Professionals' positive perceptions of fathers are associated with more favourable attitudes towards including them in family interventions.

Science.gov (United States)

de Montigny, Francine; Gervais, Christine; Meunier, Sophie; Dubeau, Diane

2017-12-01

This Université du Québec en Outaouais study examined professionals' attitudes towards fathers, their perceived self-efficacy when working with them and their perceptions of the importance of including fathers in family interventions. Professionals in Québec, Canada, working in childcare fields such as education, social services, health, community services and management answered a self-report questionnaire between 2013 and 2015. The 296 respondents (90% females) had a mean age of 39 (20-65), were from urban, semi-urban and rural settings and provided services to families with children up to five years of age. Social service professionals perceived fathers more negatively than did other professionals. Even though male professionals perceived fathers more negatively, they felt more confident working with them than did their female counterparts. Positive perceptions of fathers were associated with more favourable attitudes towards including them in family interventions, and this association was mediated by the professionals' perceptions of their own self-efficacy. The most negative attitudes were reported by social service professionals. Male professionals viewed fathers more negatively but were more confident working with them than were female colleagues. Improving professionals' perceptions of fathers could help to promote their inclusion in family interventions. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Multifaceted intervention including education, rounding checklist implementation, cost feedback, and financial incentives reduces inpatient laboratory costs.

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Yarbrough, Peter M; Kukhareva, Polina V; Horton, Devin; Edholm, Karli; Kawamoto, Kensaku

2016-05-01

Inappropriate laboratory testing is a contributor to waste in healthcare. To evaluate the impact of a multifaceted laboratory reduction intervention on laboratory costs. A retrospective, controlled, interrupted time series (ITS) study. University of Utah Health Care, a 500-bed academic medical center in Salt Lake City, Utah. All patients 18 years or older admitted to the hospital to a service other than obstetrics, rehabilitation, or psychiatry. Multifaceted quality-improvement initiative in a hospitalist service including education, process change, cost feedback, and financial incentive. Primary outcomes of lab cost per day and per visit. Secondary outcomes of number of basic metabolic panel (BMP), comprehensive metabolic panel (CMP), complete blood count (CBC), and prothrombin time/international normalized ratio tests per day; length of stay (LOS); and 30-day readmissions. A total of 6310 hospitalist patient visits (intervention group) were compared to 25,586 nonhospitalist visits (control group). Among the intervention group, the unadjusted mean cost per day was reduced from $138 before the intervention to $123 after the intervention (P analysis showed significant reductions in cost per day, cost per visit, and the number of BMP, CMP, and CBC tests per day (P = 0.034, 0.02, <0.001, 0.004, and <0.001). LOS was unchanged and 30-day readmissions decreased in the intervention group. A multifaceted approach to laboratory reduction demonstrated a significant reduction in laboratory cost per day and per visit, as well as common tests per day at a major academic medical center. Journal of Hospital Medicine 2016;11:348-354. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients

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Marie Dorow

2018-05-01

Full Text Available Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1 investigate treatment preferences for depression including internet-based interventions and (2 examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences.Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences.Results: Patients had a mean age of 43.9 years (SD = 13.8 and more than two thirds (68.6% were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy.Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions.

A reanalysis of a behavioral intervention to prevent incident HIV infections: Including indirect effects in modeling outcomes of Project EXPLORE

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Eaton, Lisa A.; Kalichman, Seth C.; Kenny, David A.; Harel, Ofer

2013-01-01

Background Project EXPLORE -- a large-scale, behavioral intervention tested among men who have sex with men (MSM) at-risk for HIV infection --was generally deemed as ineffective in reducing HIV incidence. Using novel and more precise data analytic techniques we reanalyzed Project EXPLORE by including both direct and indirect paths of intervention effects. Methods Data from 4,296 HIV negative MSM who participated in Project EXPLORE, which included ten sessions of behavioral risk reduction counseling completed from 1999-2005, were included in the analysis. We reanalyzed the data to include parameters that estimate the overtime effects of the intervention on unprotected anal sex and the over-time effects of the intervention on HIV status mediated by unprotected anal sex simultaneously in a single model. Results We found the indirect effect of intervention on HIV infection through unprotected anal sex to be statistically significant up through 12 months post-intervention, OR=.83, 95% CI=.72-.95. Furthermore, the intervention significantly reduced unprotected anal sex up through 18 months post-intervention, OR=.79, 95% CI=.63-.99. Discussion Our results reveal effects not tested in the original model that offer new insight into the effectiveness of a behavioral intervention for reducing HIV incidence. Project EXPLORE demonstrated that when tested against an evidence-based, effective control condition can result in reductions in rates of HIV acquisition at one year follow-up. Findings highlight the critical role of addressing behavioral risk reduction counseling in HIV prevention. PMID:23245226

[Studies on occupational stress intervention in workplaces abroad: a systematic review].

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Hua, Yujie; Dai, Junming

2015-10-01

To evaluate the effects of occupational stress intervention in the workplaces abroad by systematic review and to provide a reference for domestic research. The Medline database was searched to collect the literature on occupational stress intervention published from January 1 in 2000 to September 4 in 2014, Using standardized forms, the methods, contents, subjects, study design, result indicator, effectiveness and evidence of the intervention were extracted and analyzed. Thirty studies met the inclusion criteria, with a total sample size of 5699 participants, including 20 randomized trials and 10 non-randomized or self-controlled studies from 12 countries, such as Germany, Japan, and Britain. The course of intervention ranged from 4 to 16 weeks. Six types of intervention were identified, i.e., cognitive-behavioral treatment (CBT), relaxation technique, physical activity, organization-focused intervention, combined intervention, and multilevel intervention, among which CBT was used most frequently. The outcome variables mainly included social psychological variable and work-related variable. Occupational stress intervention could significantly improve the occupational stress and depressive symptoms, and also had some effects on the work-related outcomes. The effectiveness of the intervention might vary between the subjects with different occupational stress levels before intervention. The effectiveness of the intervention was better at an organizational level than at an individual level, but the effectiveness at a multiple level was not necessarily better than that at a single level. Occupational stress intervention is an effective method to improve the occupational stress at workplace. However, the occupational stress level before intervention, the duration and frequency of intervention, measures and level of intervention, and follow-up period have certain influence on the effectiveness of intervention. Future research should pay attention to methodology, focus on

Malnutrition in hip fracture patients: an intervention study.

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Olofsson, Birgitta; Stenvall, Michael; Lundström, Maria; Svensson, Olle; Gustafson, Yngve

2007-11-01

To investigate whether a nutritional intervention in older women and men with femoral neck fracture had an effect on postoperative complications during hospitalization and on nutritional status at a four-month follow-up. The design was a randomized controlled trial. The present study sample consisted of 157 patients aged 70 years and above with femoral neck fracture. The nutritional intervention included, among other things, a nutritional journal to detect nutrition deficiencies and protein-enriched meals for at least four days postoperatively. Further, at least two nutritional and protein drinks were served each day during the whole hospitalization and other factors that would influence the patient's nutrition were also considered and dealt with. Postoperative complications were registered and patients were assessed using the Mini Nutritional Assessment (MNA) scale, including body mass index (BMI), on admission and at a four-month follow-up. Malnutrition was common and low MNA scores were associated with postoperative complications such as delirium and decubitus ulcers. There were significantly fewer days of delirium in the intervention group, seven patients in the intervention group developed decubitus ulcers vs. 14 patients in the control group and the total length of hospitalization was shorter. There were no detectable significant improvements regarding nutritional parameters between the intervention and the control group at the four-month follow-up but men improved their mean BMI, body weight and MNA scores in both the intervention and the control groups while women deteriorated in both groups. Malnutrition was common among older people with hip fractures admitted to hospital. The nutritional intervention might have contributed to the patients suffering fewer days with delirium, fewer decubitus ulcers and shorter hospitalization but did not improve the long-term nutritional status, at least not in women. This nutritional intervention, which was included in a

External validity of post-stroke interventional gait rehabilitation studies.

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Kafri, Michal; Dickstein, Ruth

2017-01-01

Gait rehabilitation is a major component of stroke rehabilitation, and is supported by extensive research. The objective of this review was to examine the external validity of intervention studies aimed at improving gait in individuals post-stroke. To that end, two aspects of these studies were assessed: subjects' exclusion criteria and the ecological validity of the intervention, as manifested by the intervention's technological complexity and delivery setting. Additionally, we examined whether the target population as inferred from the titles/abstracts is broader than the population actually represented by the reported samples. We systematically researched PubMed for intervention studies to improve gait post-stroke, working backwards from the beginning of 2014. Exclusion criteria, the technological complexity of the intervention (defined as either elaborate or simple), setting, and description of the target population in the titles/abstracts were recorded. Fifty-two studies were reviewed. The samples were exclusive, with recurrent stroke, co-morbidities, cognitive status, walking level, and residency being major reasons for exclusion. In one half of the studies, the intervention was elaborate. Descriptions of participants in the title/abstract in almost one half of the studies included only the diagnosis (stroke or comparable terms) and its stage (acute, subacute, and chronic). The external validity of a substantial number of intervention studies about rehabilitation of gait post-stroke appears to be limited by exclusivity of the samples as well as by deficiencies in ecological validity of the interventions. These limitations are not accurately reflected in the titles or abstracts of the studies.

Intervention Effects on Adolescent Physical Activity in the Multicomponent SPACE Study

DEFF Research Database (Denmark)

Toftager, Mette; Christiansen, Lars B; Ersbøll, Annette K

2014-01-01

BACKGROUND: Multicomponent school-based interventions have the potential to reduce the age-related decline in adolescents' physical activity (PA), yet there is not consistent evidence to guide non-curricular and school environment interventions. The aim of this study was to assess the effectiveness......-up. A total of 1,348 students (11-13 years, in grade 5 and 6) enrolled in the study at baseline. The 14 schools included in the study were located in the Region of Southern Denmark. The intervention consisted of organizational and physical changes in the school environment with a total of 11 intervention...

The Danish Alzheimer intervention study

DEFF Research Database (Denmark)

Waldemar, G; Waldorff, F B; Buss, D V

2011-01-01

Background: There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline characteri......Background: There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline...

A systematic review of health promotion intervention studies in the police force: study characteristics, intervention design and impacts on health.

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MacMillan, Freya; Karamacoska, Diana; El Masri, Aymen; McBride, Kate A; Steiner, Genevieve Z; Cook, Amelia; Kolt, Gregory S; Klupp, Nerida; George, Emma S

2017-12-01

To systematically review studies of health promotion intervention in the police force. Four databases were searched for articles reporting on prepost single and multigroup studies in police officers and trainees. Data were extracted and bias assessed to evaluate study characteristics, intervention design and the impact of interventions on health. Database searching identified 25 articles reporting on 21 studies relevant to the aims of this review. Few studies (n=3) were of long duration (≥6 months). Nine of 21 studies evaluated structured physical activity and/or diet programmes only, 5 studies used education and behaviour change support-only interventions, 5 combined structured programmes with education and behaviour change support, and 2 studies used computer prompts to minimise sedentary behaviour. A wide array of lifestyle behaviour and health outcomes was measured, with 11/13 multigroup and 8/8 single-group studies reporting beneficial impacts on outcomes. High risk of bias was evident across most studies. In those with the lowest risk of bias (n=2), a large effect on blood pressure and small effects on diet, sleep quality, stress and tobacco use, were reported. Health promotion interventions can impact beneficially on health of the police force, particularly blood pressure, diet, sleep, stress and tobacco use. Limited reporting made comparison of findings challenging. Combined structured programmes with education and behaviour change support and programmes including peer support resulted in the most impact on health-related outcomes. © 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.

Healthy urban environments for children and young people: A systematic review of intervention studies.

Science.gov (United States)

Audrey, Suzanne; Batista-Ferrer, Harriet

2015-11-01

This systematic review collates, and presents as a narrative synthesis, evidence from interventions which included changes to the urban environment and reported at least one health behaviour or outcome for children and young people. Following a comprehensive search of six databases, 33 primary studies relating to 27 urban environment interventions were included. The majority of interventions related to active travel. Others included park and playground renovations, road traffic safety, and multi-component community-based initiatives. Public health evidence for effectiveness of such interventions is often weak because study designs tend to be opportunistic, non-randomised, use subjective outcome measures, and do not incorporate follow-up of study participants. However, there is some evidence of potential health benefits to children and young people from urban environment interventions relating to road safety and active travel, with evidence of promise for a multi-component obesity prevention initiative. Future research requires more robust study designs incorporating objective outcome measures. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Rationale, design and methods of the HEALTHY study nutrition intervention component.

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Gillis, B; Mobley, C; Stadler, D D; Hartstein, J; Virus, A; Volpe, S L; El ghormli, L; Staten, M A; Bridgman, J; McCormick, S

2009-08-01

The HEALTHY study was a randomized, controlled, multicenter and middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Here we describe the design of the HEALTHY nutrition intervention component that was developed to modify the total school food environment, defined to include the following: federal breakfast, lunch, after school snack and supper programs; a la carte venues, including snack bars and school stores; vending machines; fundraisers; and classroom parties and celebrations. Study staff implemented the intervention using core and toolbox strategies to achieve and maintain the following five intervention goals: (1) lower the average fat content of foods, (2) increase the availability and variety of fruits and vegetables, (3) limit the portion sizes and energy content of dessert and snack foods, (4) eliminate whole and 2% milk and all added sugar beverages, with the exception of low fat or nonfat flavored milk, and limit 100% fruit juice to breakfast in small portions and (5) increase the availability of higher fiber grain-based foods and legumes. Other nutrition intervention component elements were taste tests, cafeteria enhancements, cafeteria line messages and other messages about healthy eating, cafeteria learning laboratory (CLL) activities, twice-yearly training of food service staff, weekly meetings with food service managers, incentives for food service departments, and twice yearly local meetings and three national summits with district food service directors. Strengths of the intervention design were the integration of nutrition with the other HEALTHY intervention components (physical education, behavior change and communications), and the collaboration and rapport between the nutrition intervention study staff members and food service personnel at both school

An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol-related harm including violence in the United Kingdom

Directory of Open Access Journals (Sweden)

Moore Simon C

2012-06-01

Full Text Available Abstract Background To assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation. Methods An exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises’ customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews. Results The process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises. Conclusions It is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability. Trial registration UKCRN 7090; ISRCTN: 80875696

Teacher Attitudes on Including Students with Behavior Intervention Plans in a High-School Inclusive Classroom

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Tucker, Thurman D.

2017-01-01

This research examined attitudes to determine factors influencing teachers' attitudes toward including students with behavior intervention plans in inclusive high-school classrooms. For Research Question 1 one-way ANOVAs analyzed quantitative data with no significant differences found and qualitative data discovered common patterns that BIPs are…

Multimodal interventions including nutrition in the prevention and management of disease-related malnutrition in adults: a systematic review of randomised control trials.

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Thorne, Frances; Baldwin, Christine

2014-06-01

There has been a move to improve nutritional status in malnourished patients through the use of multimodal interventions (MI). There are currently no systematic reviews that have examined their effectiveness. This analysis aimed to examine the effects on nutritional, clinical, functional and patient-centred outcomes. A systematic review and meta-analysis using Cochrane methodology. 15 studies were included in the analysis, 13 comparing MI with usual care and 2 comparing MI with a nutrition intervention alone. Quality of studies varied and studies reported few relevant outcomes. Only 3 outcomes were compatible with meta-analysis; weight, mortality and length of stay (LOS). No statistically significant differences between groups were found. Narrative review was inconclusive. There was no evidence of benefit in the intervention groups in relation to body composition, functional status or quality of life (QoL). Intervention groups appeared to show a trend towards increased energy and protein intake however data was provided by only 2 studies (301 participants). No conclusive evidence of benefit for MI on any of the reviewed outcomes was found. Well designed, high quality trials addressing the impact of MI on relevant nutritional, functional and clinical outcomes are required. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

[Orion (Outbreak Reports and Intervention studies of Nosocomial Infection) used for evaluating interventions and investigations of nosocomial infection outbreaks].

Science.gov (United States)

Pires-Cronenberger, S; Nicolle, M-C; Voirin, N; Giard, M; Luxemburger, C; Vanhems, P

2009-04-01

British colleagues have developed the Outbreak Reports and Intervention studies of Nosocomial Infection (Orion) guidelines with the aim to promote transparency of publications in the field of health-care associated infections and particularly for reports of outbreak investigation or intervention studies. The aim of this study was to translate the Orion criteria and to promote their use in France. The Orion guidelines include a checklist of 22 commented items related to the title, abstract, introduction, methods, results, and discussion sections of a scientific article. Specific points for each item are developed to enhance its relevance. The use of Orion guidelines by authors and editors should be encouraged and should improve the quality of standards in research, intervention studies, and publications on nosocomial infections and health-care associated infections.

Study protocol: Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer (RESPECT).

Science.gov (United States)

Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis; Andersen, Lars Bo; Andersen, Karen Vitting; Christensen, Karl Bang; Hasle, Henrik; Heilmann, Carsten; Hejgaard, Nete; Johansen, Christoffer; Madsen, Marianne; Madsen, Svend Aage; Simovska, Venka; Strange, Birgit; Thing, Lone Friis; Wehner, Peder Skov; Schmiegelow, Kjeld; Larsen, Hanne Baekgaard

2013-11-14

During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n=120) and a matched control group in western Denmark (n=120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child's schoolteachers and classmates, and the child's parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. RESPECT is the first population-based study to examine the

Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON§ Project

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Peloso, Paul M; Khan, Mahweesh; Gross, Anita R; Carlesso, Lisa; Santaguida, Lina; Lowcock, Janet; MacDermid, Joy C; Walton, Dave; Goldsmith, Charlie H; Langevin, Pierre; Shi, Qiyun

2013-01-01

Objectives: To conduct an overview (review-of-reviews) on pharmacological interventions for neck pain. Search Strategy: Computerized databases and grey literature were searched from 2006 to 2012. Selection Criteria: Systematic reviews of randomized controlled trials (RCT) in adults with acute to chronic neck pain reporting effects of pharmacological interventions including injections on pain, function/disability, global perceived effect, quality of life and patient satisfaction. Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias and extracted data The GRADE tool was used to evaluate the body of evidence and an external panel provided critical review. Main Results: We found 26 reviews reporting on 47 RCTs. Most pharmacological interventions had low to very low quality methodologic evidence with three exceptions. For chronic neck pain, there was evidence of: a small immediate benefit for eperison hydrochloride (moderate GRADE, 1 trial, 157 participants);no short-term pain relieving benefit for botulinum toxin-A compared to saline (strong GRADE; 5 trial meta-analysis, 258 participants) nor for subacute/chronic whiplash (moderate GRADE; 4 trial meta-analysis, 183 participants) including reduced pain, disability or global perceived effect; andno long-term benefit for medial branch block of facet joints with steroids (moderate GRADE; 1 trial, 120 participants) over placebo to reduce pain or disability; Reviewers' Conclusions: While in general there is a lack of evidence for most pharmacological interventions, current evidence is against botulinum toxin-A for chronic neck pain or subacute/chronic whiplash; against medial branch block with steroids for chronic facet joint pain; but in favour of the muscle relaxant eperison hydrochloride for chronic neck pain. PMID:24155805

THE EFFECTIVENESS OF TEACCH INTERVENTION IN AUTISM SPECTRUM DISORDER: A REVIEW STUDY

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Pilar Sanz-Cervera

2018-01-01

Full Text Available This work includes a review of the literature to analyze the effectiveness of the TEACCH intervention, as well as the effect of this intervention on the level of parental and teachers’ stress of children with autism spectrum disorder (ASD. Considering the inclusion criteria, a total of 14 studies were analyzed. Regardless of the context of intervention, all the studies revealed developmental abilities improvements and a reduction in autistic symptoms and maladaptative behaviors. In 11 of the 14 studies, statistically significant improvements were obtained. As for the effect of the TEACCH intervention in the level of the parents or teachers stress, out of the 7 studies that evaluated stress, 5 of them obtained a significant decrease between Pre and Post measurements. Considering these results, TEACCH intervention could be effective not only improving the child’s development, but also enhancing the adults’ level of well-being.

Modifying the Sleep Treatment Education Program for Students to include technology use (STEPS-TECH): Intervention effects on objective and subjective sleep outcomes.

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Barber, Larissa K; Cucalon, Maria S

2017-12-01

University students often have sleep issues that arise from poor sleep hygiene practices and technology use patterns. Yet, technology-related behaviors are often neglected in sleep hygiene education. This study examined whether the Sleep Treatment Education Program for Students-modified to include information regarding managing technology use (STEPS-TECH)-helps improve both subjective and objective sleep outcomes among university students. Results of an experimental study among 78 university students showed improvements in objective indicators of sleep quantity (total sleep time) and sleep quality (less awakenings) during the subsequent week for students in the STEPS-TECH intervention group compared to a control group. Exploratory analyses indicated that effects were driven by improvements in weekend days immediately following the intervention. There were also no intervention effects on subjective sleep quality or quantity outcomes. In terms of self-reported behavioral responses to educational content in the intervention, there were no group differences in sleep hygiene practices or technology use before bedtime. However, the intervention group reported less technology use during sleep periods than the control group. These preliminary findings suggest that STEPS-TECH may be a useful educational tool to help improve objective sleep and reduce technology use during sleep periods among university students. Copyright © 2017 John Wiley & Sons, Ltd.

Examining the Outcomes of Including Students with Disabilities in a Bullying/Victimization Intervention

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Graybill, Emily C.; Vinoski, Erin; Black, Mary; Varjas, Kris; Henrich, Christopher; Meyers, Joel

2016-01-01

Students with disabilities are bullied at rates disproportionate to their typically developing peers, yet we know little about effective interventions to reduce the rates of victimization among students with disabilities across all disability categories. This study examined the effectiveness of the inclusive Bullying/Victimization Intervention…

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

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

2015-03-07

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

An observation study of radiation exposure to nurses during interventional radiology procedure

International Nuclear Information System (INIS)

Komemushi, Atsushi; Tanigawa, Noboru; Aoki, Atsuko

2010-01-01

The purpose of this study was to prospectively measure the level of radiation exposure among nursing staff during interventional radiology procedures. All interventional radiology procedures performed at our institution between April 20 and June 19, 2009 were included in this study. Radiation exposure was measured as the equivalent dose penetrating tissue to a depth of 10 mm using electronic personal dosimeters attached outside (Ha) and inside (Hb) lead aprons. Effective dose (HE) was estimated by calculating from Ha and Hb. In total, data from 68 procedures were included in this study. Four nurses performed 71 nursing cares. The mean Ha was 0.70±1.0 μSv, while the mean Hb was 0.06±0.2 μSv. The mean HE was 0.14±0.3 μSv. The present findings indicate that during interventional radiology procedures, nurses were exposed to very low levels of radiation. (author)

Exercise-training intervention studies in competitive swimming.

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Aspenes, Stian Thoresen; Karlsen, Trine

2012-06-01

Competitive swimming has a long history and is currently one of the largest Olympic sports, with 16 pool events. Several aspects separate swimming from most other sports such as (i) the prone position; (ii) simultaneous use of arms and legs for propulsion; (iii) water immersion (i.e. hydrostatic pressure on thorax and controlled respiration); (iv) propulsive forces that are applied against a fluctuant element; and (v) minimal influence of equipment on performance. Competitive swimmers are suggested to have specific anthropometrical features compared with other athletes, but are nevertheless dependent on physiological adaptations to enhance their performance. Swimmers thus engage in large volumes of training in the pool and on dry land. Strength training of various forms is widely used, and the energetic systems are addressed by aerobic and anaerobic swimming training. The aim of the current review was to report results from controlled exercise training trials within competitive swimming. From a structured literature search we found 17 controlled intervention studies that covered strength or resistance training, assisted sprint swimming, arms-only training, leg-kick training, respiratory muscle training, training the energy delivery systems and combined interventions across the aforementioned categories. Nine of the included studies were randomized controlled trials. Among the included studies we found indications that heavy strength training on dry land (one to five repetitions maximum with pull-downs for three sets with maximal effort in the concentric phase) or sprint swimming with resistance towards propulsion (maximal pushing with the arms against fixed points or pulling a perforated bowl) may be efficient for enhanced performance, and may also possibly have positive effects on stroke mechanics. The largest effect size (ES) on swimming performance was found in 50 m freestyle after a dry-land strength training regimen of maximum six repetitions across three

An Assessment of Intervention Fidelity in Published Social Work Intervention Research Studies

Science.gov (United States)

Corley, Nicole A.; Kim, Irang

2016-01-01

Objectives: Intervention fidelity is a critical strategy to help advance the usefulness and integrity of social work research. This study assessed the extent to which a selected sample of published social work intervention researchers reported its intervention protocols. Methods: Six core social work journals were reviewed in this analysis. The…

Effects of a 3-year intervention: The Copenhagen School Child Intervention Study

DEFF Research Database (Denmark)

Bugge, Anna; El-Naaman, Bianca; Dencker, Magnus

2012-01-01

INTRODUCTION: This study assessed short and long term effects of a 3-year controlled school-based physical activity (PA) intervention on fatness, cardiorespiratory fitness (VO2peak) and cardiovascular disease (CVD) risk factors in children. METHODS: The study involved 18 schools (10 intervention...

The Impact of a Community-Based Intervention Including a Monthly Food Ration on Food Insecurity Among HIV-Positive Adults During the First Year of Antiretroviral Therapy.

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Rothman, Jessica; Kayigamba, Felix; Hills, Victoria; Gupta, Neil; Machara, Faustin; Niyigena, Peter; Franke, Molly F

2018-01-01

The objective of this study was to examine how food insecurity changed among HIV-positive adults during the first 12 months of combination antiretroviral therapy (cART) and whether any change differed according to the receipt of food support, which was provided in the context of a comprehensive community-based intervention. We conducted secondary data analyses of data from a prospective cohort study of the effectiveness of a community-based cART delivery model when added to clinic-based cART delivery in Rwanda. We included patients from four health centers that implemented a clinic-based cART delivery model alone and five health centers that additionally implemented the intervention, which included 10 months of food support. We compared food insecurity at 3, 6, and 12 months, relative to baseline, and stratified by receipt of the intervention. Relative to baseline, median food insecurity score decreased after 3, 6, and 12 months (p value insecurity scores remained unchanged at 3 and 12 months and were significantly higher after 6 months. In adjusted analyses, participants enrolled in the community-based intervention with a food ration had a lower risk of severe food insecurity and a lower risk of moderate or severe food insecurity after 12 months. A comprehensive community-based HIV program including a food ration likely contributes to an alleviation of food insecurity among adults newly initiating cART.

A Narrative Review of Diabetes Intervention Studies to Explore Diabetes Care Opportunities for Pharmacists

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Shamala Ayadurai

2016-01-01

Full Text Available Background. We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care. Methods. A search on randomised controlled trials (RCT on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted. Results and Discussion. Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years; therefore long term outcomes could not be established. Conclusion. Although pharmacists’ contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful.

Effects of lifestyle interventions that include a physical activity component in class II and III obese individuals: a systematic review and meta-analysis.

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Aurélie Baillot

Full Text Available In class II and III obese individuals, lifestyle intervention is the first step to achieve weight loss and treat obesity-related comorbidities before considering bariatric surgery. A systematic review, meta-analysis, and meta-regression were performed to assess the impact of lifestyle interventions incorporating a physical activity (PA component on health outcomes of class II and III obese individuals.An electronic search was conducted in 4 databases (Medline, Scopus, CINAHL and Sportdiscus. Two independent investigators selected original studies assessing the impact of lifestyle interventions with PA components on anthropometric parameters, cardiometabolic risk factors (fat mass, blood pressure, lipid and glucose metabolism, behaviour modification (PA and nutritional changes, and quality of life in adults with body mass index (BMI ≥ 35 kg/m2. Estimates were pooled using a random-effect model (DerSimonian and Laird method. Heterogeneity between studies was assessed by the Cochran's chi-square test and quantified through an estimation of the I².Of the 3,170 identified articles, 56 met our eligibility criteria, with a large majority of uncontrolled studies (80%. The meta-analysis based on uncontrolled studies showed significant heterogeneity among all included studies. The pooled mean difference in weight loss was 8.9 kg (95% CI, 10.2-7.7; p < 0.01 and 2.8 kg/m² in BMI loss (95% CI, 3.4-2.2; p < 0.01. Long-term interventions produced superior weight loss (11.3 kg compared to short-term (7.2 kg and intermediate-term (8.0 kg interventions. A significant global effect of lifestyle intervention on fat mass, waist circumference, blood pressure, total cholesterol, LDL-C, triglycerides and fasting insulin was found (p<0.01, without significant effect on HDL-C and fasting blood glucose.Lifestyle interventions incorporating a PA component can improve weight and various cardiometabolic risk factors in class II and III obese individuals. However, further

Intravenous heroin use in Haiphong, Vietnam: Need for comprehensive care including methamphetamine use-related interventions.

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Michel, Laurent; Des Jarlais, Don C; Duong Thi, Huong; Khuat Thi Hai, Oanh; Pham Minh, Khuê; Peries, Marianne; Vallo, Roselyne; Nham Thi Tuyet, Thanh; Hoang Thi, Giang; Le Sao, Mai; Feelemyer, Jonathan; Vu Hai, Vinh; Moles, Jean-Pierre; Laureillard, Didier; Nagot, Nicolas

2017-10-01

The aim of this study was to describe patterns among people who inject drugs (PWID), risk-related behaviours and access to methadone treatment, in order to design a large-scale intervention aiming to end the HIV epidemic in Haiphong, Vietnam. A respondent-driven sampling (RDS) survey was first conducted to identify profiles of drug use and HIV risk-related behaviour among PWID. A sample of PWID was then included in a one-year cohort study to describe access to methadone treatment and associated factors. Among the 603 patients enrolled in the RDS survey, 10% were female, all were injecting heroin and 24% were using methamphetamine, including 3 (0.5%) through injection. Different profiles of risk-related behaviours were identified, including one entailing high-risk sexual behaviour (n=37) and another involving drug-related high-risk practices (n=22). High-risk sexual activity was related to binge drinking and methamphetamine use. Among subjects with low sexual risk, sexual intercourse with a main partner with unknown serostatus was often unprotected. Among the 250 PWID included in the cohort, 55.2% initiated methadone treatment during the follow-up (versus 4.4% at RDS); methamphetamine use significantly increased. The factors associated with not being treated with methadone after 52 weeks were fewer injections per month and being a methamphetamine user at RDS. Heroin is still the main drug injected in Haiphong. Methamphetamine use is increasing markedly and is associated with delay in methadone initiation. Drug-related risks are low but sexual risk behaviours are still present. Comprehensive approaches are needed in the short term. Copyright © 2017 Elsevier B.V. All rights reserved.

The nutrition-based comprehensive intervention study on childhood obesity in China (NISCOC: a randomised cluster controlled trial

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Xu Guifa

2010-05-01

Full Text Available Abstract Background Childhood obesity and its related metabolic and psychological abnormalities are becoming serious health problems in China. Effective, feasible and practical interventions should be developed in order to prevent the childhood obesity and its related early onset of clinical cardiovascular diseases. The objective of this paper is to describe the design of a multi-centred random controlled school-based clinical intervention for childhood obesity in China. The secondary objective is to compare the cost-effectiveness of the comprehensive intervention strategy with two other interventions, one only focuses on nutrition education, the other only focuses on physical activity. Methods/Design The study is designed as a multi-centred randomised controlled trial, which included 6 centres located in Beijing, Shanghai, Chongqing, Shandong province, Heilongjiang province and Guangdong province. Both nutrition education (special developed carton style nutrition education handbook and physical activity intervention (Happy 10 program will be applied in all intervention schools of 5 cities except Beijing. In Beijing, nutrition education intervention will be applied in 3 schools and physical activity intervention among another 3 schools. A total of 9750 primary students (grade 1 to grade 5, aged 7-13 years will participate in baseline and intervention measurements, including weight, height, waist circumference, body composition (bioelectrical impendence device, physical fitness, 3 days dietary record, physical activity questionnaire, blood pressure, plasma glucose and plasma lipid profiles. Data concerning investments will be collected in our study, including costs in staff training, intervention materials, teachers and school input and supervising related expenditure. Discussion Present study is the first and biggest multi-center comprehensive childhood obesity intervention study in China. Should the study produce comprehensive results, the

Data analysis methods for assessing palliative care interventions in one-group pre–post studies

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Takeshi Ioroi

2015-11-01

Full Text Available Objectives: Studies of palliative care are often performed using single-arm pre–post study designs that lack causal inference. Thus, in this study, we propose a novel data analysis approach that incorporates risk factors from single-arm studies instead of using paired t-tests to assess intervention effects. Methods: Physical, psychological and social evaluations of eligible cancer inpatients were conducted by a hospital-based palliative care team. Quality of life was assessed at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer QLQ-C15-PAL. Among 35 patients, 9 were discharged within 1 week and 26 were included in analyses. Structural equation models with observed measurements were applied to estimate direct and indirect intervention effects and simultaneously consider risk factors. Results: Parameters were estimated using full models that included associations among covariates and reduced models that excluded covariates with small effects. The total effect was calculated as the sum of intervention and covariate effects and was equal to the mean of the difference (0.513 between pre- and post-intervention quality of life (reduced model intervention effect, 14.749; 95% confidence intervals, −4.407 and 33.905; p = 0.131; covariate effect, −14.236; 95% confidence interval, −33.708 and 5.236; p = 0.152. Conclusion: Using the present analytical method for single-arm pre–post study designs, factors that modulate effects of interventions were modelled, and intervention and covariate effects were distinguished based on structural equation model.

Quality assurance in non-interventional studies.

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Theobald, Karlheinz; Capan, Müge; Herbold, Marlis; Schinzel, Stefan; Hundt, Ferdinand

2009-11-09

Nowadays, drug research and surveillance after authorisation becomes more and more important for several reasons. Non-interventional studies (NIS) investigate various aspects of drug use including efficacy and safety under real life conditions. Such kind of health services research should be on a high scientific, methodological and organisational level. Therefore accompanying measures to improve or to keep the quality are highly recommended. The aim of quality management is: first to avoid bias of results by using an appropriate study design and an adequate data analysis, second to assure authenticity, completeness and validity of the data and third to identify and resolve deficiencies at an early stage. Basic principles are laid down in corresponding guidelines and recommendations of authorities, institutes and societies. Various guidelines for good epidemiological practice (GEP) were published by the U.S. Food and Drug Administration (FDA) and international and regional societies for epidemiology. In addition in Germany the Federal Institute for Drugs and Medical Devices (BfArM) together with the Paul Ehrlich Institute (PEI) and the German Association of Research-Based Pharmaceutical Companies (VFA) have published respectively recommendations dealing with quality aspects of non-interventional observational studies. Key points are the advanced publishing of information about the project, developing of a study plan/protocol containing the scientific objectives, a sample size justification and a description of the planned analyses and the publishing of a summary of the results timely after completion of the study. The quality of the data can be improved by using standardized case report forms (CRF) and the CRF should be reviewed and tested before start of study by some participants. A source data verification (SDV) should be performed in randomly selected centres - in between 2% and 5% of the centres depending on the number of participating centres. Before start of

Quality assurance in non-interventional studies

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Capan, Müge

2009-11-01

Full Text Available Nowadays, drug research and surveillance after authorisation becomes more and more important for several reasons. Non-interventional studies (NIS investigate various aspects of drug use including efficacy and safety under real life conditions. Such kind of health services research should be on a high scientific, methodological and organisational level. Therefore accompanying measures to improve or to keep the quality are highly recommended. The aim of quality management is: first to avoid bias of results by using an appropriate study design and an adequate data analysis, second to assure authenticity, completeness and validity of the data and third to identify and resolve deficiencies at an early stage. Basic principles are laid down in corresponding guidelines and recommendations of authorities, institutes and societies. Various guidelines for good epidemiological practice (GEP were published by the U.S. Food and Drug Administration (FDA and international and regional societies for epidemiology. In addition in Germany the Federal Institute for Drugs and Medical Devices (BfArM together with the Paul Ehrlich Institute (PEI and the German Association of Research-Based Pharmaceutical Companies (VFA have published respectively recommendations dealing with quality aspects of non-interventional observational studies. Key points are the advanced publishing of information about the project, developing of a study plan/protocol containing the scientific objectives, a sample size justification and a description of the planned analyses and the publishing of a summary of the results timely after completion of the study. The quality of the data can be improved by using standardized case report forms (CRF and the CRF should be reviewed and tested before start of study by some participants. A source data verification (SDV should be performed in randomly selected centres – in between 2% and 5% of the centres depending on the number of participating centres

Intervention effects on dietary intake among children by maternal education level: results of the Copenhagen School Child Intervention Study (CoSCIS).

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Jensen, Britt W; von Kappelgaard, Lene M; Nielsen, Birgit M; Husby, Ida; Bugge, Anna; El-Naaman, Bianca; Andersen, Lars B; Trolle, Ellen; Heitmann, Berit L

2015-03-28

Dietary intake among Danish children, in general, does not comply with the official recommendations. The objectives of the present study were to evaluate the 3-year effect of a multi-component school-based intervention on nutrient intake in children, and to examine whether an intervention effect depended on maternal education level. A total of 307 children (intervention group: n 184; comparison group: n 123) were included in the present study. All had information on dietary intake pre- and post-intervention (mean age 6·8 and 9·5 years for intervention and comparison groups, respectively) assessed by a 7-d food record. Analyses were conducted based on the daily intake of macronutrients (energy percentage (E%)), fatty acids (E%), added sugar (E%) and dietary fibre (g/d and g/MJ). Analyses were stratified by maternal education level into three categories. Changes in nutrient intake were observed in the intervention group, mainly among children of mothers with a short education ( education (β = -0·8, 95 % CI -1·5, -0·03, P= 0·04). This multi-component school-based intervention resulted in changes in the dietary intake, particularly among children of mothers with a short education. As the dietary intake of this subgroup generally differs most from the recommendations, the results of the present study are particularly encouraging.

The Effectiveness and Cost of Lifestyle Interventions Including Nutrition Education for Diabetes Prevention: A Systematic Review and Meta-Analysis.

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Sun, Yu; You, Wen; Almeida, Fabio; Estabrooks, Paul; Davy, Brenda

2017-03-01

Type 2 diabetes is a significant public health concern. With the completion of the Diabetes Prevention Program, there has been a proliferation of studies attempting to translate this evidence base into practice. However, the cost, effectiveness, and cost-effectiveness of these adapted interventions is unknown. The purpose of this systematic review was to conduct a comprehensive meta-analysis to synthesize the effectiveness, cost, and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent (dietitian vs non-dietitian) and channel (in-person vs technology-delivered). English and full-text research articles published up to July 2015 were identified using the Cochrane Library, PubMed, Education Resources Information Center, CAB Direct, Science Direct, and Google Scholar. Sixty-nine studies met inclusion criteria. Most employed both dietary and physical activity intervention components (four of 69 were diet-only interventions). Changes in weight, fasting and 2-hour blood glucose concentration, and hemoglobin A1c were extracted from each article. Heterogeneity was measured by the I 2 index, and study-specific effect sizes or mean differences were pooled using a random effects model when heterogeneity was confirmed. Participants receiving intervention with nutrition education experienced a reduction of 2.07 kg (95% CI 1.52 to 2.62; Phemoglobin A1c level changes ranged from small to medium. The meta-regression analysis revealed a larger relative weight loss in dietitian-delivered interventions than in those delivered by nondietitians (full sample: -1.0 kg; US subsample: -2.4 kg), and did not find statistical evidence that the delivery channel was an important predictor of weight loss. The average cost per kilogram weight loss ranged from $34.06 over 6 months to $1,005.36 over 12 months. The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non

Can life coaching improve health outcomes?--A systematic review of intervention studies.

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Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming; Ehrensvärd, Martin; Carlsen, Ebbe B; Kofoed, Poul-Erik

2013-10-22

In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for an overview of the evidence regarding coaching interventions used in patient care, the effect of the interventions, and the quality of the studies published. However, in order to provide a clear definition of the coaching interventions selected for this review, we have found it necessary to distinguish between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were identified through systematic literature searches in PubMed, Embase, Psycinfo, and CINAHL. The quality of the methodology was independently assessed by three of the authors using a criteria list. A total of 4359 citations were identified in the electronic search and five studies were included; two of them were randomized controlled trials and met all quality criteria. The two studies investigating objective health outcomes (HbA1c) showed mixed but promising results, especially concerning the patient group that usually does not benefit from intensified interventions. Because of the very limited number of solid studies, this review can only present tendencies for patient outcomes and a preliminary description of an effective life coaching intervention.The coaching method used in these studies aims to improve self-efficacy and self-empowerment. This may explain why the studies including disadvantaged patients showed the most convincing results. The findings also indicate that some patients benefit from being met with an alternative approach and a different type of communication than they are used to

Intervention studies to foster resilience - A systematic review and proposal for a resilience framework in future intervention studies.

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Chmitorz, A; Kunzler, A; Helmreich, I; Tüscher, O; Kalisch, R; Kubiak, T; Wessa, M; Lieb, K

2018-02-01

Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major problems are the use of definitions of resilience as trait or a composite of resilience factors, the use of unsuited assessment instruments, and inappropriate study designs. To overcome these challenges, we propose 1) an outcome-oriented definition of resilience, 2) an outcome-oriented assessment of resilience as change in mental health in relation to stressor load, and 3) methodological standards for suitable study designs of future intervention studies. Our proposals may contribute to an improved quality of resilience intervention studies and may stimulate further progress in this growing research field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Long-term pain relief with optimized medical treatment including antioxidants and step-up interventional therapy in patients with chronic pancreatitis.

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Shalimar; Midha, Shallu; Hasan, Ajmal; Dhingra, Rajan; Garg, Pramod Kumar

2017-01-01

Abdominal pain is difficult to treat in patients with chronic pancreatitis (CP). Medical therapy including antioxidants has been shown to relieve pain of CP in the short-term. Our aim was to study the long-term results of optimized medical and interventional therapy for pain relief in patients with CP with a step-up approach. All consecutive patients with CP were included prospectively in the study. They were treated medically with a well-balanced diet, pancreatic enzymes, and antioxidants (9000 IU beta-carotene, 0.54 g vitamin C, 270 IU vitamin E, 600 µg organic selenium, and 2 g methionine). Endoscopic therapy and/or surgery were offered if medical therapy failed. Pain relief was the primary outcome measure. A total of 313 patients (mean age 26.16 ± 12.17; 244 males) with CP were included; 288 (92%) patients had abdominal pain. The etiology of CP was idiopathic in 224 (71.6%) and alcohol in 82 (26.2%). At 1-year follow-up, significant pain relief was achieved in 84.7% of patients: 52.1% with medical therapy, 16.7% with endoscopic therapy, 7.6% with surgery, and 8.3% spontaneously. The mean pain score decreased from 6.36 ± 1.92 to 1.62 ± 2.10 (P pain free at those follow-up periods. Significant pain relief is achieved in the majority of patients with optimized medical and interventional treatment. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Social marketing-based communications to integrate and support the HEALTHY study intervention

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DeBar, LL; Schneider, M; Ford, EG; Hernandez, AE; Showell, B; Drews, KL; Moe, EL; Gillis, B; Jessup, AN; Stadler, DD; White, M

2009-01-01

The HEALTHY study was a randomized, controlled, multicenter, middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Participants were a racially, ethnically and geographically diverse cohort from across the United States. Here, we describe the conceptual underpinnings and design of the social marketing-based communications component of the HEALTHY study intervention that combined changes in the school nutrition and physical education (PE) environment with behavior change initiatives. The communications intervention component coordinated multiple elements to deliver campaigns that served to integrate and support all aspects of the HEALTHY intervention. The campaigns unfolded across five semesters of middle school, each targeting a specific theme related to the HEALTHY objectives. Communications campaigns comprised (1) core elements such as branding, posters, banners and visual and verbal messaging, (2) student events supporting the nutrition, PE and behavior intervention components through the application of social marketing and communications strategies, including the incorporation of student-generated media and (3) distribution of premiums and theme enhancers to extend the visibility of the study beyond the intervention environment. Formative research conducted with students, parents and school administrators was used to refine the communications strategy. Student peer communicators selected from the student body were involved to influence the normative student environment. Marketing and creative design experts developed a brand, logo, activities and materials. In the latter half of the study, student-generated messages and media were used to reflect local interests and culture and enhance peer influence. The HEALTHY intervention delivery and impact were strengthened by the

Social marketing-based communications to integrate and support the HEALTHY study intervention.

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DeBar, L L; Schneider, M; Ford, E G; Hernandez, A E; Showell, B; Drews, K L; Moe, E L; Gillis, B; Jessup, A N; Stadler, D D; White, M

2009-08-01

The HEALTHY study was a randomized, controlled, multicenter, middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Participants were a racially, ethnically and geographically diverse cohort from across the United States. Here, we describe the conceptual underpinnings and design of the social marketing-based communications component of the HEALTHY study intervention that combined changes in the school nutrition and physical education (PE) environment with behavior change initiatives. The communications intervention component coordinated multiple elements to deliver campaigns that served to integrate and support all aspects of the HEALTHY intervention. The campaigns unfolded across five semesters of middle school, each targeting a specific theme related to the HEALTHY objectives. Communications campaigns comprised (1) core elements such as branding, posters, banners and visual and verbal messaging, (2) student events supporting the nutrition, PE and behavior intervention components through the application of social marketing and communications strategies, including the incorporation of student-generated media and (3) distribution of premiums and theme enhancers to extend the visibility of the study beyond the intervention environment. Formative research conducted with students, parents and school administrators was used to refine the communications strategy. Student peer communicators selected from the student body were involved to influence the normative student environment. Marketing and creative design experts developed a brand, logo, activities and materials. In the latter half of the study, student-generated messages and media were used to reflect local interests and culture and enhance peer influence. The HEALTHY intervention delivery and impact were strengthened by the

Development of an occupational advice intervention for patients undergoing lower limb arthroplasty (the OPAL study).

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Baker, Paul; Coole, Carol; Drummond, Avril; McDaid, Catriona; Khan, Sayeed; Thomson, Louise; Hewitt, Catherine; McNamara, Iain; McDonald, David; Fitch, Judith; Rangan, Amar

2018-06-28

There are an increasing number of patients of working age undergoing hip and knee replacements. Currently there is variation in the advice and support given about sickness absence, recovery to usual activities and return to work after these procedures. Earlier, sustainable, return to work improves the health of patients and benefits their employers and society. An intervention that encourages and supports early recovery to usual activities, including work, has the potential to reduce the health and socioeconomic burden of hip and knee replacements. A two-phase research programme delivered over 27 months will be used to develop and subsequently test the feasibility of an occupational advice intervention to facilitate return to work and usual activities in patients undergoing lower limb arthroplasty. The 2 phases will incorporate a six-stage intervention mapping process: Phase 1: Intervention mapping stages 1-3: 1 Needs assessment (including rapid evidence synthesis, prospective cohort analysis and structured stakeholder interviews) 2 Identification of intended outcomes and performance objectives 3 Selection of theory-based methods and practical strategies Phase 2: Intervention mapping stages 4-6: 4 Development of components and materials for the occupational advice intervention using a modified Delphi process 5 Adoption and implementation of the intervention 6 Evaluation and feasibility testing The study will be undertaken in four National Health Service (NHS) hospitals in the United Kingdom and two Higher Education Institutions. OPAL (Occupational advice for Patients undergoing Arthroplasty of the Lower limb) aims to develop an occupational advice intervention to support early recovery to usual activities including work, which is tailored to the requirements of patients undergoing hip and knee replacements. The developed intervention will then be assessed with a specific focus on evaluating its feasibility as a potential trial intervention to improve speed of

Internet-based recruitment to a depression prevention intervention: lessons from the Mood Memos study.

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Morgan, Amy Joanna; Jorm, Anthony Francis; Mackinnon, Andrew James

2013-02-12

Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions. To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned. Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations. The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards. Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable. ACTRN12609000925246.

Motivation for physical activity and exercise in severe mental illness: A systematic review of intervention studies.

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Farholm, Anders; Sørensen, Marit

2016-06-01

There has been increasing interest for research on motivation for physical activity (PA) and exercise among individuals with severe mental illness (SMI). The aim of this systematic review is to summarize findings from all intervention studies on PA or exercise that either include empirical data on motivational constructs or apply motivational techniques/theories in their intervention. Systematic searches of seven databases were conducted from database inception to February 2015. Studies were eligible if they: (i) included participants with SMI, (ii) had PA as part of the intervention, and (iii) reported empirical data on motivational constructs related to PA or incorporated motivational techniques/theory in their intervention. Of the 79 studies that met the inclusion criteria only one had motivation for PA as its main outcome. Nine additional interventions reported empirical data on motivational constructs. Altogether these studies yielded mixed results with respect to change in motivational constructs. Only one of those examined the association between motivation and PA, but found none. Sixty-four studies reported using motivational techniques/theory in their intervention. Motivational interviewing and goal-setting were the most popular techniques. Due to the exploratory nature of most of these studies, findings from intervention studies do not so far give very clear directions for motivational work with the patients. There is an urgent need for a more systematic theory based approach when developing strategies that target to increase engagement in PA among people with SMI. © 2016 Australian College of Mental Health Nurses Inc.

Increasing physical activity efficiently: an experimental pilot study of a website and mobile phone intervention.

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Thorsteinsen, Kjærsti; Vittersø, Joar; Svendsen, Gunnvald Bendix

2014-01-01

The main objective of this pilot study was to test the effectiveness of an online, interactive physical activity intervention that also incorporated gaming components. The intervention design included an activity planner, progress monitoring, and gamification components and used SMS text as a secondary delivery channel and feedback to improve engagement in the intervention content. Healthy adults (n = 21) recruited through ads in local newspapers (age 35-73) were randomized to the intervention or the control condition. Both groups reported physical activity using daily report forms in four registration weeks during the three-month study: only the experiment condition received access to the intervention. Analyses showed that the intervention group had significantly more minutes of physical activity in weeks five and nine. We also found a difference in the intensity of exercise in week five. Although the intervention group reported more minutes of physical activity at higher intensity levels, we were not able to find a significant effect at the end of the study period. In conclusion, this study adds to the research on the effectiveness of using the Internet and SMS text messages for delivering physical activity interventions and supports gamification as a viable intervention tool.

Randomized comparative efficacy study of parent-mediated interventions for toddlers with autism.

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Kasari, Connie; Gulsrud, Amanda; Paparella, Tanya; Hellemann, Gerhard; Berry, Kathleen

2015-06-01

This study compared effects of two parent-mediated interventions on joint engagement outcomes as augmentations of an early intervention program for toddlers with autism spectrum disorder (ASD). Participants included 86 toddlers (range 22-36 months) with ASD and their primary caregiver. Caregiver-child dyads were randomized to receive 10 weeks of hands-on parent training in a naturalistic, developmental behavioral intervention (joint attention, symbolic play, engagement and regulation-JASPER) or a parent-only psychoeducational intervention (PEI). Dose was controlled in terms of researcher-parent contact and early intervention services received by the child. Results yielded significant effects of the JASPER intervention on the primary outcome of joint engagement. The treatment effect was large (Cohen's f² = .69) and maintained over the 6-month follow-up. JASPER effects were also found on secondary outcomes of play diversity, highest play level achieved, and generalization to the child's classroom for child-initiated joint engagement. The PEI intervention was found to be effective in reducing parenting stress associated with child characteristics. All secondary effects were generally small to moderate. These data highlight the benefit of a brief, targeted, parent-mediated intervention on child outcomes. Future studies may consider the combination of JASPER and PEI treatments for optimal parent and child outcomes. Trial registry no. NCT00999778. (c) 2015 APA, all rights reserved).

Intervention study of needle stick injury in Iran

International Nuclear Information System (INIS)

Mobasherizadeh, Sina; Abne-Shahidi, Sayed A.; Mohammadi, Nazafarin A.; Abazari, Fereshteh

2005-01-01

Injury resulting from contaminated sharp devices among health care workers (HCWs) is one of the most important concerns in medical centers. This can lead to dangerous infections such as human immunodeficiency virus, hepatitis B virus and hepatitis C virus among such people. The documentation of needle stick injuries started in Sadi Hospital, Isfahan, Iran in 2003, and our objective was to study cases of injuries by sharp devices before and after the implementation of intervention methods. In an intervention survey of the type of before and after study, we studied injuries by needle and other sharp devices among 87 HCWs in Sadi Hospital, a private hospital in Isfahan, Iran, during the years 2003-2004. The groups under study were workers and paramedical staff; and the wards under study included surgery, internal, lab, x-ray and laundry. We entered and evaluated the data in SPSS software. In the first phase of the study in 2003, 55.2% of those injured had been injured by sharp devices. After intervention in 2004, this percentage was reduced to 19.5% (p < 0.05). At the beginning of the study, 26.4% of the injured had been injured by sharp devices more than twice, and at the end of the study this number was reduced to 2.3% (p < 0.05). Also, injuries resulting from recapping were 45.8% at the beginning of the study, which was reduced to 5.9% at the end (p < 0.05). With regard to this study and other studies carried out in other countries, a large number of injuries by contaminated sharp devices can be prevented by implementing suitable educational programs regarding disposal of sharp devices, and by using safe needle devices. (author)

Statistical analysis and application of quasi experiments to antimicrobial resistance intervention studies.

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Shardell, Michelle; Harris, Anthony D; El-Kamary, Samer S; Furuno, Jon P; Miller, Ram R; Perencevich, Eli N

2007-10-01

Quasi-experimental study designs are frequently used to assess interventions that aim to limit the emergence of antimicrobial-resistant pathogens. However, previous studies using these designs have often used suboptimal statistical methods, which may result in researchers making spurious conclusions. Methods used to analyze quasi-experimental data include 2-group tests, regression analysis, and time-series analysis, and they all have specific assumptions, data requirements, strengths, and limitations. An example of a hospital-based intervention to reduce methicillin-resistant Staphylococcus aureus infection rates and reduce overall length of stay is used to explore these methods.

Effects of a 2-year school-based daily physical activity intervention on cardiovascular disease risk factors: the Sogndal school-intervention study

DEFF Research Database (Denmark)

Resaland, G K; Anderssen, S A; Holme, I M

2011-01-01

at the I-school carried out 60 min of PA daily. The PA lessons were planned, organized and led by expert physical education (PE) teachers. In the C-school, children were offered the normal 45 min of PE twice weekly. The intervention resulted in a greater beneficial development in systolic (P=0......The aim of this study was to investigate the effect of a 2-year school-based physical activity (PA) intervention in 9-year-old children on cardiovascular disease (CVD) risk factors. One intervention school (I-school) (n=125) and one control school (C-school) (n=131) were included. The children...

Paediatric Early Warning Score - A multi-center randomized controlled intervention study

DEFF Research Database (Denmark)

Jensen, Claus Sixtus; Aagaard, Hanne; Olesen, Hanne Vebert

Paediatric Early Warning System on evolving critical illness and intervention in hospitalised children; a regional multicentre study on implementation of a Paediatric Early Warning System Background: Critical illness in the patient and death can potentially be predicted and prevented. Deterioration...... is critically ill are related to the child’s symptoms of serious illness often being uncharacteristic. Children can seem relatively unaffected until a short time before circulatory insufficiency and cardiac arrest. Thus, there is a need for developing and investigating if an Paediatric Early Warning System...... of the intervention and evaluation. The study involves all paediatric departments and some acute departments in Central Denmark Region. The project both includes quantitative studies and a qualitative evaluation study. The studies will have different designs: • Registry study - exploring and describing life...

A Nutrition Education Intervention Trial for Adolescent Girls in Isfahan: Study Design and Protocol

Directory of Open Access Journals (Sweden)

Morvarid Ghasab Shirazi

2016-11-01

Full Text Available BackgroundNutrition behaviors of adolescent girls is of serious health concerns. Although nutrition education interventions in Iran have met with some success, most of them could not promote nutrition behavioral changes. The aim of our study is to determine a school-based nutrition education intervention to improve adolescents’ nutrition behaviors and behavioral mediators based on the social cognitive theory (SCT.Materials and MethodsThis study is a single-blind randomized controlled trial. Eligible participants will be all student girls in grade 6 and 7, their parents and teachers in Isfahan governmental schools. This multi com­ponent school-based intervention include adolescents’ nutrition education package, parents’ nutrition massages, participatory homework, parents and teachers nutrition education package, supportive group, and collaboration with decision makers. Changing in nutrition behaviors including breakfast, fruit and vegetable, snack and fast food consumption will be examined, as primary outcome. Secondary outcome will be behavioral mediators such as knowledge, self-efficacy, intention, situation, self-regulation, social support, outcome expectations and expectancies, in adolescent girls. The outcomes will be assessed at baseline, and after 3 and 6-month follow-up.DiscussionThis study evaluates a school-based, guided SCT intervention, designed to improve healthy dietary behaviors, nutrition knowledge of adolescent girls. Few behavioral interventions have targeted this high-risk population in Iran. The intervention seems to be promising and has the potential to bridge the gap of the limited program outcomes of nutrition education in Iranian adolescents.

Publication bias in studies of an applied behavior-analytic intervention: an initial analysis.

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Sham, Elyssa; Smith, Tristram

2014-01-01

Publication bias arises when studies with favorable results are more likely to be reported than are studies with null findings. If this bias occurs in studies with single-subject experimental designs(SSEDs) on applied behavior-analytic (ABA) interventions, it could lead to exaggerated estimates of intervention effects. Therefore, we conducted an initial test of bias by comparing effect sizes, measured by percentage of nonoverlapping data (PND), in published SSED studies (n=21) and unpublished dissertations (n=10) on 1 well-established intervention for children with autism, pivotal response treatment (PRT). Although published and unpublished studies had similar methodologies, the mean PND in published studies was 22% higher than in unpublished studies, 95% confidence interval (4%, 38%). Even when unpublished studies are included, PRT appeared to be effective (PNDM=62%). Nevertheless, the disparity between published and unpublished studies suggests a need for further assessment of publication bias in the ABA literature.

Workplace health interventions in small enterprises: a Swedish longitudinal study.

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Vinberg, Stig

2008-01-01

This article has a two-fold approach. First, it investigates relationships between work organizational factors, and health and performance outcomes. Second, it compares two change strategy approaches in workplace health interventions by studying changes of these factors and outcomes. The sample consisted of ten Swedish small enterprises including 102 individuals, who answered a before and after questionnaire about organizational factors and outcomes. The leaders were interviewed and answered a questionnaire about performed workplace health interventions. Statistical methods used were reliability tests, correlation analyses and t-tests. Results indicate rather strong links between indicators of respectful leadership, creative work and team spirit, and the outcome indicators self-assessed health and judged workplace adaptability in association with customer satisfaction. The results concerning changes of determinants and outcomes (after workplace health interventions) showed significant differences between enterprises using a broad change strategy and those using an expert/problem-based strategy with the former having more favourable results. The leader interview results also point at obstacles concerning workplace change processes as lack of resources, insufficient competence and influence of external factors. The study results suggest that work organizational factors and integrated models for workplace health intervention are of importance for health and performance outcomes in small enterprises.

Lay health workers perceptions of an anemia control intervention in Karnataka, India: a qualitative study.

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Shet, Arun S; Rao, Abha; Jebaraj, Paul; Mascarenhas, Maya; Zwarenstein, Merrick; Galanti, Maria Rosaria; Atkins, Salla

2017-09-18

Lay health workers (LHWs) are increasingly used to complement health services internationally. Their perceptions of the interventions they implement and their experiences in delivering community based interventions in India have been infrequently studied. We developed a novel LHW led intervention to improve anemia cure rates in rural community dwelling children attending village day care centers in South India. Since the intervention is delivered by the village day care center LHW, we sought to understand participating LHWs' acceptance of and perspectives regarding the intervention, particularly in relation to factors affecting daily implementation. We conducted a qualitative study alongside a cluster randomized controlled trial evaluating a complex community intervention for childhood anemia control in Karnataka, South India. Focus group discussions (FGDs) were conducted with trained LHWs assigned to deliver the educational intervention. These were complemented by non-participant observations of LHWs delivering the intervention. Transcripts of the FGDs were translated and analyzed using the framework analysis method. Several factors made the intervention acceptable to the LHWs and facilitated its implementation including pre-implementation training modules, intervention simplicity, and ability to incorporate the intervention into the routine work schedule. LHWs felt that the intervention impacted negatively on their preexisting workload. Fluctuating relationships with mothers weakened the LHWs position as providers of the intervention and hampered efficient implementation, despite the LHWs' highly valued position in the community. Modifiable barriers to the successful implementation of this intervention were seen at two levels. At a broader contextual level, hindering factors included the LHW being overburdened, inadequately reimbursed, and receiving insufficient employer support. At the health system level, lack of streamlining of LHW duties, inability of LHWs to

Internet-Based Recruitment to a Depression Prevention Intervention: Lessons From the Mood Memos Study

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Jorm, Anthony Francis; Mackinnon, Andrew James

2013-01-01

Background Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions. Objective To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned. Methods Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations. Results The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards. Conclusions Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable. Trial Registration ACTRN

Increasing Physical Activity Efficiently: An Experimental Pilot Study of a Website and Mobile Phone Intervention

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Kjærsti Thorsteinsen

2014-01-01

Full Text Available The main objective of this pilot study was to test the effectiveness of an online, interactive physical activity intervention that also incorporated gaming components. The intervention design included an activity planner, progress monitoring, and gamification components and used SMS text as a secondary delivery channel and feedback to improve engagement in the intervention content. Healthy adults (n=21 recruited through ads in local newspapers (age 35–73 were randomized to the intervention or the control condition. Both groups reported physical activity using daily report forms in four registration weeks during the three-month study: only the experiment condition received access to the intervention. Analyses showed that the intervention group had significantly more minutes of physical activity in weeks five and nine. We also found a difference in the intensity of exercise in week five. Although the intervention group reported more minutes of physical activity at higher intensity levels, we were not able to find a significant effect at the end of the study period. In conclusion, this study adds to the research on the effectiveness of using the Internet and SMS text messages for delivering physical activity interventions and supports gamification as a viable intervention tool.

Qualitative "trial-sibling" studies and "unrelated" qualitative studies contributed to complex intervention reviews.

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Noyes, Jane; Hendry, Margaret; Lewin, Simon; Glenton, Claire; Chandler, Jackie; Rashidian, Arash

2016-06-01

To compare the contribution of "trial-sibling" and "unrelated" qualitative studies in complex intervention reviews. Researchers are using qualitative "trial-sibling" studies undertaken alongside trials to provide explanations to understand complex interventions. In the absence of qualitative "trial-sibling" studies, it is not known if qualitative studies "unrelated" to trials are helpful. Trials, "trial-sibling," and "unrelated" qualitative studies looking at three health system interventions were identified. We looked for similarities and differences between the two types of qualitative studies, such as participants, intervention delivery, context, study quality and reporting, and contribution to understanding trial results. Reporting was generally poor in both qualitative study types. We detected no substantial differences in participant characteristics. Interventions in qualitative "trial-sibling" studies were delivered using standardized protocols, whereas interventions in "unrelated" qualitative studies were delivered in routine care. Qualitative "trial-sibling" studies alone provided insufficient data to develop meaningful transferrable explanations beyond the trial context, and their limited focus on immediate implementation did not address all phenomena of interest. Together, "trial-sibling" and "unrelated" qualitative studies provided larger, richer data sets across contexts to better understand the phenomena of interest. Findings support inclusion of "trial-sibling" and "unrelated" qualitative studies to explore complexity in complex intervention reviews. Copyright © 2016 Elsevier Inc. All rights reserved.

Ergonomics intervention to reduce musculoskeletal disorders: case study in cement company production

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Abbas Moradi

2016-09-01

Full Text Available Introduction:Musculoskeletal Disorders (MSDs are one of the most important factors occupational injuries and disabilities in workplaces. The aim of the persent study was ergonomics intervention to reducemusculoskeletal disorders. Methods: This interventional study was conduct on 126 preservation and maintenance  workers in cement company by classfication sampling. The Nordic Musculoskeletal Disorders Questionnaire, QEC and Ergonomics Checkpoint methods were used to collected data before and after the interventions. The interventional program include practical and easy to implment solutions for improvement safety,health and work conditions, workers trainig, selective and corrective exer Data  were analyzed by Mcnemar test using SPSS_22 software. Result: Data analysis showed  significant differences(P_value<0.001 between prevalnce of disorders during one week before interventions.  for lower back,back and were 62.70%, 60.32% and after intervention were reduce  to 46.03% and 43.65%. Conclusion: Acoording  to QEC method, 83 maintenance  workers ( 65.87% were at high risk  and prevalence  of lower back and knee was high that applying of  simple  and inexpensive solutions, participatory solutions of Ergonomics Checkpoint andselective corrective exerciselead to  musculoskeletal disorders reduction.

Efficacy of behavioural interventions for transport behaviour change: systematic review, meta-analysis and intervention coding.

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Arnott, Bronia; Rehackova, Lucia; Errington, Linda; Sniehotta, Falko F; Roberts, Jennifer; Araujo-Soares, Vera

2014-11-28

Reducing reliance on motorised transport and increasing use of more physically active modes of travel may offer an opportunity to address physical inactivity. This review evaluates the evidence for the effects of behavioural interventions to reduce car use for journeys made by adults and codes intervention development and content. The review follows the procedure stated in the registration protocol published in the PROSPERO database (registration number CRD42011001797). Controlled studies evaluating behavioural interventions to reduce car use compared with no interventions or alternative interventions on outcome measures of transport behaviours taken in adult participants are included in this review. Searches were conducted on all records in Applied Social Sciences Index and Abstracts (ASSIA), Ovid Embase, Ovid Medline, Ovid PsycInfo, Scopus, Sociological Abstracts, Transportation Research Information Service (TRIS), Transportation Research International Documentation (TRID), and Web of Science databases. Peer reviewed publications in English language meeting the inclusion criteria are eligible. Methodological quality is assessed using the Cochrane Risk of Bias Tool. Interventions are categorised in terms of behavioural frameworks, theories and techniques. 15 full text articles are included, representing 13 unique studies, with 4895 participants and 27 intervention arms. Risk of bias across the review is appraised as considerable due to the unclear methodological quality of individual studies. Heterogeneity of included studies is considerable. Meta-analyses reveal no significant effect on reduction of frequency of car use or on increasing the proportion of journeys by alternative, more active modes of transport. There is insufficient data relating to alternative outcomes such as distance and duration which may have important health implications. Interventions were top-down but could not be described as theory-based. Intervention efficacy was associated with the use

A childhood obesity prevention programme in Barcelona (POIBA Project): Study protocol of the intervention

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Sánchez-Martínez, Francesca; Juárez, Olga; Serral, Gemma; Valmayor, Sara; Puigpinós, Rosa; Pasarín, María Isabel; Díez, Élia; Ariza, Carles

2018-01-01

Background Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-olds. Design and methods Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children’s eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. Expected impact for public health It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent. Significance for public health Overweight and obesity are a major public health concern that predispose affected individuals to the development of chronic diseases. Of importance, obesity is more common among

Collaborative, individualised lifestyle interventions are acceptable to people with first episode psychosis; a qualitative study.

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Pedley, Rebecca; Lovell, Karina; Bee, Penny; Bradshaw, Tim; Gellatly, Judith; Ward, Kate; Woodham, Adrine; Wearden, Alison

2018-04-25

The adverse impact of unhealthy lifestyle choices and the prescription of antipsychotic medications contribute to weight gain, poor cardiovascular health and reduced life expectancy for people with psychosis. The present study aimed to explore the acceptability and perceived outcomes of a lifestyle intervention designed to prevent or reduce weight gain in people with first-episode psychosis. This was a qualitative study using a data-driven approach. People recovering from first-episode psychosis recruited from UK early intervention services and taking part in the active arm of a randomised controlled trial of a lifestyle intervention (the InterACT trial), were interviewed using a semi-structured interview schedule. Interviews were transcribed verbatim and analysed using Framework Analysis. Participants valued the collaborative and individualised approach taken by the intervention deliverers, and formed high quality relationships with them. Aspects of the intervention that were positively appraised included goal setting, social opportunities, and progress monitoring. Benefits of the intervention, including increased levels of exercise; improved diet and physical health; increased psychological wellbeing (e.g. confidence, self-esteem); and improved social relationships, were identified by participants, independent of actual weight loss. Future interventions should ensure that workers have the skills to form high quality relationships with users, and to individualise the intervention according to users' needs and preferences. Future trials that test healthy living interventions should consider supplementing physical outcome measures with wider psychosocial outcome assessments, in particular social relationship quality, psychological wellbeing, self-esteem and self-efficacy. Current Controlled Trials: ISRCTN22581937 . Date of registration: 27 October 2010 (retrospectively registered).

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).

A search strategy for occupational health intervention studies

NARCIS (Netherlands)

Verbeek, J.; Salmi, J.; Pasternack, I.; Jauhiainen, M.; Laamanen, I.; Schaafsma, F.; Hulshof, C.; van Dijk, F.

2005-01-01

As a result of low numbers and diversity in study type, occupational health intervention studies are not easy to locate in electronic literature databases. To develop a search strategy that facilitates finding occupational health intervention studies in Medline, both for researchers and

The coaching on lifestyle (CooL) intervention for obesity, a study protocol for an action-oriented mixed-methods study.

Science.gov (United States)

van Rinsum, Celeste E; Gerards, Sanne M P L; Rutten, Geert M; van de Goor, Ien A M; Kremers, Stef P J

2018-01-08

Combined lifestyle interventions (CLIs) have proved to be effective in changing and maintaining behavioural lifestyle changes and reducing overweight and obesity, in clinical and real-world settings. In this CLI, lifestyle coaches are expected to promote lifestyle changes of participants regarding physical activity and diet. In the Coaching on Lifestyle (CooL) intervention, which takes a period of 8 to 10 months, lifestyle coaches counsel adults and children aged 4 years and older (and their parents) who are obese or are overweight with an increased risk of developing cardiovascular diseases or type II diabetes. In group and individual sessions, themes such as physical activity, dietary behaviours, sleep and stress are addressed. The aim of the present study is to monitor the implementation process of the CooL intervention and to examine how the lifestyle coaches contribute to a healthier lifestyle of the participants. This action-oriented study involves monitoring the implementation process of the CooL intervention and examining the lifestyle changes achieved by participants over time, in a one-group pre-post design using mixed methods. Methods include semi-structured interviews, observations, document analysis, biomedical parameters and questionnaires. The added value of the CooL study lies in its action-oriented approach and the use of mixed methods, including both qualitative and quantitative research methods. The long-term coaching used in the CooL intervention is expected to have beneficial effects on sustained lifestyle changes. NTR6208 ; date registered: 13-01-2017.

Fostering Scientific Reasoning in Education--Meta-Analytic Evidence from Intervention Studies

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Engelmann, Katharina; Neuhaus, Birgit J.; Fischer, Frank

2016-01-01

Scientific reasoning skills are not just for researchers, they are also increasingly relevant for making informed decisions in our everyday lives. How can these skills be facilitated? The current state of research on supporting scientific reasoning includes intervention studies but lacks an integrated analysis of the approaches to foster…

Developing a Hypnotic Relaxation Intervention to Improve Body Image: A Feasibility Study.

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Cieslak, Alison; Elkins, Gary; Banerjee, Tanima; Marsack, Jessica; Hickman, Kimberly; Johnson, Alisa; Henry, Norah; Barton, Debra

2016-11-01

To determine the content, feasibility, and best outcome of a mind-body intervention involving self-directed hypnotic relaxation to target body image.
. A five-week, uncontrolled, unblinded feasibility intervention study.
. Behavioral therapy offices in Ann Arbor, Michigan, and Waco, Texas.
. 10 female breast cancer survivors and 1 breast and gynecologic cancer survivor. 
. Adult women with a history of breast and gynecologic cancer and no major psychiatric history were eligible. The intervention included four face-to-face sessions with a research therapist lasting 40-60 minutes, logged home practice, one telephone check-in call at week 5, and one intervention feedback telephone call to complete the study. Descriptive statistics and paired t-tests were used to test feasibility and content validity.
. Stress from body changes as measured by the Impact of Treatment Scale, sexual function as measured by the Female Sexual Function Index, and sexual self-image as measured by the Sexual Self-Schema Scale for women were the variables of interest.
. The intervention content was confirmed. Changes in scores from the baseline to week 5 suggested that stress from body changes decreased and sexual self-schema and function improved during the intervention. Nine of the 11 women were satisfied with the intervention, and all 11 indicated that their body image improved. 
. Hypnotic relaxation therapy shows promise for improving body image and, in doing so, improving sexual health in this population. Additional testing of this intervention is warranted.
. Hypnotic relaxation therapy is feasible to improve body image and sexual health in women diagnosed with cancer and may be an important intervention that could be offered by nurses and other behavioral therapists.

A systematic review of studies evaluating diffusion and dissemination of selected cancer control interventions.

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Ellis, Peter; Robinson, Paula; Ciliska, Donna; Armour, Tanya; Brouwers, Melissa; O'Brien, Mary Ann; Sussman, Jonathan; Raina, Parminder

2005-09-01

With this review, the authors sought to determine what strategies have been evaluated (including the outcomes assessed) to disseminate cancer control interventions that promote the uptake of behavior change. Five topic areas along the cancer care continuum (smoking cessation, healthy diet, mammography, cervical cancer screening, and control of cancer pain) were selected to be representative. A systematic review was conducted of primary studies evaluating dissemination of a cancer control intervention. Thirty-one studies were identified that evaluated dissemination strategies in the 5 topic areas. No strong evidence currently exists to recommend any one dissemination strategy as effective in promoting the uptake of cancer control interventions. The authors conclude that there is a strong need for more research into dissemination of cancer control interventions. Future research should consider methodological issues such as the most appropriate study design and outcomes to be evaluated. (c) 2005 APA, all rights reserved

The use and utility of specific nonpharmacological interventions for behavioral symptoms in dementia: an exploratory study.

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Cohen-Mansfield, Jiska; Marx, Marcia S; Dakheel-Ali, Maha; Thein, Khin

2015-02-01

This study compares different nonpharmacological interventions for persons with behavioral symptoms and dementia on frequency of use and perceived efficacy in terms of change in behavior and interest. Participants were 89 nursing home residents from six Maryland nursing homes with a mean age of 85.9 years (SD: 8.6 years). Research assistants presented interventions tailored to the participants' needs and preferences in a pre-intervention trial phase and in an intervention phase. The impact of each intervention on behavioral symptoms and on the person's interest was rated immediately after the intervention by a research assistant. The most utilized interventions in both trial and treatment phases were the social intervention of one-on-one interaction, simulated social interventions such as a lifelike doll and respite video, the theme intervention of magazine, and the sensory stimulation intervention of music. In contrast, the least utilized interventions in both phases were sewing, fabric book, and flower arrangement. Interventions with the highest impact on behavioral symptoms included one-on-one social interaction, hand massage, music, video, care, and folding towels. Other high impact interventions included walking, going outside, flower arranging, food or drink, sewing, group activity, book presentation, ball toss, coloring or painting, walking, and family video. The results provide initial directions for choosing specific interventions for persons with dementia and also demonstrate a methodology for increasing knowledge through ongoing monitoring of practice. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Healthcare professionals and managers' participation in developing an intervention: A pre-intervention study in the elderly care context

Directory of Open Access Journals (Sweden)

Bergman Howard

2009-04-01

Full Text Available Abstract Background In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention. As part of a project to develop an intervention aimed at improving care for the elderly in France, a pre-intervention study was conducted to systematically gather data on the current practices, issues, and expectations of healthcare professionals and managers in order to determine the defining features of a successful intervention. Methods A qualitative study was carried out from 2004 to 2006 using a grounded theory approach and involving a purposeful sample of 56 healthcare professionals and managers in Paris, France. Four sources of evidence were used: interviews, focus groups, observation, and documentation. Results The stepwise approach comprised three phases, and each provided specific results. In the first step of the pre-intervention study, we gathered data on practices, perceived issues, and expectations of healthcare professionals and managers. The second step involved holding focus groups in order to define the characteristics of a tailor-made intervention. The third step allowed validation of the findings. Using this approach, we were able to design and develop an intervention in elderly care that met the professionals' and managers' expectations. Conclusion This article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the

Characteristics of effective interventions supporting quality pain management in Australian emergency departments: an exploratory study.

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Shaban, Ramon Z; Holzhauser, Kerri; Gillespie, Kerri; Huckson, Sue; Bennetts, Scott

2012-02-01

It is well established that pain is the most common presenting complaint in Emergency Departments. Despite great improvements in available pain management strategies, patients are left waiting for longer than 60min for pain relief on arrival to the emergency department. The aim of this study was to describe interventions that lead to successful implementation of the National Health and Medical Research Council approved guidelines Acute Pain Management: Scientific Evidence (2nd Edition) that include specific recommendations for best practice pain management. A two-phased, mixed-method, exploratory study of all 52 Australian hospital emergency departments participating in the National Emergency Care Pain Management Initiative incorporating interview and document analysis was undertaken. Interventions used by clinicians to improve pain management included nurse initiated analgesia, intranasal fentanyl for paediatric patients and lignocaine, and facio illiaca block. Education formed a major part of the intervention and the development of a working group of key stakeholders was critical in the successful implementation of change. Staff perceptions of patients' pain level and attitudes toward pain assessment and pain management were identified as barriers. This study highlighted how an effective framework to plan and implement practice change and tailored interventions, including education and training systems and products using the best available evidence, best equipped clinicians to manage pain in the ED. Copyright © 2011 College of Emergency Nursing Australasia Ltd. All rights reserved.

The importance of context in early autism intervention: A qualitative South African study.

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Guler, Jessy; de Vries, Petrus J; Seris, Noleen; Shabalala, Nokuthula; Franz, Lauren

2017-09-01

The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.

Conducting Accessible Research: Including People With Disabilities in Public Health, Epidemiological, and Outcomes Studies.

Science.gov (United States)

Rios, Dianne; Magasi, Susan; Novak, Catherine; Harniss, Mark

2016-12-01

People with disabilities are largely absent from mainstream health research. Exclusion of people with disabilities may be explicit, attributable to poorly justified exclusion criteria, or implicit, attributable to inaccessible study documents, interventions, or research measures. Meanwhile, people with disabilities experience poorer health, greater incidence of chronic conditions, and higher health care expenditure than people without disabilities. We outline our approach to "accessible research design"-research accessible to and inclusive of people with disabilities. We describe a model that includes 3 tiers: universal design, accommodations, and modifications. Through our work on several large-scale research studies, we provide pragmatic examples of accessible research design. Making efforts to include people with disabilities in public health, epidemiological, and outcomes studies will enhance the interpretability of findings for a significant patient population.

The effects of the Odense Overweight Intervention Study

DEFF Research Database (Denmark)

Larsen, Kristian Traberg; Huang, Tao; Ried-Larsen, Mathias

of the DCIA in BMI z-score, clustered risk z-score, systolic blood pressure, abdominal fat-%, waist circumference, cardiorespiratory fitness, and total cholesterol/HDL ratio. In body fat-%, waist circumference and triglycerides, there is only a significant group difference at 6 weeks and not at 52 weeks......Aim: The primary aim of the study is to evaluate the effect of the Odense Overweight Intervention Study on BMI development. Methods: The OOIS is a semi-blinded randomized controlled trial with three measurement occasions. Participants were allocated into two intervention arms; a day camp...... intervention arm (DCIA) and a standard intervention arm (SIA). For the DCIA the camp lasted for six weeks and consisted of fun-based physical activities, healthy eating, and health classes. The following 10 months a family based intervention was accomplished. The SIA was offered a weekly activity session...

THE IMPORTANCE OF STRUCTURED TEXT TALKS FOR STUDENTS’ READING COMPREHENSION AN INTERVENTION STUDY IN SPECIAL SCHOOLS

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Monica REICHENBERG

2014-09-01

Full Text Available The present intervention study reveals that students diagnosed with an intellectual disability (ID are able to construct meaning from written expository text through guided social interaction. There were 31 students recruited from four special schools participating in this intervention study.The study involves a pre-test phase and a post-test phase. The students were divided into two intervention conditions: (a reciprocal teaching (RT, which involved practice in four reading strategies—prediction, question generating, clarification, and summarisation—and (b inference training (IT, which involved practice in answering inference questions, i.e., where you have to read between the lines to find the answer. The training included 16 sessions over 8 weeks. Pre- testing and post-testing included seven tests. Improvement of test results was obtained in both conditions to about the same extent, indicating that both conditions were beneficial.

The Reversal Intervention for Metabolic Syndrome (TRIMS study: rationale, design, and baseline data

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Troughton Jacqui

2011-05-01

Full Text Available Abstract Background Recent attention has focused on strategies to combat the forecast epidemic of type-2 diabetes (T2DM and its major vascular sequelae. Metabolic syndrome (MetS comprises a constellation of factors that increase the risk of cardiovascular disease (CVD and T2DM. Our study aims to develop a structured self-management education programme for people with MetS, which includes management of cardiovascular and diabetes risk factors, and to determine its impact. This paper describes the rationale and design of the TRIMS study, including intervention development, and presents baseline data. Methods Subjects recruited from a mixed-ethnic population with MetS were randomised to intervention or control arms. The intervention arm received structured group education based on robust psychological theories and current evidence. The control group received routine care. Follow-up data will be collected at 6 and 12 months. The primary outcome measure will be reversal of metabolic syndrome in the intervention group subjects compared to controls at 12 months follow-up. Results 82 participants (44% male, 22% South Asian were recruited between November 2009 and July 2010. Baseline characteristics were similar for both the intervention (n = 42 and control groups (n = 40. Median age was 63 years (IQR 57 - 67, mean waist size 106 cm (SD ± 11, and prescribing of statins and anti-hypertensives was 51% in each case. Conclusion Results will provide information on changes in diabetes and CVD risk factors and help to inform primary prevention strategies in people with MetS from varied ethnic backgrounds who are at high risk of developing T2DM and CVD. Information gathered in relation to the programme's acceptability and effectiveness in a multi-ethnic population would ensure that our results are widely applicable. Trial registration The study is registered at ClinicalTrials.gov, study identifier: NCT01043770.

Effect of nurse-led medication reviews in psychiatric patients - an interventional study

DEFF Research Database (Denmark)

Sørensen, Ann Lykkegaard; Mainz, Jan; Poulsen, Birgitte Klindt

will contribute with information regarding the effect of pharmacological training of nurses and possibly improve medication safety for psychiatric patients. Results from this study could serve as evidence, when hospital management makes decisions on how to accede the need for medication reviews as part...... nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology...... and conducting systematic medication reviews using computer based screening. The effect is evaluated in a controlled interventional study. METHODS: An interventional study including 2 acute psychiatric wards. In one ward nurses’ will receive pharmacological training and the other ward will function as a control...

Evaluating clinical and public health interventions: a practical guide to study design and statistics

National Research Council Canada - National Science Library

Katz, Mitchell H

2010-01-01

... and observational studies. In addition to reviewing standard statistical analysis, the book has easy-to-follow explanations of cutting edge techniques for evaluating interventions, including propensity score analysis...

Web-Based Alcohol Intervention: Study of Systematic Attrition of Heavy Drinkers.

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Radtke, Theda; Ostergaard, Mathias; Cooke, Richard; Scholz, Urte

2017-06-28

Web-based alcohol interventions are a promising way to reduce alcohol consumption because of their anonymity and the possibility of reaching a high numbers of individuals including heavy drinkers. However, Web-based interventions are often characterized by high rates of attrition. To date, very few studies have investigated whether individuals with higher alcohol consumption show higher attrition rates in Web-based alcohol interventions as compared with individuals with lower alcohol consumption. The aim of this study was to examine the attrition rate and predictors of attrition in a Web-based intervention study on alcohol consumption. The analysis of the predictors of attrition rate was performed on data collected in a Web-based randomized control trial. Data collection took place at the University of Konstanz, Germany. A total of 898 people, which consisted of 46.8% males (420/898) and 53.2% females (478/898) with a mean age of 23.57 years (SD 5.19), initially volunteered to participate in a Web-based intervention study to reduce alcohol consumption. Out of the sample, 86.9% (781/898) were students. Participants were classified as non-completers (439/898, 48.9%) if they did not complete the Web-based intervention. Potential predictors of attrition were self-reported: alcohol consumption in the last seven days, per week, from Monday to Thursday, on weekends, excessive drinking behavior measured with the Alcohol Use Disorder Identification Test (AUDIT), and drinking motives measured by the Drinking Motive Questionnaire (DMQ-R SF). Significant differences between completers and non-completers emerged regarding alcohol consumption in the last seven days (B=-.02, P=.05, 95% CI [0.97-1.00]), on weekends (B=-.05, P=.003, 95% CI [0.92-0.98]), the AUDIT (B=-.06, P=.007, 95% CI [0.90-0.98], and the status as a student (B=.72, P=.001, 95% CI [1.35-3.11]). Most importantly, non-completers had a significantly higher alcohol consumption compared with completers. Hazardous

Including health economic analysis in pilot studies: lessons learned from a cost-utility analysis within the PROSPECTIV pilot study

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Richéal M. Burns

2017-07-01

Full Text Available PurposeTo assess feasibility and health economic benefits and costs as part of a pilot study for a nurse-led, psychoeducational intervention (NPLI for prostate cancer in order to understand the potential for cost effectiveness as well as contribute to the design of a larger scale trial.MethodsMen with stable prostate cancer post-treatment were recruited from two cancer centres in the UK. Eighty-three men were randomised to the NLPI plus usual care or usual care alone (UCA (42 NLPI and 41 UCA; the NLPI plus usual care was delivered in the primary-care setting (the intervention and included an initial face-to-face consultation with a trained nurse, with follow-up tailored to individual needs. The study afforded the opportunity to undertake a short-term within pilot analysis. The primary outcome measure for the economic evaluation was quality of life, as measured by the EuroQol five dimensions questionnaire (EQ-5D (EQ-5D-5L instrument. Costs (£2014 assessed included health-service resource use, out-of-pocket expenses and losses from inability to undertake usual activities.ResultsTotal and incremental costs varied across the different scenarios assessed, with mean cost differences ranging from £173 to £346; incremental effect, as measured by the change in utility scores over the duration of follow-up, exhibited wide confidence intervals highlighting inconclusive effectiveness (95% CI: -0.0226; 0.0438. The cost per patient of delivery of the intervention would be reduced if rolled out to a larger patient cohort.ConclusionsThe NLPI is potentially cost saving depending on the scale of delivery; however, the results presented are not considered generalisable.

A Problem Solving Intervention for hospice caregivers: a pilot study.

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Demiris, George; Oliver, Debra Parker; Washington, Karla; Fruehling, Lynne Thomas; Haggarty-Robbins, Donna; Doorenbos, Ardith; Wechkin, Hope; Berry, Donna

2010-08-01

The Problem Solving Intervention (PSI) is a structured, cognitive-behavioral intervention that provides people with problem-solving coping skills to help them face major negative life events and daily challenges. PSI has been applied to numerous settings but remains largely unexplored in the hospice setting. The aim of this pilot study was to demonstrate the feasibility of PSI targeting informal caregivers of hospice patients. We enrolled hospice caregivers who were receiving outpatient services from two hospice agencies. The intervention included three visits by a research team member. The agenda for each visit was informed by the problem-solving theoretical framework and was customized based on the most pressing problems identified by the caregivers. We enrolled 29 caregivers. Patient's pain was the most frequently identified problem. On average, caregivers reported a higher quality of life and lower level of anxiety postintervention than at baseline. An examination of the caregiver reaction assessment showed an increase of positive esteem average and a decrease of the average value of lack of family support, impact on finances, impact on schedules, and on health. After completing the intervention, caregivers reported lower levels of anxiety, improved problem solving skills, and a reduced negative impact of caregiving. Furthermore, caregivers reported high levels of satisfaction with the intervention, perceiving it as a platform to articulate their challenges and develop a plan to address them. Findings demonstrate the value of problem solving as a psycho-educational intervention in the hospice setting and call for further research in this area.

Interventions performed by community pharmacists in one Canadian province: a cross-sectional study.

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Young, Stephanie W; Bishop, Lisa D; Conway, Amy

2012-01-01

Interventions made by pharmacists to resolve issues when filling a prescription ensure the quality, safety, and efficacy of medication therapy for patients. The purpose of this study was to provide a current estimate of the number and types of interventions performed by community pharmacists during processing of prescriptions. This baseline data will provide insight into the factors influencing current practice and areas where pharmacists can redefine and expand their role. A cross-sectional study of community pharmacist interventions was completed. Participants included third-year pharmacy students and their pharmacist preceptor as a data collection team. The team identified all interventions on prescriptions during the hours worked together over a 7-day consecutive period. Full ethics approval was obtained. Nine student-pharmacist pairs submitted data from nine pharmacies in rural (n = 3) and urban (n = 6) centers. A total of 125 interventions were documented for 106 patients, with a mean intervention rate of 2.8%. The patients were 48% male, were mostly ≥18 years of age (94%), and 86% had either public or private insurance. Over three-quarters of the interventions (77%) were on new prescriptions. The top four types of problems requiring intervention were related to prescription insurance coverage (18%), drug product not available (16%), dosage too low (16%), and missing prescription information (15%). The prescriber was contacted for 69% of the interventions. Seventy-two percent of prescriptions were changed and by the end of the data collection period, 89% of the problems were resolved. Community pharmacists are impacting the care of patients by identifying and resolving problems with prescriptions. Many of the issues identified in this study were related to correcting administrative or technical issues, potentially limiting the time pharmacists can spend on patient-focused activities.

Developing Pedagogical Content Knowledge: Lessons Learned from Intervention Studies

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Marie Evens

2015-01-01

Full Text Available Pedagogical content knowledge (PCK is generally accepted as positively impacting teaching quality and student learning. Therefore, research on PCK development in (prospective teachers is highly relevant. Based on a search in three databases (ERIC, PsycInfo, and Web of Science, a systematic review is conducted on intervention studies aiming at PCK development. The research questions are threefold: (1 How are the studies designed? (2 How are the interventions designed? and (3 What elements of interventions contribute to PCK development? The results show that most intervention studies are conducted in math and science education and use a qualitative methodology. Reflection, PCK courses, contact with other teachers, and experiences in educational practice are typically part of effective interventions. The review enables the identification of clear guidelines that may strengthen future research on stimulating PCK.

Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study.

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Song, Fujian; Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

2011-08-16

To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. The study included 112 independent trial networks (including 1552 trials with 478,775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence.

Limitations of studies on school-based nutrition education interventions for obesity in China: a systematic review and meta-analysis.

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Kong, Kaimeng; Liu, Jie; Tao, Yexuan

2016-01-01

School-based nutrition education has been widely implemented in recent years to fight the increasing prevalence of childhood obesity in China. A comprehensive literature search was performed using six databases to identify studies of school-based nutrition education interventions in China. The methodological quality and the risk of bias of selected literature were evaluated. Stratified analysis was performed to identify whether different methodologies influenced the estimated effect of the intervention. Seventeen articles were included in the analysis. Several of the included studies had inadequate intervention duration, inappropriate randomization methods, selection bias, unbalanced baseline characteristics between control and intervention groups, and absent sample size calculation. Overall, the studies showed no significant impact of nutrition education on obesity (OR=0.76; 95% CI=0.55-1.05; p=0.09). This can be compared with an OR of 0.68 for interventions aimed at preventing malnutrition and an OR of 0.49 for interventions aimed at preventing iron-deficiency anemia. When studies with unbalanced baseline characteristics between groups and selection bias in the study subjects were excluded, the impact of nutrition education on obesity was significant (OR=0.73; 95% CI=0.55-0.98; p=0.003). An analysis stratified according to the duration of intervention revealed that the intervention was effective only when it lasted for more than 2 years (OR=0.49, 95% CI=0.42-0.58; pnutrition education programs in China have some important limitations that might affect the estimated effectiveness of the intervention.

Increasing adolescents' depth of understanding of cross-curriculum words: an intervention study.

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Spencer, Sarah; Clegg, Judy; Lowe, Hilary; Stackhouse, Joy

2017-09-01

There is some evidence that vocabulary intervention is effective for children, although further research is needed to confirm the impact of intervention within contexts of social disadvantage. Very little is known about the effectiveness of interventions to increase adolescent knowledge of cross-curriculum words. To evaluate the effectiveness of an intervention programme designed to develop adolescents' knowledge of cross-curriculum words. Participants were 35 adolescents aged between 12 and 14 years who were at risk of educational underachievement with low scores on a range of assessments. Participants received a 10-week intervention programme in small groups, targeting 10 cross-curriculum words (e.g., 'summarize'). This was evaluated using a bespoke outcome measure (the Word Knowledge Profile). The study involved an AABA design, with a repeated baseline, delayed intervention cohort and blind assessment. Intervention included both semantic and phonological information about the target words and involved the adolescents using the words in multiple contexts. Results were promising and participants' knowledge of the targeted words significantly increased following intervention. Progress was demonstrated on the Word Knowledge Profile on the item requiring participants to define the word (for the summer intervention group only). This increase in depth of knowledge was seen on taught words but not on matched non-taught words. Cross-curriculum words are not consistently understood by adolescents at risk of low educational attainment within a low socio-economic context. A 10-week intervention programme resulted in some increases to the depth of knowledge of targeted cross-curriculum words. © 2017 Royal College of Speech and Language Therapists.

AAC Modeling Intervention Research Review

Science.gov (United States)

Sennott, Samuel C.; Light, Janice C.; McNaughton, David

2016-01-01

A systematic review of research on the effects of interventions that include communication partner modeling of aided augmentative and alternative communication (AAC) on the language acquisition of individuals with complex communication needs was conducted. Included studies incorporated AAC modeling as a primary component of the intervention,…

Measuring Outcomes in Adult Weight Loss Studies That Include Diet and Physical Activity: A Systematic Review

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Rachel A. Millstein

2014-01-01

Full Text Available Background. Measuring success of obesity interventions is critical. Several methods measure weight loss outcomes but there is no consensus on best practices. This systematic review evaluates relevant outcomes (weight loss, BMI, % body fat, and fat mass to determine which might be the best indicator(s of success. Methods. Eligible articles described adult weight loss interventions that included diet and physical activity and a measure of weight or BMI change and body composition change. Results. 28 full-text articles met inclusion criteria. Subjects, settings, intervention lengths, and intensities varied. All studies measured body weight (−2.9 to −17.3 kg, 9 studies measured BMI (−1.1 to −5.1 kg/m2, 20 studies measured % body fat (−0.7 to −10.2%, and 22 studies measured fat mass (−0.9 to −14.9 kg. All studies found agreement between weight or BMI and body fat mass or body fat % decreases, though there were discrepancies in degree of significance between measures. Conclusions. Nearly all weight or BMI and body composition measures agreed. Since body fat is the most metabolically harmful tissue type, it may be a more meaningful measure of health change. Future studies should consider primarily measuring % body fat, rather than or in addition to weight or BMI.

Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who are Minimally Verbal.

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Shire, Stephanie Y; Goods, Kelly; Shih, Wendy; Distefano, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

2015-06-01

Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in Autism Res 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication intervention including parent training. Parent-child play interactions were coded for parents' strategy implementation and children's time jointly engaged (Adamson et al. in J Autism Dev Disord 39:84-96, 2009). Parents mastered an average of 70% of the strategies. Further analyses indicated some gains in implementation occurred from mere observation of sessions, while the greatest gains occurred in the first month of active coaching and workshops. Children's joint engagement was associated with parents' implementation success across time demonstrating parents' implementation was relevant to children's social engagement.

Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study.

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Buonocore, Mariachiara; Bosia, Marta; Baraldi, Maria A; Bechi, Margherita; Spangaro, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella R; Cavallaro, Roberto

2018-01-01

Recovery, or functional remission, represents the ultimate treatment goal in schizophrenia. Despite its importance, a standardized definition of remission is still lacking, thus reported rates significantly vary across studies. Moreover, the effects of rehabilitative interventions on recovery have not been thoroughly investigated. This study aimed to evaluate recovery in a sample of patients with chronic schizophrenia engaged in rehabilitation programs and to explore contributing factors, with a focus on sociocognitive rehabilitative interventions. Data from 104 patients with schizophrenia treated either with a standard rehabilitation program, including cognitive remediation (n = 46), or the latter plus a specific sociocognitive intervention (n = 58), and assessed for psychopathology, cognition, social cognition, and Quality of Life Scale, were retrospectively analyzed for this study. Recovery, evaluated with the Quality of Life Scale, was achieved by 56.76% of patients in our sample. While no effects were observed for clinical, cognitive, or sociocognitive variables, participation in the sociocognitive rehabilitative interventions was positively associated with recovery. Our results indicate that high rates of recovery can be achieved in patients treated with psychosocial interventions and suggest that rehabilitative programs targeting social cognition may further facilitate the process of recovery. If confirmed, these results may have relevant implications for daily clinical practice and service provision, allowing clinicians to develop and optimize specific rehabilitation programs in order to promote recovery. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Intervention Integrity in the Low Countries: Interventions Targeting Social-Emotional Behaviors in the School

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Taal, Margot; Ekels, Elles; van der Valk, Cindel; van der Molen, Maurits

2017-01-01

The current study presents a review of intervention studies conducted in the Low Countries (i.e., The Netherlands and Flanders) focusing on social-emotional behaviors in the school. The primary purpose of this review was to assess whether studies included an operational definition of the intervention under study and reported data on the…

A multi-modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS): Rationale, design, and uptake of online study intervention material.

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Danila, Maria I; Outman, Ryan C; Rahn, Elizabeth J; Mudano, Amy S; Thomas, Tammi F; Redden, David T; Allison, Jeroan J; Anderson, Fred A; Anderson, Julia P; Cram, Peter M; Curtis, Jeffrey R; Fraenkel, Liana; Greenspan, Susan L; LaCroix, Andrea Z; Majumdar, Sumit R; Miller, Michael J; Nieves, Jeri W; Safford, Monika M; Silverman, Stuart L; Siris, Ethel S; Solomon, Daniel H; Warriner, Amy H; Watts, Nelson B; Yood, Robert A; Saag, Kenneth G

2016-12-15

To develop an innovative and effective educational intervention to inform patients about the need for osteoporosis treatment and to determine factors associated with its online uptake. Postmenopausal women with a prior fracture and not currently using osteoporosis therapy were eligible to be included in the Activating Patients at Risk for OsteoPOroSis (APROPOS). Four nominal groups with a total of 18 racially/ethnically diverse women identified osteoporosis treatment barriers. We used the Information, Motivation, Behavior Skills conceptual model to develop a direct-to-patient intervention to mitigate potentially modifiable barriers to osteoporosis therapy. The intervention included videos tailored by participants' race/ethnicity and their survey responses: ranked barriers to osteoporosis treatment, deduced barriers to treatment, readiness to behavior change, and osteoporosis treatment history. Videos consisted of "storytelling" narratives, based on osteoporosis patient experiences and portrayed by actresses of patient-identified race/ethnicity. We also delivered personalized brief phone calls followed by an interactive voice-response phone messages aimed to promote uptake of the videos. To address the factors associated with online intervention uptake, we focused on participants assigned to the intervention arm (n = 1342). These participants were 92.9% Caucasian, with a mean (SD) age 74.9 (8.0) years and the majority (77.7%) had some college education. Preference for natural treatments was the barrier ranked #1 by most (n = 130; 27%), while concern about osteonecrosis of the jaw was the most frequently reported barrier (at any level; n = 322; 67%). Overall, 28.1% (n = 377) of participants in the intervention group accessed the videos online. After adjusting for relevant covariates, the participants who provided an email address had 6.07 (95% CI 4.53-8.14) higher adjusted odds of accessing their online videos compared to those who did not. We developed and

A pilot study combining individual-based smoking cessation counseling, pharmacotherapy, and dental hygiene intervention

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Madrid Carlos

2010-06-01

Full Text Available Abstract Background Dentists are in a unique position to advise smokers to quit by providing effective counseling on the various aspects of tobacco-induced diseases. The present study assessed the feasibility and acceptability of integrating dentists in a medical smoking cessation intervention. Methods Smokers willing to quit underwent an 8-week smoking cessation intervention combining individual-based counseling and nicotine replacement therapy and/or bupropion, provided by a general internist. In addition, a dentist performed a dental exam, followed by an oral hygiene treatment and gave information about chronic effects of smoking on oral health. Outcomes were acceptability, global satisfaction of the dentist's intervention, and smoking abstinence at 6-month. Results 39 adult smokers were included, and 27 (69% completed the study. Global acceptability of the dental intervention was very high (94% yes, 6% mostly yes. Annoyances at the dental exam were described as acceptable by participants (61% yes, 23% mostly yes, 6%, mostly no, 10% no. Participants provided very positive qualitative comments about the dentist counseling, the oral exam, and the resulting motivational effect, emphasizing the feeling of oral cleanliness and health that encouraged smoking abstinence. At the end of the intervention (week 8, 17 (44% participants reported smoking abstinence. After 6 months, 6 (15%, 95% CI 3.5 to 27.2 reported a confirmed continuous smoking abstinence. Discussion We explored a new multi-disciplinary approach to smoking cessation, which included medical and dental interventions. Despite the small sample size and non-controlled study design, the observed rate was similar to that found in standard medical care. In terms of acceptability and feasibility, our results support further investigations in this field. Trial Registration number ISRCTN67470159

Effectiveness of interventions for hypertension care in the community – a meta-analysis of controlled studies in China

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Lu Zuxun

2012-07-01

Full Text Available Abstract Background Hypertension is a serious public health problem in China and in other developing countries. Our aim is to conduct a systematic review of studies on the effectiveness of community interventions for hypertension management in China. Methods China National Knowledge Infrastructure, PubMed, and references of retrieved articles were searched to identify randomised or quasi-randomised controlled studies that evaluated community hypertension care in mainland China. One reviewer extracted and a second reviewer checked data from the included studies. Results We included 94 studies, 93 of which were in Chinese language, that evaluated the following interventions: health education, improved monitoring, family-support, self-management, healthcare management changes and training of providers. The study quality was generally poor, with high risk of biased outcome reporting and significant heterogeneity between studies. When reported, the vast majority of the included studies reported statistically significantly improved outcomes in the intervention group. By assuming zero treatment effects for missing outcomes, the weighted reduction in the intervention group was 6∙9 (95% CI: 4∙9 to 8∙9 mm Hg for systolic BP, and 3∙8 (95% CI: 2∙6 to 5∙0 mm Hg for diastolic BP. Exploratory subgroup analyses found no significant differences between different interventions. Conclusions After taking account of possible reporting biases, a wide range of community interventions for hypertension care remain effective. The findings have implications for China and other low and middle income countries facing similar challenges. Because of significant heterogeneity and high risk of bias in the available studies, further well designed studies should be conducted in China to provide high quality evidence to inform policy decisions on hypertension control.

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study.

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Paul, Ian M; Williams, Jennifer S; Anzman-Frasca, Stephanie; Beiler, Jessica S; Makova, Kateryna D; Marini, Michele E; Hess, Lindsey B; Rzucidlo, Susan E; Verdiglione, Nicole; Mindell, Jodi A; Birch, Leann L

2014-07-18

Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This "parenting" intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT's central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent-child responsibility for feeding, reducing subsequent risk for overeating and overweight. 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the "parenting" or "safety" groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3-4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic predictors of weight status. Finally, second

Acupuncture intervention in ischemic stroke: a randomized controlled prospective study.

Science.gov (United States)

Shen, Peng-Fei; Kong, Li; Ni, Li-Wei; Guo, Hai-Long; Yang, Sha; Zhang, Li-Li; Zhang, Zhi-Long; Guo, Jia-Kui; Xiong, Jie; Zhen, Zhong; Shi, Xue-Min

2012-01-01

Stroke is one of the most common causes of death and few pharmacological therapies show benefits in ischemic stroke. In this study, 290 patients aged 40-75 years old with first onset of acute ischemic stroke (more than 24 hours but within 14 days) were treated with standard treatments, and then were randomly allocated into an intervention group (treated with resuscitating acupuncture) and a control group (treated using sham-acupoints). Primary outcome measures included Barthel Index (BI), relapse and death up to six months. For the 290 patients in both groups, one case in the intervention group died, and two cases in the control group died from the disease (p = 0.558). Six patients of the 144 cases in the intervention group had relapse, whereas 34 of 143 patients had relapse in the control group (p two groups, respectively (p two groups for the National Institute of Health Stroke Scale (NIHSS), not at two weeks (7.03 ± 3.201 vs. 8.13 ± 3.634; p = 0.067), but at four weeks (4.15 ± 2.032 vs. 6.35 ± 3.131, p Stroke Scale (CSS) at four weeks showed more improvement in the intervention group than that in the control group (9.40 ± 4.51 vs. 13.09 ± 5.80, p Stroke Specific Quality of Life Scale (SS-QOL) at six months was higher in the intervention group (166.63 ± 45.70) than the control group (143.60 ± 50.24; p < 0.01). The results of this clinical trial showed a clinically relevant decrease of relapse in patients treated with resuscitating acupuncture intervention by the end of six months, compared with needling at the sham-acupoints. The resuscitating acupuncture intervention could also improve self-care ability and quality of life, evaluated with BI, NIHSS, CSS, Oxford Handicap Scale (OHS), and SS-QOL.

Therapy interventions for children with neurodisabilities: a qualitative scoping study.

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Beresford, Bryony; Clarke, Susan; Maddison, Jane

2018-01-01

therapeutic environment. They are believed to be highly complex and poorly understood. Although participation is widely endorsed as a core intervention objective of therapy interventions, its suitability, or appropriateness, as an outcome measure was questioned. Other child and/or parent outcomes were identified as more or equally important. Notions of intermediate outcomes - in terms of body structure/function, and the achievement of activities - were regarded as important and not counter to participation-focused approaches. Among therapists, research on intervention effectiveness was (cautiously) welcomed. A number of methodological challenges were identified. A portfolio of study designs - quantitative and qualitative, experimental and observational - was called for, and which included economic evaluation and clear pathways to impact. The study was not successful in recruiting children and young people. Further work is required to elucidate the views of this key stakeholder group. Therapy interventions are poorly understood. There was strong support, tempered a little by concerns among some about the feasibility of demonstrating impact, for investment in research. The identification of research priorities was a core study objective, and a wide-ranging research agenda was identified. It included 'foundational' research into neurodisability, the active components of therapy interventions and the concept of participation. Three areas of evaluation were identified: overall approaches to therapy, service organisation and delivery issues, and the evaluation of specific techniques. Parents regarded evaluations of approaches to therapy (e.g. goals-focused; supporting family-self management) as priorities, along with evaluations of models of service provision. Professionals' views were broadly similar, with an additional emphasis on methodological research. In terms of specific techniques, there was no shared agreement regarding priorities, with views informed by personal interests

Community-based interventions to enhance knowledge, protective attitudes and behaviors towards canine rabies: results from a health communication intervention study in Guangxi, China

Directory of Open Access Journals (Sweden)

Hairong Wu

2016-11-01

Full Text Available Abstract Background In China canine rabies poses a serious public health problem in that human mortality ranks the second highest globally. While rabies health education interventions are advocated by WHO to be critical components of modern rabies control and prevention programs, available studies have not adequately investigated the relative efficacy of their implementation in at-risk populations. This study aims to measure and compare the effect on knowledge and protective behavior towards rabies of health education interventions that include a novel Short Messaging Service via cell phone (SMS and rabies health information sessions (IS. Methods The study used a between-subject design involving repeated measures of rabies-related KAP (knowledge, attitude and practice. A total of 350 randomly selected villagers were randomly allocated into three intervention (SMS, IS and SMS + IS and one control group. The content of SMS and IS covered topics about rabies prevention and route of transmission. The SMS intervention consisted of ten separate messages delivered three times two weeks after the pretest; the IS intervention was conducted once immediately after the pretest. A validated questionnaire was used to capture demographic information and KAP information. Ordinary Least Squares regression was used to contrast the effects of interventions. Results Our results indicate that overall SMS outperforms IS at improving knowledge and protective behavior against rabies. Our results suggest that a combined intervention of SMS and IS can result in higher scores than any of the two in isolation. The impact of SMS, IS and SMS + IS is greatest on knowledge, followed by attitude and practice scores. Conclusion This study demonstrated that health communication modes based on SMS, IS and a combination of the two are all effective to improve rabies-related KAP in the short term. These findings highlight the potential usefulness of SMS as an additional tool

Study to Evaluate the Changes in Polycystic Ovarian Morphology after Naturopathic and Yogic Interventions.

Science.gov (United States)

Ratnakumari, M Ezhil; Manavalan, N; Sathyanath, D; Ayda, Y Rosy; Reka, K

2018-01-01

Polycystic ovarian syndrome (PCOS) is one of the commonest endocrine disorders in women, with a prevalence ranging from 2.2% to 26% in India. Patients with PCOS face challenges including irregular menstrual cycles, hirsutism, acne, acanthosis nigricans, obesity and infertility. 9.13% of South Indian adolescent girls are estimated to suffer from PCOS. The efficacy of Yoga & Naturopathy (Y&N) in the management of polycystic ovarian syndrome requires to be investigated. Aims: The aim of the present study is to observe the morphological changes in polycystic ovaries of patients following 12 weeks of Y&N intervention. The study was conducted at the Government Yoga and Naturopathy Medical College and Hospital, Chennai, India. The study was a single blinded prospective, pre-post clinical trial. Fifty PCOS patients of age between 18 and 35 years who satisfied the Rotterdam criteria were recruited for the study. According to their immediate participation in the study they were either allocated to the intervention group ( n =25) or in the wait listed control group ( n =25). The intervention group underwent Y&N therapy for 12 weeks. Change in polycystic ovarian morphology, anthropometric measurements and frequency of menstrual cycle were studied before and after the intervention. Results: Significant improvement was observed in the ovarian morphology ( P polycystic ovarian morphology. We speculate that a longer intervention might be required to regulate the frequency of menstrual cycle.

Randomized, interventional, prospective, comparative study to ...

African Journals Online (AJOL)

Randomized, interventional, prospective, comparative study to evaluate the antihypertensive efficacy and tolerability of ramipril versus telmisartan in stage 1 hypertensive patients with diabetes mellitus.

[Transparency and replicability of nursing intervention studies in long-term care: A selective literature review].

Science.gov (United States)

Gspörer, Irene; Schrems, Berta M

2018-05-01

The development and evaluation of interventions in long-term care is time-consuming and expensive due to their complexity. To ensure reproducibility and successful implementation, these interventions must be described and published in a comprehensible and qualitative manner. The aim of this study is to analyze intervention studies from the inpatient long-term care setting with regard to their completeness, reporting quality, transparency and thus reproducibility. The completeness and the reporting quality of the interventions described in the publications were examined in the context of a selective literature review by means of intervention studies from the long-term care setting (n=22). To this end, the Template for Intervention Description and Replication (TIDieR) checklist and the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare 2 (CReDECI2-DE) list were used. Transparency criteria included study registration and access to study protocols. The TIDieR checklist examination revealed that only three studies contained all the information necessary; the CReDECI2 test provided a complete description for only one study. Frequent shortcomings were observed concerning the information on modifications and titrations for the study participants and the location. Protocols were available for eight studies, 14 studies were registered. In terms of science, this means that the reproducibility of scientific findings is limited, which is why they cannot provide secure knowledge. As a result, the practical benefit to be derived from published studies that are accessible to decision-makers is limited as well. As far as publishers are concerned they should pay more attention to the completeness, registration and availability of materials. Copyright © 2018. Published by Elsevier GmbH.

Quasi-experimental study designs series-paper 5: a checklist for classifying studies evaluating the effects on health interventions-a taxonomy without labels.

Science.gov (United States)

Reeves, Barnaby C; Wells, George A; Waddington, Hugh

2017-09-01

The aim of the study was to extend a previously published checklist of study design features to include study designs often used by health systems researchers and economists. Our intention is to help review authors in any field to set eligibility criteria for studies to include in a systematic review that relate directly to the intrinsic strength of the studies in inferring causality. We also seek to clarify key equivalences and differences in terminology used by different research communities. Expert consensus meeting. The checklist comprises seven questions, each with a list of response items, addressing: clustering of an intervention as an aspect of allocation or due to the intrinsic nature of the delivery of the intervention; for whom, and when, outcome data are available; how the intervention effect was estimated; the principle underlying control for confounding; how groups were formed; the features of a study carried out after it was designed; and the variables measured before intervention. The checklist clarifies the basis of credible quasi-experimental studies, reconciling different terminology used in different fields of investigation and facilitating communications across research communities. By applying the checklist, review authors' attention is also directed to the assumptions underpinning the methods for inferring causality. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The healthy building intervention study: Objectives, methods and results of selected environmental measurements

Energy Technology Data Exchange (ETDEWEB)

Fisk, W.J.; Faulkner, D.; Sullivan, D. [and others

1998-02-17

To test proposed methods for reducing SBS symptoms and to learn about the causes of these symptoms, a double-blind controlled intervention study was designed and implemented. This study utilized two different interventions designed to reduce occupants` exposures to airborne particles: (1) high efficiency filters in the building`s HVAC systems; and (2) thorough cleaning of carpeted floors and fabric-covered chairs with an unusually powerful vacuum cleaner. The study population was the workers on the second and fourth floors of a large office building with mechanical ventilation, air conditioning, and sealed windows. Interventions were implemented on one floor while the occupants on the other floor served as a control group. For the enhanced-filtration intervention, a multiple crossover design was used (a crossover is a repeat of the experiment with the former experimental group as the control group and vice versa). Demographic and health symptom data were collected via an initial questionnaire on the first study week and health symptom data were obtained each week, for eight additional weeks, via weekly questionnaires. A large number of indoor environmental parameters were measured during the study including air temperatures and humidities, carbon dioxide concentrations, particle concentrations, concentrations of several airborne bioaerosols, and concentrations of several microbiologic compounds within the dust sampled from floors and chairs. This report describes the study methods and summarizes the results of selected environmental measurements.

A Text Messaging Intervention to Support Option B+ in Kenya: A Qualitative Study.

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Musoke, Pamela; Gakumo, C Ann; Abuogi, Lisa L; Akama, Eliud; Bukusi, Elizabeth; Helova, Anna; Nalwa, Wafula Z; Onono, Mariciannah; Spangler, Sydney A; Wanga, Iris; Turan, Janet M

Key challenges in providing lifelong antiretroviral therapy (ART) to pregnant and breastfeeding women (Option B+) in sub-Saharan Africa include achieving long-term adherence and retention in care. One intervention that may help address these challenges is mobile text messaging. We evaluated the acceptability of a text messaging intervention to support women's ART adherence and retention in care in rural western Kenya. Forty in-depth interviews with 20 pregnant/postpartum women infected with HIV, their male partners, and four focus groups with 30 health care providers were conducted during September-November 2014. Data were coded and analyzed using thematic analysis. Findings revealed the following themes: (a) overall acceptability of the text messaging intervention; (b) proposed content of text messages; (c) format, timing, and language of text messages; and (d) potential challenges of the text messaging intervention. Findings were used to refine a text messaging intervention being evaluated at Kenyan study sites rolling out Option B+. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

The sunless study: a beach randomized trial of a skin cancer prevention intervention promoting sunless tanning.

Science.gov (United States)

Pagoto, Sherry L; Schneider, Kristin L; Oleski, Jessica; Bodenlos, Jamie S; Ma, Yunsheng

2010-09-01

To examine the impact of a skin cancer prevention intervention that promoted sunless tanning as a substitute for sunbathing. Randomized controlled trial. Public beaches in Massachusetts. Women (N = 250) were recruited to participate in the study during their visit to a public beach. Intervention The intervention included motivational messages to use sunless tanning as an alternative to UV tanning, instructions for proper use of sunless tanning products, attractive images of women with sunless tans, a free trial of a sunless tanning product, skin cancer education, and UV imaging. The control participants completed surveys. The primary outcome was sunbathing 2 months and 1 year after the intervention. Secondary outcomes included sunburns, sun protection use, and sunless tanning. At 2 months, intervention participants reduced their sunbathing significantly more than did controls and reported significantly fewer sunburns and greater use of protective clothing. At 1 year, intervention participants reported significant decreases in sunbathing and increases in sunless tanning relative to control participants but no differences in the other outcomes. This intervention, which promoted sunless tanning as an alternative to UV tanning, had a short-term effect on sunbathing, sunburns, and use of protective clothing and a longer-term effect on sunbathing and sunless tanning. clinicaltrials.gov Identifier: NCT00403377.

Interventions performed by community pharmacists in one Canadian province: a cross-sectional study

Directory of Open Access Journals (Sweden)

Young SW

2012-12-01

Full Text Available Stephanie W Young, Lisa D Bishop, Amy ConwaySchool of Pharmacy, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, CanadaPurpose: Interventions made by pharmacists to resolve issues when filling a prescription ensure the quality, safety, and efficacy of medication therapy for patients. The purpose of this study was to provide a current estimate of the number and types of interventions performed by community pharmacists during processing of prescriptions. This baseline data will provide insight into the factors influencing current practice and areas where pharmacists can redefine and expand their role.Patients and methods: A cross-sectional study of community pharmacist interventions was completed. Participants included third-year pharmacy students and their pharmacist preceptor as a data collection team. The team identified all interventions on prescriptions during the hours worked together over a 7-day consecutive period. Full ethics approval was obtained.Results: Nine student–pharmacist pairs submitted data from nine pharmacies in rural (n = 3 and urban (n = 6 centers. A total of 125 interventions were documented for 106 patients, with a mean intervention rate of 2.8%. The patients were 48% male, were mostly ≥18 years of age (94%, and 86% had either public or private insurance. Over three-quarters of the interventions (77% were on new prescriptions. The top four types of problems requiring intervention were related to prescription insurance coverage (18%, drug product not available (16%, dosage too low (16%, and missing prescription information (15%. The prescriber was contacted for 69% of the interventions. Seventy-two percent of prescriptions were changed and by the end of the data collection period, 89% of the problems were resolved.Conclusion: Community pharmacists are impacting the care of patients by identifying and resolving problems with prescriptions. Many of the issues identified in this study were related

Lessons for integrated household energy conservation policies from an intervention study in Singapore

International Nuclear Information System (INIS)

Kua, H.W.; Wong, S.E.

2012-01-01

In preparation for a community energy conservation program in the southwest district of Singapore, a pilot intervention study was conducted between August and November 2008 to study the effectiveness of tailored information and feedback in promoting household conservation. A sample of 125 households was involved in the study, of which 63 were the control group. Both self-reported behavioral changes and actual energy reductions were measured and any Hawthorne effect was identified. It was found that self-reported behavioral changes were strongly correlated to the level of trust in the energy conservation information given, the need for ease in practicing the recommended conservation measures and feeling of satisfaction in executing the measures; these results differ from several past studies on energy interventions. 60.7% of those who reported behavioral changes actually reduced energy consumption. Reasons were found and discussed. Lessons from this intervention study can be applied to design integrated policies aimed at promoting energy conservation in households. - Highlights: ► Energy intervention was implemented on 125 households. ► Outreach instruments included stickers, pamphlets and counseling. ► Self-reported behavioral and actual reductions were recorded. ► Self-reported behavioral change was only correlated to trust of information given. ► It was also correlated to ease of actions and feeling of satisfaction from actions.

Mapping the evidence of prevention and intervention studies for suicidal and self-harming behaviors in young people.

Science.gov (United States)

De Silva, Stefanie; Parker, Alexandra; Purcell, Rosemary; Callahan, Patrick; Liu, Ping; Hetrick, Sarah

2013-01-01

Suicide and self-harm (SSH) in young people is a major cause of disability-adjusted life years. Effective interventions are of critical importance to reducing the mortality and morbidity associated with SSH. To investigate the extent and nature of research on interventions to prevent and treat SSH in young people using evidence mapping. A systematic search for SSH intervention studies was conducted (participant mean age between 6-25 years). The studies were restricted to high-quality evidence in the form of systematic reviews, meta-analyses, and controlled trials. Thirty-eight controlled studies and six systematic reviews met the study inclusion criteria. The majority (n = 32) involved psychological interventions. Few studies (n = 9) involved treating young people with recognized mental disorders or substance abuse (n = 1) which also addressed SSH. The map was restricted to RCTs, CCTs, systematic reviews, and meta-analyses, and thus might have neglected important information from other study designs. The effectiveness of interventions within the trials was not evaluated. The evidence base for SSH interventions in young people is not well established, which hampers best-practice efforts in this area. Promising interventions that need further research include school-based prevention programs with a skills training component, individual CBT interventions, interpersonal psychotherapy, and attachment-based family therapy. Gaps in the research exist in evaluations of interventions for SSH in young people with identifiable psychopathology, particularly substance use disorder, and research that classifies participants on the basis of their suicidal intent.

Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study

Science.gov (United States)

Fitzgerald, Sarah; Murphy, Aileen; Kirby, Ann; Geaney, Fiona; Perry, Ivan J

2018-01-01

Objective To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Design Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Setting Four multinational manufacturing workplaces in Cork, Ireland. Participants 517 randomly selected employees (18–65 years) from four workplaces. Interventions Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. Outcomes The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. Results The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is

Using the Intervention Mapping protocol to develop a family-based intervention for improving lifestyle habits among overweight and obese children: study protocol for a quasi-experimental trial

Directory of Open Access Journals (Sweden)

Tonje Holte Stea

2016-10-01

Full Text Available Abstract Background In light of the high prevalence of childhood overweight and obesity, there is a need of developing effective prevention programs to address the rising prevalence and the concomitant health consequences. The main aim of the present study is to systematically develop and implement a tailored family-based intervention for improving lifestyle habits among overweight and obese children, aged 6–10 years old, enhancing parental self-efficacy, family engagement and parent-child interaction. A subsidiary aim of the intervention study is to reduce the prevalence of overweight and obesity among those participating in the intervention study. Methods/design The Intervention Mapping protocol was used to develop a tailored family-based intervention for improving lifestyle habits among overweight and obese children. In order to gather information on local opportunities and barriers, interviews with key stakeholders and a 1-year pilot study was conducted. The main study has used a quasi-experimental controlled design. Locally based Healthy Life Centers and Public Health Clinics are responsible for recruiting families and conducting the intervention. The effect of the study will be measured both at completion of the 6 months intervention study and 6 and 18 months after the intervention period. An ecological approach was used as a basis for developing the intervention. The behavioral models and educational strategies include individual family counselling meetings, workshops focusing on regulation of family life, nutrition courses, and physical activity groups providing tailored information and practical learning sessions. Parents will be educated on how to use these strategies at home, to further support their children in improving their behaviors. Discussion A systematic and evidence-based approach was used for development of this family-based intervention study targeting overweight and obese children, 6–10 years old. This program, if

Using the Intervention Mapping protocol to develop a family-based intervention for improving lifestyle habits among overweight and obese children: study protocol for a quasi-experimental trial.

Science.gov (United States)

Stea, Tonje Holte; Haugen, Tommy; Berntsen, Sveinung; Guttormsen, Vigdis; Øverby, Nina Cecilie; Haraldstad, Kristin; Meland, Eivind; Abildsnes, Eirik

2016-10-18

In light of the high prevalence of childhood overweight and obesity, there is a need of developing effective prevention programs to address the rising prevalence and the concomitant health consequences. The main aim of the present study is to systematically develop and implement a tailored family-based intervention for improving lifestyle habits among overweight and obese children, aged 6-10 years old, enhancing parental self-efficacy, family engagement and parent-child interaction. A subsidiary aim of the intervention study is to reduce the prevalence of overweight and obesity among those participating in the intervention study. The Intervention Mapping protocol was used to develop a tailored family-based intervention for improving lifestyle habits among overweight and obese children. In order to gather information on local opportunities and barriers, interviews with key stakeholders and a 1-year pilot study was conducted. The main study has used a quasi-experimental controlled design. Locally based Healthy Life Centers and Public Health Clinics are responsible for recruiting families and conducting the intervention. The effect of the study will be measured both at completion of the 6 months intervention study and 6 and 18 months after the intervention period. An ecological approach was used as a basis for developing the intervention. The behavioral models and educational strategies include individual family counselling meetings, workshops focusing on regulation of family life, nutrition courses, and physical activity groups providing tailored information and practical learning sessions. Parents will be educated on how to use these strategies at home, to further support their children in improving their behaviors. A systematic and evidence-based approach was used for development of this family-based intervention study targeting overweight and obese children, 6-10 years old. This program, if feasible and effective, may be adjusted to local contexts and

The Importance of Risk and Subgroup Analysis of Nonparticipants in a Geriatric Intervention Study

DEFF Research Database (Denmark)

Rosted, Elizabeth; Poulsen, Ingrid; Hendriksen, Carsten

2016-01-01

Background: A major concern in intervention studies is the generalizability of the findings due to refusal of intended participants to actually take part. In studies including ill older people the number of those declining to participate may be large and the concern is therefore relevant.  Object...... recommend that intervention studies among older people or other fragile patient groups include analysis of relevant risk and subgroup analyses of refusers........  Objectives: To compare patients characteristics, rates of acute readmission, and mortality after one and six months among older persons who agreed and those who declined to participate in a randomized controlled trial and to describe subgroups of nonparticipants.  Design: Comparative study based...... on a randomized controlled trial.  Setting: University hospital in the Capital Region of Denmark.  Participants: Patients ≥70 years discharged home after a short Emergency Department stay. 399 were requested to participate; 271 consented, whereas 128 refused.  Results: Refusers were more likely to be readmitted...

Interventions for preventing abuse in the elderly.

Science.gov (United States)

Baker, Philip R A; Francis, Daniel P; Hairi, Noran N; Othman, Sajaratulnisah; Choo, Wan Yuen

2016-08-16

Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. The objective of this review was to assess the effectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention effects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people. We searched 19 databases (AgeLine, CINAHL, Psycinfo, MEDLINE, Embase, Proquest Central, Social Services Abstracts‎, ASSIA, Sociological Abstracts, ProQuest Dissertations & Theses Global, Web of Science, LILACS, EPPI, InfoBase, CENTRAL, HMIC, Opengrey and Zetoc) on 12 platforms, including multidisciplinary disciplines covering medical, health, social sciences, social services, legal, finance and education. We also browsed related organisational websites, contacted authors of relevant articles and checked reference lists. Searches of databases were conducted between 30 August 2015 and 16 March 2016 and were not restricted by language. We included randomised controlled trials (RCTs), cluster-randomised trials, and quasi-RCTs, before-and-after studies, and interrupted time series. Only studies with at least 12 weeks of follow-up investigating the effect of interventions in preventing or reducing abuse of elderly people and those who interact with the elderly were included. Two review authors

Making the most of natural experiments: What can studies of the withdrawal of public health interventions offer?

Science.gov (United States)

Craig, Peter; Gibson, Marcia; Campbell, Mhairi; Popham, Frank; Katikireddi, Srinivasa Vittal

2018-03-01

Many interventions that may have large impacts on health and health inequalities, such as social and public health policies and health system reforms, are not amenable to evaluation using randomised controlled trials. The United Kingdom Medical Research Council's guidance on the evaluation of natural experiments draws attention to the need for ingenuity to identify interventions which can be robustly studied as they occur, and without experimental manipulation. Studies of intervention withdrawal may usefully widen the range of interventions that can be evaluated, allowing some interventions and policies, such as those that have developed piecemeal over a long period, to be evaluated for the first time. In particular, sudden removal may allow a more robust assessment of an intervention's long-term impact by minimising 'learning effects'. Interpreting changes that follow withdrawal as evidence of the impact of an intervention assumes that the effect is reversible and this assumption must be carefully justified. Otherwise, withdrawal-based studies suffer similar threats to validity as intervention studies. These threats should be addressed using recognised approaches, including appropriate choice of comparators, detailed understanding of the change processes at work, careful specification of research questions, and the use of falsification tests and other methods for strengthening causal attribution. Evaluating intervention withdrawal provides opportunities to answer important questions about effectiveness of population health interventions, and to study the social determinants of health. Researchers, policymakers and practitioners should be alert to the opportunities provided by the withdrawal of interventions, but also aware of the pitfalls. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Intervention effects on physical activity: the HEIA study - a cluster randomized controlled trial

Science.gov (United States)

2013-01-01

Background Although school-based interventions to promote physical activity in adolescents have been suggested in several recent reviews, questions have been raised regarding the effects of the strategies and the methodology applied and for whom the interventions are effective. The aim of the present study was to investigate effects of a school-based intervention program: the HEalth in Adolescents (HEIA) study, on change in physical activity, and furthermore, to explore whether potential effects varied by gender, weight status, initial physical activity level and parental education level. Methods This was a cluster randomized controlled 20 month intervention study which included 700 11-year-olds. Main outcome-variable was mean count per minute (cpm) derived from ActiGraph accelerometers (Model 7164/GT1M). Weight and height were measured objectively. Adolescents reported their pubertal status in a questionnaire and parents reported their education level on the consent form. Linear mixed models were used to test intervention effects and to account for the clustering effect of sampling by school. Results The present study showed an intervention effect on overall physical activity at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to post intervention in favour of the intervention group (95% CI −0.4, 100). Subgroup analyses showed that the effect appeared to be more profound among girls (Est 65 cpm, CI 5, 124, p = 0.03) and among participants in the low-activity group (Est 92 cpm, CI 41, 142, p activity group, respectively. Furthermore, the intervention affected physical activity among the normal weight group more positively than among the overweight, and participants with parents having 13–16 years of education more positively than participants with parents having either a lower or higher number of years of education. The intervention seemed to succeed in reducing time spent sedentary among girls but not among boys. Conclusions A

SAIDO learning as a cognitive intervention for dementia care: a preliminary study.

Science.gov (United States)

Kawashima, Ryuta; Hiller, Deborah Lewis; Sereda, Sheryl L; Antonczak, Michelle; Serger, Kara; Gannon, Denise; Ito, Shinji; Otake, Hiroshi; Yunomae, Daisaku; Kobayashi, Akihito; Muller, Christopher; Murata, Hiroyuki; FallCreek, Stephanie

2015-01-01

The purpose of this study was to examine the beneficial effects on cognitive function by a cognitive intervention program designed for dementia care called Learning Therapy in Japan and SAIDO Learning in the United States (hereinafter "SAIDO Learning," as appropriate). SAIDO Learning is a working memory training program that uses systematized basic problems in arithmetic and language, including reading aloud, as well as writing. Twenty-three nursing home residents with dementia were assigned as an intervention group, and another 24 people with dementia at another nursing home were assigned as a control group. Both nursing homes were operated by the same organization, and residents of both nursing homes received essentially the same nursing care. Thirteen and 6 subjects of the intervention and control groups, respectively, were clinically diagnosed as Alzheimer disease (AD). After the 6-month intervention, the participants with AD of the intervention group showed statistically significant improvement in cognitive function, as measured by the Mini-Mental State Examination (MMSE) compared with the control participants. In addition, post hoc analysis revealed that the Frontal Assessment Battery at Bedside (FAB) scores of the intervention group tended to improve after 6-month intervention. Based on MDS scores, improvements in total mood severity scores also were observed, but only in the intervention group of the participants with AD. These results suggest that SAIDO Learning is an effective cognitive intervention and is useful for dementia care. An additional outcome of this intervention, which has not yet been evaluated in detail, appears to be that it promotes greater positive engagement of a diversity of nursing home staff in the residents' individual progress and care needs. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Children with Obesity Prioritize Social Support against Stigma: A Qualitative Study for Development of an Obesity Prevention Intervention

Directory of Open Access Journals (Sweden)

Maryam Amini

2014-01-01

Full Text Available Background: Childhood obesity is a world-wide health problem and development of interventions to prevent or control it is a priority. Obesity is prevalent and on the increase among school-students in Iran, too. As the first step for development of an intervention, the current study was designed to complete our understanding of ideas, attitudes, beliefs, and preferences of primary school children in Tehran, Iran. Methods: Twenty-seven primary school-students (11 boys, 16 girls in grade-five, most of whom were overweight or obese, participated in four focus-group discussions (FGDs. All FGD notes were analyzed to find the main themes. Results: Nine themes in three main categories emerged after analysis. The themes in the category of barriers of losing weight included environmental, psychological and physiological barriers. Category of intervention components included nutrition improvement, physical activity promotion, social support and education. Setting and deliverer of the intervention were included in the intervention conditions category. The children proposed a multi-component approach for development of an intervention. They mentioned nutrition and physical activity improvement, social support and education as the main elements of an effective intervention. Conclusions: The findings indicate that obese children need to be supported against different barriers of losing weight, mainly social barriers, especially humiliation by the community.

How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps

Science.gov (United States)

Khosla, Rajat; Krishnan, Suneeta; George, Asha; Gruskin, Sofia; Amin, Avni

2016-01-01

The importance of promoting gender equality and human rights in sexual and reproductive health (SRH) programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994–2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader set of SRH topics

How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps.

Directory of Open Access Journals (Sweden)

Miriam Hartmann

Full Text Available The importance of promoting gender equality and human rights in sexual and reproductive health (SRH programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994-2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader

How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps.

Science.gov (United States)

Hartmann, Miriam; Khosla, Rajat; Krishnan, Suneeta; George, Asha; Gruskin, Sofia; Amin, Avni

2016-01-01

The importance of promoting gender equality and human rights in sexual and reproductive health (SRH) programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994-2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader set of SRH topics

Supporting Well-Being in Retirement through Meaningful Social Roles: Systematic Review of Intervention Studies

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Heaven, Ben; Brown, Laura Je; White, Martin; Errington, Linda; Mathers, John C; Moffatt, Suzanne

2013-01-01

Context The marked demographic change toward greater proportions of older people in developed nations poses significant challenges for health and social care. Several studies have demonstrated an association between social roles in later life and positive health and well-being outcomes. After retiring from work, people may lose roles that provide purpose and social contacts. The outcomes of interventions to promote social roles in retirement have not been systematically reviewed. Methods We examined three research questions: (1) What kinds of intervention have been developed to promote social roles in retirement? (2) How much have they improved perceived roles? (3) Have these roles improved health or well-being? We included those studies that evaluated the provision of social roles; used a control or comparison group; targeted healthy retirement-transition adults who were living in the community; provided an abstract written in English; took place in a highly developed nation; and reported social role, health, or well-being outcomes. We searched eight electronic databases and combined the results with hand searches. Findings Through our searches, we identified 9,062 unique publications and eleven evaluative studies of acceptable quality, which reported seven interventions that met our inclusion criteria. These interventions varied in year of inception and scope, but only two were based outside North America. The studies rarely reported the quality or meaning of roles. Only three studies used random allocation, thus limiting inferences of causality from these studies. Interventions providing explicit roles and using supportive group structures were somewhat effective in improving one or more of the following: life satisfaction, social support and activity, physical health and activity, functional health, and cognition. Conclusions Social role interventions may improve health and well-being for people in retirement transition. Future research should improve the

Supporting well-being in retirement through meaningful social roles: systematic review of intervention studies.

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Heaven, Ben; Brown, Laura J E; White, Martin; Errington, Linda; Mathers, John C; Moffatt, Suzanne

2013-06-01

The marked demographic change toward greater proportions of older people in developed nations poses significant challenges for health and social care. Several studies have demonstrated an association between social roles in later life and positive health and well-being outcomes. After retiring from work, people may lose roles that provide purpose and social contacts. The outcomes of interventions to promote social roles in retirement have not been systematically reviewed. We examined three research questions: (1) What kinds of intervention have been developed to promote social roles in retirement? (2) How much have they improved perceived roles? (3) Have these roles improved health or well-being? We included those studies that evaluated the provision of social roles; used a control or comparison group; targeted healthy retirement-transition adults who were living in the community; provided an abstract written in English; took place in a highly developed nation; and reported social role, health, or well-being outcomes. We searched eight electronic databases and combined the results with hand searches. Through our searches, we identified 9,062 unique publications and eleven evaluative studies of acceptable quality, which reported seven interventions that met our inclusion criteria. These interventions varied in year of inception and scope, but only two were based outside North America. The studies rarely reported the quality or meaning of roles. Only three studies used random allocation, thus limiting inferences of causality from these studies. Interventions providing explicit roles and using supportive group structures were somewhat effective in improving one or more of the following: life satisfaction, social support and activity, physical health and activity, functional health, and cognition. Social role interventions may improve health and well-being for people in retirement transition. Future research should improve the quality of intervention and assessment and

Bilingual Text4Walking Food Service Employee Intervention Pilot Study.

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Buchholz, Susan Weber; Ingram, Diana; Wilbur, JoEllen; Fogg, Louis; Sandi, Giselle; Moss, Angela; Ocampo, Edith V

2016-06-01

Half of all adults in the United States do not meet the level of recommended aerobic physical activity. Physical activity interventions are now being conducted in the workplace. Accessible technology, in the form of widespread usage of cell phones and text messaging, is available for promoting physical activity. The purposes of this study, which was conducted in the workplace, were to determine (1) the feasibility of implementing a bilingual 12-week Text4Walking intervention and (2) the effect of the Text4Walking intervention on change in physical activity and health status in a food service employee population. Before conducting the study reported here, the Text4Walking research team developed a database of motivational physical activity text messages in English. Because Hispanic or Latino adults compose one-quarter of all adults employed in the food service industry, the Text4Walking team translated the physical activity text messages into Spanish. This pilot study was guided by the Physical Activity Health Promotion Framework and used a 1-group 12-week pre- and posttest design with food service employees who self-reported as being sedentary. The aim of the study was to increase the number of daily steps over the baseline by 3000 steps. Three physical activity text messages were delivered weekly. In addition, participants received 3 motivational calls during the study. SPSS version 19.0 and R 3.0 were used to perform the data analysis. There were 33 employees who participated in the study (57.6% female), with a mean age of 43.7 years (SD 8.4). The study included 11 Hispanic or Latino participants, 8 of whom requested that the study be delivered in Spanish. There was a 100% retention rate in the study. At baseline, the participants walked 102 (SD 138) minutes/day (per self-report). This rate increased significantly (P=.008) to 182 (SD 219) minutes/day over the course of the study. The participants had a baseline mean of 10,416 (SD 5097) steps, which also increased

Using Intervention Mapping to develop a programme to prevent sexually transmittable infections, including HIV, among heterosexual migrant men

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Wolfers, Mireille EG; van den Hoek, Caty; Brug, Johannes; de Zwart, Onno

2007-01-01

Background There is little experience with carefully developed interventions in the HIV/STI prevention field aimed at adult heterosexual target groups in the Netherlands. The ability to apply intervention development protocols, like Intervention Mapping, in daily practice outside of academia, is a matter of concern. An urgent need also exists for interventions aimed at the prevention of STI in migrant populations in the Netherlands. This article describes the theory and evidence based development of HIV/STI prevention interventions by the Municipal Public Health Service Rotterdam Area (MPHS), the Netherlands, for heterosexual migrant men with Surinamese, Dutch-Caribbean, Cape Verdean, Turkish and Moroccan backgrounds. Methods First a needs assessment was carried out. Then, a literature review was done, key figures were interviewed and seven group discussions were held. Subsequently, the results were translated into specific objectives ("change objectives") and used in intervention development for two subgroups: men with an Afro-Caribbean background and unmarried men with a Turkish and Moroccan background. A matrix of change objectives was made for each subgroup and suitable theoretical methods and practical strategies were selected. Culturally-tailored interventions were designed and were pre-tested among the target groups. Results This development process resulted in two interventions for specific subgroups that were appreciated by both the target groups and the migrant prevention workers. The project took place in collaboration with a university center, which provided an opportunity to get expert advice at every step of the Intervention Mapping process. At relevant points of the development process, migrant health educators and target group members provided advice and feedback on the draft intervention materials. Conclusion This intervention development project indicates that careful well-informed intervention development using Intervention Mapping is feasible in

Educating families from ethnic minorities in type 1 diabetes-experiences from a Danish intervention study

DEFF Research Database (Denmark)

Povlsen, Lene; Olsen, Birthe; Ladelund, Steen

2004-01-01

focusing on immigrant families with children with type 1 diabetes is described. The intervention included the development of adapted educational material and guidelines, and a subsequent re-education of children, adolescents and parents from 37 families. The study demonstrated that it was possible......Ethnic minorities may constitute vulnerable groups within Western health care systems as their ability to master severe chronic diseases could be affected by barriers such as different culture and health/illness beliefs, communication problems and limited educational background. An intervention...... to improve health outcome. During the study, the knowledge of diabetes increased, but with considerable differences between the families. HbA(1c) also decreased significantly during the intervention, but increased during follow-up. The paper discusses possible explanations and suggestions for optimising...

Speciation and bioavailability of selenium in yeast-based intervention agents used in cancer chemoprevention studies

DEFF Research Database (Denmark)

Larsen, Erik Huusfeldt; Hansen, Marianne; Paulin, H.

2004-01-01

This study investigated the speciation and bioavailability of selenium in yeast-based intervention agents from multiple manufacturers from several time points. Sources of selenized yeast included Nutrition 21 (San Diego, CA), which supplied the Nutritional Prevention of Cancer (NPC) Trial from 1981......-1996; Cypress Systems (Fresno, CA; 1997-1999); and Pharma Nord (Vejle, Denmark; 1999-2000), which supplied the Prevention of Cancer by Intervention by Selenium (PRECISE) Trial pilot studies. The low-molecular-selenium species were liberated from the samples by proteolytic hydrolysis followed by separation...... Trial showed a higher concentration (p studied may explain this...

Outcomes of nutritional interventions to treat dysphagia in esophageal cancer: a population-based study.

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Modi, R M; Mikhail, S; Ciombor, K; Perry, K A; Hinton, A; Stanich, P P; Zhang, C; Conwell, D L; Krishna, S G

2017-11-01

Esophageal cancer (EC) is increasing in prevalence due to rising incidence and improved treatment strategies. Dysphagia is a significant morbidity in patients with EC requiring nutritional intervention. We sought to evaluate outcomes of nutritional interventions for EC patients hospitalized with dysphagia at a population level. The National Inpatient Sample (2002-2012) was utilized to include all adult inpatients (≥18 years of age) with EC and presence of dysphagia and stricture that underwent nutritional interventions including feeding tube (FT) placement, esophageal stenting, or parenteral nutrition (PN). Temporal trends were examined with multivariate analysis performed for mortality, length of stay (LOS), and cost of hospitalization. A total of 509,593 EC patients had 12,205 hospitalizations related to dysphagia. The hospitalization rates doubled over the study period (1.52% vs. 3.28%, p esophageal stenting (13%), and PN (11%). PN was more frequently associated with a diagnosis of sepsis (6.1%, p = 0.023) compared to FT (2.5%) or esophageal stenting (1.8%). Multivariate analysis demonstrated FT and esophageal stenting had comparable mortality (OR 1.06, 95% CI: 0.49, 2.32); however, PN was associated with higher mortality (OR 2.37, 95% CI: 1.22, 4.63), cost of hospitalization ($5,510, 95% CI: 2,262, 8,759), and LOS (2.13 days, 95% CI: 0.72, 3.54). This study shows that hospitalizations for EC with dysphagia and related nutritional interventions are increasing. As a single modality, parenteral nutrition should be avoided. Among our esophageal stent and FT population, further studies are necessary to determine adequate interventions based on disease stage. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Breast Health Intervention Evaluation Study

National Research Council Canada - National Science Library

Blumenthal, Daniel

1997-01-01

The Breast Health Intervention Evaluation (BRIE) Study will evaluate the relative effectiveness of three different approaches to breast health messages--a fear appeal, a positive affect appeal, and an affectively neutral, cognitive appeal...

Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study

Directory of Open Access Journals (Sweden)

Torisson G

2013-09-01

Full Text Available Gustav Torisson,1 Lennart Minthon,1 Lars Stavenow,2 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 2Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time. Results: After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann–Whitney U test, P = 0.02. For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009. Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002 and decreased from 75 to 58 in the intervention group (P = 0.25. From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann–Whitney test, P = 0.054. Conclusion: A multidisciplinary approach

School-based cognitive behavioral interventions for anxious youth: study protocol for a randomized controlled trial.

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Haugland, Bente Storm Mowatt; Raknes, Solfrid; Haaland, Aashild Tellefsen; Wergeland, Gro Janne; Bjaastad, Jon Fauskanger; Baste, Valborg; Himle, Joe; Rapee, Ron; Hoffart, Asle

2017-03-04

Anxiety disorders are prevalent among adolescents and may have long-lasting negative consequences for the individual, the family and society. Cognitive behavioral therapy (CBT) is an effective treatment. However, many anxious youth do not seek treatment. Low-intensity CBT in schools may improve access to evidence-based services. We aim to investigate the efficacy of two CBT youth anxiety programs with different intensities (i.e., number and length of sessions), both group-based and administered as early interventions in a school setting. The objectives of the study are to examine the effects of school-based interventions for youth anxiety and to determine whether a less intensive intervention is non-inferior to a more intensive intervention. The present study is a randomized controlled trial comparing two CBT interventions to a waitlist control group. A total of 18 schools participate and we aim to recruit 323 adolescents (12-16 years). Youth who score above a cutoff on an anxiety symptom scale will be included in the study. School nurses recruit participants and deliver the interventions, with mental health workers as co-therapists and/or supervisors. Primary outcomes are level of anxiety symptoms and anxiety-related functional impairments. Secondary outcomes are level of depressive symptoms, quality of life and general psychosocial functioning. Non-inferiority between the two active interventions will be declared if a difference of 1.4 or less is found on the anxiety symptom measure post-intervention and a difference of 0.8 on the interference scale. Effects will be analyzed by mixed effect models, applying an intention to treat procedure. The present study extends previous research by comparing two programs with different intensity. A brief intervention, if effective, could more easily be subject to large-scale implementation in school health services. ClinicalTrials.gov, NCT02279251 . Registered on 15 October 2014. Retrospectively registered.

Choosing between responsive-design websites versus mobile apps for your mobile behavioral intervention: presenting four case studies.

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Turner-McGrievy, Gabrielle M; Hales, Sarah B; Schoffman, Danielle E; Valafar, Homay; Brazendale, Keith; Weaver, R Glenn; Beets, Michael W; Wirth, Michael D; Shivappa, Nitin; Mandes, Trisha; Hébert, James R; Wilcox, Sara; Hester, Andrew; McGrievy, Matthew J

2017-06-01

Both mobile apps and responsive-design websites (web apps) can be used to deliver mobile health (mHealth) interventions, but it can be difficult to discern which to use in research. The goal of this paper is to present four case studies from behavioral interventions that developed either a mobile app or a web app for research and present an information table to help researchers determine which mobile option would work best for them. Four behavioral intervention case studies (two developed a mobile app, and two developed a web app) presented include time, cost, and expertise. Considerations for adopting a mobile app or a web app-such as time, cost, access to programmers, data collection, security needs, and intervention components- are presented. Future studies will likely integrate both mobile app and web app modalities. The considerations presented here can help guide researchers on which platforms to choose prior to starting an mHealth intervention.

A review of the nature and effectiveness of nutrition interventions in adult males – a guide for intervention strategies

Directory of Open Access Journals (Sweden)

Taylor Pennie J

2013-01-01

Full Text Available Abstract Background Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. Methods A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1 published from January 1990 to August 2011 and 2 male only studies (≥18 years or 3 where males contributed to >90% of the active cohort. A study must have described, (i a significant change (p Results Nine studies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg and/or BMI (kg/m2 changes (p≤0.05. Four studies had effective interventions (p Intervention features, which appeared to be associated with better outcomes, include the delivery of quantitative information on diet and the use of self-monitoring and tailored feedback. Conclusion Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to

Comparing usage of a web and app stress management intervention: An observational study

Directory of Open Access Journals (Sweden)

Leanne G. Morrison

2018-06-01

Full Text Available Choices in the design and delivery of digital health behaviour interventions may have a direct influence on subsequent usage and engagement. Few studies have been able to make direct, detailed comparisons of differences in usage between interventions that are delivered via web or app. This study compared the usage of two versions of a digital stress management intervention, one delivered via a website (Healthy Paths and the other delivered via an app (Healthy Mind. Design modifications were introduced within Healthy Mind to take account of reported differences in how individuals engage with websites compared to apps and mobile phones. Data were collected as part of an observational study nested within a broader exploratory trial of Healthy Mind. Objective usage of Healthy Paths and Healthy Mind were automatically recorded, including frequency and duration of logins, access to specific components within the intervention and order of page/screen visits. Usage was compared for a two week period following initial registration. In total, 381 participants completed the registration process for Healthy Paths (web and 162 participants completed the registration process for Healthy Mind (app. App users logged in twice as often (Mdn = 2.00 as web users (Mdn = 1.00, U = 13,059.50, p ≤ 0.001, but spent half as much time (Mdn = 5.23 min on the intervention compared to web users (Mdn = 10.52 min, U = 19,740.00, p ≤ 0.001. Visual exploration of usage patterns over time revealed that a significantly higher proportion of app users (n = 126, 82.35% accessed both types of support available within the intervention (i.e. awareness and change-focused tools compared to web users (n = 92, 40.17%, χ2(1, n = 382 = 66.60, p < 0.001. This study suggests that the digital platform used to deliver an intervention (i.e. web versus app and specific design choices (e.g. navigation, length and volume of content may be

Evaluating health effects of transport interventions methodologic case study.

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Ogilvie, David; Mitchell, Richard; Mutrie, Nanette; Petticrew, Mark; Platt, Stephen

2006-08-01

There is little evidence about the effects of environmental interventions on population levels of physical activity. Major transport projects may promote or discourage physical activity in the form of walking and cycling, but researching the health effects of such "natural experiments" in transport policy or infrastructure is challenging. Case study of attempts in 2004-2005 to evaluate the effects of two major transport projects in Scotland: an urban congestion charging scheme in Edinburgh, and a new urban motorway (freeway) in Glasgow. These interventions are typical of many major transport projects. They are unique to their context. They cannot easily be separated from the other components of the wider policies within which they occur. When, where, and how they are implemented are political decisions over which researchers have no control. Baseline data collection required for longitudinal studies may need to be planned before the intervention is certain to take place. There is no simple way of defining a population or area exposed to the intervention or of defining control groups. Changes in quantitative measures of health-related behavior may be difficult to detect. Major transport projects have clear potential to influence population health, but it is difficult to define the interventions, categorize exposure, or measure outcomes in ways that are likely to be seen as credible in the field of public health intervention research. A final study design is proposed in which multiple methods and spatial levels of analysis are combined in a longitudinal quasi-experimental study.

Exploring Environment-Intervention Fit: A Study of a Work Environment Intervention Program for the Care Sector

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Aust, Birgit; Flyvholm, Mari-Ann

2015-01-01

Targeting occupational health and safety interventions to different groups of employees and sectors is important. The aim of this study was to explore the environment-intervention fit of a Danish psychosocial work environment intervention program for the residential and home care sector. Focus group interviews with employees and interviews with mangers were conducted at 12 selected workplaces and a questionnaire survey was conducted with managers at all 115 workplaces. The interventions enhanced the probability of employees experiencing more “good” work days, where they could make a difference to the lives of clients. The interventions may therefore be characterized as culturally compelling and having a good fit with the immediate work environment of employees. The interventions furthermore seemed to fit well with the wider organizational environment and with recent changes in the societal and economic context of workplaces. However, some workplaces had difficulties with involving all employees and adapting the interventions to the organization of work. The findings suggest that flexibility and a variety of strategies to involve all employees are important aspects, if interventions are to fit well with the care sector. The focus on employees' conceptualization of a “good” work day may be useful for intervention research in other sectors. PMID:26380356

Exploring Environment-Intervention Fit: A Study of a Work Environment Intervention Program for the Care Sector

Directory of Open Access Journals (Sweden)

Louise Hardman Smith

2015-01-01

Full Text Available Targeting occupational health and safety interventions to different groups of employees and sectors is important. The aim of this study was to explore the environment-intervention fit of a Danish psychosocial work environment intervention program for the residential and home care sector. Focus group interviews with employees and interviews with mangers were conducted at 12 selected workplaces and a questionnaire survey was conducted with managers at all 115 workplaces. The interventions enhanced the probability of employees experiencing more “good” work days, where they could make a difference to the lives of clients. The interventions may therefore be characterized as culturally compelling and having a good fit with the immediate work environment of employees. The interventions furthermore seemed to fit well with the wider organizational environment and with recent changes in the societal and economic context of workplaces. However, some workplaces had difficulties with involving all employees and adapting the interventions to the organization of work. The findings suggest that flexibility and a variety of strategies to involve all employees are important aspects, if interventions are to fit well with the care sector. The focus on employees’ conceptualization of a “good” work day may be useful for intervention research in other sectors.

The impact of a microsavings intervention on reducing violence against women engaged in sex work: a randomized controlled study.

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Tsai, Laura Cordisco; Carlson, Catherine E; Aira, Toivgoo; Norcini Pala, Andrea; Riedel, Marion; Witte, Susan S

2016-10-28

Women who engage in sex work are at risk for experiencing violence from numerous perpetrators, including paying partners. Empirical evidence has shown mixed results regarding the impact of participation in microfinance interventions on women's experiences of violence, with some studies demonstrating reductions in intimate partner violence (IPV) and others showing heightened risk for IPV. The current study reports on the impact of participation in a microsavings intervention on experiences of paying partner violence among women engaged in sex work in Mongolia. Between 2011 and 2013, we conducted a two-arm, non-blinded randomized controlled trial (RCT) comparing an HIV/STI risk reduction intervention (HIVSRR) (control condition) to a combined microsavings and HIVSRR intervention (treatment condition). Eligible women (aged 18 or older, reported having engaged in unprotected sex with paying partner in past 90 days, expressed interest in microsavings intervention) were invited to participate. One hundred seven were randomized, including 50 in the control and 57 in the treatment condition. Participants completed assessments at baseline, immediate post-test following HIVSRR, and at 3-months and 6-months after completion of the treatment group intervention. Outcomes for the current study include any violence (physical and/or sexual), sexual violence, and physical violence from paying partners in the past 90 days. An intention-to-treat approach was utilized. Linear growth models revealed significant reductions over time in both conditions for any violence (β = -0.867, p participation did not significantly impact women's risk for paying partner violence. Qualitative research is recommended to understand the cause for reductions in paying partner violence in both study conditions. Evaluating a Microfinance Intervention for High Risk Women in Mongolia; NCT01861431 ; May 20, 2013.

Integrating a Nurse-Midwife-Led Oral Health Intervention Into CenteringPregnancy Prenatal Care: Results of a Pilot Study.

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Adams, Sally H; Gregorich, Steven E; Rising, Sharon S; Hutchison, Margaret; Chung, Lisa H

2017-07-01

National and professional organizations recommend oral health promotion in prenatal care to improve women's oral health. However, few prenatal programs include education about oral health promotion. The objective of this study was to determine if women receiving a brief, low-cost, and sustainable educational intervention entitled CenteringPregnancy Oral Health Promotion had clinically improved oral health compared to women receiving standard CenteringPregnancy care. Women attending CenteringPregnancy, a group prenatal care model, at 4 health centers in the San Francisco Bay Area, participated in this nonrandomized controlled pilot study in 2010 to 2011. The intervention arm received the CenteringPregnancy Oral Health Promotion intervention consisting of two 15-minute skills-based educational modules addressing maternal and infant oral health, each module presented in a separate CenteringPregnancy prenatal care session. The present analysis focused on the maternal module that included facilitated discussions and skills-building activities including proper tooth brushing. The control arm received standard CenteringPregnancy prenatal care. Dental examinations and questionnaires were administered prior to and approximately 9 weeks postintervention. Primary outcomes included the Plaque Index, percent bleeding on probing, and percent of gingival pocket depths 4 mm or greater. Secondary outcomes were self-reported oral health knowledge, attitudes (importance and self-efficacy), and behaviors (tooth brushing and flossing). Regression models tested whether pre to post changes in outcomes differed between the intervention versus the control arms. One hundred and one women participated in the study; 49 were in the intervention arm, and 52 were in the control arm. The control and intervention arms did not vary significantly at baseline. Significant pre to post differences were noted between the arms with significant improvements in the intervention arm for the Plaque Index

Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study.

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Fitzgerald, Sarah; Murphy, Aileen; Kirby, Ann; Geaney, Fiona; Perry, Ivan J

2018-03-03

To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Four multinational manufacturing workplaces in Cork, Ireland. 517 randomly selected employees (18-65 years) from four workplaces. Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is considered in a cost-benefit analysis, whereby the system

Will environmental interventions affect the level of mastery motivation among children with disabilities? A preliminary study.

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Waldman-Levi, Amiya; Erez, Asnat Bar-Haim

2015-03-01

Children with developmental disabilities tend to demonstrate lower levels of mastery motivation in comparison with typically developing children. The goal of this study was to investigate the effect of physical and social environmental interventions on the mastery motivation of children with disabilities. Participants included 19 children (from two classes) with disabilities between the ages of 2-4 years from an educational rehabilitation centre. The Individualized Assessment of Mastery Motivation was used to assess the level of mastery motivation; the Early Childhood Environment Rating Scale - Revised and the Teacher-Child Interaction Observation were used to assess the physical and social environments. A counterbalance study design was used such that the children from the two classes received two phases of intervention, social and physical environmental interventions. The study's results point to the advantage of the social intervention, over the physical one, in improving the child's mastery motivation. However, the results lend support for the efficacy of using both aspects of environmental changes to the overall persistent score. The study findings, although preliminary, demonstrate the efficacy of providing both social and physical environmental interventions to improve mastery motivation. Copyright © 2014 John Wiley & Sons, Ltd.

Including Parents in the Continuum of School-Based Mental Health Services: A Review of Intervention Program Research from 1995 to 2010

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Mendez, Linda Raffaele; Ogg, Julia; Loker, Troy; Fefer, Sarah

2013-01-01

In this study, the authors reviewed journal articles published between 1995 and 2010 that described student mental health interventions involving parents delivered in school settings. Their review identified 100 articles describing 39 interventions. On the basis of participant selection criteria provided by the authors of the reviewed articles,…

Interventions for preventing obesity in children.

Science.gov (United States)

Summerbell, C D; Waters, E; Edmunds, L D; Kelly, S; Brown, T; Campbell, K J

2005-07-20

Obesity prevention is an international public health priority. The prevalence of obesity and overweight is increasing in child populations throughout the world, impacting on short and long-term health. Obesity prevention strategies for children can change behaviour but efficacy in terms of preventing obesity remains poorly understood. To assess the effectiveness of interventions designed to prevent obesity in childhood through diet, physical activity and/or lifestyle and social support. MEDLINE, PsycINFO, EMBASE, CINAHL and CENTRAL were searched from 1990 to February 2005. Non-English language papers were included and experts contacted. Randomised controlled trials and controlled clinical trials with minimum duration twelve weeks. Two reviewers independently extracted data and assessed study quality. Twenty-two studies were included; ten long-term (at least 12 months) and twelve short-term (12 weeks to 12 months). Nineteen were school/preschool-based interventions, one was a community-based intervention targeting low-income families, and two were family-based interventions targeting non-obese children of obese or overweight parents. Six of the ten long-term studies combined dietary education and physical activity interventions; five resulted in no difference in overweight status between groups and one resulted in improvements for girls receiving the intervention, but not boys. Two studies focused on physical activity alone. Of these, a multi-media approach appeared to be effective in preventing obesity. Two studies focused on nutrition education alone, but neither were effective in preventing obesity. Four of the twelve short-term studies focused on interventions to increase physical activity levels, and two of these studies resulted in minor reductions in overweight status in favour of the intervention. The other eight studies combined advice on diet and physical activity, but none had a significant impact. The studies were heterogeneous in terms of study design

Assessing cold chain status in a metro city of India: an intervention study.

Science.gov (United States)

Mallik, S; Mandal, P K; Chatterjee, C; Ghosh, P; Manna, N; Chakrabarty, D; Bagchi, S N; Dasgupta, S

2011-03-01

Cold chain maintenance is an essential activity to maintain the potency of vaccines and to prevent adverse events following immunization. One baseline study highlighted the unsatisfactory cold chain status in city of Kolkata in India. To assess the changes which occurred in the cold chain status after the intervention undertaken to improve the status and also to assess the awareness of the cold chain handlers regarding cold chain maintenance. Intervention consisted of reorganization of cold chain points and training of health manpower in Kolkata Municipal area regarding immunization and cold chain following the guidelines as laid by Govt of India. Reevaluation of cold chain status was done at 20 institutions selected by stratified systematic random sampling after the intervention. The results were compared with baseline survey. Significant improvement had been observed in correct placing of cold chain equipment, maintenance of stock security, orderly placing of ice packs, diluents and vaccines inside the equipment, temperature recording and maintenance. But awareness and skill of cold chain handlers regarding basics of cold chain maintenance was not satisfactory. The success of intervention included significant improvement of cold chain status including creation of a designated cold chain handler. The gaps lay in non-availability of non-electrical cold chain equipment and separate cold chain room, policy makers should stress. Cold chain handlers need reorientation training regarding heat & cold sensitive vaccines, preventive maintenance and correct contingency plan.

Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

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Huter, Kai; Dubas-Jakóbczyk, Katarzyna; Kocot, Ewa; Kissimova-Skarbek, Katarzyna; Rothgang, Heinz

2018-01-01

In the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological challenges that are discussed in the literature. They concern measurement and valuation of informal caregiving, accounting for productivity costs, effects of unrelated cost in added life years and the inclusion of 'beyond-health' benefits. This paper focuses on the question whether and to what extent specific methodological requirements are actually met in applied health economic evaluations. Following a systematic review of pertinent health economic evaluations, the included studies are analysed on the basis of four assessment criteria that are derived from methodological debates on the economic evaluation of health promotion interventions in general and economic evaluations targeting older people in particular. Of the 37 studies included in the systematic review, only very few include cost and outcome categories discussed as being of specific relevance to the assessment of health promotion interventions for older people. The few studies that consider these aspects use very heterogeneous methods, thus there is no common methodological standard. There is a strong need for the development of guidelines to achieve better comparability and to include cost categories and outcomes that are relevant for older people. Disregarding these methodological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and, hence, an age-based rationing of public health care.

Economic evaluation of angiographic interventions including a whole-radiology in- and outpatient care; Wirtschaftliche Evaluation angiographischer Interventionen einschliesslich einer radiologischen stationaeren und ambulanten Patientenbetreuung

Energy Technology Data Exchange (ETDEWEB)

Nolte-Ernsting, C.; Abel, K.; Krupski, G.; Lorenzen, J.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

2006-01-01

Purpose: To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. Materials and Methods: The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called ''ambulant operation'' (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Results: Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 Euro, the profits in our university hospital range between -872 Euro and +3411 Euro (mean: +1348 Euro). On the other hand, those angiographic interventions suitable for ''ambulant operation'' generate average profits of +372 Euro, if only direct costs are considered. The data of outpatient radiological interventions average between 381 Euro up to 1612 Euro lower than compared with profits obtained from in patient care. (orig.)

Math and Science Pursuits: A Self-Efficacy Intervention Comparison Study

Science.gov (United States)

Cordero, Elizabeth D.; Porter, Sarah H.; Israel, Tania; Brown, Michael T.

2010-01-01

This study compared two interventions to increase math self-efficacy among undergraduate students. Ninety-nine first-year undergraduate students participated in an intervention involving performance accomplishment or an intervention combining performance accomplishment and belief-perseverance techniques in which participants constructed a…

Designing and Undertaking a Health Economics Study of Digital Health Interventions.

Science.gov (United States)

McNamee, Paul; Murray, Elizabeth; Kelly, Michael P; Bojke, Laura; Chilcott, Jim; Fischer, Alastair; West, Robert; Yardley, Lucy

2016-11-01

This paper introduces and discusses key issues in the economic evaluation of digital health interventions. The purpose is to stimulate debate so that existing economic techniques may be refined or new methods developed. The paper does not seek to provide definitive guidance on appropriate methods of economic analysis for digital health interventions. This paper describes existing guides and analytic frameworks that have been suggested for the economic evaluation of healthcare interventions. Using selected examples of digital health interventions, it assesses how well existing guides and frameworks align to digital health interventions. It shows that digital health interventions may be best characterized as complex interventions in complex systems. Key features of complexity relate to intervention complexity, outcome complexity, and causal pathway complexity, with much of this driven by iterative intervention development over time and uncertainty regarding likely reach of the interventions among the relevant population. These characteristics imply that more-complex methods of economic evaluation are likely to be better able to capture fully the impact of the intervention on costs and benefits over the appropriate time horizon. This complexity includes wider measurement of costs and benefits, and a modeling framework that is able to capture dynamic interactions among the intervention, the population of interest, and the environment. The authors recommend that future research should develop and apply more-flexible modeling techniques to allow better prediction of the interdependency between interventions and important environmental influences. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Meta-Analysis of Studies Incorporating the Interests of Young Children with Autism Spectrum Disorders into Early Intervention Practices

OpenAIRE

Dunst, Carl J.; Trivette, Carol M.; Hamby, Deborah W.

2012-01-01

Incorporating the interests and preferences of young children with autism spectrum disorders into interventions to promote prosocial behavior and decrease behavior excesses has emerged as a promising practice for addressing the core features of autism. The efficacy of interest-based early intervention practices was examined in a meta-analysis of 24 studies including 78 children 2 to 6 years of age diagnosed with autism spectrum disorders. Effect size analyses of intervention versus noninterve...

Multicomponent Intervention for Patients Admitted to an Emergency Unit for Suicide Attempt: An Exploratory Study

Directory of Open Access Journals (Sweden)

Sebastien Brovelli

2017-09-01

Full Text Available Suicide is a major cause of premature deaths worldwide and belongs to the top priority public health issues. While suicide attempt is the most important risk factor for completed suicide, intervention for suicide attempters (SA have produced mixed results. Since an important proportion of SA request medical care, emergency units (EU are an opportune setting to implement such interventions. This exploratory study evaluated the feasibility and acceptability of a multicomponent intervention for SA admitted to an EU. The intervention consisted of coordination by a case manager of a joint crisis plan (JCP, an early meeting with relatives and the existing care network, as well as phone contacts during 3 months after suicide attempt. Among 107 SA admitted to the emergency unit during the study period, 51 could not be included for logistical reason, 22 were excluded, and intervention was offered to 34. Of these, 15 refused the intervention, which was thus piloted with 19 SA. First-time attempters most frequently declined the intervention. Feasibility and acceptability of phone contacts and case manager were good, while JCPs and meetings were difficult to implement and perceived as less acceptable. Refusal pattern questions the global acceptability and is discussed: JCPs and meetings will have to be modified in order to improve their feasibility and acceptability, especially among first-time attempters.

Pilot Study of a Parent Guided Website Access Package for Early Intervention Decision-Making for Autism Spectrum Disorder

Science.gov (United States)

Carlon, Sarah; Carter, Mark; Stephenson, Jennifer

2017-01-01

A pilot study of the effectiveness of guided access to websites that provide information on intervention options for children with autism spectrum disorder (ASD) was conducted with 12 parents of preschool aged children with ASD. Guided access to reliable websites that included information about the effcacy of interventions for ASD (Raising…

Partner randomized controlled trial: study protocol and coaching intervention

Directory of Open Access Journals (Sweden)

Garbutt Jane M

2012-04-01

Full Text Available Abstract Background Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. Methods and design This paper describes the protocol for a randomized controlled trial (RCT to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1 effective use of controller medications, 2 effective use of rescue medications and 3 monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1 the child's asthma control score, 2 the parent's quality of life score, and 3 the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications

A Microarray Study of Middle Cerebral Occlusion Rat Brain with Acupuncture Intervention

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Chao Zhang

2015-01-01

Full Text Available Microarray analysis was used to investigate the changes of gene expression of ischemic stroke and acupuncture intervention in middle cerebral artery occlusion (MCAo rat brain. Results showed that acupuncture intervention had a remarkable improvement in neural deficit score, cerebral blood flow, and cerebral infarction volume of MCAo rats. Microarray analysis showed that a total of 627 different expression genes were regulated in ischemic stroke. 417 genes were upregulated and 210 genes were downregulated. A total of 361 different expression genes were regulated after acupuncture intervention. Three genes were upregulated and 358 genes were downregulated. The expression of novel genes after acupuncture intervention, including Tph1 and Olr883, was further analyzed by Real-Time Quantitative Polymerase Chain Reaction (RT-PCR. Upregulation of Tph1 and downregulation of Olr883 indicated that the therapeutic effect of acupuncture for ischemic stroke may be closely related to the suppression of poststroke depression and regulation of olfactory transduction. In conclusion, the present study may enrich our understanding of the multiple pathological process of ischemic brain injury and indicate possible mechanisms of acupuncture on ischemic stroke.

A review of the nature and effectiveness of nutrition interventions in adult males--a guide for intervention strategies.

Science.gov (United States)

Taylor, Pennie J; Kolt, Gregory S; Vandelanotte, Corneel; Caperchione, Cristina M; Mummery, W Kerry; George, Emma S; Karunanithi, Mohanraj; Noakes, Manny J

2013-01-29

Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1) published from January 1990 to August 2011 and 2) male only studies (≥18 years) or 3) where males contributed to >90% of the active cohort. A study must have described, (i) a significant change (pstudies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg) and/or BMI (kg/m2) changes (p≤0.05). Four studies had effective interventions (pself-monitoring and tailored feedback. Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to guide researchers in making informed decisions on how to best utilise resources in interventions to engage adult males while highlighting the need for improved reporting of intervention protocols.

Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies.

Science.gov (United States)

Janket, S-J; Wightman, A; Baird, A E; Van Dyke, T E; Jones, J A

2005-12-01

Previous analyses regarding effects of periodontal treatment on glycemic control included studies where causal association might not be assumed, or the results were reported non-quantitatively. We initiated this meta-analysis of 10 intervention studies to quantify the effects of periodontal treatment on HbA1c level among diabetic patients, to explore possible causes for the discrepant reports, and to make recommendations for future studies. Data sources were MEDLINE (January, 1980, to January, 2005), the EBMR, Cochrane Register, and bibliographies of the published articles. Three investigators extracted data regarding intervention, outcomes, and effect size. A total of 456 patients was included in this analysis, with periodontal treatment as predictor and the actual change in hemoglobin A1c level as the outcome. The weighted average decrease in actual HbA1c level was 0.38% for all studies, 0.66% when restricted to type 2 diabetic patients, and 0.71% if antibiotics were given to them. However, none was statistically significant.

Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study

National Research Council Canada - National Science Library

Munshi, Medha

2008-01-01

.... The interventions are now being implemented with help of a geriatric life specialist (GLS). Intervention by GDT includes focused strategies to overcome barriers in the areas of clinical care, education, social environment, and finances...

Development of a novel mindfulness and cognitive behavioral intervention for stress-eating: a comparative pilot study.

Science.gov (United States)

Corsica, Joyce; Hood, Megan M; Katterman, Shawn; Kleinman, Brighid; Ivan, Iulia

2014-12-01

Stress-related eating is increasingly cited as a difficulty in managing healthy eating behaviors and weight. However few interventions have been designed to specifically target stress-related eating. In addition, the optimal target of such an intervention is unclear, as the target might be conceptualized as overall stress reduction or changing emotional eating-related thoughts and behaviors. This pilot study compared the effects of three interventions targeting those components individually and in combination on stress-related eating, perceived stress, and weight loss to determine whether the two intervention components are effective alone or are more effective when combined. Fifty-three overweight participants (98% female) who reported elevated levels of stress and stress-eating and were at risk for obesity were randomly assigned to one of three six-week interventions: a modified mindfulness-based stress reduction (MBSR) intervention, a cognitive behavioral stress-eating intervention (SEI), and a combined intervention that included all MBSR and SEI components. All three interventions significantly reduced perceived stress and stress-eating, but the combination intervention resulted in greater reductions and also produced a moderate effect on short term weight loss. Benefits persisted at six week follow-up.The pattern of results preliminarily suggests that the combination intervention (MBSR+SEI) may yield promise in the treatment of stress-related eating.

A longitudinal study of an intervention to improve road safety climate: climate as an organizational boundary spanner.

Science.gov (United States)

Naveh, Eitan; Katz-Navon, Tal

2015-01-01

This study presents and tests an intervention to enhance organizational climate and expands existing conceptualization of organizational climate to include its influence on employee behaviors outside the organization's physical boundaries. In addition, by integrating the literatures of climate and work-family interface, the study explored climate spillover and crossover from work to the home domain. Focusing on an applied practical problem within organizations, we investigated the example of road safety climate and employees' and their families' driving, using a longitudinal study design of road safety intervention versus control groups. Results demonstrated that the intervention increased road safety climate and decreased the number of traffic violation tickets and that road safety climate mediated the relationship between the intervention and the number of traffic violation tickets. Road safety climate spilled over to the family domain but did not cross over to influence family members' driving. (c) 2015 APA, all rights reserved.

Participatory modeling to support gender equality : The importance of including stakeholders in interventions

NARCIS (Netherlands)

Bleijenbergh, I.L.; van Engen, Marloes

2015-01-01

Purpose Interventions to support gender equality in organisations are often unsuccessful. Stakeholders disagree about the causes and problem definition of gender equality or pay lip service to the principle of gender equality, but fail to implement gender equality in practice. The purpose of this

Interventions for vaginismus.

Science.gov (United States)

Melnik, Tamara; Hawton, Keith; McGuire, Hugh

2012-12-12

Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitisation, have been proposed, and uncontrolled case series appear promising. To assess the effects of different interventions for vaginismus. We searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR-Studies and CCDANCTR-References) to August 2012. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched reference lists and conference abstracts. We contacted experts in the field regarding unpublished material. Controlled trials comparing treatments for vaginismus with another treatment, a placebo treatment, treatment as usual or waiting list control. The review authors extracted data which we verified with the trial investigator where possible. Five studies were included, of which four with a total of 282 participants provided data. No meta-analysis was possible due to heterogeneity of comparisons within included studies as well as inadequate reporting of data. All studies were considered to be at either moderate or high risk of bias. The results of this systematic review indicate that there is no clinical or statistical difference between systematic desensitisation and any of the control interventions (either waiting list control, systematic desensitisation combined with group therapy or in vitro (with women under instruction by the therapist) desensitisation) for the treatment of vaginismus. The drop-out rates were higher in the waiting list groups. A clinically relevant effect of systematic desensitisation when compared with any of the control interventions cannot be ruled out. None of the included trials compared other behaviour therapies (e

Bereavement care interventions: a systematic review

Directory of Open Access Journals (Sweden)

Feudtner Chris

2004-07-01

Full Text Available Abstract Background Despite abundant bereavement care options, consensus is lacking regarding optimal care for bereaved persons. Methods We conducted a systematic review, searching MEDLINE, PsychINFO, CINAHL, EBMR, and other databases using the terms (bereaved or bereavement and (grief combined with (intervention or support or counselling or therapy and (controlled or trial or design. We also searched citations in published reports for additional pertinent studies. Eligible studies had to evaluate whether the treatment of bereaved individuals reduced bereavement-related symptoms. Data from the studies was abstracted independently by two reviewers. Results 74 eligible studies evaluated diverse treatments designed to ameliorate a variety of outcomes associated with bereavement. Among studies utilizing a structured therapeutic relationship, eight featured pharmacotherapy (4 included an untreated control group, 39 featured support groups or counselling (23 included a control group, and 25 studies featured cognitive-behavioural, psychodynamic, psychoanalytical, or interpersonal therapies (17 included a control group. Seven studies employed systems-oriented interventions (all had control groups. Other than efficacy for pharmacological treatment of bereavement-related depression, we could identify no consistent pattern of treatment benefit among the other forms of interventions. Conclusions Due to a paucity of reports on controlled clinical trails, no rigorous evidence-based recommendation regarding the treatment of bereaved persons is currently possible except for the pharmacologic treatment of depression. We postulate the following five factors as impeding scientific progress regarding bereavement care interventions: 1 excessive theoretical heterogeneity, 2 stultifying between-study variation, 3 inadequate reporting of intervention procedures, 4 few published replication studies, and 5 methodological flaws of study design.

Effects of a continuum of care intervention on frail older persons' life satisfaction: a randomized controlled study.

Science.gov (United States)

Berglund, Helene; Hasson, Henna; Kjellgren, Karin; Wilhelmson, Katarina

2015-04-01

The aim of this study was to analyse effects of a comprehensive continuum of care (intervention group) on frail older persons' life satisfaction, as compared to those receiving usual care (control group). The intervention included geriatric assessment, case management, interprofessional collaboration, support for relatives and organising of care-planning meetings in older persons' own homes. Improvements in older persons' subjective well-being have been shown in studies including care planning and coordination by a case manager. However, effects of more complex continuum of care interventions on frail older persons' life satisfaction are not well explored. Randomised controlled study. The validated LiSat-11 scale was used in face-to-face interviews to assess older persons' life satisfaction at baseline and at three, six and 12 months after the baseline. The odds ratio for improving or maintaining satisfaction was compared for intervention and control groups from baseline to three-month, three- to six-month as well as six- to 12-month follow-ups. Older persons who received the intervention were more likely to improve or maintain satisfaction than those who received usual care, between 6 and 12 month follow-ups, for satisfaction regarding functional capacity, psychological health and financial situation. A comprehensive continuum of care intervention comprising several components had a positive effect on frail older persons' satisfaction with functional capacity, psychological health and financial situation. Frail older persons represent a great proportion of the persons in need of support from the health care system. Health care professionals need to consider continuum of care interventions' impact on life satisfaction. As life satisfaction is an essential part of older persons' well-being, we propose that policy makers and managers promote comprehensive continuum of care solutions. © 2014 John Wiley & Sons Ltd.

Social cognition interventions for people with schizophrenia: a systematic review focussing on methodological quality and intervention modality.

Science.gov (United States)

Grant, Nina; Lawrence, Megan; Preti, Antonio; Wykes, Til; Cella, Matteo

2017-08-01

People with a diagnosis of schizophrenia have significant social and functional difficulties. Social cognition was found to influences these outcomes and in recent years interventions targeting this domain were developed. This paper reviews the existing literature on social cognition interventions for people with a diagnosis of schizophrenia focussing on: i) comparing focussed (i.e. targeting only one social cognitive domain) and global interventions and ii) studies methodological quality. Systematic search was conducted on PubMed and PsycInfo. Studies were included if they were randomised control trials, participants had a diagnosis of schizophrenia or schizoaffective disorder, and the intervention targeted at least one out of four social cognition domains (i.e. theory of mind, affect recognition, social perception and attribution bias). All papers were assessed for methodological quality. Information on the intervention, control condition, study methodology and the main findings from each study were extracted and critically summarised. Data from 32 studies fulfilled the inclusion criteria, considering a total of 1440 participants. Taking part in social cognition interventions produced significant improvements in theory of mind and affect recognition compared to both passive and active control conditions. Results were less clear for social perception and attributional bias. Focussed and global interventions had similar results on outcomes. Overall study methodological quality was modest. There was very limited evidence showing that social cognitive intervention result in functional outcome improvement. The evidence considered suggests that social cognition interventions may be a valuable approach for people with a diagnosis of schizophrenia. However, evidence quality is limited by measure heterogeneity, modest study methodology and short follow-up periods. The findings point to a number of recommendations for future research, including measurement standardisation

Using a mixed-methods approach to measure impact of a school-based nutrition and media education intervention study on fruit and vegetable intake of Italian children.

Science.gov (United States)

Grassi, Elena; Evans, Alexandra; Ranjit, Nalini; Pria, Simona Dalla; Messina, Laura

2016-08-01

The purpose of the present study was to investigate the impact of a school-based nutrition and media education intervention on the promotion of fruit and vegetable consumption to help prevent childhood obesity. The 10-week-long intervention included sessions on nutrition education and media literacy. It also included a health communication media-based campaign workshop during which the children created posters, newsletters and video commercials related to fruits and vegetables targeted to their parents. For evaluation purposes, the study utilized a mixed-methods approach, including a quasi-experimental study (with one intervention group and one control group) and a focus group study. Four different elementary schools in Treviso (Veneto Region of Italy) agreed to participate in the research. The target population for the study included 10-year-old Italian children and their parents. Data indicate that this intervention was effective for children but not for parents. Evaluation results show that the intervention was effective in significantly increasing children's fruit and vegetable intake (Pmedia education intervention to address the children's obesity issue and, in particular, to increase children's fruit and vegetable intake. The study also opens a new perspective on the theoretical constructs investigated, because the development of 'ability of expression' could be considered one of the most important factors to determine the efficacy of the intervention.

Eat for life: a work site feasibility study of a novel mindfulness-based intuitive eating intervention.

Science.gov (United States)

Bush, Hannah E; Rossy, Lynn; Mintz, Laurie B; Schopp, Laura

2014-01-01

To examine the efficacy of a novel intervention for problematic eating behaviors and body dissatisfaction. Participants enrolled in the intervention or waitlist comparison group were assessed at pre and post 10 weeks. Midwestern university. One hundred twenty-four female employees or partners/spouses. Eat for Life is a 10-week group intervention integrating mindfulness and intuitive eating skills. Self-report questionnaires included the Intuitive Eating Scale, Body Appreciation Scale, Five-Facet Mindfulness Questionnaire, Questionnaire for Eating Disorder Diagnoses, and an author-constructed supplemental and demographic questionnaire. Analyses of covariance and ordinal regression measured group differences. Structural equation modeling examined mediation effects. Results . Significant differences between groups were observed for body appreciation (F1,121 = 40.17, p = .000, partial eta squared = .25), intuitive eating (F1,121 = 67.44, p = .000, partial eta squared = .36), and mindfulness (F1,121 = 30.50, p = .000, partial eta squared = .20), with mean scores significantly higher in the intervention group than waitlist comparison group after 10 weeks. The intervention group was 3.65 times more likely to be asymptomatic for disordered eating than the comparison group. Mindfulness served as a partial mediator. The study provides support for an intervention combining intuitive eating and mindfulness for treatment of problematic eating behaviors and body dissatisfaction, with limitations including self-selection and lack of active control group.

Functional Assessment Based Parent Intervention in Reducing Children’s Challenging Behaviors: Exploratory Study of Group Training

OpenAIRE

Angel Fettig; Michaelene M. Ostrosky

2014-01-01

This study examined the effects of group parent training on children’s challenging behaviors in home settings. Eight parents of young children with challenging behaviors were trained in a large group setting on using functional assessment to design interventions that fit the strengths and needs of individual families. The training included information sharing and collaborating with parents on designing functional-assessment based interventions. An Interrupted Time Series Design was used to ex...

Workplace physical activity interventions: a systematic review.

Science.gov (United States)

To, Quyen G; Chen, Ted T L; Magnussen, Costan G; To, Kien G

2013-01-01

To assess the effectiveness of workplace interventions in improving physical activity. EBSCO research database (and all subdatabases). Articles were published from 2000 to 2010 in English, had appropriate designs, and measured employees' physical activity, energy consumption, and/or body mass index (BMI) as primary outcomes. Articles that did not meet the inclusion criteria were excluded. Data extracted included study design, study population, duration, intervention activities, outcomes, and results. Data were synthesized into one table. Results of each relevant outcome including p values were combined. Twelve (60%) of 20 selected interventions reported an improvement in physical activity level, steps, or BMI, and there was one slowed step reduction in the intervention group. Among these, 10 were less than 6 months in duration; 9 used pedometers; 6 applied Internet-based approaches; and 5 included activities targeting social and environmental levels. Seven of 8 interventions with pre-posttest and quasi-experimental controlled design showed improvement on at least one outcome. However, 7 of 12 randomized controlled trials (RCTs) did not prove effective in any outcome. Interventions that had less rigorous research designs, used pedometers, applied Internet-based approaches, and included activities at social and environmental levels were more likely to report being effective than those without these characteristics.

The Sun Sense Study: An Intervention to Improve Sun Protection in Children

Science.gov (United States)

Glasser, Alice; Shaheen, Magda; Glenn, Beth A.; Bastani, Roshan

2010-01-01

Objectives: To assess the effect of a multicomponent intervention on parental knowledge, sun avoidance behaviors, and sun protection practices in children 3-10 years. Methods: A randomized trial at a pediatric clinic recruited 197 caregiver-child pairs (90% parents). Intervention included a brief presentation and brochure for the parent and…

Tolerability and suitability of brief group mindfulness-oriented interventions in psychiatric inpatients: a pilot study.

Science.gov (United States)

Nikolitch, Katerina; Laliberté, Vincent; Yu, Ching; Strychowsky, Natalie; Segal, Marilyn; Looper, Karl J; Rej, Soham

2016-09-01

Mindfulness-oriented therapies have a positive impact on patients' overall well-being and alleviate many psychiatric conditions. However, little is known about their use in people with severe mental illness. We aimed to identify which clinical and sociodemographic factors are associated with suitability/tolerability of a brief group mindfulness-oriented therapy. This retrospective study examines pre-/post-data from 40 psychiatric inpatients who underwent one session of a 10-min mindfulness-oriented group intervention between January and March 2014. The main outcome was 'suitability for and tolerating the brief mindfulness-oriented group intervention'. We assessed potential correlates of the main outcome, including female gender, shorter hospitalisation, the absence of psychosis and good pre-morbid functioning. The intervention was well tolerated (92.5%) and 50% of patients met both of our relatively stringent suitability and tolerability criteria. Sociodemographic and clinical variables were not associated with suitability/tolerability. Tai chi was the most suitable/tolerable compared to body scan and mindful eating (76.5% vs. 35.7% vs. 22.2%, Fisher's exact p = 0.01, Bonferroni p mindfulness therapy interventions are very well tolerated and often suitable for acutely hospitalised psychiatric inpatients, including those with acute psychosis. Mindfulness-oriented intervention with an active component (e.g., tai chi, mindful walking) may potentially be best suited for this population.

Advances in psychological interventions for lifestyle disorders: overview of interventions in cardiovascular disorder and type 2 diabetes mellitus.

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Sudhir, Paulomi M

2017-09-01

The present review examines the recent advances in psychological interventions for two major lifestyle disorders in adults namely, type 2 diabetes mellitus and cardiovascular disorders. The review summarizes findings from studies carried out between the years 2015 and 2017. The effectiveness of psychological interventions in the management of lifestyle disorders has been examined with respect to adaptation, self-care, adherence, negative emotions and improving quality of life. There is an increasing recognition that psychological interventions are important for prevention of lifestyle disorders and promotion of health. Key psychological interventions include self-management and educational interventions based on learning and motivational principles, patient empowerment, cognitive behaviour therapy, behavioural skills and coaching. Recent developments also include the use of information technology to deliver these interventions through internet, mobile applications and text messages. Another significant development is that of mindfulness-based interventions within the third-generation behaviour therapy approaches to reduce distress and increase acceptance. In addition, family and couples interventions have also been emphasised as necessary in maintenance of healthy behaviours. Studies examining psychological interventions in cardiovascular and type 2 diabetes mellitus support the efficacy of these interventions in bringing about changes in biochemical / physiological parameters and in psychological outcomes such as self-efficacy, knowledge, quality of life and a sense of empowerment.

Mediterranean diet better adherence by digital intervention (MEDADIS study on overweight and obese patients.

Directory of Open Access Journals (Sweden)

Maria Loreto Tarraga Marcos

2017-03-01

Full Text Available Objective: To evaluate the impact of based behavioral interventions delivered by digital platform to increase adherence to Mediterranean diet and physical activity in overweight or obese patients detected by laboral health service. Methods: Randomized, controlled, double-blind, parallel clinical trial comparing 2 arms, multicenter study in overweight and obese patients with a 12-month follow-up. Patients were randomized into two groups: Intervention in Primary Care Centers with a Medtep telematic platform support (G2 and a control group that was allowed to evolve under normal conditions (G1.Variables were collected: Weight, height, BMI, waist circumference, lipid parameters, blood pressure and glycemia. Results: 120 patients were included in the study where 60 were randomized to Group 2 and 60 to Group 1. 58.6% of the study population were women and 41.4% were men. In the intervention group, the subjects reduced their weight by an average of 6.5 kg, while the control group increased slightly more than 1`5 kg. It is observed that total cholesterol was reduced in both groups. On the other hand Triglycerides were significantly reduced more in the study group, without achieving significant differences in the control group (p = 0.710. HDL cholesterol was increased in both groups. Conclusion: The group in which no intervention, weight gain normal evolution was made.

Towards measurement of the Healthy Ageing Phenotype in lifestyle-based intervention studies.

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Lara, Jose; Godfrey, Alan; Evans, Elizabeth; Heaven, Ben; Brown, Laura J E; Barron, Evelyn; Rochester, Lynn; Meyer, Thomas D; Mathers, John C

2013-10-01

Given the biological complexity of the ageing process, there is no single, simple and reliable measure of how healthily someone is ageing. Intervention studies need a panel of measures which capture key features of healthy ageing. To help guide our research in this area, we have adopted the concept of the "Healthy Ageing Phenotype" (HAP) and this study aimed to (i) identify the most important features of the HAP and (ii) identify/develop tools for measurement of those features. After a comprehensive assessment of the literature we selected the following domains: physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we hoped would provide a reasonably holistic characterisation of the HAP. We reviewed the literature and identified systematic reviews and/or meta-analysis of cohort studies, and clinical guidelines on outcome measures of these domains relevant to the HAP. Selection criteria for these measures included: frequent use in longitudinal studies of ageing; expected to change with age; evidence for strong association with/prediction of ageing-related phenotypes such as morbidity, mortality and lifespan; whenever possible, focus on studies measuring these outcomes in populations rather than on individuals selected on the basis of a particular disease; (bio)markers that respond to (lifestyle-based) intervention. Proposed markers were exposed to critique in a Workshop held in Newcastle, UK in October 2012. We have selected a tentative panel of (bio)markers of physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we propose may be useful in characterising the HAP and which may have utility as outcome measures in intervention studies. In addition, we have identified a number of tools which could be applied in community-based intervention studies designed to enhance healthy ageing. We have proposed, tentatively, a panel

Study on predictors of health outcome in patients attending hypertension intervention programme in Malaysia.

OpenAIRE

Wahab, Rasidah Abd.

2008-01-01

The aim of this study is to explore predictor of health outcomes among Malaysian hypertensive patients attending a standard hypertension intervention programme. Among the psychological predictors studied are illness perception, health locus of control, and self-efficacy. Quality of life, anxiety and depression and demographic variables are among the predictors included in the study. Two series of studies were conducted to answer the research question formulated for each study. Study 1 aims to...

Treatment of Neck Pain: Noninvasive Interventions

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Carragee, Eugene J.; van der Velde, Gabrielle; Carroll, Linda J.; Nordin, Margareta; Guzman, Jaime; Peloso, Paul M.; Holm, Lena W.; Côté, Pierre; Hogg-Johnson, Sheilah; Cassidy, J. David; Haldeman, Scott

2008-01-01

Study Design. Best evidence synthesis. Objective. To identify, critically appraise, and synthesize literature from 1980 through 2006 on noninvasive interventions for neck pain and its associated disorders. Summary of Background Data. No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disorders in the past decade. Methods. We systematically searched Medline and screened for relevance literature published from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions for neck pain and associated disorders. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our best evidence synthesis. Results. Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (including health care utilization, costs, and safety). For whiplash-associated disorders, there is evidence that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions; however, none of the active treatments was clearly superior to any other in either the short-or long-term. For both whiplash-associated disorders and other neck pain without radicular symptoms, interventions that focused on regaining function as soon as possible are relatively more effective than interventions that do not have such a focus. Conclusion. Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain; this was also true of therapies which include educational interventions

The Environmental Impact on Occupational Therapy Interventions.

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Skubik-Peplaski, Camille Louise; Howell, Dana; Hunter, Elizabeth

2016-01-01

The purpose of this study was to investigate how the environment influenced the intervention choices occupational therapists made for patients recovering from a stroke in an inpatient rehabilitation hospital. Three occupational therapists were observed providing intervention for six patients over a 16-month period. Treatment spaces included a therapy gym, gym with kitchen combination, and a home-like space. Furniture was added to the therapy gym to be more home-like midway through the study. Observations included therapist selection of treatment location and interventions, and observational data of the environment and interactions among therapists and patients. This study found that inpatient rehabilitation environments did influence interventions. The occupational therapists provided therapy in the standard therapy gym environment most often, whether it was enhanced to be more home-like or not, and predominately used preparatory methods.

mHealth intervention to support asthma self-management in adolescents: the ADAPT study

Directory of Open Access Journals (Sweden)

Kosse RC

2017-03-01

Full Text Available Richelle C Kosse,1 Marcel L Bouvy,1 Tjalling W de Vries,2 Ad A Kaptein,3 Harm CJ Geers,1 Liset van Dijk,4 Ellen S Koster1 1Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, 2Department of Paediatrics, Medical Center Leeuwarden, Leeuwarden, 3Medical Psychology, Leiden University Medical Center, Leiden, 4NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands Purpose: Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. Intervention: The ADAPT intervention consists of an interactive smartphone application (app connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1 a questionnaire function to rate asthma symptoms and monitor these over time; 2 short movie clips with medication and disease information; 3 a medication reminder; 4 a chat function with peers; and 5 a chat function with the pharmacist. The pharmacist receives data from the patient’s app through the desktop application, which enables the pharmacist to send information and feedback to the patient. Study design: The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient’s self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. Conclusion: This study will provide in

Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

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Besharati, Fereshteh; Karimi-Shahanjarini, Akram; Hazavehei, Seyed Mohammad Mehdi; Bashirian, Saeid; Bagheri, Fahimeh; Faradmal, Javad

2017-08-27

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (Pintervention addressing CRC screening among Iranian population. Creative Commons Attribution License

Interactive Multimedia Training in Osteoporosis Prevention of Female High School Students: An Interventional Study.

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Zarshenas, Ladan; Keshavarz, Tala; Momennasab, Marzieh; Zarifsanaiey, Nahid

2017-08-01

Given the limitations of traditional teaching methods in the learning process of adolescents, this study was designed to investigate the effects of osteoporosis prevention training through interactive multimedia method on the degree of knowledge and self-efficacy of female high school students. In this interventional study which was conducted in 2016 in Fars province, Iran, 120 high school students were selected through proportional stratified sampling from schools and different classes at first, second, third, and pre-university grades. The participants were randomly divided into two groups, each containing 60 students. Educational interventions for the test group included an interactive multimedia CD, and for the control group was an educational booklet. Before and one month after the intervention the students' level of knowledge and self-efficacy was measured. The spss 19 statistical software was used, and descriptive and analytical tests were performed to analyze the data. Results showed a significant difference in self-efficacy scores after the intervention (P=0.012) with the test group obtained a higher self-efficacy score than the control group. Also, a significant increase was observed in the knowledge score of both groups after the training (Pstatistically significant (P=0.38) after the intervention. The use of new training methods like interactive multimedia CD for public education, particular adolescents about health and hygiene is recommended.

SAFE MOTHERHOOD INTERVENTION STUDIES IN AFRICA: A ...

African Journals Online (AJOL)

hi-tech

2000-11-01

Nov 1, 2000 ... East African Medical Journal Vol. .... The present literature review identified two studies ... strategies used were: education of community members ... Three studies tested interventions to reduce travel ... home outweighed the perceived benefit of the homes in ..... concept: the Nsawam, Ghana experience.

Interventional studies of the upper gastrointestinal tract

International Nuclear Information System (INIS)

Shapiro, B.; Gross, M.D.

1985-01-01

Nuclear Medicine studies of the upper gastrointestinal (GI) tract provide a means whereby physiologic and pathophysiologic features can be observed from a unique and noninvasive perspective. While nuclear medicine studies by their very nature lack the high spatial resolution of the radiographic approach, the data derived are readily quantitated and presented in numerical fashion to provide functional and dynamic information in which the influences of interventions may be observed. This chapter outlines the scope of such interventions in studies of the upper GI tract with emphasis on examinations for gastroesophageal reflux and gastric emptying. The interactions of nutrients, physical maneuvers of pharmacologic agents on nuclear medicine studies of the upper GI tract may be intentional to render a test more sensitive or to evaluate the effect of therapy, or may represent an unintentional side effect that must be taken into account if misinterpretation is to be avoided

mHealth intervention to support asthma self-management in adolescents: the ADAPT study.

Science.gov (United States)

Kosse, Richelle C; Bouvy, Marcel L; de Vries, Tjalling W; Kaptein, Ad A; Geers, Harm Cj; van Dijk, Liset; Koster, Ellen S

2017-01-01

Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. The ADAPT intervention consists of an interactive smartphone application (app) connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1) a questionnaire function to rate asthma symptoms and monitor these over time; 2) short movie clips with medication and disease information; 3) a medication reminder; 4) a chat function with peers; and 5) a chat function with the pharmacist. The pharmacist receives data from the patient's app through the desktop application, which enables the pharmacist to send information and feedback to the patient. The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient's self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. This study will provide in-depth knowledge on the effectiveness of an mHealth intervention to support asthma self-management in adolescents. These insights will also be useful for adolescents with other chronic diseases.

A feasibility study of a theory-based intervention to improve appropriate polypharmacy for older people in primary care.

Science.gov (United States)

Cadogan, Cathal A; Ryan, Cristín; Gormley, Gerard J; Francis, Jill J; Passmore, Peter; Kerse, Ngaire; Hughes, Carmel M

2018-01-01

A general practitioner (GP)-targeted intervention aimed at improving the prescribing of appropriate polypharmacy for older people was previously developed using a systematic, theory-based approach based on the UK Medical Research Council's complex intervention framework. The primary intervention component comprised a video demonstration of a GP prescribing appropriate polypharmacy during a consultation with an older patient. The video was delivered to GPs online and included feedback emphasising the positive outcomes of performing the behaviour. As a complementary intervention component, patients were invited to scheduled medication review consultations with GPs. This study aimed to test the feasibility of the intervention and study procedures (recruitment, data collection). GPs from two general practices were given access to the video, and reception staff scheduled consultations with older patients receiving polypharmacy (≥4 medicines). Primary feasibility study outcomes were the usability and acceptability of the intervention to GPs. Feedback was collected from GP and patient participants using structured questionnaires. Clinical data were also extracted from recruited patients' medical records (baseline and 1 month post-consultation). The feasibility of applying validated assessment of prescribing appropriateness (STOPP/START criteria, Medication Appropriateness Index) and medication regimen complexity (Medication Regimen Complexity Index) to these data was investigated. Data analysis was descriptive, providing an overview of participants' feedback and clinical assessment findings. Four GPs and ten patients were recruited across two practices. The intervention was considered usable and acceptable by GPs. Some reservations were expressed by GPs as to whether the video truly reflected resource and time pressures encountered in the general practice working environment. Patient feedback on the scheduled consultations was positive. Patients welcomed the

Boosting Reading Fluency: An Intervention Case Study at Subword Level

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Kairaluoma, Leila; Ahonen, Timo; Aro, Mikko; Holopainen, Leena

2007-01-01

This study is an intervention case study of fluency in Finnish-speaking children with dyslexia. Two 7-year-old children, a girl and a boy, were selected from the Jyvaskyla Longitudinal Study of Dyslexia. The intervention emphasised syllables as reading units, and proceeded from reading syllables to reading words and text. Letter knowledge, reading…

Efficacy of a Multicomponent Positive Psychology Self-Help Intervention: Study Protocol of a Randomized Controlled Trial

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Drossaert, Constance HC; Pieterse, Marcel E; Walburg, Jan A; Bohlmeijer, Ernst T

2015-01-01

Background Positive psychology interventions have been found to enhance well-being and decrease clinical symptomatology. However, it is still unknown how flourishing can also be increased. Although multicomponent interventions seem to be necessary for this purpose, different formats can be used. A cost-effective approach could be a positive psychology-based self-help book with tailored email support to reach large target groups and to prevent dropout. Objective This study will evaluate the efficacy of a comprehensive multicomponent self-help intervention with or without email support on well-being and flourishing, and will seek to determine the working mechanisms underlying the intervention. Methods In this 3-armed, parallel, randomized controlled trial, 396 participants with low or moderate levels of well-being and without clinical symptomatology will be randomly assigned to (1) a self-help book condition with weekly email support, (2) a self-help book condition without email support but with a weekly information email, or (3) a waiting list control condition. Online measurements will be assessed at baseline, at post-test (3 months after baseline), and at 6 and 12 months after baseline. Results The primary outcomes are well-being and flourishing (ie, high levels of well-being). Secondary outcomes are the well-being components included in the intervention: positive emotion, use of strengths, optimism, self-compassion, resilience, and positive relations. Other measures include depressive and anxiety symptoms, personality traits, direct medical and non-medical costs, life-events, and client satisfaction. Conclusions This study will add knowledge to the efficacy and cost-effectiveness of a multicomponent positive psychology intervention. We will also explore who can benefit most from this intervention. If the intervention is found to be effective, our results will be especially relevant for public mental health services, governments, and primary care. Trial

The forgotten parent: Fathers' representation in family interventions to prevent childhood obesity.

Science.gov (United States)

Davison, K K; Kitos, N; Aftosmes-Tobio, A; Ash, T; Agaronov, A; Sepulveda, M; Haines, J

2018-06-01

Despite recognition that parents are critical stakeholders in childhood obesity prevention, obesity research has overwhelmingly focused on mothers. In a recent review, fathers represented only 17% of parent participants in >600 observational studies on parenting and childhood obesity. The current study examined the representation of fathers in family interventions to prevent childhood obesity and characteristics of interventions that include fathers compared with those that only include mothers. Eligible studies included family-based interventions for childhood obesity prevention published between 2008 and 2015 identified in a recent systematic review. Data on intervention characteristics were extracted from the original review. Using a standardized coding scheme, these data were augmented with new data on the number of participating fathers/male caregivers and mothers/female caregivers. Out of 85 eligible interventions, 31 (37%) included mothers and fathers, 29 (34%) included only mothers, 1 (1%) included only fathers, and 24 (28%) did not provide information on parent gender. Of the interventions that included fathers, half included 10 or fewer fathers. Across all interventions, fathers represented a mere 6% of parent participants. Father inclusion was more common in interventions targeting families with elementary school-aged children (6-10 years) and those grounded in Ecological Systems Theory, and was less common in interventions focused on very young children (0-1 years) or the prenatal period and those targeting the sleep environment. This study emphasizes the lack of fathers in childhood obesity interventions and highlights a particular need to recruit and engage fathers of young children in prevention efforts. Copyright © 2018 Elsevier Inc. All rights reserved.

Study protocol: intervention in maternal perception of preschoolers' weight among Mexican and Mexican-American mothers.

Science.gov (United States)

Flores-Peña, Yolanda; He, Meizi; Sosa, Erica T; Avila-Alpirez, Hermelinda; Trejo-Ortiz, Perla M

2018-05-30

Childhood obesity is a public health issue negatively affecting children's physical and psychosocial health. Mothers are children's primary caregivers, thus key players in childhood obesity prevention. Studies have indicated that mothers underestimate their children's weight. If mothers are unaware of their children's weight problem, they are less likely to participate in activities preventing and treating excess weight. The "Healthy Change" intervention is designed to change maternal perception of child's weight (MPCW) through peer-led group health education in childcare settings. The "Healthy Change" is a multicenter two-arm randomized trial in four centers. Three centers are in Mexican States (Nuevo Leon, Tamaulipas, and Zacatecas). The fourth center is in San Antonio, Texas, USA. A total of 360 mother-child pairs (90 pairs per center) are to be randomly and evenly allocated to either the intervention or the control group. Intervention group will receive four-session group obesity prevention education. Control group will receive a four-session personal and food hygiene education. The education is delivered by trained peer-mother promotoras. Data will be collected using questionnaires and focus groups. The primary outcome is a change in proportion of mothers with accurate MPCW. Secondary outcomes include change in maternal feeding styles and practices, maternal self-efficacy and actions for managing child excessive weight gain. McNemar's Test will be used to test the primary outcome. The GLM Univariate procedure will be used to determine intervention effects on secondary outcomes. The models will include the secondary outcome measures as the dependent variables, treatment condition (intervention/control) as the fixed factor, and confounding factors (e.g., mother's education, children's gender and age) as covariates. Sub-analyses will be performed to compare intervention effects on primary and secondary outcomes between the samples from Mexico and Texas, USA

Interventions for preventing unintended pregnancies among adolescents.

Science.gov (United States)

Oringanje, Chioma; Meremikwu, Martin M; Eko, Hokehe; Esu, Ekpereonne; Meremikwu, Anne; Ehiri, John E

2016-02-03

Unintended pregnancy among adolescents represents an important public health challenge in high-income countries, as well as middle- and low-income countries. Numerous prevention strategies such as health education, skills-building and improving accessibility to contraceptives have been employed by countries across the world, in an effort to address this problem. However, there is uncertainty regarding the effects of these interventions, hence the need to review the evidence-base. To assess the effects of primary prevention interventions (school-based, community/home-based, clinic-based, and faith-based) on unintended pregnancies among adolescents. We searched all relevant studies regardless of language or publication status up to November 2015. We searched the Cochrane Fertility Regulation Group Specialised trial register, The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015 Issue 11), MEDLINE, EMBASE, LILACS, Social Science Citation Index and Science Citation Index, Dissertations Abstracts Online, The Gray Literature Network, HealthStar, PsycINFO, CINAHL and POPLINE and the reference lists of articles. We included both individual and cluster randomised controlled trials (RCTs) evaluating any interventions that aimed to increase knowledge and attitudes relating to risk of unintended pregnancies, promote delay in the initiation of sexual intercourse and encourage consistent use of birth control methods to reduce unintended pregnancies in adolescents aged 10 years to 19 years. Two authors independently assessed trial eligibility and risk of bias, and extracted data. Where appropriate, binary outcomes were pooled using a random-effects model with a 95% confidence interval (Cl). Where appropriate, we combined data in meta-analyses and assessed the quality of the evidence using the GRADE approach. We included 53 RCTs that enrolled 105,368 adolescents. Participants were ethnically diverse. Eighteen studies randomised individuals, 32

Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study.

Science.gov (United States)

Grossert, Astrid; Urech, Corinne; Alder, Judith; Gaab, Jens; Berger, Thomas; Hess, Viviane

2016-11-03

Being diagnosed with cancer causes major psychological distress, yet the majority of newly diagnosed cancer patients lack psychological support. Internet interventions overcome many barriers for seeking face-to-face support and allow for independence in time and place. We assess efficacy and feasibility of the first web-based stress management intervention (STREAM: STREss-Aktiv-Mindern) for newly diagnosed, German-speaking cancer patients. In a prospective, wait-list controlled trial 120 newly diagnosed cancer patients will be included within 12 weeks of starting anti-cancer treatment and randomized between an immediate (intervention group) or delayed (control group) 8-week, web-based intervention. The intervention consists of eight modules with weekly written feedback by a psychologist ("minimal-contact") based on well-established stress management manuals including downloadable audio-files and exercises. The aim of this study is to evaluate efficacy in terms of improvement in quality of life (FACT-F), as well as decrease in anxiety and depression (HADS), as compared to patients in the wait-list control group. A sample size of 120 patients allows demonstrating a clinically relevant difference of nine points in the FACT score after the intervention (T2) with a two-sided alpha of 0.05 and 80 % power. As this is the first online stress management intervention for German-speaking cancer patients, more descriptive outcomes are equally important to further refine the group of patients with the largest potential for benefit who then will be targeted more specifically in future trials. These descriptive endpoints include: patients' characteristics (type of cancer, type of treatment, socio-demographic factors), dropout rate and dropout reasons, adherence and satisfaction with the program. New technologies open new opportunities: minimal-contact psychological interventions are becoming standard of care in several psychological disorders, where their efficacy is often

Variations in childbirth interventions in high-income countries: protocol for a multinational cross-sectional study.

Science.gov (United States)

Seijmonsbergen-Schermers, Anna; van den Akker, Thomas; Beeckman, Katrien; Bogaerts, Annick; Barros, Monalisa; Janssen, Patricia; Binfa, Lorena; Rydahl, Eva; Frith, Lucy; Gross, Mechthild M; Hálfdánsdóttir, Berglind; Daly, Deirdre; Calleja-Agius, Jean; Gillen, Patricia; Vika Nilsen, Anne Britt; Declercq, Eugene; de Jonge, Ank

2018-01-10

There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women. This multinational cross-sectional study will use data from births in 2013 with national population data or representative samples of the population of pregnant women in high-income countries. Data from women who gave birth to a single child from 37 weeks gestation onwards will be included and the results will be presented for nulliparous and multiparous women separately. Anonymised individual level data will be analysed. Primary outcomes are rates of commonly used childbirth interventions, including induction and/or augmentation of labour, intrapartum antibiotics, epidural and pharmacological pain relief, episiotomy in vaginal births, instrument-assisted birth (vacuum or forceps), caesarean section and use of oxytocin postpartum. Secondary outcomes are maternal and perinatal mortality, Apgar score below 7 at 5 min, postpartum haemorrhage and obstetric anal sphincter injury. Univariable and multivariable logistic regression analyses will be conducted to investigate variations among countries, adjusted for maternal age, body mass index, gestational weight gain, ethnic background, socioeconomic status and infant birth weight. The overall mean rates will be considered as a reference category, weighted for the size of the study population per country. The Medical Ethics Review Committee of VU University Medical Center Amsterdam confirmed that an official approval of this study was not required

Using the intervention mapping protocol to develop a maintenance programme for the SLIMMER diabetes prevention intervention.

Science.gov (United States)

Elsman, Ellen B M; Leerlooijer, Joanne N; Ter Beek, Josien; Duijzer, Geerke; Jansen, Sophia C; Hiddink, Gerrit J; Feskens, Edith J M; Haveman-Nies, Annemien

2014-10-27

Although lifestyle interventions have shown to be effective in reducing the risk for type 2 diabetes mellitus, maintenance of achieved results is difficult, as participants often experience relapse after the intervention has ended. This paper describes the systematic development of a maintenance programme for the extensive SLIMMER intervention, an existing diabetes prevention intervention for high-risk individuals, implemented in a real-life setting in the Netherlands. The maintenance programme was developed using the Intervention Mapping protocol. Programme development was informed by a literature study supplemented by various focus group discussions and feedback from implementers of the extensive SLIMMER intervention. The maintenance programme was designed to sustain a healthy diet and physical activity pattern by targeting knowledge, attitudes, subjective norms and perceived behavioural control of the SLIMMER participants. Practical applications were clustered into nine programme components, including sports clinics at local sports clubs, a concluding meeting with the physiotherapist and dietician, and a return session with the physiotherapist, dietician and physical activity group. Manuals were developed for the implementers and included a detailed time table and step-by-step instructions on how to implement the maintenance programme. The Intervention Mapping protocol provided a useful framework to systematically plan a maintenance programme for the extensive SLIMMER intervention. The study showed that planning a maintenance programme can build on existing implementation structures of the extensive programme. Future research is needed to determine to what extent the maintenance programme contributes to sustained effects in participants of lifestyle interventions.

Promoting physical activity and health literacy: study protocol for a longitudinal, mixed methods evaluation of a cross-provider workplace-related intervention in Germany (The AtRisk study).

Science.gov (United States)

Schaller, Andrea; Dejonghe, Lea; Alayli-Goebbels, Adrienne; Biallas, Bianca; Froboese, Ingo

2016-07-22

Physical activity and health literacy are topics of utmost importance in the prevention of chronic diseases. The present article describes the study protocol for evaluating a cross-provider workplace-related intervention promoting physical activity and health literacy. The RE-AIM Framework will be the conceptual framework of the AtRisk study. A controlled natural experiment and a qualitative study will be conducted. The cross-provider intervention is based on the cooperation of the German Pension Fund Rhineland and cooperating German Statutory Health Insurances. It combines two components: a behavior-oriented lifestyle intervention and the assignment of a health coach. The single-provider intervention only includes the behavior-oriented lifestyle intervention. The quantitative study (natural experiment) encompasses three measuring points (T0 = start of the behavior-oriented lifestyle intervention (baseline); T1 = end of the behavior-oriented lifestyle intervention (16 weeks); T2 = 6 month follow-up) and will compare the effectiveness of the cross-provider workplace-related intervention compared with the single provider intervention. Participants are employees with health related risk factors. ANCOVA will be used to evaluate the effect of the intervention on the outcome variables leisure time physical (primary outcome) activity and health literacy (secondary outcome). The qualitative study comprises semi-structured interviews, systematic field notes of stakeholder meetings and document analyses. The AtRisk study will contribute towards the claim for cross-provider interventions and workplace-related approaches described in the new Preventive Health Care Act. The results of this study will inform providers, payers and policy makers about the effectiveness of a cross-provider workplace-related lifestyle intervention compared to a single-provider intervention. Beyond, the study will identify challenges for implementing cross-provider preventive

Promoting physical activity and health literacy: study protocol for a longitudinal, mixed methods evaluation of a cross-provider workplace-related intervention in Germany (The AtRisk study

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Andrea Schaller

2016-07-01

Full Text Available Abstract Background Physical activity and health literacy are topics of utmost importance in the prevention of chronic diseases. The present article describes the study protocol for evaluating a cross-provider workplace-related intervention promoting physical activity and health literacy. Methods The RE-AIM Framework will be the conceptual framework of the AtRisk study. A controlled natural experiment and a qualitative study will be conducted. The cross-provider intervention is based on the cooperation of the German Pension Fund Rhineland and cooperating German Statutory Health Insurances. It combines two components: a behavior-oriented lifestyle intervention and the assignment of a health coach. The single-provider intervention only includes the behavior-oriented lifestyle intervention. The quantitative study (natural experiment encompasses three measuring points (T0 = start of the behavior-oriented lifestyle intervention (baseline; T1 = end of the behavior-oriented lifestyle intervention (16 weeks; T2 = 6 month follow-up and will compare the effectiveness of the cross-provider workplace-related intervention compared with the single provider intervention. Participants are employees with health related risk factors. ANCOVA will be used to evaluate the effect of the intervention on the outcome variables leisure time physical (primary outcome activity and health literacy (secondary outcome. The qualitative study comprises semi-structured interviews, systematic field notes of stakeholder meetings and document analyses. Discussion The AtRisk study will contribute towards the claim for cross-provider interventions and workplace-related approaches described in the new Preventive Health Care Act. The results of this study will inform providers, payers and policy makers about the effectiveness of a cross-provider workplace-related lifestyle intervention compared to a single-provider intervention. Beyond, the study will identify challenges

A region-based palliative care intervention trial using the mixed-method approach: Japan OPTIM study

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Morita Tatsuya

2012-01-01

Full Text Available Abstract Background Disseminating palliative care is a critical task throughout the world. Several outcome studies explored the effects of regional palliative care programs on a variety of end-points, and some qualitative studies investigated the process of developing community palliative care networks. These studies provide important insights into the potential benefits of regional palliative care programs, but the clinical implications are still limited, because: 1 many interventions included fundamental changes in the structure of the health care system, and, thus, the results would not be applicable for many regions where structural changes are difficult or unfeasible; 2 patient-oriented outcomes were not measured or explored only in a small number of populations, and interpretation of the results from a patient's view is difficult; and 3 no studies adopted a mixed-method approach using both quantitative and qualitative methodologies to interpret the complex phenomenon from multidimensional perspectives. Methods/designs This is a mixed-method regional intervention trial, consisting of a pre-post outcome study and qualitative process studies. The primary aim of the pre-post outcome study is to evaluate the change in the number of home deaths, use of specialized palliative care services, patient-reported quality of palliative care, and family-reported quality of palliative care after regional palliative care intervention. The secondary aim is to explore the changes in a variety of outcomes, including patients' quality of life, pain intensity, family care burden, and physicians' and nurses' knowledge, difficulties, and self-perceived practice. Outcome measurements used in this study include the Care Evaluation Scale, Good Death Inventory, Brief pain Inventory, Caregiving Consequence Inventory, Sense of Security Scale, Palliative Care Knowledge test, Palliative Care Difficulties Scale, and Palliative Care Self-reported Practice Scale. Study

Feasibility study of a family-focused intervention to improve outcomes for children with FASD.

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Reid, Natasha; Dawe, Sharon; Harnett, Paul; Shelton, Doug; Hutton, Lauren; O'Callaghan, Frances

2017-08-01

Growing evidence shows that children with fetal alcohol spectrum disorder (FASD) can benefit from interventions, and specifically interventions focused on improving self-regulation. However, novel ways of improving outcomes for children with FASD need further investigation so that programs target not only the individual child but also the family context, which includes the parent-child relationship. The current study aimed to evaluate the feasibility of an adapted version of the Parents under Pressure (PuP) program that addresses self-regulatory processes, through improving the parent-child relationship and the use of mindfulness-based strategies for both children and parents. This was a mixed methods study. Feasibility was examined by evaluating recruitment, data collection/outcome measures, and intervention procedures. The study used a phenomenological approach to obtain qualitative information from caregivers and a single-case experimental design to evaluate the preliminary participant responses to the intervention. Two out of three families completed treatment. The recruitment and intervention procedures were found to be suitable for and acceptable to the families involved. Some concerns were identified regarding the outcome measures that would need to be addressed in future research. Quantitative and qualitative outcomes were positive. The results provide preliminary support for the feasibility of an adapted version of the PuP program. Thus, offering a potential multi-component option, that aims to improve self-regulatory skills for children with FASD, through focusing on improving the parent-child relationship and incorporating mindfulness-based techniques for both parents and children. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies.

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Ryoko Katagiri

Full Text Available Although several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported.We conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081.50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27 and 2.03 (CI:1.58 to 2.62 in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies.Although universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required.

Reviewing evidence on complex social interventions: appraising implementation in systematic reviews of the health effects of organisational-level workplace interventions

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Egan, M; Bambra, C; Petticrew, M; Whitehead, M

2009-01-01

Background: The reporting of intervention implementation in studies included in systematic reviews of organisational-level workplace interventions was appraised. Implementation is taken to include such factors as intervention setting, resources, planning, collaborations, delivery and macro-level socioeconomic contexts. Understanding how implementation affects intervention outcomes may help prevent erroneous conclusions and misleading assumptions about generalisability, but implementation must be adequately reported if it is to be taken into account. Methods: Data on implementation were obtained from four systematic reviews of complex interventions in workplace settings. Implementation was appraised using a specially developed checklist and by means of an unstructured reading of the text. Results: 103 studies were identified and appraised, evaluating four types of organisational-level workplace intervention (employee participation, changing job tasks, shift changes and compressed working weeks). Many studies referred to implementation, but reporting was generally poor and anecdotal in form. This poor quality of reporting did not vary greatly by type or date of publication. A minority of studies described how implementation may have influenced outcomes. These descriptions were more usefully explored through an unstructured reading of the text, rather than by means of the checklist. Conclusions: Evaluations of complex interventions should include more detailed reporting of implementation and consider how to measure quality of implementation. The checklist helped us explore the poor reporting of implementation in a more systematic fashion. In terms of interpreting study findings and their transferability, however, the more qualitative appraisals appeared to offer greater potential for exploring how implementation may influence the findings of specific evaluations. Implementation appraisal techniques for systematic reviews of complex interventions require further

Assessing Statistical Change Indices in Selected Social Work Intervention Research Studies

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Ham, Amanda D.; Huggins-Hoyt, Kimberly Y.; Pettus, Joelle

2016-01-01

Objectives: This study examined how evaluation and intervention research (IR) studies assessed statistical change to ascertain effectiveness. Methods: Studies from six core social work journals (2009-2013) were reviewed (N = 1,380). Fifty-two evaluation (n= 27) and intervention (n = 25) studies met the inclusion criteria. These studies were…

Community interventions for preventing smoking in young people.

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Sowden, A; Arblaster, L; Stead, L

2003-01-01

Decisions to smoke are made within a broad social context. Community interventions use co-ordinated, widespread, multi-component programmes to try and influence behaviour. To determine the effectiveness of community interventions in preventing the uptake of smoking in young people. The Tobacco Addiction group specialised register, Medline and other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and contact was made with content area specialists. Searches were updated in September 2002. Randomised and non randomised controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years. Information relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined using qualitative narrative synthesis. Seventeen studies were included in the review, 46 studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with six using random allocation of schools or communities. Of thirteen studies which compared community interventions to no intervention controls, two, which were part of cardiovascular disease prevention programmes, reported lower smoking prevalence. Of three studies comparing community interventions to school-based programmes only, one found differences in reported smoking prevalence. One study reported a lower rate of increase in prevalence in a community receiving a multi-component intervention compared to a community exposed to a mass media campaign alone. One study reported a significant difference in smoking prevalence between a group receiving a media, school and homework intervention compared to a group

A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.

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Maria Benedetta Michelazzo

2017-03-01

Full Text Available Background. Aging is frequently accompanied by chronic diseases; as a consequence, older people are often exposed to polypharmacy that has been associated with negative health-consequences. The aim of this study is to conduct a systematic review of the literature reporting on the effectiveness of different approaches to reduce polypharmacy in the elderly. Methods. We conducted a comprehensive literature search of MEDLINE, Scopus and ISI Web of Knowledge databases. Eligible studies were case-series reporting outcomes of interventions aimed at reducing polypharmacy and its consequences in the elderly. A quality appraisal of the studies included was performed. Results. Nineteen studies were included, of which six conducted in community setting, seven in hospital setting, and six in nursing homes. Seventeen of them were judged as moderate quality, and two of them as poor quality. The majority of the interventions were carried out by pharmacists, alone (35% or with other professionals (40%. Interventions consisted in pharmacotherapy reviews based on various tools and software; in some cases educational interventions were performed for review-performers and patients. Studies conducted in community-setting provided also a feedback to primary care physician. The outcomes included five categories: therapy’s characteristics (e.g. number of drugs, appropriate prescriptions, quality of life, health-related outcomes, costs, healthcare services’ utilization. Therapy-related outcomes were those more affected by all types of interventions. Conclusion. Interventions aimed at reviewing patients’ therapy are effective in optimizing the use of drugs, and could be considered also  in improving quality of life, healthcare costs, services’ utilization, and health-related outcomes.

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study

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Waters Lauren

2012-08-01

Full Text Available Abstract Background Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Methods Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. Results 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. Conclusions There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis.

Digital Behaviour Change Interventions for Osteoarthritis - A Systematic Literature Review

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Alice Berry

2015-10-01

•\tTo examine how uptake and usage of digital interventions has been reported Methods: A pre-defined search was carried out using databases including: AMED, CINAHL Plus, Cochrane Library, Embase, Medline, Psycinfo, Pubmed, SPORTDiscus and Web of Science. Articles were included if: they reported PA data; included people with OA; and if the intervention was accessed via a digital platform. Results: The database searches generated 2132 published papers. After applying selection criteria, eight studies were included in the final review. 5 out of the 8 included studies showed a statistically significant increase in self-reported levels of PA for up to 12 months. A number of outcome measures were used but were predominantly self-reported. BCTs used included: goal setting, action planning, problem solving, feedback, shaping knowledge, self-talk, and self-monitoring. Most studies (n=6 were based on social cognitive theory. A variety of methods were employed to report uptake and usage of digital interventions, making it difficult for comparisons to be made. Discussion and Conclusions: There is limited evidence supporting the effectiveness of internet based interventions to increase PA in OA. Most studies rely on self-report to determine change in levels of PA; objective measurement may be beneficial. Interventions were generally based on Social Cognitive Theory; other constructs may increase effectiveness. Clearer reporting of BCTs and intervention usage is needed.

The challenges of interventions to promote healthier food in independent takeaways in England: qualitative study of intervention deliverers' views.

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Goffe, Louis; Penn, Linda; Adams, Jean; Araujo-Soares, Vera; Summerbell, Carolyn D; Abraham, Charles; White, Martin; Adamson, Ashley; Lake, Amelia A

2018-01-27

Much of the food available from takeaways, pubs and restaurants particularly that sold by independent outlets, is unhealthy and its consumption is increasing. These food outlets are therefore important potential targets for interventions to improve diet and thus prevent diet related chronic diseases. Local authorities in England have been charged with delivering interventions to increase the provision of healthy food choices in independent outlets, but prior research shows that few such interventions have been rigorously developed or evaluated. We aimed to learn from the experiences of professionals delivering interventions in independent food outlets in England to identify the operational challenges and their suggestions for best practice. We used one-to-one semi-structured qualitative interviews to explore the views and experiences of professionals who were either employees of, or contracted by, a local authority to deliver interventions to increase the provision of healthier food choices in independent food outlets. Purposive sampling was used to recruit a sample which included men and women, from a range of professional roles, across different areas of England. Interviews were informed by a topic guide, and proceeded until no new themes emerged. Interviews were recorded, transcribed verbatim and analysed using the Framework method. We conducted 11 individual interviews. Participants focussed on independent takeaways and their unhealthy food offerings, and highlighted the advantages and disadvantages of intervention delivery methods, their evaluation and impact. The main barriers to implementation of interventions in independent takeaways were identified as limited funding and the difficulties of engaging the food outlet owner/manager. Engagement was thought to be facilitated by delivering intensive, interactive and tailored interventions, clear and specific information, and incentives, whilst accounting for practical, primarily financial, constraints of food

Classroom intervention to change peers’ attitudes towards children who stutter: A feasibility study

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Harsha Kathard

2014-12-01

Method: The study used a cluster randomised control trial design. The study included 211 Grade 7 participants from schools in the Cape Town Metropole. The CCR intervention was administered to 97 participants in the experimental group, whilst 114 participants in the control group did not receive the intervention. The Stuttering Resource Outcome Measure(SROM used as the outcome measure during pre- and post-test period. STATISTICA was used for in-depth data analysis. Results: An overall positive direction of change in scores was observed for the experimental group compared with the control group. However, the magnitude of change in the experimental group was not statistically significant (p = 0.2683. Male and female participants did not differ significantly in their scores on the SROM across pre-test and post-test periods. Participants who had exposure to individuals who stutter had significantly more positive scores on the SROM in the pre-test and post-test periods compared to those who had no direct exposure to stuttering. Conclusion: This result indicated the beginning of positive attitude change which may be attributed to the intervention. Further investigation is warranted.

A prospective three-step intervention study to prevent medication errors in drug handling in paediatric care.

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Niemann, Dorothee; Bertsche, Astrid; Meyrath, David; Koepf, Ellen D; Traiser, Carolin; Seebald, Katja; Schmitt, Claus P; Hoffmann, Georg F; Haefeli, Walter E; Bertsche, Thilo

2015-01-01

To prevent medication errors in drug handling in a paediatric ward. One in five preventable adverse drug events in hospitalised children is caused by medication errors. Errors in drug prescription have been studied frequently, but data regarding drug handling, including drug preparation and administration, are scarce. A three-step intervention study including monitoring procedure was used to detect and prevent medication errors in drug handling. After approval by the ethics committee, pharmacists monitored drug handling by nurses on an 18-bed paediatric ward in a university hospital prior to and following each intervention step. They also conducted a questionnaire survey aimed at identifying knowledge deficits. Each intervention step targeted different causes of errors. The handout mainly addressed knowledge deficits, the training course addressed errors caused by rule violations and slips, and the reference book addressed knowledge-, memory- and rule-based errors. The number of patients who were subjected to at least one medication error in drug handling decreased from 38/43 (88%) to 25/51 (49%) following the third intervention, and the overall frequency of errors decreased from 527 errors in 581 processes (91%) to 116/441 (26%). The issue of the handout reduced medication errors caused by knowledge deficits regarding, for instance, the correct 'volume of solvent for IV drugs' from 49-25%. Paediatric drug handling is prone to errors. A three-step intervention effectively decreased the high frequency of medication errors by addressing the diversity of their causes. Worldwide, nurses are in charge of drug handling, which constitutes an error-prone but often-neglected step in drug therapy. Detection and prevention of errors in daily routine is necessary for a safe and effective drug therapy. Our three-step intervention reduced errors and is suitable to be tested in other wards and settings. © 2014 John Wiley & Sons Ltd.

Systematic review of meditation-based interventions for children with ADHD.

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Evans, Subhadra; Ling, Mathew; Hill, Briony; Rinehart, Nicole; Austin, David; Sciberras, Emma

2018-01-01

Meditation-based interventions such as mindfulness and yoga are commonly practiced in the general community to improve mental and physical health. Parents, teachers and healthcare providers are also increasingly using such interventions with children. This review examines the use of meditation-based interventions in the treatment of children with Attention-Deficit Hyperactivity Disorder (ADHD). Electronic databases searched included PsycINFO, Medline, CINAHL, and AMED. Inclusion criteria involved children (aged to 18 years) diagnosed with ADHD, delivery of a meditation-based intervention to children and/or parents, and publication in a peer-reviewed journal. Studies were identified and coded using standard criteria, risk of bias was assessed using Risk of Bias in Non-randomised Studies- of interventions (ROBINS-I), and effect sizes were calculated. A total of 16 studies were identified (8 that included children in treatment, and 8 that included combined parent-child treatment). Results indicated that risk of bias was high across studies. At this stage, no definitive conclusions can be offered regarding the utility of meditation-based interventions for children with ADHD and/or their parents, since the methodological quality of the studies reviewed is low. Future well designed research is needed to establish the efficacy of meditation-based interventions, including commonly used practices such as mindfulness, before recommendations can be made for children with ADHD and their families.

Effective return-to-work interventions after acquired brain injury: A systematic review.

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Donker-Cools, Birgit H P M; Daams, Joost G; Wind, Haije; Frings-Dresen, Monique H W

2016-01-01

To gather knowledge about effective return-to-work (RTW) interventions for patients with acquired brain injury (ABI). A database search was performed in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library using keywords and Medical Subject Headings. Studies were included if they met inclusion criteria: adult patients with non-progressive ABI, working pre-injury and an intervention principally designed to improve RTW as an outcome. The methodological quality of included studies was determined and evidence was assessed qualitatively. Twelve studies were included, of which five were randomized controlled trials and seven were cohort studies. Nine studies had sufficient methodological quality. There is strong evidence that work-directed interventions in combination with education/coaching are effective regarding RTW and there are indicative findings for the effectiveness of work-directed interventions in combination with skills training and education/coaching. Reported components of the most effective interventions were tailored approach, early intervention, involvement of patient and employer, work or workplace accommodations, work practice and training of social and work-related skills, including coping and emotional support. Effective RTW interventions for patients with ABI are a combination of work-directed interventions, coaching/education and/or skills training. These interventions have the potential to facilitate sustained RTW for patients with ABI.

Developing a community-based psycho-social intervention with older people and third sector workers for anxiety and depression: a qualitative study.

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Kingstone, Tom; Burroughs, Heather; Bartlam, Bernadette; Ray, Mo; Proctor, Janine; Shepherd, Thomas; Bullock, Peter; Chew-Graham, Carolyn Anne

2017-07-12

One-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). However, evidence to support such provision, including the most effective interventions, is limited. The qualitative study reported here constitutes the first phase of a feasibility study which aims to assess whether third sector workers can deliver a psychosocial intervention to older people with anxiety and/or depression. The aim of this qualitative study is to explore the views of older people and third sector workers about anxiety and depression among older people in order to refine an intervention to be delivered by third sector workers. Semi-structured interviews with participants recruited through purposive sampling from third sector groups in North Staffordshire. Interviews were digitally recorded with consent, transcribed and analysed using principles of constant comparison. Nineteen older people and 9 third sector workers were interviewed. Key themes included: multiple forms of loss, mental health as a personal burden to bear, having courage and providing/receiving encouragement, self-worth and the value of group activities, and tensions in existing service provision, including barriers and gaps. The experience of loss was seen as central to feelings of anxiety and depression among community-dwelling older people. This study contributes to the evidence pointing to the scale and severity of mental health needs for some older people which can arise from multiple forms of loss, and which present a significant challenge to health, social care and third sector services. The findings informed development of a psychosocial intervention and training for third sector

Burnout intervention studies for inpatient elderly care nursing staff: systematic literature review.

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Westermann, Claudia; Kozak, Agnessa; Harling, Melanie; Nienhaus, Albert

2014-01-01

Staff providing inpatient elderly and geriatric long-term care are exposed to a large number of factors that can lead to the development of burnout syndrome. Burnout is associated with an increased risk of absence from work, low work satisfaction, and an increased intention to leave. Due to the fact that the number of geriatric nursing staff is already insufficient, research on interventions aimed at reducing work-related stress in inpatient elderly care is needed. The aim of this systematic review was to identify and analyse burnout intervention studies among nursing staff in the inpatient elderly and geriatric long-term care sector. A systematic search of burnout intervention studies was conducted in the databases Embase, Medline and PsycNet published from 2000 to January 2012. We identified 16 intervention studies. Interventions were grouped into work-directed (n=2), person-directed (n=9) and combined approaches (work- and person-directed, n=5). Seven out of 16 studies observed a reduction in staff burnout. Among them are two studies with a work-directed, two with a person-directed and three with a combined approach. Person-directed interventions reduced burnout in the short term (up to 1 month), while work-directed interventions and those with a combined approach were able to reduce burnout over a longer term (from 1 month to more than 1 year). In addition to staff burnout, three studies observed positive effects relating to the client outcomes. Only three out of ten Randomised Control Trials (RCT) found that interventions had a positive effect on staff burnout. Work-directed and combined interventions are able to achieve beneficial longer-term effects on staff burnout. Person-directed interventions achieve short-term results in reducing staff burnout. However, the evidence is limited. Copyright © 2012 Elsevier Ltd. All rights reserved.

The role of intervention mapping in designing disease prevention interventions: A systematic review of the literature.

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Garba, Rayyan M; Gadanya, Muktar A

2017-01-01

To assess the role of Intervention Mapping (IM) in designing disease prevention interventions worldwide. Systematic search and review of the relevant literature-peer-reviewed and grey-was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Only five of the twenty two included studies reviewed were RCTs that compared intervention using IM protocol with placebo intervention, and provided the outcomes in terms of percentage increase in the uptake of disease-prevention programmes, and only one of the five studies provided an effect measure in the form of relative risk (RR = 1.59, 95% CI = 1.08-2.34, p = 0.02). Of the five RCTs, three were rated as strong evidences, one as a medium evidence and one as a weak evidence, and they all reported statistically significant difference between the two study groups, with disease prevention interventions that have used the intervention mapping approach generally reported significant increases in the uptake of disease-prevention interventions, ranging from 9% to 28.5% (0.0001 ≤ p ≤ 0.02), On the other hand, all the 22 studies have successfully identified the determinants of the uptake of disease prevention interventions that is essential to the success of disease prevention programmes. Intervention Mapping has been successfully used to plan, implement and evaluate interventions that showed significant increase in uptake of disease prevention programmes. This study has provided a good understanding of the role of intervention mapping in designing disease prevention interventions, and a good foundation upon which subsequent reviews can be guided.

Internet-based interventions for smoking cessation.

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Civljak, Marta; Stead, Lindsay F; Hartmann-Boyce, Jamie; Sheikh, Aziz; Car, Josip

2013-07-10

The Internet is now an indispensable part of daily life for the majority of people in many parts of the world. It offers an additional means of effecting changes to behaviour such as smoking. To determine the effectiveness of Internet-based interventions for smoking cessation. We searched the Cochrane Tobacco Addiction Group Specialized Register. There were no restrictions placed on language of publication or publication date. The most recent search was conducted in April 2013. We included randomized and quasi-randomized trials. Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet intervention was eligible. The comparison condition could be a no-intervention control, a different Internet intervention, or a non-Internet intervention. Two authors independently assessed and extracted data. Methodological and study quality details were extracted using a standardized form. We extracted smoking cessation outcomes of six months follow-up or more, reporting short-term outcomes where longer-term outcomes were not available. We reported study effects as a risk ratio (RR) with a 95% confidence interval (CI). Clinical and statistical heterogeneity limited our ability to pool studies. This updated review includes a total of 28 studies with over 45,000 participants. Some Internet programmes were intensive and included multiple outreach contacts with participants, whilst others relied on participants to initiate and maintain use.Fifteen trials compared an Internet intervention to a non-Internet-based smoking cessation intervention or to a no-intervention control. Ten of these recruited adults, one recruited young adult university students and two recruited adolescents. Seven of the trials in adults had follow-up at six months or longer and compared an Internet intervention to usual care or printed self help. In a post hoc subgroup analysis, pooled results from three trials that compared

A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating: The Entre Familia: Reflejos de Salud Study.

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Schmied, Emily; Parada, Humberto; Horton, Lucy; Ibarra, Leticia; Ayala, Guadalupe

2015-10-01

Entre Familia: Reflejos de Salud was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker (promotora) model with an entertainment-education component. This process evaluation examined intervention implementation and assessed relationships between implementation factors and dietary change. Participants included 180 mothers randomized to an intervention condition. Process evaluation measures were obtained from participant interviews and promotora notes and included fidelity, dose delivered (i.e., minutes of promotora in-person contact with families, number of promotora home visits), and dose received (i.e., participant use of and satisfaction with intervention materials). Outcome variables included changes in vegetable intake and the use of behavioral strategies to increase dietary fiber and decrease dietary fat intake. Participant satisfaction was high, and fidelity was achieved; 87.5% of families received the planned number of promotora home visits. In the multivariable model, satisfaction with intervention materials predicted more frequent use of strategies to increase dietary fiber (p ≤ .01). Trends suggested that keeping families in the prescribed intervention timeline and obtaining support from other social network members through sharing of program materials may improve changes. Study findings elucidate the relationship between specific intervention processes and dietary changes. © 2015 Society for Public Health Education.

Psychological interventions for antisocial personality disorder.

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Gibbon, Simon; Duggan, Conor; Stoffers, Jutta; Huband, Nick; Völlm, Birgit A; Ferriter, Michael; Lieb, Klaus

2010-06-16

Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment, homelessness and relationship difficulties. To evaluate the potential beneficial and adverse effects of psychological interventions for people with AsPD. Our search included CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BIOSIS and COPAC. Prospective, controlled trials in which participants with AsPD were randomly allocated to a psychological intervention and a control condition (either treatment as usual, waiting list or no treatment). Three authors independently selected studies. Two authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. Eleven studies involving 471 participants with AsPD met the inclusion criteria, although data were available from only five studies involving 276 participants with AsPD. Only two studies focused solely on an AsPD sample. Eleven different psychological interventions were examined. Only two studies reported on reconviction, and only one on aggression. Compared to the control condition, cognitive behaviour therapy (CBT) plus standard maintenance was superior for outpatients with cocaine dependence in one study, but CBT plus treatment as usual was not superior for male outpatients with recent verbal/physical violence in another. Contingency management plus standard maintenance was superior for drug misuse for outpatients with cocaine dependence in one study but not in another, possibly because of differences in the behavioural intervention. However, contingency management was superior in social functioning and counselling session attendance in the latter. A multi-component intervention utilising motivational interviewing principles, the 'Driving Whilst Intoxicated program', plus incarceration was superior to incarceration alone for imprisoned drink-driving offenders. Results suggest

Evaluating the impact of a quality management intervention on post-abortion contraceptive uptake in private sector clinics in western Kenya: a pre- and post-intervention study.

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Wendot, Susy; Scott, Rachel H; Nafula, Inviolata; Theuri, Isaac; Ikiugu, Edward; Footman, Katharine

2018-01-19

Integration of family planning counselling and method provision into safe abortion services is a key component of quality abortion care. Numerous barriers to post-abortion family planning (PAFP) uptake exist. This study aimed to evaluate the effect of a quality management intervention for providers on PAFP uptake. We conducted a pre- and post-intervention study between November 2015 and July 2016 in nine private clinics in Western Kenya. We collected baseline and post-intervention data using in-person interviews on the day of procedure, and follow-up telephone interviews to measure contraceptive uptake in the 2 weeks following abortion. We also conducted semi-structured interviews with providers. The intervention comprised a 1-day orientation, a counselling job-aide, and enhanced supervision visits. The primary outcome was the proportion of clients receiving any method of PAFP (excluding condoms) within 14 days of obtaining an abortion. Secondary outcomes were the proportion of clients receiving PAFP counselling, and the proportion of clients receiving long-acting reversible contraception (LARC) within 14 days of the service. We used chi-squared tests and multivariate logistic regression to determine whether there were significant differences between baseline and post-intervention, adjusting for potential confounding factors and clustering at the clinic level. Interviews were completed with 769 women, and 54% (414 women) completed a follow-up telephone interview. Reported quality of counselling and satisfaction with services increased between baseline and post-intervention. Same-day uptake of PAFP was higher at post-intervention compared to baseline (aOR 1.94, p quality of their services. A quality management intervention was successful in improving the quality of PAFP counselling and provision. Uptake of same-day PAFP, including LARC, increased, but there was no increase in overall uptake of PAFP 2 weeks after the abortion.

Systematic review with meta-analysis: online psychological interventions for mental and physical health outcomes in gastrointestinal disorders including irritable bowel syndrome and inflammatory bowel disease.

Science.gov (United States)

Hanlon, I; Hewitt, C; Bell, K; Phillips, A; Mikocka-Walus, A

2018-06-14

Online psychotherapy has been successfully used as supportive treatment in many chronic illnesses. However, there is a lack of evidence on its role in the management of gastrointestinal (GI) diseases. To examine whether online psychological interventions improve mental and physical outcomes in gastrointestinal diseases. We searched CINAHL Plus, MEDLINE, EMBASE, Health Management Information Consortium, PsycINFO, British Nursing Index, Cochrane Library, a specialised register of the IBD/FBD Cochrane Group, MEDLINE (PubMed) WHO International Clinical Trial Registry, ClinicalTrials.gov, and reference lists of all papers included in the review. The Cochrane Risk of Bias Tool was used to assess internal validity. Where possible, data were pooled using random-effects meta-analysis. We identified 11 publications (encompassing nine studies) meeting inclusion criteria. One study had a high risk of selection bias (allocation concealment), all studies had a high risk of performance and detection bias. Eight studies were included in the meta-analyses (6 on irritable bowel syndrome [IBS] and two on inflammatory bowel disease [IBD]). Online cognitive behavioural therapy (CBT) was shown to significantly improve gastrointestinal symptom-specific anxiety (MD: -8.51, 95% CI -12.99 to -4.04, P = 0.0002) and lessen symptom-induced disability (MD: -2.78, 95% CI -5.43 to -0.12, P = 0.04) in IBS post intervention. There was no significant effect of online CBT on any other outcomes in IBS. No significant effect of online psychotherapy was demonstrated in IBD. There is insufficient evidence to demonstrate the effectiveness of online CBT to manage mental and physical outcomes in gastrointestinal diseases. © 2018 John Wiley & Sons Ltd.

Knowledge translation interventions for critically ill patients: a systematic review*.

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Sinuff, Tasnim; Muscedere, John; Adhikari, Neill K J; Stelfox, Henry T; Dodek, Peter; Heyland, Daren K; Rubenfeld, Gordon D; Cook, Deborah J; Pinto, Ruxandra; Manoharan, Venika; Currie, Jan; Cahill, Naomi; Friedrich, Jan O; Amaral, Andre; Piquette, Dominique; Scales, Damon C; Dhanani, Sonny; Garland, Allan

2013-11-01

We systematically reviewed ICU-based knowledge translation studies to assess the impact of knowledge translation interventions on processes and outcomes of care. We searched electronic databases (to July, 2010) without language restrictions and hand-searched reference lists of relevant studies and reviews. Two reviewers independently identified randomized controlled trials and observational studies comparing any ICU-based knowledge translation intervention (e.g., protocols, guidelines, and audit and feedback) to management without a knowledge translation intervention. We focused on clinical topics that were addressed in greater than or equal to five studies. Pairs of reviewers abstracted data on the clinical topic, knowledge translation intervention(s), process of care measures, and patient outcomes. For each individual or combination of knowledge translation intervention(s) addressed in greater than or equal to three studies, we summarized each study using median risk ratio for dichotomous and standardized mean difference for continuous process measures. We used random-effects models. Anticipating a small number of randomized controlled trials, our primary meta-analyses included randomized controlled trials and observational studies. In separate sensitivity analyses, we excluded randomized controlled trials and collapsed protocols, guidelines, and bundles into one category of intervention. We conducted meta-analyses for clinical outcomes (ICU and hospital mortality, ventilator-associated pneumonia, duration of mechanical ventilation, and ICU length of stay) related to interventions that were associated with improvements in processes of care. From 11,742 publications, we included 119 investigations (seven randomized controlled trials, 112 observational studies) on nine clinical topics. Interventions that included protocols with or without education improved continuous process measures (seven observational studies and one randomized controlled trial; standardized

Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.

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Hardison, Mark E; Roll, Shawn C

2016-01-01

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association's Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Obesity prevention and obesogenic behavior interventions in child care: A systematic review.

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Sisson, Susan B; Krampe, Megan; Anundson, Katherine; Castle, Sherri

2016-06-01

Review peer-reviewed interventions designed to reduce obesity and improve obesogenic behaviors, including physical activity, diet, and screen time, at child care centers. Interventions components and outcomes, study design, duration, use of behavioral theory, and level of social ecological influence are detailed. Article searches were conducted from March 2014, October 2014, March 2015, January 2016 across three databases. Eligible interventions were conducted in child care settings, included 3-to-5-year-old children, included an outcome measure of obesity or obesogenic behavior, and published in English. Study design quality was assessed using Stetler's Level of Quantitative Evidence. All unique records were screened (n=4589): 237 articles were assessed for eligibility. Of these, 97 articles describing 71 interventions met inclusion criteria. Forty-four articles included multi-level interventions. Twenty-nine interventions included an outcome measure of obesity. Forty-one interventions included physical activity. Forty-five included diet. Eight included screen time. Fifty-five percent of interventions were Level II (randomized controlled trials), while 37% were Level III (quasi-experimental or pre-post only study design), and 8% were Level IV (non-experimental or natural experiments). Most interventions had the intended effect on the target: obesity 48% (n=14), physical activity 73% (n=30), diet 87% (n=39), and screen time 63% (n=5). Summarizing intervention strategies and assessing their effectiveness contributes to the existing literature and may provide direction for practitioners and researchers working with young children in child care. Most interventions produced the targeted changes in obesity and obesity-associated behaviors, supporting current and future efforts to collaborate with early-care centers and professionals for obesity prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of an intervention program to increase effective behaviours by patients and clinicians in psychiatric services: Intervention Mapping study.

Science.gov (United States)

Koekkoek, Bauke; van Meijel, Berno; Schene, Aart; Hutschemaekers, Giel

2010-10-25

Health clinicians perceive certain patients as 'difficult' across all settings, including mental health care. In this area, patients with non-psychotic disorders that become long-term care users may be perceived as obstructing their own recovery or seeking secondary gain. This negative perception of patients results in ineffective responses and low-quality care by health clinicians. Using the concept of illness behaviour, this paper describes the development, implementation, and planned evaluation of a structured intervention aimed at prevention and management of ineffective behaviours by long-term non-psychotic patients and their treating clinicians. The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the intervention. Qualitative (individual and group interviews), quantitative (survey), and mixed methods (Delphi-procedure) research was used to gain a broad perspective of the problem. Empirical findings, theoretical models, and existing evidence were combined to construct a program tailored to the needs of the target groups. A structured program to increase effective illness behaviour in long-term non-psychotic patients and effective professional behaviour in their treating clinicians was developed, consisting of three subsequent stages and four substantial components, that is described in detail. Implementation took place and evaluation of the intervention is being carried out. Intervention Mapping proved to be a suitable method to develop a structured intervention for a multi-faceted problem in mental health care.

Intradialytic Laughter Yoga therapy for haemodialysis patients: a pre-post intervention feasibility study.

Science.gov (United States)

Bennett, Paul N; Parsons, Trisha; Ben-Moshe, Ros; Neal, Merv; Weinberg, Melissa K; Gilbert, Karen; Ockerby, Cherene; Rawson, Helen; Herbu, Corinne; Hutchinson, Alison M

2015-06-09

Laughter Yoga consists of physical exercise, relaxation techniques and simulated vigorous laughter. It has been associated with physical and psychological benefits for people in diverse clinical and non-clinical settings, but has not yet been tested in a haemodialysis setting. The study had three aims: 1) to examine the feasibility of conducting Laughter Yoga for patients with end stage kidney disease in a dialysis setting; 2) to explore the psychological and physiological impact of Laughter Yoga for these patients; and 3) to estimate the sample size required for future research. Pre/post intervention feasibility study. Eighteen participants were recruited into the study and Laughter Yoga therapists provided a four week intradialytic program (30-min intervention three times per week). Primary outcomes were psychological items measured at the first and last Laughter Yoga session, including: quality of life; subjective wellbeing; mood; optimism; control; self-esteem; depression, anxiety and stress. Secondary outcomes were: blood pressure, intradialytic hypotensive episodes and lung function (forced expiratory volume). Dialysis nurses exposed to the intervention completed a Laughter Yoga attitudes and perceptions survey (n = 11). Data were analysed using IBM SPSS Statistics v22, including descriptive and inferential statistics, and sample size estimates were calculated using G*Power. One participant withdrew from the study for medical reasons that were unrelated to the study during the first week (94 % retention rate). There were non-significant increases in happiness, mood, and optimism and a decrease in stress. Episodes of intradialytic hypotension decreased from 19 pre and 19 during Laughter Yoga to 4 post Laughter Yoga. There was no change in lung function or blood pressure. All nurses agreed or strongly agreed that Laughter Yoga had a positive impact on patients' mood, it was a feasible intervention and they would recommend Laughter Yoga to their patients. Sample

Mobile phone-based interventions for smoking cessation.

Science.gov (United States)

Whittaker, Robyn; McRobbie, Hayden; Bullen, Chris; Rodgers, Anthony; Gu, Yulong

2016-04-10

Access to mobile phones continues to increase exponentially globally, outstripping access to fixed telephone lines, fixed computers and the Internet. Mobile phones are an appropriate and effective option for the delivery of smoking cessation support in some contexts. This review updates the evidence on the effectiveness of mobile phone-based smoking cessation interventions. To determine whether mobile phone-based smoking cessation interventions increase smoking cessation in people who smoke and want to quit. For the most recent update, we searched the Cochrane Tobacco Addiction Group Specialised Register in April 2015. We also searched the UK Clinical Research Network Portfolio for current projects in the UK, and the ClinicalTrials.gov register for ongoing or recently completed studies. We searched through the reference lists of identified studies and attempted to contact the authors of ongoing studies. We applied no restrictions on language or publication date. We included randomised or quasi-randomised trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention for smoking cessation. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone. Review authors extracted information on risk of bias and methodological details using a standardised form. We considered participants who dropped out of the trials or were lost to follow-up to be smoking. We calculated risk ratios (RR) and 95% confidence intervals (CI) for each included study. Meta-analysis of the included studies used the Mantel-Haenszel fixed-effect method. Where meta-analysis was not possible, we presented a narrative summary and descriptive statistics. This updated search identified 12 studies with six-month smoking cessation outcomes, including seven studies completed since the previous review. The

Global school-based childhood obesity interventions: a review.

Science.gov (United States)

Ickes, Melinda J; McMullen, Jennifer; Haider, Taj; Sharma, Manoj

2014-08-28

The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.

Global School-Based Childhood Obesity Interventions: A Review

Directory of Open Access Journals (Sweden)

Melinda J. Ickes

2014-08-01

Full Text Available Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1 primary research; (2 overweight or obesity prevention interventions; (3 school-based; (4 studies published between 1 January 2002 through 31 December 2013; (5 published in the English language; (6 child-based interventions, which could include parents; and (7 studies that reported outcome data. Results: A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Discussion: Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.

Do Technical Aids for Patient Handling Prevent Musculoskeletal Complaints in Health Care Workers?—A Systematic Review of Intervention Studies

Directory of Open Access Journals (Sweden)

Janice Hegewald

2018-03-01

Full Text Available The physical load ensuing from the repositioning and moving of patients puts health care workers at risk of musculoskeletal complaints. Technical equipment developed to aid with patient handling should reduce physical strain and workload; however, the efficacy of these aids in preventing musculoskeletal disorders and complaints is still unclear. A systematic review of controlled intervention studies was conducted to examine if the risk of musculoskeletal complaints and disorders is reduced by technical patient handling equipment. MEDLINE®/PubMed®, EMBASE®, Allied and Complementary Medicine Database (AMED, and Cumulative Index of Nursing and Allied Health Literature (CINAHL® were searched using terms for nursing, caregiving, technical aids, musculoskeletal injuries, and complaints. Randomized controlled trials and controlled before-after studies of interventions including technical patient handling equipment were included. The titles and abstracts of 9554 publications and 97 full-texts were screened by two reviewers. The qualitative synthesis included one randomized controlled trial (RCT and ten controlled before-after studies. A meta-analysis of four studies resulted in a pooled risk ratio for musculoskeletal injury claims (post-intervention of 0.78 (95% confidence interval 0.68–0.90. Overall, the methodological quality of the studies was poor and the results often based on administrative injury claim data, introducing potential selection bias. Interventions with technical patient handling aids appear to prevent musculoskeletal complaints, but the certainty of the evidence according to GRADE approach ranged from low to very low.

Preventing Sexual Violence Through Bystander Intervention: Attitudes, Behaviors, Missed Opportunities, and Barriers to Intervention Among Australian University Students.

Science.gov (United States)

Kania, Rachel; Cale, Jesse

2018-03-01

The concept of bystander intervention is gaining popularity in universities as a mechanism to prevent sexual violence. Prior research has focused on correlates of bystanders' intentions to intervene and intervention behaviors in situations where there is a risk of sexual violence. The current study builds on this literature by exploring the nature of missed opportunities, including perceived barriers to intervention. In all, 380 Australian undergraduate university students completed an online survey. Measures included a rape myth acceptance scale, bystander intentions to intervene, actual intervention behaviors, missed opportunities for intervention, and perceived barriers for missed opportunities. Promisingly, students reported high levels of intentions to intervene in situations where there was a risk of sexual violence and reported relatively few missed opportunities to do so when these situations did occur. Intervention behaviors varied by important demographic characteristics such as gender, age, attitudes toward sexual violence, and the nature of the situation. Younger female students, with lower levels of rape myth acceptance, who had previously engaged in bystander intervention behaviors were more likely to report intentions to intervene in future risky situations, and female international students reported fewer missed opportunities for intervention. The most common barrier to intervention for identified missed opportunities was a failure to recognize situations as having a potential risk for sexual violence, and students were most likely to intervene in situations when the opportunity to help a friend in distress arose. This study provides some preliminary empirical evidence about bystander intervention against sexual violence among Australian university students, and identifies unique contexts for intervention and what current barriers to intervention may be.

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

Science.gov (United States)

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

2017-01-01

Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. Novel, large-scale, effective, and sustainable interventions to control hypertension in Vietnam are needed. We report the results of a cluster-randomized feasibility trial at 3 months follow-up conducted in Hung Yen province, Vietnam, designed to evaluate the feasibility and acceptability of two community-based interventions to improve hypertension control: a "storytelling" intervention, "We Talk about Our Hypertension," and a didactic intervention. The storytelling intervention included stories about strategies for coping with hypertension, with patients speaking in their own words, and didactic content about the importance of healthy lifestyle behaviors including salt reduction and exercise. The didactic intervention included only didactic content. The storytelling intervention was delivered by two DVDs at 3-month intervals; the didactic intervention included only one installment. The trial was conducted in four communes, equally randomized to the two interventions. The mean age of the 160 study patients was 66 years, and 54% were men. Most participants described both interventions as understandable, informative, and motivational. Between baseline and 3 months, mean systolic blood pressure declined by 8.2 mmHg (95% CI 4.1-12.2) in the storytelling group and by 5.5 mmHg (95% CI 1.4-9.5) in the didactic group. The storytelling group also reported a significant increase in hypertension medication adherence. Both interventions were well accepted in several rural communities and were shown to be potentially effective in lowering blood pressure. A large-scale randomized trial is needed to compare the effectiveness of the two interventions in controlling hypertension. ClinicalTrials.gov, NCT02483780.

Brief Behavioral Sleep Intervention for Adolescents: An Effectiveness Study.

Science.gov (United States)

Paavonen, E Juulia; Huurre, Taina; Tilli, Maija; Kiviruusu, Olli; Partonen, Timo

2016-01-01

Sleep disturbances are common among adolescents, but there are no brief interventions to treat them. The objective of this study was to evaluate the effectiveness of a brief semistructured, individually delivered sleep intervention to ameliorate adolescents' sleeping difficulties and lengthen sleep duration. All students aged 16-18 years in a high school were screened for sleeping difficulties and 36 students with the highest sleep problem scores were invited to the intervention. Postintervention improvements were observed on self-reported and actiwatch-registered sleep duration, self-reported sleep quality and sleep latency, perceived stress and anxiety (all p values sleep efficiency and sleep latency did not change (p > 0.05). A brief individual sleep intervention can be effective in lengthening sleep duration and improving subjective sleep quality and well-being among adolescents.

Representativeness of Participants in a Lifestyle Intervention Study in Obese Pregnant Women - the Difference between Study Participants and Non-Participants

Directory of Open Access Journals (Sweden)

Joanna Gesche

2014-11-01

Full Text Available Objective: To examine the representativeness of participants attending a lifestyle intervention study addressing obese pregnant women. Methods: Retrospective comparison of baseline data, attendance to oral glucose tolerance test (OGTT during pregnancy, and pregnancy outcome in eligible women stratified according to study participation. Of 750 eligible women with a self-reported BMI > 30 kg/m2, and a live singleton pregnancy, 510 were eligible for inclusion and 425 were randomized to either active intervention (n= 284 or to standard obstetric care (n= 141 including two standard OGTT. The 85 women who declined participation or were excluded due to competing diseases and 240 women who did not respond to the initial invitation received the same standard care. Results: The randomized women had similar BMI but a lower parity and age, and were more frequently non-smokers, born in Denmark and married or cohabitating with their partner than the non-participants. Women participating in the trial had a higher compliance to the second OGTT compared to non-participants, also after correcting for age and nationality. There was no difference in pregnancy outcome, i.e., fetal weight and length, gestational age as well as mode of delivery. Conclusion: Women declining participation in a randomized lifestyle intervention study in pregnancy have characteristics indicating they are those who might benefit the most from lifestyle intervention.

Internet-based interventions for smoking cessation.

Science.gov (United States)

Taylor, Gemma M J; Dalili, Michael N; Semwal, Monika; Civljak, Marta; Sheikh, Aziz; Car, Josip

2017-09-04

Tobacco use is estimated to kill 7 million people a year. Nicotine is highly addictive, but surveys indicate that almost 70% of US and UK smokers would like to stop smoking. Although many smokers attempt to give up on their own, advice from a health professional increases the chances of quitting. As of 2016 there were 3.5 billion Internet users worldwide, making the Internet a potential platform to help people quit smoking. To determine the effectiveness of Internet-based interventions for smoking cessation, whether intervention effectiveness is altered by tailoring or interactive features, and if there is a difference in effectiveness between adolescents, young adults, and adults. We searched the Cochrane Tobacco Addiction Group Specialised Register, which included searches of MEDLINE, Embase and PsycINFO (through OVID). There were no restrictions placed on language, publication status or publication date. The most recent search was conducted in August 2016. We included randomised controlled trials (RCTs). Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet intervention was eligible. The comparison condition could be a no-intervention control, a different Internet intervention, or a non-Internet intervention. To be included, studies must have measured smoking cessation at four weeks or longer. Two review authors independently assessed and extracted data. We extracted and, where appropriate, pooled smoking cessation outcomes of six-month follow-up or more, reporting short-term outcomes narratively where longer-term outcomes were not available. We reported study effects as a risk ratio (RR) with a 95% confidence interval (CI).We grouped studies according to whether they (1) compared an Internet intervention with a non-active control arm (e.g. printed self-help guides), (2) compared an Internet intervention with an active control arm (e.g. face-to-face counselling), (3) evaluated the

Preliminary study of interventional treatment for tubal pregnancy

International Nuclear Information System (INIS)

Tang Yukuan; Chen Hanwei; Li Kaifang; Jiang Zaibo; Ma Zhuang; Liu Huanling

2000-01-01

Objective: To study the clinical value and methods of interventional treatment for tubal pregnancy. Methods: Two different methods were used in the interventional treatment of 18 patients with tubal pregnancy, which were transvaginal tubal intra-gestational methotrexate (MTX) injection and intra-utero-arterial MTX infusion. The former was selected for the treatment of 8 patients and the latter for 10 patients. Cook-fallopian tube catheterization set and the general angiographic catheters of 4.1 Fr Cobra were used. After the treatment, conditions of the patients, β-HCG level and ultrasound changes of the pregnant bladder were the main indexes for monitoring the therapeutic effect in this study. Results: The successful rate, cure rate, embryo killing rate reached 100%, 88.9%(16/18) and 94.4% (17/18) respectively. Two cases of intra-utero-arterial MTX infusion treatment failed, β-HCG was reduced to normal level with an average of 11.2 +- 11.6 d (3-28 d). In 10 cases, the ultrasound showed that the pregnancy bladder disappeared in 2-3 weeks, accounting for 76.9% (10/13). The longest time was 60 days. The range of menstruation recovery was 37 +- 9 d (21-50 d). Conclusions: Interventional treatment of tubal pregnancy is effective, reliable and easy for operation. It will be especially effective by arterial procedure. Interventional treatment will be a important method for terminating tubal pregnancy

Effects of web-based interventions on cancer patients' symptoms: review of randomized trials.

Science.gov (United States)

Fridriksdottir, N; Gunnarsdottir, S; Zoëga, S; Ingadottir, B; Hafsteinsdottir, E J G

2018-02-01

Symptom management is of high priority in cancer care. Information and communication technology allows interventions to be provided through the internet to enhance the delivery of care. This study aimed to review the effects of web-based interventions on cancer patients' symptoms. MEDLINE, PSychINFO, PubMed, CINAHL, and Cochrane databases were systematically searched. Included were randomized controlled trials (RCTs), pilot RCTs, or quasi-experimental (QE) studies focusing on web-based interventions in adult cancer patients with at least one outcome primary or secondary, in terms of symptoms, treatment side effects, or distress. Data were analyzed study by study. Twenty studies were identified. All web interventions included information, 16 included self-management support, 14 included self-monitoring, 13 included feedback/tailored information, 12 used communication with health-care professionals, and eight used communication with other patients. Overall, 13 studies reported positive symptom outcomes. Psychological distress was reported in eight studies with positive intervention effects in three. Symptoms of anxiety/depression were reported in ten studies with positive intervention effects in five. Somatic symptom severity was reported in ten studies with intervention effects found in six, and symptom distress was reported in six studies with intervention effects found in all. This review shows the promising potential of web-based interventions for cancer symptom management, although it was limited by considerable heterogeneity in the interventions tested and targeted outcomes. The multidimensional nature of symptoms was partly addressed; only one study was guided by a comprehensive theoretical model of cancer symptom management. It can only be speculated which web elements are important for effective symptom outcomes. Further testing is needed for web-based cancer symptom management.

Community wide interventions for increasing physical activity.

Science.gov (United States)

Baker, Philip R A; Francis, Daniel P; Soares, Jesus; Weightman, Alison L; Foster, Charles

2015-01-05

Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. We searched the Cochrane Public Health Group Segment of the Cochrane Register of Studies,The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, the British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORT Discus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.org; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA); the US Centre for Disease Control and Prevention (CDC) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were searched and we contacted experts in the field. The searches were updated to 16 January 2014, unrestricted by language or publication status. Cluster randomised controlled trials, randomised controlled trials, quasi-experimental designs which used a control population for comparison, interrupted time-series studies, and prospective controlled cohort studies were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised individuals from the same community were excluded. At least two review authors independently extracted the data and assessed the risk of bias. Each study was assessed for the setting, the number of included components

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.

The Danish Alzheimer Intervention Study: Rationale, Study Design and Baseline Characteristics of the Cohort

DEFF Research Database (Denmark)

Waldemar, G.; Waldorff, F.B.; Buss, D.V.

2011-01-01

There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline characteristics...

Well-being, health and fitness of children who use wheelchairs: feasibility study protocol to develop child-centred 'keep-fit' exercise interventions.

Science.gov (United States)

O'Brien, Thomas D; Noyes, Jane; Spencer, Llinos Haf; Kubis, Hans-Peter; Edwards, Rhiannon T; Bray, Nathan; Whitaker, Rhiannon

2015-02-01

To undertake the pre-clinical and modelling phases of the Medical Research Council complex intervention framework to underpin development of child-centred 'keep-fit', exercise and physical activity interventions for children and young people who use wheelchairs. Children who use wheelchairs face many barriers to participation in physical activity, which compromises fitness, obesity, well-being and health. 'Keep-fit' programmes that are child-centred and engaging are urgently required to enhance participation of disabled children and their families as part of a healthy lifestyle. Nurses will likely be important in promoting and monitoring 'keep-fit' intervention(s) when implemented in the community. Mixed-method (including economic analysis) feasibility study to capture child and family preferences and keep-fit needs and to determine outcome measures for a 'keep-fit' intervention. The study comprises three stages. Stage 1 includes a mixed-method systematic review of effectiveness, cost effectiveness and key stakeholder views and experiences of keep-fit interventions, followed by qualitative interviews with children, young people and their parents to explore preferences and motivations for physical activity. Stage 2 will identify standardized outcome measures and test their application with children who use wheelchairs to obtain baseline fitness data. Options for an exercise-based keep-fit intervention will then be designed based on Stage 1 and 2 findings. In stage 3, we will present intervention options for feedback and further refinement to children and parents/carers in focus groups. (Project funded October 2012). At completion, this study will lead to the design of the intervention and a protocol to test its efficacy. © 2014 John Wiley & Sons Ltd.

Child language interventions in public health: a systematic literature review.

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De Cesaro, Bruna Campos; Gurgel, Léia Gonçalves; Nunes, Gabriela Pisoni Canedo; Reppold, Caroline Tozzi

2013-01-01

Systematically review the literature on interventions in children's language in primary health care. One searched the electronic databases (January 1980 to March 2013) MEDLINE (accessed by PubMed), Scopus, Lilacs and Scielo. The search terms used were "child language", "primary health care", "randomized controlled trial" and "intervention studies" (in English, Portuguese and Spanish). There were included any randomized controlled trials that addressed the issues child language and primary health care. The analysis was based on the type of language intervention conducted in primary health care. Seven studies were included and used intervention strategies such as interactive video, guidance for parents and group therapy. Individuals of both genders were included in the seven studies. The age of the children participant in the samples of the articles included in this review ranged from zero to 11 years. These seven studies used approaches that included only parents, parents and children or just children. The mainly intervention in language on primary health care, used in randomized controlled trials, involved the use of interactional video. Several professionals, beyond speech and language therapist, been inserted in the language interventions on primary health care, demonstrating the importance of interdisciplinary work. None of the articles mentioned aspects related to hearing. There was scarcity of randomized controlled trials that address on language and public health, either in Brazil or internationally.

The Northern Manhattan Caregiver Intervention Project: a randomised trial testing the effectiveness of a dementia caregiver intervention in Hispanics in New York City.

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Luchsinger, José; Mittelman, Mary; Mejia, Miriam; Silver, Stephanie; Lucero, Robert J; Ramirez, Mildred; Kong, Jian; Teresi, Jeanne A

2012-01-01

Dementia prevalence and its burden on families are increasing. Caregivers of persons with dementia have more depression and stress than the general population. Several interventions have proven efficacy in decreasing depression and stress in selected populations of caregivers. Hispanics in New York City tend to have a higher burden of dementia caregiving compared to non-Hispanic whites (NHW) because Hispanics have a higher prevalence of dementia, tend to have high family involvement, and tend to have higher psychosocial and economic stressors. Thus, we chose to test the effectiveness of a dementia caregiving intervention, the New York University Caregiver Intervention (NYUCI), with demonstrated efficacy in spouse caregivers in Hispanic relative caregivers of persons with dementia. Including the community health worker (CHW) intervention in both arms alleviates general psychosocial stressors and allows the assessment of the effectiveness of the intervention. Compared to two original efficacy studies of the NYUCI, which included only spouse caregivers, our study includes all relative caregivers, including common law spouses, children, siblings, a nephew and nieces. This study will be the first randomised trial to test the effectiveness of the NYUCI in Hispanic caregivers including non-spouses. The design of the study is a randomised controlled trial (RCT). Participants are randomised to two arms: case management by a CHW and an intervention arm including the NYUCI in addition to case management by the CHW. The duration of intervention is 6 months. The main outcomes in the trial are changes in the Geriatric Depression Scale (GDS) and the Zarit Caregiver Burden Scale (ZCBS) from baseline to 6 months. This trial is approved by the Columbia University Medical Center Institutional Review Board (AAAI0022), and funded by the National Institute on Minority Health and Health Disparities. The funding agency has no role in dissemination.  www.ClinicalTrials.gov NCT01306695.

Positive psychology interventions: A meta-analysis of randomized controlled studies

NARCIS (Netherlands)

Bolier, Linda; Haverman, M.; Westerhof, Gerben Johan; Riper, H.; Smit, F.; Bohlmeijer, Ernst Thomas

2013-01-01

Background The use of positive psychological interventions may be considered as a complementary strategy in mental health promotion and treatment. The present article constitutes a meta-analytical study of the effectiveness of positive psychology interventions for the general public and for

Positive psychology interventions: a meta-analysis of randomized controlled studies

NARCIS (Netherlands)

Bolier, L.; Haverman, M.; Westerhof, G.J.; Riper, H.; Smit, H.F.E.; Bohlmeijer, E.

2013-01-01

Background: The use of positive psychological interventions may be considered as a complementary strategy in mental health promotion and treatment. The present article constitutes a meta-analytical study of the effectiveness of positive psychology interventions for the general public and for

Impact of a multifaceted educational intervention including serious games to improve the management of invasive candidiasis in critically ill patients.

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Ferrer, R; Zaragoza, R; Llinares, P; Maseda, E; Rodríguez, A; Quindós, G

Infections caused by Candida species are common in critically ill patients and contribute to significant morbidity and mortality. The EPICO Project (Epico 1 and Epico 2.0 studies) recently used a Delphi approach to elaborate guidelines for the diagnosis and treatment of this condition in critically ill adult patients. We aimed to evaluate the impact of a multifaceted educational intervention based on the Epico 1 and Epico 2.0 recommendations. Specialists anonymously responded to two online surveys before and after a multifaceted educational intervention consisting of 60-min educational sessions, the distribution of slide kits and pocket guides with the recommendations, and an interactive virtual case presented at a teleconference and available for online consultation. A total of 74 Spanish hospitals. Specialists of the Intensive Care Units in the participating hospitals. Specialist knowledge and reported practices evaluated using a survey. The McNemar test was used to compare the responses in the pre- and post-intervention surveys. A total of 255 and 248 specialists completed both surveys, in both periods, respectively. The pre-intervention surveys showed many specialists to be unaware of the best approach for managing invasive candidiasis. After both educational interventions, specialist knowledge and reported practices were found to be more in line with nearly all the recommendations of the Epico 1 and Epico 2.0 guidelines, except as regards de-escalation from echinocandins to fluconazole in Candida glabrata infections (p=0.055), and the duration of antifungal treatment in both candidemia and peritoneal candidiasis. This multifaceted educational intervention based on the Epico Project recommendations improved specialist knowledge of the management of invasive candidiasis in critically ill patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

The evaluation of complex interventions in palliative care: an exploration of the potential of case study research strategies.

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Walshe, Catherine

2011-12-01

Complex, incrementally changing, context dependent and variable palliative care services are difficult to evaluate. Case study research strategies may have potential to contribute to evaluating such complex interventions, and to develop this field of evaluation research. This paper explores definitions of case study (as a unit of study, a process, and a product) and examines the features of case study research strategies which are thought to confer benefits for the evaluation of complex interventions in palliative care settings. Ten features of case study that are thought to be beneficial in evaluating complex interventions in palliative care are discussed, drawing from exemplars of research in this field. Important features are related to a longitudinal approach, triangulation, purposive instance selection, comprehensive approach, multiple data sources, flexibility, concurrent data collection and analysis, search for proving-disproving evidence, pattern matching techniques and an engaging narrative. The limitations of case study approaches are discussed including the potential for subjectivity and their complex, time consuming and potentially expensive nature. Case study research strategies have great potential in evaluating complex interventions in palliative care settings. Three key features need to be exploited to develop this field: case selection, longitudinal designs, and the use of rival hypotheses. In particular, case study should be used in situations where there is interplay and interdependency between the intervention and its context, such that it is difficult to define or find relevant comparisons.

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

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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

Social Competence Intervention in Autistic Spectrum Disorders (ASDS) - A Case Study

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Amin, Noor A.; Oweini, Ahmad

2013-01-01

The purpose of this case study was to determine the effectiveness of a combined intervention in remediating the social skills in a first-grader with a disorder from the autism spectrum disorders (ASDs). The researcher also aimed to identify the changes observed during the intervention period. The combined intervention consisted of reading…

Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review

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Alexandra Martini de Oliveira

2015-01-01

Full Text Available Introduction. Behavioral and psychological symptoms of dementia (BPSD are defined as a group of symptoms of disturbed perceptive thought content, mood, or behavior that include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, and wandering. Care of patients with BPSD involves pharmacological and nonpharmacological interventions. We reviewed studies of nonpharmacological interventions published in the last 10 years. Methods. We performed a systematic review in Medline and Embase databases, in the last 10 years, until June 2015. Key words used were (1 non-pharmacological interventions, (2 behavioral symptoms, (3 psychological symptoms, and (4 dementia. Results. We included 20 studies published in this period. Among these studies, program activities were more frequent (five studies and the symptoms more responsive to the interventions were agitation. Discussion. Studies are heterogeneous in many aspects, including size sample, intervention, and instruments of measures. Conclusion. Nonpharmacological interventions are able to provide positive results in reducing symptoms of BPSD. Most studies have shown that these interventions have important and significant efficacy.

Equine-assisted activities and the impact on perceived social support, self-esteem and self-efficacy among adolescents – an intervention study

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Hauge, Hilde; Kvalem, Ingela L.; Berget, Bente; Enders-Slegers, Marie-José; Braastad, Bjarne O.

2013-01-01

In this project, we examined the effect of a 4-month intervention with horses on perceived social support, self-esteem and general self-efficacy among Norwegian adolescents aged 12–15 years. The intervention took place at farm-based stables and included work with the horses and riding. A waiting-list crossover design was used and the participants answered questionnaires at three time periods. Study I (N = 49) examined the effect of the intervention compared with the control group. Study II (N = 41) examined the relationship between the same psychological variables and change in mastering skills with horse. The intervention group reported a significant increase in perceived social support compared with the control group. There were no differences in self-esteem and general self-efficacy between the groups. The results from study II showed that a lower level of perceived social support prior to the intervention predicted an increase in mastering skills with the horse during the intervention. PMID:24833811

Theoretical rationale for music selection in oncology intervention research: an integrative review.

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Burns, Debra S

2012-01-01

Music-based interventions have helped patients with cancer improve their quality of life, decrease treatment related distress, and manage pain. However, quantitative findings from music intervention studies are inconsistent. The purpose of this review was to explore the theoretical underpinnings for the selection of the music stimuli used to influence targeted outcomes. It was hypothesized that disparate findings were due in part to the atheoretical nature of music selection and the resulting diversity in music stimuli between and within studies. A systematic research synthesis including a comprehensive database and reference list search resulted in 22 studies. Included studies were compiled into two tables cataloging intervention theory, intervention content, and outcomes. A majority of studies did not provide a rationale or intervention theory for the delivery of music or choice of outcomes. Recorded music was the most common delivery method, but the specific music was rarely included within the report. Only two studies that included a theoretical framework reported null results on at least some of the outcomes. Null results are partially explained by an incomplete or mismatch in intervention theory and music selection and delivery. While the inclusion of an intervention theory does not guarantee positive results, including a theoretical rationale for the use of music, particular therapeutic processes or mechanisms, and the specifics of how music is selected and delivered increases scientific rigor and the probability of clinical translation.

The utility of Geographical Information Systems (GIS) in systems-oriented obesity intervention projects: the selection of comparable study sites for a quasi-experimental intervention design--TX CORD.

Science.gov (United States)

Oluyomi, Abiodun O; Byars, Allison; Byrd-Williams, Courtney; Sharma, Shreela V; Durand, Casey; Hoelscher, Deanna M; Butte, Nancy F; Kelder, Steven H

2015-02-01

The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in community-level intervention studies, TX CORD uses a quasi-experimental design. Comparable intervention and comparison study sites are needed to address internal validity bias. TX CORD was designed to be implemented in low-income, ethnically diverse communities in Austin and Houston, Texas. A three-stage Geographical Information System (GIS) methodology was used to establish and ascertain the comparability of the intervention and comparison study sites. Census tract (stage 1) and school (stage 2) data were used to identify spatially exclusive geographic areas that were comparable. In stage 3, study sites were compared on demographic characteristics, socioeconomic status (SES), food assets, and physical activity (PA) assets. Student's t-test was used to examine significant differences between the selected sites. The methodology that was used resulted in the selection of catchment areas with demographic and socioeconomic characteristics that fit the target population: ethnically diverse population; lower-median household income; and lower home ownership rates. Additionally, the intervention and comparison sites were statistically comparable on demographic and SES variables, as well as food assets and PA assets. This GIS approach can provide researchers, program evaluators, and policy makers with useful tools for both research and practice. Area-level information that allows for robust understanding of communities can enhance analytical procedures in community health research and offer significant contributions in terms of community assessment and engagement.

Walk well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

Science.gov (United States)

2013-01-01

Background Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities. Trial registration ISRCTN: ISRCTN50494254 PMID:23816316

The Role and Reprocessing of Attitudes in Fostering Employee Work Happiness: An Intervention Study.

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Williams, Paige; Kern, Margaret L; Waters, Lea

2017-01-01

This intervention study examines the iterative reprocessing of explicit and implicit attitudes as the process underlying associations between positive employee attitudes (PsyCap), perception of positive organization culture (organizational virtuousness, OV), and work happiness. Using a quasi-experimental design, a group of school staff ( N = 69) completed surveys at three time points. After the first assessment, the treatment group ( n = 51) completed a positive psychology training intervention. Results suggest that employee PsyCap, OV, and work happiness are associated with one another through both implicit and explicit attitudes. Further, the Iterative-Reprocessing Model of attitudes (IRM) provides some insights into the processes underlying these associations. By examining the role and processes through which explicit and implicit attitudes relate to wellbeing at work, the study integrates theories on attitudes, positive organizational scholarship, positive organizational behavior and positive education. It is one of the first studies to apply the theory of the IRM to explain associations amongst PsyCap, OV and work happiness, and to test the IRM theory in a field-based setting. In applying attitude theory to wellbeing research, this study provides insights to mechanisms underlying workplace wellbeing that have not been previously examined and in doing so responds to calls for researchers to learn more about the mechanisms underlying wellbeing interventions. Further, it highlights the need to understand subconscious processes in future wellbeing research and to include implicit measures in positive psychology interventions measurement programs. Practically, this research calls attention to the importance of developing both the positive attitudes of employees and the organizational culture in developing employee work happiness.

A cluster randomised trial testing an intervention to improve parents' recognition of their child's weight status: study protocol.

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Parkinson, Kathryn N; Jones, Angela R; Tovee, Martin J; Ells, Louisa J; Pearce, Mark S; Araujo-Soares, Vera; Adamson, Ashley J

2015-06-12

Parents typically do not recognise their child's weight status accurately according to clinical criteria, and thus may not take appropriate action if their child is overweight. We developed a novel visual intervention designed to improve parental perceptions of child weight status according to clinical criteria for children aged 4-5 and 10-11 years. The Map Me intervention comprises age- and sex-specific body image scales of known body mass index and supporting information about the health risks of childhood overweight. This cluster randomised trial will test the effectiveness of the Map Me intervention. Primary schools will be randomised to: paper-based Map Me; web-based Map Me; no information (control). Parents of reception (4-5 years) and year 6 (10-11 years) children attending the schools will be recruited. The study will work with the National Child Measurement Programme which measures the height and weight of these year groups and provides feedback to parents about their child's weight status. Before receiving the feedback, parents will complete a questionnaire which includes assessment of their perception of their child's weight status and knowledge of the health consequences of childhood overweight. The control group will provide pre-intervention data with assessment soon after recruitment; the intervention groups will provide post-intervention data after access to Map Me for one month. The study will subsequently obtain the child height and weight measurements from the National Child Measurement Programme. Families will be followed-up by the study team at 12 months. The primary outcome is any difference in accuracy in parental perception of child weight status between pre-intervention and post-intervention at one month. The secondary outcomes include differences in parent knowledge, intention to change lifestyle behaviours and/or seek advice or support, perceived control, action planning, coping planning, and child weight status at 12 month follow-up. The

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.

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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

A Positive Psychology Intervention With Emerging Adults

OpenAIRE

Sophie Leontopoulou

2015-01-01

This study assessed the impact of a positive psychology intervention in a sample of 40 young men (35%) and women (65%) aged 18-30 years. Participants were 1st and 4th year undergraduate University students, postgraduate students and working youths. The study examined the effects of a battery of interventions commonly used in positive psychology interventions, including a video and three exercises (i.e. expressing gratitude, best possible selves, goal setting) on character strengths, hope, gra...

A qualitative study of tobacco interventions for LGBTQ+ youth and young adults: overarching themes and key learnings.

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Bruce Baskerville, N; Wong, Katy; Shuh, Alanna; Abramowicz, Aneta; Dash, Darly; Esmail, Aamer; Kennedy, Ryan

2018-01-18

Smoking prevalence is very high among lesbian, gay, bisexual, transgendered and queer (LGBTQ+) youth and young adults (YYA) compared to non-LGBTQ+ YYA. A knowledge gap exists on culturally appropriate and effective prevention and cessation efforts for members of this diverse community, as limited interventions have been developed with and for this population, and there are very few studies determining the impact of these interventions. This study identifies the most salient elements of LGBTQ+ cessation and prevention interventions from the perspective of LGBTQ+ YYA. Three descriptions of interventions tailored for LGBTQ+ YYA (group cessation counselling, social marketing, and a mobile phone app with social media incorporated), were shared with LGBTQ+ YYA via 24 focus groups with 204 participants in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, and concerns about the culturally modified intervention descriptions. Framework analysis was used to identify overarching themes across all three intervention descriptions. The data revealed eight overarching themes across all three intervention descriptions. Smoking cessation and prevention interventions should have the following key attributes: 1) be LGBTQ+ - specific; 2) be accessible in terms of location, time, availability, and cost; 3) be inclusive, relatable, and highlight diversity; 4) incorporate LGBTQ+ peer support and counselling services; 5) integrate other activities beyond smoking; 6) be positive, motivational, uplifting, and empowering; 7) provide concrete coping mechanisms; and 8) integrate rewards and incentives. LGBTQ+ YYA focus group participants expressed a desire for an intervention that can incorporate these key elements. The mobile phone app and social media campaign were noted as potential interventions that could include all the essential elements.

Assessing validity of observational intervention studies - the Benchmarking Controlled Trials.

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Malmivaara, Antti

2016-09-01

Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. To create and pilot test a checklist for appraising methodological validity of a BCT. The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies. Key messages Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies.

Design of the study: How can health care help female breast cancer patients reduce their stress symptoms? A randomized intervention study with stepped-care

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Nordin Karin

2012-05-01

Full Text Available Abstract Background A life threatening illness such as breast cancer can lead to a secondary diagnosis of PTSD (post traumatic stress disorder with intrusive thoughts and avoidance as major symptoms. In a former study by the research group, 80% of the patients with breast cancer reported a high level of stress symptoms close to the diagnosis, such as intrusive thoughts and avoidance behavior. These symptoms remained high throughout the study. The present paper presents the design of a randomized study evaluating the effectiveness and cost-effectiveness of a stress management intervention using a stepped-care design. Method Female patients over the age of 18, with a recent diagnosis of breast cancer and scheduled for adjuvant treatment in the form of chemotherapy, radiation therapy and/or hormonal therapy are eligible and will consecutively be included in the study. The study is a prospective longitudinal intervention study with a stepped-care approach, where patients will be randomised to one of two interventions in the final stage of treatment. The first step is a low intensity stress-management intervention that is given to all patients. Patients who do not respond to this level are thereafter given more intensive treatment at later steps in the program and will be randomized to more intensive stress-management intervention in a group setting or individually. The primary out-come is subjective distress (intrusion and avoidance assessed by the Impact of Event Scale (IES. According to the power-analyses, 300 patients are planned to be included in the study and will be followed for one year. Other outcomes are anxiety, depression, quality of life, fatigue, stress in daily living and utilization of hospital services. This will be assessed with well-known psychometric tested questionnaires. Also, the cost-effectiveness of the intervention given in group or individually will be evaluated. Discussion This randomized clinical trial will provide

Economic evaluations of ergonomic interventions preventing work-related musculoskeletal disorders: a systematic review of organizational-level interventions.

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Sultan-Taïeb, Hélène; Parent-Lamarche, Annick; Gaillard, Aurélie; Stock, Susan; Nicolakakis, Nektaria; Hong, Quan Nha; Vezina, Michel; Coulibaly, Youssouph; Vézina, Nicole; Berthelette, Diane

2017-12-08

Work-related musculoskeletal disorders (WMSD) represent a major public health problem and economic burden to employers, workers and health insurance systems. This systematic review had two objectives: (1) to analyze the cost-benefit results of organizational-level ergonomic workplace-based interventions aimed at preventing WMSD, (2) to explore factors related to the implementation process of these interventions (obstacles and facilitating factors) in order to identify whether economic results may be due to a successful or unsuccessful implementation. Systematic review. Studies were searched in eight electronic databases and in reference lists of included studies. Companion papers were identified through backward and forward citation tracking. A quality assessment tool was developed following guidelines available in the literature. An integration of quantitative economic results and qualitative implementation data was conducted following an explanatory sequential design. Out of 189 records, nine studies met selection criteria and were included in our review. Out of nine included studies, grouped into four types of interventions, seven yielded positive economic results, one produced a negative result and one mixed results (negative cost-effectiveness and positive net benefit). However, the level of evidence was limited for the four types of interventions given the quality and the limited number of studies identified. Our review shows that among the nine included studies, negative and mixed economic results were observed when the dose delivered and received by participants was low, when the support from top and/or middle management was limited either due to limited participation of supervisors in training sessions or a lack of financial resources and when adequacy of intervention to workers' needs was low. In studies where economic results were positive, implementation data showed strong support from supervisors and a high rate of employee participation. Studies

What interventions increase commuter cycling? A systematic review.

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Stewart, Glenn; Anokye, Nana Kwame; Pokhrel, Subhash

2015-08-14

To identify interventions that will increase commuter cycling. All settings where commuter cycling might take place. Adults (aged 18+) in any country. Individual, group or environmental interventions including policies and infrastructure. A wide range of 'changes in commuter cycling' indicators, including frequency of cycling, change in workforce commuting mode, change in commuting population transport mode, use of infrastructure by defined populations and population modal shift. 12 studies from 6 countries (6 from the UK, 2 from Australia, 1 each from Sweden, Ireland, New Zealand and the USA) met the inclusion criteria. Of those, 2 studies were randomised control trials and the remainder preintervention and postintervention studies. The majority of studies (n=7) evaluated individual-based or group-based interventions and the rest environmental interventions. Individual-based or group-based interventions in 6/7 studies were found to increase commuter cycling of which the effect was significant in only 3/6 studies. Environmental interventions, however, had small but positive effects in much larger but more difficult to define populations. Almost all studies had substantial loss to follow-up. Despite commuter cycling prevalence varying widely between countries, robust evidence of what interventions will increase commuter cycling in low cycling prevalence nations is sparse. Wider environmental interventions that make cycling conducive appear to reach out to hard to define but larger populations. This could mean that environmental interventions, despite their small positive effects, have greater public health significance than individual-based or group-based measures because those interventions encourage a larger number of people to integrate physical activity into their everyday lives. 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.

Transforming primary healthcare by including the stakeholders involved in delivering care to people living in poverty: EQUIhealThY study protocol.

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Loignon, Christine; Hudon, Catherine; Boudreault-Fournier, Alexandrine; Dupéré, Sophie; Macaulay, Ann C; Pluye, Pierre; Gaboury, Isabelle; Haggerty, Jeannie L; Fortin, Martin; Goulet, Émilie; Lambert, Mireille; Pelissier-Simard, Luce; Boyer, Sophie; de Laat, Marianne; Lemire, Francine; Champagne, Louise; Lemieux, Martin

2013-03-11

Ensuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the healthcare system in the development of research interventions. The aim of this project is to stimulate changes in healthcare organizations and practices by encouraging collaboration between care teams and people living in poverty. Our objectives are twofold: 1) to identify actions required to promote the adoption of professional practices oriented toward social competence in primary care teams; and 2) to examine factors that would encourage the inclusion of people living in poverty in the process of developing social competence in healthcare organizations. This study will use a participatory action research design applied in healthcare organizations. Participatory research is an increasingly recognized approach that is helpful for involving the people for whom the research results are intended. Our research team consists of 19 non-academic researchers, 11 academic researchers and six partners. A steering committee composed of academic researchers and stakeholders will have a decision-making role at each step, including knowledge dissemination and recommendations for new interventions. In this project we will adopt a multiphase approach and will use a variety of methods, including photovoice, group discussions and interviews. The proposed study will be one of only a few using participatory research in primary care to foster changes aimed at enhancing quality and access to care for people living in poverty. To our knowledge this will be the first study to use photovoice in healthcare organizations to promote new interventions. Our project includes partners who are targeted for practice changes and improvements in delivering primary care to persons living in poverty

Non-pharmacological interventions for caregivers of stroke survivors.

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Legg, Lynn A; Quinn, Terry J; Mahmood, Fahd; Weir, Christopher J; Tierney, Jayne; Stott, David J; Smith, Lorraine N; Langhorne, Peter

2011-10-05

A substantial component of care is provided to stroke survivors by informal caregivers. However, providing such care is often a new and challenging experience and has been linked to a number of adverse outcomes. A range of interventions targeted towards stroke survivors and their family or other informal caregivers have been tested in randomised controlled trials (RCTs).  To evaluate the effect of interventions targeted towards informal caregivers of stroke survivors or targeted towards informal caregivers and the care recipient (the stroke survivor). We searched the Cochrane Stroke Group Trials Register (March 2011), CENTRAL (The Cochrane Library Issue 2010, Issue 4), MEDLINE (1950 to August 2010), EMBASE (1980 to December 2010), CINAHL (1982 to August 2010), AMED (1985 to August 2010), PsycINFO (1967 to August 2010) and 11 additional databases. In an effort to identify further published, unpublished and ongoing studies, we searched conference proceedings and trials registers, scanned reference lists of relevant articles and contacted authors and researchers. There were no language restrictions. We included RCTs if they evaluated the effect of non-pharmacological interventions (compared with no care or routine care) on informal caregivers of stroke survivors. We included trials of interventions delivered to stroke survivors and informal caregivers only if the stroke survivor and informal caregiver were randomised as a dyad. We excluded studies which included stroke survivors and caregivers if the stroke survivors were the primary target of the intervention. Two review authors selected studies for inclusion, independently extracted data and assessed methodological quality. We sought original data from trialists. We categorised interventions into three groups: support and information, teaching procedural knowledge/vocational training type interventions, and psycho-educational type interventions. The primary outcome was caregivers' stress or strain. We resolved

Psychosocial interventions for cannabis use disorder

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Gates, Peter J; Sabioni, Pamela; Copeland, Jan; Le Foll, Bernard; Gowing, Linda

2016-01-01

Background Cannabis use disorder is the most commonly reported illegal substance use disorder in the general population; although demand for assistance from health services is increasing internationally, only a minority of those with the disorder seek professional assistance. Treatment studies have been published, but pressure to establish public policy requires an updated systematic review of cannabis-specific treatments for adults. Objectives To evaluate the efficacy of psychosocial interventions for cannabis use disorder (compared with inactive control and/or alternative treatment) delivered to adults in an out-patient or community setting. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 6), MEDLINE, EMBASE, PsycINFO, the Cumulaive Index to Nursing and Allied Health Literature (CINAHL) and reference lists of articles. Searched literature included all articles published before July 2015. Selection criteria All randomised controlled studies examining a psychosocial intervention for cannabis use disorder (without pharmacological intervention) in comparison with a minimal or inactive treatment control or alternative combinations of psychosocial interventions. Data collection and analysis We used standard methodological procedures as expected by The Cochrane Collaboration. Main results We included 23 randomised controlled trials involving 4045 participants. A total of 15 studies took place in the United States, two in Australia, two in Germany and one each in Switzerland, Canada, Brazil and Ireland. Investigators delivered treatments over approximately seven sessions (range, one to 14) for approximately 12 weeks (range, one to 56). Overall, risk of bias across studies was moderate, that is, no trial was at high risk of selection bias, attrition bias or reporting bias. Further, trials included a large total number of participants, and each trial ensured the fidelity of treatments provided. In contrast, because of the

Psychosocial interventions for cannabis use disorder.

Science.gov (United States)

Gates, Peter J; Sabioni, Pamela; Copeland, Jan; Le Foll, Bernard; Gowing, Linda

2016-05-05

Cannabis use disorder is the most commonly reported illegal substance use disorder in the general population; although demand for assistance from health services is increasing internationally, only a minority of those with the disorder seek professional assistance. Treatment studies have been published, but pressure to establish public policy requires an updated systematic review of cannabis-specific treatments for adults. To evaluate the efficacy of psychosocial interventions for cannabis use disorder (compared with inactive control and/or alternative treatment) delivered to adults in an out-patient or community setting. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 6), MEDLINE, EMBASE, PsycINFO, the Cumulaive Index to Nursing and Allied Health Literature (CINAHL) and reference lists of articles. Searched literature included all articles published before July 2015. All randomised controlled studies examining a psychosocial intervention for cannabis use disorder (without pharmacological intervention) in comparison with a minimal or inactive treatment control or alternative combinations of psychosocial interventions. We used standard methodological procedures as expected by The Cochrane Collaboration. We included 23 randomised controlled trials involving 4045 participants. A total of 15 studies took place in the United States, two in Australia, two in Germany and one each in Switzerland, Canada, Brazil and Ireland. Investigators delivered treatments over approximately seven sessions (range, one to 14) for approximately 12 weeks (range, one to 56).Overall, risk of bias across studies was moderate, that is, no trial was at high risk of selection bias, attrition bias or reporting bias. Further, trials included a large total number of participants, and each trial ensured the fidelity of treatments provided. In contrast, because of the nature of the interventions provided, participant blinding was not possible, and reports of

Student radiographers' attitudes toward the older patient – An intervention study

International Nuclear Information System (INIS)

Booth, L.; Kada, S.

2015-01-01

Purpose: To design, implement and evaluate the effect of an educational intervention on Norwegian student (diagnostic) radiographers' attitudes towards older people. Design: This study is part of a wider longitudinal study that will evaluate student radiographer attitudes towards the older patient as they progress through their training. In this phase an educational intervention, aimed at improving student radiographer attitudes towards the older person, was designed and implemented. What is reported here are the findings of a pre-test, post-test design that used the Kogan's attitudes towards older people scale to determine whether this intervention had any effect of student radiographer attitudes towards older people. Results: Overall students reported significantly more positive attitudes towards older people after intervention (p = 0.01). However, analysis of responses to individual questions reveals that this difference was not significant in all cases. Conclusion: The results of the present study suggest that an educational intervention can have a significant impact on student radiographer's attitudes towards older people. Whether this positive attitude remains throughout training, forms part of the wider basis for this study. - Highlights: • We designed an education intervention to improve Norwegian student radiographer attitudes towards older people. • Pre-intervention we found that these student radiographers generally had positive attitudes towards older people. • Post intervention the student radiographer's attitudes towards older people were significantly improved

Infant Safe Sleep Interventions, 1990-2015: A Review.

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Salm Ward, Trina C; Balfour, Giselle M

2016-02-01

Sleep-related infant deaths remain a major public health issue. Multiple interventions have been implemented in efforts to increase adherence to safe sleep recommendations. We conducted a systematic review of the international research literature to synthesize research on interventions to reduce the risk of sleep-related deaths and their effectiveness in changing infant sleep practices. We searched PubMed, CINAHL, PsycINFO, and Google Scholar for peer-reviewed articles published between 1990 and 2015 which described an intervention and reported results. Twenty-nine articles were included for review. Studies focused on infant caregivers, health care professionals, peers, and child care professionals. Targeted behaviors included sleep position, location, removing items from the crib, breastfeeding, smoke exposure, clothing, pacifier use, and knowledge of Sudden Infant Death Syndrome. Most articles described multi-faceted interventions, including: one-on-one or group education, printed materials, visual displays, videos, and providing resources such as cribs, pacifiers, wearable blankets, and infant t-shirts. Two described public education campaigns, one used an educative questionnaire, and one encouraged maternal note taking. Health professional interventions included implementing safe sleep policies, in-service training, printed provider materials, eliciting agreement on a Declaration of Safe Sleep Practice, and sharing adherence data. Data collection methods included self-report via surveys and observational crib audits. Over half of the studies utilized comparison groups which helped determine effectiveness. Most articles reported some degree of success in changing some of the targeted behaviors; no studies reported complete adherence to recommendations. Future studies should incorporate rigorous evaluation plans, utilize comparison groups, and collect demographic and collect follow-up data.

Meta-Analysis of Studies Incorporating the Interests of Young Children with Autism Spectrum Disorders into Early Intervention Practices

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Carl J. Dunst

2012-01-01

Full Text Available Incorporating the interests and preferences of young children with autism spectrum disorders into interventions to promote prosocial behavior and decrease behavior excesses has emerged as a promising practice for addressing the core features of autism. The efficacy of interest-based early intervention practices was examined in a meta-analysis of 24 studies including 78 children 2 to 6 years of age diagnosed with autism spectrum disorders. Effect size analyses of intervention versus nonintervention conditions and high-interest versus low-interest contrasts indicated that interest-based intervention practices were effective in terms of increasing prosocial and decreasing aberrant child behavior. Additionally, interest-based interventions that focused on two of the three core features of autism spectrum disorders (poor communication, poor interpersonal relationships were found most effective in influencing child outcomes. Implications for very early intervention are discussed in terms addressing the behavior markers of autism spectrum disorders before they become firmly established.

A pilot study of radiation exposures arising from interventional radiology procedures

International Nuclear Information System (INIS)

Pellet, S.; Giczi, F.; Gaspardy, G.; Temesi, A.; Ballay, L.

2006-01-01

Full text of publication follows: In the past 25 years, considerable number of new therapeutic procedures have been worked out and adopted in radiology. These interventional procedures are mainly based on angiographic methods. During these procedures the exposure of patients and staff are usually greater than of conventional radiography and fluoroscopy as a consequence of longer fluoroscopy times and great number of cine-radiography. In the latest years radiation-induced skin injuries occurred in some patients. Injuries to physicians and staff performing interventional procedures have also been observed. In our days interventional procedures are widely used and more sophisticated procedures are worked out and adopted. Consequently, there is a need for the protection of the patient and the staff on a higher level. Radiation protection of intervention radiology deserves a distinguish attention. In Hungary interventional radiology were performed in 36 laboratories in 2003. According to statistical data the gross number of interventional radiological procedures were 19442. The most frequently performed procedures were the P.T.C.A., the coronary and ilio-femoral stent implantation and chemo-embolization. In 2004, the National Research Institute for Radiobiology and Radio-hygiene and the National Patient Dose Evaluation Program started a pilot study of radiation exposures arising from interventional radiology procedures. During the study the patient exposure were measured by D.A.P.-meters. The patient skin dose and the staff dose were performed by thermoluminescent chips. In their presentation the authors present the most important results of the study. (authors)

Neuropsychological and psychological interventions for people with newly diagnosed epilepsy.

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Jackson, Cerian F; Makin, Selina M; Baker, Gus A

2015-07-22

Many people with epilepsy report experiencing psychological difficulties such as anxiety, depression and neuropsychological deficits including memory problems. Research has shown that these difficulties are often present not only for people with chronic epilepsy but also for people with newly diagnosed epilepsy. Despite this, there are very few published interventions that detail means to help people with newly diagnosed epilepsy manage these problems. To identify and assess possible psychological and neuropsychological interventions for adults with newly diagnosed epilepsy. We searched the following databases on 30 June 2015: the Cochrane Epilepsy Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), SCOPUS, PsycINFO, CINAHL, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). This review includes all randomised controlled trials, quasi-randomised controlled trials, prospective cohort controlled studies, and prospective before and after studies which include psychological or neuropsychological interventions for people with newly diagnosed epilepsy. We excluded studies that included people with epilepsy and any other psychological disorder or neurological condition. We excluded studies carried out which recruited only children. We used the standard methodological procedure expected by The Cochrane Collaboration. Two authors independently completed data extraction and risk of bias analysis. The results of this were cross-checked and third author resolved any discrepancies. In the event of missing data, we contacted the study authors. Meta-analysis was not completed due to differences in the intervention and outcomes reported in the two studies. We included two randomised controlled trials assessing psychological interventions for people with newly diagnosed epilepsy. One study assessed a cognitive behavioural intervention (CBI) in an adolescent

Meditation Interventions for Chronic Disease Populations: A Systematic Review.

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Chan, Roxane Raffin; Larson, Janet L

2015-12-01

The rapidly growing body of research regarding the use of meditation interventions in chronic disease presents an opportunity to compare outcomes based on intervention content. For this review, meditation interventions were described as those interventions delivered to persons with chronic disease where sitting meditation was the main or only content of the intervention with or without the addition of mindful movement. This systematic review identified 45 individual research studies that examined meditations effect on levels of anxiety, depression, and chronic disease symptoms in persons with chronic disease. Individual studies were assessed based on interventional content, the consistency with which interventions were applied, and the research quality. This study identified seven categories of meditation interventions based on the meditation skills and mindful movement practices that were included in the intervention. Overall, half of the interventions had clearly defined and specific meditation interventions (25/45) and half of the studies were conducted using randomized control trials (24/45). © The Author(s) 2015.

Biobehavioral Intervention for Cancer Stress: Conceptualization, Components, and Intervention Strategies

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Andersen, Barbara L.; Golden-Kreutz, Deanna M.; Emery, Charles F.; Thiel, Debora L.

2009-01-01

Trials testing the efficacy of psychological interventions for cancer patients had their beginnings in the 1970s. Since then, hundreds of trials have found interventions to be generally efficacious. In this article, we describe an intervention grounded in a conceptual model that includes psychological, behavioral, and biological components. It is…

Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation.

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Hamoda, Reem E; Gander, Jennifer C; McPherson, Laura J; Arriola, Kimberly J; Cobb, Loren; Pastan, Stephen O; Plantinga, Laura; Browne, Teri; Hartmann, Erica; Mulloy, Laura; Zayas, Carlos; Krisher, Jenna; Patzer, Rachel E

2018-01-15

The Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement intervention in increasing referral for kidney transplant evaluation among selected Georgia dialysis facilities. To assess implementation of the RaDIANT intervention, we conducted a process evaluation at the conclusion of the intervention period (January-December 2014). We administered a 20-item survey to the staff involved with transplant education in 67 dialysis facilities randomized to participate in intervention activities. Survey items assessed facility participation in the intervention (fidelity and reach), helpfulness and willingness to continue intervention activities (sustainability), suggestions for improving intervention components (sustainability), and factors that may have influenced participation and study outcomes (context). We defined high fidelity to the intervention as completing 11 or more activities, and high participation in an activity as having at least 75% participation across intervention facilities. Staff from 65 of the 67 dialysis facilities completed the questionnaire, and more than half (50.8%) reported high adherence (fidelity) to RaDIANT intervention requirements. Nearly two-thirds (63.1%) of facilities reported that RaDIANT intervention activities were helpful or very helpful, with 90.8% of facilities willing to continue at least one intervention component beyond the study period. Intervention components with high participation emphasized staff and patient-level education, including in-service staff orientations, patient and family education programs, and patient educational materials. Suggested improvements for intervention activities emphasized addressing financial barriers to transplantation, with financial education materials perceived as most helpful among Ra

Faith-Based Mental Health Interventions with African Americans: A Review

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Hays, Krystal; Aranda, Maria P.

2016-01-01

Faith-based interventions have emerged culturally sensitive way to address mental health issues among African Americans. This systematic review explores the scope and efficacy of faith-based mental health intervention outcomes among African Americans. Extracted data included the study population, setting, study design, intervention, adaptations,…

Improving diets and nutrition through an integrated poultry value chain and nutrition intervention (SELEVER) in Burkina Faso: study protocol for a randomized trial.

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Gelli, Aulo; Becquey, Elodie; Ganaba, Rasmane; Headey, Derek; Hidrobo, Melissa; Huybregts, Lieven; Verhoef, Hans; Kenfack, Romain; Zongouri, Sita; Guedenet, Hannah

2017-09-06

The SELEVER study is designed to evaluate the impact of an integrated agriculture-nutrition package of interventions (including poultry value chain development, women's empowerment activities, and a behavior change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso. This paper presents the rationale and study design. The impact evaluation involves a cluster randomized controlled trial design that will be implemented in 120 rural communities/villages within 60 communes supported by SELEVER in the Boucle de Mouhoun, Centre-Ouest, and Haut-Bassins regions of Burkina Faso. Communities will be randomly assigned to one of three treatment arms, including: (1) SELEVER intervention group; (2) SELEVER with an intensive WASH component; and (3) control group without intervention. Primary outcomes include the mean probability of adequacy of diets for women and children (aged 2-4 years at baseline), infant and young child feeding practices of caregivers of children aged 0-2 years, and household poultry production and sales. Intermediate outcomes along the agriculture and nutrition pathways will also be measured, including child nutrition status and development. The evaluation will follow a mixed-methods approach, including a panel of child-, household-, community-, and market-level surveys, and data collection points during post-harvest and lean seasons, as well as one year after implementation completion to examine sustainability. To our knowledge, this study is the first to rigorously examine from a food systems perspective, the simultaneous impact of scaling-up nutrition-specific and nutrition-sensitive interventions through a livestock value-chain and community-intervention platform, across nutrition, health, and agriculture domains. The findings of this evaluation will provide evidence to support the design of market-based nutrition

Narrative-Based Intervention for Word-Finding Difficulties: A Case Study

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Marks, Ian; Stokes, Stephanie F.

2010-01-01

Background: Children with word-finding difficulties manifest a high frequency of word-finding characteristics in narrative, yet word-finding interventions have concentrated on single-word treatments and outcome measures. Aims: This study measured the effectiveness of a narrative-based intervention in improving single-word picture-naming and…

Relapse prevention in patients with schizophrenia : A nursing intervention study

NARCIS (Netherlands)

Meijel, Berno van

2003-01-01

This thesis describes a study into the development and testing of a nursing intervention with a view to preventing psychotic relapses in patients suffering from schizophrenia or a related disorder. The purpose of the intervention is to recognise the early signs of an oncoming psychotic relapse. If

Design of a study evaluating the effects, health economics, and stakeholder perspectives of a multi-component occupational rehabilitation program with an added workplace intervention - a  study protocol.

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Rise, Marit B; Skagseth, Martin; Klevanger, Nina E; Aasdahl, Lene; Borchgrevink, Petter; Jensen, Chris; Tenggren, Hanne; Halsteinli, Vidar; Jacobsen, Trym N; Løland, Svein B; Johnsen, Roar; Fimland, Marius S

2018-02-05

Recent research has suggested that interventions at the workplace might be the most potent ingredient in return to work interventions, but few studies have investigated the different effects of workplace interventions as part of occupational rehabilitation programs. The comprehensive design described in this article includes effect (on return to work and health outcomes), and health economic evaluations of a workplace intervention added to a multicomponent rehabilitation program. Qualitative and mixed method studies will investigate sick-listed persons', rehabilitation therapists' and employers' perspectives on the usability and outcomes of the rehabilitation program and the workplace intervention. The program and intervention are provided to patients with musculoskeletal, psychological or general and unspecified diagnoses. The program is multi-component and includes Acceptance and Commitment Therapy, physical exercise, patient education and creating a plan for increased work participation. Persons who are employed, aged from 18 to 60 years, with a current sick leave status of 50% or more and a diagnosis within the musculoskeletal, psychological or general and unspecified chapters of International Classification of Primary Care-2 (ICPC-2) will be recruited to a researcher-blinded parallel-group randomized controlled trial. All participants take part in an in-patient occupational rehabilitation program, while the intervention group also takes part in an intervention at the workplace. The effect and economic evaluation will investigate the effect of the added workplace intervention. The primary outcome measures will be time until full sustainable return to work and total number of sickness absence days in the 12 months after inclusion. Health economic evaluations will investigate the cost-effectiveness and cost-utility. Qualitative studies will investigate rehabilitation therapists' experiences with working towards return to work within an ACT-approach and

A pilot study: mindfulness meditation intervention in COPD

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Chan, Roxane Raffin; Giardino, Nicholas; Larson, Janet L

2015-01-01

Living well with chronic obstructive pulmonary disease (COPD) requires people to manage disease-related symptoms in order to participate in activities of daily living. Mindfulness practice is an intervention that has been shown to reduce symptoms of chronic disease and improve accurate symptom assessment, both of which could result in improved disease management and increased wellness for people with COPD. A randomized controlled trial was conducted to investigate an 8-week mindful meditation intervention program tailored for the COPD population and explore the use of breathing timing parameters as a possible physiological measure of meditation uptake. Results demonstrated that those randomized to the mindful meditation intervention group (N=19) had a significant increase in respiratory rate over time as compared to those randomized to the wait-list group (N=22) (P=0.045). It was also found that the mindful meditation intervention group demonstrated a significant decrease in level of mindfulness over time as compared to the wait-list group (P=0.023). When examining participants from the mindful meditation intervention who had completed six or more classes, it was found that respiratory rate did not significantly increase in comparison to the wait-list group. Furthermore, those who completed six or more classes (N=12) demonstrated significant improvement in emotional function in comparison to the wait-list group (P=0.032) even though their level of mindfulness did not improve. This study identifies that there may be a complex relationship between breathing parameters, emotion, and mindfulness in the COPD population. The results describe good feasibility and acceptability for meditation interventions in the COPD population. PMID:25767382

Designing an Agent-Based Model for Childhood Obesity Interventions: A Case Study of ChildObesity180.

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Hennessy, Erin; Ornstein, Joseph T; Economos, Christina D; Herzog, Julia Bloom; Lynskey, Vanessa; Coffield, Edward; Hammond, Ross A

2016-01-07

Complex systems modeling can provide useful insights when designing and anticipating the impact of public health interventions. We developed an agent-based, or individual-based, computation model (ABM) to aid in evaluating and refining implementation of behavior change interventions designed to increase physical activity and healthy eating and reduce unnecessary weight gain among school-aged children. The potential benefits of applying an ABM approach include estimating outcomes despite data gaps, anticipating impact among different populations or scenarios, and exploring how to expand or modify an intervention. The practical challenges inherent in implementing such an approach include data resources, data availability, and the skills and knowledge of ABM among the public health obesity intervention community. The aim of this article was to provide a step-by-step guide on how to develop an ABM to evaluate multifaceted interventions on childhood obesity prevention in multiple settings. We used data from 2 obesity prevention initiatives and public-use resources. The details and goals of the interventions, overview of the model design process, and generalizability of this approach for future interventions is discussed.

Psychological interventions for antisocial personality disorder

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Gibbon, Simon; Duggan, Conor; Stoffers, Jutta; Huband, Nick; Völlm, Birgit A; Ferriter, Michael; Lieb, Klaus

2014-01-01

Background Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment, homelessness and relationship difficulties. Objectives To evaluate the potential beneficial and adverse effects of psychological interventions for people with AsPD. Search methods Our search included CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BIOSIS and COPAC. Selection criteria Prospective, controlled trials in which participants with AsPD were randomly allocated to a psychological intervention and a control condition (either treatment as usual, waiting list or no treatment). Data collection and analysis Three authors independently selected studies. Two authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. Main results Eleven studies involving 471 participants with AsPD met the inclusion criteria, although data were available from only five studies involving 276 participants with AsPD. Only two studies focused solely on an AsPD sample. Eleven different psychological interventions were examined. Only two studies reported on reconviction, and only one on aggression. Compared to the control condition, cognitive behaviour therapy (CBT) plus standard maintenance was superior for outpatients with cocaine dependence in one study, but CBT plus treatment as usual was not superior for male outpatients with recent verbal/physical violence in another. Contingency management plus standard maintenance was superior for drug misuse for outpatients with cocaine dependence in one study but not in another, possibly because of differences in the behavioural intervention. However, contingency management was superior in social functioning and counselling session attendance in the latter. A multi-component intervention utilising motivational interviewing principles, the ‘Driving Whilst Intoxicated program’, plus

[Determination of arm circumference for correct measurement of blood pressure. Results of an intervention study].

Science.gov (United States)

Oliveras Puig, A; Dalfó-Pibernat, A; Jdid Rosàs, N; Mayor Isaac, E; Pérez-Romero, L; Gibert Llorach, E; Dalfó-Baqué, A

2015-01-01

To assess the effectiveness of an intervention to promote standardized arm circumference measurement as way to choose appropriate cuff size to measure blood pressure. A before-after intervention study was performed in a basic health care area in Barcelona. Doctors, nurses and pharmacy staff participated by filling out an anonymous self-administered questionnaire pre- and post-intervention (3m). Variables included: demographics, type of professional, years since they finished their studies, availability of different cuff sizes, if arm circumference measurement were obtained or not, knowledge about the cutoff values for each cuff size and type of blood pressure monitor. The written results were given to the participants and presented in sessions. Pre- and post-intervention: 74.3 and 67.3% answered the questionnaires (P=ns), respectively. Determination of arm circumference varied from 1.3 to 19.1% (P=.009). A total of 37.3% and 44.1% declared that they had 2 or more available cuff sizes (P=ns). Knowledge about the correct measurement of the cuffs was 2.7 to 33.8% regarding the standard cuff size (P=.0198) and 0 to 23.5% for obese subjects (P<.05). When more than one cuff was available, reasons for the choice went from: «making a rough guess» or «when velcro stops sticking» before and after the intervention. All blood pressure devices in our primary health care center were electronic and automatic as were those of the 9 pharmacies. The intervention increased the determination of arm circumference prior to the reading of the blood pressure and the knowledge about the cutoff interval for standard and obese cuff size after intervention. There was greater availability of different sized cuffs. Despite this, the choice of the appropriate cuff size was not made based on arm circumference. Copyright © 2014 SEHLELHA. Published by Elsevier Espana. All rights reserved.

Community wide interventions for increasing physical activity.

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Baker, Philip Ra; Francis, Daniel P; Soares, Jesus; Weightman, Alison L; Foster, Charles

2011-04-13

Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. We searched the Cochrane Public Health Group Specialised Register, The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, The British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORTDiscus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.ca; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were followed up. We contacted experts in the field from the National Obesity Observatory Oxford, Oxford University; Queensland Health, Queensland University of Technology, the University of Central Queensland; the University of Tennessee and Washington University; and handsearched six relevant journals. The searches were last updated to the end of November 2009 and were not restricted by language or publication status. Cluster randomised controlled trials, randomised controlled trials (RCT), quasi-experimental designs which used a control population for comparison, interrupted time-series (ITS) studies, and prospective controlled cohort studies (PCCS) were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised

Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients

Directory of Open Access Journals (Sweden)

Guillaume Marquis-Gravel

2015-01-01

Conclusion: Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects.

A livelihood intervention to improve economic and psychosocial well-being in rural Uganda: Longitudinal pilot study

Directory of Open Access Journals (Sweden)

Bernard Kakuhikire

2016-01-01

Full Text Available HIV and poverty are inextricably intertwined in sub-Saharan Africa. Economic and livelihood intervention strategies have been suggested to help mitigate the adverse economic effects of HIV, but few intervention studies have focused specifically on HIV-positive persons. We conducted three pilot studies to assess a livelihood intervention consisting of an initial orientation and loan package of chickens and associated implements to create poultry microenterprises. We enrolled 15 HIV-positive and 22 HIV-negative participants and followed them for up to 18 months. Over the course of follow-up, participants achieved high chicken survival and loan repayment rates. Median monthly income increased, and severe food insecurity declined, although these changes were not statistically significant (P-values ranged from 0.11 to 0.68. In-depth interviews with a purposive sample of three HIV-positive participants identified a constellation of economic and psychosocial benefits, including improved social integration and reduced stigma.

A pilot randomized study of a gratitude journaling intervention on HRV and inflammatory biomarkers in Stage B heart failure patients

Science.gov (United States)

Redwine, Laura; Henry, Brook L.; Pung, Meredith A.; Wilson, Kathleen; Chinh, Kelly; Knight, Brian; Jain, Shamini; Rutledge, Thomas; Greenberg, Barry; Maisel, Alan; Mills, Paul J

2016-01-01

Objective Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Methods Patients (N = 70; mean age = 66.2 years, SD = 7.6) were randomized to an 8-week gratitude journaling intervention or treatment as usual (TAU). Baseline (T1) assessments included 6-item Gratitude Questionnaire (GQ-6), resting heart rate variability (HRV), and an inflammatory biomarker index. At T2 (mid-intervention) GQ6 was measured. At T3 (post-intervention), T1 measures were repeated but also included a gratitude journaling task. Results The gratitude intervention was associated with improved trait gratitude scores (F = 6.0, p = .017, η2 = .10), reduced inflammatory biomarker index score over time (F = 9.7, p = .004, η2 = .21) and increased parasympathetic HRV responses during the gratitude journaling task (F = 4.2, p = .036, η2 = .15), compared with TAU. However, there were no resting pre- to post-intervention group differences in HRV (p's > .10). Conclusions Gratitude journaling may improve biomarkers related to HF morbidity, such as reduced inflammation; large-scale studies with active control conditions are needed to confirm these findings. PMID:27187845

Mind-body interventions during pregnancy.

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Beddoe, Amy E; Lee, Kathryn A

2008-01-01

To examine published evidence on the effectiveness of mind-body interventions during pregnancy on perceived stress, mood, and perinatal outcomes. Computerized searches of PubMed, Cinahl, PsycINFO, and the Cochrane Library. Twelve out of 64 published intervention studies between 1980 and February 2007 of healthy, adult pregnant women met criteria for review. Studies were categorized by type of mind-body modality used. Progressive muscle relaxation was the most common intervention. Other studies used a multimodal psychoeducation approach or a yoga and meditation intervention. The research contained methodological problems, primarily absence of a randomized control group or failure to adequately control confounding variables. Nonetheless, there was modest evidence for the efficacy of mind-body modalities during pregnancy. Treatment group outcomes included higher birthweight, shorter length of labor, fewer instrument-assisted births, and reduced perceived stress and anxiety. There is evidence that pregnant women have health benefits from mind-body therapies used in conjunction with conventional prenatal care. Further research is necessary to build on these studies in order to predict characteristics of subgroups that might benefit from mind-body practices and examine cost effectiveness of these interventions on perinatal outcomes.

A Community-Based Intervention to Prevent Obesity Beginning at Birth among American Indian Children: Study Design and Rationale for the PTOTS study

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Karanja, Njeri; Aickin, Mikel; Lutz, Tam; Mist, Scott; Jobe, Jared B.; Maupomé, Gerardo; Ritenbaugh, Cheryl

2012-01-01

Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that American Indian (AI) children have higher rates of overweight and obesity than children of other races/ethnicities. The Prevention of Toddler Obesity and Teeth Health Study (PTOTS) is a community-partnered randomized controlled trial designed to prevent obesity beginning at birth in AI children. PTOTS was developed to test the effectiveness of a multi-component intervention designed to: promote breastfeeding, reduce sugar-sweetened beverage consumption, appropriately time the introduction of healthy solid foods, and counsel parents to reduce sedentary lifestyles in their children. A birth cohort of 577 children from five AI tribes is randomized by tribe to either the intervention (three tribes) or the comparison condition (two tribes). The strengths and weaknesses of PTOTS include a focus on a critical growth phase, placement in the community, and intervention at many levels, using a variety of approaches. PMID:23001689

Interventions for tobacco cessation in the dental setting.

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Carr, Alan B; Ebbert, Jon

2012-06-13

Tobacco use has significant adverse effects on oral health. Oral health professionals in the dental office or community setting have a unique opportunity to increase tobacco abstinence rates among tobacco users. This review assesses the effectiveness of interventions for tobacco cessation delivered by oral health professionals and offered to cigarette smokers and smokeless tobacco users in the dental office or community setting. We searched the Cochrane Tobacco Addiction Group Specialized Register (CENTRAL), MEDLINE (1966-November 2011), EMBASE (1988-November 2011), CINAHL (1982-November 2011), Healthstar (1975-November 2011), ERIC (1967-November 2011), PsycINFO (1984-November 2011), National Technical Information Service database (NTIS, 1964-November 2011), Dissertation Abstracts Online (1861-November 2011), Database of Abstract of Reviews of Effectiveness (DARE, 1995-November 2011), and Web of Science (1993-November 2011). We included randomized and pseudo-randomized clinical trials assessing tobacco cessation interventions conducted by oral health professionals in the dental office or community setting with at least six months of follow-up. Two authors independently reviewed abstracts for potential inclusion and abstracted data from included trials. Disagreements were resolved by consensus. The primary outcome was abstinence from smoking or all tobacco use (for users of smokeless tobacco) at the longest follow-up, using the strictest definition of abstinence reported. The effect was summarised as an odds ratio, with correction for clustering where appropriate. Heterogeneity was assessed using the I² statistic and where appropriate a pooled effect was estimated using an inverse variance fixed-effect model. Fourteen clinical trials met the criteria for inclusion in this review. Included studies assessed the efficacy of interventions in the dental office or in a community school or college setting. Six studies evaluated the effectiveness of interventions among

Kidney transplantation: a systematic review of interventional and observational studies of physical activity on intermediate outcomes.

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Macdonald, Jamie Hugo; Kirkman, Danielle; Jibani, Mahdi

2009-11-01

Kidney transplant patients have decreased quality and longevity of life. Whether exercise can positively affect associated outcomes such as physical functioning, metabolic syndrome, kidney function, and immune function, has only been addressed in relatively small studies. Thus the aim of this systematic review was to determine effects of physical activity level on these intermediate outcomes in kidney transplant patients. We electronically and hand searched to identify 21 studies (6 retrospective assessments of habitual physical activity and 15 intervention studies including 6 controlled trials). After study quality assessment, intermediate outcomes associated with quality and longevity of life were expressed as correlations or percentage changes in addition to effect sizes. Habitual physical activity level was positively associated with quality of life and aerobic fitness and negatively associated with body fat (medium to large effect sizes). Exercise interventions also showed medium to large positive effects on aerobic capacity (10%-114% increase) and muscle strength (10%-22% increase). However, exercise programs had minimal or contradictory effects on metabolic syndrome and immune and kidney function. In kidney transplant patients, physical activity intervention is warranted to enhance physical functioning. Whether exercise impacts on outcomes associated with longevity of life requires further study.

Infant and young child feeding counseling: an intervention study.

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Bassichetto, Katia Cristina; Réa, Marina Ferreira

2008-01-01

To evaluate the effectiveness of an integrated infant and young child feeding counseling course for transforming the knowledge, attitudes and practices of pediatricians and nutritionists working for the municipal health system of São Paulo, Brazil. A randomized intervention study enrolling 29 professionals in the intervention group and 27 in the control group. Interviewers were trained in advance to collect data on the professionals working at health centers, before and 2 months after the intervention. Three research instruments were used, the first was to assess the profile of each professional, the second assessed their knowledge and the third was a clinical observation protocol. Analysis was performed using the Kruskal-Wallis test for independent samples and the Tukey method. The results for the knowledge questionnaire showed improvements in the intervention group (p < 0.001) for the whole questionnaire and for questions on breastfeeding (p = 0.004); HIV and infant and young child feeding (p = 0.049); complementary feeding (p = 0.012); and counseling in infant and young child feeding (p = 0.004). In terms of performance, it was observed that the intervention group had significantly improved their dietary anamnesis after the intervention (p < 0.001). This course effectively promoted an increase in knowledge and improvements in dietary anamnesis performance, but the same was not true of counseling skills.

Clinical correlates of weight loss and attrition during a 10-week dietary intervention study

DEFF Research Database (Denmark)

Handjieva-Darlenska, Teodora; Holst, Claus; Grau, Katrine

2012-01-01

clinical centres in 7 European countries, who underwent a 10-week dietary intervention study comparing two hypo-energetic (-600 kcal/day) diets varying in fat content. Results: The multiple regression model showed that weight loss at week 10 was predicted by: 6.55 + 1.27 × early weight loss (kg) at week 1...... kg weight loss at week 5 emerged as an optimal predictor for reaching at least 10% weight loss at week 10. Greater attrition likelihood was predicted by high-fat diet, decreased early and half-way weight losses. Conclusion: Early and half-way weight losses are associated with and could contribute......Objective: The aim of this study was to identify the pre-treatment subject characteristics and weight loss changes as determinants of weight loss and attrition during a 10-week dietary intervention study. Methods: A total of 771 obese subjects (BMI 35.6 kg/m(2)) of both genders were included from 8...

Motivational interviewing interventions and alcohol abuse among college students: a systematic review.

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Appiah-Brempong, Emmanuel; Okyere, Paul; Owusu-Addo, Ebenezer; Cross, Ruth

2014-01-01

The study sought to assess the effectiveness of Motivational Interviewing (MI) interventions in reducing alcohol consumption among college students, as compared to no intervention or alternative interventions. It also sought to identify the potential moderators to MI intervention effects. Database sources consulted included Cochrane Central Register of Control Trials, PsycINFO, PsycARTICLE, PsycLIT, CINAHL, and MEDLINE. Included studies were (1) underpinned by experimental, quasi-experimental, and nonexperimental designs; (2) studies in which participants were either college males only or females only or both; and (3) studies in which adaptations of MI were based on key MI principles. Excluded studies were (1) non-English language studies; (2) studies not published from 2000-2012; (3) studies in which participants were not college students; (4) studies in which intervention was not delivered by face-to-face approach; and (5) studies that failed to embark on postintervention follow-ups. A total of 115 abstracts were screened. These were narrowed down to 13 studies from which data for the study were extracted. Selected studies were underpinned by experimental, quasi-experimental, and nonexperimental designs. Owing to the heterogeneity in selected studies, a narrative synthesis was used. MI interventions were found to be effective in reducing alcohol consumption among college students, when compared to alternative interventions or no intervention. Potential moderators of MI intervention effects were identified to include practitioner's adherence to MI techniques and individual's drinking motives. MI presents itself as a promising tool that can augment the many existing social-environmental strategies of health promotion.

Web-based office ergonomics intervention on work-related complaints: a field study.

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Meinert, Marina; König, Mirjam; Jaschinski, Wolfgang

2013-01-01

The aim of this study was a proof of concept to examine the effects of a Web-based office ergonomics intervention on subjects' individual workplace adjustments. An intervention study was conducted with 24 office workers lasting 6 weeks with three consecutive phases (before, 1 and 5 weeks after the intervention). Employees used a purpose-made website for adjusting their computer workplaces without any personal support of ergonomics experts. Workplace measurements were taken directly on site and by analysing photos taken of the employee. Self-reported complaints were assessed by filling in a questionnaire. It was found that 96% of the employees changed their workplaces on their own and retained them mostly unchanged after the intervention. Furthermore, self-reported musculoskeletal complaints and headache symptoms decreased significantly after the intervention. These findings suggest an improvement of workplace conditions so that cost-effective ergonomic Web-based interventions appear promising in further research and application.

Planning strategies for the avoidance of pitfalls in intervention research.

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Pruitt, R H; Privette, A B

2001-08-01

With the exception of large clinical trials, few studies in nursing and other social sciences test interventions. The discipline of nursing needs to maintain a full range of research designs for continued knowledge development. Intervention research presents unique opportunities and challenges for the novice as well as the seasoned researcher. Some of these methodological challenges include the complex nature of human subjects and interventions, including many factors that interfere with the study variables. Preliminary studies often reveal challenges that may not always be predicted or reflected in research texts. These challenges may be as important as the study results for success in future research efforts. Difficulties encountered in intervention research and suggested strategies for maintaining the integrity of the study are addressed. These challenges include maintaining an adequate sample size, intervention demands, measuring variables, timing issues, and experiencing unexpected events. Strategies presented include the importance of extensive planning, minimizing subject expectations and rewarding efforts, attention to control group members, incorporating retention strategies, expanding knowledge of variables and the study population, preliminary studies as well as anticipating unexpected events. The need for enhanced communication among nurse researchers, educators and clinicians is addressed. In the current health care arena, nurse researchers must understand organizational dynamics and marketing strategies. Collaborative research efforts can increase the visibility of nursing research as well as funding opportunities.

A Cluster-Randomized Controlled Intervention Study to Assess the Effect of a Contact Intervention in Reducing Leprosy-Related Stigma in Indonesia.

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Ruth M H Peters

Full Text Available Can deliberate interaction between the public and persons affected by leprosy reduce stigmatization? The study described in this paper hypothesises that it can and assesses the effectiveness of a 'contact intervention'.This cluster-randomized controlled intervention study is part of the Stigma Assessment and Reduction of Impact (SARI project conducted in Cirebon District, Indonesia. Testimonies, participatory videos and comics given or made by people affected by leprosy were used as methods to facilitate a dialogue during so-called 'contact events'. A mix of seven quantitative and qualitative methods, including two scales to assess aspects of stigma named the SDS and EMIC-CSS, were used to establish a baseline regarding stigma and knowledge of leprosy, monitor the implementation and assess the impact of the contact events. The study sample were community members selected using different sampling methods. The baseline shows a lack of knowledge about leprosy, a high level of stigma and contrasting examples of support. In total, 91 contact events were organised in 62 villages, directly reaching 4,443 community members (mean 49 per event. The interview data showed that knowledge about leprosy increased and that negative attitudes reduced. The adjusted mean total score of the EMIC-CSS reduced by 4.95 points among respondents who had attended a contact event (n = 58; p < 0.001, effect size = 0.75 compared to the score at baseline (n = 213; for the SDS this was 3.56 (p < 0.001, effect size = 0.81. About 75% of those attending a contact event said they shared the information with others (median 10 persons.The contact intervention was effective in increasing knowledge and improving public attitudes regarding leprosy. It is relatively easy to replicate elsewhere and does not require expensive technology. More research is needed to improve scalability. The effectiveness of a contact intervention to reduce stigma against other neglected tropical diseases

Well-Being and the Social Environment of Work: A Systematic Review of Intervention Studies.

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Daniels, Kevin; Watson, David; Gedikli, Cigdem

2017-08-16

There is consistent evidence that a good social environment in the workplace is associated with employee well-being. However, there has been no specific review of interventions to improve well-being through improving social environments at work. We conducted a systematic review of such interventions, and also considered performance as an outcome. We found eight studies of interventions. Six studies were of interventions that were based on introducing shared social activities into workgroups. Six out of the six studies demonstrated improvements in well-being across the sample (five studies), or for an identifiable sub-group (one study). Four out of the five studies demonstrated improvements in social environments, and four out of the five studies demonstrated improvements in indicators of performance. Analysis of implementation factors indicated that the interventions based on shared activities require some external facilitation, favorable worker attitudes prior to the intervention, and several different components. We found two studies that focused on improving fairness perceptions in the workplace. There were no consistent effects of these interventions on well-being or performance. We conclude that there is some evidence that interventions that increase the frequency of shared activities between workers can improve worker well-being and performance. We offer suggestions for improving the evidence base.

The Utility of Geographical Information Systems (GIS) in Systems-Oriented Obesity Intervention Projects: The Selection of Comparable Study Sites for a Quasi-Experimental Intervention Design—TX CORD

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Byars, Allison; Byrd-Williams, Courtney; Sharma, Shreela V.; Durand, Casey; Hoelscher, Deanna M.; Butte, Nancy F.; Kelder, Steven H.

2015-01-01

Abstract Background: The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in community-level intervention studies, TX CORD uses a quasi-experimental design. Comparable intervention and comparison study sites are needed to address internal validity bias. Methods: TX CORD was designed to be implemented in low-income, ethnically diverse communities in Austin and Houston, Texas. A three-stage Geographical Information System (GIS) methodology was used to establish and ascertain the comparability of the intervention and comparison study sites. Census tract (stage 1) and school (stage 2) data were used to identify spatially exclusive geographic areas that were comparable. In stage 3, study sites were compared on demographic characteristics, socioeconomic status (SES), food assets, and physical activity (PA) assets. Student's t-test was used to examine significant differences between the selected sites. Results: The methodology that was used resulted in the selection of catchment areas with demographic and socioeconomic characteristics that fit the target population: ethnically diverse population; lower-median household income; and lower home ownership rates. Additionally, the intervention and comparison sites were statistically comparable on demographic and SES variables, as well as food assets and PA assets. Conclusions: This GIS approach can provide researchers, program evaluators, and policy makers with useful tools for both research and practice. Area-level information that allows for robust understanding of communities can enhance analytical procedures in community health research and offer significant contributions in terms of community assessment and engagement. PMID:25587670

Ergonomic Chair Explorative Intervention Study: Effect on Chronic ...

African Journals Online (AJOL)

Ergonomic Chair Explorative Intervention Study: Effect on Chronic Upper ... they are associated with a complex relationship between individual, work-related and ... in chronic upper quadrant musculoskeletal dysfunction and work productivity ...

HRD Interventions, Employee Competencies and Organizational Effectiveness: An Empirical Study

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Potnuru, Rama Krishna Gupta; Sahoo, Chandan Kumar

2016-01-01

Purpose: The purpose of the study is to examine the impact of human resource development (HRD) interventions on organizational effectiveness by means of employee competencies which are built by some of the selected HRD interventions. Design/methodology/approach: An integrated research model has been developed by combining the principal factors…

The effectiveness of online pain resources for health professionals: a systematic review with subset meta-analysis of educational intervention studies.

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Liossi, Christina; Failo, Alessandro; Schoth, Daniel E; Williams, Glyn; Howard, Richard F

2018-04-01

Online educational interventions are increasingly developed for health professionals and students, although graduate and undergraduate medical curricula often contain limited information about how to assess and manage pain. This study reviews the literature on the effectiveness of pain-related online educational resources. Studies were identified through a search of Medline, PsychINFO, Web of Science, CINAHL, PubMed, Scopus, Cochrane Library, Google Scholar, and OpenGrey databases. Search terms included 3 concept blocks: (1) type of intervention-online education, computer-based, e-learning, web-based, and internet-based; (2) population-pediatrician, physician, nurse, psychologist, and medical; and (3) outcome-pain*. Thirty-two studies (13 randomised controlled trials, 5 nonrandomised controlled trials, and 14 single-group pre-post studies) were included. Ten provided data for inclusion in a series of between-groups meta-analyses. After intervention, participants receiving online instruction had significantly greater knowledge compared with those receiving training as usual/alternative training (Hedges' g = 0.80, 95% confidence interval [CI]: 0.12-1.49), and students had significantly greater skills compared with students receiving training as usual (g = 1.34, CI: 0.38-2.30). No significant differences were found for confidence/competence (g = 0.02, CI: -0.79 to 0.84) or attitudes/beliefs (g = 0.16, CI: -0.48 to 0.79). Although online educational resources show promise in improving learner knowledge, considerable heterogeneity exists between studies in quality, design, educational content, and outcomes. Furthermore, methodologically robust RCTs are required to establish the effectiveness of online educational interventions and a greater understanding of the key features of successful online resources, including cognitive interactivity. Few studies assessed health outcomes for patients, remaining a major priority for future investigations.

mHealth Intervention Promoting Cardiovascular Health Among African-Americans: Recruitment and Baseline Characteristics of a Pilot Study

Science.gov (United States)

2018-01-01

Background Mobile health (mHealth) interventions are promising avenues to promote cardiovascular (CV) health among African-Americans (AAs) and culturally tailored technology-based interventions are emerging for this population. Objective The objectives of this study were to use a community-based participatory research (CBPR) approach to recruit AAs into a pilot intervention study of an innovative mHealth CV health promotion program and to characterize technology use patterns and eHealth literacy (EHL). Methods Community partners from five predominately AA churches in southeast Minnesota collaborated with our academic institution to recruit AA congregants into the pilot study. Field notes as well as communications between the study team and community partners were used to design the recruitment strategy and its implementation with a goal of enrolling 50 participants. At its core, the recruitment strategy included community kickoff events to detail the state-of-the-art nature of the mHealth intervention components, the utility of CV health assessments (physical examination, laboratory studies and surveys) and the participants’ role in advancing our understanding of the efficacy of mHealth interventions among racial/ethnic minority groups. Detailed recruitment data were documented throughout the study. A self-administered, electronic survey measured sociodemographics, technology use and EHL (eHEALS scale). Results A total of 50 participants (70% women) from five AA churches were recruited over a one-month period. The majority (>90%) of participants reported using some form of mobile technology with all utilizing these technologies within their homes. Greater than half (60% [30/50]) reported being “very comfortable” with mobile technologies. Overall, participants had high EHL (84.8% [39/46] with eHEALS score ≥26) with no differences by sex. Conclusions This study illustrates the feasibility and success of a CBPR approach in recruiting AAs into m

Screen-time Weight-loss Intervention Targeting Children at Home (SWITCH: A randomized controlled trial study protocol

Directory of Open Access Journals (Sweden)

Tsai Midi

2011-06-01

Full Text Available Abstract Background Approximately one third of New Zealand children and young people are overweight or obese. A similar proportion (33% do not meet recommendations for physical activity, and 70% do not meet recommendations for screen time. Increased time being sedentary is positively associated with being overweight. There are few family-based interventions aimed at reducing sedentary behavior in children. The aim of this trial is to determine the effects of a 24 week home-based, family oriented intervention to reduce sedentary screen time on children's body composition, sedentary behavior, physical activity, and diet. Methods/Design The study design is a pragmatic two-arm parallel randomized controlled trial. Two hundred and seventy overweight children aged 9-12 years and primary caregivers are being recruited. Participants are randomized to intervention (family-based screen time intervention or control (no change. At the end of the study, the control group is offered the intervention content. Data collection is undertaken at baseline and 24 weeks. The primary trial outcome is child body mass index (BMI and standardized body mass index (zBMI. Secondary outcomes are change from baseline to 24 weeks in child percentage body fat; waist circumference; self-reported average daily time spent in physical and sedentary activities; dietary intake; and enjoyment of physical activity and sedentary behavior. Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity. Discussion This study provides an excellent example of a theory-based, pragmatic, community-based trial targeting sedentary behavior in overweight children. The study has been specifically designed to allow for estimation of the consistency of effects on body composition for Māori (indigenous, Pacific and non-Māori/non-Pacific ethnic groups. If effective, this intervention is imminently scalable and could be integrated within existing weight

Mass media interventions for preventing smoking in young people.

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Carson, Kristin V; Ameer, Faisal; Sayehmiri, Kourosh; Hnin, Khin; van Agteren, Joseph Em; Sayehmiri, Fatemeh; Brinn, Malcolm P; Esterman, Adrian J; Chang, Anne B; Smith, Brian J

2017-06-02

Mass media interventions can be used as a way of delivering preventive health messages. They have the potential to reach and modify the knowledge, attitudes and behaviour of a large proportion of the community. To assess the effects of mass media interventions on preventing smoking in young people, and whether it can reduce smoking uptake among youth (under 25 years), improve smoking attitudes, intentions and knowledge, improve self-efficacy/self-esteem, and improve perceptions about smoking, including the choice to follow positive role models. We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE and Embase in June 2016. This is an update of a review first published in 1998. Randomized trials, controlled trials without randomization and interrupted time-series studies that assessed the effect of mass media campaigns (defined as channels of communication such as television, radio, newspapers, social media, billboards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person-to-person contact) in influencing the smoking behaviour (either objective or self-reported) of young people under the age of 25 years. We define smoking behaviour as the presence or absence of tobacco smoking or other tobacco use, or both, and the frequency of tobacco use. Eligible comparators included education or no intervention. Two review authors independently extracted information relating to the characteristics and the content of media interventions, participants, outcomes, methods of the study and risks of bias. We combined studies using qualitative narrative synthesis. We assessed the risks of bias for each study using the Cochrane 'Risk of bias' tool, alongside additional domains to account for the nature of the intervention. We assessed the quality of evidence contributing to outcomes using GRADE. We identified eight eligible studies reporting information about mass media smoking

Interventions to Improve Hand Hygiene Compliance in the ICU: A Systematic Review.

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Lydon, Sinéad; Power, Michael; McSharry, Jennifer; Byrne, Molly; Madden, Caoimhe; Squires, Janet Elaine; O'Connor, Paul

2017-11-01

To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened. English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included. Data were extracted on the setting, participant characteristics, experimental design, hand hygiene measurement, intervention characteristics, and outcomes. Interventional components were categorized using the Behavior Change Wheel. Methodological quality was examined using the Downs and Black Checklist. Thirty-eight studies were included. The methodological quality of studies was poor, with studies scoring a mean of 8.6 of 24 (SD= 2.7). Over 90% of studies implemented a bundled intervention. The most frequently employed interventional strategies were education (78.9%), enablement (71.1%), training (68.4%), environmental restructuring (65.8%), and persuasion (65.8%). Intervention outcomes were variable, with a mean relative percentage change of 94.7% (SD= 195.7; range, 4.3-1155.4%) from pre to post intervention. This review demonstrates that best practice for improving hand hygiene in ICUs remains unestablished. Future research employing rigorous experimental designs, careful statistical analysis, and clearly described interventions is important.

A Systematic Review of Economic Evidence on Community Hypertension Interventions.

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Zhang, Donglan; Wang, Guijing; Joo, Heesoo

2017-12-01

Effective community-based interventions are available to control hypertension. It is important to determine the economics of these interventions. Peer-reviewed studies from January 1995 through December 2015 were screened. Interventions were categorized into educational interventions, self-monitoring interventions, and screening interventions. Incremental cost-effectiveness ratios were summarized by types of interventions. The review was conducted in 2016. Thirty-four articles were included in the review (16 from the U.S., 18 from other countries), including 25 on educational interventions, three on self-monitoring interventions, and six on screening interventions. In the U.S., five (31.3%) studies on educational interventions were cost saving. Among the studies that found the interventions cost effective, the median incremental costs were $62 (range, $40-$114) for 1-mmHg reduction in systolic blood pressure (SBP) and $13,986 (range, $6,683-$58,610) for 1 life-year gained. Outside the U.S., educational interventions cost from $0.62 (China) to $29 (Pakistan) for 1-mmHg reduction in SBP. Self-monitoring interventions, evaluated in the U.S. only, cost $727 for 1-mmHg reduction in SBP and $41,927 for 1 life-year gained. For 1 quality-adjusted life-year, screening interventions cost from $21,734 to $56,750 in the U.S., $613 to $5,637 in Australia, and $7,000 to $18,000 in China. Intervention costs to reduce 1 mmHg blood pressure or 1 quality-adjusted life-year were higher in the U.S. than in other countries. Most studies found that the three types of interventions were either cost effective or cost saving. Quality of economic studies should be improved to confirm the findings. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

The roles of health culture and physical environment in workplace health promotion: a two-year prospective intervention study in China.

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Jia, Yingnan; Fu, Hua; Gao, Junling; Dai, Junming; Zheng, Pinpin

2018-04-05

To understand the potential influencing factors on the effectiveness of workplace health promotion interventions and examine whether workplace health culture and physical environment can mediate the relationship between workplace health promotion and intervention effectiveness. A total of 719 participants from 10 Chinese government agencies were recruited for a prospective self-controlled trial. Questionnaires, qualitative interviews, and direct observation were used for the baseline evaluation, process evaluation, and effectiveness evaluation. Based on the results of the need assessment and risk assessment at each workplace, a two-year comprehensive health intervention was conducted by each workplace. Health outcomes including self-rated health (SRH) and mental health were measured at baseline and 24 months. Health culture was measured at 24 months. Physical environment and intervention implementation were measured at 12 months and 24 months. Compared with the baseline, the means of SRH and mental health increased significantly by 0.302 and 2.698, respectively. The SRH scores were different before and after intervention; furthermore, the differences varied by workplace. Health culture mediated the relationship between intervention implementation and intervention effectiveness, including SRH and mental health improvement, but physical environment did not. Physical environment quality was significantly negatively correlated with SRH improvement and mental health improvement. Under the relatively high-quality interventions with scores higher than 4.047 or 4.151 (out of 5), better health culture may led to greater SRH and mental health improvements. Health culture may mediate the relationship between intervention implementation and intervention effectiveness, whereas physical environment does not seem to mediate this relationship. Under relatively high-quality interventions, a better health culture may lead to more positive improvements in SRH and mental health

Recruitment rates in workplace physical activity interventions: characteristics for success.

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Ryde, Gemma C; Gilson, Nicholas D; Burton, Nicola W; Brown, Wendy J

2013-01-01

To conduct a systematic review to assess recruitment rates in workplace physical activity (PA) intervention studies and describe characteristics of studies with high recruitment rates. Data Source. Electronic and manual searches were conducted. Workplace PA intervention studies that reported the number of employees invited to participate and the number who responded were included. Studies with recruitment rates of ≥70% were categorized as high with the remaining studies (recruitment rate. Seventy-six percent of studies failed to report recruitment rates (n = 30 included for review). Studies with high recruitment rates (n = 8) tended to have longer study duration (mean 1.6 years) and target smaller cohorts of employees (mean n = 199) than comparison studies (3.9 months; n = 1241). For recruitment strategies and intervention components of high studies, involvement of employees was driven by the organization, with PA interventions provided as part of the working day in paid time. These findings suggest a potential to improve recruitment through targeting small cohorts of employees, incorporating PA as a long-term strategy, facilitating organizationally driven employee involvement, and providing PA interventions during paid time.

Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

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Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

2015-05-03

Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

A study of the influence of protective factors as a resource to African American males in traditional batterers' interventions.

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Jones, Norma Gray

2002-01-01

The purpose of this study was to examine the relationship between protective factors and the responses of African American males in traditional batterers' interventions. African American male batterers have been viewed as responding poorly to batterers' interventions and were reported in the literature as at risk for dropout and treatment failure. This research proposed that there were culturally related protective factors that enhanced traditional interventions for African American males, increasing their potential for changing abusive behaviors. This within-group study used secondary data to examine the influence of protective factors on the responses of 268 active duty Navy African American males. They were a sub-sample of 861 males randomly assigned to one of four different interventions for batterers. The interventions included a cognitive behavioral men's group, couple's group, safety and stabilization group, and a control group. Each of their cases had been officially substantiated by the Navy for assault of their spouses. The measures for the protective factors of religion, self-esteem, and family support were drawn from the original study's self-report measurement tool. The results of the statistical analyses were found to be significant. The protective factors performed as social controls for reducing certain types of abusive behaviors. Little research has been conducted on the influence of cultural factors on batterers intervention outcome for African Americans. This study established a strong support for further research.

Positive psychology interventions in breast cancer. A systematic review.

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Casellas-Grau, Anna; Font, Antoni; Vives, Jaume

2014-01-01

Positive psychology is an emerging area of empirical study, not only in clinical, but also in health psychology. The present systematic review aims to synthesize the evidence about the positive psychology interventions utilized in breast cancer. Relevant studies were identified via Pubmed, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, Wiley Online Library, TDX, and DIALNET databases (up to April 2013). Only those papers focused on interventions related to positive psychology and carried out on breast cancer patients were included. Of the 7266 articles found through databases, 16 studies were finally included in this review. Five groups of therapies were found: mindfulness-based approaches, expression of positive emotions, spiritual interventions, hope therapy, and meaning-making interventions. These specific interventions promoted positive changes in breast cancer participants, such as enhanced quality of life, well-being, hope, benefit finding, or optimism. However, the disparity of the interventions and some methodological issues limit the outcomes. Some studies provided relevant evidence about the clear development of positive aspects from the breast cancer experience. Positive interventions applied to patients and survivors of breast cancer were found to be able to promote positive aspects. A global consensus of a positive therapies classification is needed to take one more step in structuring positive psychology. Copyright © 2013 John Wiley & Sons, Ltd.

Sustainability of knowledge translation interventions in healthcare decision-making: a scoping review.

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Tricco, Andrea C; Ashoor, Huda M; Cardoso, Roberta; MacDonald, Heather; Cogo, Elise; Kastner, Monika; Perrier, Laure; McKibbon, Ann; Grimshaw, Jeremy M; Straus, Sharon E

2016-04-21

Knowledge translation (KT, also known as research utilization, and sometimes referring to implementation science) is a dynamic and iterative process that includes the synthesis, dissemination, exchange, and ethically sound application of knowledge to improve health. A KT intervention is one which facilitates the uptake of research. The long-term sustainability of KT interventions is unclear. We aimed to characterize KT interventions to manage chronic diseases that have been used for healthcare outcomes beyond 1 year or beyond the termination of initial grant funding. We conducted a scoping review by searching MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Campbell from inception until February 2013. We included experimental, quasi-experimental, and observational studies providing information on the sustainability of KT interventions for managing chronic diseases in adults and focusing on end-users including patients, clinicians, public health officials, health service managers, and policy-makers. Articles were screened and abstracted by two reviewers, independently. The data were charted and results described narratively. We included 62 studies reported in 103 publications (total 260,688 patients) plus 41 companion reports after screening 12,328 titles and abstracts and 464 full-text articles. More than half of the studies were randomized controlled trials (RCTs). The duration of the KT intervention ranged from 61 to 522 weeks. Nine chronic conditions were examined across the studies, such as diabetes (34 %), cardiovascular disease (28 %), and hypertension (16 %). Thirteen KT interventions were reported across the studies. Patient education was the most commonly examined (20 %), followed by self-management (17 %). Most studies (61 %) focused on patient-level outcomes (e.g. disease severity), while 31 % included system-level outcomes (e.g. number of eye examinations

Interventions to improve social determinants of health among elderly ethnic minority groups: a review.

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Pool, Michelle S; Agyemang, Charles O; Smalbrugge, Martin

2017-12-01

Like the European general population, ethnic minorities are aging. In this group, important social determinants of health (social participation, social isolation and loneliness) that lead to negative health outcomes frequently occur. Interventions targeting these determinants may decrease negative health outcomes. The goal of this article was to identify effective interventions that improve social participation, and minimise social isolation and loneliness in community dwelling elderly ethnic minorities. An electronic database (PubMed) was systematically searched using an extensive search strategy, for intervention studies in English, French, Dutch of German, without time limit. Additional articles were found using references. Articles were included if they studied an intervention aimed to improve social participation or minimise social isolation or loneliness and were focusing on community dwelling elderly ethnic minorities. Data regarding studies characteristics and results were extracted. Six studies (three randomized controlled trials, three non-controlled intervention studies) were included in the review. All studies were group-based interventions and had a theoretical basis. Five out of six studies showed improvement on a social participation, -isolation or loneliness outcome. Type of intervention included volunteering-, educational- and physical activities. In three studies active participation of the participant was required, these interventions were not more effective than other interventions. Some interventions improved the included social determinants of health in community dwelling elderly ethnic minorities. Investment in further development and implementation of these interventions may help to improve social determinants of health in these populations. It is necessary to evaluate these interventions in the European setting. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

A community health worker intervention to improve management of hypertension among Filipino Americans in New York and New Jersey: a pilot study.

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Ursua, Rhodora A; Aguilar, David E; Wyatt, Laura C; Katigbak, Carina; Islam, Nadia S; Tandon, S Darius; Nur, Potri Ranka Manis Queano; Van Devanter, Nancy; Rey, Mariano J; Trinh-Shevrin, Chau

2014-01-01

The purpose of the pilot study was to assess the feasibility and efficacy of a 4-month community health worker (CHW) intervention to improve hypertension management among Filipino immigrants in New York and New Jersey. Single-arm CHW pilot intervention using a pre-post design delivered by 5 CHWs. New York City, NY and Jersey City, NJ. Of 88 Filipino individuals recruited for the study, 39 received the full pilot intervention, 18 received a partial intervention, and 31 dropped out; 13 Filipino participants, 10 CHW Trainers, and 3 Filipino CHWs were interviewed for qualitative analysis. Individuals participated in 4 workshops related to hypertension management and cardiovascular disease (CVD) risk factors and received monthly in-person visits, and twice monthly phone calls individually from a CHW. Primary outcomes included blood pressure (BP) reduction and control, appointment keeping, and medication adherence; secondary outcomes included weight, body mass index (BMI), self-efficacy related to diet, exercise, and medication taking, CVD knowledge, and nutrition (salt/ sodium and cholesterol/fat). A mixed method analysis was used to assess the intervention, utilizing quantitative and qualitative methods. By the end of the intervention, significant changes were exhibited for systolic and diastolic BP, weight, and BMI (PFilipino Americans.

Interventions for promoting physical activity among European teenagers: a systematic review

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Lien Nanna

2009-12-01

Full Text Available Abstract Background Although physical activity is considered to yield substantial health benefits, the level of physical activity among European teenagers is not sufficient. Adolescence is characterized by a decline in physical activity level. Many studies investigated the effectiveness of interventions promoting physical activity among young people, but none dealt with the available evidence specific for Europe. This review was conducted to summarize the effectiveness of interventions to promote physical activity among European teenagers. Methods A systematic review was conducted to identify European intervention studies published in the scientific literature since 1995. Four databases were searched, reference lists were scanned and the publication lists of the authors of the retrieved articles were checked. The ANGELO framework was used to categorise the included studies by setting and by intervention components. Results The literature search identified 20 relevant studies. Fifteen interventions were delivered through the school setting, of which three included a family component and another three a family and community component. One intervention was conducted within a community setting, three were delivered in primary care and one was delivered through the internet. Ten interventions included only an individual component, whereas the other ten used a multi-component approach. None of the interventions included only an environmental component. Main findings of the review were: (1 school-based interventions generally lead to short term improvements in physical activity levels; (2 improvements in physical activity levels by school-based interventions were limited to school related physical activity with no conclusive transfer to leisure time physical activity; (3 including parents appeared to enhance school-based interventions; (4 the support of peers and the influence of direct environmental changes increased the physical activity level of

Analysis of a Community-based Intervention to Reduce Heat-related Illness during Heat Waves in Licheng, China: a Quasi-experimental Study.

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Li, Jing; Xu, Xin; Wang, Jun; Zhao, Yun; Song, Xiu Ping; Liu, Zhi Dong; Cao, Li Na; Jiang, Bao Fa; Liu, Qi Yong

2016-11-01

To reduce health-related threats of heat waves, interventions have been implemented in many parts of the world. However, there is a lack of higher-level evidence concerning the intervention efficacy. This study aimed to determine the efficacy of an intervention to reduce the number of heat-related illnesses. A quasi-experimental design was employed by two cross-sectional surveys in the year 2014 and 2015, including 2,240 participants and 2,356 participants, respectively. Each survey was designed to include one control group and one intervention group, which conducted in Licheng, China. A representative sample was selected using a multistage sampling method. Data, collected from questionnaires about heat waves in 2014 and 2015, were analyzed using a difference-in-difference analysis and cost effectiveness analysis. Outcomes included changes in the prevalence of heat-related illnesses and cost-effectiveness variables. Relative to the control participants, the prevalence of heat-related illness in the intervention participants decreased to a greater extent in rural areas than in urban areas (OR=0.495 vs. OR=1.281). Moreover, the cost-effectiveness ratio in the intervention group was less than that in the control group (US$15.06 vs. US$15.69 per participant). Furthermore, to avoid one additional patient, the incremental cost-effectiveness ratio showed that an additional US$14.47 would be needed for the intervention compared to when no intervention was applied. The intervention program may be considered a worthwhile investment for rural areas that are more likely to experience heat waves. Meanwhile, corresponding improving measures should be presented towards urban areas. Future research should examine whether the intervention strategies could be spread out in other domestic or international regions where heat waves are usually experienced. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Community-centred eco-bio-social approach to control dengue vectors: an intervention study from Myanmar.

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Wai, Khin Thet; Htun, Pe Than; Oo, Tin; Myint, Hla; Lin, Zaw; Kroeger, Axel; Sommerfeld, Johannes; Petzold, Max

2012-12-01

To build up and analyse the feasibility, process, and effectiveness of a partnership-driven ecosystem management intervention in reducing dengue vector breeding and constructing sustainable partnerships among multiple stakeholders. A community-based intervention study was conducted from May 2009 to January 2010 in Yangon city. Six high-risk and six low-risk clusters were randomized and allocated as intervention and routine service areas, respectively. For each cluster, 100 households were covered. Bi-monthly entomological evaluations (i.e. larval and pupal surveys) and household acceptability surveys at the end of 6-month intervention period were conducted, supplemented by qualitative evaluations. Intervention description: The strategies included eco-friendly multi-stakeholder partner groups (Thingaha) and ward-based volunteers, informed decision-making of householders, followed by integrated vector management approach. Pupae per person index (PPI) decreased at the last evaluation by 5·7% (0·35-0·33) in high-risk clusters. But in low-risk clusters, PPI remarkably decreased by 63·6% (0·33-0·12). In routine service area, PPI also decreased due to availability of Temephos after Cyclone Nargis. As for total number of pupae in all containers, when compared to evaluation 1, there was a reduction of 18·6% in evaluation 2 and 44·1% in evaluation 3 in intervention area. However, in routine service area, more reduction was observed. All intervention tools were found as acceptable, being feasible to implement by multi-stakeholder partner groups. The efficacy of community-controlled partnership-driven interventions was found to be superior to the vertical approach in terms of sustainability and community empowerment.

Generating political priority for regulatory interventions targeting obesity prevention: an Australian case study.

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Baker, Phillip; Gill, Timothy; Friel, Sharon; Carey, Gemma; Kay, Adrian

2017-03-01

Effective obesity prevention requires a synergistic mix of population-level interventions including a strong role for government and the regulation of the marketing, labelling, content and pricing of energy-dense foods and beverages. In this paper we adopt the agenda of the Australian Federal Government (AFG) as a case study to understand the factors generating or hindering political priority for such 'regulatory interventions' between 1990 and 2011. Using a theoretically-guided process tracing method we undertook documentary analysis and conducted 27 interviews with a diversity of actors involved in obesity politics. The analysis was structured by a theoretical framework comprising four dimensions: the power of actors involved; the ideas the actors deploy to interpret and portray the issue; the institutional and political context; and issue characteristics. Despite two periods of sustained political attention, political priority for regulatory interventions did not emerge and was hindered by factors from all four dimensions. Within the public health community, limited cohesion among experts and advocacy groups hampered technical responses and collective action efforts. An initial focus on children (child obesity), framing the determinants of obesity as 'obesogenic environments', and the deployment of 'protecting kids', 'industry demonization' and 'economic costs' frames generated political attention. Institutional norms within government effectively selected out regulatory interventions from consideration. The 'productive power' and activities of the food and advertising industries presented formidable barriers, buttressed by a libertarian/neolibertarian rhetoric emphasizing individual responsibility, a negative view of freedom (as free from 'nanny-state' intervention) and the idea that regulation imposes an unacceptable cost on business. Issue complexity, the absence of a supportive evidence base and a strict 'evidence-based' policy-making approach were used as

Reducing stillbirths: interventions during labour

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Darmstadt, Gary L; Yakoob, Mohammad Yawar; Haws, Rachel A; Menezes, Esme V; Soomro, Tanya; Bhutta, Zulfiqar A

2009-01-01

Background Approximately one million stillbirths occur annually during labour; most of these stillbirths occur in low and middle-income countries and are associated with absent, inadequate, or delayed obstetric care. The low proportion of intrapartum stillbirths in high-income countries suggests that intrapartum stillbirths are largely preventable with quality intrapartum care, including prompt recognition and management of intrapartum complications. The evidence for impact of intrapartum interventions on stillbirth and perinatal mortality outcomes has not yet been systematically examined. Methods We undertook a systematic review of the published literature, searching PubMed and the Cochrane Library, of trials and reviews (N = 230) that reported stillbirth or perinatal mortality outcomes for eight interventions delivered during labour. Where eligible randomised controlled trials had been published after the most recent Cochrane review on any given intervention, we incorporated these new trial findings into a new meta-analysis with the Cochrane included studies. Results We found a paucity of studies reporting statistically significant evidence of impact on perinatal mortality, especially on stillbirths. Available evidence suggests that operative delivery, especially Caesarean section, contributes to decreased stillbirth rates. Induction of labour rather than expectant management in post-term pregnancies showed strong evidence of impact, though there was not enough evidence to suggest superior safety for the fetus of any given drug or drugs for induction of labour. Planned Caesarean section for term breech presentation has been shown in a large randomised trial to reduce stillbirths, but the feasibility and consequences of implementing this intervention routinely in low-/middle-income countries add caveats to recommending its use. Magnesium sulphate for pre-eclampsia and eclampsia is effective in preventing eclamptic seizures, but studies have not demonstrated impact

A multi-modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS: Rationale, design, and uptake of online study intervention material