n = 1) and price decreases for healthier choices (n = 2); enable choice = signposting (highlighting healthier/unhealthier options) (n = 10) and telemarketing (offering support for the provision of healthier options to businesses via telephone) (n = 2); and provide information = calorie labelling law (n = 12), voluntary nutrient labelling (n = 1) and personalized receipts (n = 1). Most interventions were aimed at adults in US fast food chains and assessed customer-level outcomes. More 'intrusive' interventions that restricted or guided choice generally showed a positive impact on food-outlet-level and customer-level outcomes. However, interventions that simply provided information or enabled choice had a negligible impact. Interventions to promote healthier ready-to-eat meals sold by food outlets should restrict choice or guide choice through incentives/disincentives. Public health policies and practice that simply involve providing information are unlikely to be effective. © 2016 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

  11. Delivering Science from Big Data

    Science.gov (United States)

    Quinn, Peter Joseph

    2015-08-01

    The SKA will be capable of producing a stream of science data products that are Exa-scale in terms of their storage and processing requirements. This Google-scale enterprise is attracting considerable international interest and excitement from within the industrial and academic communities. In this paper we examine the data flow, storage and processing requirements of a number of key SKA survey science projects to be executed on the baseline SKA1 configuration. Based on a set of conservative assumptions about trends for HPC and storage costs, and the data flow process within the SKA Observatory, it is apparent that survey projects of the scale proposed will potentially drive construction and operations costs beyond the current anticipated SKA1 budget. This implies a sharing of the resources and costs to deliver SKA science between the community and what is contained within the SKA Observatory. A similar situation was apparent to the designers of the LHC more than 10 years ago. We propose that it is time for the SKA project and broader community to consider the effort and process needed to design and implement a distributed science data system that leans on the lessons of other projects and looks to recent developments in Cloud technologies to ensure an affordable, effective and global achievement of science goals.

  12. The Madeira River, Society and Power Industry: the construction of hydropower plants and its impacts and interventions in society

    Directory of Open Access Journals (Sweden)

    Artur de Souza Moret

    2011-12-01

    Full Text Available Energy is made operational in an industry with great spectrum and impact on world and local economic activities, as it enables the generation production of various products and facilitates human activities, such as transportation, comfort and leisure. The figures in the industry are exceedingly large regarding supply, consumption, financial volume, and influence on individuals, and social imaginarium. Thus, it is understood that Energy defines the course of society, whether positive or negative. The construction of dams on the Madeira River will be examined from this theoretical framework.

  13. “Real Men Don't”: Constructions of Masculinity and Inadvertent Harm in Public Health Interventions

    Science.gov (United States)

    Lee, Joseph G. L.; Dworkin, Shari L.

    2014-01-01

    Research shows that constraining aspects of male gender norms negatively influence both women’s and men’s health. Messaging that draws on norms of masculinity in health programming has been shown to improve both women’s and men’s health, but some types of public health messaging (e.g., Man Up Monday, a media campaign to prevent the spread of sexually transmitted infections) can reify harmful aspects of hegemonic masculinity that programs are working to change. We critically assess the deployment of hegemonic male norms in the Man Up Monday campaign. We draw on ethical paradigms in public health to challenge programs that reinforce harmful aspects of gender norms and suggest the use of gender-transformative interventions that challenge constraining masculine norms and have been shown to have a positive effect on health behaviors. PMID:24825202

  14. Strengthening health services to deliver nutrition education to promote complementary feeding and healthy growth of infants and young children: formative research for a successful intervention in peri-urban Trujillo, Peru.

    Science.gov (United States)

    Robert, Rebecca C; Creed-Kanashiro, Hilary M; Villasante, Ruben; Narro, M Rocio; Penny, Mary E

    2017-04-01

    Formative research is critical for developing effective nutrition-specific interventions to improve infant and young child (IYC) feeding practices and promote healthy growth. Health workers interact with caregivers during health facility visits, yet there is limited research about how to optimize delivery of such interventions during these visits. The extensive reach of IYC health services globally calls for research to address this gap. In Trujillo, Peru, formative research was conducted to explore complementary feeding practices with caregivers as well as health worker routines and interactions with caregivers related to feeding and healthy growth; results informed the development and delivery of an educational intervention. Multiple qualitative methods were used to collect data on a purposive sample of health workers and caregivers from three health facilities and communities: household trials followed. Complementary feeding messages with doable behaviours were developed, and three were selected as key to promote based on their nutritional impact and cultural acceptability. In the health facilities, medical consultation, well-child visits and nutrition consultation all dealt with aspects of IYC nutrition/growth during their interactions with caregivers but were independent and inconsistent in approach. A nutrition education strategy was developed based on consistency, quality and coverage in the IYC health services. We conclude that formative research undertaken in the community and IYC health services was critical to developing a successful and culturally relevant intervention to promote optimal complementary feeding practices and healthy growth during interactions between health workers and caregivers at routine health facility visits. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

  15. The Feasibility, Acceptability, and Efficacy of Delivering Internet-Based Self-Help and Guided Self-Help Interventions for Generalized Anxiety Disorder to Indian University Students: Design of a Randomized Controlled Trial.

    Science.gov (United States)

    Kanuri, Nitya; Newman, Michelle G; Ruzek, Josef I; Kuhn, Eric; Manjula, M; Jones, Megan; Thomas, Neil; Abbott, Jo-Anne M; Sharma, Smita; Taylor, C Barr

    2015-12-11

    Generalized anxiety disorder (GAD) is one of the most common mental disorders among university students; however, many students go untreated due to treatment costs, stigma concerns, and limited access to trained mental health professionals. These barriers are heightened in universities in India, where there are scant mental health care services and severe stigma surrounding help seeking. To evaluate the feasibility, acceptability, and efficacy of Internet-based, or "online," cognitive behavioral therapy (CBT)-based unguided and guided self-help interventions (using the programs GAD Online and Lantern, respectively) to reduce GAD symptoms in students with clinical and subthreshold GAD and, ultimately, reduce the prevalence and incidence of GAD among the student population. Students will be recruited via 3 colleges in Hyderabad, India, and referred for a campus-wide online screening. Self-report data will be collected entirely online. A total of 300 qualifying students will be randomized in a 1:1:1 ratio to receive GAD Online, Lantern, or to be in a wait-list control condition, stratified by clinical and subthreshold GAD symptomatology. Students will complete a postintervention assessment after 3 months and a follow-up assessment 6 months later, at which point students in the wait-list control condition will receive one of the programs. The primary outcome is GAD symptom severity at 3 months postintervention. Secondary outcomes include GAD caseness at 9 months, other anxiety and depression symptoms, self-efficacy, and functional measures (eg, sleep, social functioning) at 3 and 9 months, respectively. Primary analyses will be differences between each of the intervention groups and the wait-list control group, analyzed on an intention-to-treat (ITT) basis using mixed-design ANOVA. The study commenced in February 2015. The sample was recruited over a 3-week period at each college. The trial is expected to end in December 2015. This trial will be the first to evaluate

  16. The Feasibility, Acceptability, and Efficacy of Delivering Internet-Based Self-Help and Guided Self-Help Interventions for Generalized Anxiety Disorder to Indian University Students: Design of a Randomized Controlled Trial

    Science.gov (United States)

    Newman, Michelle G; Ruzek, Josef I; Kuhn, Eric; Manjula, M; Jones, Megan; Thomas, Neil; Abbott, Jo-Anne M; Sharma, Smita; Taylor, C. Barr

    2015-01-01

    Background Generalized anxiety disorder (GAD) is one of the most common mental disorders among university students; however, many students go untreated due to treatment costs, stigma concerns, and limited access to trained mental health professionals. These barriers are heightened in universities in India, where there are scant mental health care services and severe stigma surrounding help seeking. Objective To evaluate the feasibility, acceptability, and efficacy of Internet-based, or “online,” cognitive behavioral therapy (CBT)-based unguided and guided self-help interventions (using the programs GAD Online and Lantern, respectively) to reduce GAD symptoms in students with clinical and subthreshold GAD and, ultimately, reduce the prevalence and incidence of GAD among the student population. Methods Students will be recruited via 3 colleges in Hyderabad, India, and referred for a campus-wide online screening. Self-report data will be collected entirely online. A total of 300 qualifying students will be randomized in a 1:1:1 ratio to receive GAD Online, Lantern, or to be in a wait-list control condition, stratified by clinical and subthreshold GAD symptomatology. Students will complete a postintervention assessment after 3 months and a follow-up assessment 6 months later, at which point students in the wait-list control condition will receive one of the programs. The primary outcome is GAD symptom severity at 3 months postintervention. Secondary outcomes include GAD caseness at 9 months, other anxiety and depression symptoms, self-efficacy, and functional measures (eg, sleep, social functioning) at 3 and 9 months, respectively. Primary analyses will be differences between each of the intervention groups and the wait-list control group, analyzed on an intention-to-treat (ITT) basis using mixed-design ANOVA. Results The study commenced in February 2015. The sample was recruited over a 3-week period at each college. The trial is expected to end in December 2015

  17. Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits.

    Science.gov (United States)

    Gray, Cindy M; Hunt, Kate; Mutrie, Nanette; Anderson, Annie S; Leishman, Jim; Dalgarno, Lindsay; Wyke, Sally

    2013-03-16

    The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the development and optimization of the Football Fans in Training (FFIT) programme, which aims to help overweight men (many of them football supporters) lose weight through becoming more active and adopting healthier eating habits. The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases. In Phase 1, a multidisciplinary working group developed the pilot programme (p-FFIT) and used a scoping review to summarize previous research and identify the target population. Phase 2 involved a process evaluation of p-FFIT in 11 Scottish Premier League (SPL) clubs. Participant and coach feedback, focus group discussions and interviews explored the utility/acceptability of programme components and suggestions for changes. Programme session observations identified examples of good practice and problems/issues with delivery. Together, these findings informed redevelopment of the optimized programme (FFIT), whose components were mapped onto specific behaviour change techniques using an evidence-based taxonomy. p-FFIT comprised 12, weekly, gender-sensitised, group-based weight management classroom and 'pitch-side' physical activity sessions. These in-stadia sessions were complemented by an incremental, pedometer-based walking programme. p-FFIT was targeted at men aged 35-65 years with body mass index ≥ 27 kg/m(2). Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components, and valued the camaraderie and peer-support offered by the programme. Coaches appreciated the simplicity of the key healthy eating and physical activity messages. Suggestions for improvements that

  18. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1966-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1965 in compliance with requests the Agency had made under Article IX. D. Part III contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

  19. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1965-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1964 in compliance with requests the Agency had made under Article IX. D. Part II contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

  20. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1968-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1968 in compliance with requests the Agency had made under Article IX,D. Part II contains information about materials which had not been delivered by 30 June 1968 but which had been allocated, in accordance with Article XI.F.I of the Statute, to approved Agency projects for which project arrangements were in force on that date

  1. The efficacy of internet-delivered treatment for generalized anxiety disorder: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Derek Richards

    2015-09-01

    Full Text Available Generalized Anxiety Disorder (GAD is typically considered a chronic condition characterized by excessive worry. Lifetime prevalence is 4.3–5.9%, yet only a small percentage seeks treatment. GAD is treatable and in recent years internet-delivered treatment interventions have shown promise. This paper aims to systematically search for literature on internet-delivered psychological interventions for the treatment of GAD and conduct a meta-analysis to examine their efficacy. The purpose of the paper is to inform the community of researchers, program developers and practitioners in internet delivered interventions of the current state-of-the-art and research gaps that require attention. A systematic search of the literature was conducted to find all studies of internet-delivered treatments for GAD (N = 20. Using Review Manager 5 all Randomized Controlled Trials (RCTs; n = 11 that met our established eligibility criteria were included into a meta-analysis that calculated effect sizes via the standardized mean difference. Compared to the waiting-list controls, the results demonstrate positive outcomes for GAD symptoms (d = −0.91 and its central construct of pathological worry (d = −0.74. The meta-analysis supports the efficacy of internet-delivered treatments for GAD including the use of disorder-specific (4 studies and transdiagnostic treatment protocols (7 studies. Caution is advised regarding the results as the data is limited and highly heterogeneous, but revealing of what future research might be needed.

  2. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1969-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1969 in compliance with requests the Agency had made under Article IX. D

  3. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1975-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 30 June 1975, in compliance with requests the Agency had made under Article IX. D

  4. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1974-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 31 March 1974, in compliance with requests the Agency had made under Article IX. D

  5. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1971-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1970, in compliance with requests the Agency had made under Article IX. D

  6. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1973-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1972, in compliance with requests the Agency had made under Article IX. D

  7. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1972-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1971, in compliance with requests the Agency had made under Article IX. D

  8. School Nurse-Delivered Adolescent Relationship Abuse Prevention

    Science.gov (United States)

    Raible, Claire A.; Dick, Rebecca; Gilkerson, Fern; Mattern, Cheryl S.; James, Lisa; Miller, Elizabeth

    2017-01-01

    Background: Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office…

  9. LA CONSTRUCTION DE L’ETHOS POLITIQUE DU PRÉSIDENT BIYA DANS SES DISCOURS À LA JEUNESSE CAMEROUNAISE / THE CONSTRUCTION OF POLITICAL ETHOS IN PRESIDENT PAUL BIYA’S SPEECHES DELIVERED FOR THE YOUTH IN CAMEROON / CONSTRUCŢIA ETOSULUI POLITIC ȊN DISCURSURILE PREŞEDINTELUI BIYA CĂTRE TINERETUL CAMERUNEZ

    Directory of Open Access Journals (Sweden)

    Nzessé Ladislas

    2017-12-01

    Full Text Available This work aims at showing how President Paul Biya constructs self image (ethos in his speeches to cameroonian youth. Analysing the relationship between prediscursive and discursive ethos of president Biya, is to put into perspective his discursive and social identity respectively. For an effectiveness project of persuasion, the political operator achieves a work either or favourable features reinforcement, or of deconstruction of the negative representations for both specifics identity and self image. This ethos consists of three major figures namely: credibility ethos, identification ethos and paternalist ethos.

  10. A qualitative study of the anticipated barriers and facilitators to the implementation of a lifestyle intervention in the dutch construction industry

    NARCIS (Netherlands)

    Tonnon, S.C.; Proper, K.I.; van der Ploeg, H.P.; Westerman, M.J.; Sijbesma, E.; van der Beek, A.J.

    2014-01-01

    Background: Lifestyle interventions have proven effective for lowering a cardiovascular risk profile by improving lifestyle behaviors, blood glucose and blood cholesterol levels. However, implementation of lifestyle interventions is often met with barriers. This qualitative study sought to determine

  11. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1962-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered up to 30 September 1962 by Member States in compliance with requests the Agency has made under Article IX. D. Part II contains information about materials which have not yet been delivered but which have been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project agreements were in force on 30 September 1962. Reports on subsequent deliveries of materials and revised information about allocated but undelivered materials will be issued from time to time

  12. Evidence-based selection of theories for designing behaviour change interventions: using methods based on theoretical construct domains to understand clinicians' blood transfusion behaviour.

    Science.gov (United States)

    Francis, Jill J; Stockton, Charlotte; Eccles, Martin P; Johnston, Marie; Cuthbertson, Brian H; Grimshaw, Jeremy M; Hyde, Chris; Tinmouth, Alan; Stanworth, Simon J

    2009-11-01

    Many theories of behaviour are potentially relevant to predictive and intervention studies but most studies investigate a narrow range of theories. Michie et al. (2005) agreed 12 'theoretical domains' from 33 theories that explain behaviour change. They developed a 'Theoretical Domains Interview' (TDI) for identifying relevant domains for specific clinical behaviours, but the framework has not been used for selecting theories for predictive studies. It was used here to investigate clinicians' transfusion behaviour in intensive care units (ICU). Evidence suggests that red blood cells transfusion could be reduced for some patients without reducing quality of care. (1) To identify the domains relevant to transfusion practice in ICUs and neonatal intensive care units (NICUs), using the TDI. (2) To use the identified domains to select appropriate theories for a study predicting transfusion behaviour. An adapted TDI about managing a patient with borderline haemoglobin by watching and waiting instead of transfusing red blood cells was used to conduct semi-structured, one-to-one interviews with 18 intensive care consultants and neonatologists across the UK. Relevant theoretical domains were: knowledge, beliefs about capabilities, beliefs about consequences, social influences, behavioural regulation. Further analysis at the construct level resulted in selection of seven theoretical approaches relevant to this context: Knowledge-Attitude-Behaviour Model, Theory of Planned Behaviour, Social Cognitive Theory, Operant Learning Theory, Control Theory, Normative Model of Work Team Effectiveness and Action Planning Approaches. This study illustrated, the use of the TDI to identify relevant domains in a complex area of inpatient care. This approach is potentially valuable for selecting theories relevant to predictive studies and resulted in greater breadth of potential explanations than would be achieved if a single theoretical model had been adopted.

  13. Qualitative content analysis from the lean construction perspective ...

    African Journals Online (AJOL)

    'how organisations working together' overcome complexities and deliver value ... Dr Fidelis A. Emuze, Research Associate, Built Environment Research Centre .... applications in construction. Safety. Safety systems in construction. Logistics.

  14. "The effect of a template when constructing individual syllabuses in nursing education – an evaluation of student perspective in a mixed methods intervention study"

    DEFF Research Database (Denmark)

    Vilstrup, Dorte Lindstrøm; Udsen, Helle; Prip, Anne

    2014-01-01

    of the individual syllabus in a clinical setting. Design: A mixed methods intervention study involving first year nursing students and clinical teachers. The intervention consisted of: 1) design of a template and a precise description, 2) testing of the template and description in the form of baseline and post...

  15. Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development

    Directory of Open Access Journals (Sweden)

    Jeff C. Huffman

    2015-01-01

    Full Text Available Most patients with type 2 diabetes (T2D have suboptimal adherence to recommended diet, physical activity, and/or medication. Current approaches to improve health behaviors in T2D have been variably effective, and successful interventions are often complex and intensive. It is therefore vital to develop interventions that are simple, well-accepted, and applicable to a wide range of patients who suffer from T2D. One approach may be to boost positive psychological states, such as positive affect or optimism, as these constructs have been prospectively and independently linked to improvements in health behaviors. Positive psychology (PP interventions, which utilize systematic exercises to increase optimism, well-being, and positive affect, consistently increase positive states and are easily delivered to patients with chronic illnesses. However, to our knowledge, PP interventions have not been formally tested in T2D. In this paper, we review a theoretical model for the use of PP interventions to target health behaviors in T2D, describe the structure and content of a PP intervention for T2D patients, and describe baseline data from a single-arm proof-of-concept (N=15 intervention study in T2D patients with or without depression. We also discuss how PP interventions could be combined with motivational interviewing (MI interventions to provide a blended psychological-behavioral approach.

  16. A Psychometric Approach to Theory-Based Behavior Change Intervention Development: Example From the Colorado Meaning-Activity Project.

    Science.gov (United States)

    Masters, Kevin S; Ross, Kaile M; Hooker, Stephanie A; Wooldridge, Jennalee L

    2018-05-18

    There has been a notable disconnect between theories of behavior change and behavior change interventions. Because few interventions are both explicitly and adequately theory-based, investigators cannot assess the impact of theory on intervention effectiveness. Theory-based interventions, designed to deliberately engage the theory's proposed mechanisms of change, are needed to adequately test theories. Thus, systematic approaches to theory-based intervention development are needed. This article will introduce and discuss the psychometric method of developing theory-based interventions. The psychometric approach to intervention development utilizes basic psychometric principles at each step of the intervention development process in order to build a theoretically driven intervention to, subsequently, be tested in process (mechanism) and outcome studies. Five stages of intervention development are presented as follows: (i) Choice of theory; (ii) Identification and characterization of key concepts and expected relations; (iii) Intervention construction; (iv) Initial testing and revision; and (v) Empirical testing of the intervention. Examples of this approach from the Colorado Meaning-Activity Project (COMAP) are presented. Based on self-determination theory integrated with meaning or purpose, and utilizing a motivational interviewing approach, the COMAP intervention is individually based with an initial interview followed by smart phone-delivered interventions for increasing daily activity. The psychometric approach to intervention development is one method to ensure careful consideration of theory in all steps of intervention development. This structured approach supports developing a research culture that endorses deliberate and systematic operationalization of theory into behavior change intervention from the outset of intervention development.

  17. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework.

    Science.gov (United States)

    Sekhon, Mandeep; Cartwright, Martin; Francis, Jill J

    2017-01-26

    It is increasingly acknowledged that 'acceptability' should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients. Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators. From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews). From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Despite frequent claims that healthcare interventions have assessed acceptability, it is

  18. Improving occupational health care for construction workers: a process evaluation.

    Science.gov (United States)

    Boschman, Julitta S; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2013-03-11

    To evaluate the process of a job-specific workers' health surveillance (WHS) in improving occupational health care for construction workers. From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0-10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received. Reach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation. Programme implementation was acceptable. Low reach, limited protocol adherence and modest engagement of the workers with respect

  19. Short and long term effects of a lifestyle intervention for construction workers at risk for cardiovascular disease: A randomized controlled trial

    NARCIS (Netherlands)

    Groeneveld, I.F.; Proper, K.I.; Beek, A.J. van der; Hildebrandt, V.H.; Mechelen, W. van

    2011-01-01

    Background: The prevalence of overweight and elevated cardiovascular disease (CVD) risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity

  20. Meeting the challenges of implementing an intervention to promote work ability and health-related quality of life at construction worksites: A process evaluation

    NARCIS (Netherlands)

    Oude Hengel, K.M.; Blatter, B.M.; Molen, H.F. van der; Joling, C.I.; Proper, K.I.; Bongers, P.M.; Beek, A.J. van der

    2011-01-01

    Objective: To evaluate the process of a prevention program among construction workers. Methods: The program consisted of training sessions of a physical therapist and an empowerment trainer, and a Rest-Break Tool. Data on seven process items were collected by means of questionnaires and interviews.

  1. Construction of a Precursor Model for the Concept of Rolling Friction in the Thought of Preschool Age Children: A Socio-cognitive Teaching Intervention

    Science.gov (United States)

    Ravanis, Konstantinos; Koliopoulos, Dimitris; Boilevin, Jean-Marie

    2008-08-01

    The aim of this study was to explore the extent to which the characteristics of two teaching interventions can bring about cognitive progress in preschoolers with regard to the factors rolling friction depends on, when it is applied to an object that is freely rolling on a horizontal surface. The study was conducted in three phases: pre-test, teaching intervention, and post-test. Two teaching strategies were compared: one inspired by Piaget’s theory (Piagetian approach) and one inspired by post-Piagetian and Vygotkian assumptions (socio-cognitive approach). A statistically significant difference was found between the pre-test and post-test, providing evidence that the socio-cognitive approach allows for the creation of a more appropriate teaching framework compared to the Piagetian one.

  2. Simply delivered meals: a tale of collaboration.

    Science.gov (United States)

    Martin, Sarah L; Connelly, Nancy; Parsons, Cassandra; Blackstone, Katlyn

    2018-06-01

    Western medicine is undergoing a transition toward transparency of quality and costs, and healthcare systems are striving to achieve the Triple Aim, a framework for improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare. Meanwhile, there is growing recognition of the impact of social determinants of health and a new federal requirement for nonprofit hospitals to implement prevention strategies. A specialized meal delivery program called Simply Delivered for ME (SDM) was formed in an effort to improve care and reduce 30-day hospital readmission rates.The Maine Medical Center (MMC) partnered with the Southern Maine Agency on Aging to offer SDM on a voluntary basis to high-risk Medicare patients already enrolled in the Community-based Care Transition Program (CCTP) at MMC. We report the results of the 2-year intervention in terms of 30-day hospital readmission rates and cost measures (ie, return on investment and cost savings).Of the 622 MMC patients who received SDM during the 24 months, the 30-day readmission rate was 10.3% (compared with the 16.6% 30-day rate of hospital readmission at baseline [ie, before the adoption of CCTP]) for all-cause readmissions. The cost savings for reduced readmissions were $212,160. The return on investment was 387%, or a benefit-cost ratio of $3.87 for every $1.00 spent on meals. Programs such as SDM may reduce the rate of hospital readmission among high-risk older adults and, thereby, yield lower healthcare costs.

  3. Accelerating risk reduction in Kathmandu Valley, Nepal: Theory-based mass-media intervention proven to increase knowledge of, belief in, and intent to support earthquake-resistant construction.

    Science.gov (United States)

    Sanquini, A.; Thapaliya, S. M.; Wood, M. M.; Hilley, G. E.

    2015-12-01

    Motivating people in rapidly urbanizing areas to take protective actions against natural disasters faces the challenge that these people often do not know what actions to take, do not believe that such actions are effective, and/or believe that the disaster will not happen to them within their lifetimes. Thus, finding demonstrated ways of motivating people to take protective action likely constitutes a grand challenge for natural disaster risk reduction and resiliency, because it may be one of the largest, lowest-cost sources of potential risk reduction in these situations. We developed a theory-based documentary film (hereafter, intervention) targeted at motivating retrofits of local school buildings, and tested its effectiveness in Kathmandu, Nepal, using a matched-pair clustered randomized controlled trial. The intervention features Nepalese who have strengthened their school buildings as role models to others at schools still in need of seismic work. It was tested at 16 Kathmandu Valley schools from November 2014 through March 2015. Schools were matched into 8 pairs, then randomly assigned to see either the intervention film or an attention placebo control film on an unrelated topic. Testing was completed just five weeks before the M 7.8 Gorkha earthquake struck central Nepal. When compared to the control schools, the schools whose community members saw the retrofit intervention film increased their knowledge of specific actions to take in support of earthquake-resistant construction, belief in the feasibility of making buildings earthquake-resistant, willingness to support seismic strengthening of the local school building, and likelihood to recommend to others that they build earthquake-resistant homes, which have all been shown to be precursors to taking self-protective action. This suggests that employing a mass-media intervention featuring community members who have already taken the desired action increases factors that may accelerate adoption of risk

  4. Modeling patients' acceptance of provider-delivered e-health.

    Science.gov (United States)

    Wilson, E Vance; Lankton, Nancy K

    2004-01-01

    Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

  5. Hydropower's role in delivering sustainability

    International Nuclear Information System (INIS)

    Altinbilek, D.; Seelos, K.; Taylor, R.

    2005-01-01

    Johannesburg's World Summit on Sustainable Development stipulated in its Implementation Plan that hydropower of all scales should be included in the drive to increase the contribution of renewable energy. This can be achieved through the plant-life extension and upgrading of existing schemes as well as by the sustainable development of new projects according to the needs, opportunities and resources available. Hydropower is the world's largest source of renewable energy used for power generation; it accounts for 19 percent of the world's supply (by 2010 wind power is expected to contribute 0.6 percent and solar power 0.12 percent. Hydropower is also a truly global resource, as more than 150 countries generate hydroelectric power. There is about 730 GW of hydro capacity in operation worldwide, generating 2650 TWh/year. A further 101 GW is under construction and 338 GW is at the planning stage. Hydropower plays an important role in reducing global GhG emissions by an estimated 10 percent per annum; in its current role, hydropower offsets 4.4 million barrels of oil-equivalent (thermal electric generation) each day. There is vast unexploited potential worldwide for new hydro plants, with only 33 percent of the economic potential having been developed so far. The majority of the remaining potential exists in lesser developed countries in Asia, South America and Africa. For example, Europe has developed 75 percent of its economic potential, whereas Africa has only developed seven percent. Hydropower technologies are reliable, advanced and efficient. The energy conversion efficiency of 80 to 93 percent is far higher than that for other major types of power plant. The level of service from the various types of hydro scheme varies from base-load supply, typically from run-of-river schemes, to peak-load and system-back-up services from hydro storage schemes. In regions where there is long-developed hydro capacity, plant-life extension can be achieved by the replacement of

  6. Delivering high performance BWR fuel reliably

    International Nuclear Information System (INIS)

    Schardt, J.F.

    1998-01-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  7. Live Cell Characterization of DNA Aggregation Delivered through Lipofection.

    Science.gov (United States)

    Mieruszynski, Stephen; Briggs, Candida; Digman, Michelle A; Gratton, Enrico; Jones, Mark R

    2015-05-27

    DNA trafficking phenomena, such as information on where and to what extent DNA aggregation occurs, have yet to be fully characterised in the live cell. Here we characterise the aggregation of DNA when delivered through lipofection by applying the Number and Brightness (N&B) approach. The N&B analysis demonstrates extensive aggregation throughout the live cell with DNA clusters in the extremity of the cell and peri-nuclear areas. Once within the nucleus aggregation had decreased 3-fold. In addition, we show that increasing serum concentration of cell media results in greater cytoplasmic aggregation. Further, the effects of the DNA fragment size on aggregation was explored, where larger DNA constructs exhibited less aggregation. This study demonstrates the first quantification of DNA aggregation when delivered through lipofection in live cells. In addition, this study has presents a model for alternative uses of this imaging approach, which was originally developed to study protein oligomerization and aggregation.

  8. Constructed Wetlands

    Science.gov (United States)

    these systems can improve water quality, engineers and scientists construct systems that replicate the functions of natural wetlands. Constructed wetlands are treatment systems that use natural processes

  9. Particle tracker system delivered to CERN

    CERN Multimedia

    Pitcher, Graham

    2006-01-01

    "The CCLRC Rutherford Appleton Laboratory (RAL) has delivered a system to CERN that will help to process the vast amounts of data generated by the silicon tracking detector within the Compact Muon Solenoid experiment." (1/2 page)

  10. Applying lean thinking in construction

    Directory of Open Access Journals (Sweden)

    Remon Fayek Aziz

    2013-12-01

    Full Text Available The productivity of the construction industry worldwide has been declining over the past 40 years. One approach for improving the situation is using lean construction. Lean construction results from the application of a new form of production management to construction. Essential features of lean construction include a clear set of objectives for the delivery process, aimed at maximizing performance for the customer at the project level, concurrent design, construction, and the application of project control throughout the life cycle of the project from design to delivery. An increasing number of construction academics and professionals have been storming the ramparts of conventional construction management in an effort to deliver better value to owners while making real profits. As a result, lean-based tools have emerged and have been successfully applied to simple and complex construction projects. In general, lean construction projects are easier to manage, safer, completed sooner, and cost less and are of better quality. Significant research remains to complete the translation to construction of lean thinking in Egypt. This research will discuss principles, methods, and implementation phases of lean construction showing the waste in construction and how it could be minimized. The Last Planner System technique, which is an important application of the lean construction concepts and methodologies and is more prevalent, proved that it could enhance the construction management practices in various aspects. Also, it is intended to develop methodology for process evaluation and define areas for improvement based on lean approach principles.

  11. Delivering high performance BWR fuel reliably

    Energy Technology Data Exchange (ETDEWEB)

    Schardt, J.F. [GE Nuclear Energy, Wilmington, NC (United States)

    1998-07-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  12. Computational Paradigm to Elucidate the Effects of Arts-Based Approaches and Interventions: Individual and Collective Emerging Behaviors in Artwork Construction.

    Directory of Open Access Journals (Sweden)

    Billie Sandak

    Full Text Available Art therapy, as well as other arts-based therapies and interventions, is used to reduce pain, stress, depression, breathlessness and other symptoms in a wide variety of serious and chronic diseases, such as cancer, Alzheimer and schizophrenia. Arts-based approaches are also known to contribute to one's well-being and quality of life. However, much research is required, since the mechanisms by which these non-pharmacological treatments exert their therapeutic and psychosocial effects are not adequately understood. A typical clinical setting utilizing the arts consists of the creation work itself, such as the artwork, as well as the therapist and the patient, all of which constitute a rich and dynamic environment of occurrences. The underlying complex, simultaneous and interwoven processes of this setting are often considered intractable to human observers, and as a consequence are usually interpreted subjectively and described verbally, which affect their subsequent analyses and understanding. We introduce a computational research method for elucidating and analyzing emergent expressive and social behaviors, aiming to understand how arts-based approaches operate. Our methodology, which centers on the visual language of Statecharts and tools for its execution, enables rigorous qualitative and quantitative tracking, analysis and documentation of the underlying creation and interaction processes. Also, it enables one to carry out exploratory, hypotheses-generating and knowledge discovery investigations, which are empirical-based. Furthermore, we illustrate our method's use in a proof-of-principle study, applying it to a real-world artwork investigation with human participants. We explore individual and collective emergent behaviors impacted by diverse drawing tasks, yielding significant gender and age hypotheses, which may account for variation factors in response to art use. We also discuss how to gear our research method to systematic and

  13. Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

    Science.gov (United States)

    Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

    2016-04-01

    Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

  14. Construction management

    CERN Document Server

    Pellicer, Eugenio; Teixeira, José C; Moura, Helder P; Catalá, Joaquín

    2014-01-01

    The management of construction projects is a wide ranging and challenging discipline in an increasingly international industry, facing continual challenges and demands for improvements in safety, in quality and cost control, and in the avoidance of contractual disputes. Construction Management grew out of a Leonardo da Vinci project to develop a series of Common Learning Outcomes for European Managers in Construction. Financed by the European Union, the project aimed to develop a library of basic materials for developing construction management skills for use in a pan-European context. Focused exclusively on the management of the construction phase of a building project from the contractor's point of view, Construction Management covers the complete range of topics of which mastery is required by the construction management professional for the effective delivery of new construction projects. With the continued internationalisation of the construction industry, Construction Management will be required rea...

  15. Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program

    Science.gov (United States)

    Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.

    2007-01-01

    The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.

  16. Delivering phonological and phonics training within whole-class teaching.

    Science.gov (United States)

    Shapiro, Laura R; Solity, Jonathan

    2008-12-01

    Early, intensive phonological awareness and phonics training is widely held to be beneficial for children with poor phonological awareness. However, most studies have delivered this training separately from children's normal whole-class reading lessons. We examined whether integrating this training into whole class, mixed-ability reading lessons could impact on children with poor phonological awareness, whilst also benefiting normally developing readers. Teachers delivered the training within a broad reading programme to whole classes of children from Reception to the end of Year 1 (N=251). A comparison group of children received standard teaching methods (N=213). Children's literacy was assessed at the beginning of Reception, and then at the end of each year until 1 year post-intervention. The strategy significantly impacted on reading performance for normally developing readers and those with poor phonological awareness, vastly reducing the incidence of reading difficulties from 20% in comparison schools to 5% in intervention schools. Phonological and phonics training is highly effective for children with poor phonological awareness, even when incorporated into whole-class teaching.

  17. Partner-delivered reflexology: effects on cancer pain and anxiety.

    Science.gov (United States)

    Stephenson, Nancy L N; Swanson, Melvin; Dalton, Joann; Keefe, Frances J; Engelke, Martha

    2007-01-01

    To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. Four hospitals in the southeastern United States. 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. Pain and anxiety. Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.

  18. MATES in Construction: Impact of a Multimodal, Community-Based Program for Suicide Prevention in the Construction Industry

    Directory of Open Access Journals (Sweden)

    Graham Martin

    2011-11-01

    Full Text Available A large-scale workplace-based suicide prevention and early intervention program was delivered to over 9,000 construction workers on building sites across Queensland. Intervention components included universal General Awareness Training (GAT; general mental health with a focus on suicide prevention; gatekeeper training provided to construction worker volunteer ‘Connectors’; Suicide First Aid (ASIST training offered to key workers; outreach support provided by trained and supervised MIC staff; state-wide suicide prevention hotline; case management service; and postvention support provided in the event of a suicide. Findings from over 7,000 workers (April 2008 to November 2010 are reported, indicating strong construction industry support, with 67% building sites and employers approached agreeing to participate in MIC. GAT participants demonstrated significantly increased suicide prevention awareness compared with a comparison group. Connector training participants rated MIC as helpful and effective, felt prepared to intervene with a suicidal person, and knew where to seek help for a suicidal individual following the training. Workers engaged positively with the after-hours crisis support phone line and case management. MIC provided postvention support to 10 non-MIC sites and sites engaged with MIC, but not yet MIC-compliant. Current findings support the potential effectiveness and social validity of MIC for preventing suicide in construction workers.

  19. MATES in Construction: Impact of a Multimodal, Community-Based Program for Suicide Prevention in the Construction Industry

    Science.gov (United States)

    Gullestrup, Jorgen; Lequertier, Belinda; Martin, Graham

    2011-01-01

    A large-scale workplace-based suicide prevention and early intervention program was delivered to over 9,000 construction workers on building sites across Queensland. Intervention components included universal General Awareness Training (GAT; general mental health with a focus on suicide prevention); gatekeeper training provided to construction worker volunteer ‘Connectors’; Suicide First Aid (ASIST) training offered to key workers; outreach support provided by trained and supervised MIC staff; state-wide suicide prevention hotline; case management service; and postvention support provided in the event of a suicide. Findings from over 7,000 workers (April 2008 to November 2010) are reported, indicating strong construction industry support, with 67% building sites and employers approached agreeing to participate in MIC. GAT participants demonstrated significantly increased suicide prevention awareness compared with a comparison group. Connector training participants rated MIC as helpful and effective, felt prepared to intervene with a suicidal person, and knew where to seek help for a suicidal individual following the training. Workers engaged positively with the after-hours crisis support phone line and case management. MIC provided postvention support to 10 non-MIC sites and sites engaged with MIC, but not yet MIC-compliant. Current findings support the potential effectiveness and social validity of MIC for preventing suicide in construction workers. PMID:22163201

  20. Animated construction of line drawings

    KAUST Repository

    Fu, Hongbo; Zhou, Shizhe; Liu, Ligang; Mitra, Niloy J.

    2011-01-01

    system produces plausible animated constructions of input line drawings, with no or little user intervention. We test our algorithm on a range of input sketches, with varying degree of complexity and structure, and evaluate the results via a user study

  1. Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.

    Science.gov (United States)

    Snowden, Austyn; Telfer, Iain

    2017-01-01

    Chaplains are employed by health organizations around the world to support patients in recognizing and addressing their spiritual needs. There is currently no generalizable measure of the impact of these interventions and so the clinical and strategic worth of chaplaincy is difficult to articulate. This article introduces the Scottish PROM, an original five-item patient reported outcome measure constructed specifically to address this gap. It describes the validation process from its conceptual grounding in the spiritual care literature through face and content validity cycles. It shows that the Scottish PROM is internally consistent and unidimensional. Responses to the Scottish PROM show strong convergent validity with responses to the Warwick and Edinburgh Mental Well-Being Scale, a generic well-being scale often used as a proxy for spiritual well-being. In summary, the Scottish PROM is fit for purpose. It measures the outcomes of spiritual care as delivered by chaplains in this study. This novel project introduces an essential and original breakthrough; the possibility of generalizable international chaplaincy research.

  2. Electrochemical construction

    Science.gov (United States)

    Einstein, Harry; Grimes, Patrick G.

    1983-08-23

    An electrochemical cell construction features a novel co-extruded plastic electrode in an interleaved construction with a novel integral separator-spacer. Also featured is a leak and impact resistant construction for preventing the spill of corrosive materials in the event of rupture.

  3. Usability Constructs

    DEFF Research Database (Denmark)

    Hertzum, Morten; Clemmesen, Torkil; Hornbæk, Kasper Anders Søren

    2007-01-01

    Whereas research on usability predominantly employs universal definitions of the aspects that comprise usability, people experience their use of information systems through personal constructs. Based on 48 repertory-grid interviews, this study investigates how such personal constructs are affected...... use of constructs traditionally associated with usability (e.g., easy-to-use, intuitive, and liked). Further analysis of the data is ongoing...

  4. Delivering service adaptation with 3G technology

    NARCIS (Netherlands)

    Liotta, A.; Yew, A.; Bohoris, C.; Pavlou, G.; Feridun, M.; Kropf, P.G.; Babin, G.

    2002-01-01

    Now that 3G technologies have reached their maturity, newly advanced services can be delivered to the mobile user. These include context- aware services, adaptable services and Virtual Home Environment (VHE)-like services. Important research issues relate, however, to managing such services through

  5. Utah Delivers Opportunities for Career Exploration

    Science.gov (United States)

    Dobson, Kristine; Fischio, Shannon

    2006-01-01

    Providing information and resources to support career exploration is key to the mission of career and technical education (CTE) in Utah. Utah CTE has responded in a variety of ways to meet the career exploration needs of students of all ages. This article discusses how the career and technical education in Utah delivers opportunities for career…

  6. Is International Accounting Education Delivering Pedagogical Value?

    Science.gov (United States)

    Patel, Chris; Millanta, Brian; Tweedie, Dale

    2016-01-01

    This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

  7. Delivering Online Examinations: A Case Study

    Directory of Open Access Journals (Sweden)

    John MESSING

    2004-07-01

    Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

  8. How natural capital delivers ecosystem services

    NARCIS (Netherlands)

    Smith, A.C.; Harrison, P.A.; Pérez Soba, M.; Archaux, F.; Blicharska, M.; Egoh, B.N.; Erős, T.; Fabrega Domenech, N.; György, I.; Haines-Young, R.; Li, S.; Lommelen, E.; Meiresonne, L.; Miguel Ayala, L.; Mononen, L.; Simpson, G.; Stange, E.; Turkelboom, F.; Uiterwijk, M.; Veerkamp, C.J.; Wyllie de Echeverria, V.

    2017-01-01

    There is no unified evidence base to help decision-makers understand how the multiple components of natural capital interact to deliver ecosystem services. We systematically reviewed 780 papers, recording how natural capital attributes (29 biotic attributes and 11 abiotic factors) affect the

  9. Avaliação da tipologia dos resíduos de construção civil entregues nas usinas de beneficiamento de Belo Horizonte Evaluation of the typology of construction waste delivered to processing plants in Belo Horizonte, Brazil

    Directory of Open Access Journals (Sweden)

    Daniel de Souza Carmo

    2012-06-01

    Full Text Available O objetivo deste artigo foi expor a atual conjuntura da geração de resíduos em Belo Horizonte de forma a apresentar as principais características dos resíduos de construção civil (RCC acerca de sua tipologia, origem, predominância em sua composição, além de dados a respeito das obras que o geraram, como seu padrão construtivo e tipo de edificação. Os resultados demonstraram que a maior parte dos rejeitos gerados na capital é de base cerâmica, oriundos de obras de reformas residenciais de casas, classificadas em padrão normal de acabamento, localizadas, sobretudo, nas regionais Centro-sul e Pampulha. Pela determinação destas características foi possível estabelecer recomendações aplicáveis tanto às usinas de reciclagem como ao sistema de gerenciamento de resíduos da capital como forma de minimizar as causas da variabilidade dos agregados reciclados gerados a partir dos RCC.The aim of this article was to expose the current state of affairs regarding the generation of waste in Belo Horizonte so as to present the main characteristics of construction civil waste (CCW involving their typology, origin, predominance in their composition, as well as data about the construction sites that generated them, their construction pattern and type of building. The results show that the majority of the waste generated in Belo Horizonte is of ceramic base, deriving from house renovations construction sites classified as normal finishing standard located mainly in the center south and Pampulha areas. By determining these characteristics it was possible to establish recommendations applicable to the recycling plants as well as to the waste management system in Belo Horizonte to minimize the causes of the variability of the recycled aggregates generated from construction civil waste.

  10. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

    OpenAIRE

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-01-01

    Introduction The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. Methods and analysis This systematic review addresses the following question: in underserviced populations and low-reso...

  11. The Cost Effectiveness of Psychological and Pharmacological Interventions for Social Anxiety Disorder: A Model-Based Economic Analysis.

    Directory of Open Access Journals (Sweden)

    Ifigeneia Mavranezouli

    Full Text Available Social anxiety disorder is one of the most persistent and common anxiety disorders. Individually delivered psychological therapies are the most effective treatment options for adults with social anxiety disorder, but they are associated with high intervention costs. Therefore, the objective of this study was to assess the relative cost effectiveness of a variety of psychological and pharmacological interventions for adults with social anxiety disorder.A decision-analytic model was constructed to compare costs and quality adjusted life years (QALYs of 28 interventions for social anxiety disorder from the perspective of the British National Health Service and personal social services. Efficacy data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published literature and national sources, supplemented by expert opinion.Individual cognitive therapy was the most cost-effective intervention for adults with social anxiety disorder, followed by generic individual cognitive behavioural therapy (CBT, phenelzine and book-based self-help without support. Other drugs, group-based psychological interventions and other individually delivered psychological interventions were less cost-effective. Results were influenced by limited evidence suggesting superiority of psychological interventions over drugs in retaining long-term effects. The analysis did not take into account side effects of drugs.Various forms of individually delivered CBT appear to be the most cost-effective options for the treatment of adults with social anxiety disorder. Consideration of side effects of drugs would only strengthen this conclusion, as it would improve even further the cost effectiveness of individually delivered CBT relative to phenelzine, which was the next most cost-effective option, due to the serious side effects associated with phenelzine. Further research needs to determine more accurately the long

  12. Design Processes and Constructive Ergonomics

    DEFF Research Database (Denmark)

    Broberg, Ole

    2015-01-01

    This paper discusses some central issues in the concept of constructive ergonomics. It does so by reflecting on experiences from ergonomics intervention projects carried out in Denmark. Constructive ergonomics has a huge potential as a new way to go for ergonomics research and practice. However, ...

  13. Persuasion to use personal protective equipment in constructing subway stations: application of social marketing.

    Science.gov (United States)

    Shamsi, Mahmoud; Pariani, Abbas; Shams, Mohsen; Soleymani-nejad, Marzieh

    2016-04-01

    To study the effects of an intervention based on social marketing to persuade workers to use personal protective equipment (PPE) in constructing subway stations in Isfahan, Iran. This was a quasi-experimental study. Two stations were selected as intervention and control groups. Intervention was designed based on results of a formative research. A free package containing a safety helmet with a tailored message affixed to it, mask and gloves and an educational pamphlet was delivered to the intervention group. After 6 weeks, behaviours in the intervention and control stations were measured using an observational checklist. After the intervention, the percentage of workers who used PPE at the intervention station increased significantly. OR for helmet and mask usage was 7.009 and 2.235, respectively, in the intervention group. Social marketing can be used to persuade workers to use PPE in the workplace. 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/

  14. Increasing Customer Service Behaviors Using Manager-Delivered Task Clarification and Social Praise

    Science.gov (United States)

    Rice, Anna; Austin, John; Gravina, Nicole

    2009-01-01

    This project assessed an intervention to improve employee customer service behaviors (correct greetings and closing behaviors). A combination of task clarification and manager-delivered social praise resulted in increased correct greeting from 11.5% to 66% and correct closing from 8% to 70%. The effect was maintained at a 48-week follow-up for…

  15. Brief Report: Predictors of Outcomes in the Early Start Denver Model Delivered in a Group Setting

    Science.gov (United States)

    Vivanti, Giacomo; Dissanayake, Cheryl; Zierhut, Cynthia; Rogers, Sally J.

    2013-01-01

    There is a paucity of studies that have looked at factors associated with responsiveness to interventions in preschoolers with autism spectrum disorder (ASD). We investigated learning profiles associated with response to the Early Start Denver Model delivered in a group setting. Our preliminary results from 21 preschool children with an ASD aged…

  16. Impact of Performance Feedback Delivered via Electronic Mail on Preschool Teachers' Use of Descriptive Praise

    Science.gov (United States)

    Hemmeter, Mary Louise; Snyder, Patricia; Kinder, Kiersten; Artman, Kathleen

    2011-01-01

    We examined the effects of a professional development intervention that included data-based performance feedback delivered via electronic mail (e-mail) on preschool teachers' use of descriptive praise and whether increased use of descriptive praise was associated with changes in classroom-wide measures of child engagement and challenging behavior.…

  17. Construction mathematics

    CERN Document Server

    Virdi, Surinder; Virdi, Narinder Kaur

    2014-01-01

    Construction Mathematics is an introductory level mathematics text, written specifically for students of construction and related disciplines. Learn by tackling exercises based on real-life construction maths. Examples include: costing calculations, labour costs, cost of materials and setting out of building components. Suitable for beginners and easy to follow throughout. Learn the essential basic theory along with the practical necessities. The second edition of this popular textbook is fully updated to match new curricula, and expanded to include even more learning exercises. End of chapter exercises cover a range of theoretical as well as practical problems commonly found in construction practice, and three detailed assignments based on practical tasks give students the opportunity to apply all the knowledge they have gained. Construction Mathematics addresses all the mathematical requirements of Level 2 construction NVQs from City & Guilds/CITB and Edexcel courses, including the BTEC First Diploma in...

  18. A service model for delivering care closer to home.

    Science.gov (United States)

    Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

    2011-04-01

    Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

  19. Internet delivered diabetes self-management education: a review.

    Science.gov (United States)

    Pereira, Katherine; Phillips, Beth; Johnson, Constance; Vorderstrasse, Allison

    2015-01-01

    Diabetes self-management education is a cornerstone of successful diabetes management. Various methods have been used to reach the increasing numbers of patients with diabetes, including Internet-based education. The purpose of this article is to review various delivery methods of Internet diabetes education that have been evaluated, as well as their effectiveness in improving diabetes-related outcomes. Literature was identified in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Medline, EBSCO, the Cochrane Library, and the Web of Science databases through searches using the following terms: "type 2 diabetes AND internet/web based AND education" and "type 2 diabetes AND diabetes self-management education (DSME) AND web-based/internet OR technology assisted education." The search was limited to English language articles published in the last 10 years. The search yielded 111 articles; of these, 14 met criteria for inclusion in this review. Nine studies were randomized controlled trials, and study lengths varied from 2 weeks to 24 months, for a total of 2,802 participants. DSME delivered via the Internet is effective at improving measures of glycemic control and diabetes knowledge compared with usual care. In addition, results demonstrate that improved eating habits and increased attendance at clinic appointments occur after the online DSME, although engagement and usage of Internet materials waned over time. Interventions that included an element of interaction with healthcare providers were seen as attractive to participants. Internet-delivered diabetes education has the added benefit of easier access for many individuals, and patients can self-pace themselves through materials. More research on the cost-benefits of Internet diabetes education and best methods to maintain patient engagement are needed, along with more studies assessing the long-term impact of Internet-delivered DSME.

  20. FFTF constructibility

    International Nuclear Information System (INIS)

    Weber, S.A.; Hulbert, D.I.

    1975-01-01

    The influence of the design criteria on the constructibility of the Fast Flux Test Facility is described. Specifically, the effects of requirements due to maintenance accessibility, inerting of cells, seismicity, codes, and standards are addressed. The design and construction techniques developed to minimize the impact of the design criteria on cost and schedule are presented with particular emphasis on the cleanliness and humidity controls imposed during construction of the sodium systems. (U.S.)

  1. Intervention mapping as a guide for the development of a diabetes peer support intervention in rural Alabama.

    Science.gov (United States)

    Cherrington, Andrea; Martin, Michelle Y; Hayes, Michaela; Halanych, Jewell H; Wright, Mary Annette; Appel, Susan J; Andreae, Susan J; Safford, Monika

    2012-01-01

    Peer support is a promising strategy for the reduction of diabetes-related health disparities; however, few studies describe the development of such strategies in enough detail to allow for replication. The objective of this article is to describe the development of a 1-year peer support intervention to improve diabetes self-management among African American adults with diabetes in Alabama's Black Belt. We used principles of intervention mapping, including literature review, interviews with key informants, and a discussion group with community health workers, to guide intervention development. Qualitative data were combined with behavioral constructs and principles of diabetes self-management to create a peer support intervention to be delivered by trained peer advisors. Feedback from a 1-month pilot was used to modify the training and intervention. The resulting intervention includes a 2-day training for peer advisors, who were each paired with 3 to 6 clients. A one-on-one in-person needs assessment begins an intensive intervention phase conducted via telephone for 8 to 12 weeks, followed by a maintenance phase of at least once monthly contacts for the remainder of the intervention period. A peer support network and process measures collected monthly throughout the study supplement formal data collection points at baseline, 6 months, and 12 months. Intervention mapping provided a useful framework for the development of culturally relevant diabetes peer support intervention for African Americans living in Alabama's Black Belt. The process described could be implemented by others in public health to develop or adapt programs suitable for their particular community or context.

  2. Short preventive intervention in a group – a constructive use of cognitive dissonance in prevention for an increased risk group, using the example of the “Korekta” [Correction] program

    Directory of Open Access Journals (Sweden)

    Krzysztof A. Wojcieszek

    2011-12-01

    Full Text Available People socially maladjusted often drink alcohol-containing drinks in a problematic manner (risky, harmful or addictive. Thus there is continuous need for appropriate selective and dedicated prevention. One of such procedures, developed for the military, is the „Korekta” program. It is a therapeutic treatment here referred to as a „short preventive intervention within a group”, and its structure enables to circumvent the typical obstacles encountered during preventive work, such as the effects of cognitive dissonance and the resulting resistance from the ones being treated. The specific structure of the program is the reason why the participants have got a limited possibility to use unconstructive strategies aiming at releasing the tension (resulting from the cognitive dissonance caused by the confrontation between their lifestyle and their knowledge of potential losses caused by drinking alcohol. It brings them closer to changing their lifestyle (contemplation phase according to Prochaski model as a result of using constructive strategies of releasing the tension caused by the cognitive dissonance. Thanks to such solutions the program is highly accepted by the participants, what is shown in formative evaluation scores and what is a sort of a paradox of prevention. It is recommended to apply this tool systematically in the resocialization system.

  3. A simple circuit to deliver bubbling CPAP.

    Science.gov (United States)

    Kaur, Charanjit; Sema, Akatoli; Beri, Rajbir S; Puliyel, Jacob M

    2008-04-01

    Nasal continuous positive airway pressure (CPAP), especially bubbling CPAP, is known to reduce the need for more invasive ventilation. We here describe a circuit that can deliver bubbling CPAP in resource poor settings. We describe how the oxygen concentration can be altered from 98% to 21% oxygen using this system. Addition of a humidifier in the circuit has the effect of reducing the oxygen concentration by 1 to 5%. The cost of putting together the system is approximately Rs 5000.

  4. Brief Report: Remotely Delivered Video Modeling for Improving Oral Hygiene in Children with ASD: A Pilot Study

    Science.gov (United States)

    Popple, Ben; Wall, Carla; Flink, Lilli; Powell, Kelly; Discepolo, Keri; Keck, Douglas; Mademtzi, Marilena; Volkmar, Fred; Shic, Frederick

    2016-01-01

    Children with autism have heightened risk of developing oral health problems. Interventions targeting at-home oral hygiene habits may be the most effective means of improving oral hygiene outcomes in this population. This randomized control trial examined the effectiveness of a 3-week video-modeling brushing intervention delivered to patients over…

  5. Impact of peer delivered wellness coaching.

    Science.gov (United States)

    Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

    2016-09-01

    People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  6. Process evaluation of a worksite social and physical environmental intervention

    NARCIS (Netherlands)

    Coffeng, J.K.; Hendriksen, I.J.M.; Mechelen, W. van; Boot, C.R.L.

    2013-01-01

    OBJECTIVE:: To evaluate the process of implementation of a social and physical environmental intervention and to explore differences regarding this process between both interventions. METHODS:: Context, recruitment, dose delivered, fidelity, reach, dose received, satisfaction, and implementation

  7. Construction Management.

    Science.gov (United States)

    Abbott, James F.

    This article provides a detailed discussion of a team approach to building that involves a construction manager, an architect, and a contractor. Bidding methods are outlined; the major components in construction management -- value engineering and fast track scheduling -- and the use of performance specifications are discussed. The construction…

  8. Construction fraud

    NARCIS (Netherlands)

    Graafland, J.J.; Liedekerke, L.; Dubbink, W.; van Liedekerke, L.; van Luijk, H.

    2011-01-01

    Due to the actions of a whistleblower The Netherlands was confronted with a massive case of construction fraud involving almost the entire construction sector. Price fixing, prior consulting, duplicate accounts, fictitious invoices and active corruption of civil servants were rampant practices. This

  9. Superstring construction

    CERN Document Server

    1989-01-01

    The book includes a selection of papers on the construction of superstring theories, mainly written during the years 1984-1987. It covers ten-dimensional supersymmetric and non-supersymmetric strings, four-dimensional heterotic strings and four-dimensional type-II strings. An introduction to more recent developments in conformal field theory in relation to string construction is provided.

  10. Computer-enhanced interventions for drug use and HIV risk in the emergency room: preliminary results on psychological precursors of behavior change.

    Science.gov (United States)

    Bonar, Erin E; Walton, Maureen A; Cunningham, Rebecca M; Chermack, Stephen T; Bohnert, Amy S B; Barry, Kristen L; Booth, Brenda M; Blow, Frederic C

    2014-01-01

    This article describes process data from a randomized controlled trial among 781 adults recruited in the emergency department who reported recent drug use and were randomized to: intervener-delivered brief intervention (IBI) assisted by computer, computerized BI (CBI), or enhanced usual care (EUC). Analyses examined differences between baseline and post-intervention on psychological constructs theoretically related to changes in drug use and HIV risk: importance, readiness, intention, help-seeking, and confidence. Compared to EUC, participants receiving the IBI significantly increased in confidence and intentions; CBI patients increased importance, readiness, confidence, and help-seeking. Both groups increased relative to the EUC in likelihood of condom use with regular partners. Examining BI components suggested that benefits of change and tools for change were associated with changes in psychological constructs. Delivering BIs targeting drug use and HIV risk using computers appears promising for implementation in healthcare settings. This trial is ongoing and future work will report behavioral outcomes. © 2013.

  11. Externally Delivered Focused Ultrasound for Renal Denervation.

    Science.gov (United States)

    Neuzil, Petr; Ormiston, John; Brinton, Todd J; Starek, Zdenek; Esler, Murray; Dawood, Omar; Anderson, Thomas L; Gertner, Michael; Whitbourne, Rob; Schmieder, Roland E

    2016-06-27

    The aim of this study was to assess clinical safety and efficacy outcomes of renal denervation executed by an externally delivered, completely noninvasive focused therapeutic ultrasound device. Renal denervation has emerged as a potential treatment approach for resistant hypertension. Sixty-nine subjects received renal denervation with externally delivered focused ultrasound via the Kona Medical Surround Sound System. This approach was investigated across 3 consecutive studies to optimize targeting, tracking, and dosing. In the third study, treatments were performed in a completely noninvasive way using duplex ultrasound image guidance to target the therapy. Short- and long-term safety and efficacy were evaluated through use of clinical assessments, magnetic resonance imaging scans prior to and 3 and 24 weeks after renal denervation, and, in cases in which a targeting catheter was used to facilitate targeting, fluoroscopic angiography with contrast. All patients tolerated renal denervation using externally delivered focused ultrasound. Office blood pressure (BP) decreased by 24.6 ± 27.6/9.0 ± 15.0 mm Hg (from baseline BP of 180.0 ± 18.5/97.7 ± 13.7 mm Hg) in 69 patients after 6 months and 23.8 ± 24.1/10.3 ± 13.1 mm Hg in 64 patients with complete 1-year follow-up. The response rate (BP decrease >10 mm Hg) was 75% after 6 months and 77% after 1 year. The most common adverse event was post-treatment back pain, which was reported in 32 of 69 patients and resolved within 72 h in most cases. No intervention-related adverse events involving motor or sensory deficits were reported. Renal function was not altered, and vascular safety was established by magnetic resonance imaging (all patients), fluoroscopic angiography (n = 48), and optical coherence tomography (n = 5). Using externally delivered focused ultrasound and noninvasive duplex ultrasound, image-guided targeting was associated with substantial BP reduction without any major safety signals. Further

  12. A better way to deliver bad news.

    Science.gov (United States)

    Manzoni, Jean-François

    2002-09-01

    In an ideal world, a subordinate would accept critical feedback from a manager with an open mind. He or she would ask a few clarifying questions, promise to work on certain performance areas, and show signs of improvement over time. But things don't always turn out that way. Such conversations can be unpleasant. Emotions can run high; tempers can flare. Fearing that the employee will become angry and defensive, the boss all too often inadvertently sabotages the meeting by preparing for it in a way that stifles honest discussion. This unintentional--indeed, unconscious--stress-induced habit makes it difficult to deliver corrective feedback effectively. Insead professor Jean-François Manzoni says that by changing the mind-set with which they develop and deliver negative feedback, managers can increase their odds of having productive conversations without damaging relationships. Manzoni describes two behavioral phenomena that color the feedback process--the fundamental attribution error and the false consensus effect--and uses real-world examples to demonstrate how bosses' critiques can go astray. Managers tend to frame difficult situations and decisions in a way that is narrow (alternatives aren't considered) and binary (there are only two possible outcomes--win or lose). And during the feedback discussion, managers' framing of the issues often remains frozen, regardless of the direction the conversation takes. Manzoni advises managers not to just settle on the first acceptable explanation for a behavior or situation they've witnessed. Bosses also need to consider an employee's circumstances rather than just attributing weak performance to a person's disposition. In short, delivering more effective feedback requires an open-minded approach, one that will convince employees that the process is fair and that the boss is ready for an honest conversation.

  13. Delivering IT and eBusiness value

    CERN Document Server

    Willcocks, Leslie

    2001-01-01

    Delivering Business Value from IT' is focused on the evaluation issue in IT and how IT evaluation can proceed across the life-cycle of any IT investment and be linked positively to improving business performance. .Chapters 1,2 and 3 detail an approach to IT evaluation whilst chapters 4 and 5 build on these by showing two distinctive approaches to linking IT to business performance. The remaining three chapters deal with a range of evaluation issues emerging as important - specifically Internet evaluation, Y2K and beyond, EMU, quality outsourcing, infrastructure, role of benchmarking, and cost

  14. How to deliver better policy integration?

    International Nuclear Information System (INIS)

    Hattori, Takashi

    2015-01-01

    Several challenges and possible ways forward in reconciling the delivery of energy policy goals including security and affordability are presented, based on the recent analyses by the International Energy Agency (IEA). This article addresses five topics: multiple challenging policy goals of the IEA’s 3 E’s (energy security, economic growth, and environmental sustainability); needs in the transformation to low carbon societies in the energy sectors; major policies and measures for energy sector transformation; multiple related policy goals and multiple benefits of energy efficiency policy; and realising climate and energy policy integration. Overall, this article explores how to better deliver climate and energy policy integration in the real world.

  15. A typology of practice narratives during the implementation of a preventive, community intervention trial

    Science.gov (United States)

    2009-01-01

    Background Traditional methods of process evaluation encompass what components were delivered, but rarely uncover how practitioners position themselves and act relative to an intervention being tested. This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness. Methods We undertook a narrative analysis of in-depth, unstructured field diaries kept by nine community development practitioners for two years. The practitioners were responsible for implementing a multi-component, preventive, community-level intervention for mothers of new babies in eight communities, as part of a cluster randomised community intervention trial. We constructed a narrative typology of approaches to practice, drawing on the phenomenology of Alfred Schutz and Max Weber's Ideal Type theory. Results Five types of practice emerged, from a highly 'technology-based' type that was faithful to intervention specifications, through to a 'romantic' type that held relationships to be central to daily operations, with intact relationships being the final arbiter of intervention success. The five types also differed in terms of how others involved in the intervention were characterized, the narrative form (e.g., tragedy, satire) and where and how transformative change in communities was best created. This meant that different types traded-off or managed the priorities of the intervention differently, according to the deeply held values of their type. Conclusions The data set constructed for this analysis is unique. It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern. The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions. PMID:20003399

  16. Adaptation of community health worker-delivered behavioral activation for torture survivors in Kurdistan, Iraq.

    Science.gov (United States)

    Magidson, J F; Lejuez, C W; Kamal, T; Blevins, E J; Murray, L K; Bass, J K; Bolton, P; Pagoto, S

    2015-12-01

    Growing evidence supports the use of Western therapies for the treatment of depression, trauma, and stress delivered by community health workers (CHWs) in conflict-affected, resource-limited countries. A recent randomized controlled trial (Bolton et al . 2014 a ) supported the efficacy of two CHW-delivered interventions, cognitive processing therapy (CPT) and brief behavioral activation treatment for depression (BATD), for reducing depressive symptoms and functional impairment among torture survivors in the Kurdish region of Iraq. This study describes the adaptation of the CHW-delivered BATD approach delivered in this trial (Bolton et al .2014 a ), informed by the Assessment-Decision-Administration-Production-Topical experts-Integration-Training-Testing (ADAPT-ITT) framework for intervention adaptation (Wingood & DiClemente, 2008). Cultural modifications, adaptations for low-literacy, and tailored training and supervision for non-specialist CHWs are presented, along with two clinical case examples to illustrate delivery of the adapted intervention in this setting. Eleven CHWs, a study psychiatrist, and the CHW clinical supervisor were trained in BATD. The adaptation process followed the ADAPT-ITT framework and was iterative with significant input from the on-site supervisor and CHWs. Modifications were made to fit Kurdish culture, including culturally relevant analogies, use of stickers for behavior monitoring, cultural modifications to behavioral contracts, and including telephone-delivered sessions to enhance feasibility. BATD was delivered by CHWs in a resource-poor, conflict-affected area in Kurdistan, Iraq, with some important modifications, including low-literacy adaptations, increased cultural relevancy of clinical materials, and tailored training and supervision for CHWs. Barriers to implementation, lessons learned, and recommendations for future efforts to adapt behavioral therapies for resource-limited, conflict-affected areas are discussed.

  17. Worldwide construction

    International Nuclear Information System (INIS)

    Williamson, M.

    1994-01-01

    The paper lists major construction projects in worldwide processing and pipelining, showing capacities, contractors, estimated costs, and time of construction. The lists are divided into refineries, petrochemical plants, sulfur recovery units, gas processing plants, pipelines, and related fuel facilities. This last classification includes cogeneration plants, coal liquefaction and gasification plants, biomass power plants, geothermal power plants, integrated coal gasification combined-cycle power plants, and a coal briquetting plant

  18. DESIGNS MATTER: Delivering Information Sources for Tourism

    Directory of Open Access Journals (Sweden)

    Margie A. Nolasco

    2016-11-01

    Full Text Available Tourism has benefits not just for travelers, but also to the local economy. Since, Bicol Region has natural and cultural attractions; it is a potential travel destination in the country. Technology in delivering information sources played vital role for the success of the tourism industry in the Region. This allows travel enthusiasts to get more information about various tourist attractions. This paper analyzes the effectiveness of delivering information sources such as web advertisement and desktop publishing for tourist promotion in the Bicol Region. Specifically, it determined the status of tourism, and identified common forms of promotions for tourism development. The study adopted mixed method of research. This method was utilized to confirm and validate findings. Interviews and focus group discussions were used to gather data from the respondents of the selected Local Government Units, Department of Tourism, Travel Agencies and Hotel Agents in the Region. Based on the findings, of the total foreign visitors in the country, only 9.14% visited Bicol Region in 2014. That is why, domestic tourist showed high percentage against foreign visitors with 25.7%. Brochures with EZ maps as most commonly used desktop publishing materials and websites and social media for web advertisement. Thus, there is a need to reevaluate promotional activities by the DOT and other agencies. Adoption suggestive features for creative desktop publishing materials and web services should be considered to increase tourist visitors in the Region.

  19. Can the Clean Development Mechanism (CDM) deliver?

    International Nuclear Information System (INIS)

    Subbarao, Srikanth; Lloyd, Bob

    2011-01-01

    The paper investigates whether the Clean Development Mechanism (CDM) under the Kyoto Protocol has played a significant role in the development of rural communities, specifically investigating uptake of small-scale renewable energy projects. The investigation involved an assessment of 500 registered small-scale CDM projects under the Kyoto Protocol in terms of their potential impact on the envisaged sustainable development goals for rural communities. Five case studies from the Indian subcontinent were also examined. The paper concludes that the CDM in its current state and design has typically failed to deliver the promised benefits with regard to development objectives in rural areas. Successful projects were found to have had good community involvement and such projects were typically managed by cooperative ventures rather than money making corporations. The paper puts forward a new framework for the assessment of such benefits in the hope that future projects can be better assessed in this regard. The key problem, however, remains on how to deal with the inherent contradiction between development and sustainability. - Research Highlights: → Role of CDM towards sustainable development of rural communities. → Assessment of 500 registered small-scale CDM projects. → CDM in its current state and design has typically failed to deliver. → A new framework for sustainable development assessment of small-scale CDM projects. → Inherent contradiction between development and sustainability.

  20. Delivering is never remote: NGOs’ vital role

    Directory of Open Access Journals (Sweden)

    FMR authors

    2007-06-01

    Full Text Available The plight of Iraqi refugees is grave but is the tip of the iceberg of Iraq’s gathering humanitarian crisis. The (grossly under-reported plight of those still in Iraq is even more worrying. Despite the insecure environment and numerous constraints, humanitarian intervention in Iraq is on-going, possible and greatly needed.

  1. Construction history and construction management

    International Nuclear Information System (INIS)

    Agh, S.

    1999-01-01

    The process of pre-design and design preparation of the Mochovce NPP as well as the construction history of the plant is highlighted, including the financing aspect and problems arising from changes in the technological and other conditions of start-up of the reactor units. The results of international audits performed to improve the level of nuclear safety and implementation of the measures suggested are also described. The milestones of the whole construction process and start-up process, the control and quality system, and the methods of control and management of the complex construction project are outlined. (author)

  2. Mindfulness for Novice Pediatric Nurses: Smartphone Application Versus Traditional Intervention.

    Science.gov (United States)

    Morrison Wylde, Chelsey; Mahrer, Nicole E; Meyer, Rika M L; Gold, Jeffrey I

    The current study compares the effects of a traditionally delivered mindfulness (TDM) intervention to a smartphone delivered mindfulness (SDM) intervention, Headspace, an audio-guided mindfulness meditation program, in a group of novice nurses. Novice nurses participating in a pediatric nurse residency program were asked to participate in either a TDM or SDM intervention. Participants (N=95) completed self-administered pencil and paper questionnaires measuring mindfulness skills, and risk and protective factors at the start of their residency and three months after entering the program. Nurses in the SDM group reported significantly more "acting with awareness" and marginally more "non-reactivity to inner experience" skills compared to the TDM group. The smartphone intervention group also showed marginally more compassion satisfaction and marginally less burnout. Additionally, nurses in the SDM group had lower risk for compassion fatigue compared to the TDM group, but only when the nurses had sub-clinical posttraumatic symptoms at the start of the residency training program. Smartphone delivered mindfulness interventions may provide more benefits for novice nurses than traditionally delivered mindfulness interventions. However, the smart-phone intervention may be better indicated for nurses without existing symptoms of posttraumatic stress. Mindfulness interventions delivered through smartphone applications show promise in equipping nurses with important coping skills to manage stress. Because of the accessibility of smartphone applications, more nurses can benefit from the intervention as compared to a therapist delivered intervention. However, nurses with existing stress symptoms may require alternate interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Delivering Hubble Discoveries to the Classroom

    Science.gov (United States)

    Eisenhamer, B.; Villard, R.; Weaver, D.; Cordes, K.; Knisely, L.

    2013-04-01

    Today's classrooms are significantly influenced by current news events, delivered instantly into the classroom via the Internet. Educators are challenged daily to transform these events into student learning opportunities. In the case of space science, current news events may be the only chance for educators and students to explore the marvels of the Universe. Inspired by these circumstances, the education and news teams developed the Star Witness News science content reading series. These online news stories (also available in downloadable PDF format) mirror the content of Hubble press releases and are designed for upper elementary and middle school level readers to enjoy. Educators can use Star Witness News stories to reinforce students' reading skills while exposing students to the latest Hubble discoveries.

  4. Delivering advanced therapies: the big pharma approach.

    Science.gov (United States)

    Tarnowski, J; Krishna, D; Jespers, L; Ketkar, A; Haddock, R; Imrie, J; Kili, S

    2017-09-01

    After two decades of focused development and some recent clinical successes, cell and gene therapy (CGT) is emerging as a promising approach to personalized medicines. Genetically engineered cells as a medical modality are poised to stand alongside or in combination with small molecule and biopharmaceutical approaches to bring new therapies to patients globally. Big pharma can have a vital role in industrializing CGT by focusing on diseases with high unmet medical need and compelling genetic evidence. Pharma should invest in manufacturing and supply chain solutions that deliver reproducible, high-quality therapies at a commercially viable cost. Owing to the fast pace of innovation in this field proactive engagement with regulators is critical. It is also vital to understand the needs of patients all along the patient care pathway and to establish product pricing that is accepted by prescribers, payers and patients.

  5. Delivering Results for Peace and Development

    International Nuclear Information System (INIS)

    Pattison, Hazel

    2013-01-01

    The IAEA’s technical cooperation programme is the primary mechanism for delivering the IAEA’s capacity-building services to its Member States. The programme supports the safe and secure application of nuclear technology for sustainable socioeconomic development in Member States. The overall strategic framework of the TC programme is determined by pertinent provisions laid down in key documents of the IAEA. Strategic direction for the multi-annual TC programme is provided by the Agency’s Members States and, more specifically, by relevant advisory and governance entities. The programme concentrates on: improving human health; supporting agriculture, rural development and food security; advancing water resource management; addressing environmental challenges; helping sustainable energy development, including the use of nuclear power for electricity; and promoting safety and security

  6. Combining Technologies to Deliver Distance Education

    Directory of Open Access Journals (Sweden)

    Vicki Freeman

    1999-01-01

    Full Text Available In 1997 a Health Resources and Services Administration (HRSA grant was awarded to the Department of Clinical Laboratory Sciences (CLS at The University of Texas Medical Branch - Galveston (UTMB for support of the Laboratory Education and Advancement Project (LEAP. The project entailed three primary objectives, targeting laboratory practitioners in rural and medically underserved areas of Texas for delivering a bachelor's degree, laboratory-intensive course of study via distance education. Several delivery mechanisms were utilized and evaluated for their effectiveness and friendliness to both the faculty and students. The authors discuss and describe the mechanisms utilized for delivery of courses, the advantages and disadvantages encountered with each mechanism, and subjective evaluation of the effectiveness of the courses. Also discussed are the lessons learned and plans for future development.

  7. Photochemical internalization enhanced macrophage delivered chemotherapy.

    Science.gov (United States)

    Shin, Diane; Christie, Catherine; Ju, David; Nair, Rohit Kumar; Molina, Stephanie; Berg, Kristian; Krasieva, Tatiana B; Madsen, Steen J; Hirschberg, Henry

    2018-03-01

    Macrophage (Ma) vectorization of chemotherapeutic drugs has the advantage for cancer therapy in that it can actively target and maintain an elevated concentration of drugs at the tumor site, preventing their spread into healthy tissue. A potential drawback is the inability to deliver a sufficient number of drug-loaded Ma into the tumor, thus limiting the amount of active drug delivered. This study examined the ability of photochemical internalization (PCI) to enhance the efficacy of released drug by Ma transport. Tumor spheroids consisting of either F98 rat glioma cells or F98 cells combined with a subpopulation of empty or doxorubicin (DOX)-loaded mouse Ma (RAW264.7) were used as in vitro tumor models. PCI was performed with the photosensitizer AlPcS 2a and laser irradiation at 670 nm. RAW264.7 Ma pulsed with DOX released the majority of the incorporated DOX within two hours of incubation. PCI significantly increased the toxicity of DOX either as pure drug or derived from monolayers of DOX-loaded Ma. Significant growth inhibition of hybrid spheroids was also observed with PCI even at subpopulations of DOX-loaded Ma as low as 11% of the total initial hybrid spheroid cell number. Results show that RAW264.7 Ma, pulsed with DOX, could effectively incorporate and release DOX. PCI significantly increased the ability of both free and Ma-released DOX to inhibit the growth of tumor spheroids in vitro. The growth of F98 + DOX loaded Ma hybrid spheroids were synergistically reduced by PCI, compared to either photodynamic therapy or released DOX acting alone. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Temperature of gas delivered from ventilators.

    Science.gov (United States)

    Chikata, Yusuke; Onodera, Mutsuo; Imanaka, Hideaki; Nishimura, Masaji

    2013-01-01

    Although heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high. Because portable and home-care ventilators use turbines, blowers, pistons, or compressors to inhale in ambient air, they may have higher gas temperature than ventilators with piping systems. We carried out a bench study to investigate the temperature of gas delivered from portable and home-care ventilators, including the effects of distance from ventilator outlet, fraction of inspiratory oxygen (FIO2), and minute volume (MV). We evaluated five ventilators equipped with turbine, blower, piston, or compressor system. Ambient air temperature was adjusted to 24°C ± 0.5°C, and ventilation was set at FIO2 0.21, 0.6, and 1.0, at MV 5 and 10 L/min. We analyzed gas temperature at 0, 40, 80, and 120 cm from ventilator outlet and altered ventilator settings. While temperature varied according to ventilators, the outlet gas temperature of ventilators became stable after, at the most, 5 h. Gas temperature was 34.3°C ± 3.9°C at the ventilator outlet, 29.5°C ± 2.2°C after 40 cm, 25.4°C ± 1.2°C after 80 cm and 25.1°C ± 1.2°C after 120 cm (P < 0.01). FIO2 and MV did not affect gas temperature. Gas delivered from portable and home-care ventilator was not too hot to induce heated humidifier malfunctioning. Gas soon declined when passing through the limb.

  9. Construction safety

    CERN Document Server

    Li, Rita Yi Man

    2013-01-01

    A close-to-ideal blend of suburb and city, speedy construction of towers of Babylon, the sparkling proportion of glass and steel buildings’ facade at night showcase the wisdom of humans. They also witness the footsteps, sweats and tears of architects and engineers. Unfortunately, these signatures of human civilizations are swathed in towering figures of construction accidents. Fretting about these on sites, different countries adopt different measures on sites. This book firstly sketches the construction accidents on sites, followed by a review on safety measures in some of the developing countries such as Bermuda, Egypt, Kuwait and China; as well as developed countries, for example, the United States, France and Singapore. It also highlights the enormous compensation costs with the courts’ experiences in the United Kingdom and Hong Kong.

  10. Constructing sanctions

    DEFF Research Database (Denmark)

    Jaeger, Mark Daniel

    2016-01-01

    such an effect. This paper explores sanctions conflicts as social constructs. It purports that rally-around-the-flag is all but one part of the discursive dimension of sanctions conflicts. Sanctions are intricately connected with the conflict setting they occur in. The study suggests a dialectical relation...... between how opponents perceive conflicts and the meaning of sanctions therein. This nexus of different constructions of sanctions moreover extends to “targeted” sanctions as well: As restrictive measures against Zimbabwe demonstrate, they are not the kind of minimally-invasive operations with clinical...

  11. Construction work

    CERN Multimedia

    2004-01-01

    Construction work on building 179 will start on the 16th February 2004 and continue until November 2004. The road between buildings 179 and 158 will temporarily become a one way street from Route Democrite towards building 7. The parking places between buildings 179 and 7 will become obsolete. The ISOLDE collaboration would like to apologize for any inconveniences.

  12. Mindfulness Interventions.

    Science.gov (United States)

    Creswell, J David

    2017-01-03

    Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.

  13. Impact of student pharmacist-delivered asthma education on child and caregiver knowledge.

    Science.gov (United States)

    Elliott, Jennifer Padden; Marcotullio, Nicole; Skoner, David P; Lunney, Phil; Gentile, Deborah A

    2014-12-15

    To evaluate the effectiveness of asthma education delivered by student pharmacists and to assess the impact of child and caregiver baseline asthma knowledge on asthma control in children. Student pharmacists developed and implemented asthma self-management education interventions for children and their caregivers and performed asthma screenings for children at a series of asthma camps. Eighty-seven children, ages 5-17 years, and their caregivers were enrolled in this study. A previously validated asthma questionnaire was modified to assess asthma knowledge among children and adults. Asthma knowledge increased significantly in children following participation in the education intervention (pasthma. A significant association was observed between caregiver baseline asthma knowledge and better asthma control in their children (p=0.019). The results of this study demonstrate that student pharmacist-delivered asthma education can positively impact asthma knowledge in children, and that caregivers' knowledge of asthma is strongly correlated with better asthma control in their children.

  14. Design Processes and Constructive Ergonomics

    OpenAIRE

    Broberg, Ole

    2015-01-01

    This paper discusses some central issues in the concept of constructive ergonomics. It does so by reflecting on experiences from ergonomics intervention projects carried out in Denmark. Constructive ergonomics has a huge potential as a new way to go for ergonomics research and practice. However, many challenges are to be overcome. They relate among others to education and training of ergonomist, and the cultural and institutional setting of ergonomics in specific countries.

  15. Perturbative and constructive renormalization

    International Nuclear Information System (INIS)

    Veiga, P.A. Faria da

    2000-01-01

    These notes are a survey of the material treated in a series of lectures delivered at the X Summer School Jorge Andre Swieca. They are concerned with renormalization in Quantum Field Theories. At the level of perturbation series, we review classical results as Feynman graphs, ultraviolet and infrared divergences of Feynman integrals. Weinberg's theorem and Hepp's theorem, the renormalization group and the Callan-Symanzik equation, the large order behavior and the divergence of most perturbation series. Out of the perturbative regime, as an example of a constructive method, we review Borel summability and point out how it is possible to circumvent the perturbation diseases. These lectures are a preparation for the joint course given by professor V. Rivasseau at the same school, where more sophisticated non-perturbative analytical methods based on rigorous renormalization group techniques are presented, aiming at furthering our understanding about the subject and bringing field theoretical models to a satisfactory mathematical level. (author)

  16. Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel

    Science.gov (United States)

    Trucks Seattle Bakery Delivers With Biodiesel Trucks to someone by E-mail Share Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Facebook Tweet about Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Twitter Bookmark Alternative Fuels

  17. Adapting Behavioral Interventions for Social Media Delivery

    Science.gov (United States)

    Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L

    2016-01-01

    Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals—a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality. PMID:26825969

  18. Adapting Behavioral Interventions for Social Media Delivery.

    Science.gov (United States)

    Pagoto, Sherry; Waring, Molly E; May, Christine N; Ding, Eric Y; Kunz, Werner H; Hayes, Rashelle; Oleski, Jessica L

    2016-01-29

    Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals--a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality.

  19. Apparatus for delivering and receiving radioactive gas

    International Nuclear Information System (INIS)

    Dansky, B.; Epifano, L.; Farella, R.

    1980-01-01

    An apparatus for delivering and receiving gas to and from a patient, such as for lung ventilation studies. In accordance with the invention there is provided a restrictive breathing chamber adapted for coupling to the patient's breathing organs. A system, including a first check valve, is provided for coupling the breathing chamber to an inflatable gas receptacle so as to allow flow only toward the inflatable gas receptacle. Active gas input apparatus, including a second check valve, is also coupled to the breathing chamber, the second check valve allowing flow only toward the breathing chamber means. First and second auxiliary tubes and a gas filter are also provided. A system is provided for coupling the first auxiliary tube from the inflatable receptacle through the gas filter and to an ambient air environment. The second auxiliary tube is coupled from the inflatable receptacle to an ambient air environment. Finally, a gas pump is switchably coupled as between the first and second auxiliary tubes and operative to selectively cause gas flow in the first auxiliary tube toward the ambient environment, and in the second auxiliary tube toward the inflatable receptacle. A gas trap structure is also disclosed

  20. Delivering bad news in emergency care medicine.

    Science.gov (United States)

    Maynard, Douglas W

    2017-01-01

    Forecasting is a strategy for delivering bad news and is compared to two other strategies, stalling and being blunt. Forecasting provides some warning that bad news is forthcoming without keeping the recipient in a state of indefinite suspense (stalling) or conveying the news abruptly (being blunt). Forecasting appears to be more effective than stalling or being blunt in helping a recipient to "realize" the bad news because it involves the deliverer and recipient in a particular social relation. The deliverer of bad news initiates the telling by giving an advance indication of the bad news to come; this allows the recipient to calculate the news in advance of its final presentation, when the deliverer confirms what the recipient has been led to anticipate. Thus, realization of bad news emerges from intimate collaboration, whereas stalling and being blunt require recipients to apprehend the news in a social vacuum. Exacerbating disruption to recipients' everyday world, stalling and being blunt increase the probability of misapprehension (denying, blaming, taking the situation as a joke, etc.) and thereby inhibit rather than facilitate realization. Particular attention is paid to the "perspective display sequence", a particular forecasting strategy that enables both confirming the recipient's perspective and using that perspective to affirm the clinical news. An example from acute or emergency medicine is examined at the close of the paper.

  1. Changes in nurse education: delivering the curriculum.

    Science.gov (United States)

    Carr, Graham

    2008-01-01

    The aim of this study is to examine changes in pre-registration nursing education through the personal accounts of nurse teachers. This paper is based on 37 in-depth interviews within a central London Healthcare Faculty. Each interview was subjected to a process of content analysis described by Miles and Huberman. The interviews took place between August 2003 and March 2004 and totalled 34.4 hours or 305,736 words. There were thirty female and seven male participants, who shared 1015 years of nursing experience, averaging at 27.4 years (min 7-max 42). These were supplemented by 552 years of teaching practice, the average being 15 years (min 0.5-max 29). This paper--delivering the nursing curriculum--identifies that the nature of nursing has changed as it has both expanded and contracted. Participants identified three major changes; the nature of nursing, selection of future nurses and the current impact that large cohorts have on our traditional model of person-centred education. The practice placements remain central to nursing education and it is the nursing role that should define the curriculum and the values of higher education should be supportive of this identity.

  2. Delivering new physics at impressive speed

    CERN Multimedia

    2010-01-01

    The speed with which the heavy ion run at the LHC is delivering new physics is impressive not only for the insights it is bringing to the early Universe, but also for the clear demonstration it gives of the value of competition and complementarity between the experiments.   ALICE was the first off the mark to publish papers from the ion run, as you’d expect from the LHC’s dedicated ion experiment, but results emerging from ATLAS and CMS are bringing new understanding in their own right. Each collaboration’s result plays to the strengths of its detector, and it is by taking all the results together that our knowledge advances. The creation, observation and understanding of the hot dense matter that would have existed in the early Universe, normally known as Quark Gluon Plasma (QGP), is complex science and one of the ion programme’s key goals. Many signals for QGP exist, and like pieces of a puzzle, we must assemble all of them to get the full picture. At th...

  3. Designing equitable workplace dietary interventions: perceptions of intervention deliverers.

    Science.gov (United States)

    Smith, Sarah A; Visram, Shelina; O'Malley, Claire; Summerbell, Carolyn; Araujo-Soares, Vera; Hillier-Brown, Frances; Lake, Amelia A

    2017-10-16

    Workplaces are a good setting for interventions that aim to support workers in achieving a healthier diet and body weight. However, little is known about the factors that impact on the feasibility and implementation of these interventions, and how these might vary by type of workplace and type of worker. The aim of this study was to explore the views of those involved in commissioning and delivering the Better Health at Work Award, an established and evidence-based workplace health improvement programme. One-to-one semi-structured interviews were conducted with 11 individuals in North East England who had some level of responsibility for delivering workplace dietary interventions. Interviews were transcribed verbatim and analysed using thematic framework analysis. A number of factors were felt to promote the feasibility and implementation of interventions. These included interventions that were cost-neutral (to employee and employer), unstructured, involved colleagues for support, took place at lunchtimes, and were well-advertised and communicated via a variety of media. Offering incentives, not necessarily monetary, was perceived to increase recruitment rates. Factors that militate against feasibility and implementation of interventions included worksites that were large in size and remote, working patterns including shifts and working outside of normal working hours that were not conducive to workers being able to access intervention sessions, workplaces without appropriate provision for healthy food on site, and a lack of support from management. Intervention deliverers perceived that workplace dietary interventions should be equally and easily accessible (in terms of cost and timing of sessions) for all staff, regardless of their job role. Additional effort should be taken to ensure those staff working outside normal working hours, and those working off-site, can easily engage with any intervention, to avoid the risk of intervention-generated inequalities (IGIs).

  4. Modelling Constructs

    DEFF Research Database (Denmark)

    Kindler, Ekkart

    2009-01-01

    , these notations have been extended in order to increase expressiveness and to be more competitive. This resulted in an increasing number of notations and formalisms for modelling business processes and in an increase of the different modelling constructs provided by modelling notations, which makes it difficult......There are many different notations and formalisms for modelling business processes and workflows. These notations and formalisms have been introduced with different purposes and objectives. Later, influenced by other notations, comparisons with other tools, or by standardization efforts...... to compare modelling notations and to make transformations between them. One of the reasons is that, in each notation, the new concepts are introduced in a different way by extending the already existing constructs. In this chapter, we go the opposite direction: We show that it is possible to add most...

  5. Increasing capacity to deliver diabetes self-management education

    DEFF Research Database (Denmark)

    Carey, M. E.; Mandalia, P. K.; Daly, H.

    2014-01-01

    Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 di...... educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.......Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2...... diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months...

  6. Promoting mental wellbeing: developing a theoretically and empirically sound complex intervention.

    Science.gov (United States)

    Millar, S L; Donnelly, M

    2014-06-01

    This paper describes the development of a complex intervention to promote mental wellbeing using the revised framework for developing and evaluating complex interventions produced by the UK Medical Research Council (UKMRC). Application of the first two phases of the framework is described--development and feasibility and piloting. The theoretical case and evidence base were examined analytically to explicate the theoretical and empirical foundations of the intervention. These findings informed the design of a 12-week mental wellbeing promotion programme providing early intervention for people showing signs of mental health difficulties. The programme is based on the theoretical constructs of self-efficacy, self-esteem, purpose in life, resilience and social support and comprises 10 steps. A mixed methods approach was used to conduct a feasibility study with community and voluntary sector service users and in primary care. A significant increase in mental wellbeing was observed following participation in the intervention. Qualitative data corroborated this finding and suggested that the intervention was feasible to deliver and acceptable to participants, facilitators and health professionals. The revised UKMRC framework can be successfully applied to the development of public health interventions. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Habitable Worlds: Delivering on the Promises of Online Education

    Science.gov (United States)

    Horodyskyj, Lev B.; Mead, Chris; Belinson, Zack; Buxner, Sanlyn; Semken, Steven; Anbar, Ariel D.

    2018-01-01

    Critical thinking and scientific reasoning are central to higher education in the United States, but many courses (in-person and online) teach students information about science much more than they teach the actual process of science and its associated knowledge and skills. In the online arena specifically, the tools available for course construction exacerbate this problem by making it difficult to build the types of active learning activities that research shows to be the most effective. Here, we present a report on Habitable Worlds, offered by Arizona State University for 12 semesters over the past 6 years. This is a unique online course that uses an array of novel technologies to deliver an active, inquiry-driven learning experience. Learning outcomes and quantitative data from more than 3000 students demonstrate the success of our approach but also identify several remaining challenges. The design and development of this course offers valuable lessons for instructional designers and educators who are interested in fully capitalizing on the capabilities of 21st-century technology to achieve educational goals.

  8. Sustainable Construction Risk Perceptions in the Kuwaiti Construction Industry

    Directory of Open Access Journals (Sweden)

    Dalya Ismael

    2018-06-01

    Full Text Available Sustainable construction is fundamentally different than traditional construction because it requires whole systems thinking, early collaboration across stakeholders, and core principles like reducing resource consumption, eliminating toxins, and applying life cycle costing. Construction professionals unfamiliar with this mindset and approach may perceive sustainable construction as risky. One of the global regions in need of more sustainable construction is the Middle Eastern and North African (MENA region. The MENA region is one of the fastest developing in the world. However, it is the slowest one in implementing sustainable construction practices. Kuwait, in particular, contributes 53% more carbon emissions per capita than the United States. To understand how the Kuwaiti construction industry perceives risks associated with more sustainable construction, a survey was developed with 52 risk elements in which 131 industry professionals responded. The results indicate that industry professionals perceive a lack of public awareness as the risk element with the highest probability of occurrence. The risk element with the highest possible negative impact on future projects is designers’ and contractors’ inexperience with sustainable construction. Other risks were found to include a high initial cost for materials and overall project costs. Educational interventions, changes in risk allocation, and behavioral science to reframe upfront costs as long-term savings are offered as possible solutions.

  9. Constructing Catalonia

    Directory of Open Access Journals (Sweden)

    Bill Philips

    2009-07-01

    Full Text Available Catalonia, in common with other nations, has long been concerned with the question of identity and difference. Its problematic relationship with Spain has led to an emphasis on differentiating itself from its larger neighbour (if we are to accept, as most Spaniards do not, that Catalonia is not Spain, a situation complicated by the loss of the Spanish colonies of Cuba and The Philippines in 1898, and the Spanish Civil War and subsequent dictatorship from 1936 to 1976. Beginning in the late nineteenth century, the construction of a Catalan identity followed a similar route to that taken by other European nations such as England, Ireland and, indeed, Spain, including an emphasis on rural values, activities and the countryside, and the conversion of specifically local traditions into national past times. It is only in the last ten years or so that this model of Catalan identity has been recognised for what it is – a model constructed and encouraged for and by specific nationalist political interests. Ironically, Catalonia’s identity abroad has also been constructed and manipulated for political purposes, but from quite a different perspective. Orwell’s /Homage to Catalonia/ (1938 narrates an extremely blinkered version of the Spanish Civil War which has achieved iconic status as a result of cold war politics. Subsequent portrayals of the Spanish Civil War – Valentine Cunningham’s /The Penguin Book of Spanish Civil War Verse/ (ed., Penguin, 1980, or Ken Loach’s 1995 film /Land and Freedom/ base their arguments unquestioningly on /Homage to Catalonia/, perpetuating a view of the nation’s recent history that is both reductive and inaccurate

  10. Layout Construction

    DEFF Research Database (Denmark)

    Frandsen, Gudmund Skovbjerg; Palsberg, Jens; Schmidt, Erik Meineche

    We design a system for generating newspaper layout proposals. The input to the system consists of editorial information (text, pictures, etc) and style information (non-editorial information that specifies the aesthetic appearance of a layout). We consider the automation of layout construction...... to pose two main problems. One problem consists in optimizing the layout with respect to the constraints and preferences specified in the style information. Another problem consists in finding a representation of the style information that both supports its use in the combinatorial optimization...

  11. Nonpathologizing trauma interventions in abnormal psychology courses.

    Science.gov (United States)

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research.

  12. Gestational age and birth weight centiles of singleton babies delivered normally following spontaneous labor, in Southern Sri Lanka

    Science.gov (United States)

    Attanayake, K; Munasinghe, S; Goonewardene, M; Widanapathirana, P; Sandeepani, I; Sanjeewa, L

    2018-03-31

    To estimate the gestational age and birth weight centiles of babies delivered normally, without any obstetric intervention, in women with uncomplicated singleton pregnancies establishing spontaneous onset of labour. Consecutive women with uncomplicated singleton pregnancies, attending the Academic Obstetrics and Gynecology Unit of the Teaching Hospital Mahamodara Galle, Sri Lanka, with confirmed dates and establishing spontaneous onset of labor and delivering vaginally between gestational age of 34 - 41 weeks, without any obstetric intervention , during the period September 2013 to February 2014 were studied. The gestational age at spontaneous onset of labor and vaginal delivery and the birth weights of the babies were recorded. There were 3294 consecutive deliveries during this period, and of them 1602 (48.6%) met the inclusion criteria. Median gestational age at delivery was 275 days (range 238-291 days, IQR 269 to 280 days) and the median birth weight was 3000 g (range1700g - 4350g; IQR 2750-3250g). The 10th, 50th and 90th birth weight centiles of the babies delivered at a gestational age of 275 days were approximately 2570g, 3050g and 3550g respectively. The median gestational age among women with uncomplicated singleton pregnancies who established spontaneous onset of labor and delivered vaginally, without any obstetric intervention, was approximately five days shorter than the traditionally accepted 280 days. At a gestational age of 275 days, the mean birth weight was approximately 3038g and the 50th centile of the birth weight of the babies delivered was approximately 3050g.

  13. Feasibility of smartphone application and social media intervention on breast cancer survivors' health outcomes.

    Science.gov (United States)

    Pope, Zachary; Lee, Jung Eun; Zeng, Nan; Lee, Hee Yun; Gao, Zan

    2018-02-17

    Breast cancer survivors are at risk for poor health, with physical activity a possible treatment. Little research has examined how technology might promote breast cancer survivor physical activity or health. The aim of this study is to investigate the feasibility of employing a commercially available mobile health application- and social media-based health education intervention to improve breast cancer survivor physical activity or health.Ten breast cancer survivors (X̅ age = 45.80 ± 10.23 years; X̅ weight = 79.51 ± 20.85 kg) participated in this 10-week single-group pilot study from 2015 to 2016. Participants downloaded the MapMyFitness application, documented all physical activity with MapMyFitness, and were enrolled in a Social Cognitive Theory-based, Facebook-delivered health education intervention. Objectively measured physical activity, weight or body composition, cardiovascular fitness, psychosocial constructs, and quality of life indices were measured at baseline and 10 weeks. Intervention use and acceptability was evaluated during and following the intervention. Descriptive statistics were calculated for all study outcomes, with qualitative analyses performed regarding use and acceptability. At postintervention, average daily moderate-to-vigorous physical activity and steps increased by 2.6 min and 1,657, respectively, with notable decreases in weight (2.4 kg) and body fat percentage (2.3%). Physical activity-related social support and ability to engage in social roles or activity demonstrated the greatest improvements among all psychosocial and quality of life indices, respectively. Participants enjoyed the feedback and tracking features of MapMyFitness, with most finding the Facebook component helpful. All participants recommended the intervention for future use.Physical activity interventions combining commercially available mobile health applications and theoretically based social media-delivered health interventions may promote certain

  14. Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support.

    Science.gov (United States)

    Nahum-Shani, Inbal; Smith, Shawna N; Spring, Bonnie J; Collins, Linda M; Witkiewitz, Katie; Tewari, Ambuj; Murphy, Susan A

    2018-05-18

    The just-in-time adaptive intervention (JITAI) is an intervention design aiming to provide the right type/amount of support, at the right time, by adapting to an individual's changing internal and contextual state. The availability of increasingly powerful mobile and sensing technologies underpins the use of JITAIs to support health behavior, as in such a setting an individual's state can change rapidly, unexpectedly, and in his/her natural environment. Despite the increasing use and appeal of JITAIs, a major gap exists between the growing technological capabilities for delivering JITAIs and research on the development and evaluation of these interventions. Many JITAIs have been developed with minimal use of empirical evidence, theory, or accepted treatment guidelines. Here, we take an essential first step towards bridging this gap. Building on health behavior theories and the extant literature on JITAIs, we clarify the scientific motivation for JITAIs, define their fundamental components, and highlight design principles related to these components. Examples of JITAIs from various domains of health behavior research are used for illustration. As we enter a new era of technological capacity for delivering JITAIs, it is critical that researchers develop sophisticated and nuanced health behavior theories capable of guiding the construction of such interventions. Particular attention has to be given to better understanding the implications of providing timely and ecologically sound support for intervention adherence and retention.

  15. Construction of an access shaft for LEP

    CERN Document Server

    1983-01-01

    The main contract for underground work in the plain was signed end of February 1983. It foresaw a five-month preparation period before the order to start construction work could be issued. The latter was delivered on 1 September. See Annual Report 1983 p. 114

  16. The co-constructive processes in physiotherapy

    OpenAIRE

    Areskoug Josefsson, Kristina; Andersson, Ann-Christine

    2017-01-01

    To employ a person-centred approach, it is essential to work with the patient in deciding the important issues that the physiotherapy intervention should target, and to develop and adjust the individual treatment accordingly. Those co-constructive processes of physiotherapy consist of several parts, aiming to improve patient involvement and to optimize intervention outcomes. This paper aims to discuss and bring forward the role of the co-constructive processes in physiotherapy, by using persp...

  17. Nanosolar: Delivering Grid-Parity Solar Electricity

    Energy Technology Data Exchange (ETDEWEB)

    Sager, Brian [Nanosolar, Inc., San Jose, CA (United States)

    2012-05-31

    Nanosolar has developed proprietary technology based on Copper-Indium-Gallium-diSelenide (CIGS) absorber technology that allows the printing of this semiconductor material using a high-speed, high-throughput roll-to-roll manufacturing process. A central challenge in cost-effectively constructing a large-area CIGS-based solar cell or module is that the elements of the CIGS layer must be within a narrow stoichiometric ratio on nano-, meso-, and macroscopic length scale in all three dimensions in order for the resulting cell or module to be highly efficient. Achieving precise stoichiometric composition over relatively large substrate areas is however difficult using traditional vacuum-based deposition processes. For example, it is difficult to uniformly deposit compounds and/or alloys containing more than one element by sputtering or evaporation. Both techniques rely on deposition approaches that are limited to line-of-sight and limited-area sources, tending to result in poor surface coverage. Line-of-sight trajectories and limited-area sources can result in non-uniform three-dimensional distribution of the elements in all three dimensions and/or poor film-thickness uniformity over large areas. These non-uniformities can occur over the nano-, meso-, and/or macroscopic scales. Such non-uniformity also alters the local stoichiometric ratios of the absorber layer, decreasing the potential power conversion efficiency of the complete cell or module. Nanosolar has overcome these challenges by printing nanoparticulate CIGS precursor materials onto low-cost metal foil substrates, and performing a rapid thermal processing to convert the nanoparticulate coating into a CIGS absorber layer By locking in the appropriate stochiometry into the nanoparticulate precursor material, spatial uniformity is ensured in the coated layers, while printing at high speed and throughput minimizes solar cell cost.

  18. Remember Your MEDS: Medication Education Delivers Success

    Directory of Open Access Journals (Sweden)

    Kelsey M. Rife

    2012-01-01

    Full Text Available Background: Medication adherence is one of the largest barriers to better patient outcomes today. As pharmacists and student pharmacists expand their roles with community outreach projects, they have the potential to make a huge impact on improving adherence. Objective: To improve medication adherence through patient counseling and constructive resources, and to determine patient preferences of adherence tools. Methods: Student pharmacists partnered with a 340B pharmacy to promote the importance of medication adherence. Patients were counseled in an initial 10 minute session, and then given the opportunity to receive one or more of the following adherence tools: a pill box, timer, reminder refrigerator magnets, calendar stickers, refill reminder phone calls and/or text message reminders. A pre-survey was conducted to establish the patients' baseline medication adherence using the validated ©Morisky Medication Adherence Scale (©MMAS-8. After three months, students conducted the post-survey via the ©MMAS-8 by calling the patients and asking them questions about the helpfulness of the adherence tools as well as the effectiveness of the initial counseling visit. Results: Sixty five patients with hypertension enrolled in the study, and 51 patients completed both the pre- and post-surveys. Patients improved from a 6.02 (SD +/- 1.62 average pre-score to a 6.83 (SD +/-1.25 average post score (p < 0.001. Pill boxes, text message reminders, and calendar stickers were respectively ranked as the top 3 most helpful tools studied. The refrigerator magnets were also considered helpful by most patients who used them. The timers were ranked the least helpful, mostly due to difficulty of use. Conclusion: Student pharmacists can have a positive impact on medication adherence through simple counseling and offering effective adherence tools.   Type: Student Project

  19. Remember Your MEDS: Medication Education Delivers Success

    Directory of Open Access Journals (Sweden)

    Kelsey M. Rife, PharmD Candidate

    2012-01-01

    Full Text Available Background: Medication adherence is one of the largest barriers to better patient outcomes today. As pharmacists and student pharmacists expand their roles with community outreach projects, they have the potential to make a huge impact on improving adherence. Objective: To improve medication adherence through patient counseling and constructive resources, and to determine patient preferences of adherence tools. Methods: Student pharmacists partnered with a 340B pharmacy to promote the importance of medication adherence. Patients were counseled in an initial 10 minute session, and then given the opportunity to receive one or more of the following adherence tools: a pill box, timer, reminder refrigerator magnets, calendar stickers, refill reminder phone calls and/or text message reminders. A pre-survey was conducted to establish the patients’ baseline medication adherence using the validated ©Morisky Medication Adherence Scale (©MMAS-8. After three months, students conducted the post-survey via the ©MMAS-8 by calling the patients and asking them questions about the helpfulness of the adherence tools as well as the effectiveness of the initial counseling visit. Results: Sixty five patients with hypertension enrolled in the study, and 51 patients completed both the pre- and post-surveys. Patients improved from a 6.02 (SD +/- 1.62 average pre-score to a 6.83 (SD +/-1.25 average post score (p < 0.001. Pill boxes, text message reminders, and calendar stickers were respectively ranked as the top 3 most helpful tools studied. The refrigerator magnets were also considered helpful by most patients who used them. The timers were ranked the least helpful, mostly due to difficulty of use. Conclusion: Student pharmacists can have a positive impact on medication adherence through simple counseling and offering effective adherence tools.

  20. Oral microflora in infants delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

  1. Technology-based interventions in social work practice: a systematic review of mental health interventions.

    Science.gov (United States)

    Ramsey, Alex T; Montgomery, Katherine

    2014-10-01

    Despite concerns around the use of technology-based interventions, they are increasingly being employed by social workers as a direct practice methodology to address the mental health needs of vulnerable clients. Researchers have highlighted the importance of using innovative technologies within social work practice, yet little has been done to summarize the evidence and collectively assess findings. In this systematic review, we describe accounts of technology-based mental health interventions delivered by social workers over the past 10 years. Results highlight the impacts of these tools and summarize advantages and disadvantages to utilizing technologies as a method for delivering or facilitating interventions.

  2. 1999 Annual Report: Delivering energy value

    International Nuclear Information System (INIS)

    2000-01-01

    Union Gas Limited, a subsidiary of Westcoast Energy Company, is a major Canadian natural gas utility, providing energy delivery and related services to 1.1 million residential, commercial and industrial customers in over 400 communities in northern, southwestern and eastern Ontario. Union Gas also provides natural gas storage and transportation services for other utilities and energy market participants in Ontario, Quebec and the northeastern United States. In 1999 the Company had revenues of 1.5 billion, net income of $ 95 million, and assets totalling $ 3.8 billion. Net income was down from $ 109 million in 1998, due mainly to the impact of the sale of the Company's retail merchandise program to Union Energy, a lower approved rate of return on common equity. Full-time employees number about 2,500. Total throughput for 1999 was 34.6 billion cubic metres of natural gas, up 8.9 per cent from 1998. The Company undertook significant reorganization and restructuring during 1999, to emphasize critical business processes. The reorganization, which saw the divestiture of the retail merchandise programs to an unregulated affiliate, Union Energy, resulted in a flat, flexible and efficient enterprise, more capable of timely response to changing market opportunities and customer needs. Union Gas also filed application with the Ontario Energy Board for rates for the year 2000 and beyond, using the performance-based regulation framework; completed construction of a $ 16 million, 90 km pipeline to make natural gas service available to Parry Sound; Launched 'enoms' a new Internet-based natural gas nominations system; completed the first phase of the $ 17 million Century Pools storage development project, and applied to build the second phase, comprising a $37 million addition to the storage pools at the Mandasumin, Bluewater and Oil City pools; and completed several smaller projects totalling $ 5.2 million to give access to natural gas to 2,300 new customers at various parts of

  3. How to design and deliver a local teaching program

    OpenAIRE

    Limb, Christopher; Whitehurst, Katharine; Gundogan, Buket; Koshy, Kiron; Agha, Riaz

    2017-01-01

    Teaching is an invaluable aspect of any medical or surgical career. Many trainees will find themselves delivering teaching at several stages in their career and in this “How to” article we explain how to design, set up, and deliver a successful teaching program, as well as how to evidence this in your portfolio.

  4. Linking ecological science to decision-making: delivering environmental monitoring information as societal feedback.

    Science.gov (United States)

    Vaughan, Hague; Whitelaw, Graham; Craig, Brian; Stewart, Craig

    2003-01-01

    The paper describes the Ecological Monitoring and Assessment Network's (EMAN) operational and program response to certain challenges of environmental monitoring in Canada, in particular, efforts to improve the ability of the network to deliver relevant information to decision makers. In addition to its familiar roles, environmental monitoring should deliver feedback to society on environmental changes associated with development patterns, trends, processes and interventions. In order for such feedback to be effective, it must be relevant, timely, useful and accessible: all characteristics that are defined by the user, not the provider. Demand driven environmental monitoring is explored through EMAN's experiences with Canada's Biosphere Reserves, the NatureWatch Program and the Canadian Community Monitoring Network.

  5. Machinima interventions: innovative approaches to immersive virtual world curriculum integration

    Directory of Open Access Journals (Sweden)

    Andrew John Middleton

    2008-12-01

    Full Text Available The educational value of Immersive Virtual Worlds (IVWs seems to be in their social immersive qualities and as an accessible simulation technology. In contrast to these synchronous applications this paper discusses the use of educational machinima developed in IVW virtual film sets. It also introduces the concept of media intervention, proposing that digital media works best when simply developed for deployment within a blended curriculum to inform learning activity, and where the media are specifically designed to set challenges, seed ideas, or illustrate problems. Machinima, digital films created in IVWs, or digital games offer a rich mechanism for delivering such interventions. Scenes are storyboarded, constructed, shot and edited using techniques similar to professional film production, drawing upon a cast of virtual world avatars controlled through a human–computer interface, rather than showing real-life actors. The approach enables academics or students to make films using screen capture software and desktop editing tools. In student-generated production models the learning value may be found in the production process itself. This paper discusses six case studies and several themes from research on ideas for educational machinima including: access to production; creativity in teaching and learning; media intervention methodology; production models; reusability; visualisation and simulation.

  6. A School Nurse-Delivered Intervention for Anxious Children: An Open Trial

    Science.gov (United States)

    Muggeo, Michela A.; Stewart, Catherine E.; Drake, Kelly L.; Ginsburg, Golda S.

    2017-01-01

    Anxiety disorders are common in children and severely impair their functioning. Because a hallmark symptom of anxiety is somatic complaints, anxious youth often seek help from their school nurse. Thus, school nurses are in an ideal position to identify anxious children and intervene early. This study assessed the feasibility of a brief…

  7. Work–Life Interventions

    Directory of Open Access Journals (Sweden)

    He Lu Calvin Ong

    2014-07-01

    Full Text Available Despite disparities in the conceptualization of work–life balance (WLB and work–life harmony (WLH in the literature, there remains no evidence till date to validate these differences. Furthermore, there are currently no insights that shed light on the relationship between work–life initiatives and key business strategies of contemporary organizations. Hence, the current study investigated the differences between the constructs of WLB and WLH using a cognitive dissonance approach and assessed the impact of work–life interventions, based on these approaches, on individual creativity at work. Hundred participants, age ranging from 18 to 32 years (M = 23.94, SD = 3.87, with at least 6 months of working experience were recruited. Using an online questionnaire, participants were randomly assigned into WLB (n = 55 or WLH (n = 45 conditions. Participants were tasked to complete pre- and post-intervention measures of individual creativity, as well as a manipulation check using a cognitive dissonance scale. Results showed that participants in the WLB condition elicit higher levels of cognitive dissonance compared with participants in the WLH condition. This indicates an implicit difference in the constructs of WLB and harmony. Second, findings also suggest that work–life interventions adopting a WLH approach will have a more positive impact on individuals’ creativity at work compared with interventions targeted at achieving balance. Research, practical, and cultural implications of the findings are discussed in the article.

  8. Interventional ultrasound

    International Nuclear Information System (INIS)

    VanSonnenberg, E.

    1987-01-01

    This book contains 12 chapters and several case studies. Some of the chapter titles are: The Interplay of Ultrasound and Computed Tomography in the Planning and Execution of Interventional Procedures: Ulltrasound Guided Biopsy; Interventioal Genitourinary Sonography; Diagnosis and Treatment of Pericardial Effusion Using Ultrasonic Guidance; and New Ultrasound-Guided Interventional Procedures--Cholecystostomy, Pancreatography, Gastrostomy

  9. An evaluation of a collaborative bibliotherapy scheme delivered via a library service.

    Science.gov (United States)

    Macdonald, J; Vallance, D; McGrath, M

    2013-12-01

    This paper reports on the evaluation of a bibliotherapy scheme delivered via a local library service, in conjunction with General Practice (GP) practices, local social welfare agencies and through self-referral. The Read Yourself Well (RYW) scheme was based on principles established from other similar schemes and as a way of delivering support for adults experiencing mild to moderate mental health problems for whom clinical treatments are not appropriate. The intervention consisted of initial referral and evaluation by the scheme bibliotherapist, a one-hour session at the beginning and end of the intervention where a purpose-designed questionnaire and two mental health assessments were carried out (the General Health Questionnaire and the Clinical Outcomes in Routine Evaluation questionnaire). Contact and support from the bibliotherapist was provided during the intervention period. One hundred and fifty-seven participants were recruited to the evaluation of whom 114 provided full data. Statistical analyses of the mental health scores showed significant improvements post treatment, for, both male and female participants, for all three referral routes, and for participants who were previously library users, and those who joined the library service to participate in the RYW scheme. The results of this large sample evaluation support the proposal that library-based bibliotherapy can be effective in the treatment of mental health problems. © 2012 John Wiley & Sons Ltd.

  10. Social media interventions to prevent HIV: A review of interventions and methodological considerations.

    Science.gov (United States)

    Tso, Lai Sze; Tang, Weiming; Li, Haochu; Yan, H Yanna; Tucker, Joseph D

    2016-06-01

    Persistent new HIV infections and risky behaviors underscore the need for enhanced HIV prevention. Social media interventions may promote safe sexual behaviors, increase HIV testing uptake, and promote safe injection behaviors. This review discusses how social media interventions tap into the wisdom of crowds through crowdsourcing, build peer-mentored communities, and deliver interventions through social networks. Social media HIV prevention interventions are constrained by ethical issues, low social media usage among some key populations, and implementation issues. Comprehensive measurement of social media interventions to prevent HIV is necessary, but requires further development of metrics.

  11. Boosting restraint norms: a community-delivered campaign to promote booster seat use.

    Science.gov (United States)

    Bryant-Stephens, Tyra; Garcia-Espana, J Felipe; Winston, Flaura K

    2013-01-01

    The objective of this study was to evaluate the effectiveness of a theoretically grounded community-delivered marketing campaign to promote belt-positioning booster seat (BPB) use among vulnerable populations when disseminated by community members. A prospective, nonrandomized community intervention trial was conducted to evaluate the "Boosting Restraint Norms" social marketing campaign delivered by community partners in Norristown, Pennsylvania (intervention community), between October 2008 and November 2008. York, Pennsylvania, served as the comparison community. In total, 800 vehicles with 822 children aged 4 to 7 years were observed for BPB use, the primary outcome of interest, at baseline (September 2008) and at 6 months after intervention (April 2009). During the study period, a 28 percent increase in the prevalence of BP