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Sample records for prevention intervention delivered

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

    Science.gov (United States)

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

    2016-08-01

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 A systematic literature search identified 22 universal and 26 indicated controlled interventions, both published and unpublished, involving 4763 college, graduate, or professional students.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

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

    Science.gov (United States)

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

    2013-01-01

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

  3. Do email and mobile phone prompts stimulate primary school children to reuse an Internet-delivered smoking prevention intervention?

    Science.gov (United States)

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

    2014-03-18

    Improving the use (eg, initial visit and revisits) of Internet-delivered interventions to promote healthy lifestyles such as non-smoking is one of the largest challenges in the field of eHealth. Prompts have shown to be effective in stimulating reuse of Internet-delivered interventions among adults and adolescents. However, evidence concerning effectiveness of prompts to promote reuse of a website among children is still scarce. The aim of this study is to investigate (1) whether prompts are effective in promoting reuse of an intervention website containing information on smoking prevention for children, (2) whether the content of the prompt is associated with its effect in terms of reuse, and (3) whether there are differences between children who do or do not respond to prompts. The sample of this cluster-randomized study consisted of 1124 children (aged 10-11 years) from 108 Dutch primary schools, who were assigned to the experimental group of an Internet-delivered smoking prevention intervention study. All participants completed a Web-based questionnaire on factors related to (non-)smoking. Schools were randomized to a no-prompt group (n=50) or a prompt group (n=58). All children could revisit the intervention website, but only the children in the prompt group received email and SMS prompts to revisit the website. Those prompt messages functioned as a teaser to stimulate reuse of the intervention website. Reuse of the website was objectively tracked by means of a server registration system. Repeated measures analysis of variance and linear regression analysis were performed to assess the effects of prompts on website reuse and to identify individual characteristics of participants who reuse the intervention website. Children in the prompt group reused the intervention website significantly more often compared to children in the no-prompt group (B=1.56, Pchildren with a low socioeconomic status (SES) reused the intervention website more often (B=2.19, Pchildren

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

    Science.gov (United States)

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

    2017-05-01

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

  5. Development and Initial Testing of a Tailored Telephone Intervention Delivered by Peers to Prevent Recurring Opioid-Overdoses (TTIP-PRO)

    Science.gov (United States)

    Winhusen, T.; Theobald, J.; Lewis, D.; Wilder, C. M.; Lyons, M. S.

    2016-01-01

    Individuals with opioid use disorder experiencing a non-fatal opioid-overdose (OOD) are at heightened risk for future OODs; there are no interventions to facilitate treatment enrollment for these patients. Our goal was to develop and initially test the "tailored telephone intervention delivered by peers to prevent recurring…

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

    Science.gov (United States)

    Hawkes, Anna L; Patrao, Tania A; Green, Anita; Aitken, Joanne F

    2012-11-27

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

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

    Directory of Open Access Journals (Sweden)

    Hawkes Anna L

    2012-11-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Chithambo, Taona P; Huey, Stanley J

    2017-10-01

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

  10. Efficacy of a Health Educator–Delivered HIV Prevention Intervention for Latina Women: A Randomized Controlled Trial

    Science.gov (United States)

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

    2011-01-01

    Objectives. We developed and assessed AMIGAS (Amigas, Mujeres Latinas, Inform andonos, Gui andonos, y Apoy andonos contra el SIDA [friends, Latina women, informing each other, guiding each other, and supporting each other against AIDS]), a culturally congruent HIV prevention intervention for Latina women adapted from SiSTA (Sistas Informing Sistas about Topics on AIDS), an intervention for African American women. Methods. We recruited 252 Latina women aged 18 to 35 years in Miami, Florida, in 2008 to 2009 and randomized them to the 4-session AMIGAS intervention or a 1-session health intervention. Participants completed audio computer-assisted self-interviews at baseline and follow-up. Results. Over the 6-month follow-up, AMIGAS participants reported more consistent condom use during the past 90 (adjusted odds ratio [AOR] = 4.81; P < .001) and 30 (AOR = 3.14; P < .001) days and at last sexual encounter (AOR = 2.76; P < .001), and a higher mean percentage condom use during the past 90 (relative change = 55.7%; P < .001) and 30 (relative change = 43.8%; P < .001) days than did comparison participants. AMIGAS participants reported fewer traditional views of gender roles (P = .008), greater self-efficacy for negotiating safer sex (P < .001), greater feelings of power in relationships (P = .02), greater self-efficacy for using condoms (P < .001), and greater HIV knowledge (P = .009) and perceived fewer barriers to using condoms (P < .001). Conclusions. Our results support the efficacy of this linguistically and culturally adapted HIV intervention among ethnically diverse, predominantly foreign-born Latina women. PMID:22021297

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Science.gov (United States)

    Gilmore, Brynne; McAuliffe, Eilish

    2013-09-13

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

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

    Science.gov (United States)

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

    2017-12-10

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

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

    Science.gov (United States)

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

    2016-04-01

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

  15. Japan Diabetes Outcome Intervention Trial-1 (J-DOIT1), a nationwide cluster randomized trial of type 2 diabetes prevention by telephone-delivered lifestyle support for high-risk subjects detected at health checkups: rationale, design, and recruitment.

    Science.gov (United States)

    Sakane, Naoki; Kotani, Kazuhiko; Takahashi, Kaoru; Sano, Yoshiko; Tsuzaki, Kokoro; Okazaki, Kentaro; Sato, Juichi; Suzuki, Sadao; Morita, Satoshi; Izumi, Kazuo; Kato, Masayuki; Ishizuka, Naoki; Noda, Mitsuhiko; Kuzuya, Hideshi

    2013-01-29

    Lifestyle modifications are considered the most effective means of delaying or preventing the development of type 2 diabetes (T2DM). To contain the growing population of T2DM, it is critical to clarify effective and efficient settings for intervention and modalities for intervention delivery with a wide population reach.The Japan Diabetes Outcome Intervention Trial-1 (J-DOIT1) is a cluster randomized controlled trial to test whether goal-focused lifestyle coaching delivered by telephone can prevent the development of T2DM in high-risk individuals in a real-world setting. This paper describes the study design and recruitment of the study subjects. For the recruitment of study subjects and their follow-up annually over 3 years, we employed health checkups conducted annually at communities and worksites. Health care divisions recruited from communities and companies across Japan formed groups as a cluster randomization unit. Candidates for the study, aged 20-65 years with fasting plasma glucose (FPG) of 5.6-6.9 mmol/l, were recruited from each group using health checkups results in 2006. Goal-focused lifestyle support is delivered by healthcare providers via telephone over a one-year period. Study subjects will be followed-up for three years by annual health checkups. Primary outcome is the development of diabetes defined as FPG≥7.0 mmol/l on annual health checkup or based on self-report, which is confirmed by referring to medical cards. Forty-three groups (clusters), formed from 17 health care divisions, were randomly assigned to an intervention arm (22 groups) or control arm (21 clusters) between March 2007 and February 2008. A total of 2840 participants, 1336 from the intervention and 1504 from the control arm, were recruited. Consent rate was about 20%, with no difference between the intervention and control arms. There were no differences in cluster size and characteristics of cluster between the groups. There were no differences in individual characteristics

  16. Japan Diabetes Outcome Intervention Trial-1(J-DOIT1, a nationwide cluster randomized trial of type 2 diabetes prevention by telephone-delivered lifestyle support for high-risk subjects detected at health checkups: rationale, design, and recruitment

    Directory of Open Access Journals (Sweden)

    Sakane Naoki

    2013-01-01

    Full Text Available Abstract Background Lifestyle modifications are considered the most effective means of delaying or preventing the development of type 2 diabetes (T2DM. To contain the growing population of T2DM, it is critical to clarify effective and efficient settings for intervention and modalities for intervention delivery with a wide population reach. The Japan Diabetes Outcome Intervention Trial-1 (J-DOIT1 is a cluster randomized controlled trial to test whether goal-focused lifestyle coaching delivered by telephone can prevent the development of T2DM in high-risk individuals in a real-world setting. This paper describes the study design and recruitment of the study subjects. Methods For the recruitment of study subjects and their follow-up annually over 3 years, we employed health checkups conducted annually at communities and worksites. Health care divisions recruited from communities and companies across Japan formed groups as a cluster randomization unit. Candidates for the study, aged 20-65 years with fasting plasma glucose (FPG of 5.6-6.9 mmol/l, were recruited from each group using health checkups results in 2006. Goal-focused lifestyle support is delivered by healthcare providers via telephone over a one-year period. Study subjects will be followed-up for three years by annual health checkups. Primary outcome is the development of diabetes defined as FPG≥7.0 mmol/l on annual health checkup or based on self-report, which is confirmed by referring to medical cards. Results Forty-three groups (clusters, formed from 17 health care divisions, were randomly assigned to an intervention arm (22 groups or control arm (21 clusters between March 2007 and February 2008. A total of 2840 participants, 1336 from the intervention and 1504 from the control arm, were recruited. Consent rate was about 20%, with no difference between the intervention and control arms. There were no differences in cluster size and characteristics of cluster between the groups. There

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2017-09-16

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

  20. A Review of Physical Activity Interventions Delivered via Facebook.

    Science.gov (United States)

    Ferrer, David A; Ellis, Rebecca

    2017-10-01

    The use of social networking sites to deliver behavioral interventions is becoming more prevalent. The purpose of this review was to systematically evaluate the published research to determine the effectiveness of Facebook-delivered interventions for promoting physical activity behavior change. A search of interventions delivered via Facebook (as the primary delivery method or part of a multifaceted intervention) in which physical activity was the primary or secondary outcome resulted in 8 studies for review. Overall, 87.5% of the Facebook interventions reported some type of significant physical activity behavior change (ie, interactions, main effects for time, differences between conditions); however, only 2 of these interventions found this change to be significantly better for the treatment group than the control group. Future researchers are encouraged to test the effectiveness of Facebook-delivered physical activity interventions with additional control groups that receive no aspects of the intervention within experimental study designs, more diverse samples, theory-based content with assessment of mediators of behavior change, direct observations of physical activity, and long-term follow-ups. Although based on a small sample of studies, Facebook appears to be a promising delivery method for physical activity interventions.

  1. Identifying potential programs and platforms to deliver multiple micronutrient interventions.

    Science.gov (United States)

    Olney, Deanna K; Rawat, Rahul; Ruel, Marie T

    2012-01-01

    This article reviews the potential of four broad types of platforms, health, agriculture, market-based, and social protection programs, to deliver multiple micronutrient (MMN) interventions (supplementation, fortification, and dietary modification). We assessed the platforms' potential based on seven performance criteria related to programs within these platforms: 1) targeting, 2) efficacy of interventions, 3) quality of implementation, 4) utilization, 5) impact, 6) coverage, and 7) sustainability. We highlight one type of program per platform to illustrate strengths and weaknesses for delivering MMN interventions, identify critical knowledge gaps, and highlight what is needed to increase effectiveness for delivering MMN interventions. We found that all four platforms have the potential to effectively deliver MMN interventions if the following key program elements are addressed: 1) strong behavior change communication strategies to increase demand and proper utilization of services/products; 2) supply side interventions to ensure consistent availability of high quality interventions, products, and well-trained staff; 3) rigorous evaluations of effectiveness, quality of delivery, and impact pathways to generate best practices for replication and scale-up; and 4) timely dissemination of evaluation results to ensure use by program implementers and policy makers. The diversification of delivery platforms, which simultaneously addresses multiple determinants of MMN deficiencies and expands coverage, is needed to accelerate progress in reducing MMN deficiencies.

  2. Developmental Implications of HIV Prevention during Adolescence: Examination of the Long-Term Impact of HIV Prevention Interventions Delivered in Randomized Controlled Trials in Grade Six and in Grade 10

    Science.gov (United States)

    Dinaj-Koci, Veronica; Chen, Xinguang; Deveaux, Lynette; Lunn, Sonja; Li, Xiaoming; Wang, Bo; Braithwaite, Nanika; Marshall, Sharon; Gomez, Perry; Stanton, Bonita

    2015-01-01

    Dramatic changes occur in abstract reasoning, physical maturation, familial relationships and risk exposure during adolescence. It is probable that delivery of behavioral interventions addressing decision-making during the preadolescent period and later in adolescence would result in different impacts. We evaluated the intervention effects of an…

  3. A randomized comparative effectiveness trial of using cable television to deliver diabetes prevention programming

    Science.gov (United States)

    Ackermann, Ronald T; Sandy, Lewis G; Beauregard, Tom; Coblitz, Mark; Norton, Kristi L; Vojta, Deneen

    2014-01-01

    Objective To evaluate the use and effectiveness of two “in-home” strategies for delivering diabetes prevention programming using cable television. Methods An individually randomized, two-arm intervention trial including adults with diabetes risk factors living in two US cities. Interventions involved a 16-session lifestyle intervention delivered via “video-on-demand” cable television, offered alone versus in combination with web-based lifestyle support tools. Repeated measures longitudinal linear regression with imputation of missing observations was used to compare changes in body weight. Results A total of 306 individuals were randomized and offered the interventions. After 5 months, 265 (87%) participants viewed at least 1, and 110 (36%) viewed ≥9 of the video episodes. A total of 262 (86%) participants completed a 5-month weight measurement. In intention-to-treat analysis with imputation of missing observations, mean weight loss at 5 months for both treatment groups combined was 3.3% (95% CI 0.7-5.0%), regardless of intervention participation (with no differences between randomized groups (P = 0.19)), and was 4.9% (95% CI 2.1-6.5%) for participants who viewed ≥9 episodes. Conclusions In-home delivery of evidence-based diabetes prevention programming in a reality television format, offered with or without online behavioral support tools, can achieve modest weight losses consistent with past implementation studies of face-to-face programs using similar content. PMID:24740868

  4. Social media interventions to prevent HIV: A review of interventions and methodological considerations.

    Science.gov (United States)

    Tso, Lai Sze; Tang, Weiming; Li, Haochu; Yan, H Yanna; Tucker, Joseph D

    2016-06-01

    Persistent new HIV infections and risky behaviors underscore the need for enhanced HIV prevention. Social media interventions may promote safe sexual behaviors, increase HIV testing uptake, and promote safe injection behaviors. This review discusses how social media interventions tap into the wisdom of crowds through crowdsourcing, build peer-mentored communities, and deliver interventions through social networks. Social media HIV prevention interventions are constrained by ethical issues, low social media usage among some key populations, and implementation issues. Comprehensive measurement of social media interventions to prevent HIV is necessary, but requires further development of metrics.

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

    Science.gov (United States)

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

    2013-10-01

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

  6. Computer-delivered interventions for alcohol and tobacco use: a meta-analysis.

    Science.gov (United States)

    Rooke, Sally; Thorsteinsson, Einar; Karpin, Anne; Copeland, Jan; Allsop, David

    2010-08-01

    To quantify the overall effectiveness of computer-delivered interventions for alcohol and tobacco use. Meta-analysis of 42 effect sizes from randomized controlled trials, based on the responses of 10 632 individuals. The weighted average effect size (d) was 0.20, P types of outcome measure used. Effect sizes did not vary significantly as a function of treatment location, inclusion of entertaining elements, provision of normative feedback, availability of a discussion feature, number of treatment sessions, emphasis on relapse prevention, level of therapist involvement or follow-up period. Findings of the meta-analysis suggest that minimal contact computer-delivered treatments that can be accessed via the internet may represent a cost-effective means of treating uncomplicated substance use and related problems.

  7. Can community care workers deliver a falls prevention exercise program? A feasibility study

    Directory of Open Access Journals (Sweden)

    Burton E

    2018-03-01

    Full Text Available Elissa Burton,1 Gill Lewin,2 Hilary O’Connell,3 Mark Petrich,4,5 Eileen Boyle,1 Keith D Hill1 1School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; 2School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; 3Independent Living Centre Western Australia, Perth, Western Australia, Australia; 4Western Australian Department of Health, Perth, Western Australia, Australia; 5School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia Background: Almost half of older people receiving community care fall each year and this rate has not improved in the last decade. Falls prevention programs targeted at this group are uncommon, and expensively delivered by university trained allied health professionals. Purpose: To investigate the feasibility of community care workers delivering a falls prevention exercise program to older clients, at low or medium risk of falling, as part of an existing service provision. Patients and methods: Community care workers from 10 community care organizations participated in the training for, and delivery to their clients of, an 8-week evidence-based falls prevention exercise program. Community care workers included assessment staff (responsible for identifying the need for community care services through completing an assessment and support workers (responsible for providing support in the home. Clients were surveyed anonymously at the completion of the intervention and workers participated in a semi-structured interview. Results: Twenty-five community care workers participated in the study. The falls prevention program was delivered to 29 clients, with an average age of 82.7 (SD: 8.72 years and consisting of 65.5% female. The intervention was delivered safely with no adverse events recorded, and the eligibility and assessment tools

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

    Science.gov (United States)

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

    2009-01-01

    impact of the wide-scale implementation of these strategies on stillbirth rates. Strategies to improve quality of care by upgrading the skills of community cadres have shown demonstrable impact on perinatal mortality, particularly in conjunction with health systems strengthening and facilitation of referrals. Neonatal resuscitation training for physicians and other health workers shows potential to prevent many neonatal deaths currently misclassified as stillbirths. Perinatal audit systems, which aim to improve quality of care by identifying deficiencies in care, are a quality improvement measure that shows some evidence of benefit for changes in clinical practice that prevent stillbirths, and are strongly recommended wherever practical, whether as hospital case review or as confidential enquiry at district or national level. Conclusion Delivering interventions to reduce the global burden of stillbirths requires action at all levels of the health system. Packages of interventions should be tailored to local conditions, including local levels and causes of stillbirth, accessibility of care and health system resources and provider skill. Antenatal care can potentially serve as a platform to deliver interventions to improve maternal nutrition, promote behaviour change to reduce harmful exposures and risk of infections, screen for and treat risk factors, and encourage skilled attendance at birth. Following the example of high-income countries, improving intrapartum monitoring for fetal distress and access to Caesarean section in low-/middle-income countries appears to be key to reducing intrapartum stillbirth. In remote or low-resource settings, families and communities can be galvanised to demand and seek quality care through financial incentives and health promotion efforts of local cadres of health workers, though these interventions often require simultaneous health systems strengthening. Perinatal audit can aid in the development of better standards of care, improving

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2011-09-24

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

  11. Translating an Effective Group-Based HIV Prevention Program to a Program Delivered Primarily by a Computer: Methods and Outcomes

    Science.gov (United States)

    Card, Josefina J.; Kuhn, Tamara; Solomon, Julie; Benner, Tabitha A.; Wingood, Gina M.; DiClemente, Ralph J.

    2011-01-01

    We describe development of SAHARA (SiSTAS Accessing HIV/AIDS Resources At-a-click), an innovative HIV prevention program that uses a computer to deliver an updated version of SiSTA, a widely used, effective group-level HIV prevention intervention for African American women ages 18-29. Fidelity to SiSTA's core components was achieved using: (1)…

  12. Feasibility of a home-delivered Internet obesity prevention program for fourth-grade students.

    Science.gov (United States)

    Owens, Scott; Lambert, Laurel; McDonough, Suzanne; Green, Kenneth; Loftin, Mark

    2009-08-01

    This pilot study examined the feasibility of an interactive obesity prevention program delivered to a class of fourth-grade students utilizing daily e-mail messages sent to the students' home computers. The study involved a single intact class of 22 students, 17 (77%) of whom submitted parental permission documentation and received e-mail messages each school day over the course of one month. Concerns regarding Internet safety and children's use of e-mail were addressed fairly easily. Cost/benefit issues for the school did not seem prohibitive. Providing e-mail access to students without a home computer was accomplished by loaning them personal digital assistant (PDA) devices. In larger interventions, loaning PDAs is probably not feasible economically, although cell phones may be an acceptable alternative. It was concluded that this type of interactive obesity prevention program is feasible from most perspectives. Data from a larger scale effectiveness study is still needed.

  13. Which intervention characteristics are related to more exposure to internet-delivered healthy lifestyle promotion interventions? A systematic review

    NARCIS (Netherlands)

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

    2011-01-01

    textabstractBackground: The Internet has become a popular medium for the delivery of tailored healthy lifestyle promoting interventions. The actual reach of Internet-delivered interventions seems, however, lower than expected, and attrition from interventions is generally high. Characteristics of an

  14. Developing a computer delivered, theory based intervention for guideline implementation in general practice

    Directory of Open Access Journals (Sweden)

    Ashworth Mark

    2010-11-01

    Full Text Available Abstract Background Non-adherence to clinical guidelines has been identified as a consistent finding in general practice. The purpose of this study was to develop theory-informed, computer-delivered interventions to promote the implementation of guidelines in general practice. Specifically, our aim was to develop computer-delivered prompts to promote guideline adherence for antibiotic prescribing in respiratory tract infections (RTIs, and adherence to recommendations for secondary stroke prevention. Methods A qualitative design was used involving 33 face-to-face interviews with general practitioners (GPs. The prompts used in the interventions were initially developed using aspects of social cognitive theory, drawing on nationally recommended standards for clinical content. The prompts were then presented to GPs during interviews, and iteratively modified and refined based on interview feedback. Inductive thematic analysis was employed to identify responses to the prompts and factors involved in the decision to use them. Results GPs reported being more likely to use the prompts if they were perceived as offering support and choice, but less likely to use them if they were perceived as being a method of enforcement. Attitudes towards using the prompts were also related to anticipated patient outcomes, individual prescriber differences, accessibility and presentation of prompts and acceptability of guidelines. Comments on the prompts were largely positive after modifying them based on participant feedback. Conclusions Acceptability and satisfaction with computer-delivered prompts to follow guidelines may be increased by working with practitioners to ensure that the prompts will be perceived as valuable tools that can support GPs' practice.

  15. Interventions for preventing postpartum constipation.

    Science.gov (United States)

    Turawa, Eunice B; Musekiwa, Alfred; Rohwer, Anke C

    2015-09-18

    Postpartum constipation, with symptoms such as pain or discomfort, straining, and hard stool, is a common condition affecting mothers. Haemorrhoids, pain at the episiotomy site, effects of pregnancy hormones and haematinics used in pregnancy can increase the risk of postpartum constipation. Eating a high-fibre diet and increasing fluid intake is usually encouraged, although laxatives are commonly used in relieving constipation. The effectiveness and safety of available interventions for preventing postpartum constipation needs to be ascertained. To evaluate the effectiveness and safety of interventions for preventing postpartum constipation. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2015), Stellenbosch University database, ProQuest Dissertation and Theses database, World Health Organization International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov (30 April 2015) and reference lists of included studies. All randomised controlled trials (RCTs) comparing any intervention for preventing postpartum constipation versus another intervention, placebo or no intervention. Interventions could include pharmacological (e.g. laxatives) and non-pharmacological interventions (e.g. acupuncture, educational and behavioural interventions).We included quasi-randomised trials. Cluster-RCTs were eligible for inclusion but none were identified. Studies using a cross-over design were not eligible for inclusion in this review. Two review authors independently screened the results of the search to select potentially relevant studies, extracted data and assessed risk of bias. Results were pooled in a meta-analysis only where there was no substantial statistical heterogeneity. We included five trials (1208 postpartum mothers); four compared a laxative with placebo and one compared a laxative alone versus the same laxative plus a bulking agent in women who underwent surgical repair of third degree perineal tears. Trials were poorly

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2018-02-20

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

  18. Effective interventions for pressure ulcer prevention.

    Science.gov (United States)

    Bonomini, Joanna

    This article examines the causes of pressure ulcers and provides an overview of the best advice available in preventing them in the clinical setting. This should enable nurses to provide more effective interventions for preventing patients from developing pressure ulcers.

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

    Science.gov (United States)

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

    2014-08-06

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  1. Meta-analysis of internet-delivered interventions to increase physical activity levels

    Directory of Open Access Journals (Sweden)

    Davies Cally A

    2012-04-01

    Full Text Available Abstract Many internet-delivered physical activity behaviour change programs have been developed and evaluated. However, further evidence is required to ascertain the overall effectiveness of such interventions. The objective of the present review was to evaluate the effectiveness of internet-delivered interventions to increase physical activity, whilst also examining the effect of intervention moderators. A systematic search strategy identified relevant studies published in the English-language from Pubmed, Proquest, Scopus, PsychINFO, CINHAL, and Sport Discuss (January 1990 – June 2011. Eligible studies were required to include an internet-delivered intervention, target an adult population, measure and target physical activity as an outcome variable, and include a comparison group that did not receive internet-delivered materials. Studies were coded independently by two investigators. Overall effect sizes were combined based on the fixed effect model. Homogeneity and subsequent exploratory moderator analysis was undertaken. A total of 34 articles were identified for inclusion. The overall mean effect of internet-delivered interventions on physical activity was d = 0.14 (p = 0.00. Fixed-effect analysis revealed significant heterogeneity across studies (Q = 73.75; p = 0.00. Moderating variables such as larger sample size, screening for baseline physical activity levels and the inclusion of educational components significantly increased intervention effectiveness. Results of the meta-analysis support the delivery of internet-delivered interventions in producing positive changes in physical activity, however effect sizes were small. The ability of internet-delivered interventions to produce meaningful change in long-term physical activity remains unclear.

  2. The effectiveness of suicide prevention delivered by GPs: A systematic review and meta-analysis.

    Science.gov (United States)

    Milner, Allison; Witt, Katrina; Pirkis, Jane; Hetrick, Sarah; Robinson, Jo; Currier, Dianne; Spittal, Matthew J; Page, Andrew; Carter, Gregory L

    2017-03-01

    The aim of this review was to assess whether suicide prevention provided in the primary health care setting and delivered by GPs results in fewer suicide deaths, episodes of self-harm, attempts and lower frequency of thoughts about suicide. We conducted a systematic review and meta-analysis using PRIMSA guidelines. Eligible studies: 1) evaluated an intervention provided by GPs; 2) assessed suicide, self-harm, attempted suicide or suicide ideation as outcomes, and; 3) used a quasi-experimental observational or trial design. Study specific effect sizes were combined using the random effects meta-analysis, with effects transformed into relative risk (RR). We extracted data from 14 studies for quantitative meta-analysis. The RR for suicide death in quasi-experimental observational studies comparing an intervention region against another region acting as a "control" was 1.26 (95% CI 0.58, 2.74). When suicide in the intervention region was compared before and after the GP program, the RR was 0.78 (95% CI 0.62, 0.97). There was no evidence of a treatment effect for GP training on rates of suicide death in one cRCT (RR 1.07, 95% CI 0.79, 1.45). There was no evidence of effect for the most other outcomes studied. All of the studies included in this review are likely to have a high level of bias. It is also possible that we excluded or missed relevant studies in our review process CONCLUSIONS: Interventions have produced equivocal results, which varied by study design and outcome. Given these results, we cannot recommend the roll out of GP suicide prevention initiatives. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Exploratory Research to Design a School Nurse-Delivered Intervention to Treat Adolescent Overweight and Obesity

    Science.gov (United States)

    Gellar, Lauren; Druker, Sue; Osganian, Stavroula K.; Gapinski, Mary Ann; LaPelle, Nancy; Pbert, Lori

    2012-01-01

    Objective: In preparation for a pilot study to evaluate the efficacy of a school nurse-delivered intervention, focus groups were conducted to gain insight into the perceptions of stakeholders regarding the design and implementation of the intervention. Setting and Participants: Fifteen focus groups at participating schools. One hundred subjects,…

  4. An Investigation of Student-Selected and Parent-Delivered Reading Interventions

    Science.gov (United States)

    Daly, Edward J., III; Kupzyk, Sara

    2012-01-01

    In this study, we examined whether individualized, student-selected, parent-delivered reading interventions would produce generalized oral reading fluency improvements. Three 3rd-grade students received reading fluency interventions (repeated readings, modeling, error correction, and flashcard instruction) 1 at a time and were shown the results…

  5. Internet-delivered interventions aimed at adolescents: A Delphi study on dissemination and exposure

    NARCIS (Netherlands)

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

    2008-01-01

    textabstractIt appears that in practice exposure to Internet-delivered behaviour change interventions, encouraging a healthy lifestyle for adolescents with regard to health risk behaviours, is quite low. There is, however, a lack of evidence-based insight into how to disseminate such interventions

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

    Science.gov (United States)

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

    2013-01-01

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

  7. Suicide Prevention Referrals in a Mobile Health Smoking Cessation Intervention.

    Science.gov (United States)

    Christofferson, Dana E; Hamlett-Berry, Kim; Augustson, Erik

    2015-08-01

    Automated mobile health (mHealth) programs deliver effective smoking cessation interventions through text message platforms. Smoking is an independent risk factor for suicide, so the Department of Veterans Affairs incorporated information about the Veterans Crisis Line into its SmokefreeVET smoking cessation text messaging program. Almost 7% of all SmokefreeVET enrollees have accessed this information. Because of the reach and automated nature of this and similar programs, we recommend including a referral to a suicide prevention hotline for all smoking cessation mHealth interventions.

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

    Science.gov (United States)

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

    2016-07-11

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

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

    Science.gov (United States)

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

    2009-07-01

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

  10. Implementing prevention interventions for non-communicable ...

    African Journals Online (AJOL)

    Implementing prevention interventions for non-communicable diseases within the Primary Health Care system in the Federal Capital Territory, Nigeria. ... Conclusion: The capacity of the PHC system to implement NCDs interventions is weak, necessitating a need to strengthen coordination, partnership and funding for better ...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  12. Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

    Directory of Open Access Journals (Sweden)

    Jukes Matthew CH

    2008-09-01

    Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

  13. Interventions for preventing occupational irritant hand dermatitis

    NARCIS (Netherlands)

    Bauer, Andrea; Schmitt, Jochen; Bennett, Cathy; Coenraads, Pieter-Jan; Elsner, Peter; English, John; Williams, Hywel C.

    2010-01-01

    Background Occupational irritant hand dermatitis (OIHD) is an important cause of discomfort in the working population. Different preventive measures are in place but it is not clear how effective these are. Objectives To assess the effect of interventions for preventing OIHD in healthy people who

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

    Science.gov (United States)

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

    2018-01-01

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

  15. Mathematics intervention for prevention of neurocognitive deficits in childhood leukemia.

    Science.gov (United States)

    Moore, Ida M; Hockenberry, Marilyn J; Anhalt, Cynthia; McCarthy, Kathy; Krull, Kevin R

    2012-08-01

    Despite evidence that CNS treatment is associated with cognitive and academic impairment, interventions to prevent or mitigate these problems are limited. The purpose was to determine if early intervention can prevent declines in mathematics abilities. Fifty-seven children with ALL were enrolled and randomized to a Mathematics Intervention or Standard Care. Subjects completed neurocognitive assessments prior to the intervention, post-intervention, and 1 year later. Parents received written results and recommendations for use with their school. The Mathematics Intervention was based on Multiple Representation Theory and delivered individually over 1 year. Thirty-two of 57 subjects completed the study and were included in data analyses. These 32 subjects completed all neurocognitive assessments and, for those in the Intervention Group, 40-50 hours of the Mathematics Intervention. There were no group differences on relevant demographic variables; risk stratification; number of intrathecal methotrexate injections; or high dose systemic methotrexate. Significant improvements in calculation and applied mathematics from Baseline to Post-Intervention (P = 0.003 and 0.002, respectively) and in visual working memory from Baseline to 1 year Follow-up (P = 0.02) were observed in the Intervention but not the Standard Care Group. Results from repeated measures ANOVA demonstrated significant between group differences for applied mathematics [F(2,29) = 12.47, P Mathematics Intervention improved mathematics abilities and visual working memory compared to standard care. Future studies are needed to translate the Mathematics Intervention into a "virtual" delivery method more readily available to parents and children. Copyright © 2011 Wiley Periodicals, Inc.

  16. Fidelity scorecard: evaluation of a caregiver-delivered symptom management intervention.

    Science.gov (United States)

    Frambes, Dawn; Lehto, Rebecca; Sikorskii, Alla; Tesnjak, Irena; Given, Barbara; Wyatt, Gwen

    2017-08-01

    To evaluate and quantify the intervention fidelity of a symptom management protocol through implementation of a scorecard, using an exemplar study of caregiver-delivered reflexology for people with breast cancer. Studies on caregiver-delivered symptom management interventions seldom include adequate information on protocol fidelity, contributing to potentially suboptimal provision of the therapeutic intervention, hindering reproducibility and generalizability of the results. Fidelity assessment of a 4-week intervention protocol in a randomized controlled trial (RCT) with data collection between 2012 - 2016. The National Institutes of Health Behaviour Change Consortium (NIH-BCC) conceptual model for intervention fidelity guided the study. The five NIH-BCC fidelity elements are: (1) dose; (2) provider training; (3) intervention delivery; (4) intervention receipt; and (5) enactment. To illustrate the elements, an intervention protocol was deconstructed and each element quantified using a newly developed fidelity scorecard. Mean scores and frequency distributions were derived for the scorecard elements. For dose, the mean number of sessions was 4·4, 96% used the correct intervention duration and 29% had 4 weeks with at least one session. Provider training was achieved at 80% of the maximum score, intervention delivery was 96%, intervention receipt was 99% and enactment indicated moderate adoption at 3·8 sessions per patient. The sample mean score was 15·4 out of 16, indicating the high overall fidelity. Research findings that include description of how fidelity is both addressed and evaluated are necessary for clinical translation. Clinicians can confidently recommend symptom management strategies to patients and caregivers when fidelity standards are explicitly reported and measured. © 2017 John Wiley & Sons Ltd.

  17. Effectiveness of extended contact interventions for weight management delivered via text messaging: a systematic review and meta-analysis.

    Science.gov (United States)

    Job, J R; Fjeldsoe, B S; Eakin, E G; Reeves, M M

    2018-04-01

    Extended contact interventions provide support for continued weight management (weight loss/prevention of weight regain) following a weight loss intervention. Text messages offer a medium for delivery in a potentially cost-effective, broad-reach manner. This study aims to examine (i) the effectiveness of extended contact, text message interventions for adults in supporting weight management, and (ii) which intervention characteristics are common to those that are effective. A systematic database search (to 19 September 2016) was conducted. Meta-analyses were performed to quantify the average weight changes (kg) during the extended contact intervention, net of control (if a control group was present) and within-group. Seven studies were eligible for inclusion. The pooled effect of the extended contact intervention compared with control (n = 3 studies) was -0.82 kg (95% confidence interval -1.43, -0.21), while the pooled within-group weight loss (n = 6 studies) during the extended contact interventions was -2.16 kg (95% confidence interval -3.40, -0.91). Interventions considered 'effective' (n = 4) were more likely to be >12 weeks duration, compared with interventions considered 'ineffective' (n = 3). Evidence from the small number of studies reviewed suggests that extended contact, text message-delivered interventions are effective. Further research is required to elucidate effective intervention components and the longer-term impact on weight, diet and physical activity behaviour. © 2017 World Obesity Federation.

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

    Science.gov (United States)

    Kwan, Matthew; Faulkner, Guy; Bray, Steven

    2013-04-29

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

  19. Preventive interventions for tendinopathy: A systematic review.

    Science.gov (United States)

    Peters, Janne A; Zwerver, Johannes; Diercks, Ronald L; Elferink-Gemser, Marije T; van den Akker-Scheek, Inge

    2016-03-01

    Tendinopathy, the most prevalent tendon disorder which is considered as the clinical diagnosis of pain and dysfunction, is common in sports and its prevalence is ever-increasing. Despite the lack of clarity about risk factors, various preventive interventions for tendinopathy have been investigated. The main objective of this study is to review current preventive interventions for tendinopathy in the major regions: ankle, knee, hip, groin, shoulder and elbow. A systematic literature search was conducted. The PubMed and Embase databases were explored to identify articles that met the inclusion criteria. The included studies were assessed on methodological quality and data was summarized. Ten articles were included that describe a wide variety of preventive interventions. These were divided into three categories: stretch and exercise interventions, shoe adaptations and other interventions. The methodological quality of the studies was moderate to high. Three out of ten studies showed a significant beneficial result. There is limited evidence that a long-term intervention including balance training is effective in the prevention of patellar and Achilles tendinopathy. Shoe adaptations in the form of shock absorbing insoles could have a preventive effect on Achilles tendinopathy. Hormone replacement therapy seems to reduce the risk for structural Achilles tendon changes in active post-menopausal women. No evidence was found for a positive effect of stretching exercises. Prophylactic eccentric training and stretching can increase the risk of injury in asymptomatic players with patellar tendon abnormalities. A limited amount of studies was available and more research is needed on (multifactorial) etiology, risk factors and preventive interventions. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Burnout prevention: a review of intervention programs.

    Science.gov (United States)

    Awa, Wendy L; Plaumann, Martina; Walter, Ulla

    2010-02-01

    To evaluate the effectiveness of intervention programs at the workplace or elsewhere aimed at preventing burnout, a leading cause of work related mental health impairment. A systematic search of burnout intervention studies was conducted in the databases Medline, PsycINFO and PSYNDEX from 1995 to 2007. Data was also extracted from papers found through a hand search. A total of 25 primary intervention studies were reviewed. Seventeen (68%) were person-directed interventions, 2 (8%) were organization-directed and 6 (24%) were a combination of both interventions types. Eighty percent of all programs led to a reduction in burnout. Person-directed interventions reduced burnout in the short term (6 months or less), while a combination of both person- and organization-directed interventions had longer lasting positive effects (12 months and over). In all cases, positive intervention effects diminished in the course of time. Intervention programs against burnout are beneficial and can be enhanced with refresher courses. Better implemented programs including both person- and organization-directed measures should be offered and evaluated. A combination of both intervention types should be further investigated, optimized and practiced. Institutions should recognize the need for and make burnout intervention programs available to employees. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  1. Systematic review of youth crime prevention interventions

    DEFF Research Database (Denmark)

    Manuel, Celie; Jørgensen, Anne-Marie Klint

    This review centers on evaluations of youth crime prevention interventions published between 2008 and 2012. The aim of the review is to bring forward the newest information to supplement existing knowledge about crime preventive methods targeting youth. The review lists 56 studies, all targeting 12...... produced for TrygFonden and the Danish Crime Prevention Council TrygFonden and The Danish Crime Prevention Council have entered into an ambitious collaboration. The objective of this collaboration is to reduce crime and increase the feeling of security in Denmark by engaging citizens and creating new...

  2. Strategies for developing and delivering a parental physical activity intervention: answers to the what and how.

    Science.gov (United States)

    Hamilton, Kyra; White, Katherine M

    2014-01-01

    Parents are at risk for physical inactivity; however, few studies have designed physical activity (PA) interventions specifically applied to individuals with young children. To ensure the effectiveness of interventions, it may be useful to first elicit the needs from the target population and incorporate salient strategies identified to the design and delivery of a resultant intervention. We aimed to explore strategies for what to include in and how to best deliver a program designed to increase parental PA. Twelve parents (6 mothers, 6 fathers) of children younger than 5 years participated in focus group discussions exploring strategies for an intervention program designed to increase parental PA. A range of themes such as Focus on the Children and Flexible Life/Family Plans imbedded in strategies such as persuasion and information, problem-solving, skill building, and environmental approaches were identified. In addition, a range of strategies for how to best deliver a parental PA intervention evidenced in emerging themes such as Diverse and Brief and Individualized Approach was discussed. Future research should continue to adopt a ground up, community-based approach to the development and implementation of interventions for this at-risk group to ensure sustained involvement in regular PA.

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

    Science.gov (United States)

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

    2015-01-01

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

  4. 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

  5. E-health interventions for suicide prevention.

    Science.gov (United States)

    Christensen, Helen; Batterham, Philip J; O'Dea, Bridianne

    2014-08-12

    Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals' posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.

  6. Randomized Trials on Consider This, a Tailored, Internet-Delivered Smoking Prevention Program for Adolescents

    Science.gov (United States)

    Buller, David B.; Borland, Ron; Woodall, W. Gill; Hall, John R.; Hines, Joan M.; Burris-Woodall, Patricia; Cutter, Gary R.; Miller, Caroline; Balmford, James; Starling, Randall; Ax, Bryan; Saba, Laura

    2008-01-01

    The Internet may be an effective medium for delivering smoking prevention to children. Consider This, an Internet-based program, was hypothesized to reduce expectations concerning smoking and smoking prevalence. Group-randomized pretest-posttest controlled trials were conducted in Australia (n = 2,077) and the United States (n = 1,234) in schools…

  7. Comparing a telephone- and a group-delivered diabetes prevention program

    DEFF Research Database (Denmark)

    S, Lim; Dunbar, James; Versace, Vin

    2017-01-01

    Aims To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement. Methods Postpartum women participated in a lifestyle modification program delivere...

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

    Directory of Open Access Journals (Sweden)

    Sue Grogan-Johnson

    2011-05-01

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

  9. A pilot exploration of speech sound disorder intervention delivered by telehealth to school-age children.

    Science.gov (United States)

    Grogan-Johnson, Susan; Gabel, Rodney M; Taylor, Jacquelyn; Rowan, Lynne E; Alvares, Robin; Schenker, Jason

    2011-01-01

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

  10. Computer-tailored health interventions delivered over the Web: review and analysis of key components.

    Science.gov (United States)

    Lustria, Mia Liza A; Cortese, Juliann; Noar, Seth M; Glueckauf, Robert L

    2009-02-01

    This systematic review explores how computer-tailored, behavioral interventions implemented and delivered via the Web have been operationalized in a variety of settings. Computer-tailored, online behavioral intervention studies published from 1996 to early 2007 were selected and reviewed by two independent coders. Of 503 studies screened, 30 satisfied the selection criteria. The level of sophistication of these interventions varied from immediate risk/health assessment, tailored web content to full-blown customized health programs. The most common variables for tailoring content were health behaviors and stages of change. Message tailoring was achieved through a combination mechanisms including: feedback, personalization and adaptation. Tailored, self-guided health interventions delivered via the Web to date have involved a great diversity of features and formats. While some programs have been relatively brief and simple, others have involved complex, theory-based tailoring with iterative assessment, tools for development of self-regulatory skills, and various mechanisms for providing feedback. Our ability to fully optimize the use of computer-assisted tailoring will depend on the development of empirically based guidelines for tailoring across populations, health foci, health behaviors and situations. Further outcome research is needed to enhance our understanding of how and under what conditions computer-tailoring leads to positive health outcomes in online behavioral interventions.

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

    Science.gov (United States)

    Ridout, Brad; Campbell, Andrew

    2014-11-01

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

  12. A school nurse-delivered intervention for overweight and obese adolescents.

    Science.gov (United States)

    Pbert, Lori; Druker, Susan; Gapinski, Mary A; Gellar, Lauren; Magner, Robert; Reed, George; Schneider, Kristin; Osganian, Stavroula

    2013-03-01

    Models are needed for implementing weight management interventions for adolescents through readily accessible venues. This study evaluated the feasibility and efficacy of a school nurse-delivered intervention in improving diet and activity and reducing body mass index (BMI) among overweight and obese adolescents. Six high schools were randomized to either a 6-session school nurse-delivered counseling intervention utilizing cognitive-behavioral techniques or nurse contact with provision of information. Eighty-four overweight or obese adolescents in grades 9 through 11 completed behavioral and physiological assessments at baseline and 2- and 6-month follow-ups. At 2 months, intervention participants ate breakfast on more days/week (difference = 1.01 days; 95% CI: 0.11, 1.92), and had a lower intake of total sugar (difference = -45.79 g; 95% CI: -88.34, -3.24) and added sugar (difference = -51.35 g; 95% CI: -92.45, -10.26) compared to control participants. At 6 months, they were more likely to drink soda ≤ one time/day (OR 4.10; 95% CI: 1.19, 16.93) and eat at fast food restaurants ≤ one time/week (OR 4.62; 95% CI: 1.10, 23.76) compared to control participants. There were no significant differences in BMI, activity, or caloric intake. A brief school nurse-delivered intervention was feasible, acceptable, and improved selected obesogenic behaviors, but not BMI. © 2013, American School Health Association.

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

    Directory of Open Access Journals (Sweden)

    Fanaian Mahnaz

    2010-02-01

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

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

    Science.gov (United States)

    Laws, Rachel A; Chan, Bibiana C; Williams, Anna M; Davies, Gawaine Powell; Jayasinghe, Upali W; Fanaian, Mahnaz; Harris, Mark F

    2010-02-23

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

  15. Multilevel interventions aimed at adult obesity prevention

    DEFF Research Database (Denmark)

    Benwell, Ann Fenger

    A growing body of literature emphasizes the importance of using both quantitative and qualitative methods to investigate the wide range of aspects which hinder or promote the success of health interventions. The pilot phase of this study highlights how mixed-method approaches can be strengthened ...... to investigate factors associated with multi-level obesity prevention....

  16. Preventive interventions for tendinopathy : A systematic review

    NARCIS (Netherlands)

    Peters, Janne A; Zwerver, Johannes; Diercks, Ronald L; Elferink-Gemser, Marije T; van den Akker-Scheek, Inge

    Objectives: Tendinopathy, the most prevalent tendon disorder which is considered as the clinical diagnosis of pain and dysfunction, is common in sports and its prevalence is ever-increasing. Despite the lack of clarity about risk factors, various preventive interventions for tendinopathy have been

  17. Can community based interventions prevent child maltreatment

    NARCIS (Netherlands)

    van Dijken, M.W.; Stams, Geert-Jan; de Winter, M.

    Despite the many efforts taken to prevent child maltreatment, this continues to be a significant worldwide problem. Interventions predominantly focus on ‘at risk’ populations and individual characteristics of the victim or abuser, but is that enough? The present review was designed to examine the

  18. Intervention Studies in Suicide Prevention Research

    NARCIS (Netherlands)

    Huisman, A.; Pirkis, J; Robinson, J.

    2010-01-01

    Background: Despite the growing strength of the field of suicidology, various commentators have recently noted that insufficient effort is being put into intervention research, and that this is limiting our knowledge of which suicide prevention strategies might be the most effective. Aims: To

  19. Interventions for Violence Prevention among Young Female ...

    African Journals Online (AJOL)

    Interventions for Violence Prevention among Young Female Hawkers in Motor Parks in South-Western Nigeria: A Review of Effectiveness. ... Findings show that they had greater knowledge of the different types of violence (p < 0.05), were more aware of their vulnerability to violence (99.4% after compared to 82.7% before ...

  20. Improved Prevention Counseling by HIV Care Providers in a Multisite, Clinic-Based Intervention: Positive STEPs

    Science.gov (United States)

    Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol

    2009-01-01

    The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…

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

    Science.gov (United States)

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

    2011-03-01

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

  2. A Pilot Telerehabilitation Program: Delivering Early Intervention Services to Rural Families

    Directory of Open Access Journals (Sweden)

    Jana Cason

    2009-09-01

    Full Text Available The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services. Keywords: Telerehabilitation, Occupational Therapy, Rural, Early Intervention, Children, Program Evaluation, Cost Analysis

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

    Science.gov (United States)

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

    2013-05-31

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

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

    Directory of Open Access Journals (Sweden)

    Strom Joni L

    2010-03-01

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

  5. Internet-Delivered Health Interventions That Work: Systematic Review of Meta-Analyses and Evaluation of Website Availability.

    Science.gov (United States)

    Rogers, Mary Am; Lemmen, Kelsey; Kramer, Rachel; Mann, Jason; Chopra, Vineet

    2017-03-24

    [PTSD], phobias, panic disorders, obsessive compulsive disorder [OCD]), and on diet and physical activity. There were also evidence-based programs on insomnia, chronic pain, cardiovascular risk, and childhood health problems. These programs tended to be intensive, requiring weeks to months of engagement by the user, often including interaction, personalized and normative feedback, and self-monitoring. English was the most common language, although some were available in Spanish, French, Portuguese, Dutch, German, Norwegian, Finnish, Swedish, and Mandarin. There were several interventions with numbers needed to treat of Internet programs are currently available for health-related behaviors, as well as disease prevention and treatment. However, the majority of Internet-delivered health interventions found to be efficacious in RCTs do not have websites for general use. Increased efforts to provide mechanisms to host "interventions that work" on the Web and to assist the public in locating these sites are necessary. ©Mary AM Rogers, Kelsey Lemmen, Rachel Kramer, Jason Mann, Vineet Chopra. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.03.2017.

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

    Science.gov (United States)

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

    2016-05-31

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

  7. The quality of preventive health care delivered to adults: results from a cross-sectional study in Southern Italy

    Directory of Open Access Journals (Sweden)

    Nobile Carmelo GA

    2010-06-01

    Full Text Available Abstract Background It is assumed that providing clinical preventive services to patients can identify or detect early important causes of adult mortality. The aim of this study was to quantify access to preventive services in Southern Italy and to assess whether and how the provision of preventive care was influenced by any specific characteristics of patients. Methods In a cross-sectional study adults aged 18 years and over attending primary care physician (PCP offices located in Southern Italy were interviewed from June through December 2007. Quality indicators of preventive health care developed from RAND's Quality Assessment Tools and Behavioral Risk Factor Surveillance System (BRFSS were used. Multivariate analysis was performed to identify and to assess the role of patients' characteristics on delivery of clinical preventive services. Results A total of 1467 subjects participated in the study. Excepting blood pressure preventive check (delivered to 64.4% of eligible subjects and influenza vaccination (recommended to 90.2% of elderly, the rates of delivery of clinical preventive services were low across all measures, particularly for screening and counseling on health habits. Rates for providing cancer screening tests at recommended times were 21.3% for colonoscopy, 51.5% for mammography and 52.4% for Pap smear. Statistical analysis showed clear disparities in the provision of clinical preventive services associated with age, gender, education level, perceived health status, current health conditions and primary care access measures. Conclusions There is overwhelming need to develop and implement effective interventions to improve delivery of routine clinical preventive services.

  8. Using synchronous distance education to deliver a weight loss intervention: A randomized trial.

    Science.gov (United States)

    Dunn, Carolyn; Olabode-Dada, Olusola; Whetstone, Lauren; Thomas, Cathy; Aggarwal, Surabhi; Nordby, Kelly; Thompson, Samuel; Johnson, Madison; Allison, Christine

    2016-01-01

    To implement a randomized trial to evaluate the effectiveness of a weight loss program delivered using synchronous distance education compared with a wait-list control group with 6-month follow-up. Adults with a body mass index (BMI) ≥25 were randomized to the intervention (n = 42) or wait-list control group (n = 38). The intervention group participated in a synchronous, online, 15-week weight loss program; weight loss was the primary outcome. Secondary measures included height, BMI, and confidence in ability to be physically active and eat healthy. Assessments occurred at three and four time points in the intervention and control group, respectively. Participants who completed the program lost significantly more weight (1.8 kg) than those in the wait-list control group (0.25 kg) at week 15 [F(1,61) = 6.19, P = 0.02] and had a greater reduction in BMI (0.71 vs. 0.14 kg/m(2) ), [F(1,61) = 7.45, P = 0.01]. There were no significant differences between the intervention and the wait-list control groups for change in confidence in ability to be physically active or eat healthy. Weight loss was maintained at 6 months. Use of synchronous distance education is a promising approach for weight loss. The results of this study will help to inform future research that employs Web-based interventions. © 2015 The Obesity Society.

  9. Cyber bullying prevention: intervention in Taiwan.

    Science.gov (United States)

    Lee, Ming-Shinn; Zi-Pei, Wu; Svanström, Leif; Dalal, Koustuv

    2013-01-01

    This study aimed to explore the effectiveness of the cyber bullying prevention WebQuest course implementation. The study adopted the quasi-experimental design with two classes made up of a total of 61 junior high school students of seventh grade. The study subjects comprised of 30 students from the experimental group and 31 students from the control group. The experimental group received eight sessions (total 360 minutes) of the teaching intervention for four consecutive weeks, while the control group did not engage in any related courses. The self-compiled questionnaire for the student's knowledge, attitudes, and intentions toward cyber bullying prevention was adopted. Data were analysed through generalized estimating equations to understand the immediate results on the student's knowledge, attitudes, and intentions after the intervention. The results show that the WebQuest course immediately and effectively enhanced the knowledge of cyber bullying, reduced the intentions, and retained the effects after the learning. But it produced no significant impact on the attitude toward cyber bullying. The intervention through this pilot study was effective and positive for cyber bulling prevention. It was with small number of students. Therefore, studies with large number of students and long experimental times, in different areas and countries are warranted.

  10. Cyber bullying prevention: intervention in Taiwan.

    Directory of Open Access Journals (Sweden)

    Ming-Shinn Lee

    Full Text Available BACKGROUND: This study aimed to explore the effectiveness of the cyber bullying prevention WebQuest course implementation. METHODOLOGY/FINDINGS: The study adopted the quasi-experimental design with two classes made up of a total of 61 junior high school students of seventh grade. The study subjects comprised of 30 students from the experimental group and 31 students from the control group. The experimental group received eight sessions (total 360 minutes of the teaching intervention for four consecutive weeks, while the control group did not engage in any related courses. The self-compiled questionnaire for the student's knowledge, attitudes, and intentions toward cyber bullying prevention was adopted. Data were analysed through generalized estimating equations to understand the immediate results on the student's knowledge, attitudes, and intentions after the intervention. The results show that the WebQuest course immediately and effectively enhanced the knowledge of cyber bullying, reduced the intentions, and retained the effects after the learning. But it produced no significant impact on the attitude toward cyber bullying. CONCLUSIONS/SIGNIFICANCE: The intervention through this pilot study was effective and positive for cyber bulling prevention. It was with small number of students. Therefore, studies with large number of students and long experimental times, in different areas and countries are warranted.

  11. A Pilot Telerehabilitation Program: Delivering Early Intervention Services to Rural Families

    Science.gov (United States)

    Cason, Jana

    2009-01-01

    The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services. PMID:25945160

  12. A pilot telerehabilitation program: delivering early intervention services to rural families.

    Science.gov (United States)

    Cason, Jana

    2009-01-01

    The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services.

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

    Science.gov (United States)

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

    2015-10-23

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Craig Wright

    2011-10-01

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

  16. Development of an intervention map for a parent education intervention to prevent violence among Hispanic middle school students.

    Science.gov (United States)

    Murray, N; Kelder, S; Parcel, G; Orpinas, P

    1998-02-01

    This paper describes development of Padres Trabajando por la Paz, a violence prevention intervention for Hispanic parents to increase parental monitoring. The intervention was developed using an innovative new program planning process: intervention mapping. Theory and empirical evidence broadly defined performance objectives and determinants of parental monitoring. These objectives were further refined through group and individual interviews with the target parent group. Learning objectives for the intervention guided the content of the intervention that used modeling as the primary method and role model stories as a strategy delivered through newsletters. Stage-matching members of the target population for their readiness to implement the parental monitoring behaviors further refined the social cognitive message design strategies. Intervention mapping provides an explicit theory- and data-driven guide for intervention development that maximizes intervention impact for a specific target population.

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Science.gov (United States)

    Voerman, Jessica S; Remerie, Sylvia; Westendorp, Tessa; Timman, Reinier; Busschbach, Jan J V; Passchier, Jan; de Klerk, Cora

    2015-11-01

    Cognitive-behavioral therapy (CBT) is effective in reducing the frequency and intensity of chronic pain in adolescents. However, CBT seems not to be considered acceptable by all adolescents. The main aim of our study was therefore to evaluate the effects of guided Internet-delivered self-help for adolescents with chronic pain. Adolescents (N = 69) were assessed on the outcome measures of pain, coping, disability, catastrophizing, rewarding of pain behavior by parents, and quality of life. Measures were taken 7 weeks before treatment and at pretreatment, posttreatment, and 3-month follow-up. Multilevel modeling was used for longitudinal analysis of the data. Pain intensity, interference caused by pain, rewarding of pain behavior by parents, and sleep problems significantly decreased during the intervention. The quality-of-life scores for pain, general behavior, mental health, family activities, and health changes also significantly improved during the intervention. With regard to coping, only problem-focused avoidance behavior significantly increased. No significant differences were found for pain-related disability and pain catastrophizing. Contrary to expectations, guided Internet-delivered self-help for chronic pain is difficult to use in adolescents, resulting in treatment attrition and loss to follow-up. Dutch Trial Register NTR1926. The results of this trial suggest that Internet-based self-management is effective in decreasing pain intensity in adolescents with chronic pain. Because the intervention is grounded in CBT, we expect the underlying mechanism to be a change in self-management skills and in the ability of challenging dysfunctional thoughts. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  19. Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: Post-Intervention Results

    Science.gov (United States)

    Fitzgibbon, M. L.; Stolley, M. R.; Schiffer, L.; Braunschweig, C. L.; Gomez, S. L.; Van Horn, L.; Dyer, A.

    2013-01-01

    The preschool years offer an opportunity to interrupt the trajectory toward obesity in black children. The Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial was a group-randomized controlled trial assessing the feasibility and effectiveness of a teacher-delivered weight control intervention for black preschool children. The 618 participating children were enrolled in 18 schools administered by the Chicago Public Schools. Children enrolled in the 9 schools randomized to the intervention group received a 14-week weight control intervention delivered by their classroom teachers. Children in the 9 control schools received a general health intervention. Height and weight, physical activity, screen time, and diet data were collected at baseline and post-intervention. At post-intervention, children in the intervention schools engaged in more moderate-to vigorous physical activity than children in the control schools (difference between adjusted group means=7.46 min/day, p=.02). Also, children in the intervention group had less total screen time (−27.8 min/day, p=.05). There were no significant differences in BMI, BMI Z score, or dietary intake. It is feasible to adapt an obesity prevention program to be taught by classroom teachers. The intervention showed positive influences on physical activity and screen time, but not diet. Measuring diet and physical activity in preschool children remains a challenge, and interventions delivered by classroom teachers require both intensive initial training and ongoing individualized supervision. PMID:21193852

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

    OpenAIRE

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

    2017-01-01

    Background: Stress, depression and anxiety amongst working populations can result in reduced work performance and increased absenteeism, but while there is evidence that these common mental health problems are preventable and treatable in the workplace, uptake of psychological treatments amongst the working population is low. One way to address this may be the delivery of occupational digital mental health interventions, but while there is convincing evidence for delivering digital psychologi...

  1. Interventions to prevent injuries in construction workers.

    Science.gov (United States)

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

    2018-02-05

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

  2. Interventions to prevent occupational noise induced hearing loss

    NARCIS (Netherlands)

    Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wout; Sorgdrager, Bas

    2009-01-01

    BACKGROUND: Millions of workers worldwide are exposed to noise levels that increase their risk of hearing impairment. Little is known about the effectiveness of hearing loss prevention interventions. OBJECTIVES: To assess the effectiveness of non-pharmaceutical interventions for preventing

  3. Interventions to prevent occupational noise-induced hearing loss

    NARCIS (Netherlands)

    Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina

    2012-01-01

    Background Millions of workers worldwide are exposed to noise levels that increase their risk of hearing impairment. Little is known about the effectiveness of hearing loss prevention interventions. Objectives To assess the effectiveness of non-pharmaceutical interventions for preventing

  4. A meta-analysis of overall effects of weight loss interventions delivered via mobile phones and effect size differences according to delivery mode, personal contact, and intervention intensity and duration

    NARCIS (Netherlands)

    Schippers, M; Adam, P C G; Smolenski, D J; Wong, H T H; de Wit, J B F|info:eu-repo/dai/nl/06883652X

    Weight loss interventions are delivered through various mediums including, increasingly, mobile phones. This systematic review and meta-analysis assesses whether interventions delivered via mobile phones reduce body weight and which intervention characteristics are associated with efficacy. The

  5. Preventing Online Victimization: College Students' Views on Intervention and Prevention.

    Science.gov (United States)

    White, Wendi E; Carmody, Dianne

    2016-01-14

    Facebook, Twitter, and other social networking sites have changed the way we interact online. Technological advances have also facilitated the emergence of cyberstalking and online harassment, a growing issue on college campuses. This study utilizes focus group data to examine college students' experiences with online harassment and cyberstalking. Students voiced concerns with online tracking, falsifying identities, and harassment. They also noted that incoming first-year students and those negotiating some of their first romantic relationships are especially vulnerable. In addition, students were asked to propose appropriate prevention, education, and intervention strategies at the college level. Surprisingly, many students recommended offline programs to battle this online problem. © The Author(s) 2016.

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

    Science.gov (United States)

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

    2016-05-12

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

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

    Science.gov (United States)

    Garbett, Kirsty M; Diedrichs, Phillippa C

    2016-12-01

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

  8. A systematic review investigating the behaviour change strategies in interventions to prevent misuse of anabolic steroids.

    Science.gov (United States)

    Bates, Geoff; Begley, Emma; Tod, David; Jones, Lisa; Leavey, Conan; McVeigh, Jim

    2017-10-01

    We examined intervention effectiveness of strategies to prevent image- and performance-enhancing drug use. Comprehensive searches identified 14 interventions that met review inclusion criteria. Interventions were predominantly educational and delivered within school sport settings, but targeted a wide range of mediating factors. Identification of effective components was limited across studies by brief or imprecise descriptions of intervention content, lack of behavioural outcome measures and short-term follow-up times. However, studies with components in addition to information provision may be more promising. Interventions outside of sport settings are required to reflect the transition of this form of substance use to the general population.

  9. 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

  10. 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

  11. Better Strength, Better Balance! Partnering to deliver a fall prevention program for older adults.

    Science.gov (United States)

    Taing, Darcie; McKay, Kelly

    2017-09-14

    Falls incur significant health and economic costs, particularly among older adults. Physical activity has been found to be the single most important fall prevention behaviour an older adult can do. This manuscript describes Ottawa Public Health's (OPH) experience implementing the Better Strength, Better Balance! (BSBB) program, a fall prevention exercise program for older adults, through an innovative partnership with the local Recreation, Cultural & Facility Services (RCFS) Department. BSBB aims to reach 1300 community-dwelling adults (aged 65 years and older) per year through approximately 86-130 exercise programs. Designed as a universal program, BSBB addresses participation barriers such as transportation, cost and location. BSBB was enabled with funding from the Champlain Local Health Integration Network, and coincided with the implementation of an Older Adult Plan for the City of Ottawa. BSBB is a beginner-level, fall prevention exercise and education program that takes place twice a week, over 12 weeks. Certified RCFS instructors delivered the exercise components of the program and OPH staff incorporated fall prevention messaging and conducted the evaluation. The formative evaluation indicated that participants experienced improved strength and balance, decreased fear of falling and the intent to adopt new fall prevention behaviours following the program. The partnership between OPH and RCFS allowed both partners to leverage their unique and mutual strengths to continually improve the program. Improving access to strength and balance programming is an important public health strategy to reduce falls. The recreation sector is an ideal partner to help public health in this pursuit.

  12. Hospitalized patients' acceptability of nurse-delivered screening, brief intervention, and referral to treatment.

    Science.gov (United States)

    Broyles, Lauren M; Rosenberger, Emily; Hanusa, Barbara H; Kraemer, Kevin L; Gordon, Adam J

    2012-04-01

    Inpatient healthcare providers in the United States may soon be required to offer alcohol screening, brief intervention, and referral to treatment (SBIRT) for hospital accreditation, but little is known about inpatient acceptability for SBIRT, particularly when performed by nonphysician providers such as nurses. The purpose of this study was to assess patient acceptability for and comfort with nurse-delivered SBIRT care among hospitalized patients and to identify factors associated with SBIRT acceptability. We conducted a cross-sectional survey of 370 hospitalized medical-surgical patients at a large university-affiliated medical center, which is part of the U.S. Department of Veterans Affairs. Patient acceptability for 8 of 10 individual nurse-delivered SBIRT tasks was >84%. Patients were more accepting of SBIRT tasks if they felt able to determine their alcohol risk, able to reduce alcohol-related health risks, and expressed some degree of concern about their own use of alcohol. Approximately 20% of patients reported some degree of personal discomfort with alcohol-related discussions. Patients who were less comfortable with these discussions had lower perceived ability to reduce alcohol-related health risk, were >60 years old, had a positive AUDIT-C screening, and were of nonblack race. Among hospitalized patients, patient acceptability for nurse-delivered SBIRT is high, and alcohol-related risk perceptions appear to be important factors associated with acceptability for SBIRT tasks. Providers can proceed with greater confidence in SBIRT-related discussions with most hospitalized patients but may need particular sensitivity and skill addressing alcohol with patient subgroups such as older patients and those with positive alcohol screenings. Copyright © 2012 by the Research Society on Alcoholism.

  13. Interventions for preventing obesity in children

    Directory of Open Access Journals (Sweden)

    Elizabeth Waters

    Full Text Available BACKGROUND: Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can implement to prevent obesity, and promote health, has been accumulating but remains unclear. OBJECTIVE: This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI. Secondary aims were to examine the characteristics of the programs and strategies to answer the questions "What works for whom, why and for what cost?" METHODS: Search methods: The searches were re-run in CENTRAL, MEDLINE, EMBASE, PsychINFO and CINAHL in March 2010 and searched relevant websites. Non-English language papers were included and experts were contacted. Selection criteria: The review includes data from childhood obesity prevention studies that used a controlled study design (with or without randomisation. Studies were included if they evaluated interventions, policies or programs in place for twelve weeks or more. If studies were randomized at a cluster level, six clusters were required. Data collection and analysis: Two review authors independently extracted data and assessed the risk of bias of included studies. Data was extracted on intervention implementation, cost, equity and outcomes. Outcome measures were grouped according to whether they measured adiposity, physical activity (PA-related behaviours or diet-related behaviours. Adverse outcomes were recorded. A meta-analysis was conducted using available BMI or standardized BMI (zBMI score data with subgroup analysis by age group (0-5, 6-12, 13-18 years, corresponding to stages of developmental and childhood settings. MAIN RESULTS: This

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

    Science.gov (United States)

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

    2012-01-01

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

  15. Effects on Coping Skills and Anxiety of a Universal School-Based Mental Health Intervention Delivered in Scottish Primary Schools

    Science.gov (United States)

    Collins, Sabrina; Woolfson, Lisa Marks; Durkin, Kevin

    2014-01-01

    Anxiety disorders are common in children and may signal risk of depression, social, or academic difficulties. This study evaluated the effects of a universal mental health promotion intervention delivered in primary schools. Three hundred and seventeen 9- to 10-year-olds were randomly allocated by class group to intervention conditions…

  16. WITHDRAWN: Interventions for preventing ankle ligament injuries.

    Science.gov (United States)

    Handoll, Helen Hg; Rowe, Brian H; Quinn, Kathryn M; de Bie, Rob

    2011-05-11

    Some sports, for example basketball and soccer, have a very high incidence of ankle injuries, mainly sprains. Consequently, ankle sprains are one of the most commonly treated injuries in acute care. To assess the effects of interventions used for the prevention of ankle ligament injuries or sprains in physically active individuals from adolescence to middle age. We searched the Cochrane Bone, Joint and Muscle Trauam Group's specialised register, MEDLINE, PubMed, EMBASE, CINAHL, the National Research Register and bibliographies of study reports. We also contacted colleagues and some trialists. The most recent search was conducted in July 2000. Randomised or quasi-randomised trials of interventions for the prevention of ankle sprains in physically active individuals from adolescence to middle age were included provided that ankle sprains were recorded. Interventions included use of modified footwear, external ankle supports, co-ordination training and health education. These could be applied as a supplement to treatment provided that prevention of re-injury was the primary objective. At least two reviewers independently assessed methodological quality and extracted data. Wherever possible, results of outcome measures were pooled and sub-grouped by history of previous sprain. Relative risks (RR) and 95% confidence intervals (95% CI) are reported for individual and pooled data. In this review update, a further nine new trials were included. Overall, 14 randomised trials with data for 8279 participants were included. Twelve trials involved active, predominantly young, adults participating in organised, generally high-risk, activities. The other two trials involved injured patients who had been active in sports before their injury. The prophylactic interventions under test included the application of an external ankle support in the form of a semi-rigid orthosis (three trials), air-cast brace (one trial) or high top shoes (one trial); ankle disk training; taping; muscle

  17. Interventions for preventing ankle ligament injuries.

    Science.gov (United States)

    Handoll, H H; Rowe, B H; Quinn, K M; de Bie, R

    2001-01-01

    Some sports, for example basketball and soccer, have a very high incidence of ankle injuries, mainly sprains. Consequently, ankle sprains are one of the most commonly treated injuries in acute care. To assess the effects of interventions used for the prevention of ankle ligament injuries or sprains in physically active individuals from adolescence to middle age. We searched the Cochrane Musculoskeletal Injuries Group's specialised register, MEDLINE, PubMed, EMBASE, CINAHL, the National Research Register and bibliographies of study reports. We also contacted colleagues and some trialists. The most recent search was conducted in July 2000. Randomised or quasi-randomised trials of interventions for the prevention of ankle sprains in physically active individuals from adolescence to middle age were included provided that ankle sprains were recorded. Interventions included use of modified footwear, external ankle supports, co-ordination training and health education. These could be applied as a supplement to treatment provided that prevention of re-injury was the primary objective. At least two reviewers independently assessed methodological quality and extracted data. Wherever possible, results of outcome measures were pooled and sub-grouped by history of previous sprain. Relative risks (RR) and 95% confidence intervals (95% CI) are reported for individual and pooled data. In this review update, a further nine new trials were included. Overall, 14 randomised trials with data for 8279 participants were included. Twelve trials involved active, predominantly young, adults participating in organised, generally high-risk, activities. The other two trials involved injured patients who had been active in sports before their injury. The prophylactic interventions under test included the application of an external ankle support in the form of a semi-rigid orthosis (three trials), air-cast brace (one trial) or high top shoes (one trial); ankle disk training; taping; muscle

  18. The Benefits of a Friendship-Based HIV/STI Prevention Intervention for African American Youth

    Science.gov (United States)

    Harper, Gary W.; Dolcini, M. Margaret; Benhorin, Shira; Watson, Susan E.; Boyer, Cherrie B.

    2014-01-01

    This article presents findings from a qualitative evaluation of an HIV/STI (sexually transmitted infection) prevention intervention for urban African American youth (Project ÒRÉ), which was delivered to groups of 3 to 8 adolescents who were members of the same friendship network. Sixteen focus groups (N = 63) were conducted with youth following…

  19. Delivering prevention for alcohol and cannabis using the Internet: a cluster randomised controlled trial.

    Science.gov (United States)

    Newton, Nicola C; Andrews, Gavin; Teesson, Maree; Vogl, Laura E

    2009-06-01

    To establish the efficacy of an internet based prevention program to reduce alcohol and cannabis use in adolescents. A cluster randomised controlled trial was conducted with 764 13-year olds from ten Australian secondary schools in 2007-2008. Half the schools were randomly allocated to the computerised prevention program (n=397), and half to their usual health classes (n=367). The Climate Schools: Alcohol and Cannabis prevention course is facilitated by the internet and consists of novel, evidence-based, curriculum consistent lessons aimed at reducing alcohol and cannabis use. Participants were assessed at baseline, immediately post, and at six months following the intervention. Compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge at the end of the course and the six month follow-up. In addition, the intervention group showed a reduction in average weekly alcohol consumption and frequency of cannabis use at the six month follow-up. No differences between groups were found on alcohol expectancies, cannabis attitudes, or alcohol and cannabis related harms. The course is acceptable, scalable and fidelity is assured. It increased knowledge regarding alcohol and cannabis, and decreased use of these drugs.

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

    Science.gov (United States)

    Mares, Sarah; Robinson, Gary

    2012-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Middleton Sandy

    2010-01-01

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

  2. Improving surgical site infection prevention practices through a multifaceted educational intervention.

    LENUS (Irish Health Repository)

    Owens, P

    2015-03-01

    As part of the National Clinical Programme on healthcare-associated infection prevention, a Royal College of Surgeons in Ireland (RCSI) and Royal College of Physicians of Ireland (RCPI) working group developed a quality improvement tool for prevention of surgical site infection (SS). We aimed to validate the effectiveness of an educational campaign, which utilises this quality improvement tool to prevent SSI in a tertiary hospital. Prior to the SSI educational campaign, surgical patients were prospectively audited and details of antibiotic administration recorded. Prophylactic antibiotic administration recommendations were delivered via poster and educational presentations. Post-intervention, the audit was repeated. 50 patients were audited pre-intervention, 45 post-intervention. Post-intervention, prophylaxis within 60 minutes prior to incision increased from 54% to 68% (p = 0.266). Appropriate postoperative prescribing improved from 71% to 92% (p = 0.075). A multifaceted educational program may be effective in changing SSI prevention practices.

  3. Universal preventive interventions for children in the context of disasters and terrorism.

    Science.gov (United States)

    Pfefferbaum, Betty; Varma, Vandana; Nitiéma, Pascal; Newman, Elana

    2014-04-01

    This review addresses universal disaster and terrorism services and preventive interventions delivered to children before and after an event. The article describes the organization and structure of services used to meet the needs of children in the general population (practice applications), examines screening and intervention approaches (tools for practice), and suggests future directions for the field. A literature search identified 17 empirical studies that were analyzed to examine the timing and setting of intervention delivery, providers, conditions addressed and outcomes, and intervention approaches and components. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Development and feasibility of a self-management intervention for chronic obstructive pulmonary disease delivered with motivational interviewing strategies.

    Science.gov (United States)

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

    2013-01-01

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

  5. Efficacy of computer technology-based HIV prevention interventions: a meta-analysis.

    Science.gov (United States)

    Noar, Seth M; Black, Hulda G; Pierce, Larson B

    2009-01-02

    To conduct a meta-analysis of computer technology-based HIV prevention behavioral interventions aimed at increasing condom use among a variety of at-risk populations. Systematic review and meta-analysis of existing published and unpublished studies testing computer-based interventions. Meta-analytic techniques were used to compute and aggregate effect sizes for 12 randomized controlled trials that met inclusion criteria. Variables that had the potential to moderate intervention efficacy were also tested. The overall mean weighted effect size for condom use was d = 0.259 (95% confidence interval = 0.201, 0.317; Z = 8.74, P partners, and incident sexually transmitted diseases. In addition, interventions were significantly more efficacious when they were directed at men or women (versus mixed sex groups), utilized individualized tailoring, used a Stages of Change model, and had more intervention sessions. Computer technology-based HIV prevention interventions have similar efficacy to more traditional human-delivered interventions. Given their low cost to deliver, ability to customize intervention content, and flexible dissemination channels, they hold much promise for the future of HIV prevention.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

  8. Prevention of Mental Health Disorders using Internet and mobile-based Interventions: a narrative review and recommendations for future research.

    NARCIS (Netherlands)

    Ebert, David Daniel; Cuijpers, Pim; Muñoz, Ricardo F.; Baumeister, Harald

    2017-01-01

    Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD), their current impact on the reduction of disease burden is questionable. Possible reasons include that it is not practical to deliver those interventions to the community en

  9. Prevention of mental health disorders using internet- and mobile-based interventions : A narrative review and recommendations for future research

    NARCIS (Netherlands)

    Ebert, David Daniel; Cuijpers, Pim; Muñoz, Ricardo F.; Baumeister, Harald

    2017-01-01

    Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD), their current impact on the reduction of disease burden is questionable. Possible reasons include that it is not practical to deliver those interventions to the community en

  10. Mass media interventions for preventing smoking in young people.

    Science.gov (United States)

    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

  11. An internet-delivered exercise intervention for workplace health promotion in overweight sedentary employees: A randomized trial

    OpenAIRE

    Pressler, Alex;Knebel, Uta;Esch, Sebastian;Kölbl, Dominik;Esefeld, Katrin;Scherr, Johannes;Haller, Bernhard;Schmidt-Trucksäss, Arno;Krcmar, Helmut;Halle, Martin;Leimeister, Jan Marco

    2014-01-01

    Objective. To evaluate the effect of structured vs. non-structured internet-delivered exercise recommendations on aerobic exercise capacity and cardiovascular risk profile in overweight sedentary employees. Methods. 140 employees of an automobile company (11 BMI 29.0 kg/m2 (25.0?34.8)) were randomized in a 3:2 ratio to an intervention group receiving structured exercise schedules or a control group choosing workouts individually via an interactive website. The 12- week intervention took place...

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

    OpenAIRE

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

    2017-01-01

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

  13. School-based eating disorder prevention: a pilot effectiveness trial of teacher-delivered Media Smart.

    Science.gov (United States)

    Wilksch, Simon M

    2015-02-01

    This pilot study tested teacher-delivered Media Smart, a school-based eating disorder prevention program that has achieved significant benefits when delivered by health professionals. Two Grade 7 classes (N = 51; M age = 12.43 years) participated, with one randomly allocated to Media Smart (n = 27; 67% girls) and the other to a control condition of usual lessons (n = 24; 37% girls). Program feasibility was assessed by teacher self-report, whereas student self-report of shape and weight concern (primary outcome variable) and seven additional risk factors were measured at baseline, post-program and 6-month follow up. Teacher ratings of program feasibility revealed that 25 of the 29 (86.2%) program activities were taught with 96% of activities rated as either highly (19 activities) or moderately (5 activities) valuable for students. Mixed model analyses were conducted using a 2 (group: Media Smart, control) × 2 (time: post-program, 6-month follow up) × 2 (gender: girls, boys) design, with baseline scores as a covariate. A not-significant trend for group favouring Media Smart was observed for shape and weight concern (Cohen's d effect size [d] = 0.32), whereas significant effects were found for feelings of ineffectiveness (d = 0.52) and weight-related peer teasing (d = 0.68). The program was feasible for teacher delivery and showed some promising results, supporting a more substantial randomized-controlled effectiveness trial. © 2013 Wiley Publishing Asia Pty Ltd.

  14. Overweight and obesity interventions and prevention strategies.

    Science.gov (United States)

    ALBashtawy, Mohammed

    2015-09-01

    To determine what secondary schoolchildren in Jordan want from overweight and obesity intervention strategies and prevention programmes. A school-based, cross-sectional study using a quantitative design was carried out during October 2014. The participants were secondary schoolchildren in grades 11 and 12. Data were analysed using SPSS program version 17. Percentages, standard deviations and means were computed. The main suggestions were for programmes at school, during school hours (n=962, 85.4%), followed by one that involved family and friends (n=951, 84.5%), and a programme at a convenient time free of charge (n=919, 81.6%). The students also suggested many strategies to tackle overweight and obesity, such as: taking more physical exercise (n=925, 82.1%), increasing consumption of more fruit and vegetables (n=712, 63.2%) eating less fast food (n=689, 61.2%). Schools, families, health providers and community organisations should encourage students to adopt healthy lifestyles, and facilitate their selection and participation in health programmes.

  15. Efficacy of a Web-Based, Tailored, Alcohol Prevention/Intervention Program for College Students: 3-Month Follow-Up

    Science.gov (United States)

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

    2011-01-01

    This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called "Michigan Prevention and Alcohol Safety for Students" (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and…

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

    Directory of Open Access Journals (Sweden)

    Amy Waller

    2017-11-01

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

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

    Science.gov (United States)

    Olcay-Gül, Seray; Tekin-Iftar, Elif

    2016-01-01

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

  18. Internet-Delivered Targeted Group Intervention for Body Dissatisfaction and Disordered Eating in Adolescent Girls: A Randomized Controlled Trial

    Science.gov (United States)

    Heinicke, Brooke E.; Paxton, Susan J.; McLean, Sian A.; Wertheim, Eleanor H.

    2007-01-01

    This study evaluated a targeted intervention designed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program. The program consisted of six, 90-minute weekly small group, synchronous on-line sessions and was facilitated by a therapist and manual. Participants were…

  19. Interventions for preventing eating disorders in children and adolescents.

    Science.gov (United States)

    Pratt, B M; Woolfenden, S R

    2002-01-01

    psychopathology or general psychological and physical well-being in the general sample or those classified as being at high risk for eating disorder (Buddeberg-F 1998; Killen 1993/1996; Santonastaso 1999; Zanetti 1999). Given only one program used a psychoeducation approach to prevent bulimia nervosa (Jerome, unpublished) and only one program adopted a focus on self-esteem (O'Dea 2000), the effect of these approaches could not be evaluated via meta-analyses. In relation to potential harmful effects, there is not sufficient evidence to suggest that harm resulted from any of the prevention programs included in the review. The one significant pooled effect in the current review does not allow for any firm conclusions to be made about the impact of prevention programs for eating disorders in children and adolescents, although none of the pooled comparisons indicated evidence of harm. From a clinical perspective, the development and refinement of prevention programs is complicated by a lack of knowledge about risk factors associated with eating disorders and the need to strike a balance between delivering preventive interventions for eating disorders and considering the potential to cause harm. From a research perspective, the idea of "thresholds" for identifying young people at risk of developing eating disorders has been raised, and denial of concern or denial of illness represents a further issue complicating early identification in relation to eating disorder symptomatology. Longer-term effects of the intervention approaches will need to be monitored across development in order to demonstrate a decline in the incidence of eating disorders and associated risk factors.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Implementation examined in a health center-delivered, educational intervention that improved infant growth in Trujillo, Peru: successes and challenges.

    Science.gov (United States)

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

    2007-06-01

    Process evaluation was used to examine the implementation of a randomized, controlled trial of an education intervention that improved infant growth in Trujillo, Peru. Health personnel delivered the multi-component intervention as part of usual care in the government health centers. Quantitative and qualitative methods were used to examine process indicators, which included the extent of delivery (dose), fidelity to intervention protocol, barriers to implementation and context. Results demonstrated that most intervention components were delivered at a level of 50-90% of expectations. Fidelity to intervention protocol, where measured, was lower (28-70% of expectations). However, when compared with existing nutrition education, as represented by the control centers, significant improvements were demonstrated. This included both improved delivery of existing educational activities as well as delivery of new intervention components to strengthen overall nutrition education. Barriers to, and facilitators of, implementation were explored with health personnel and helped to explain results. This study demonstrates the importance of examining actual versus planned implementation in order to improve our understanding of how interventions succeed. The information gained from this study will inform future evaluation designs, and lead to the development and implementation of more effective intervention programs for child health.

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

    Directory of Open Access Journals (Sweden)

    Steven J. Ondersma

    2016-05-01

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

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

    Science.gov (United States)

    Krupp, Anna; Steege, Linsey; King, Barbara

    2018-04-19

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

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

    Science.gov (United States)

    Bostick, Geoff P

    2017-11-01

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

  5. Prevention and early intervention to improve mental health in higher education students: a review.

    Science.gov (United States)

    Reavley, Nicola; Jorm, Anthony F

    2010-05-01

    The age at which most young people are in higher education is also the age of peak onset for mental and substance use disorders, with these having their first onset before age 24 in 75% of cases. In most developed countries, over 50% of young people are in higher education. To review the evidence for prevention and early intervention in mental health problems in higher education students. The review was limited to interventions targeted to anxiety, depression and alcohol misuse. Interventions to review were identified by searching PubMed, PsycINFO and the Cochrane Database of Systematic Reviews. Interventions were included if they were designed to specifically prevent or intervene early in the general (non-health professional) higher education student population, in one or more of the following areas: anxiety, depression or alcohol misuse symptoms, mental health literacy, stigma and one or more behavioural outcomes. For interventions to prevent or intervene early for alcohol misuse, evidence of effectiveness is strongest for brief motivational interventions and for personalized normative interventions delivered using computers or in individual face-to-face sessions. Few interventions to prevent or intervene early with depression or anxiety were identified. These were mostly face-to-face, cognitive-behavioural/skill-based interventions. One social marketing intervention to raise awareness of depression and treatments showed some evidence of effectiveness. There is very limited evidence that interventions are effective in preventing or intervening early with depression and anxiety disorders in higher education students. Further studies, possibly involving interventions that have shown promise in other populations, are needed.

  6. Cyberbullying Prevention and Intervention Programs in Schools: A Systematic Review

    Science.gov (United States)

    Tanrikulu, Ibrahim

    2018-01-01

    This article presents a systematic review of school-based cyberbullying prevention and intervention programs. Research presenting empirical evidence about the effectiveness of a school-based cyberbullying prevention or intervention program published before August 2016 was searched. Seventeen studies were obtained and reviewed. The findings showed…

  7. Long-Term Maintenance of Physical Function in Older Adults Following a DVD-Delivered Exercise Intervention.

    Science.gov (United States)

    Roberts, Sarah; Awick, Elizabeth; Fanning, Jason T; Ehlers, Diane; Motl, Robert W; McAuley, Edward

    2017-01-01

    Previous evidence suggests physical activity interventions effectively produce short-term improvements in physical function for older adults. The present study examined whether improvements in physical function after a DVD-delivered exercise intervention were maintained 18 months postintervention. Older adults (n = 153) randomized to a 6-month DVD-delivered exercise intervention or an attentional control condition were contacted 18 months postintervention. Participants completed the Short Physical Performance Battery (SPPB) and measures of flexibility, strength, and functional limitations were taken. Analyses of variance were conducted to determine if improvements in physical function as a result of the intervention were maintained at follow-up. Improvements in the SPPB, F (1,125) = 3.70, p = .06, η 2 = .03, and upper body strength, F (1,121) = 3.04, p = .08, η 2 = .03 were maintained for the intervention condition. Home-based DVD exercise training interventions may hold promise for long-term maintenance of physical function in older adults.

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

    Directory of Open Access Journals (Sweden)

    Balaji Madhumitha

    2012-02-01

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

  9. Interventions Using Social Media for Cancer Prevention and Management: A Systematic Review.

    Science.gov (United States)

    Han, Claire Jungyoun; Lee, Young Ji; Demiris, George

    2017-07-27

    Regarding cancer awareness, social media effectively promotes health and supports self-management. Given the diverse study designs, methodologies, and approaches of social media interventions in oncology, it is difficult to determine the effects of social media on cancer prevention and management. We aim to systematically review intervention studies using social media for cancer care. A systematic search, using 7 electronic databases (PubMed, Web of Science, CINAHL, Cochrane Library, Scopus, EMBASE, and PsycINFO), was conducted to identify surveys and interventions using contemporary social media tools with a focus on cancer. Of the 18 selected studies, 7 were randomized controlled trials. Most studies were conducted for all types of cancer, and some were conducted for breast cancer in the United States, with mostly white female participants. Facebook was the most frequently used platform. Most studies targeted healthy participants providing cancer prevention education. With social media platforms as part of a larger intervention, or the main component of interventions, interventions were overall feasible and showed a significant improvement in cancer prevention and management. Social media tools have the potential to be effective in delivering interventions for cancer prevention and management. However, there was a dearth of studies with rigorous study methodologies to test social media effects on various cancer-related clinical outcomes. Social media use in cancer care will facilitate improved communication and support among patients, caregivers, and clinicians and, ultimately, improved patient care. Clinicians need to carefully harness social media to enhance patient care and clinical outcomes.

  10. Group Delivered Literacy-Based Behavioral Interventions for Children with Intellectual Disability

    Science.gov (United States)

    Keeter, Dana; Bucholz, Jessica L.

    2012-01-01

    This study was conducted to examine the effects literacy-based behavioral interventions have on improving the behavior of students with intellectual disability. A second purpose of this study was to determine if literacy-based behavioral interventions could be an effective intervention strategy when used simultaneously with a group of students…

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

    Science.gov (United States)

    Kwok, Timothy; Wong, Bel; Ip, Isaac; Chui, Kenny; Young, Daniel; Ho, Florence

    2013-01-01

    Many family caregivers of persons with dementia (PWD) are unable to participate in community center-based caregiver support services because of logistical constraints. This study evaluated the effectiveness of a telephone-delivered psychoeducational intervention for family caregivers of PWD in alleviating caregiver burden and enhancing caregiving self-efficacy. In a single-blinded randomized controlled trial, 38 family caregivers of PWD were randomly allocated into an intervention group or a control group. The intervention group received psychoeducation from a registered social worker over the phone for 12 sessions. Caregivers in the control group were given a DVD containing educational information about dementia caregiving. Outcomes of the intervention were measured by the Chinese versions of the Zarit Burden Interview and the Revised Scale for Caregiving Self-efficacy. Mann-Whitney U tests were used to compare the differences between the intervention and control groups. The level of burden of caregivers in the intervention group reduced significantly compared with caregivers in the control group. Caregivers in the intervention group also reported significantly more gain in self-efficacy in obtaining respite than the control group. A structured telephone intervention can benefit dementia caregivers in terms of self-efficacy and caregiving burden. The limitations of the research and recommendations for intervention are discussed.

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2014-05-16

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

  14. The effect of caregiver-delivered social-communication interventions on skill generalization and maintenance in ASD.

    Science.gov (United States)

    Hong, Ee Rea; Neely, Leslie; Gerow, Stephanie; Gann, Candace

    2018-03-01

    Although caregiver-delivered social communication interventions have been considered scientifically proven practices for individuals with autism spectrum disorders, it is not well examined if these types of intervention modes are truly effective in promoting skill generalization and maintenance within those individuals with autism spectrum disorders. The purpose of this meta-analysis was to evaluate the status of the extant literature regarding the measures on generalization and/or maintenance of effects of caregiver-delivered communication interventions for children with autism spectrum disorders. This systematic literature review and meta-analysis evaluated peer-reviewed research regarding the effects of caregiver-implemented interventions on the maintenance and generalization of the social-communication skills for children with autism spectrum disorders. A total of 34 articles were included following a systematic search. Articles were summarized according to the following categories: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) generalization/maintenance teaching strategy, and (e) latency to maintenance probes. After application of design standards, aggregate Tau-U and non-overlap of pairs effect sizes were calculated with a total of 67 separate contrasts across seven studies. Overall, effect size scores ranged from small to large effects across all comparisons. On average, most of the baseline to maintenance and generalization comparisons produced moderate to large effects. Whereas, small to moderate or even deteriorate effects were found in most of the intervention to maintenance and generalization comparisons. The findings in this review suggest that caregiver-delivered social-communication interventions are likely to result in mixed effects on skill generalization and maintenance within children with autism spectrum disorders. Implications for future research and practice are discussed. Copyright

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

    Science.gov (United States)

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

    2018-01-01

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

  16. Development, Theoretical Framework, and Outcome Evaluation from Implementation of a Parent and Teacher-Delivered Adolescent Intervention on Adolescent Vaccination

    Science.gov (United States)

    Gargano, Lisa M.; Herbert, Natasha L.; Painter, Julia E.; Sales, Jessica M.; Vogt, Tara M.; Morfaw, Christopher; Jones, LaDawna M.; Murray, Dennis; DiClemente, Ralph J.; Hughes, James M.

    2017-01-01

    The Advisory Committee on Immunization Practices recommended immunization schedule for adolescents includes three vaccines (Tdap, HPV, and MCV4) and annual influenza vaccination. Given the increasing number of recommended vaccines for adolescents and health and economic costs associated with non-vaccination, it is imperative that effective strategies for increasing vaccination rates among adolescents be developed. This article describes the development, theoretical framework, and initial first-year evaluation of an intervention designed to promote vaccine acceptance among a middle- and high-school based sample of adolescents and their parents in eastern Georgia. Adolescents, parents, and teachers were active participants in the development of the intervention. The intervention, which consisted of a brochure for parents and a teacher-delivered curriculum for adolescents, was guided by constructs from the Health Belief Model and Theory of Reasoned Action. Evaluation results indicated that our intervention development methods were successful in creating a brochure that met cultural relevance and literacy needs of parents. We also demonstrated an increase in student knowledge of and attitudes toward vaccines. To our knowledge, this study is the first to extensively engage middle- and high-school students, parents, and teachers in the design and implementation of key theory-based educational components of a school-based, teacher-delivered adolescent vaccination intervention. PMID:24440920

  17. The IDEFICS intervention trial to prevent childhood obesity: design and study methods.

    Science.gov (United States)

    Pigeot, I; Baranowski, T; De Henauw, S

    2015-12-01

    One of the major research dimensions of the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study involved the development, implementation and evaluation of a setting-based community-oriented intervention programme for primary prevention of childhood obesity. In this supplement of Obesity Reviews, a compilation of key results of the IDEFICS intervention is packaged in a series of complementary papers. This paper describes the overall design and methods of the IDEFICS intervention in order to facilitate a comprehensive reading of the supplement. In addition, some 'best practice' examples are described. The IDEFICS intervention trial was conducted to assess whether the IDEFICS intervention prevented obesity in young children aged 2 to 9.9 years. The study was a non-randomized, quasi-experimental trial with one intervention matched to one control region in each of eight participating countries. The intervention was designed following the intervention mapping framework, using a socio-ecological theoretical approach. The intervention was designed to address several key obesity-related behaviours in children, parents, schools and community actors; the primary outcome was the prevalence of overweight/obesity according to the IOTF criteria based on body mass index. The aim was to achieve a reduction of overweight/obesity prevalence in the intervention regions. The intervention was delivered in school and community settings over a 2-year period. Data were collected in the intervention and control cohort regions at baseline and 2 years later. This paper offers an introductory framework for a comprehensive reading of this supplement on IDEFICS intervention key results. © 2015 World Obesity.

  18. Parents and prevention: a systematic review of interventions involving parents that aim to prevent body dissatisfaction or eating disorders.

    Science.gov (United States)

    Hart, Laura M; Cornell, Chelsea; Damiano, Stephanie R; Paxton, Susan J

    2015-03-01

    To systematically review the literature on interventions involving parents that aim to prevent body dissatisfaction or eating disorders in children, and provide directions for future research by highlighting current gaps. The literature was searched for articles using key concepts: parents, prevention and eating disorders or disordered eating or body dissatisfaction. All English language publications between 1992 and 2013 were searched across a range of academic databases. Studies were reviewed if they: (i) delivered an intervention designed to reduce eating disorders or body dissatisfaction or their risk factors, in children or adolescents; (ii) provided some intervention component for parents; and (iii) included some outcome measure of intervention effectiveness on disordered eating or body dissatisfaction. A scoring matrix based on the Critical Appraisal Skills Program (CASP) screening questions was used to assess each study's sample representativeness, relevance and data quality. From 647 novel records uncovered by the search, 20 separate studies met inclusion criteria. The CASP scoring matrix revealed eight studies provided no relevant data, four relevant and eight highly relevant data on the effects of involving parents in prevention programs. Two of four high-quality studies reported that parental involvement significantly improved child outcomes on measures of body dissatisfaction or disordered eating. Although a greater focus on engaging and retaining parents is needed, this review demonstrates that a small number of prevention studies with parents have led to significant reductions in risk of body image and eating problems, and future research is indicated. © 2014 Wiley Periodicals, Inc.

  19. Delivering vaccines for the prevention of pneumonia - programmatic and financial issues

    Directory of Open Access Journals (Sweden)

    Diana C Otczyk

    2013-01-01

    Full Text Available Pneumonia is the leading cause of morbidity and mortality in children younger than 5 years. Vaccines are available against the main bacterial pathogens Haemophilus influenzae type b and Streptococcus pneumoniae. There are also vaccines against measles and pertussis; diseases that can predispose a child to pneumonia. Partners such as the Global Alliance for Vaccines and Immunisation (GAVI, the Hib Initiative, the Accelerated Development and Introduction Plan for pneumococcal vaccines and the Measles Initiative, have accelerated the introduction of vaccines into developing countries. Whilst significant improvements in vaccine coverage have occurred globally over the past decade, there still remains an urgent need to scale-up key pneumonia protection and treatment interventions as identified in the Global Action Plan for the Prevention and Control of Pneumonia (GAPP. There is promise that global immunisation will continue to improve child survival. However, there are several challenges to vaccine implementation that must first be addressed, including: a lack of access to under-served and marginalised populations; inadequate planning and management; a lack of political commitment; weak monitoring and surveillance programmes and assured sustainable finance and supply of quality vaccines. There is an urgent need to increase global awareness of the devastation that pneumonia brings to the worlds poorest communities.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Computer-Delivered and Web-Based Interventions to Improve Depression, Anxiety, and Psychological Well-Being of University Students: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Morriss, Richard; Glazebrook, Cris

    2014-01-01

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

  2. A music-based HIV prevention intervention for urban adolescents.

    Science.gov (United States)

    Lemieux, Anthony F; Fisher, Jeffrey D; Pratto, Felicia

    2008-05-01

    This research examines the process of conducting and evaluating a music-based HIV prevention intervention among urban adolescents, and is informed by the information, motivation, behavioral skills (IMB) model. Musically talented opinion leaders were recruited to write, record, and distribute HIV prevention themed music to their peers to increase HIV prevention motivation, behavioral skills, and behaviors. In this 3-month field experiment, participants were 306 students enrolled in health classes at each of three large multiracial urban high schools (one treatment school; two control schools). Measures of HIV prevention information, motivation, behavioral skills, and behaviors, both pre- and postintervention. Results indicate that the intervention influenced several aspects of HIV prevention motivation, behavioral skills, and condom use and HIV testing behaviors. This research demonstrates that the incorporation of music into HIV prevention interventions for adolescents has the potential to be effective.

  3. TEACHERS’ PERCEPTIONS OF ANTI-BULLYING INTERVENTIONS AND THE TYPES OF BULLYING EACH INTERVENTION PREVENTS

    OpenAIRE

    EMMA ELISE ROBERTS

    2011-01-01

    Teachers have a central role in the management and prevention of bullying within schools and are in turn involved in the implementation of anti-bullying interventions (Kochenderfer-Ladd & Pelletier, 2008). Therefore an assessment of teachers’ attitudes towards bullying interventions is needed to determine how helpful they perceived interventions to be. This study investigated teachers’ attitudes towards anti-bullying interventions and the types of bullying they perceived the interventions wou...

  4. The Effect of Technology-Mediated Diabetes Prevention Interventions on Weight: A Meta-Analysis.

    Science.gov (United States)

    Bian, Rachel R; Piatt, Gretchen A; Sen, Ananda; Plegue, Melissa A; De Michele, Mariana L; Hafez, Dina; Czuhajewski, Christina M; Buis, Lorraine R; Kaufman, Neal; Richardson, Caroline R

    2017-03-27

    Lifestyle interventions targeting weight loss, such as those delivered through the Diabetes Prevention Program, reduce the risk of developing type 2 diabetes. Technology-mediated interventions may be an option to help overcome barriers to program delivery, and to disseminate diabetes prevention programs on a larger scale. We conducted a meta-analysis to evaluate the effect of such technology-mediated interventions on weight loss. In this meta-analysis, six databases were searched to identify studies reporting weight change that used technology to mediate diet and exercise interventions, and targeted individuals at high risk for developing type 2 diabetes. Studies published between January 1, 2002 and August 4, 2016 were included. The search identified 1196 citations. Of those, 15 studies met the inclusion criteria and evaluated 18 technology-mediated intervention arms delivered to a total of 2774 participants. Study duration ranged from 12 weeks to 2 years. A random-effects meta-analysis showed a pooled weight loss effect of 3.76 kilograms (95% CI 2.8-4.7; Ptechnology-mediated intervention method was most efficacious. Technology-mediated diabetes prevention programs can result in clinically significant amounts of weight loss, as well as improvements in glycaemia in patients with prediabetes. Due to their potential for large-scale implementation, these interventions will play an important role in the dissemination of diabetes prevention programs. ©Rachel R Bian, Gretchen A Piatt, Ananda Sen, Melissa A Plegue, Mariana L De Michele, Dina Hafez, Christina M Czuhajewski, Lorraine R Buis, Neal Kaufman, Caroline R Richardson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 27.03.2017.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-08-09

    The peer-led, social media-delivered intervention is an emerging method in sexual health promotion. However, no research has yet investigated its effectiveness as compared with other online channels or in an Asian population. The objective of this study is to compare a peer-led, social media-delivered, safer sex intervention with a sexual health website. Both conditions target Chinese college students in Hong Kong. A randomized controlled trial was conducted with a peer-led, safer sex Facebook group as the intervention and an existing online sexual health website as the control. The intervention materials were developed with peer input and followed the information-motivation-behavioral skills model; the intervention was moderated by peer educators. The participants filled out the online questionnaires before and after the 6-week intervention period. Outcome evaluations included safer sex attitudes, behavioral skills, and behaviors, while process evaluation focused on online experience, online-visiting frequency, and online engagement. The effect of online-visiting frequency and online engagement on outcome variables was investigated. Of 196 eligible participants-100 in the control group and 96 in the intervention group-who joined the study, 2 (1.0%) control participants joined the Facebook group and 24 of the remaining 194 participants (12.4%) were lost to follow-up. For the process evaluation, participants in the intervention group reported more satisfying online experiences (Pintervention group, but not in the control group. No significant between-group difference was found. After adjusting for demographic data, increased online-visiting frequency was associated with better contraceptive use behavioral intention (P=.05), better behavioral skills (P=.02), and more frequent condom use (P=.04). A peer-led, social media-delivered, safer sex intervention was found to be feasible and effective in improving attitudes toward condom use and behavioral skills, but was not

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

    Science.gov (United States)

    Sun, Wai Han; Wong, Carlos King Ho

    2017-01-01

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

  8. Information processing versus social cognitive mediators of weight loss in a podcast-delivered health intervention.

    Science.gov (United States)

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

    2014-04-01

    Podcasting is an emerging technology, and previous interventions have shown promising results using theory-based podcast for weight loss among overweight and obese individuals. This study investigated whether constructs of social cognitive theory and information processing theories (IPTs) mediate the effect of a podcast intervention on weight loss among overweight individuals. Data are from Pounds off Digitally, a study testing the efficacy of two weight loss podcast interventions (control podcast and theory-based podcast). Path models were constructed (n = 66). The IPTs, elaboration likelihood model, information control theory, and cognitive load theory mediated the effect of a theory-based podcast on weight loss. The intervention was significantly associated with all IPTs. Information control theory and cognitive load theory were related to elaboration, and elaboration was associated with weight loss. Social cognitive theory constructs did not mediate weight loss. Future podcast interventions grounded in theory may be effective in promoting weight loss.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Effectiveness of alcohol brief intervention delivered by community pharmacists: study protocol of a two-arm randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Dhital Ranjita

    2013-02-01

    Full Text Available Abstract Background There is strong evidence to support the effectiveness of Brief Intervention (BI in reducing alcohol consumption in primary healthcare. Methods and design This study is a two-arm randomised controlled trial to determine the effectiveness of BI delivered by community pharmacists in their pharmacies. Eligible and consenting participants (aged 18 years or older will be randomised in equal numbers to either a BI delivered by 17 community pharmacists or a non-intervention control condition. The intervention will be a brief motivational discussion to support a reduction in alcohol consumption and will take approximately 10 minutes to deliver. Participants randomised to the control arm will be given an alcohol information leaflet with no opportunity for discussion. Study pharmacists will be volunteers who respond to an invitation to participate, sent to all community pharmacists in the London borough of Hammersmith and Fulham. Participating pharmacists will receive 7 hours training on trial procedures and the delivery of BI. Pharmacy support staff will also receive training (4 hours on how to approach and inform pharmacy customers about the study, with formal trial recruitment undertaken by the pharmacist in a consultation room. At three month follow up, alcohol consumption and related problems will be assessed with the Alcohol Use Disorders Identification Test (AUDIT administered by telephone. Discussion The UK Department of Health’s stated aim is to involve community pharmacists in the delivery of BI to reduce alcohol harms. This will be the first RCT study to assess the effectiveness of BI delivered by community pharmacists. Given this policy context, it is pragmatic in design. Trial registration Current Controlled Trials ISRCTN95216873

  11. Lessons learned: feasibility and acceptability of a telehealth-delivered exercise intervention for rural-dwelling individuals with dementia and their caregivers.

    Science.gov (United States)

    Dal Bello-Haas, Vanina P M; O'Connell, Megan E; Morgan, Debra G; Crossley, Margaret

    2014-01-01

    Until dementias can be prevented or cured, interventions that maintain or maximize cognitive and functional abilities will remain critical healthcare and research priorities. Best practice guidelines suggest that individualized exercise programs may improve fitness, cognition, and function for people with mild to moderate dementia; however, few high quality exercise intervention trials exist for this population. Increasingly, telehealth is being used to improve the delivery and availability of healthcare services for individuals living in rural areas, including exercise. This article describes the feasibility of a telehealth-delivered exercise intervention for rural, community-dwelling individuals diagnosed with dementia and their caregivers. A mixed-methods two-phase exploratory approach was used. In phase 1, Rural and Remote Memory Clinic (RRMC; Saskatoon, Saskatchewan, Canada) patients and caregivers were surveyed about current exercise levels, perceptions about exercise, exercise preferences, and perceived barriers to exercise; community resources, acceptability of telehealth exercise interventions, and physical activity and exercise attitudes (Older Persons Attitudes Toward Physical Activity and Exercise Questionnaire). Data were analyzed using descriptive statistics and factors associated with willingness to participate in a telehealth exercise intervention were explored using hierarchical linear regression. In phase 2, acceptability, practicality, and implementation were examined. Two RRMC patient-caregiver dyads completed a 4-week exercise program delivered via telehealth. Observed engagement in the telehealth-based exercise intervention, using a revised version of the Menorah Park Engagement Scale (by Hearthstone Alzheimer Care), and attendance were monitored. Patient-caregiver dyads were interviewed at the end of the intervention phase and completed a telehealth and intervention satisfaction questionnaire. Interviews were thematically analyzed and

  12. A teacher-delivered intervention for adolescents exposed to ongoing and intense traumatic war-related stress: a quasi-randomized controlled study.

    Science.gov (United States)

    Berger, Rony; Gelkopf, Marc; Heineberg, Yotam

    2012-11-01

    For the past 8 years, the residents of Sderot-a town in southern Israel-have been exposed to ongoing and intense war-related threat due to daily rocket attacks and mortar shelling from the adjacent Gaza region. This study first evaluates the prevalence of posttraumatic symptomatology in a sample of seventh- and eighth-grade students, and then assesses the efficacy of a universal teacher-delivered skill-oriented and present-focused intervention in preventing and reducing adolescents' posttraumatic stress-related symptoms. In a quasi-randomized controlled trial, 154 seventh- and eighth-grade students with significant levels of war-related exposure were assigned to participate in either a manualized active 16-session intervention (Extended Enhancing Resiliency Amongst Students Experiencing Stress, ERASE-Stress) or a waiting-list control group. They were assessed using self-report measures before and after the intervention on posttraumatic stress-related symptoms, somatic complaints, functional impairment, and anxiety. At baseline, 43.5% were found to have a likely diagnosis of posttraumatic stress disorder. A month after the intervention ended, students in the active intervention showed statistically significant reduction on all outcome measures compared with those in the waiting-list control group. Extended ERASE-Stress-a universal teacher-delivered skill-oriented program not targeting traumatic memories and involving trained and supervised homeroom teachers-may help students suffering from significant war-related posttraumatic symptoms reduce their level of symptomatology and can serve as an important and effective component of a community mental health policy for communities affected by chronic trauma, such as war and terrorism. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. Intervention Costs From Communities Putting Prevention to Work

    Science.gov (United States)

    Khavjou, Olga A.; Bradley, Christina; Neuwahl, Simon; Hoerger, Thomas J.; Bellard, David; Cash, Amanda J.

    2016-01-01

    Introduction In 2010, the Centers for Disease Control and Prevention funded 50 communities to participate in the Communities Putting Prevention to Work (CPPW) program. CPPW supported community-based approaches to prevent or delay chronic disease and promote wellness by reducing tobacco use and obesity. We collected the direct costs of CPPW for the 44 communities funded through the American Recovery and Reinvestment Act (ARRA) and analyzed costs per person reached for all CPPW interventions and by intervention category. Methods From 2011 through 2013, we collected quarterly data on costs from the 44 CPPW ARRA-funded communities. We estimated CPPW program costs as spending on labor; consultants; materials, travel, and services; overhead activities; and partners plus the value of in-kind donations. We estimated communities’ costs per person reached for each intervention implemented and compared cost allocations across communities that focused on reducing tobacco use, or obesity, or both. Analyses were conducted in 2014; costs are reported in 2012 dollars. Results The largest share of CPPW total costs of $363 million supported interventions in communities that focused on obesity ($228 million). Average costs per person reached were less than $5 for 84% of tobacco-related interventions, 88% of nutrition interventions, and 89% of physical activity interventions. Costs per person reached were highest for social support and services interventions, almost $3 for tobacco‑use interventions and $1 for obesity prevention interventions. Conclusions CPPW cost estimates are useful for comparing intervention cost per person reached with health outcomes and for addressing how community health intervention costs vary by type of intervention and by community size. PMID:27468157

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

    Directory of Open Access Journals (Sweden)

    Kwok T

    2013-09-01

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

  15. Nutritional interventions for Alzheimer's prevention: a clinical precision medicine approach.

    Science.gov (United States)

    Schelke, Matthew W; Hackett, Katherine; Chen, Jaclyn L; Shih, Chiashin; Shum, Jessica; Montgomery, Mary E; Chiang, Gloria C; Berkowitz, Cara; Seifan, Alon; Krikorian, Robert; Isaacson, Richard Scott

    2016-03-01

    Alzheimer's disease (AD) is a major source of morbidity and mortality, with the disease burden expected to rise as the population ages. No disease-modifying agent is currently available, but recent research suggests that nutritional and lifestyle modifications can delay or prevent the onset of AD. However, preventive nutritional interventions are not universally applicable and depend on the clinical profile of the individual patient. This article reviews existing nutritional modalities for AD prevention that act through improvement of insulin resistance, correction of dyslipidemia, and reduction of oxidative stress, and discusses how they may be modified on the basis of individual biomarkers, genetics, and behavior. In addition, we report preliminary results of clinical application of these personalized interventions at the first AD prevention clinic in the United States. The use of these personalized interventions represents an important application of precision medicine techniques for the prevention of AD that can be adopted by clinicians across disciplines. © 2016 New York Academy of Sciences.

  16. Complex interventions for preventing diabetic foot ulceration

    NARCIS (Netherlands)

    Hoogeveen, Ruben C; Dorresteijn, Johannes A N; Kriegsman, Didi M W; Valk, Gerlof D.

    2015-01-01

    BACKGROUND: Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent.

  17. Pharmacological interventions for alcohol relapse prevention ...

    African Journals Online (AJOL)

    Alcohol dependence is a chronic, debilitating disorder that is an important public health problem worldwide. Combined psychological and pharmacological treatment packages produce best outcomes in its management. In this paper we discuss the three NICE – approved relapse prevention medications used in treatment of ...

  18. Screening and Brief Interventions: Research Update. Prevention Update

    Science.gov (United States)

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    Developed in 1993 at the University of Washington, Brief Alcohol Screening and Intervention for College Students (BASICS) is a preventive intervention program to reduce drinking and enhance awareness about alcohol-related issues. BASICS targets college students who are considered at risk because of heavy drinking behaviors. The brief intervention…

  19. 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

  20. School-Based Obesity Prevention Intervention in Chilean Children: Effective in Controlling, but not Reducing Obesity

    Directory of Open Access Journals (Sweden)

    Juliana Kain

    2014-01-01

    Full Text Available Objective. To evaluate the effectiveness of a 12-month multicomponent obesity prevention intervention. Setting. 9 elementary schools in Santiago, Chile. Subjects. 6–8 y old low-income children (N=1474. Design. Randomized controlled study; 5 intervention/4 control schools. We trained teachers to deliver nutrition contents and improve the quality of PE classes. We determined % healthy snacks brought from home, children’s nutrition knowledge, nutritional status, duration of PE classes, and % time in moderate/vigorous activity (MVA. Effectiveness was determined by comparing Δ BMI Z between intervention and control children using PROCMIXED. Results. % obesity increased in boys from both types of schools and in girls from control schools, while decreasing in girls from intervention schools (all nonsignificant. % class time in MVA declined (24.5–16.2 while remaining unchanged (24.8–23.7% in classes conducted by untrained and trained teachers, respectively. In boys, BMI Z declined (1.33–1.24 and increased (1.22–1.35 in intervention and control schools, respectively. In girls, BMI Z remained unchanged in intervention schools, while increasing significantly in control schools (0.91–1.06, P=0.024. Interaction group * time was significant for boys (P<0.0001 and girls (P=0.004. Conclusions. This intervention was effective in controlling obesity, but not preventing it. Even though impact was small, results showed that when no intervention is implemented, obesity increases.

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

    Science.gov (United States)

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

    2017-07-26

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

  2. Interventions to improve water quality for preventing diarrhoea

    Science.gov (United States)

    Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy

    2015-01-01

    Background Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces. In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home. Objectives To assess the effectiveness of interventions to improve water quality for preventing diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014. Selection criteria Randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach. Main results Forty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with

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

    Science.gov (United States)

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

    2018-04-16

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

  4. Using online interventions to deliver college student mental health resources: Evidence from randomized clinical trials.

    Science.gov (United States)

    Nguyen-Feng, Viann N; Greer, Christiaan S; Frazier, Patricia

    2017-11-01

    This study evaluated the efficacy of Internet-based stress management programs for college students. This approach is particularly fitting for students owing to a lack of mental health resources on campus and to high levels of Internet use among students. Because a history of interpersonal trauma (IPT) is associated with more distress and poorer academic performance, IPT history was assessed as a moderator of intervention efficacy. Students (N = 365) were randomly assigned to a mindfulness plus present control intervention, a mindfulness only intervention, or a stress management information condition that served as an active comparison. Prior research has supported the efficacy of the mindfulness plus present control intervention (Nguyen-Feng et al., 2015). Outcome measures were self-report measures of stress, anxiety, depression, and perceived stress completed online at preintervention, postintervention, and 2 follow-ups (2-3 weeks and 4-5 weeks postintervention). Linear mixed modeling was used to assess change over time. Participants in all 3 groups reported significant decreases on all primary outcomes. All time-by-intervention group interaction effects were nonsignificant, suggesting that the 3 conditions were equally effective. When examining IPT history as a moderator, the mindfulness plus present control and stress management conditions were both more effective for IPT survivors than the mindfulness only intervention. Results suggested that Internet-based interventions are effective for lowering distress among college students and that specific approaches may be differentially effective for certain subgroups of students. They also suggested that providing students with stress management information without providing training in 1 specific skill may also be helpful. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Narrative Means to Preventative Ends: A Narrative Engagement Framework for Designing Prevention Interventions

    Science.gov (United States)

    Miller-Day, Michelle; Hecht, Michael L.

    2013-01-01

    This paper describes a Narrative Engagement Framework (NEF) for guiding communication-based prevention efforts. This framework suggests that personal narratives have distinctive capabilities in prevention. The paper discusses the concept of narrative, links narrative to prevention, and discusses the central role of youth in developing narrative interventions. As illustration, the authors describe how the NEF is applied in the keepin’ it REAL adolescent drug prevention curriculum, pose theoretical directions, and offer suggestions for future work in prevention communication. PMID:23980613

  6. THE EARLY VIOLENCE PREVENTION: REVISION OF PROGRAMS AND INTERVENTION MODALITIES

    Directory of Open Access Journals (Sweden)

    JUANITA HENAO ESCOBAR

    2005-07-01

    Full Text Available The article presents a review of different kinds of international early violence prevention-intervention programs,which have shown effectiveness in the reduction of preschooler’s aggression, and in some cases, in the prevention ofviolent behavior during adolescence and youth. The central matter of this article is what we can learn from theexperiences on this field of knowledge around the world. First, the target intervention problem is presented andframed in the colombian context. After presenting the main research findings about aggressive behavior in childrenand the risk factors associated with it, the related intervention modalities will be analyzed and described. Finally, thearticle derives some pragmatic conclusions and recommendations.

  7. International school-based interventions for preventing obesity in children.

    Science.gov (United States)

    Sharma, M

    2007-03-01

    The purpose of this article was to review international (excluding the United States) school-based interventions for preventing obesity in children published between 1999 and 2005. A total of 21 such interventions were found from Australia (1), Austria (1), Canada (1), Chile (1), France (1), Germany (3), Greece (1), New Zealand (1), Norway (1), Singapore (1) and the United Kingdom (9). The grade range of these interventions was from pre-school to high school with the majority (17) from elementary schools. Nine of these interventions targeted nutrition behaviours followed by seven aiming to modify both physical activity and nutrition behaviours. Only five interventions in international settings were based on any explicit behavioural theory which is different than the interventions developed in the United States. Majority of the interventions (9) were one academic year long. It can be speculated that if the interventions are behavioural theory-based, then the intervention length can be shortened. All interventions that documented parental involvement successfully influenced obesity indices. Most interventions (16) focused on individual-level behaviour change approaches. Most published interventions (16) used experimental designs with at least 1-year follow-up. Recommendations from international settings for enhancing the effectiveness of school-based childhood obesity interventions are presented.

  8. Impact of Mano a Mano Mujer, an HIV Prevention Intervention, on Depressive Symptoms among Chilean Women

    Science.gov (United States)

    Cianelli, Rosina; Lara, Loreto; Villegas, Natalia; Bernales, Margarita; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda

    2012-01-01

    Background Worldwide, an in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low income Chilean women. Depressed people are less willing to participate in behaviors that protect them against HIV. Objectives To analyze the impact of Mano a Mano-Mujer (MM-M) on depressive symptoms among Chilean women. Methods A quasi-experimental design was used to test the impact of MM-M, an HIV prevention intervention. The research was conducted in Santiago- Chile, a total of 400 women participated in the study (intervention group, n = 182; control group, n = 218). The intervention was guided by the social-cognitive model and the primary health model. The intervention consists of six two-hour sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face to face interviews were conducted at baseline and at 3 months follow-up Results At 3 months post-intervention, Chilean women who participated in MM-M significantly decreased their reported depressive symptoms. Conclusions MM-M provided significant benefits for women's depression symptoms. This study offers a model that address depression, a risk factor for HIV. It uses nurses as leaders for the screening of depressive symptoms and as facilitators of community interventions. PMID:22452388

  9. Cardiac rehabilitation: an effective secondary prevention intervention.

    Science.gov (United States)

    Milligan, Fiona

    A combination of quantitative and qualitative research was used to determine the effectiveness of a cardiac rehabilitation (CR) programme in a cohort of patients referred to the service at a London hospital. Quantitative data analysis provided evidence of effectiveness of participation in CR in reduced hospital readmission rates and use of recognised pharmacological management strategies. Self-reported physical activity levels and quality of life (QOL) in individuals who participated in the cardiac rehabilitation programme were qualitatively measured with questionnaires. Results provided evidence of benefit in continued participation in exercise. However, there was no evidence of benefit to QOL status post participation at 1 year. A p-value of 0.001 provided significant statistical evidence supporting the hypothesis of benefit in continued participation in exercise in participants following attendance at a cardiac rehabilitation programme. QOL status; a statistically significant p-value of 0.001 rejected the hypothesis (H1) of benefit. This would imply that participation CR programmes does not appear to provide sustained benefits in QOL. A number of moderating variables were suggested as explaining the finding such as homogeneity of respondents, age, mood bias and the timeframe of 1 year between participation in rehabilitation and self-reporting. CR appears to be an effective but time-limited intervention in relation to improvements in QOL. Collaborative working partnerships between specialist interventions, such as CR with chronic disease management strategies may provide greater sustainability of benefits gained from participation in cardiac rehabilitation programmes.

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

    Science.gov (United States)

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

    2014-02-01

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

  11. Burnout and Doctors: Prevalence, Prevention and Intervention

    Directory of Open Access Journals (Sweden)

    Shailesh Kumar

    2016-06-01

    Full Text Available Doctors are exposed to high levels of stress in the course of their profession and are particularly susceptible to experiencing burnout. Burnout has far-reaching implications on doctors; patients and the healthcare system. Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide. Sources of stress in medical practice may range from the emotions arising in the context of patient care to the environment in which doctors practice. The extent of burnout may vary depending on the practice setting; speciality and changing work environment. Understanding dynamic risk factors associated with burnout may help us develop strategies for preventing and treating burnout. Some of these strategies will be reviewed in this paper.

  12. Burnout and Doctors: Prevalence, Prevention and Intervention.

    Science.gov (United States)

    Kumar, Shailesh

    2016-06-30

    Doctors are exposed to high levels of stress in the course of their profession and are particularly susceptible to experiencing burnout. Burnout has far-reaching implications on doctors; patients and the healthcare system. Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide. Sources of stress in medical practice may range from the emotions arising in the context of patient care to the environment in which doctors practice. The extent of burnout may vary depending on the practice setting; speciality and changing work environment. Understanding dynamic risk factors associated with burnout may help us develop strategies for preventing and treating burnout. Some of these strategies will be reviewed in this paper.

  13. Preventive care delivered within Public Dental Service after caries risk assessment of young adults.

    Science.gov (United States)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-08-01

    To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative score was constructed and dichotomized to 'basic prevention' and 'additional prevention'. More additional preventive care was provided to the patients in the 'low-risk' and 'some risk' categories than to those classified as 'high' or 'very high' risk (OR = 2.0, 95% CI 1.4-3.0; P risk' and 'some risk' categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the 'very high-risk' group. The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. A Pilot Telerehabilitation Program: Delivering Early Intervention Services to Rural Families

    OpenAIRE

    Cason, Jana

    2009-01-01

    The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/str...

  15. First adaptation of coping power program as a classroom-based prevention intervention on aggressive behaviors among elementary school children.

    Science.gov (United States)

    Muratori, Pietro; Bertacchi, Iacopo; Giuli, Consuelo; Lombardi, Lavinia; Bonetti, Silvia; Nocentini, Annalaura; Manfredi, Azzurra; Polidori, Lisa; Ruglioni, Laura; Milone, Annarita; Lochman, John E

    2015-04-01

    Children with high levels of aggressive behavior create a major management problem in school settings and interfere with the learning environment of their classmates. We report results from a group-randomized trial of a program aimed at preventing aggressive behaviors. The purpose of the current study, therefore, was to determine the extent to which an indicated prevention program, Coping Power Program, is capable of reducing behavioral problems and improving pro-social behavior when delivered as a universal classroom-based prevention intervention. Nine classes (five first grade and four second grade) were randomly assigned to intervention or control conditions. Findings showed a significant reduction in overall problematic behaviors and in inattention-hyperactivity problems for the intervention classes compared to the control classes. Students who received Coping Power Program intervention also showed more pro-social behaviors at postintervention. The implications of these findings for the implementation of strategies aimed at preventing aggressive behavior in school settings are discussed.

  16. Delivery and impact of household waste prevention intervention campaigns (at the local level).

    Science.gov (United States)

    Sharp, Veronica; Giorgi, Sara; Wilson, David C

    2010-03-01

    This paper presents one strand of the findings from a comprehensive synthesis review of policy-relevant evidence on household waste prevention. Understanding what is achievable in terms of local household waste prevention intervention campaigns enables policy makers, local authorities and practitioners to identify optimum approaches to deliver effective behaviour change. The results of the evidence have been assembled and are discussed in two contexts: (1) the delivery of intervention campaigns as a package of measures used to 'enable', 'engage' and 'encourage' householders to change their behaviour; and (2) the impact of local household waste prevention intervention campaigns in terms of tonnage data. Waste prevention measures adopted include home composting, reducing food waste, smart shopping, donating items for reuse, small changes in the home, reducing junk mail and using cloth/reusable nappies. In terms of diverting biodegradable municipal waste from landfill, the biggest impacts can be attributed to food waste prevention (1.5 kg household(- 1) week(-1)) and home composting (2.9 kg household( -1) week(-1)). Projects providing a package of other waste prevention interventions have shown a very wide range of impacts: a broad indication is that such a package could achieve around 0.5 to 1 kg household(-1) week(- 1) reduction at source. Disaggregating which waste prevention measures influenced uptake is generally not possible, but the evidence suggests that this does not matter: behaviour change has been supported by integrating a range of intervention tools and campaign promotions which have made a collective rather than isolated difference: it is a collection and an accumulation of measures that will have impact.

  17. Mental health and quality of life benefits of a pedometer-based walking intervention delivered in a primary care setting

    Directory of Open Access Journals (Sweden)

    Tomas Vetrovsky

    2017-10-01

    Full Text Available Background: Physical activity level is positively associated with mental health and health-related quality of life. Primary care providers are ideally situated to offer physical activity interventions, and pedometers are commonly used as motivational tools to increase walking. However, several recent trials of pedometer-based interventions in primary care settings neither improved patients' quality of life nor reduced anxiety or depression, but these interventions only had relatively modest effects on physical activity levels. Objective: Our aim was to assess whether a pedometer-based walking intervention delivered in a primary care setting affects anxiety, depression, and health-related quality of life. Methods: A quasi-experimental, pre-post, single group study was conducted in 23 physically inactive patients from four general practices who participated in a pedometer-based intervention. The patients were administered the Hospital Anxiety and Depression Scale (HADS and MOS 36-Item Short-Form Health Survey (SF-36 questionnaires before and after the 3-month intervention. Results: Following the intervention, the patients increased their walking volume by 1,676 steps per day (p < .001. Both the anxiety (-1.4, p = .011 and depression (-2.4, p = .001 subscales of HADS decreased, while the physical functioning (+6, p = .023, social functioning (+9, p = .035, mental health (+12, p = .001, vitality (+12, p = .003, and general health (+7, p = .013 subscales of SF-36 increased. Conclusions: Providing physically inactive patients with a pedometer and encouraging them to walk more in a primary care setting was associated with lower anxiety and depression scores, and improved health-related quality of life.

  18. Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis.

    Science.gov (United States)

    Booth, Helen P; Prevost, Toby A; Wright, Alison J; Gulliford, Martin C

    2014-12-01

    Overweight and obesity have negative health effects. Primary care clinicians are best placed to intervene in weight management. Previous reviews of weight loss interventions have included studies from specialist settings. The aim of this review was to estimate the effect of behavioural interventions delivered in primary care on body weight in overweight and obese adults. The review included randomized controlled trials (RCTs) of behavioural interventions in obese or overweight adult participants in a primary care setting, with weight loss as the primary outcome, and a minimum of 12 months of follow-up. A systematic search strategy was implemented in Medline, Embase, Web of Science and the Cochrane Central Registry of Controlled Trials. Risk of bias was assessed using the Cochrane Risk of Bias tool and behavioural science components of interventions were evaluated. Data relating to weight loss in kilograms were extracted, and the results combined using meta-analysis. Fifteen RCTs, with 4539 participants randomized, were selected for inclusion. The studies were heterogeneous with respect to inclusion criteria and type of intervention. Few studies reported interventions informed by behavioural science theory. Pooled results from meta-analysis indicated a mean weight loss of -1.36 kg (-2.10 to -0.63, P < 0.0001) at 12 months, and -1.23 kg (-2.28 to -0.18, P = 0.002) at 24 months. Behavioural weight loss interventions in primary care yield very small reductions in body weight, which are unlikely to be clinically significant. More effective management strategies are needed for the treatment of overweight and obesity. © The Author 2014. Published by Oxford University Press.

  19. A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Brazil: Study Protocol for a Randomized Trial.

    Science.gov (United States)

    Xavier, Luiz Eduardo De Freitas; Bernardes-Souza, Breno; Lisboa, Oscar Campos; Seeger, Werner; Groneberg, David Alexander; Tran, Thien-An; Fries, Fabian Norbert; Corrêa, Paulo César Rodrigues Pinto; Brinker, Titus Josef

    2017-01-30

    Smoking is the largest preventable cause of morbidity and mortality in Brazil. Education Against Tobacco (EAT) is a large network of medical students in 13 countries who volunteer for school-based prevention in the classroom setting. A recent quasi-experimental EAT study conducted in Germany showed significant short-term smoking cessation effects on 11- to 15-year-old adolescents. The aim of this study is both to describe and to provide the first randomized long-term evaluation of the EAT intervention involving a photoaging app for its effectiveness to reduce the smoking prevalence among 12- to 17-year-old pupils in Brazilian public schools. A randomized controlled trial will be conducted among approximately 1500 adolescents aged 12 to 17 years in grades 7-11 of public secondary schools in Brazil. The prospective experimental study design includes measurements at baseline and at 6 and 12 months postintervention. The study groups will consist of randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes within the same schools (no intervention). The questionnaire measures smoking status, gender, social, and cultural aspects as well as predictors of smoking. Biochemical validation of smoking status is conducted via random carbon monoxide measurements. The primary end point is the difference of the change in smoking prevalence in the intervention group versus the difference in the control group at 12 months of follow-up. The differences in smoking behavior (smoking onset, quitting) between the 2 groups as well as effects on the different genders will be studied as secondary outcomes. The recruitment of schools, participating adolescents, and medical students was conducted from August 2016 until January 2017. The planned period of data collection is February 2017 until June 2018. Data analysis will follow in July 2018 and data presentation/publication will follow shortly thereafter. This is the

  20. A Medical Student–Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Brazil: Study Protocol for a Randomized Trial

    Science.gov (United States)

    Xavier, Luiz Eduardo De Freitas; Bernardes-Souza, Breno; Lisboa, Oscar Campos; Seeger, Werner; Groneberg, David Alexander; Tran, Thien-An; Fries, Fabian Norbert; Corrêa, Paulo César Rodrigues Pinto

    2017-01-01

    Background Smoking is the largest preventable cause of morbidity and mortality in Brazil. Education Against Tobacco (EAT) is a large network of medical students in 13 countries who volunteer for school-based prevention in the classroom setting. A recent quasi-experimental EAT study conducted in Germany showed significant short-term smoking cessation effects on 11- to 15-year-old adolescents. Objective The aim of this study is both to describe and to provide the first randomized long-term evaluation of the EAT intervention involving a photoaging app for its effectiveness to reduce the smoking prevalence among 12- to 17-year-old pupils in Brazilian public schools. Methods A randomized controlled trial will be conducted among approximately 1500 adolescents aged 12 to 17 years in grades 7-11 of public secondary schools in Brazil. The prospective experimental study design includes measurements at baseline and at 6 and 12 months postintervention. The study groups will consist of randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes within the same schools (no intervention). The questionnaire measures smoking status, gender, social, and cultural aspects as well as predictors of smoking. Biochemical validation of smoking status is conducted via random carbon monoxide measurements. The primary end point is the difference of the change in smoking prevalence in the intervention group versus the difference in the control group at 12 months of follow-up. The differences in smoking behavior (smoking onset, quitting) between the 2 groups as well as effects on the different genders will be studied as secondary outcomes. Results The recruitment of schools, participating adolescents, and medical students was conducted from August 2016 until January 2017. The planned period of data collection is February 2017 until June 2018. Data analysis will follow in July 2018 and data presentation/publication will

  1. Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a multinational medical-student-delivered smoking prevention programme for secondary schools in Germany.

    Science.gov (United States)

    Brinker, Titus J; Stamm-Balderjahn, Sabine; Seeger, Werner; Klingelhöfer, Doris; Groneberg, David A

    2015-09-18

    To evaluate the multinational medical-student-delivered tobacco prevention programme for secondary schools for its effectiveness to reduce the smoking prevalence among adolescents aged 11-15 years in Germany at half year follow-up. We used a prospective quasi-experimental study design with measurements at baseline (t1) and 6 months postintervention (t2) to investigate an intervention in 8 German secondary schools. The participants were split into intervention and control classes in the same schools and grades. A total of 1474 eligible participants of both genders at the age of 11-15 years were involved within the survey for baseline assessment of which 1200 completed the questionnaire at 6-month follow-up (=longitudinal sample). The schools participated voluntarily. The inclusion criteria were age (10-15 years), grade (6-8) and school type (regular secondary schools). Two 60 min school-based modules delivered by medical students. The primary end point was the difference from t1 to t2 of the smoking prevalence in the control group versus the difference from t1 to t2 in the intervention group (difference of differences approach). The percentage of former smokers and new smokers in the two groups were studied as secondary outcome measures. In the control group, the percentage of students who claimed to be smokers doubled from 4.2% (t1) to 8.1% (t2), whereas it remained almost the same in the intervention group (7.1% (t1) to 7.4% (t2); p=0.01). The likelihood of quitting smoking was almost six times higher in the intervention group (total of 67 smokers at t1; 27 (4.6%) and 7 (1.1%) in the control group; OR 5.63; 95% CI 2.01 to 15.79; p<0.01). However, no primary preventive effect was found. We report a significant secondary preventive (smoking cessation) effect at 6-month follow-up. Long-term evaluation is planned. 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.

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

    Science.gov (United States)

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

    2014-04-01

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

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

    Science.gov (United States)

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

    2010-09-17

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

  4. Prevention and intervention trials for colorectal cancer.

    Science.gov (United States)

    Komiya, Masami; Fujii, Gen; Takahashi, Mami; Iigo, Masaaki; Mutoh, Michihiro

    2013-07-01

    There have been a number of candidates for chemopreventive agents from synthetic drugs and natural compounds suggested to prevent colorectal cancer. However, they have shown modest efficacy in humans. The reason for this could be partly explained by the use of inappropriate models in vitro and in vivo, and the limitation of chemoprevention trials. In Japan, there are no cancer chemopreventive medicines, and few cancer chemoprevention trials to date. In contrast, an increase in the prevalence of colorectal cancer in Japan has forced us to develop more efficient chemopreventive strategies. It is now a good time to review in detail the current status and future prospects for chemoprevention of colorectal cancer with respect to the future development of chemopreventive medicines, particularly using synthetic drugs and natural compounds in Asian populations. The role and mode of action of available synthetic drugs, mainly aspirin and metformin, are reviewed. In addition, the possible impact of natural compounds with anti-inflammatory/immunosuppressive properties, such as ω3 polyunsaturated fatty acid and lactoferrin, are also reviewed.

  5. HIV risk and preventive interventions in transgender women sex workers

    Science.gov (United States)

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  6. Predictors of dentists' behaviours in delivering prevention in primary dental care in England: using the theory of planned behaviour.

    Science.gov (United States)

    Yusuf, Huda; Kolliakou, Anna; Ntouva, Antiopi; Murphy, Marie; Newton, Tim; Tsakos, Georgios; Watt, Richard G

    2016-02-08

    To explore the factors predicting preventive behaviours among NHS dentists in Camden, Islington and Haringey in London, using constructs from the Theory of Planned Behaviour. A cross-sectional survey of NHS dentists working in North Central London was conducted. A self-completed questionnaire based on the theoretical framework of the Theory of Planned Behaviour was developed. It assessed dentists' attitudes, current preventive activities, subjective norms and perceived behavioural control in delivering preventive care. In model 1, logistic regression was conducted to assess the relationship between a range of preventive behaviours (diet, smoking and alcohol) and the three TPB constructs attitude, subjective norms and perceived behavioural control. Model 2 was adjusted for intention. Overall, 164 questionnaires were returned (response rate: 55.0%). Dentists' attitudes were important predictors of preventive behaviours among a sample of dentists in relation to asking and providing diet, alcohol and tobacco advice. A dentist was 3.73 times (95 % CI: 1.70, 8.18) more likely ask about a patient's diet, if they had a positive attitude towards prevention, when adjusted for age, sex and intention. A similar pattern emerged for alcohol advice (OR 2.35, 95 % CI 1.12, 4.96). Dentists who had a positive attitude were also 2.59 times more likely to provide smoking cessation advice. The findings of this study have demonstrated that dentists' attitudes are important predictors of preventive behaviours in relation to delivery of diet, smoking and alcohol advice.

  7. Experiences of doctors and nurses implementing nurse-delivered cardiovascular prevention in primary care: a qualitative study.

    Science.gov (United States)

    Voogdt-Pruis, Helene R; Beusmans, George H M I; Gorgels, Anton P M; van Ree, Jan W

    2011-08-01

    This paper reports on a study of the experiences of general practitioners and practice nurses implementing nurse-delivered cardiovascular prevention to high risk patients in primary care. Difficulties may arise when innovations are introduced into routine daily practice. Whether or not implementation is successful is determined by different factors related to caregivers, patients, type of innovation and context. A qualitative study nested in a randomized trial (2006-2008) to evaluate the effectiveness of nurse-delivered cardiovascular prevention. Six primary health care centres in the Netherlands (25 general practitioners, 6 practice nurses) participated in the trial. Interviews were held on two occasions: at 3 and at 18 months after commencement of consultation. The first occasion was a group interview with six practice nurses. The second consisted of semi-structured interviews with one general practitioner and one practice nurse from each centre. Main barriers to the implementation included: lack of knowledge about the guideline, attitudes towards treatment targets, lack of communication, insufficient coaching by doctors, content of life style advice. At the start of the consultation project, practice nurses expressed concern of losing nursing tasks. Other barriers were related to patients (lack of motivation), the guideline (target population) and organizational issues (insufficient patient recording and computer systems). Both general practitioners and practice nurses were positive about nurse-delivered cardiovascular prevention in primary care. Nurses could play an important role in successive removal of barriers to implementation of cardiovascular prevention. Mutual confidence between care providers in the healthcare team is necessary. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  8. Using synchronous distance-education technology to deliver a weight management intervention.

    Science.gov (United States)

    Dunn, Carolyn; Whetstone, Lauren MacKenzie; Kolasa, Kathryn M; Jayaratne, K S U; Thomas, Cathy; Aggarwal, Surabhi; Nordby, Kelly; Riley, Kenisha E M

    2014-01-01

    To compare the effectiveness of online delivery of a weight management program using synchronous (real-time), distance-education technology to in-person delivery. Synchronous, distance-education technology was used to conduct weekly sessions for participants with a live instructor. Program effectiveness was indicated by changes in weight, body mass index (BMI), waist circumference, and confidence in ability to eat healthy and be physically active. Online class participants (n = 398) had significantly greater reductions in BMI, weight, and waist circumference than in-person class participants (n = 1,313). Physical activity confidence increased more for in-person than online class participants. There was no difference for healthy eating confidence. This project demonstrates the feasibility of using synchronous distance-education technology to deliver a weight management program. Synchronous online delivery could be employed with no loss to improvements in BMI, weight, and waist circumference. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2013-08-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  11. An internet-delivered exercise intervention for workplace health promotion in overweight sedentary employees: a randomized trial.

    Science.gov (United States)

    Pressler, Axel; Knebel, Uta; Esch, Sebastian; Kölbl, Dominik; Esefeld, Katrin; Scherr, Johannes; Haller, Bernhard; Schmidt-Trucksäss, Arno; Krcmar, Helmut; Halle, Martin; Leimeister, Jan Marco

    2010-01-01

    To evaluate the effect of structured vs. non-structured internet-delivered exercise recommendations on aerobic exercise capacity and cardiovascular risk profile in overweight sedentary employees. 140 employees of an automobile company (11% female, median age 48 years (range 25-60), BMI 29.0 kg/m(2) (25.0-34.8)) were randomized in a 3:2 ratio to an intervention group receiving structured exercise schedules or a control group choosing workouts individually via an interactive website. The 12-week intervention took place in Munich, Germany, during summer 2008. Main outcome measure was performance at the lactate anaerobic threshold (P(AT)/kg) during ergometry. 77 participants completed the study. The intervention group (n=50) improved significantly in P(AT)/kg ((mean (SD)) 1.68 (0.31) vs. 1.81 (0.33) W/kg; p=0.002), VO(2)peak (3.21 (0.63) vs. 3.35 (0.74) L/min; p=0.04), and waist circumference (100.5 (7.9) vs. 98.0 (7.8) cm; p=0.001). The control group (n=27) improved significantly in P(AT)/kg (1.59 (0.38) vs. 1.80 (0.49); pvs. 98.3 (8.5) cm; plifestyle intervention strategies are, however, limited by high dropout rates. Copyright © 2010 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Nelson, Eve-Lynn; Patton, Susana

    2016-04-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

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

    Science.gov (United States)

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

    2015-07-13

    Online social networks offer considerable potential for delivery of socially influential health behavior change interventions. To determine the efficacy, engagement, and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app. A total of 110 adults with a mean age of 35.6 years (SD 12.4) were recruited online in teams of 3 to 8 friends. Teams were randomly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring, social elements, and pedometers ("Active Team" Facebook app; n=51 individuals, 12 teams) or a wait-listed control condition (n=59 individuals, 13 teams). Assessments were undertaken online at baseline, 8 weeks, and 20 weeks. The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity (MVPA). Secondary outcomes were weekly walking, vigorous physical activity time, moderate physical activity time, overall quality of life, and mental health quality of life. Analyses were undertaken using random-effects mixed modeling, accounting for potential clustering at the team level. Usage statistics were reported descriptively to determine engagement and feasibility. At the 8-week follow-up, the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group (P=.03), due primarily to increases in walking time (155 min/week increase relative to controls, Psocial networking physical activity intervention with pedometers can produce sizable short-term physical activity changes. Future work is needed to determine how to maintain behavior change in the longer term, how to reach at-need populations, and how to disseminate such interventions on a mass scale. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000488606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366239 (Archived by WebCite at http://www.webcitation.org/6

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

    Science.gov (United States)

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

    2015-01-01

    Background Online social networks offer considerable potential for delivery of socially influential health behavior change interventions. Objective To determine the efficacy, engagement, and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app. Methods A total of 110 adults with a mean age of 35.6 years (SD 12.4) were recruited online in teams of 3 to 8 friends. Teams were randomly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring, social elements, and pedometers (“Active Team” Facebook app; n=51 individuals, 12 teams) or a wait-listed control condition (n=59 individuals, 13 teams). Assessments were undertaken online at baseline, 8 weeks, and 20 weeks. The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity (MVPA). Secondary outcomes were weekly walking, vigorous physical activity time, moderate physical activity time, overall quality of life, and mental health quality of life. Analyses were undertaken using random-effects mixed modeling, accounting for potential clustering at the team level. Usage statistics were reported descriptively to determine engagement and feasibility. Results At the 8-week follow-up, the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group (P=.03), due primarily to increases in walking time (155 min/week increase relative to controls, Ponline, social networking physical activity intervention with pedometers can produce sizable short-term physical activity changes. Future work is needed to determine how to maintain behavior change in the longer term, how to reach at-need populations, and how to disseminate such interventions on a mass scale. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000488606; https://www

  16. How can we improve preventive and educational interventions for intimate relationships?

    Science.gov (United States)

    Bradbury, Thomas N; Lavner, Justin A

    2012-03-01

    Improving intimate relationships with preventive and educational interventions has proven to be more difficult than originally conceived, and earlier models and approaches may be reaching their limits. Basic concerns remain about the long-term effectiveness of these interventions, whether they are reaching and benefiting couples most likely to need them, and how they might be exerting their effects. We identify six problems that we believe are hindering progress in the field, and for each we outline research findings that point to new ways forward. These problems include (a) the incomplete understanding of couple communication and unwarranted translation of communication findings into interventions; (b) the surprising stability of relationship satisfaction; (c) the powerful roles that personal histories, personalities, and stress play in determining relationship outcomes; (d) the difficulties involved in recruiting and retaining high-risk couples in intervention programs; (e) the lack of attention given to specific stages of relationship development in interventions; and (f) the tendency to deliver preventive and educational interventions in the same format as therapies for distressed couples. We conclude by noting that a large body of basic research about intimate relationships, and large-scale outcome research with diverse populations, hold great promise for advancing the field. Copyright © 2011. Published by Elsevier Ltd.

  17. Interventions for preventing excessive weight gain during pregnancy

    Science.gov (United States)

    Muktabhant, Benja; Lumbiganon, Pisake; Ngamjarus, Chetta; Dowswell, Therese

    2014-01-01

    Background Excessive weight gain during pregnancy is associated with multiple maternal and neonatal complications. However, interventions to prevent excessive weight gain during pregnancy have not been adequately evaluated. Objectives To evaluate the effectiveness of interventions for preventing excessive weight gain during pregnancy and associated pregnancy complications. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (20 October 2011) and MEDLINE (1966 to 20 October 2011). Selection criteria All randomised controlled trials and quasi-randomised trials of interventions for preventing excessive weight gain during pregnancy. Data collection and analysis We assessed for inclusion all potential studies we identified as a result of the search strategy. At least two review authors independently assessed trial quality and extracted data. We resolved discrepancies through discussion. We have presented results using risk ratio (RR) for categorical data and mean difference for continuous data. We analysed data using a fixed-effect model. Main results We included 28 studies involving 3976 women; 27 of these studies with 3964 women contributed data to the analyses. Interventions focused on a broad range of interventions. However, for most outcomes we could not combine data in a meta-analysis, and where we did pool data, no more than two or three studies could be combined for a particular intervention and outcome. Overall, results from this review were mainly not statistically significant, and where there did appear to be differences between intervention and control groups, results were not consistent. For women in general clinic populations one (behavioural counselling versus standard care) of three interventions examined was associated with a reduction in the rate of excessive weight gain (RR 0.72, 95% confidence interval 0.54 to 0.95); for women in high-risk groups no intervention appeared to reduce excess weight gain. There were

  18. The Diabetes Prevention Program (DPP): Description of lifestyle intervention

    OpenAIRE

    2002-01-01

    The purpose of the present article is to provide a detailed description of the highly successful lifestyle intervention administered to 1,079 participants, which included 45% racial and ethnic minorities and resulted in a 58% reduction in the incidence rate of diabetes (2). The two major goals of the Diabetes Prevention Program (DPP) lifestyle intervention were a minimum of 7% weight loss/weight maintenance and a minimum of 150 min of physical activity similar in intensity to brisk walking. B...

  19. Interventions to improve water quality for preventing diarrhoea.

    Science.gov (United States)

    Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy

    2015-10-20

    Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces.In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home. To assess the effectiveness of interventions to improve water quality for preventing diarrhoea. We searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014. Randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults. Two review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach. Forty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with unimproved water sources (30 studies) and unimproved or unclear sanitation (34 studies). The primary

  20. Efficient interventions on suicide prevention: a literature review.

    Science.gov (United States)

    du Roscoät, E; Beck, F

    2013-08-01

    This review focuses on interventions to prevent suicide. It excludes psychotherapy evaluations and pharmaceutical clinical trials. The aim of this article is to provide useful input to the reflection on and the development of actions for professionals who may be concerned by suicide prevention. This research is based on 41 published evaluation studies presenting results on at least one of the three following outcomes: completed suicides, suicide attempts, and suicidal ideations. These studies have been classified into seven categories of preventive action. According to data from the literature selected for our analysis, the three most efficient categories of intervention seem to be the limitation of access to lethal means, the preservation of contact with the patients hospitalized for a suicide attempt after hospitalization, and the implementation of emergency call centers. The four other categories of intervention examined in this study - the training of general practitioners, the reorganization of care, programs in schools, and information campaigns - have not yet shown sufficient proof of their efficacy. Nevertheless, these interventions, under certain conditions, can also contribute significantly to the prevention of suicide. The majority of effective interventions minister to people already suffering from psychological disorders, but health promotion initiatives prior to situations of psychological disorders also deserve to be considered, in particular the implementation of services for the isolated elderly. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Prevention Interventions of Alcohol Problems in the Workplace

    Science.gov (United States)

    Ames, Genevieve M.; Bennett, Joel B.

    2011-01-01

    The workplace offers advantages as a setting for interventions that result in primary prevention of alcohol abuse. Such programs have the potential to reach broad audiences and populations that would otherwise not receive prevention programs and, thereby, benefit both the employee and employer. Researchers have implemented and evaluated a variety of workplace alcohol problem prevention efforts in recent years, including programs focused on health promotion, social health promotion, brief interventions, and changing the work environment. Although some studies reported significant reductions in alcohol use outcomes, additional research with a stronger and integrated methodological approach is needed. The field of workplace alcohol prevention also might benefit from a guiding framework, such as the one proposed in this article. PMID:22330216

  2. Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a programme for preventing smoking in secondary schools delivered by medical students: a study protocol.

    Science.gov (United States)

    Brinker, Titus J; Stamm-Balderjahn, Sabine; Seeger, Werner; Groneberg, David A

    2014-07-24

    A survey conducted by the German Federal Centre for Health Education in 2012 showed that 35.2% of all young adults (18-25 years) and 12.0% of all adolescents (12-17 years) in Germany are regular cigarette smokers. Most smoked their first cigarette in early adolescence. We recently reported a significantly positive short-term effect of a physician-delivered school-based smoking prevention programme on the smoking behaviour of schoolchildren in Germany. However, physician-based programmes are usually very expensive. Therefore, we will evaluate and optimise Education against Tobacco (EAT), a widespread, low-cost programme delivered by about 400 medical students from 16 universities in Germany. A prospective quasi-experimental study design with two measurements at baseline (t1) and 6 months post-intervention (t2) to investigate an intervention in 10-15-year-olds in grades 6-8 at German secondary schools. The intervention programme consists of two 60-min school-based medical-student-delivered modules with (module 1) and without the involvement of patients with tobacco-related diseases and control groups (no intervention). The study questionnaire measuring smoking status (water pipe and cigarette smoking), smoking-related cognitions, and gender, social and cultural aspects was designed and pre-tested in advance. The primary end point is the prevalence of smokers and non-smokers in the two study arms at 6 months after the intervention. The percentage of former smokers and new smokers in the two groups and the measures of smoking behaviour will be studied as secondary outcome measures. In accordance with Good Epidemiologic Practice (GEP) guidelines, the study protocol was submitted for approval by the responsible ethics committee, which decided that the study does not need ethical approval (Goethe University, Frankfurt-Main, Germany). Findings will be disseminated in peer-reviewed journals, at conferences, within our scientific advisory board and through medical

  3. Community-Based Intervention for Prevention of Dementia in Japan.

    Science.gov (United States)

    Suzuki, T; Makizako, H; Doi, T; Park, H; Lee, S; Tsutsumimoto, K; Umemura, K; Maki, Y; Shimada, H

    2015-01-01

    Population aging is accelerating, with prolonged life expectancy and a decrease in birth rate. As age is a significant risk factor for dementia, we are confronted with an ever-increasing prevalence of mild cognitive impairment (MCI)/dementia. Thus, the Japanese National Center for Geriatrics and Gerontology launched a project to promote community-based research, including the development of an effective screening system for high-risk groups and intervention for dementia prevention. This review introduces the project, the Obu Study of Health Promotion for the Elderly, with the following strategic triad: 1) Identification of the target population by population screening; we regarded patients with MCI as the target population, and developed a screening test battery to identify MCI in a population screening setting. 2) Scientific evaluation of community-based intervention; we developed an interventional method combining exercise and cognitive training ("cognicise"). In practical settings, "cognicise" is programmed into multicomponent exercise intervention, which was reported to have benefits of cognitive improvement and reduction of brain atrophy based on randomized controlled trials. 3) Standardization of the methods of population screening and community-based intervention for evidence-based policy making and widespread implementation. Dementia prevention, or at least delaying the onset of dementia and/or stopping/slowing the progression of dementia, should benefit the whole society as well as individuals. It is our continuing challenge to improve the screening system and community-based intervention for dementia prevention through accumulation of evidence.

  4. HIV prevention in Mexican schools: prospective randomised evaluation of intervention

    OpenAIRE

    Walker, Dilys; Gutierrez, Juan Pablo; Torres, Pilar; Bertozzi, Stefano M

    2006-01-01

    OBJECTIVE: To assess effects on condom use and other sexual behaviour of an HIV prevention programme at school that promotes the use of condoms with and without emergency contraception. DESIGN: Cluster randomised controlled trial. SETTING: 40 public high schools in the state of Morelos, Mexico. PARTICIPANTS: 10 954 first year high school students. INTERVENTION: Schools were randomised to one of three arms: an HIV prevention course that promoted condom use, the same course with emergency contr...

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

    Science.gov (United States)

    Gorski, Stanislaw; Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina; Grodzicki, Tomasz

    2017-01-01

    Purpose . Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods . Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy medicine ward.

  6. Challenges to delivering quality care in a prevention of mother-to ...

    African Journals Online (AJOL)

    There has been little focus on the quality of care provided in the prevention of mother-to-child transmission .... was staffed by a professional nurse – a 'PMTCT ..... Job satisfaction was low, mostly in terms remuneration. Moreover, several staff members expressed negative opinions about HIV-infected women having children.

  7. Challenges to delivering quality care in a prevention of mother-to ...

    African Journals Online (AJOL)

    Background. There has been little focus on the quality of care provided in the prevention of mother-to-child transmission (PMTCT) of HIV services in South Africa (SA). Objective. To assess the quality of care in PMTCT services in Soweto, SA, focusing on the knowledge and experiences of healthcare workers and ...

  8. RCT of a client-centred, caseworker-delivered smoking cessation intervention for a socially disadvantaged population

    Directory of Open Access Journals (Sweden)

    Girgis Afaf

    2011-01-01

    Full Text Available Abstract Background Disadvantaged groups are an important target for smoking cessation intervention. Smoking rates are markedly higher among severely socially disadvantaged groups such as indigenous people, the homeless, people with a mental illness or drug and alcohol addiction, and the unemployed than in the general population. This proposal aims to evaluate the efficacy of a client-centred, caseworker delivered cessation support intervention at increasing validated self reported smoking cessation rates in a socially disadvantaged population. Methods/Design A block randomised controlled trial will be conducted. The setting will be a non-government organisation, Community Care Centre located in New South Wales, Australia which provides emergency relief and counselling services to predominantly government income assistance recipients. Eligible clients identified as smokers during a baseline touch screen computer survey will be recruited and randomised by a trained research assistant located in the waiting area. Allocation to intervention or control groups will be determined by time periods with clients randomised in one-week blocks. Intervention group clients will receive an intensive client-centred smoking cessation intervention offered by the caseworker over two face-to-face and two telephone contacts. There will be two primary outcome measures obtained at one, six, and 12 month follow-up: 1 24-hour expired air CO validated self-reported smoking cessation and 2 7-day self-reported smoking cessation. Continuous abstinence will also be measured at six and 12 months follow up. Discussion This study will generate new knowledge in an area where the current information regarding the most effective smoking cessation approaches with disadvantaged groups is limited. Trial registration number ISRCTN: ISRCTN85202510

  9. RCT of a client-centred, caseworker-delivered smoking cessation intervention for a socially disadvantaged population.

    Science.gov (United States)

    Bonevski, Billie; Paul, Christine; D'Este, Catherine; Sanson-Fisher, Robert; West, Robert; Girgis, Afaf; Siahpush, Mohammad; Carter, Robert

    2011-01-31

    Disadvantaged groups are an important target for smoking cessation intervention. Smoking rates are markedly higher among severely socially disadvantaged groups such as indigenous people, the homeless, people with a mental illness or drug and alcohol addiction, and the unemployed than in the general population. This proposal aims to evaluate the efficacy of a client-centred, caseworker delivered cessation support intervention at increasing validated self reported smoking cessation rates in a socially disadvantaged population. A block randomised controlled trial will be conducted. The setting will be a non-government organisation, Community Care Centre located in New South Wales, Australia which provides emergency relief and counselling services to predominantly government income assistance recipients. Eligible clients identified as smokers during a baseline touch screen computer survey will be recruited and randomised by a trained research assistant located in the waiting area. Allocation to intervention or control groups will be determined by time periods with clients randomised in one-week blocks. Intervention group clients will receive an intensive client-centred smoking cessation intervention offered by the caseworker over two face-to-face and two telephone contacts. There will be two primary outcome measures obtained at one, six, and 12 month follow-up: 1) 24-hour expired air CO validated self-reported smoking cessation and 2) 7-day self-reported smoking cessation. Continuous abstinence will also be measured at six and 12 months follow up. This study will generate new knowledge in an area where the current information regarding the most effective smoking cessation approaches with disadvantaged groups is limited. ISRCTN: ISRCTN85202510.

  10. Impact and Acceptability of the Coach and Teacher Training within a School-Based Sport-for-Health Smoking Prevention Intervention: Smokefree Sports

    Science.gov (United States)

    Garnham-Lee, Katy; Trigwell, Joanne; McGee, Ciara E.; Knowles, Zoe; Foweather, Lawrence

    2016-01-01

    This study evaluated the impact and acceptability of a three-hour bespoke training workshop for sports coaches and teachers to subsequently deliver a sport-for-health smoking prevention intervention in primary schools. Questionnaires were completed pre- and post-training by both teachers (N = 24) and coaches (N = 8), and post-intervention by…

  11. Preventing drug use among sexual-minority youths: findings from a tailored, web-based intervention.

    Science.gov (United States)

    Schwinn, Traci Marie; Thom, Bridgette; Schinke, Steven Paul; Hopkins, Jessica

    2015-05-01

    Rates of drug use among sexual-minority youths are disproportionately high. Yet, expressly designed prevention programs targeting this population are absent. This study developed and tested a web-based drug abuse prevention program for sexual-minority youths. A sample (N = 236) of sexual-minority youths was recruited via Facebook. Online, all youths completed pretests; youths randomly assigned to the intervention received a 3-session prevention program; and all youths completed posttest and 3-month follow-up measurements. At 3-month follow-up and compared to youths in the control arm, intervention-arm youths reported less stress, reduced peer drug use, lower rates of past 30-day other drug use, and higher coping, problem solving, and drug-use refusal skills. Outcome data suggest the potential of tailored intervention content to address sexual-minority youths' drug use rates and related risk factors. Moreover, study procedures lend support to the feasibility of using the Internet to recruit sexual-minority youths, collect data, and deliver intervention. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  13. Interventions to prevent occupational noise-induced hearing loss

    NARCIS (Netherlands)

    Tikka, Christina; Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Ferrite, Silvia

    2017-01-01

    This is the second update of a Cochrane Review originally published in 2009. Millions of workers worldwide are exposed to noise levels that increase their risk of hearing disorders. There is uncertainty about the effectiveness of hearing loss prevention interventions. To assess the effectiveness of

  14. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  15. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological

  16. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2012-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  17. Prevention and Firesetting: Juvenile Justice and Intervention Strategies.

    Science.gov (United States)

    Slavkin, Michael L.

    2003-01-01

    Examines the literature on preventing firesetting behavior in preadolescents and adolescents, suggesting the need for policies and programs designed to help juveniles by providing community support and stability. Alternatives to juvenile justice interventions include making changes in the home environment, acquiring a greater sense of self, and…

  18. a descriptive study of outcomes of interventions to prevent mother

    African Journals Online (AJOL)

    Esem

    Conclusion: This study indicates that the Prevention of. Mother-to- Child Transmission of HIV treatment interventions in reducing transmission of HIV in infants and young children in two Lusaka urban clinics had been effective. Exclusive breastfeeding for 6 months, and use of triple therapy can reduce the transmission of HIV.

  19. A systematic review of psychosocial suicide prevention interventions for youth.

    NARCIS (Netherlands)

    Calear, A.L.; Christensen, H.; Freeman, A.; Fenton, K.; Grant, J.B.; van Spijker, B.; Donker, T.

    2016-01-01

    Youth suicide is a significant public health problem. A systematic review was conducted to examine the effectiveness of school, community and healthcare-based interventions in reducing and preventing suicidal ideation, suicide attempts and deliberate self-harm in young people aged 12–25 years.

  20. The Child Anxiety Prevention Study: intervention model and primary outcomes.

    Science.gov (United States)

    Ginsburg, Golda S

    2009-06-01

    The article presents the intervention model and primary outcomes of a preventive intervention designed to reduce anxiety symptoms and prevent the onset of anxiety disorders in the offspring of parents with anxiety disorders. Participants were 40 volunteer children (mean age = 8.94 years; 45% girls; 90% Caucasian) whose parents met criteria for a broad range of anxiety disorders. Families were randomly assigned to an 8-week cognitive-behavioral intervention, the Coping and Promoting Strength program (CAPS; n = 20) or a wait list control condition (WL; n = 20). Independent evaluators (IEs) conducted diagnostic interviews, and children and parents completed measures of anxiety symptoms. Assessments were conducted pre- and postintervention and 6 and 12 months after the postintervention assessment. On the basis of intent to treat analyses, 30% of the children in the WL group developed an anxiety disorder by the 1-year follow-up compared with 0% in the CAPS group. IE and parent-reported (but not child-reported) levels of anxiety showed significant decreases from the preintervention assessment to the 1-year follow-up assessment in the CAPS but not the WL group. Parental satisfaction with the intervention was high. Findings suggest that a family-based intervention may prevent the onset of anxiety disorders in the offspring of parents with anxiety disorders. Copyright 2009 APA

  1. Preventing Obesity Across Generations: Evidence for Early Life Intervention.

    Science.gov (United States)

    Haire-Joshu, Debra; Tabak, Rachel

    2016-01-01

    To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life.

  2. Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions.

    Science.gov (United States)

    Espelage, Dorothy L; Hong, Jun Sung

    2017-06-01

    Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents' use of social media, and online communication platforms have exposed adolescents to another mode of bullying- cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.

  3. Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions

    Science.gov (United States)

    Hong, Jun Sung

    2016-01-01

    Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents’ use of social media, and online communication platforms have exposed adolescents to another mode of bullying—cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided. PMID:28562094

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

    Science.gov (United States)

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

    2011-06-01

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

  5. Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial.

    Science.gov (United States)

    Larimer, Mary E; Neighbors, Clayton; Lostutter, Ty W; Whiteside, Ursula; Cronce, Jessica M; Kaysen, Debra; Walker, Denise D

    2012-06-01

    The purpose of the current study was to evaluate feasibility and efficacy of two promising approaches to indicated prevention of disordered gambling in a college population. Randomized clinical trial with assignment to a personalized feedback intervention (PFI), cognitive-behavioral intervention (CBI) or assessment-only control (AOC). PFI was delivered individually in a single session and included feedback regarding gambling behavior, norms, consequences and risk-reduction tips, delivered in a motivational interviewing style. CBI was delivered in small groups over four to six sessions and included functional analysis and brief cognitive correction, as well as identification of and alternatives for responding to gambling triggers. College campus. At-risk or probable pathological gamblers (n = 147; 65.3% male; group assignment: PFI, n = 52; CBI, n = 44; AOC, n = 51). Self-reported gambling quantity, frequency, consequences, psychopathology, normative perceptions and beliefs. Relative to control, results at 6-month follow-up indicated reductions in both interventions for gambling consequences (PFI d = 0.48; CBI d = 0.39) and DSM-IV criteria (PFI d = 0.60; CBI d = 0.48), reductions in frequency for PFI (d = 0.48). CBI was associated with reduced illusions of control, whereas PFI was associated with reduced perceptions of gambling frequency norms. Reductions in perceived gambling frequency norms mediated effects of PFI on gambling frequency. A single-session personalized feedback intervention and a multi-session cognitive-behavioral intervention may be helpful in reducing disordered gambling in US college students. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  6. A typology of practice narratives during the implementation of a preventive, community intervention trial.

    Science.gov (United States)

    Riley, Therese; Hawe, Penelope

    2009-12-14

    Traditional methods of process evaluation encompass what components were delivered, but rarely uncover how practitioners position themselves and act relative to an intervention being tested. This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness. We undertook a narrative analysis of in-depth, unstructured field diaries kept by nine community development practitioners for two years. The practitioners were responsible for implementing a multi-component, preventive, community-level intervention for mothers of new babies in eight communities, as part of a cluster randomised community intervention trial. We constructed a narrative typology of approaches to practice, drawing on the phenomenology of Alfred Schutz and Max Weber's Ideal Type theory. Five types of practice emerged, from a highly 'technology-based' type that was faithful to intervention specifications, through to a 'romantic' type that held relationships to be central to daily operations, with intact relationships being the final arbiter of intervention success. The five types also differed in terms of how others involved in the intervention were characterized, the narrative form (e.g., tragedy, satire) and where and how transformative change in communities was best created. This meant that different types traded-off or managed the priorities of the intervention differently, according to the deeply held values of their type. The data set constructed for this analysis is unique. It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern. The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions.

  7. A typology of practice narratives during the implementation of a preventive, community intervention trial

    Science.gov (United States)

    2009-01-01

    Background Traditional methods of process evaluation encompass what components were delivered, but rarely uncover how practitioners position themselves and act relative to an intervention being tested. This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness. Methods We undertook a narrative analysis of in-depth, unstructured field diaries kept by nine community development practitioners for two years. The practitioners were responsible for implementing a multi-component, preventive, community-level intervention for mothers of new babies in eight communities, as part of a cluster randomised community intervention trial. We constructed a narrative typology of approaches to practice, drawing on the phenomenology of Alfred Schutz and Max Weber's Ideal Type theory. Results Five types of practice emerged, from a highly 'technology-based' type that was faithful to intervention specifications, through to a 'romantic' type that held relationships to be central to daily operations, with intact relationships being the final arbiter of intervention success. The five types also differed in terms of how others involved in the intervention were characterized, the narrative form (e.g., tragedy, satire) and where and how transformative change in communities was best created. This meant that different types traded-off or managed the priorities of the intervention differently, according to the deeply held values of their type. Conclusions The data set constructed for this analysis is unique. It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern. The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions. PMID:20003399

  8. A Review of Technology-Assisted Interventions for Diabetes Prevention.

    Science.gov (United States)

    Grock, Shira; Ku, Jeong-Hee; Kim, Julie; Moin, Tannaz

    2017-09-23

    The high prevalence of prediabetes and success of the diabetes prevention program (DPP) has led to increasing efforts to provide readily accessible, cost-effective DPP interventions to the general public. Technology-assisted DPP interventions are of particular interest since they may be easier to widely distribute and sustain as compared to traditional in-person DPP. The purpose of this article is to provide an overview of currently available technology-assisted DPP interventions. This review focuses on studies that have examined the use of mobile phone text messaging, smartphone/web-based apps, and telehealth programs to help prevent or delay the onset of incident type 2 diabetes. While there is variability in the results of studies focused on technology-assisted DPP and weight loss interventions, there is evidence to suggest that these programs have been associated with clinically meaningful weight loss and can be cost-effective. Patients who are at risk for diabetes can be offered technology-assisted DPP and weight loss interventions to lower their risk of incident diabetes. Further research should determine what specific combination of intervention features would be most successful.

  9. Psychosocial preventive interventions for obesity and eating disorders in youths.

    Science.gov (United States)

    Tanofsky-Kraff, Marian

    2012-06-01

    Abstract The rates of paediatric obesity have risen dramatically. Given the challenge of successful weight loss and maintenance, preventive interventions are sorely needed. Furthermore, since a substantial proportion of individuals do not respond to traditional behavioural weight loss therapy, alternative approaches are required. Psychological treatments for binge eating disorder have been generally effective at reducing binge episodes and producing weight maintenance or modest weight loss in obese adults. Given the strong link between loss of control eating and obesity in youths, binge eating disorder treatment may serve as a viable form of excess weight gain prevention. An adapted version of interpersonal psychotherapy for binge eating disorder is one such intervention that we have considered. A description of the theoretical basis and proposed mechanism is described. Adaptations of interpersonal psychotherapy and other established therapies for binge eating disorder may serve as platforms from which to develop and disseminate obesity and eating disorder prevention programs in children and adolescents.

  10. Preventing malaria in pregnancy through community-directed interventions: evidence from Akwa Ibom State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ishola Gbenga

    2011-08-01

    Full Text Available Abstract Background Despite massive anti-malaria campaigns across the subcontinent, effective access to intermittent preventive treatment (IPTp and insecticide-treated nets (ITNs among pregnant women remain low in large parts of sub-Saharan Africa. The slow uptake of malaria prevention products appears to reflect lack of knowledge and resistance to behavioural change, as well as poor access to resources, and limited support of programmes by local communities and authorities. Methods A recent community-based programme in Akwa Ibom State, Nigeria, is analysed to determine the degree to which community-directed interventions can improve access to malaria prevention in pregnancy. Six local government areas in Southern Nigeria were selected for a malaria in pregnancy prevention intervention. Three of these local government areas were selected for a complementary community-directed intervention (CDI programme. Under the CDI programme, volunteer community-directed distributors (CDDs were appointed by each village and kindred in the treatment areas and trained to deliver ITNs and IPTp drugs as well as basic counseling services to pregnant women. Findings Relative to women in the control area, an additional 7.4 percent of women slept under a net during pregnancy in the treatment areas (95% CI [0.035, 0.115], p-value Conclusion The presented results suggest that the inclusion of community-based programmes can substantially increase effective access to malaria prevention, and also increase access to formal health care access in general, and antenatal care attendance in particular in combination with supply side interventions. Given the relatively modest financial commitments they require, community-directed programmes appear to be a cost-effective way to improve malaria prevention; the participatory approach underlying CDI programmes also promises to strengthen ties between the formal health sector and local communities.

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

    Science.gov (United States)

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

    2017-07-02

    Delivery of interventions via smartphone is a relatively new initiative in public health, and limited evidence exists regarding optimal strategies for recruitment. We describe the effectiveness of approaches used to recruit participants to a smartphone-enabled nutrition intervention trial. Internet and social media advertising, mainstream media advertising and research team networks were used to recruit New Zealand adults to a fully automated smartphone-delivered nutrition labelling trial (no face-to-face visits were required). Recruitment of Māori and Pacific participants was a key focus and ethically relevant recruitment materials and approaches were used where possible. The effectiveness of recruitment strategies was evaluated using Google Analytics, monitoring of study website registrations and randomisations, and self-reported participant data. The cost of the various strategies and associations with participant demographics were assessed. Over a period of 13 months, there were 2448 registrations on the study website, and 1357 eligible individuals were randomised into the study (55%). Facebook campaigns were the most successful recruitment strategy overall (43% of all randomised participants) and for all ethnic groups (Māori 44%, Pacific 44% and other 43%). Significant associations were observed between recruitment strategy and age (pFacebook campaigns resulted in the highest absolute numbers of study registrations and randomisations (966 and 584, respectively). Network strategies and Facebook campaigns cost least per randomised participant (NZ$4 and NZ$5, respectively), whereas radio advertising costs most (NZ$179 per participant). Internet and social media advertising were the most effective and least costly approaches to recruiting participants to a smartphone-delivered trial. These approaches also reached diverse ethnic groups. However, more culturally appropriate recruitment strategies are likely to be necessary in studies where large numbers of

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

    Directory of Open Access Journals (Sweden)

    Yardley Lucy

    2010-09-01

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

  13. Improving Intervention Decisions to Prevent Genocide: Less Muddle, More Structure

    Directory of Open Access Journals (Sweden)

    Robin Gregory

    2018-03-01

    Full Text Available Decisions to intervene in a foreign country to prevent genocide and mass atrocities are among the most challenging and controversial choices facing national leaders. Drawing on techniques from decision analysis, psychology, and negotiation analysis, we propose a structured approach to these difficult choices that can provide policy makers with additional insight, consistency, efficiency, and defensibility. We propose the use of a values-based framework to clarify the key elements of these complex choices and to provide a consistent structure for comparison of the likely benefits, risks, and tradeoffs associated with alternative intervention strategies. Results from a workshop involving Ambassadors and experienced policy makers provide a first test of this new method for clarifying intervention choices. A decision-aiding framework is shown to improve the clarity and relevance of intervention deliberations, laying the groundwork for a more comprehensive and clearer understanding of the threats and opportunities associated with various intervention options.

  14. Early intervention for preventing posttraumatic stress disorder: an Internet-based virtual reality treatment

    Directory of Open Access Journals (Sweden)

    Sara A. Freedman

    2015-04-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD develops in approximately 20% of people exposed to a traumatic event, and studies have shown that cognitive-behavioral therapy (CBT is effective as a treatment for chronic PTSD. It has also been shown to prevent PTSD when delivered early after a traumatic event. However, studies have shown that uptake of early treatment is generally low, and therefore, the need to provide interventions through other mediums has been identified. The use of technology may overcome barriers to treatment. Objective: This paper describes a randomized controlled trial that will examine an early CBT intervention for PTSD. The treatment incorporates virtual reality (VR as a method for delivering exposure-based elements of the treatment. The intervention is Internet based, such that the therapist and patient will “meet” in a secure online site. This site will also include multi-media components of the treatment (such as videos, audios, VR that can be accessed by the patient between sessions. Method: Two hundred patients arriving to a Level 1 emergency department following a motor vehicle accident will be randomly assigned to either treatment or control groups. Inclusion criteria are age 18–65, PTSD symptoms 2 weeks posttrauma related to current trauma, no suicidality, no psychosis. Patients will be assessed by telephone by a team blind to the study group, on four occasions: before and after treatment, and 6 and 12 months posttreatment. The primary outcome is PTSD symptoms at follow up. Secondary outcomes include depression and cost effectiveness. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions, in general, and Internet-based early interventions, in particular, on PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations.

  15. Estimating intervention effects of prevention programs: accounting for noncompliance.

    Science.gov (United States)

    Stuart, Elizabeth A; Perry, Deborah F; Le, Huynh-Nhu; Ialongo, Nicholas S

    2008-12-01

    Individuals not fully complying with their assigned treatments is a common problem encountered in randomized evaluations of behavioral interventions. Treatment group members rarely attend all sessions or do all "required" activities; control group members sometimes find ways to participate in aspects of the intervention. As a result, there is often interest in estimating both the effect of being assigned to participate in the intervention, as well as the impact of actually participating and doing all of the required activities. Methods known broadly as "complier average causal effects" (CACE) or "instrumental variables" (IV) methods have been developed to estimate this latter effect, but they are more commonly applied in medical and treatment research. Since the use of these statistical techniques in prevention trials has been less widespread, many prevention scientists may not be familiar with the underlying assumptions and limitations of CACE and IV approaches. This paper provides an introduction to these methods, described in the context of randomized controlled trials of two preventive interventions: one for perinatal depression among at-risk women and the other for aggressive disruptive behavior in children. Through these case studies, the underlying assumptions and limitations of these methods are highlighted.

  16. [Scientific Evidence on Preventive Interventions in Childhood Obesity].

    Science.gov (United States)

    Alba-Martín, Raquel

    The increasing prevalence of obesity or overweight at all ages, their associated morbidity and mortality associated, and the increased perception of the problem by the society have generated several hypotheses in response to the scientific and the international community. Investigate the preventive interventions in childhood obesity so far. Integrative review during the study period from April 2013 to November 2014. The MEDLINE international database was used, including PubMed, the Cochrane Library (Issue 4 2002), the national database Isooc (CSIC) national database, as well as the Internet. The review included health articles published in Spanish and English between 1990 and 2014 that focused on or included education, prevention, diagnostic, and treatment of obesity interventions. Of the 726 articles identified, 34 of most relevant (peer reviewed) were selected. It was noted that there is limited generisable evidence on interventions that could be implemented in Primary Care or referral services available, although numerous studies suggest that improvements in the overweight are possible. Despite the abundant literature and that many institutions place childhood obesity as one of the priorities of Public Health, we face the paradox that the evidence on cost-effectiveness of prevention interventions is sparse. Knowing these gaps in knowledge should lead to filling them with rigorous and well-designed studies. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  17. The prevention of musculoskeletal injuries in volleyball: the systematic development of an intervention and its feasibility.

    Science.gov (United States)

    Gouttebarge, Vincent; van Sluis, Marije; Verhagen, Evert; Zwerver, Johannes

    2017-12-01

    A scientific research project has started in the Netherlands with the aim of developing and implementing an evidence-based intervention to prevent the occurrence of musculoskeletal injuries among young and adult recreational volleyball players. This article describes (i) the systematic development of the intervention; and (ii) the assessment of its feasibility in terms of relevancy, suitability and usability. The development of the intervention was based on the Intervention Mapping structured and systematic process. First, the needs assessment conducted among the main actors within recreational volleyball revealed that an intervention was needed for injury prevention, ideally embedded prior to a volleyball activity (training or match) within the warm-up, delivered by trainers/coaches, and available in an application for smartphone/tablet or website. Second, the objective and target groups of the intervention were defined, namely to prevent or reduce the occurrence of finger/wrist, shoulder, knee and ankle injuries among both young and adult recreational volleyball players. Third, preventive measures and strategies (e.g. core stability, strength and balance) were selected in order to accomplish a decrease in injury incidence. Last, the intervention 'VolleyVeilig' was finally developed, a warm-up programme including more than 50 distinct exercises and lasting 15 min. A quasi-experimental research based on a one-group post-test design was conducted over a period of 3 weeks among 41 volleyball players and five coaches from five adult recreational teams, who were asked to use the intervention. Degree of relevancy, suitability and usability of the warm-up programme 'VolleyVeilig' were measured among players and coaches on an 11-point scale (varying from 'completely disagree' to 'completely agree'). All groups of exercises within the warm-up programme were positively assessed with regard to their relevancy, suitability and usability, mean scores ranging from 7.7 to 8

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

    Science.gov (United States)

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

    2013-05-29

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

  19. Randomized controlled trial of an Internet delivered family cognitive behavioral therapy intervention for children and adolescents with chronic pain

    Science.gov (United States)

    Palermo, Tonya M.; Wilson, Anna C.; Peters, Meaghan; Lewandowski, Amy; Somhegyi, Hannah

    2009-01-01

    Cognitive-behavioral therapy (CBT) interventions show promise for decreasing chronic pain in youth. However, the availability of CBT is limited by many factors including distance to major treatment centers and expense. This study evaluates a more accessible treatment approach for chronic pediatric pain using an Internet-delivered family CBT intervention. Participants included 48 children, ages 11–17 years, with chronic headache, abdominal, or musculoskeletal pain and associated functional disability, and their parents. Children were randomly assigned to a wait-list control group or an Internet treatment group. Primary treatment outcomes were pain intensity ratings (0–10 NRS) and activity limitations on the Child Activity Limitations Interview, both completed via an online daily diary. In addition to their medical care, the Internet treatment group completed 8 weeks of online modules including relaxation training, cognitive strategies, parent operant techniques, communication strategies, and sleep and activity interventions. Youth randomized to the wait-list control group continued with current medical care only. Findings demonstrated significantly greater reduction in activity limitations and pain intensity at post-treatment for the Internet treatment group and these effects were maintained at three-month follow-up. Rate of clinically significant improvement in pain was also greater for the Internet treatment group in comparison to the wait-list control group. There were no significant group differences in parental protectiveness or child depressive symptoms post-treatment. Internet treatment was rated as acceptable by all children and parents. Findings support the efficacy and acceptability of Internet delivery of family CBT for reducing pain and improving function among children and adolescents with chronic pain. PMID:19695776

  20. Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes?

    Science.gov (United States)

    Fish, James; Brimson, James; Lynch, Siobhan

    New cost-effective psychological interventions are needed to contribute to treatment options for psychiatric and physical health conditions. This systematic review aims to investigate the current literature on one potentially cost-effective form of mindfulness-based therapy, those delivered through technological platforms without any mindfulness facilitator input beyond the initial design of the programme. Three electronic databases (Ovid Medline, PsychINFO and Embase) were searched for relevant keywords, titles, medical subject headings (MeSH) and abstracts using search terms derived from a combination of two subjects: 'mindfulness' and 'technology'. Overall, ten studies were identified. The majority of studies were web-based and similar in structure and content to face-to-face mindfulness-based stress reduction courses. Clinical outcomes of stress ( n  = 5), depression ( n  = 6) and anxiety (n = 4) were reported along with mindfulness ( n  = 4), the supposed mediator of effects. All eight studies that measured significance found at least some significant effects ( p   .005). However, methodological issues (e.g. selection bias, lack of control group and follow-up) which reflect the early nature of the work mean these largest effects are likely to be representative of maximal rather than average effects. Whilst there are important differences in the construction, length and delivery of interventions, it is difficult to draw firm conclusions about the most effective models. Suggestions of key characteristics are made though, needing further investigation preferably in standardised interventions. Given the existing research and the speed at which technology is making new platforms and tools available, it seems important that further research explores two parallel lines: first, refinement and thorough evaluation of already established technology-based mindfulness programmes and second, exploration of novel approaches to mindfulness training that

  1. Emotion processes in normal and abnormal development and preventive intervention.

    Science.gov (United States)

    Izard, Carroll E; Fine, Sarah; Mostow, Allison; Trentacosta, Christopher; Campbell, Jan

    2002-01-01

    We present an analysis of the role of emotions in normal and abnormal development and preventive intervention. The conceptual framework stems from three tenets of differential emotions theory (DET). These principles concern the constructs of emotion utilization; intersystem connections among modular emotion systems, cognition, and action; and the organizational and motivational functions of discrete emotions. Particular emotions and patterns of emotions function differentially in different periods of development and in influencing the cognition and behavior associated with different forms of psychopathology. Established prevention programs have not emphasized the concept of emotion as motivation. It is even more critical that they have generally neglected the idea of modulating emotions, not simply to achieve self-regulation, but also to utilize their inherently adaptive functions as a means of facilitating the development of social competence and preventing psychopathology. The paper includes a brief description of a theory-based prevention program and suggestions for complementary targeted interventions to address specific externalizing and internalizing problems. In the final section, we describe ways in which emotion-centered preventions can provide excellent opportunities for research on the development of normal and abnormal behavior.

  2. Lifestyle interventions for diabetes mellitus type 2 prevention.

    Science.gov (United States)

    Sagarra, R; Costa, B; Cabré, J J; Solà-Morales, O; Barrio, F

    2014-03-01

    Transferring the results from clinical trials on type 2 diabetes prevention is the objective of the Diabetes in Europe-Prevention using Lifestyle, Physical Activity and Nutritional intervention (DE-PLAN) project in Catalonia, whose cost-effectiveness analysis is now presented. A prospective cohort study was performed in primary care involving individuals without diagnosed diabetes aged 45-75 years (n=2054) screened using the questionnaire Finnish Diabetes Risk Score (FINDRISC) and a subsequent oral glucose tolerance test. Where feasible, high-risk individuals who were identified (n=552) were allocated sequentially to standard care (n=219), a group-based (n=230) or an individual-level (n=103) intensive (structured programme of six hours using specific teaching techniques) lifestyle intervention (n=333). The primary outcome was the development of diabetes (WHO). We evaluated the cost of resources used with comparison of standard care and the intervention groups in terms of effectiveness and quality of life (15D questionnaire). After 4.2-year median follow-up, the cumulative incidences were 18.3% (14.3-22.9%) in the intensive intervention group and 28.8% (22.9-35.3%) in the standard care group (36.5% relative-risk-reduction). The corresponding 4-year HR was 0.64 (0.47-0.87; P<.004). The incremental cost induced by intensive intervention compared with the standard was 106€ per participant in the individual level and 10€ in the group-based intervention representing 746€ and 108€ per averted case of diabetes, respectively. The estimated incremental cost-utility ratio was 3243€ per quality-adjusted life-years gained. The intensive lifestyle intervention delayed the development of diabetes and was efficient in economic analysis. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  3. Multi-College Bystander Intervention Evaluation for Violence Prevention.

    Science.gov (United States)

    Coker, Ann L; Bush, Heather M; Fisher, Bonnie S; Swan, Suzanne C; Williams, Corrine M; Clear, Emily R; DeGue, Sarah

    2016-03-01

    The 2013 Campus Sexual Violence Elimination Act requires U.S. colleges to provide bystander-based training to reduce sexual violence, but little is known about the efficacy of such programs for preventing violent behavior. This study provides the first multiyear evaluation of a bystander intervention's campus-level impact on reducing interpersonal violence victimization and perpetration behavior on college campuses. First-year students attending three similarly sized public university campuses were randomly selected and invited to complete online surveys in the spring terms of 2010-2013. On one campus, the Green Dot bystander intervention was implemented in 2008 (Intervention, n=2,979) and two comparison campuses had no bystander programming at baseline (Comparison, n=4,132). Data analyses conducted in 2014-2015 compared violence rates by condition over the four survey periods. Multivariable logistic regression was used to estimate violence risk on Intervention relative to Comparison campuses, adjusting for demographic factors and time (2010-2013). Interpersonal violence victimization rates (measured in the past academic year) were 17% lower among students attending the Intervention (46.4%) relative to Comparison (55.7%) campuses (adjusted rate ratio=0.83; 95% CI=0.79, 0.88); a similar pattern held for interpersonal violence perpetration (25.5% in Intervention; 32.2% in Comparison; adjusted rate ratio=0.79; 95% CI=0.71, 0.86). Violence rates were lower on Intervention versus Comparison campuses for unwanted sexual victimization, sexual harassment, stalking, and psychological dating violence victimization and perpetration (preduce violence at the community level and meet Campus Sexual Violence Elimination Act bystander training requirements. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

  4. A Web nursing intervention to prevent Eating Disorders

    OpenAIRE

    Esther Quirós Abajo

    2008-01-01

    Eating Disorders are an important health problem of our society because of their rising incidence in the last years, as well as their high cost in terms of Public Health. Nowadays the best option to face this problem is through prevention. The objective of the present work is to evaluate if a Web nursing intervention based on Cognitive-Behavioural Therapy can prevent Eating Disorders by reducing risk factors in 15 to 18 years old women.Methodology: It is a randomized clinical trial in which t...

  5. An Effective Psychoeducational Intervention for Early Childhood Caries Prevention: Part I

    Science.gov (United States)

    Weber-Gasparoni, Karin; Reeve, Johnmarshall; Ghosheh, Natalie; Warren, Joh J.; Drake, David R.; Kramer, Katherine W.O.; Dawson, Deborah V.

    2016-01-01

    Purpose The purpose was to compare whether mothers exposed to an autonomy-supportive psychoeducational videotaped message, informed by the self-determination theory (SDT), demonstrated greater changes in oral health knowledge and behavioral intentions as a preventive means for early childhood caries (ECC) than mothers exposed to a neutral message delivered by brochure. Methods Data were collected at baseline, one-, and six-month follow-ups from 415 12- to 49-month-old WIC-enrolled children and their mothers: 283 in the video intervention group and 132 in the brochure control group. Mothers completed questionnaires on maternal knowledge and behavioral intentions for oral health care. Chi-square, Wilcoxon rank-sum, and Mann-Whitney tests were used to analyze data (P<.05). Results Relative to their baseline scores, the intervention group showed a greater increase in knowledge than the control group, both at one-month (P=.002) and six-month follow-ups (P<.001). The video group also demonstrated a greater increase in behavioral intentions than controls, both at one-month (P<.05) and six-month follow-ups (P<.001). Knowledge and behavioral intention levels at six-month follow-up did not differ significantly from those at one-month follow-up, indicating that intervention-based increases in these measures were maintained over time. Conclusions Data provided evidence of the effectiveness of the autonomy-supportive psychoeducational intervention for ECC prevention relative to a neutral brochure. PMID:23756308

  6. A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change.

    Science.gov (United States)

    Omaki, Elise; Rizzutti, Nicholas; Shields, Wendy; Zhu, Jeffrey; McDonald, Eileen; Stevens, Martha W; Gielen, Andrea

    2017-04-01

    The aims of this literature review are to (1) summarise how computer and mobile technology-based health behaviour change applications have been evaluated in unintentional injury prevention, (2) describe how these successes can be applied to injury-prevention programmes in the future and (3) identify research gaps. Studies included in this systematic review were education and behaviour change intervention trials and programme evaluations in which the intervention was delivered by either a computer or mobile technology and addressed an unintentional injury prevention topic. Articles were limited to those published in English and after 1990. Among the 44 technology-based injury-prevention studies included in this review, 16 studies evaluated locally hosted software programmes, 4 studies offered kiosk-based programmes, 11 evaluated remotely hosted internet programmes, 2 studies used mobile technology or portable devices and 11 studies evaluated virtual-reality interventions. Locally hosted software programmes and remotely hosted internet programmes consistently increased knowledge and behaviours. Kiosk programmes showed evidence of modest knowledge and behaviour gains. Both programmes using mobile technology improved behaviours. Virtual-reality programmes consistently improved behaviours, but there were little gains in knowledge. No studies evaluated text-messaging programmes dedicated to injury prevention. There is much potential for computer-based programmes to be used for injury-prevention behaviour change. The reviewed studies provide evidence that computer-based communication is effective in conveying information and influencing how participants think about an injury topic and adopt safety behaviours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. YOUTH HOMELESSNESS: PREVENTION AND INTERVENTION EFFORTS IN PSYCHOLOGY

    Directory of Open Access Journals (Sweden)

    JHON J. SANABRIA

    2006-01-01

    Full Text Available In this paper, I review the prevention and intervention efforts addressing youth homelessness in the fieldof psychology between 1994 and 2004. Analyses of the literature revealed that the majority of papersincluding homeless youth as a population for study have focused on issues other than homelessness.These issues include HIV/AIDS and substance abuse prevention. Eleven journal articles addressing youthhomelessness were reviewed. These articles focused on outcomes, interventions, and recommendationsfor clinical practice. Literature findings revealed that demographic variables did not predict outcomesfor homeless youth; youth returning home with their parents have more positive outcomes than youthmoving into other locations, emergency shelter services improve youth’s mental health and social condition,and services should be comprehensive and move beyond the individuals. Implications for communitypsychology, policy makers, and shelters are discussed.

  8. Partnering with women collectives for delivering essential women's nutrition interventions in tribal areas of eastern India: a scoping study.

    Science.gov (United States)

    Sethi, Vani; Bhanot, Arti; Bhalla, Surbhi; Bhattacharjee, Sourav; Daniel, Abner; Sharma, Deepika Mehrish; Gope, Rajkumar; Mebrahtu, Saba

    2017-05-22

    We examined the feasibility of engaging women collectives in delivering a package of women's nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach. Conducted between July 2014 and March 2015, an exploratory mix-methods design was adopted (review of coverage data and government reports, field interviews and focus group discussion with multiple stakeholders and intended communities) to assess coverage of women's nutrition services. A capacity assessment tool was developed to map all types of community collectives and assess their awareness, institutional and programme capacity as a funded stakeholder for delivering women's nutrition services/behaviour promotion. Limited targeting of pre-pregnancy period, delays in first trimester registration of pregnant women, and low micronutrient supplementation supply and awareness issues emerged as key bottlenecks in improving women's nutrition in these districts. Amongst the 18 different types of community collectives mapped, Self Help Groups (SHGs) and their federations (tier 2 and tier 3), with total membership of over 650,000, emerged as the most promising community collective due to their vast network, governance structure, bank linkage, and regular interface. Nearly 400,000 (or 20% of women) in these districts can be reached through the mapped 31,919 SHGs. SHGs with organisational readiness for receiving and managing grants for income generation and community development activities varied from 41 to 94% across study districts. Stakeholders perceived that SHGs federations managing grants from government and be engaged for nutrition promotion and service delivery and SHG weekly meetings can serve as community interface for discussing/resolving local issues impeding access to services. Women SHGs (with tier 2 and tier 3) can become direct

  9. HIV/AIDS/STD prevention intervention messages: An evaluation of ...

    African Journals Online (AJOL)

    The aim of this study is to evaluate HIV/AIDS/STD prevention intervention messages on a rural adult (25-49 years) sample in South Africa over a period of 15 months. A representative community sample of 398 adults at time 1 and 382 at time 2 (25-49 years) participated in the study using a three-stage cluster sampling ...

  10. Cancer risk and preventive behavior: persuasion as an intervention strategy

    OpenAIRE

    Tonani,Marcela; Carvalho,Emilia Campos de

    2008-01-01

    The effectiveness of interventions for health promotion, protection, and early diagnosis may include the process of persuasion employed. This study aims to evaluate the risk level of developing cancer, considering the pertinent risk factors, and the presence of persuasion and characteristics in communication regarding cancer prevention and early detection. It is an observational study, conducted among 110 inhabitants of a neighborhood in Ribeirao Preto, Sao Paulo, Brazil. It was confirmed tha...

  11. 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.

  12. A Web nursing intervention to prevent Eating Disorders

    Directory of Open Access Journals (Sweden)

    Esther Quirós Abajo

    2008-01-01

    Full Text Available Eating Disorders are an important health problem of our society because of their rising incidence in the last years, as well as their high cost in terms of Public Health. Nowadays the best option to face this problem is through prevention. The objective of the present work is to evaluate if a Web nursing intervention based on Cognitive-Behavioural Therapy can prevent Eating Disorders by reducing risk factors in 15 to 18 years old women.Methodology: It is a randomized clinical trial in which the experimental group will receive the Web nursing intervention and the control group will not receive any kind of preventive intervention related to Eating Disorders. The study will be developed in six Secondary Education Institutes of the areas 9 and 10 of Madrid Community. Women at risk will be selected by the Body Shape Questionnaire (BSQ. Risk factors such as body image dissatisfaction, eating and depressive symptoms will be evaluated. Measurements will be, besides BSQ, the Body Attitudes Test (BAT, the Eating Disorders Inventory (EDI, the Eating Attitudes Test (EAT and the Beck Depression Inventory (BDI.

  13. Por La Vida intervention model for cancer prevention in Latinas.

    Science.gov (United States)

    Navarro, A M; Senn, K L; Kaplan, R M; McNicholas, L; Campo, M C; Roppe, B

    1995-01-01

    Our goal was to describe the development and implementation of an intervention on cancer prevention for Latinas in San Diego, Calif. Thirty-six lay community workers ("consejeras") were recruited and trained to conduct educational group sessions. Each consejera recruited approximately 14 peers from the community to participate in the program (total number = 512). Half of the consejeras were randomly assigned to a control group, in which they participated in an equally engaging program entitled "Community Living Skills." Implementation of the intervention was assessed by qualitative and quantitative methods. Preintervention and postintervention self-report information was obtained from project participants on access to health care services, cancer knowledge, preventive measures, and previous cancer-screening examinations. Base-line data suggest that lack of knowledge, costs of cancer-screening tests, and the lack of a regular health care provider are the major obstacles against obtaining cancer-screening tests. Predisposing factors, such as fear and embarrassment, also constitute barriers to getting regular cervical cancer screening. Preliminary analysis indicates that the Por La Vida intervention increases use of cancer-screening tests in comparison to a community living skills control group. Universal access to health care would remove some of the major financial barriers to cancer screening. The Por La Vida program attempts to overcome the substantial barriers by reaching out to low-income Latinas and by providing information regarding the availability, acceptability, and preventive nature of cancer-screening tests.

  14. Preliminary Effectiveness of Project ImPACT: A Parent-Mediated Intervention for Children with Autism Spectrum Disorder Delivered in a Community Program

    Science.gov (United States)

    Stadnick, Nicole A.; Stahmer, Aubyn; Brookman-Frazee, Lauren

    2015-01-01

    This is a pilot study of the effectiveness of Project ImPACT, a parent-mediated intervention for ASD delivered in a community program. The primary aim was to compare child and parent outcomes between the intervention group and a community comparison for 30 young children with ASD at baseline and 12 weeks. The secondary aim was to identify parent factors associated with changes in child outcomes. Results indicated significant improvement in child communication skills and a strong trend for parent intervention adherence for the intervention group from baseline to 12 weeks. Higher baseline parenting stress was negatively related to child social gains from baseline to 12 weeks. Findings provide further support for delivering parent-mediated interventions in community settings to children with ASD. PMID:25633920

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zarnie Khadjesari

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

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

    Science.gov (United States)

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

    2017-04-01

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

  18. Interventions for prevention of bullying in the workplace.

    Science.gov (United States)

    Gillen, Patricia A; Sinclair, Marlene; Kernohan, W George; Begley, Cecily M; Luyben, Ans G

    2017-01-30

    Bullying has been identified as one of the leading workplace stressors, with adverse consequences for the individual employee, groups of employees, and whole organisations. Employees who have been bullied have lower levels of job satisfaction, higher levels of anxiety and depression, and are more likely to leave their place of work. Organisations face increased risk of skill depletion and absenteeism, leading to loss of profit, potential legal fees, and tribunal cases. It is unclear to what extent these risks can be addressed through interventions to prevent bullying. To explore the effectiveness of workplace interventions to prevent bullying in the workplace. We searched: the Cochrane Work Group Trials Register (August 2014); Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1); PUBMED (1946 to January 2016); EMBASE (1980 to January 2016); PsycINFO (1967 to January 2016); Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus; 1937 to January 2016); International Bibliography of the Social Sciences (IBSS; 1951 to January 2016); Applied Social Sciences Index and Abstracts (ASSIA; 1987 to January 2016); ABI Global (earliest record to January 2016); Business Source Premier (BSP; earliest record to January 2016); OpenGrey (previously known as OpenSIGLE-System for Information on Grey Literature in Europe; 1980 to December 2014); and reference lists of articles. Randomised and cluster-randomised controlled trials of employee-directed interventions, controlled before and after studies, and interrupted time-series studies of interventions of any type, aimed at preventing bullying in the workplace, targeted at an individual employee, a group of employees, or an organisation. Three authors independently screened and selected studies. We extracted data from included studies on victimisation, perpetration, and absenteeism associated with workplace bullying. We contacted study authors to gather additional data. We used the

  19. Preventing the development of depression at work: a systematic review and meta-analysis of universal interventions in the workplace

    Science.gov (United States)

    2014-01-01

    Background Depression is a major public health problem among working-age adults. The workplace is potentially an important location for interventions aimed at preventing the development of depression, but to date, the mental health impact of universal interventions in the workplace has been unclear. Method A systematic search was conducted in relevant databases to identify randomized controlled trials of workplace interventions aimed at universal prevention of depression. The quality of studies was assessed using the Downs and Black checklist. A meta-analysis was performed using results from studies of adequate methodological quality, with pooled effect size estimates obtained from a random effects model. Results Nine workplace-based randomized controlled trials (RCT) were identified. The majority of the included studies utilized cognitive behavioral therapy (CBT) techniques. The overall standardized mean difference (SMD) between the intervention and control groups was 0.16 (95% confidence interval (CI): 0.07, 0.24, P = 0.0002), indicating a small positive effect. A separate analysis using only CBT-based interventions yielded a significant SMD of 0.12 (95% CI: 0.02, 0.22, P = 0.01). Conclusions There is good quality evidence that universally delivered workplace mental health interventions can reduce the level of depression symptoms among workers. There is more evidence for the effectiveness of CBT-based programs than other interventions. Evidence-based workplace interventions should be a key component of efforts to prevent the development of depression among adults. PMID:24886246

  20. Age effects in eating disorder baseline risk factors and prevention intervention effects.

    Science.gov (United States)

    Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M; Ohls, Olivia C

    2017-11-01

    Examine the impact of age on baseline eating disorder symptoms/risk factors and on the effects of completing three variants of an eating disorder prevention program. Six hundred and eighty women (60% White) were randomized to clinician-led Body Project groups, peer-led Body Project groups, an Internet-based version of the Body Project (eBodyProject), or educational video control condition. Participants, who were on average 22.2 years old (SD = 7.1, range 17-64, median = 19), were assessed at pretest, posttest, and 6-month follow-up. Two of the seven baseline variables were significantly associated with age, indicating that older age was associated with lower reported dieting (r = -.12) and better psychosocial functioning (r = -.13). Interactions indicated that age moderated the intervention effects, such that group-based programs were superior to the Internet-delivered version in terms of eating disorder symptom reductions for women up to age 20, whereas the Internet-delivered program was superior to group-based interventions, particularly in terms of BMI reduction, for women over approximately age 25. None of the four tests examining whether age moderated the effects of delivering Body Project groups by mental health clinicians versus undergraduate peer educators were significant. Results suggest that group-based versions of the Body Project should be implemented with young women up to the age of 20, as they produce larger eating disorder symptom reductions, whereas the Internet version of the Body Project should be implemented with women aged 25 or older, as it produces superior weight loss/gain prevention effects. © 2017 Wiley Periodicals, Inc.

  1. Age Effects in Eating Disorder Baseline Risk Factors and Prevention Intervention Effects

    Science.gov (United States)

    Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M.; Ohls, Olivia C.

    2017-01-01

    Objective Examine the impact of age on baseline eating disorder symptoms/risk factors and on the effects of completing three variants of an eating disorder prevention program. Method 680 women (60% White) were randomized to clinician-led Body Project groups, peer-led Body Project groups, an Internet-based version of the Body Project (eBodyProject), or educational video control condition. Participants, who were on average 22.2 years old (SD = 7.1, range 17-64, median = 19), were assessed at pretest, posttest, and 6-month follow-up. Results Two of the seven baseline variables were significantly associated with age, indicating that older age was associated with lower reported dieting (r = −.12) and better psychosocial functioning (r = −.13). Interactions indicated that age moderated the intervention effects, such that group-based programs were superior to the Internet-delivered version in terms of eating disorder symptom reductions for women up to age 20, whereas the Internet-delivered program were superior to group-based interventions, particularly in terms of BMI reduction, for women over approximately age 25. None of the four tests examining whether age moderated the effects of delivering Body Project groups by mental health clinicians versus undergraduate peer educators were significant. Conclusions Results suggest that group-based versions of the Body Project should be implemented with young women up to the age of 20, as they produce larger eating disorder symptom reductions, whereas the Internet version of the Body Project should be implemented with women aged 25 or older, as it produces superior weight loss/gain prevention effects. PMID:28861902

  2. Mobile Health Technology Interventions for Suicide Prevention: Protocol for a Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Melia, Ruth; Francis, Kady; Duggan, Jim; Bogue, John; O'Sullivan, Mary; Chambers, Derek; Young, Karen

    2018-01-26

    Previous research has reported that two of the major barriers to help-seeking for individuals at risk of suicide are stigma and geographical isolation. Mobile technology offers a potential means of delivering evidence-based interventions with greater specificity to the individual, and at the time that it is needed. Despite documented motivation by at-risk individuals to use mobile technology to track mental health and to support psychological interventions, there is a shortfall of outcomes data on the efficacy of mobile health (mHealth) technology on suicide-specific outcomes. The objective of this study is to develop a protocol for a systematic review and meta-analysis that aims to evaluate the effectiveness of mobile technology-based interventions for suicide prevention. The search includes the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase, PsycINFO, CRESP and relevant sources of gray literature. Studies that have evaluated psychological or nonpsychological interventions delivered via mobile computing and communication technology, and have suicidality as an outcome measure will be included. Two authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, suicidal behavior). Secondary outcomes will be measures of symptoms of depression. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. A narrative synthesis will be conducted if the data is unsuitable for a meta-analysis. The review is in progress, with findings expected by summer 2018. To date, evaluations of mobile technology-based interventions in suicide prevention have focused on evaluating content as opposed to efficacy. Indeed, previous research has

  3. Using Elite Athletes to Promote Drug Abstinence: Evaluation of a Single-Session School-Based Drug Use Prevention Program Delivered by Junior Hockey Players

    Science.gov (United States)

    Wong, Jennifer

    2016-01-01

    School-based substance use prevention programs are a common method to approaching drug use in youths. Project SOS is a single-session drug prevention program developed by police officers and delivered by elite junior hockey players to students in grades 6 and 7. The current study evaluates the effects of Project SOS at achieving its objectives of…

  4. HIV prevention in Mexican schools: prospective randomised evaluation of intervention.

    Science.gov (United States)

    Walker, Dilys; Gutierrez, Juan Pablo; Torres, Pilar; Bertozzi, Stefano M

    2006-05-20

    To assess effects on condom use and other sexual behaviour of an HIV prevention programme at school that promotes the use of condoms with and without emergency contraception. Cluster randomised controlled trial. 40 public high schools in the state of Morelos, Mexico. 10 954 first year high school students. Schools were randomised to one of three arms: an HIV prevention course that promoted condom use, the same course with emergency contraception as back-up, or the existing sex education course. Self administered anonymous questionnaires were completed at baseline, four months, and 16 months. Students at intervention schools received a 30 hour course (over 15 weeks) on HIV prevention and life skills, designed in accordance with guidelines of the joint United Nations programme on HIV/AIDS. Two extra hours of education on emergency contraception were given to students in the condom promotion with contraception arm. Primary outcome measure was reported condom use. Other outcomes were reported sexual activity; knowledge and attitudes about HIV and emergency contraception; and attitudes and confidence about condom use. Intervention did not affect reported condom use. Knowledge of HIV improved in both intervention arms and knowledge of emergency contraception improved in the condom promotion with contraception arm. Reported sexual behaviour was similar in the intervention arms and the control group. A rigorously designed, implemented, and evaluated HIV education course based in public high schools did not reduce risk behaviour, so such courses need to be redesigned and evaluated. Addition of emergency contraception did not decrease reported condom use or increase risky sexual behaviour but did increase reported use of emergency contraception.

  5. A community intervention to prevent traffic accidents among bicycle commuters.

    Science.gov (United States)

    Bacchieri, Giancarlo; Barros, Aluísio J D; Santos, Janaína V dos; Gonçalves, Helen; Gigante, Denise P

    2010-10-01

    To evaluate an educational intervention designed to prevent traffic accidents among workers that use the bicycle for commuting. A longitudinal intervention study with a stepped wedge implementation was carried out between January 2006 and May 2007. Five neighborhoods with distinct geographic characteristics were selected in the city of Pelotas, Brazil, and 42 census tracts were randomly selected from these neighborhoods. All households were screened for male bicycle commuters, resulting in a sample of 1,133 individuals. The outcomes analyzed were "traffic accidents" and "near accidents". The cyclists were interviewed monthly by phone to record traffic accidents and "near accidents". Every 15 days, from the second month of study, a group of about 60 cyclists was invited to attend the intervention meeting that included an educational component (a talk and a video presentation), distribution of a safety kit (reflective belt & sash, reflective tape and an educational booklet) and a bicycle breaks check-up (maintenance performed if necessary). Poisson regression adjusted for time effect was used to assess the intervention effect. Nearly 45% of the cyclists did not attend the intervention. During the study period, 9% of the study individuals reported a traffic accident and 88% reported a "near accident". In total there were 106 accidents and 1,091 near accidents. There was no effect observed from the intervention on either of the outcomes. The intervention tested was not capable of reducing traffic accidents among bicycle commuters. Lack of interest in safety by commuters and external factors, such as road design and motorist behavior, may have together influenced this result.

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

    Science.gov (United States)

    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

  7. A comprehensive review of the barriers and promoters health workers experience in delivering prevention of vertical transmission of HIV services in sub-Saharan Africa.

    Science.gov (United States)

    Schuster, Roseanne C; McMahon, Devon E; Young, Sera L

    2016-01-01

    Despite significant biomedical and policy advances, 199,000 infants and young children in sub-Saharan Africa (SSA) became infected with HIV in 2013, indicating challenges to implementation of these advances. To understand the nature of these challenges, we sought to (1) characterize the barriers and facilitators that health workers encountered delivering prevention of vertical transmission of HIV (PVT) services in SSA and (2) evaluate the use of theory to guide PVT service delivery. The PubMed and CINAHL databases were searched using keywords barriers, facilitators, HIV, prevention of vertical transmission of HIV, health workers, and their synonyms to identify relevant studies. Barriers and facilitators were coded at ecological levels according to the Determinants of Performance framework. Factors in this framework were then classified as affecting motivation, opportunity, or ability, per the Motivation-Opportunity-Ability (MOA) framework in order to evaluate domains of health worker performance within each ecological level. We found that the most frequently reported challenges occurred within the health facility level and spanned all three MOA domains. Barriers reported in 30% or more of studies from most proximal to distal included those affecting health worker motivation (stress, burnout, depression), patient opportunity (stigma), work opportunity (poor referral systems), health facility opportunity (overburdened workload, lack of supplies), and health facility ability (inadequate PVT training, inconsistent breastfeeding messages). Facilitators were reported in lower frequencies than barriers and tended to be resolutions to challenges (e.g., quality supervision, consistent supplies) or responses to an intervention (e.g., record systems and infrastructure improvements). The majority of studies did not use theory to guide study design or implementation. Interventions addressing health workers' multiple ecological levels of interactions, particularly the health

  8. A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial.

    Science.gov (United States)

    Brinker, Titus Josef; Owczarek, Andreas Dawid; Seeger, Werner; Groneberg, David Alexander; Brieske, Christian Martin; Jansen, Philipp; Klode, Joachim; Stoffels, Ingo; Schadendorf, Dirk; Izar, Benjamin; Fries, Fabian Norbert; Hofmann, Felix Johannes

    2017-06-06

    More than 8.5 million Germans suffer from chronic diseases attributable to smoking. Education Against Tobacco (EAT) is a multinational network of medical students who volunteer for school-based prevention in the classroom setting, amongst other activities. EAT has been implemented in 28 medical schools in Germany and is present in 13 additional countries around the globe. A recent quasi-experimental study showed significant short-term smoking cessation effects on 11-to-15-year-old adolescents. The aim of this study was to provide the first randomized long-term evaluation of the optimized 2014 EAT curriculum involving a photoaging software for its effectiveness in reducing the smoking prevalence among 11-to-15-year-old pupils in German secondary schools. A randomized controlled trial was undertaken with 1504 adolescents from 9 German secondary schools, aged 11-15 years in grades 6-8, of which 718 (47.74%) were identifiable for the prospective sample at the 12-month follow-up. The experimental study design included measurements at baseline (t1), 6 months (t2), and 12 months postintervention (t3), via questionnaire. The study groups consisted of 40 randomized classes that received the standardized EAT intervention (two medical student-led interactive modules taking 120 minutes total) and 34 control classes within the same schools (no intervention). The primary endpoint was the difference in smoking prevalence from t1 to t3 in the control group versus the difference from t1 to t3 in the intervention group. The differences in smoking behavior (smoking onset, quitting) between the two groups, as well as gender-specific effects, were studied as secondary outcomes. None of the effects were significant due to a high loss-to-follow-up effect (52.26%, 786/1504). From baseline to the two follow-up time points, the prevalence of smoking increased from 3.1% to 5.2% to 7.2% in the control group and from 3.0% to 5.4% to 5.8% in the intervention group (number needed to treat [NNT

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

    Science.gov (United States)

    Munodawafa, Memory; Lund, Crick; Schneider, Marguerite

    2017-07-01

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

  10. Contextual community prevention theory: building interventions with community agency collaboration.

    Science.gov (United States)

    Morales, Eduardo S

    2009-11-01

    Translation from research to practice faces numerous problems that include replicating effectiveness, fidelity to the protocol and processes, and adaptations to different types of target populations. Working collaboratively with existing service providers can speed up the time for development and can ease the implementation of empirical randomized trials. Contextual community prevention theory is an innovative approach that focuses on changing behaviors of community members by creating a visible institutional presence that draws and pulls the targeted population into the organization's activities and interventions. The result is an institution or organization within the community that provides a new active and dynamic context, engaging its community members into its activities, interventions, and functions. An HIV prevention program developed collaboratively from the ground up for Latino gay/bisexual men is presented. Results from the program evaluation efforts across the years suggest promise for testing its efficacy through a randomized trial. HIV prevention efforts need to develop dynamic support systems within communities where these men have ownership, have control, and feel safe; otherwise HIV infection rates in this population will increase. Copyright 2009 by the American Psychological Association

  11. Health improvement and prevention study (HIPS - evaluation of an intervention to prevent vascular disease in general practice

    Directory of Open Access Journals (Sweden)

    Davies Gawaine

    2010-08-01

    Full Text Available Abstract Background The Health Improvement and Prevention Study (HIPS study aims to evaluate the capacity of general practice to identify patients at high risk for developing vascular disease and to reduce their risk of vascular disease and diabetes through behavioural interventions delivered in general practice and by the local primary care organization. Methods/Design HIPS is a stratified randomized controlled trial involving 30 general practices in NSW, Australia. Practices are randomly allocated to an 'intervention' or 'control' group. General practitioners (GPs and practice nurses (PNs are offered training in lifestyle counselling and motivational interviewing as well as practice visits and patient educational resources. Patients enrolled in the trial present for a health check in which the GP and PN provide brief lifestyle counselling based on the 5As model (ask, assess, advise, assist, and arrange and refer high risk patients to a diet education and physical activity program. The program consists of two individual visits with a dietician or exercise physiologist and four group sessions, after which patients are followed up by the GP or PN. In each practice 160 eligible patients aged between 40 and 64 years are invited to participate in the study, with the expectation that 40 will be eligible and willing to participate. Evaluation data collection consists of (1 a practice questionnaire, (2 GP and PN questionnaires to assess preventive care attitudes and practices, (3 patient questionnaire to assess self-reported lifestyle behaviours and readiness to change, (4 physical assessment including weight, height, body mass index (BMI, waist circumference and blood pressure, (5 a fasting blood test for glucose and lipids, (6 a clinical record audit, and (7 qualitative data collection. All measures are collected at baseline and 12 months except the patient questionnaire which is also collected at 6 months. Study outcomes before and after the

  12. The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chovnick, Gary

    2010-01-01

    In the past 25 years, the field of HIV prevention research has been transformed repeatedly. Today, effective HIV prevention requires a combination of behavioral, biomedical, and structural intervention strategies. Risk of transmitting or acquiring HIV is reduced by consistent male and female-condom use, reductions in concurrent and/or sequential sexual and needle-sharing partners, male circumcision, and treatment with antiretroviral medications. At least 144 behavioral prevention programs have been found effective in reducing HIV transmission acts; however, scale up of these programs has not occurred outside of the United States. A series of recent failures of HIV-prevention efficacy trials for biomedical innovations such as HIV vaccines, treating herpes simplex 2 and other sexually transmitted infections, and diaphragm and microbicide barriers highlights the need for behavioral strategies to accompany biomedical strategies. This challenges prevention researchers to reconceptualize how cost-effective, useful, realistic, and sustainable prevention programs will be designed, delivered, tested, and diffused. The next generation of HIV prevention science must draw from the successes of existing evidence-based interventions and the expertise of the market sector to integrate preventive innovations and behaviors into everyday routines. PMID:19327028

  13. Effectiveness of Nurse-Practitioner-Delivered Brief Motivational Intervention for Young Adult Alcohol and Drug Use in Primary Care in South Africa: A Randomized Clinical Trial

    OpenAIRE

    Mertens, Jennifer R.; Ward, Catherine L.; Bresick, Graham F.; Broder, Tina; Weisner, Constance M.

    2014-01-01

    Aims: To assess the effectiveness of brief motivational intervention for alcohol and drug use in young adult primary care patients in a low-income population and country. Methods: A randomized controlled trial in a public-sector clinic in Delft, a township in the Western Cape, South Africa recruited 403 patients who were randomized to either single-session, nurse practitioner-delivered Brief Motivational Intervention plus referral list or usual care plus referral list, and followed up at 3 mo...

  14. Effectiveness of nurse-practitioner-delivered brief motivational intervention for young adult alcohol and drug use in primary care in South Africa: A randomized clinical trial

    OpenAIRE

    Mertens, JR; Ward, CL; Bresick, GF; Broder, T; Weisner, CM

    2014-01-01

    Aims: To assess the effectiveness of brief motivational intervention for alcohol and drug use in young adult primary care patients in a low-income population and country. Methods: A randomized controlled trial in a public-sector clinic in Delft, a township in the Western Cape, South Africa recruited 403 patients who were randomized to either single-session, nurse practitioner-delivered Brief Motivational Intervention plus referral list or usual care plus referral list, and followed up at 3 mo...

  15. Behavior change in a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention content

    NARCIS (Netherlands)

    Vermunt, P.W.A.; Milder, I.E.J.; Wielaard, F.; Baan, C.A.; Schelfhout, J.D.M.; Westert, G.P.; van Oers, J.A.M.

    2013-01-01

    Background Despite the favorable effects of behavior change interventions on diabetes risk, lifestyle modification is a complicated process. In this study we therefore investigated opportunities for refining a lifestyle intervention for type 2 diabetes prevention, based on participant perceptions of

  16. Room temperature stable carbetocin for the prevention of postpartum haemorrhage during the third stage of labour in women delivering vaginally: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Widmer, Mariana; Piaggio, Gilda; Abdel-Aleem, Hany; Carroli, Guillermo; Chong, Yap-Seng; Coomarasamy, Arri; Fawole, Bukola; Goudar, Shivaprasad; Hofmeyr, G Justus; Lumbiganon, Pisake; Mugerwa, Kidza; Nguyen, Thi My Huong; Qureshi, Zahida; Souza, Joao Paulo; Gülmezoglu, A Metin

    2016-03-17

    Postpartum haemorrhage (PPH) is the leading cause of maternal mortality in low-income countries and contributes to nearly a quarter of maternal deaths globally. The current available interventions for prevention of postpartum haemorrhage, oxytocin and carbetocin, are limited by their need for refrigeration to maintain potency, as the ability to maintain a cold chain across the drug distribution and storage network is inconsistent, thus restricting their use in countries with the highest burden of maternal mortality. We describe a randomized, double-blind non-inferiority trial comparing a newly developed room temperature stable formulation of carbetocin to the standard intervention (oxytocin) for the prevention of PPH after vaginal birth. Approximately 30,000 women delivering vaginally will be recruited across 22 centres in 10 countries. The primary objectives are to evaluate the non-inferiority of room temperature stable carbetocin (100 μg intramuscular) versus oxytocin (10 IU intramuscular) in the prevention of PPH and severe PPH after vaginal birth. The primary endpoints are blood loss ≥500 mL or the use of additional uterotonics (composite endpoint required by drug regulatory authorities) and blood loss ≥1,000 mL (WHO requirement). Non-inferiority will be assessed using a two-sided 95 % confidence interval for the relative risk of the above endpoints for room temperature stable carbetocin versus oxytocin. The upper limit of the two-sided 95 % confidence interval for the relative risk for the composite endpoint of blood loss ≥500 mL or the use of additional uterotonics, and for the endpoint of blood loss ≥1,000 mL, will be compared to a non-inferiority margin of 1.16 and 1.23, respectively. If the upper limit is below the corresponding margin, non-inferiority will have been demonstrated. The safety analysis will include all women receiving treatment. Safety and tolerability will be assessed by a review of adverse events, by conducting inferential testing

  17. Preventive intervention for early childhood behavioral problems: an ecological perspective.

    Science.gov (United States)

    Shepard, Stephanie A; Dickstein, Susan

    2009-07-01

    The purpose of this article is to highlight the importance of preventive interventions targeting parents when addressing early childhood behavior problems. The authors briefly review evidence-based parent management training programs, focusing on one particular program, the Incredible Years (IY) Series. Next, the authors discuss the barriers to embedding evidence-based practice such as IY in community contexts and demonstrate how early childhood mental health consultation can be used to enhance community capacity to adopt evidence-based practice and improve outcomes for the large number of young children and their families in need.

  18. Intervention to Prevent Child Custody Loss in Mothers with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Mary V. Seeman

    2012-01-01

    Full Text Available Depending on jurisdiction, time period studied, and specifics of the population, approximately 50 percent of mothers who suffer from schizophrenia lose custody of their children. The aim of this paper is to recommend interventions aimed at preventing unnecessary custody loss. This paper reviews the social work, nursing, psychology, psychiatry, and law literature on mental illness and custody loss, 2000–2011. Recommendations to mothers are to (a ensure family health (b prevent psychotic relapse, (c prepare in advance for crisis, (d document daily parenting activities, (e take advantage of available parenting resources, and f become knowledgeable about legal issues that pertain to mental health and custody. From a policy perspective, child protection and adult mental health agencies need to dissolve administrative barriers and collaborate. Access to appropriate services will help mothers with schizophrenia to care appropriately for their children and allow these children to grow and develop within their family and community.

  19. Community response to intermittent preventive treatment of malaria in infants (IPTi delivered through the expanded programme of immunization in five African settings

    Directory of Open Access Journals (Sweden)

    Slutsker Lawrence

    2009-08-01

    Full Text Available Abstract Background IPTi delivered through EPI has been shown to reduce the incidence of clinical malaria by 20–59%. However, new health interventions can only be effective if they are also socially and culturally acceptable. It is also crucial to ensure that attitudes to IPTi do not negatively influence attitudes to and uptake of immunization, or that people do not misunderstand IPTi as immunization against malaria and neglect other preventive measures or delay treatment seeking. Methods These issues were studied in five African countries in the context of clinical trials and implementation studies of IPTi. Mixed methods were used, including structured questionnaires (1,296, semi-structured interviews (168, in-depth interviews (748 and focus group discussions (95 with mothers, fathers, health workers, community members, opinion leaders, and traditional healers. Participant observation was also carried out in the clinics. Results IPTi was widely acceptable because it resonated with existing traditional preventive practices and a general concern about infant health and good motherhood. It also fit neatly within already widely accepted routine vaccination. Acceptance and adherence were further facilitated by the hierarchical relationship between health staff and mothers and by the fact that clinic attendance had a social function for women beyond acquiring health care. Type of drug and regimen were important, with newer drugs being seen as more effective, but potentially also more dangerous. Single dose infant formulations delivered in the clinic seem to be the most likely to be both acceptable and adhered to. There was little evidence that IPTi per se had a negative impact on attitudes to EPI or that it had any affect on EPI adherence. There was also little evidence of IPTi having a negative impact on health seeking for infants with febrile illness or existing preventive practices. Conclusion IPTi is generally acceptable across a wide range of

  20. Family-Based HIV Preventive Intervention: Child Level Results from the CHAMP Family Program

    Science.gov (United States)

    McBride, Cami K.; Baptiste, Donna; Traube, Dorian; Paikoff, Roberta L.; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl C.; Coleman, Ida; McKay, Mary M.

    2010-01-01

    SUMMARY Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth’s exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth’s best hope to grow up and survive multiple-dangers in urban neighborhoods (Pequegnat & Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided. PMID:20852742

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  2. Comparison of a Targeted Intervention Program Delivered Face-to-Face and by Personal Videoconferencing for Primary and Middle School Students with Mathematical Learning Difficulties

    Science.gov (United States)

    Kestel, Eugénie

    2014-01-01

    This paper describes part of a mixed-methods study comparing the effectiveness of an individual, conceptual instruction based, tuition program delivered face-to-face and by personal videoconferencing (PVC) for 30 upper primary and middle school students with mathematical learning difficulties (MLDs). The experimental intervention targeted number…

  3. Early Intervention May Prevent the Development of PTSD: A Randomized Pilot Civilian Study with Modified Prolonged Exposure

    Science.gov (United States)

    Rothbaum, Barbara Olasov; Kearns, Megan C.; Price, Matthew; Malcoun, Emily; Davis, Michael; Ressler, Kerry J.; Lang, Delia; Houry, Debra

    2012-01-01

    Background Posttraumatic stress disorder is a major public health concern with long term sequelae. There are no accepted interventions delivered in the immediate aftermath of trauma. This study tested an early intervention aimed at modifying the memory to prevent the development of PTSD prior to memory consolidation. Methods Patients (N=137) were randomly assigned to receive 3 sessions of an early intervention beginning in the emergency department (ED) compared to an assessment only control group. Posttraumatic stress reactions (PTSR) were assessed at 4 and 12 weeks post-injury and depression at baseline and week 4. The intervention consisted of modified prolonged exposure including imaginal exposure to the trauma memory, processing of traumatic material, and in vivo and imaginal exposure homework. Results Patients were assessed an average of 11.79 hours post-trauma. Intervention participants reported significantly lower PTSR than the assessment group at 4 weeks post-injury, p rape victims at Week 4 (p=.004) and Week 12 (p=.05). Conclusions These findings suggest that the modified prolonged exposure intervention initiated within hours of the trauma in the ED is successful at reducing PTSR and depression symptoms one and three months after trauma exposure and is safe and feasible. This is the first behavioral intervention delivered immediately post-trauma that has been shown to be effective at reducing PTSR. PMID:22766415

  4. Early intervention may prevent the development of posttraumatic stress disorder: a randomized pilot civilian study with modified prolonged exposure.

    Science.gov (United States)

    Rothbaum, Barbara Olasov; Kearns, Megan C; Price, Matthew; Malcoun, Emily; Davis, Michael; Ressler, Kerry J; Lang, Delia; Houry, Debra

    2012-12-01

    Posttraumatic stress disorder (PTSD) is a major public health concern with long-term sequelae. There are no accepted interventions delivered in the immediate aftermath of trauma. This study tested an early intervention aimed at modifying the memory to prevent the development of PTSD before memory consolidation. Patients (n = 137) were randomly assigned to receive three sessions of an early intervention beginning in the emergency department compared with an assessment only control group. Posttraumatic stress reactions (PTSR) were assessed at 4 and 12 weeks postinjury and depression at baseline and week 4. The intervention consisted of modified prolonged exposure including imaginal exposure to the trauma memory, processing of traumatic material, and in vivo and imaginal exposure homework. Patients were assessed an average of 11.79 hours posttrauma. Intervention participants reported significantly lower PTSR than the assessment group at 4 weeks postinjury, p rape victims at week 4 (p = .004) and week 12 (p = .05). These findings suggest that the modified prolonged exposure intervention initiated within hours of the trauma in the emergency department is successful at reducing PTSR and depression symptoms 1 and 3 months after trauma exposure and is safe and feasible. This is the first behavioral intervention delivered immediately posttrauma that has been shown to be effective at reducing PTSR. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. Development of a repository of individual participant data from randomized controlled trials of therapists delivered interventions for low back pain.

    Science.gov (United States)

    Hee, S W; Dritsaki, M; Willis, A; Underwood, M; Patel, S

    2017-05-01

    Individual patient data (IPD) meta-analysis of existing randomized controlled trials (RCTs) is a promising approach to achieving sufficient statistical power to identify sub-groups. We created a repository of IPD from multiple low back pain (LBP) RCTs to facilitate a study of treatment moderators. Due to sparse heterogeneous data, the repository needed to be robust and flexible to accommodate millions of data points prior to any subsequent analysis. We systematically identified RCTs of therapist delivered intervention for inclusion to the repository. Some were obtained through project publicity. We requested both individual items and aggregate scores of all baseline characteristics and outcomes for all available time points. The repository is made up of a hybrid database: entity-attribute-value and relational database which is capable of storing sparse heterogeneous datasets. We developed a bespoke software program to extract, transform and upload the shared data. There were 20 datasets with more than 3 million data points from 9328 participants. All trials collected covariates and outcomes data at baseline and follow-ups. The bespoke standardized repository is flexible to accommodate millions of data points without compromising data integrity. Data are easily retrieved for analysis using standard statistical programs. The bespoke hybrid repository is complex to implement and to query but its flexibility in supporting datasets with varying sets of responses and outcomes with different data types is a worthy trade off. The large standardized LBP dataset is also an important resource useable by other LBP researchers. A flexible adaptive database for pain studies that can easily be expanded for future researchers to map, transform and upload their data in a safe and secure environment. The data are standardized and harmonized which will facilitate future requests from other researchers for secondary analyses. © 2016 The Authors. European Journal of Pain published by

  6. S-13: Interventions for Prevention and Rehabilitation of Hamstring Injuries

    Directory of Open Access Journals (Sweden)

    Reza Rahimi Moghaddam

    2017-03-01

    Full Text Available INTRODUCTION: The hamstring muscles have very important role in the stabilization of body posture, movement of the lower extremities and trunk movements in relation to the thigh. Hamstring injuries are common among athletes, especially in sports like soccer with sprinting demands, kicking, and sudden accelerations. Hamstring strains are frustrating for the injured athletes because the symptoms are persistent, healing is slow, and the rate of re-injury is high. This indicates a need to develop prevention strategies for hamstring injuries. The aims of this review are introducing hamstring strains, associated risk factors, and providing rehabilitative ecommendations for injured athletes to prevent re-injury. METHOD: Information was gathered from an online literatures search using the key words hamstring injuries, soccer injuries, injury prevention, hamstring rehabilitation, and stretching exercises. Screening of references and hand searches of relevant journals were also employed. All relevant studies in English were reviewed and abstracted.RESULTS: It has been shown that hamstring strains account for 12-16% of all injuries in athletes with a re-injury rate reported as high as 22-34%. The hamstrings have a tendency to shorten. Tight hamstrings with limited range of motion and flexibility may lead to postural deficiency and deformities. It also makes the hamstring susceptible to re-injury. Risk factors such as age, strength imbalance, previous injury and flexibility should be considered. CONCLUSION: Prevention intervention may minimize the risk factors of hamstring injuries. Training modalities should emphasize on eccentric strength training, and prevention of fatigue. There is wide disagreement about the impact of stretching exercise on prevention/rehabilitation of hamstring injuries.

  7. Interventions for preventing or reducing domestic violence against pregnant women.

    Science.gov (United States)

    Jahanfar, Shayesteh; Howard, Louise M; Medley, Nancy

    2014-11-12

    Domestic violence during pregnancy is a major public health concern. This preventable risk factor threatens both the mother and baby. Routine perinatal care visits offer opportunities for healthcare professionals to screen and refer abused women for effective interventions. It is, however, not clear which interventions best serve mothers during pregnancy and postpartum to ensure their safety. To examine the effectiveness and safety of interventions in preventing or reducing domestic violence against pregnant women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014), scanned bibliographies of published studies and corresponded with investigators. We included randomised controlled trials (RCTs) including cluster-randomised trials, and quasi-randomised controlled trials (e.g. where there was alternate allocation) investigating the effect of interventions in preventing or reducing domestic violence during pregnancy. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included 10 trials with a total of 3417 women randomised. Seven of these trials, recruiting 2629 women, contributed data to the review. However, results for all outcomes were based on single studies. There was limited evidence for the primary outcomes of reduction of episodes of violence (physical, sexual, and/or psychological) and prevention of violence during and up to one year after pregnancy (as defined by the authors of trials). In one study, women who received the intervention reported fewer episodes of partner violence during pregnancy and in the postpartum period (risk ratio (RR) 0.62, 95% confidence interval (CI) 0.43 to 0.88, 306 women, moderate quality). Groups did not differ for Conflict Tactics Score - the mean partner abuse scores in the first three months postpartum (mean difference (MD) 4.20 higher, 95% CI -10.74 to 19.14, one study, 46 women, very low quality). The Current

  8. Allergic diseases among children: nutritional prevention and intervention

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2016-03-01

    Full Text Available Mohamed A Hendaus,1,2 Fatima A Jomha,3 Mohammad Ehlayel2,4 1Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, 2Weill Cornell Medical College, Doha, Qatar; 3School of Pharmacy, Lebanese International University, Khiara, Lebanon; 4Department of Pediatrics, Section of Pediatric Allergy-Immunology, Hamad Medical Corporation, Doha, Qatar Abstract: Allergic diseases comprise a genetically heterogeneous group of chronic, immunomediated diseases. It has been clearly reported that the prevalence of these diseases has been on the rise for the last few decades, but at different rates, in various areas of the world. This paper discusses the epidemiology of allergic diseases among children and their negative impact on affected patients, their families, and societies. These effects include the adverse effects on quality of life and economic costs. Medical interest has shifted from tertiary or secondary prevention to primary prevention of these chronic diseases among high-risk infants in early life. Being simple, practical, and cost-effective are mandatory features for any candidate methods delivering these strategies. Dietary therapy fits this model well, as it is simple, practical, and cost-effective, and involves diverse methods. The highest priority strategy is feeding these infants breast milk. For those who are not breast-fed, there should be a strategy to maintain beneficial gut flora that positively influences intestinal immunity. We review the current use of probiotics, prebiotics, and synbiotics, and safety and adverse effects. Other dietary modalities of possible potential in achieving this primary prevention, such as a Mediterranean diet, use of milk formula with modified (hydrolyzed proteins, and the role of micronutrients, are also explored. Breast-feeding is effective in reducing the risk of asthma, allergic rhinitis, and atopic eczema among children. In addition, breast milk constitutes a major source

  9. Delivering prostate cancer prevention messages to the public: how the National Cancer Institute (NCI) effectively spread the word about the Prostate Cancer Prevention Trial (PCPT) results.

    Science.gov (United States)

    Croker, Kara Smigel; Ryan, Anne; Morzenti, Thuy; Cave, Lynn; Maze-Gallman, Tamara; Ford, Leslie

    2004-01-01

    The Prostate Cancer Prevention Trial was the first clinical trial to show that a direct intervention (5 mg of finasteride daily for 7 years) could reduce a man's risk of developing prostate cancer. Initial results also suggested that men taking finasteride had an increased risk of developing what appeared to be higher-grade disease (Gleason score 7-10). The National Cancer Institute has a congressional mandate to communicate health information to the public and has established methods to reach the public directly and to reach information intermediaries in the media, professional societies, and advocacy groups. The groundbreaking yet complicated results of the Prostate Cancer Prevention Trial were widely disseminated by National Cancer Institute using the social marketing and public-relations strategies and tactics detailed here. Copyright 2004 Elsevier Inc.

  10. Prevention of hand eczema among Danish hairdressing apprentices: an intervention study

    DEFF Research Database (Denmark)

    Bregnhøj, Anne; Menné, Torkil; Johansen, Jeanne Duus

    2012-01-01

    for this study and delivered by teachers specially trained in the prevention of hand eczema; the other half received normal training and served as a control group. All apprentices completed self-administered questionnaires including questions regarding hand eczema, use of gloves and degree of wet work, and were...... used gloves during wet work procedures and significantly fewer developed hand eczema compared with apprentices from the control group (p=0.04). A logistic regression model showed that atopic dermatitis had a significant influence on the development of hand eczema in the cohort irrespective...... of the intervention.ConclusionsWe were able to increase the use of gloves and reduce the incidence of hand eczema in hairdressing apprentices by implementing a training program in hairdressing schools....

  11. Prevention of generalized anxiety disorder using a web intervention, iChill: randomized controlled trial.

    Science.gov (United States)

    Christensen, Helen; Batterham, Philip; Mackinnon, Andrew; Griffiths, Kathleen M; Kalia Hehir, Kanupriya; Kenardy, Justin; Gosling, John; Bennett, Kylie

    2014-09-02

    Generalized Anxiety Disorder (GAD) is a high prevalence, chronic disorder. Web-based interventions are acceptable, engaging, and can be delivered at scale. Few randomized controlled trials evaluate the effectiveness of prevention programs for anxiety, or the factors that improve effectiveness and engagement. The intent of the study was to evaluate the effectiveness of a Web-based program in preventing GAD symptoms in young adults, and to determine the role of telephone and email reminders. A 5-arm randomized controlled trial with 558 Internet users in the community, recruited via the Australian Electoral Roll, was conducted with 6- and 12-month follow-up. Five interventions were offered over a 10-week period. Group 1 (Active website) received a combined intervention of psycho-education, Internet-delivered Cognitive Behavioral Therapy (ICBT) for anxiety, physical activity promotion, and relaxation. Group 2 (Active website with telephone) received the identical Web program plus weekly telephone reminder calls. Group 3 (Active website with email) received the identical Web program plus weekly email reminders. Group 4 (Control) received a placebo website. Group 5 (Control with telephone) received the placebo website plus telephone calls. Main outcome measures were severity of anxiety symptoms as measured by the GAD 7-item scale (GAD-7) (at post-test, 6, and 12 months). Secondary measures were GAD caseness, measured by the Mini International Neuropsychiatric Interview (MINI) at 6 months, Centre for Epidemiologic Studies-Depression scale (CES-D), Anxiety Sensitivity Index (ASI), Penn State Worry Questionnaire (PSWQ), and Days out of Role. GAD-7 symptoms reduced over post-test, 6-month, and 12-month follow-up. There were no significant differences between Group 4 (Control) and Groups 1 (Active website), 2 (Active website with telephone), 3 (Active website with email), or 5 (Control with telephone) at any follow-up. A total of 16 cases of GAD were identified at 6 months

  12. A randomized controlled trial of an intervention delivered by mobile phone app instant messaging to increase the acceptability of effective contraception among young people in Tajikistan.

    Science.gov (United States)

    McCarthy, Ona; Ahamed, Irrfan; Kulaeva, Firuza; Tokhirov, Ravshan; Saibov, Salokhiddin; Vandewiele, Marieka; Standaert, Sarah; Leurent, Baptiste; Edwards, Phil; Palmer, Melissa; Free, Caroline

    2018-02-13

    Unintended pregnancy is associated with poorer health outcomes for women and their families. In Tajikistan, around 26% of married 15-24 year old women have an unmet need for contraception. There is some evidence that interventions delivered by mobile phone can affect contraceptive-related behaviour and knowledge. We developed an intervention delivered by mobile phone app instant messaging to improve acceptability of effective contraceptive methods among young people in Tajikistan. This was a randomized controlled trial among Tajik people aged 16-24. Participants allocated to the intervention arm had access to an app plus intervention messages. Participants allocated to the control arm had access to the app plus control messages. The primary outcome was acceptability of at least one method of effective contraception at 4 months. Secondary outcomes were use of effective contraception at 4 months and during the study, acceptability of individual methods, service uptake, unintended pregnancy and induced abortion. Process outcomes were knowledge, perceived norms, personal agency and intention. Outcomes were analysed using logistic and linear regression. We conducted a pre-specified subgroup analysis and a post-hoc analysis of change in acceptability from baseline to follow-up. Five hundred and seventy-three participants were enrolled. Intervention content was included on the app, causing contamination. Four hundred and seventy-two (82%) completed follow-up for the primary outcome. There was no evidence of a difference in acceptability of effective contraception between the groups (66% in the intervention arm vs 64% in the control arm, adjusted OR 1.21, 95% CI .80-1.83, p = 0.36). There were no differences in the secondary or process outcomes between groups. There was some evidence that the effect of the intervention was greater among women compared to men (interaction test p = 0.03). There was an increase in acceptability of effective contraception from baseline

  13. Combined diet and exercise interventions for preventing gestational diabetes mellitus.

    Science.gov (United States)

    Shepherd, Emily; Gomersall, Judith C; Tieu, Joanna; Han, Shanshan; Crowther, Caroline A; Middleton, Philippa

    2017-11-13

    Gestational diabetes mellitus (GDM) is associated with a wide range of adverse health consequences for women and their infants in the short and long term. With an increasing prevalence of GDM worldwide, there is an urgent need to assess strategies for GDM prevention, such as combined diet and exercise interventions. This is an update of a Cochrane review that was first published in 2015. To assess the effects of diet interventions in combination with exercise interventions for pregnant women for preventing GDM, and associated adverse health consequences for the mother and her infant/child. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 November 2016) and reference lists of retrieved studies. We included randomised controlled trials (RCTs) and cluster-RCTs, comparing combined diet and exercise interventions with no intervention (i.e. standard care), that reported on GDM diagnosis as an outcome. Quasi-RCTs were excluded. Cross-over trials were not eligible for inclusion. We planned to include RCTs comparing two or more different diet/exercise interventions, however none were identified. Two review authors independently assessed study eligibility, extracted data, assessed the risk of bias of the included trials and assessed quality of evidence for selected maternal and infant/child outcomes using the GRADE approach. We checked data for accuracy. In this update, we included 23 RCTs (involving 8918 women and 8709 infants) that compared combined diet and exercise interventions with no intervention (standard care). The studies varied in the diet and exercise programs evaluated and health outcomes reported. None reported receiving funding from a drug manufacturer or agency with interests in the results. Overall risk of bias was judged to be unclear due to the lack of methodological detail reported. Most studies were undertaken in high-income countries.For our primary review outcomes, there was a possible reduced risk of GDM in the diet and

  14. Community based interventions for the prevention and control of tuberculosis.

    Science.gov (United States)

    Arshad, Ahmed; Salam, Rehana A; Lassi, Zohra S; Das, Jai K; Naqvi, Imama; Bhutta, Zulfiqar A

    2014-01-01

    In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an overall improvement in treatment success rates (RR: 1.09, 95% CI: 1.07, 1.11) and evidence from a single study suggests significant reduction in relapse rate (RR: 0.26, 95% CI: 0.18, 0.39). The results were consistent for various study design and delivery mechanism. Qualitative synthesis suggests that community based TB treatment delivery through community health workers (CHW) not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems. CBI coupled with the DOTS strategy seem to be an effective approach, however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.

  15. [INTERVENTIONS FOR PREVENTION AND MANAGEMENT OF CHILD AND YOUTH OBESITY].

    Science.gov (United States)

    Pérez Morente, Ma Angeles; Sánchez Ocón, Ma Teresa; Mingorance Ruiz, Ma Visitación; Pérez Robles, Angustias; Munoz de la Fuente, José Manuel; Sánchez De Arias, Celia

    2015-02-01

    To determine the current epidemiological situation, prevention and management of child and youth obesity based on the best scientific evidence available. Literature search in PubMed, Cochrane, Science Direct, ENFISPO, Lilacs and SciELO, selecting articles about child and youth obesity, its prevention and treatment. Child and youth obesity is a multifactorial chronic disease that it has been increasing, tending to stay in adolescence and adulthood with greater intensity than more early starts. The data vary from country to country, although most articles are governed by body mass index (BMI). Pediatric overweight is defined by a BMI percentiles located between 91-98 and obesity by a percentile equal or greater than 99. Its prevalence varies according to time, geography, age, gender and race. The prevalence rates of obesity in Spain are one of the highest around the world. The overweight prevalence is lower slightly and there is no difference in gender. Its implications include the metabolic syndrome and diabetes mellitus II. Unanimously, the combination of interventions on life and dietary habits and physical activity is important for the management of obesity and overweight. Currently, the obesity management requires a generalized approach, with changes in lifestyle, diet and physical activity. The best solution for reducing this epidemic lies in prevention rather than treatment.

  16. A lifetime approach to major depressive disorder: The contributions of psychological interventions in preventing relapse and recurrence.

    Science.gov (United States)

    Bockting, Claudi L; Hollon, Steven D; Jarrett, Robin B; Kuyken, Willem; Dobson, Keith

    2015-11-01

    Major depressive disorder (MDD) is highly disabling and typically runs a recurrent course. Knowledge about prevention of relapse and recurrence is crucial to the long-term welfare of people who suffer from this disorder. This article provides an overview of the current evidence for the prevention of relapse and recurrence using psychological interventions. We first describe a conceptual framework to preventive interventions based on: acute treatment; continuation treatment, or; prevention strategies for patients in remission. In brief, cognitive-behavioral interventions, delivered during the acute phase, appear to have an enduring effect that protects patients against relapse and perhaps others from recurrence following treatment termination. Similarly, continuation treatment with either cognitive therapy or perhaps interpersonal psychotherapy appears to reduce risk for relapse and maintenance treatment appears to reduce risk for recurrence. Preventive relapse strategies like preventive cognitive therapy or mindfulness based cognitive therapy (MBCT) applied to patients in remission protects against subsequent relapse and perhaps recurrence. There is some preliminary evidence of specific mediation via changing the content or the process of cognition. Continuation CT and preventive interventions started after remission (CBT, MBCT) seem to have the largest differential effects for individuals that need them the most. Those who have the greatest risk for relapse and recurrence including patients with unstable remission, more previous episodes, potentially childhood trauma, early age of onset. These prescriptive indications, if confirmed in future research, may point the way to personalizing prevention strategies. Doing so, may maximize the efficiency with which they are applied and have the potential to target the mechanisms that appear to underlie these effects. This may help make this prevention strategies more efficacious. Copyright © 2015 Elsevier Ltd. All rights

  17. Enhancing Documentation of Pressure Ulcer Prevention Interventions: A Quality Improvement Strategy to Reduce Pressure Ulcers.

    Science.gov (United States)

    Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine

    2016-01-01

    Prevention of hospital-acquired pressure ulcers requires the implementation of evidence-based interventions. A quality improvement project was conducted to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed as measured by documentation. Documentation reports provided feedback to stakeholders, triggering reminders and reeducation. Intervention reports and modifications to the documentation system were effective both in increasing the documentation of pressure ulcer prevention interventions and in decreasing the number of avoidable hospital-acquired pressure ulcers.

  18. Interventions to combat or prevent drug counterfeiting: a systematic review.

    Science.gov (United States)

    El-Jardali, Fadi; Akl, Elie A; Fadlallah, Racha; Oliver, Sandy; Saleh, Nadine; El-Bawab, Lamya; Rizk, Rana; Farha, Aida; Hamra, Rasha

    2015-03-18

    Drug counterfeiting has serious public health and safety implications. The objective of this study was to systematically review the evidence on the effectiveness of interventions to combat or prevent drug counterfeiting. We searched multiple electronic databases and the grey literature up to March 2014. Two reviewers completed, in duplicate and independently, the study selection, data abstraction and risk of bias assessment. We included randomised trials, non-randomised studies, and case studies examining any intervention at the health system-level to combat or prevent drug counterfeiting. Outcomes of interest included changes in failure rates of tested drugs and changes in prevalence of counterfeit medicines. We excluded studies that focused exclusively on substandard, degraded or expired drugs, or that focused on medication errors. We assessed the risk of bias in each included study. We reported the results narratively and, where applicable, we conducted meta-analyses. We included 21 studies representing 25 units of analysis. Overall, we found low quality evidence suggesting positive effects of drug registration (OR=0.23; 95% CI 0.08 to 0.67), and WHO-prequalification of drugs (OR=0.06; 95% CI 0.01 to 0.35) in reducing the prevalence of counterfeit and substandard drugs. Low quality evidence suggests that licensing of drug outlets is probably ineffective (OR=0.66; 95% CI 0.41 to 1.05). For multifaceted interventions (including a mix of regulations, training of inspectors, public-private collaborations and legal actions), low quality evidence suggest they may be effective. The single RCT provided moderate quality evidence of no effect of 'two extra inspections' in improving drug quality. Policymakers and stakeholders would benefit from registration and WHO-prequalification of drugs and may also consider multifaceted interventions. Future effectiveness studies should address the methodological limitations of the available evidence. PROSPERO CRD42014009269

  19. Process evaluation of a point-of-care cluster randomised trial using a computer-delivered intervention to reduce antibiotic prescribing in primary care.

    Science.gov (United States)

    McDermott, Lisa; Yardley, Lucy; Little, Paul; van Staa, Tjeerd; Dregan, Alex; McCann, Gerard; Ashworth, Mark; Gulliford, Martin

    2014-12-03

    The study aimed to conduct a process evaluation for a cluster randomised trial of a computer-delivered, point-of-care intervention to reduce antibiotic prescribing in primary care. The study aimed to evaluate both the intervention and implementation of the trial. The intervention comprised a set of electronic educational and decision support tools that were remotely installed and activated during consultations with patients with acute respiratory infections over a 12 month intervention period. A mixed method evaluation was conducted with 103 general practitioners (GPs) who participated in the trial. Semi-structured telephone interviews were conducted with 20 GPs who had been in the intervention group of the trial and 4 members of the implementation staff. Questionnaires, consisting of both intervention evaluation and theory-based measures, were self-administered to 83 GPs (56 control group and 27 intervention group). Interviews suggested that a key factor influencing GPs' use of the intervention appeared to be their awareness of the implementation of the system into their practice. GPs who were aware of the implementation of the intervention reported feeling confident in using it if they chose to and understood the purpose of the intervention screens. However, GPs who were unaware that the intervention would be appearing often reported feeling confused when they saw the messages appear on the screen and not fully understanding what they were for or how they could be used. Intervention evaluation questionnaires indicated that GPs were satisfied with the usability of the prompts, and theory-based measures revealed that intervention group GPs reported higher levels of self-efficacy in managing RTI patients according to recommended guidelines compared to GPs in the control group. Remote installation of a computer-delivered intervention for use at the point-of-care was feasible and acceptable. Additional measures to promote awareness of the intervention may be required

  20. Randomized controlled trial of a web-delivered personalized normative feedback intervention to reduce alcohol-related risky sexual behavior among college students.

    Science.gov (United States)

    Lewis, Melissa A; Patrick, Megan E; Litt, Dana M; Atkins, David C; Kim, Theresa; Blayney, Jessica A; Norris, Jeanette; George, William H; Larimer, Mary E

    2014-06-01

    The purpose of this study was to evaluate the efficacy of personalized normative feedback (PNF) on college student alcohol-related risky sexual behavior (RSB). In a randomized controlled trial, 480 (57.6% female) sexually active college students were stratified by gender and level of drinking and randomly assigned to an alcohol-only intervention, an alcohol-related RSB-only intervention, a combined alcohol and alcohol-related RSB intervention, or control. All assessment and intervention procedures were Web-based. Results indicated a significant reduction in drinking outcomes for the alcohol only and the combined alcohol and alcohol-related RSB interventions relative to control. Findings further demonstrated a significant reduction in alcohol-related RSB outcomes for the alcohol-related RSB only and the combined alcohol and alcohol-related RSB interventions relative to control. There were no significant intervention effects on alcohol-related negative consequences. These findings demonstrate that the combined alcohol and alcohol-related RSB intervention was the only intervention successful at reducing both drinking and alcohol-related RSB outcomes relative to control. There were no significant differences when comparing the combined alcohol and alcohol-related RSB intervention to the alcohol-only intervention or the alcohol-related RSB-only intervention. Finally, results suggested that the intervention effects on high-risk behaviors were mediated by reductions in descriptive normative perceptions. These findings demonstrate that PNF specific to drinking in sexual situations was needed to reduce alcohol-related RSB. Furthermore, this study highlights the potential utility of a brief intervention that can be delivered via the Internet to reduce high-risk drinking and alcohol-related RSB among college students. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  1. Developing PeerLink to engage out-of-care HIV+ substance users: training peers to deliver a peer-led motivational intervention with fidelity.

    Science.gov (United States)

    Wolfe, Hannah; Haller, Deborah L; Benoit, Ellen; Bolger, Kelly W; Cancienne, James C; Ingersoll, Karen S; Sharp, Victoria

    2013-01-01

    Substance use among HIV+ individuals can be a barrier to HIV care, resulting in poor health outcomes. Motivational interviewing (MI) is an effective intervention to reduce substance abuse and increase HIV-related health. Healthcare workers from various backgrounds can be effectively trained in delivering MI interventions; however, there has been limited evidence that peers can effectively deliver MI interventions with fidelity. Peers have traditionally worked in HIV care settings and represent a valid context for a peer-delivered intervention focused on motivational issues. We trained four peers in MI. In this paper, we describe the intervention, explain the MI training methods, and investigate whether peers can be trained in MI with fidelity. The MI training included didactic instruction, group workshops, and individual feedback sessions. Two of four peers achieved MI treatment fidelity as measured by the Motivational Interviewing Treatment Integrity Code Version 3.0. Overall, peers had difficulty using open-ended questions and querying pros and cons, skills thought necessary to elicit change talk. They also tended to give too much direct advice where reflections would have been appropriate. A challenge was training peers to change familiar ways of communicating. Nonetheless, they did well at assessing and highlighting motivation to change. The total training hours (40 h) was long compared with other published MI studies. However, the intervention included several components with two targeted change behaviors. It is likely that peers can be trained in MI with fidelity in less time given a more streamlined intervention. When working with peers who have life stressors similar to the target group, it is important to be flexible in the training.

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

    Science.gov (United States)

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

    2013-04-01

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

  3. Nutritional interventions for preventing and treating pressure ulcers.

    Science.gov (United States)

    Langer, Gero; Fink, Astrid

    2014-06-12

    ulcer development (pooled RR 0.86; 95% CI 0.73 to 1.00; P value 0.05; I(2) = 13%, random effects). This outcome is at unclear or high risk of bias.Fourteen trials evaluated the effects of nutritional supplements on the healing of existing pressure ulcers: seven trials examined mixed nutritional supplements, three the effects of proteins, two trials examined zinc, and two studies examined ascorbic acid. The included trials were heterogeneous with regard to participants, interventions, comparisons and outcomes and meta-analysis was not appropriate. There was no clear evidence of an improvement in pressure ulcer healing from the nutritional supplements evaluated in any of these individual studies. There is currently no clear evidence of a benefit associated with nutritional interventions for either the prevention or treatment of pressure ulcers. Further trials of high methodological quality are necessary.

  4. Taking snapshots of preventive interventions : On the effectiveness of preventive interventions for youth and how it relates to implementation and conflict of interest

    NARCIS (Netherlands)

    Goossens, F.X.

    2017-01-01

    Intervention studies This dissertation describes three trials in which the effectiveness of three preventive interventions for youth were tested in the Netherlands. The interventions aim to improve the social and emotional development of children in elementary school (PATHS), reduce alcohol use and

  5. Falls assessment and prevention: a multidisciplinary teaching intervention.

    Science.gov (United States)

    Boardman, Kerry; Al-Jawad, Muna; Briggs, Louise; Kendrick, Damien

    2010-09-01

    Falls are a common and important clinical problem, and with ageing populations worldwide it is important for health care professionals to learn about falls management. The multidisciplinary nature of falls teams also provides an ideal opportunity for interprofessional collaboration in teaching. In this article, we describe a pilot multidisciplinary falls assessment and prevention workshop for second-year medical students at a London medical school. An interprofessional team worked together to design and deliver this workshop. During a 90-minute clinical skills session, students rotated through medical, occupational therapy and physiotherapy areas. They worked in small groups, using brainstorming, discussion and practical exercises to learn about multiple risk factors contributing to falls, and how professionals work together in the management of patients at risk of falling. Evaluation was carried out using a combination of quantitative Likert ratings and qualitative free-text comments. The session was well received, with identified strengths and areas for improvement helping to confirm the importance of this workshop in the curriculum, and leading to improvements in the design for future sessions. © Blackwell Publishing Ltd 2010.

  6. Brief Training of HIV Medical Providers Increases Their Frequency of Delivering Prevention Counselling to Patients at Risk of Transmitting HIV to Others

    Science.gov (United States)

    Patel, Shilpa N.; Marks, Gary; Gardner, Lytt; Golin, Carol E.; Shinde, Sanjyot; O'Daniels, Christine; Wilson, Tracey E.; Quinlivan, E. Byrd; Banderas, Julie W.

    2013-01-01

    Objective: The aim of this study was to examine whether brief training of human immunodeficiency virus (HIV) medical providers increased the frequency with which they routinely delivered prevention counselling to patients, and whether patient characteristics were associated with receipt of that counselling. Design: Longitudinal. Setting: Seven HIV…

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

    Directory of Open Access Journals (Sweden)

    Lewin Simon

    2011-10-01

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

  8. Interventions to prevent occupational noise-induced hearing loss.

    Science.gov (United States)

    Tikka, Christina; Verbeek, Jos H; Kateman, Erik; Morata, Thais C; Dreschler, Wouter A; Ferrite, Silvia

    2017-07-07

    This is the second update of a Cochrane Review originally published in 2009. Millions of workers worldwide are exposed to noise levels that increase their risk of hearing disorders. There is uncertainty about the effectiveness of hearing loss prevention interventions. To assess the effectiveness of non-pharmaceutical interventions for preventing occupational noise exposure or occupational hearing loss compared to no intervention or alternative interventions. We searched the CENTRAL; PubMed; Embase; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; and OSH UPDATE to 3 October 2016. We included randomised controlled trials (RCT), controlled before-after studies (CBA) and interrupted time-series (ITS) of non-clinical interventions under field conditions among workers to prevent or reduce noise exposure and hearing loss. We also collected uncontrolled case studies of engineering controls about the effect on noise exposure. Two authors independently assessed study eligibility and risk of bias and extracted data. We categorised interventions as engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance. We included 29 studies. One study evaluated legislation to reduce noise exposure in a 12-year time-series analysis but there were no controlled studies on engineering controls for noise exposure. Eleven studies with 3725 participants evaluated effects of personal hearing protection devices and 17 studies with 84,028 participants evaluated effects of hearing loss prevention programmes (HLPPs). Effects on noise exposure Engineering interventions following legislationOne ITS study found that new legislation in the mining industry reduced the median personal noise exposure dose in underground coal mining by 27.7 percentage points (95% confidence interval (CI) -36.1 to -19.3 percentage points) immediately after the implementation of stricter legislation. This roughly translates to a 4.5 dB(A) decrease in

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

    Science.gov (United States)

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

    2017-04-01

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

  10. Early interventions to prevent retinal vasculopathy in diabetes: a review

    Directory of Open Access Journals (Sweden)

    Harrison WW

    2015-08-01

    Full Text Available Wendy W Harrison, Vladimir YevseyenkovArizona College of Optometry, Midwestern University, Glendale, AZ, USAAbstract: Diabetic eye disease is a public health concern in all areas of the world as a leading cause of blindness in the working aged to elderly populations. Diabetes damages the lining of the microvasculature throughout the body through prolonged exposure to hyperglycemic conditions. The ocular changes are progressive with very little recourse for improvement once damage begins. Current treatments for the eye focus mainly on the late stages of the disease when neovascularization or edema threatens sight. Early interventions for diabetic vasculopathy involve metabolic therapy to improve blood glucose and blood pressure control. Technology improvements have a large part to play in advancing diagnosis of diabetic eye disease. These new technologies offer both structural and functional means for assessment of retinal health. This review focuses on current treatments for diabetic eye disease at all stages with an emphasis on new and early interventions. It also details established and emerging technologies used for earlier detection of diabetic eye disease, which is vital to the development and approval of much needed treatments targeted at earlier stages of diabetic retinopathy. Possible future treatments should be aimed to prevent retinal vasculopathy from progressing. This review will explore current research on this topic and what is needed moving forward.Keywords: diabetes, diabetic retinopathy, vascular disease

  11. Getting the message straight: effects of a brief hepatitis prevention intervention among injection drug users.

    Science.gov (United States)

    Grau, Lauretta E; Green, Traci C; Singer, Merrill; Bluthenthal, Ricky N; Marshall, Patricia A; Heimer, Robert

    2009-12-15

    To redress gaps in injection drug users' (IDUs) knowledge about hepatitis risk and prevention, we developed a brief intervention to be delivered to IDUs at syringe exchange programs (SEPs) in three US cities. Following a month-long campaign in which intervention packets containing novel injection hygiene supplies and written materials were distributed to every client at each visit, intervention effectiveness was evaluated by comparing exposed and unexposed participants' self-reported injection practices. Over one-quarter of the exposed group began using the novel hygiene supplies which included an absorbent pad ("Safety Square") to stanch blood flow post-injection. Compared to those unexposed to the intervention, a smaller but still substantial number of exposed participants continued to inappropriately use alcohol pads post-injection despite exposure to written messages to the contrary (22.8% vs. 30.0%). It should also be noted that for those exposed to the intervention, 8% may have misused Safety Squares as part of pre-injection preparation of their injection site; attention should be paid to providing explicit and accurate instruction on the use of any health promotion materials being distributed. While this study indicates that passive introduction of risk reduction materials in injection drug users through syringe exchange programs can be an economical and relatively simple method of changing behaviors, discussions with SEP clients regarding explicit instructions about injection hygiene and appropriate use of novel risk reduction materials is also needed in order to optimize the potential for adoption of health promotion behaviors. The study results suggest that SEP staff should provide their clients with brief, frequent verbal reminders about the appropriate use when distributing risk reduction materials. Issues related to format and language of written materials are discussed.

  12. Impact of Mano a Mano-Mujer, an HIV prevention intervention, on depressive symptoms among Chilean women.

    Science.gov (United States)

    Cianelli, R; Lara, L; Villegas, N; Bernales, M; Ferrer, L; Kaelber, L; Peragallo, N

    2013-04-01

    Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions. © 2012 Blackwell Publishing.

  13. Integrated Interventions Delivered in Health Systems, Home, and Community Have the Highest Impact on Breastfeeding Outcomes in Low- and Middle-Income Countries.

    Science.gov (United States)

    Sinha, Bireshwar; Chowdhury, Ranadip; Upadhyay, Ravi Prakash; Taneja, Sunita; Martines, Jose; Bahl, Rajiv; Sankar, Mari Jeeva

    2017-11-01

    Background: Improving breastfeeding rates is critical. In low- and middle-income countries (LMICs), only subtle improvements in breastfeeding rates have been observed over the past decade, which highlights the need for accelerating breastfeeding promotion interventions. Objective: The objective of this article is to update evidence on the effect of interventions on early initiation of and exclusive (CABI databases to identify new articles relevant to our current review, which were published after the search date of our earlier meta-analysis (October 2014). Nine new articles were found to be relevant and were included, in addition to the other 52 studies that were identified in our earlier meta-analysis. We reported the pooled ORs and corresponding 95% CIs as our outcome estimates. In cases of high heterogeneity, random-effects models were used and causes were explored by subgroup analysis and meta-regression. Results: Early initiation of and exclusive (<1 and 1-5 mo) and continued (6-23 mo) breastfeeding rates in LMICs improved significantly as a result of interventions delivered in health systems, in the home or community, or a combination of these. Interventions delivered concurrently in a combination of settings were found to show the largest improvements in desired breastfeeding outcomes. Counseling provided in any setting and baby-friendly support in health systems appear to be the most effective interventions to improve breastfeeding. Conclusions: Improvements in breastfeeding practices are possible in LMICs with judicious use of tested interventions, particularly when delivered in a combination of settings concurrently. The findings can be considered for inclusion in the Lives Saved Tool model. © 2017 American Society for Nutrition.

  14. Randomized trial comparing computer-delivered and face-to-face personalized feedback interventions for high-risk drinking among college students.

    Science.gov (United States)

    Wagener, Theodore L; Leffingwell, Thad R; Mignogna, Joe; Mignogna, Melissa R; Weaver, Cameron C; Cooney, Nathaniel J; Claborn, Kasey R

    2012-09-01

    This study evaluated the efficacy of two brief personalized feedback interventions (PFIs) using identical feedback and motivational interviewing strategies aimed at reducing alcohol consumption and alcohol-related problems to two control conditions among a sample of high-risk drinking college students. Students (N = 152) were randomly assigned to a computer-delivered PFI with a video interviewer, a face-to-face PFI with a live interviewer, a comprehensive assessment condition, or a minimal assessment-only condition. At 10 weeks posttreatment, the face-to-face PFI significantly reduced weekly drinking quantity and peak and typical blood alcohol concentration compared with the comprehensive assessment and minimal assessment-only conditions (d values ranged from 0.32 to 0.61). No significant between-group differences were evidenced for the computer-delivered PFI condition, although effect sizes were comparable to other college drinking studies using computer-delivered interventions (d values ranged from 0.20 to 0.27). Results provide further support for the use of a face-to-face PFI to help reduce college students' alcohol consumption and suggest that a video interviewer in the context of a computer-delivered PFI is likely a helpful but not necessarily a complete substitute for a live interviewer. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Assessing impact of blanket interventions for MAM prevention

    International Nuclear Information System (INIS)

    Grais, Rebecca F.; Isanaka, I; Langendorf, C; Roederer, T

    2014-01-01

    Full text: Blanket interventions for MAM prevention (Blanket supplementary feeding programming (BSFP)) provide a supplementary food ration often accompanied by a basic medical treatment and prevention package to a vulnerable population for a defined period in a defined geographic location. There is little strong evidence on the impact of BSFP on rates of malnutrition and mortality, and scare guidance on program monitoring and evaluation to improve the implementation of specific programs. Assessing the impact of BSFP has been fraught with difficulty. Their isolated impact is difficult, if not often impossible to disentangle from larger care and prevention packages, the objectives of BSFP may vary by context, implementing agency, time and geography. Various and often multiple co-morbidities among children in the targeted group complicate matters further with respect to impact assessment. This leads to difficulties in generalizing results from one context to another and the need for more complex metrics to guide operational decision-making. Ideally, impact or effectiveness of BSFP should be addressed in a research framework where appropriate and complete data is collected in order to address specific questions. The gold standard is the conduct of randomized studies including a control group. These studies have been scarce as they may be perceived as either rarely feasible or not ethical or both. However, as generating evidence on impact of BSFP is essential to provide operational guidance, these studies should be encouraged through a diversity of robust, yet creative and pragmatic, methodological approaches. As a case study, a series of studies conducted over the past decade are reviewed in the same location in Niger highlighting the lessons learned. (author)

  16. Male urinary incontinence: prevalence, risk factors, and preventive interventions.

    Science.gov (United States)

    Shamliyan, Tatyana A; Wyman, Jean F; Ping, Ryan; Wilt, Timothy J; Kane, Robert L

    2009-01-01

    Urinary incontinence (UI) in community-dwelling men affects quality of life and increases the risk of institutionalization. Observational studies and randomized, controlled trials published in English from 1990 to November 2007 on the epidemiology and prevention of UI were identified in several databases to abstract rates and adjusted odds ratios (OR) of incontinence, calculate absolute risk difference (ARD) after clinical interventions, and synthesize evidence with random-effects models. Of 1083 articles identified, 126 were eligible for analysis. Pooled prevalence of UI increased with age to 21% to 32% in elderly men. Poor general health, comorbidities, severe physical limitations, cognitive impairment, stroke (pooled OR 1.54; 95% confidence interval [CI], 1.14-2.1), urinary tract infections (pooled OR 3.49; 95% CI, 2.33-5.23), prostate diseases, and diabetes (pooled OR 1.36; 95% CI, 1.14-1.61) were associated with UI. Treatment with tolterodine alone (ARD 0.17; 95% CI, 0.02-0.32) or combined with tamsulosin (ARD 0.17; 95% CI, 0.08-0.25) resulted in greater self-reported benefit compared with placebo. Radical prostatectomy or radiotherapy for prostate cancer compared with watchful waiting increased UI. Short-term prevention of UI with pelvic floor muscle rehabilitation after prostatectomy was not consistently seen across randomized, controlled trials. The prevalence of incontinence increased with age and functional dependency. Stroke, diabetes, poor general health, radiation, and surgery for prostate cancer were associated with UI in community-dwelling men. Men reported overall benefit from drug treatments. Limited evidence of preventive effects of pelvic floor rehabilitation requires future investigation.

  17. Taking snapshots of preventive interventions : On the effectiveness of preventive interventions for youth and how it relates to implementation and conflict of interest

    OpenAIRE

    Goossens, F.X.

    2017-01-01

    Intervention studies This dissertation describes three trials in which the effectiveness of three preventive interventions for youth were tested in the Netherlands. The interventions aim to improve the social and emotional development of children in elementary school (PATHS), reduce alcohol use and mental health problems in students in secondary education (Preventure), and empower adolescent second generation migrants (POWER). The results revealed no effectiveness of the PATHS intervention, w...

  18. Pharmacological interventions for preventing post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Amos, Taryn; Stein, Dan J; Ipser, Jonathan C

    2014-07-08

    Post-traumatic stress disorder (PTSD) is a debilitating disorder which, after a sufficient delay, may be diagnosed amongst individuals who respond with intense fear, helplessness or horror to traumatic events. There is some evidence that the use of pharmacological interventions immediately after exposure to trauma may reduce the risk of developing of PTSD. To assess the effects of pharmacological interventions for the prevention of PTSD in adults following exposure to a traumatic event. We searched the Cochrane Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR-Studies and CCDANCTR-References) (to 14 February 2014). This register contains relevant reports of randomised controlled trials from the following bibliographic databases: CENTRAL (all years); EMBASE (1974 to date); MEDLINE (1950 to date) and PsycINFO (1967 to date). We identified unpublished trials by searching the National Institute of Health (NIH) Reporter, the metaRegister of Controlled Trials database (mRCT) and the WHO International Clinical Trials Registry Platform (to December 2013). We scanned the reference lists of articles for additional studies. We placed no constraints on language and setting. We restricted studies to randomised controlled trials (RCTs) of pharmacological interventions compared with placebo for the prevention of PTSD in adults. Two authors (TA and JI) independently assessed trials for eligibility and inclusion based on the review selection criteria. We independently extracted sample, methodological, outcome and 'Risk of bias' data, as well as the number of side effects, from each trial and entered these into a customised data extraction form. We contacted investigators for missing information. We calculated summary statistics for continuous and dichotomous variables (if provided). We did not undertake subgroup analyses due to the small number of included studies. We included nine short-term RCTs (duration 12 weeks or less) in the analysis (345 participants

  19. eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis.

    Science.gov (United States)

    Hutchesson, M J; Rollo, M E; Krukowski, R; Ells, L; Harvey, J; Morgan, P J; Callister, R; Plotnikoff, R; Collins, C E

    2015-05-01

    A systematic review of randomized controlled trials was conducted to evaluate the effectiveness of eHealth interventions for the prevention and treatment of overweight and obesity in adults. Eight databases were searched for studies published in English from 1995 to 17 September 2014. Eighty-four studies were included, with 183 intervention arms, of which 76% (n = 139) included an eHealth component. Sixty-one studies had the primary aim of weight loss, 10 weight loss maintenance, eight weight gain prevention, and five weight loss and maintenance. eHealth interventions were predominantly delivered using the Internet, but also email, text messages, monitoring devices, mobile applications, computer programs, podcasts and personal digital assistants. Forty percent (n = 55) of interventions used more than one type of technology, and 43.2% (n = 60) were delivered solely using eHealth technologies. Meta-analyses demonstrated significantly greater weight loss (kg) in eHealth weight loss interventions compared with control (MD -2.70 [-3.33,-2.08], P eHealth weight loss interventions with extra components or technologies (MD 1.46 [0.80, 2.13], P eHealth programmes. The findings support the use of eHealth interventions as a treatment option for obesity, but there is insufficient evidence for the effectiveness of eHealth interventions for weight loss maintenance or weight gain prevention. © 2015 World Obesity.

  20. A case study on a home-based caregiver-delivered music-with-movement intervention for people with early dementia.

    Science.gov (United States)

    Lai, Daniel Ll; Lai, Claudia Ky

    2017-01-01

    Music has been found to improve sleep and reduce anxiety. This article reports a 78-year-old Chinese female who had been diagnosed with early dementia underwent an 8-week music-with-movement intervention delivered by her husband at home after being trained in a day care center. Both the patient and the husband's data were collected through repeated interviews and regular observations. The results indicated signs of improvement of the patient in terms of sleep quality and depressive symptoms.

  1. Prevention of Mental Health Disorders Using Internet- and Mobile-Based Interventions: A Narrative Review and Recommendations for Future Research

    Directory of Open Access Journals (Sweden)

    David Daniel Ebert

    2017-08-01

    Full Text Available Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD, their current impact on the reduction of disease burden is questionable. Possible reasons include that it is not practical to deliver those interventions to the community en masse due to limited health care resources and the limited availability of evidence-based interventions and clinicians in routine practice, especially in rural areas. Therefore, new approaches are needed to maximize the impact of psychological preventive interventions. Limitations of traditional prevention programs could potentially be overcome by providing Internet- and mobile-based interventions (IMIs. This relatively new medium for promoting mental health and preventing MHD introduces a fresh array of possibilities, including the provision of evidence-based psychological interventions that are free from the restraints of travel and time and allow reaching participants for whom traditional opportunities are not an option. This article provides an introduction to the subject and narratively reviews the available evidence for the effectiveness of IMIs with regard to the prevention of MHD onsets. The number of randomized controlled trials that have been conducted to date is very limited and so far it is not possible to draw definite conclusions about the potential of IMIs for the prevention of MHD for specific disorders. Only for the indicated prevention of depression there is consistent evidence across four different randomized trial trials. The only trial on the prevention of general anxiety did not result in positive findings in terms of eating disorders (EDs, effects were only found in post hoc subgroup analyses, indicating that it might be possible to prevent ED onset for subpopulations of people at risk of developing EDs. Future studies need to identify those subpopulations likely to profit from preventive. Disorders not examined so far include

  2. Internet-based interventions for the secondary prevention of coronary heart disease.

    Science.gov (United States)

    Devi, Reena; Singh, Sally J; Powell, John; Fulton, Emily A; Igbinedion, Ewemade; Rees, Karen

    2015-12-22

    The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease (CHD). To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, in December 2014. We also searched six other databases in October 2014, and three trials registers in January 2015 together with reference checking and handsearching to identify additional studies. Randomised controlled trials (RCTs) evaluating Internet-delivered secondary prevention interventions aimed at people with CHD. Two review authors independently assessed risk of bias and extracted data according to the Cochrane Handbook for Systematic Reviews of Interventions. We assessed evidence quality using the GRADE approach and presented this in a 'Summary of findings' table. Eighteen trials met our inclusion criteria. Eleven studies are complete (1392 participants), and seven are ongoing. Of the completed studies, seven interventions are broad, targeting the lifestyle management of CHD, and four focused on physical activity promotion. The comparison group in trials was usual care (n = 6), minimal intervention (n = 3), or traditional cardiac rehabilitation (n = 2).We found no effects of Internet-based interventions for all-cause mortality (odds ratio (OR) 0.27, 95% confidence interval (CI) 0.04 to 1.63; participants = 895; studies = 6; low-quality evidence). There was only one case of cardiovascular mortality in a control group (participants = 895; studies = 6). No incidences of non-fatal re-infarction were reported across any of the studies. We found no effects for revascularisation (OR 0.69, 95% CI 0.37 to 1.27; participants = 895; studies = 6; low-quality evidence).We found no effects for total cholesterol (mean difference (MD) 0.00, 95% CI -0.27 to 0.28; participants = 439; studies = 4; low

  3. Mental health and quality of life benefits of a pedometer-based walking intervention delivered in a primary care setting

    OpenAIRE

    Tomas Vetrovsky; Jozef Cupka; Martin Dudek; Blanka Kuthanova; Klaudia Vetrovska; Vaclav Capek; Vaclav Bunc

    2017-01-01

    Background: Physical activity level is positively associated with mental health and health-related quality of life. Primary care providers are ideally situated to offer physical activity interventions, and pedometers are commonly used as motivational tools to increase walking. However, several recent trials of pedometer-based interventions in primary care settings neither improved patients' quality of life nor reduced anxiety or depression, but these interventions only had relatively modest e...

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

    Science.gov (United States)

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

    2008-04-16

    The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure. The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention. A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD Internet intervention and perceiving the intervention as personally relevant appeared to be important factors related to a first visit. The provision of tailored feedback, relevant and reliable information, and an easy navigation structure were related to an extended visit. Provision of regular new content and the possibility to monitor personal progress toward behavior change were identified as important factors to encourage a revisit. Primarily traditional promotion

  5. Combined Home and School Obesity Prevention Interventions for Children: What Behavior Change Strategies and Intervention Characteristics Are Associated with Effectiveness?

    Science.gov (United States)

    Hendrie, Gilly A.; Brindal, Emily; Corsini, Nadia; Gardner, Claire; Baird, Danielle; Golley, Rebecca K.

    2012-01-01

    This review identifies studies describing interventions delivered across both the home and school/community setting, which target obesity and weight-related nutrition and physical activity behaviors in children. Fifteen studies, published between 1998 and 2010, were included and evaluated for effectiveness, study quality, nutrition/activity…

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

    Science.gov (United States)

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

    2007-01-01

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

  7. Pragmatic Language Outcomes of Children With Attention Deficit Hyperactivity Disorder After Therapist- and Parent-Delivered Play-Based Interventions: Two One-Group Pretest-Posttest Studies With a Longitudinal Component.

    Science.gov (United States)

    Wilkes-Gillan, Sarah; Munro, Natalie; Cordier, Reinie; Cantrill, Alycia; Pearce, Wendy

    The pragmatic language outcomes of children with attention deficit hyperactivity disorder (ADHD) were explored across two feasibility studies. Five children with ADHD (ages 6-11 yr), their parents, and 5 typically developing peers completed an assessment 18 mo after a therapist-delivered intervention (Study 1). Participants then completed a parent-delivered intervention (Study 2). Blinded ratings of peer-to-peer play interactions documented changes in children's pragmatic language 18 mo after the Study 1 intervention and before, immediately after, and 1 mo after the Study 2 intervention. Nonparametric statistics and Cohen's d were used to measure change. Children's pragmatic language outcomes were maintained 18 mo after the therapist-delivered intervention and significantly improved from before to 1 mo after the parent-delivered intervention. Interventions involving occupational therapist and speech-language pathologist collaboration, play, and parent and peer involvement may facilitate children's pragmatic language skills.

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

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2012-07-01

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

  9. Process evaluation of a sport-for-health intervention to prevent smoking amongst primary school children: SmokeFree Sports.

    Science.gov (United States)

    Trigwell, Joanne; McGee, Ciara E; Murphy, Rebecca C; Porcellato, Lorna A; Ussher, Michael; Garnham-Lee, Katy; Knowles, Zoe R; Foweather, Lawrence

    2015-04-10

    SmokeFree Sports (SFS) was a multi-component sport-for-health intervention aiming at preventing smoking among nine to ten year old primary school children from North West England. The purpose of this study was to evaluate the process and implementation of SFS, examining intervention reach, dose, fidelity, acceptability and sustainability, in order to understand the feasibility and challenges of delivering such interventions and inform interpretations of intervention effectiveness. Process measures included: booking logs, 18 focus groups with children (n = 95), semi-structured interviews with teachers (n = 20) and SFS coaches (n = 7), intervention evaluation questionnaires (completed by children, n = 1097; teachers, n = 50), as well direct observations (by researchers, n = 50 observations) and self-evaluations (completed by teachers, n = 125) of intervention delivery (e.g. length of sessions, implementation of activities as intended, children's engagement and barriers). Descriptive statistics and thematic analysis were applied to quantitative and qualitative data, respectively. Overall, SFS reached 30.8% of eligible schools, with 1073 children participating in the intervention (across 32 schools). Thirty-one schools completed the intervention in full. Thirty-three teachers (55% female) and 11 SFS coaches (82% male) attended a bespoke SFS training workshop. Disparities in intervention duration (range = 126 to 201 days), uptake (only 25% of classes received optional intervention components in full), and the extent to which core (mean fidelity score of coaching sessions = 58%) and optional components (no adaptions made = 51% of sessions) were delivered as intended, were apparent. Barriers to intervention delivery included the school setting and children's behaviour and knowledge. SFS was viewed positively (85% and 82% of children and teachers, respectively, rated SFS five out of five) and recommendations to increase school engagement were provided. SFS was considered

  10. A multicenter evaluation of a brief manualized psychoeducation intervention for psychogenic nonepileptic seizures delivered by health professionals with limited experience in psychological treatment.

    Science.gov (United States)

    Wiseman, Hannah; Mousa, Saafi; Howlett, Stephanie; Reuber, Markus

    2016-10-01

    The aim of this study was to add to our understanding of the impact of psychoeducation on patients' acceptance of the diagnosis of psychogenic nonepileptic seizures (PNESs), the frequency of their seizures, and their quality of life. The study also aimed to evaluate the effectiveness of brief manualized psychoeducation interventions for PNESs, delivered by a more diverse range of clinicians and in a wider range of treatment settings. The final sample consisted of 25 patients diagnosed with PNESs by a neurologist specializing in the treatment of seizure disorder and referred to the psychotherapy service. The study included patients from four centers, using a manualized psychoeducation intervention delivered over 4 sessions by specialist epilepsy nurses and assistant psychologists. All patients completed self-measure questionnaires for Seizure Frequency, Impaired Functioning (WSAS), Psychological Distress (CORE-OM), Illness Perception (BIPQ), Health-Related Quality of Life: general (ED-QOL) and epilepsy-specific (NewQOL-6D), Symptom Attribution, and patient's perception of usefulness and relevance of the intervention. All measures were collected at baseline and after the completion of the fourth session. All measures improved from baseline to postintervention, but this improvement was only significant for CORE-OM (ppsychological distress, and have an effect on patients' illness perceptions that should help them engage with a more extended psychotherapy program if that was necessary. The intervention was carried out successfully by staff with relatively little training in delivering psychological interventions. Further controlled studies are required to provide proof of efficacy. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Intraoperative interventions for preventing surgical site infection: an overview of Cochrane Reviews.

    Science.gov (United States)

    Liu, Zhenmi; Dumville, Jo C; Norman, Gill; Westby, Maggie J; Blazeby, Jane; McFarlane, Emma; Welton, Nicky J; O'Connor, Louise; Cawthorne, Julie; George, Ryan P; Crosbie, Emma J; Rithalia, Amber D; Cheng, Hung-Yuan

    2018-02-06

    Surgical site infection (SSI) rates vary from 1% to 5% in the month following surgery. Due to the large number of surgical procedures conducted annually, the costs of these SSIs can be considerable in financial and social terms. Many interventions are used with the aim of reducing the risk of SSI in people undergoing surgery. These interventions can be broadly delivered at three stages: preoperatively, intraoperatively and postoperatively. The intraoperative interventions are largely focused on decontamination of skin using soap and antiseptics; the use of barriers to prevent movement of micro-organisms into incisions; and optimising the patient's own bodily functions to promote best recovery. Both decontamination and barrier methods can be aimed at people undergoing surgery and operating staff. Other interventions focused on SSI prevention may be aimed at the surgical environment and include methods of theatre cleansing and approaches to managing theatre traffic. To present an overview of Cochrane Reviews of the effectiveness and safety of interventions, delivered during the intraoperative period, aimed at preventing SSIs in all populations undergoing surgery in an operating theatre. Published Cochrane systematic reviews reporting the effectiveness of interventions delivered during the intraoperative period in terms of SSI prevention were eligible for inclusion in this overview. We also identified Cochrane protocols and title registrations for future inclusion into the overview. We searched the Cochrane Library on 01 July 2017. Two review authors independently screened search results and undertook data extraction and 'Risk of bias' and certainty assessment. We used the ROBIS (risk of bias in systematic reviews) tool to assess the quality of included reviews, and we used GRADE methods to assess the certainty of the evidence for each outcome. We summarised the characteristics of included reviews in the text and in additional tables. We included 32 Cochrane Reviews

  12. Effectiveness of a brief school-based body image intervention 'Dove Confident Me: Single Session' when delivered by teachers and researchers: Results from a cluster randomised controlled trial.

    Science.gov (United States)

    Diedrichs, Phillippa C; Atkinson, Melissa J; Steer, Rebecca J; Garbett, Kirsty M; Rumsey, Nichola; Halliwell, Emma

    2015-11-01

    This study evaluated a 90-min single session school-based body image intervention (Dove Confident Me: Single Session), and investigated if delivery could be task-shifted to teachers. British adolescents (N = 1707; 11-13 years; 50.83% girls) participated in a cluster randomised controlled trial [lessons as usual control; intervention teacher-led (TL); intervention researcher-led (RL)]. Body image, risk factors, and psychosocial and disordered eating outcomes were assessed 1-week pre-intervention, immediate post-intervention, and 4-9.5 weeks follow-up. Multilevel mixed-models showed post-intervention improvements for intervention students relative to control in body esteem (TL; girls only), negative affect (TL), dietary restraint (TL; girls only), eating disorder symptoms (TL), and life engagement (TL; RL). Awareness of sociocultural pressures increased at post-intervention (TL). Effects were small-medium in size (ds 0.19-0.76) and were not maintained at follow-up. There were no significant differences between conditions at post or follow-up on body satisfaction, appearance comparisons, teasing, appearance conversations and self-esteem. The intervention had short-term benefits for girls' body image and dietary restraint, and for eating disorder symptoms and some psychosocial outcomes among girls and boys. A multi-session version of the intervention is likely to be necessary for sustained improvements. Teachers can deliver this intervention effectively with minimal training, indicating broader scale dissemination is feasible. ISRCTN16782819. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Data-as-a-Service Platform for Delivering Healthy Lifestyle and Preventive Medicine: Concept and Structure of the DAPHNE Project.

    Science.gov (United States)

    Gibbons, Catherine; Bailador Del Pozo, Gonzalo; Andrés, Javier; Lobstein, Tim; Manco, Melania; Lewy, Hadas; Bergman, Einat; O'Callaghan, David; Doherty, Gavin; Kudrautseva, Olga; Palomares, Angel; Ram, Roni; Olmo, Alberto

    2016-12-09

    Overweight and obesity is related to many health problems and diseases. The current obesity epidemic, which is a major health problem, is closely related to a lack of physical activity, high levels of sedentary behavior, and increased energy intake; with evidence to show increasing incidence of these issues in the younger population. Tackling obesity and its comorbid conditions requires a holistic approach encompassing attention on physical activity, healthy diet, and behavioral activation in order to enable and maintain meaningful and long-term weight loss and weight maintenance. The objective of the Data-as-a-Service Platform for Healthy Lifestyle and Preventive Medicine (DAPHNE) project is to develop a breakthrough information communications technology (ICT) platform for tracking health, weight, physical activity, diet, lifestyle, and psychological components within health care systems, whereby the platform and clinical support is linked. The DAPHNE platform aims to deliver personalized guidance services for lifestyle management to the citizen/patient by means of (1) advanced sensors and mobile phone apps to acquire and store continuous/real-time data on lifestyle aspects, behavior, and surrounding environment; (2) individual models to monitor their health and fitness status; (3) intelligent data processing for the recognition of behavioral trends; and (4) specific services for personalized guidance on healthy lifestyle and disease prevention. It is well known that weight loss and maintenance of weight loss are particularly difficult. This tool will address some of the issues found with conventional treatment/advice in that it will collect data in real time, thereby reducing reliability issues known with recalling events once they have passed and will also allow adjustment of behavior through timely support and recommendations sent through the platform without the necessity of formal one-to-one visits between patient and clinician. Patient motivation

  14. A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

    Science.gov (United States)

    2012-01-01

    Background Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808 PMID:22909327

  15. A Technology-Mediated Behavioral Weight Gain Prevention Intervention for College Students: Controlled, Quasi-Experimental Study.

    Science.gov (United States)

    West, Delia Smith; Monroe, Courtney M; Turner-McGrievy, Gabrielle; Sundstrom, Beth; Larsen, Chelsea; Magradey, Karen; Wilcox, Sara; Brandt, Heather M

    2016-06-13

    Both men and women are vulnerable to weight gain during the college years, and this phenomenon is linked to an increased risk of several chronic diseases and mortality. Technology represents an attractive medium for the delivery of weight control interventions focused on college students, given its reach and appeal among this population. However, few technology-mediated weight gain prevention interventions have been evaluated for college students. This study examined a new technology-based, social media-facilitated weight gain prevention intervention for college students. Undergraduates (n =58) in two sections of a public university course were allocated to either a behavioral weight gain prevention intervention (Healthy Weight, HW; N=29) or a human papillomavirus (HPV) vaccination awareness intervention (control; N=29). All students were enrolled, regardless of initial body weight or expressed interest in weight management. The interventions delivered 8 lessons via electronic newsletters and Facebook postings over 9 weeks, which were designed to foster social support and introduce relevant educational content. The HW intervention targeted behavioral strategies to prevent weight gain and provided participants with a Wi-Fi-enabled scale and an electronic physical activity tracker to facilitate weight regulation. A repeated-measures analysis of variance was conducted to examine within- and between-group differences in measures of self-reported weight control practices and objectively measured weight. Use of each intervention medium and device was objectively tracked, and intervention satisfaction measures were obtained. Students remained weight stable (HW: -0.48+1.9 kg; control: -0.45+1.4 kg), with no significant difference between groups over 9 weeks (P =.94). However, HW students reported a significantly greater increase in the number of appropriate weight control strategies than did controls (2.1+4.5 vs -1.1+3.4, respectively; P =.003) and there was no increase in

  16. Scientific evidence is just the starting point: A generalizable process for developing sports injury prevention interventions

    Directory of Open Access Journals (Sweden)

    Alex Donaldson

    2016-09-01

    Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development.

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

    Science.gov (United States)

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

    2017-06-01

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

  18. Cultural translation: acceptability and efficacy of a US-based injury prevention intervention in China.

    Science.gov (United States)

    Erkoboni, Danielle; Ozanne-Smith, Joan; Rouxiang, Cao; Winston, Flaura K

    2010-10-01

    Increased belt-positioning booster seat (BPB) awareness and access have led to increased use in the USA. Although transportation in Beijing is rapidly becoming 'motorised', Beijing's population has limited awareness of or access to BPBs. To explore the efficacy and acceptability of using a US-developed BPB use promotion intervention in Beijing. Methods were adapted from a previously executed US-based study involving parents of 3-8-year old children. Focus groups (five groups, 71 participants) elicited behavioural antecedents to BPB use and reactions to video interventions promoting BPB use: a Chinese-produced instructional video and an English-language (dubbed into Mandarin) video that delivered concrete, theoretically driven messages through a personal story. Immediately after the focus groups, participants were provided with education and a free BPB. Participants were contacted 6 weeks later via telephone about use, knowledge and attitudes. Chinese parents saw safety as the most important benefit of BPB use; lack of accurate knowledge about and access to BPBs were parents' most prevalent barriers. Chinese participants described the videos as persuasive and instructional. At 6 weeks, participants remembered the messages of the English-language video, and reported BPB use increased from a baseline of 15.5% to 85.5%. This study shows the possibility of exporting US-designed prevention interventions dubbed into Mandarin without the need to alter their original context (in this case, an African American family in a US setting) into a Chinese context. Successful cultural translation involved ensuring that the behavioural antecedents targeted in the intervention (eg, barriers and benefits) were of relevance to the Chinese population.

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

    Science.gov (United States)

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

    2015-07-01

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

  20. Psychological Outcomes following a nurse-led Preventative Psychological Intervention for critically ill patients (POPPI): protocol for a cluster-randomised clinical trial of a complex intervention.

    Science.gov (United States)

    Richards-Belle, Alvin; Mouncey, Paul R; Wade, Dorothy; Brewin, Chris R; Emerson, Lydia M; Grieve, Richard; Harrison, David A; Harvey, Sheila; Howell, David; Mythen, Monty; Sadique, Zia; Smyth, Deborah; Weinman, John; Welch, John; Rowan, Kathryn M

    2018-02-08

    Acute psychological stress, as well as unusual experiences including hallucinations and delusions, are common in critical care unit patients and have been linked to post-critical care psychological morbidity such as post-traumatic stress disorder (PTSD), depression and anxiety. Little high-quality research has been conducted to evaluate psychological interventions that could alleviate longer-term psychological morbidity in the critical care unit setting. Our research team developed and piloted a nurse-led psychological intervention, aimed at reducing patient-reported PTSD symptom severity and other adverse psychological outcomes at 6 months, for evaluation in the POPPI trial. This is a multicentre, parallel group, cluster-randomised clinical trial with a staggered roll-out of the intervention. The trial is being carried out at 24 (12 intervention, 12 control) NHS adult, general, critical care units in the UK and is evaluating the clinical effectiveness and cost-effectiveness of a nurse-led preventative psychological intervention in reducing patient-reported PTSD symptom severity and other psychological morbidity at 6 months. All sites deliver usual care for 5 months (baseline period). Intervention group sites are then trained to carry out the POPPI intervention, and transition to delivering the intervention for the rest of the recruitment period. Control group sites deliver usual care for the duration of the recruitment period. The trial also includes a process evaluation conducted independently of the trial team. This protocol was reviewed and approved by the National Research Ethics Service South Central - Oxford B Research Ethics Committee (reference: 15/SC/0287). The first patient was recruited in September 2015 and results will be disseminated in 2018. The results will be presented at national and international conferences and published in peer reviewed medical journals. ISRCTN53448131; Pre-results. © Article author(s) (or their employer(s) unless

  1. Evaluation of a Workplace Disability Prevention Intervention in Canada: Examining Differing Perceptions of Stakeholders

    OpenAIRE

    Maiwald, Karin; de Rijk, Angelique; Guzman, Jaime; Schonstein, Eva; Yassi, Annalee

    2010-01-01

    Introduction Workplace disability prevention is important, but stakeholders can differ in their appreciation of such interventions. We present a responsive evaluation of a workplace disability prevention intervention in a Canadian healthcare organization. Three groups of stakeholders were included: designers of the intervention, deliverers, and workers. The aim was to examine the appreciation of this intervention by analyzing the discrepancies with respect to what these various stakeholders s...

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

    Directory of Open Access Journals (Sweden)

    Elena Salmoirago-Blotcher

    2012-01-01

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

  3. Feasibility of Group Lifestyle Intervention for Diabetes Prevention in Arab Americans

    Science.gov (United States)

    Jaber, Linda A.; Pinelli, Nicole R.; Brown, Morton B.; Funnell, Martha M.; Anderson, Robert; Hammad, Adnan; Herman, William H.

    2010-01-01

    AIMS To assess the feasibility and acceptability of a community-based, culturally-specific, Diabetes Prevention Program (DPP)-adapted, group lifestyle intervention in Arab-Americans. METHODS Overweight (BMI≥27 kg/m2) Arab-Americans aged ≥30 years and without a history of diabetes were recruited to participate in a 24-week group lifestyle intervention. The DPP core-curriculum was culturally rewritten, translated into Arabic, and delivered in weekly sessions over a 12-week period. Follow-up was performed at week-24. The primary goals were to achieve ≥7% weight loss and ≥150 minutes/week of physical activity. An intent-to-treat analysis was performed. RESULTS Of the 71 participants (mean age±SD 47±10 years, 38% males), 44% achieved ≥7% weight loss, 59% achieved ≥5% reduction in weight, and 78% reached the physical activity goal of ≥150-minutes/week. The mean±SD weight loss was 5.2±4.4 kg at week-24 (pArab-Americans. PMID:21168232

  4. Prevention of agricultural injuries: an evaluation of an education-based intervention.

    Science.gov (United States)

    Hagel, L M; Pickett, W; Pahwa, P; Day, L; Brison, R J; Marlenga, B; Crowe, T; Snodgrass, P; Ulmer, K; Dosman, J A

    2008-10-01

    To evaluate the effectiveness of an agricultural health and safety program in reducing risks of injury. Cross-sectional survey. 50 rural municipalities in the Province of Saskatchewan, Canada. The Agricultural Health and Safety Network (AHSN), a mainly educational program that administered 112 farm safety interventions over 19 years. 5292 farm people associated with 2392 Saskatchewan farms. Farms and associated farm people were categorized into three groups according to years of participation in the AHSN. self-reported prevalence of: (1) farm safety practices; (2) physical farm hazards. (1) self-reported agricultural injuries. After adjustment for group imbalances and clustering at the rural municipality level, the prevalence of all impact and outcome measures was not significantly different on farms grouped according to years of AHSN participation. To illustrate, the adjusted relative risk of reporting no rollover protection on tractors among farms with none (0 years) versus high (>8 years) levels of AHSN participation was 0.95 (95% CI 0.69 to 1.30). The adjusted relative risk for agricultural injuries (all types) reported for the year before the survey was 0.99 (95% CI 0.74 to 1.32). Educational interventions delivered via the AHSN program were not associated with observable differences in farm safety practices, physical farm hazards, or farm-related injury outcomes. There is a need for the agricultural sector to extend the scope of its injury prevention initiatives to include the full public health model of education, engineering, and regulation.

  5. Internet-based educational intervention to prevent risky sexual behaviors in Mexican adolescents: study protocol

    Directory of Open Access Journals (Sweden)

    Svetlana V. Doubova

    2016-04-01

    Full Text Available Abstract Background Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15–19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents. Methods A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1 when the adolescents enter the study (baseline, 2 once the intervention is completed (at 1 month and 3 after 3 months of follow-up (at the fourth month. There will be three outcome variables: 1 knowledge in regard to sexually transmitted infections, 2 attitudes regarding condom use, and 3 self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates. Discussion The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large

  6. Internet-based educational intervention to prevent risky sexual behaviors in Mexican adolescents: study protocol.

    Science.gov (United States)

    Doubova, Svetlana V; Infante-Castañeda, Claudia; Pérez-Cuevas, Ricardo

    2016-04-18

    Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15-19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents. A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1) when the adolescents enter the study (baseline), 2) once the intervention is completed (at 1 month) and 3) after 3 months of follow-up (at the fourth month). There will be three outcome variables: 1) knowledge in regard to sexually transmitted infections, 2) attitudes regarding condom use, and 3) self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates. The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large-scale, easily implemented preventive tool. The

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

    Directory of Open Access Journals (Sweden)

    Ørner Roderick

    2009-01-01

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

  8. Development of a lifestyle intervention using the MRC framework for diabetes prevention in people with impaired glucose regulation.

    Science.gov (United States)

    Troughton, Jacqui; Chatterjee, Sudesna; Hill, Siân E; Daly, Heather; Martin Stacey, Lorraine; Stone, Margaret A; Patel, Naina; Khunti, Kamlesh; Yates, Thomas; Gray, Laura J; Davies, Melanie J

    2016-09-01

    We report development of a group-based lifestyle intervention, Let's Prevent, using the UK Medical Research Council (MRC) framework, and delivered by structured education to prevent type 2 diabetes mellitus (T2DM) in people with impaired glucose regulation (IGR) in a UK multi-ethnic population. Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) is the first national T2DM programme that meets National Institute for Health and Care Excellence criteria and formed the basis for Let's Prevent. An iterative cycle of initial development, piloting, collecting and collating qualitative and quantitative data, and reflection and modification, was used to inform and refine lifestyle intervention until it was fit for evaluation in a definitive randomized controlled trial (RCT). The programme encouraged IGR self-management using simple, non-technical language and visual aids. Qualitative and quantitative data suggested that intervention resulted in beneficial short-term behaviour change such as healthier eating patterns, improved health beliefs and greater participant motivation and empowerment. We also demonstrated that recruitment strategy and data collection methods were feasible for RCT implementation. Let's Prevent was developed following successful application of MRC framework criteria and the subsequent RCT will determine whether it is feasible, reliable and transferable from research into a real-world NHS primary healthcare setting. ISRCTN80605705. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

  9. Evidence-based obesity prevention in childhood and adolescence: critique of recent etiological studies, preventive interventions, and policies.

    Science.gov (United States)

    Reilly, John J

    2012-07-01

    Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the "energy gap" that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers.

  10. Evidence-Based Obesity Prevention in Childhood and Adolescence: Critique of Recent Etiological Studies, Preventive Interventions, and Policies123

    Science.gov (United States)

    Reilly, John J.

    2012-01-01

    Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the “energy gap” that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers. PMID:22798005

  11. Interventions to strengthen the HIV prevention cascade: a systematic review of reviews.

    Science.gov (United States)

    Krishnaratne, Shari; Hensen, Bernadette; Cordes, Jillian; Enstone, Joanne; Hargreaves, James R

    2016-07-01

    Much progress has been made in interventions to prevent HIV infection. However, development of evidence-informed prevention programmes that translate the efficacy of these strategies into population effect remain a challenge. In this systematic review, we map current evidence for HIV prevention against a new classification system, the HIV prevention cascade. We searched for systematic reviews on the effectiveness of HIV prevention interventions published in English from Jan 1, 1995, to July, 2015. From eligible reviews, we identified primary studies that assessed at least one of: HIV incidence, HIV prevalence, condom use, and uptake of HIV testing. We categorised interventions as those seeking to increase demand for HIV prevention, improve supply of HIV prevention methods, support adherence to prevention behaviours, or directly prevent HIV. For each specific intervention, we assigned a rating based on the number of randomised trials and the strength of evidence. From 88 eligible reviews, we identified 1964 primary studies, of which 292 were eligible for inclusion. Primary studies of direct prevention mechanisms showed strong evidence for the efficacy of pre-exposure prophylaxis (PrEP) and voluntary medical male circumcision. Evidence suggests that interventions to increase supply of prevention methods such as condoms or clean needles can be effective. Evidence arising from demand-side interventions and interventions to promote use of or adherence to prevention tools was less clear, with some strategies likely to be effective and others showing no effect. The quality of the evidence varied across categories. There is growing evidence to support a number of efficacious HIV prevention behaviours, products, and procedures. Translating this evidence into population impact will require interventions that strengthen demand for HIV prevention, supply of HIV prevention technologies, and use of and adherence to HIV prevention methods. Bill & Melinda Gates Foundation

  12. Computer-based versus in-person interventions for preventing and reducing stress in workers.

    Science.gov (United States)

    Kuster, Anootnara Talkul; Dalsbø, Therese K; Luong Thanh, Bao Yen; Agarwal, Arnav; Durand-Moreau, Quentin V; Kirkehei, Ingvild

    2017-08-30

    Chronic exposure to stress has been linked to several negative physiological and psychological health outcomes. Among employees, stress and its associated effects can also result in productivity losses and higher healthcare costs. In-person (face-to-face) and computer-based (web- and mobile-based) stress management interventions have been shown to be effective in reducing stress in employees compared to no intervention. However, it is unclear if one form of intervention delivery is more effective than the other. It is conceivable that computer-based interventions are more accessible, convenient, and cost-effective. To compare the effects of computer-based interventions versus in-person interventions for preventing and reducing stress in workers. We searched CENTRAL, MEDLINE, PubMed, Embase, PsycINFO, NIOSHTIC, NIOSHTIC-2, HSELINE, CISDOC, and two trials registers up to February 2017. We included randomised controlled studies that compared the effectiveness of a computer-based stress management intervention (using any technique) with a face-to-face intervention that had the same content. We included studies that measured stress or burnout as an outcome, and used workers from any occupation as participants. Three authors independently screened and selected 75 unique studies for full-text review from 3431 unique reports identified from the search. We excluded 73 studies based on full-text assessment. We included two studies. Two review authors independently extracted stress outcome data from the two included studies. We contacted study authors to gather additional data. We used standardised mean differences (SMDs) with 95% confidence intervals (CIs) to report study results. We did not perform meta-analyses due to variability in the primary outcome and considerable statistical heterogeneity. We used the GRADE approach to rate the quality of the evidence. Two studies met the inclusion criteria, including a total of 159 participants in the included arms of the studies

  13. Effective weight-loss using an e-health delivered physical activity and dietary intervention: A federal credit union pilot study.

    Science.gov (United States)

    Gregoski, Mathew J; Newton, Janis; Ling, Catherine G; Blaylock, Kathleen; Smith, Sheila A O; Paguntalan, John; Treiber, Frank A

    2016-04-06

    This pilot study investigated the effectiveness of a distance-based e-health program delivered across multiple rural Federal Credit Union worksites that focused on physical activity and dietary education. Program design and implementation were based on the premises of Social Impact Theory (SIT). A sample of fifty-four participants (47 white. 7 black) aged 24 to 58 across different worksite locations completed 10 weeks of e-health delivered physical activity and dietary intervention. Pre to post weight changes were examined as a primary outcome. The findings showed that regardless of worksite location, participants on average reduced their weight by 10.13 lbs if they completed both the exercise and lunch and learn components of the study compared to a decrease of 2.73 lbs for participants who chose not to engage in the exercise related activities. Participant dropout from either group was less than four percent. The results of this study show the beneficial influence of physical activity integration using SIT upon distance programs targeting weight loss. In addition, the high adherence and weight loss success show promise and demonstrates the potential for e-health delivered exercise and lifestyle interventions. Further replication of results via additional randomized controlled trials is needed.

  14. Mechanical Restraint - Which Interventions Prevent Episodes of Mechanical Restraint? - A Systematic Review

    DEFF Research Database (Denmark)

    Bak, Jesper; Brandt-Christensen, Anne Mette; Sestoft, Dorte Maria

    2012-01-01

    PURPOSE:  To identify interventions preventing mechanical restraints. DESIGN AND METHODS:  Systematic review of international research papers dealing with mechanical restraint. The review combines qualitative and quantitative research in a new way, describing the quality of evidence and the effect...... of intervention. FINDINGS:  Implementation of cognitive milieu therapy, combined interventions, and patient-centered care were the three interventions most likely to reduce the number of mechanical restraints. PRACTICE IMPLICATIONS:  There is a lack of high-quality and effective intervention studies. This leaves...... patients and metal health professionals with uncertainty when choosing interventions in an attempt to prevent mechanical restraints....

  15. Interventions for the prevention of recurrent erysipelas and cellulitis.

    Science.gov (United States)

    Dalal, Adam; Eskin-Schwartz, Marina; Mimouni, Daniel; Ray, Sujoy; Days, Walford; Hodak, Emmilia; Leibovici, Leonard; Paul, Mical

    2017-06-20

    Erysipelas and cellulitis (hereafter referred to as 'cellulitis') are common bacterial skin infections usually affecting the lower extremities. Despite their burden of morbidity, the evidence for different prevention strategies is unclear. To assess the beneficial and adverse effects of antibiotic prophylaxis or other prophylactic interventions for the prevention of recurrent episodes of cellulitis in adults aged over 16. We searched the following databases up to June 2016: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS. We also searched five trials registry databases, and checked reference lists of included studies and reviews for further references to relevant randomised controlled trials (RCTs). We searched two sets of dermatology conference proceedings, and BIOSIS Previews. Randomised controlled trials evaluating any therapy for the prevention of recurrent cellulitis. Two authors independently carried out study selection, data extraction, assessment of risks of bias, and analyses. Our primary prespecified outcome was recurrence of cellulitis when on treatment and after treatment. Our secondary outcomes included incidence rate, time to next episode, hospitalisation, quality of life, development of resistance to antibiotics, adverse reactions and mortality. We included six trials, with a total of 573 evaluable participants, who were aged on average between 50 and 70. There were few previous episodes of cellulitis in those recruited to the trials, ranging between one and four episodes per study.Five of the six included trials assessed prevention with antibiotics in participants with cellulitis of the legs, and one assessed selenium in participants with cellulitis of the arms. Among the studies assessing antibiotics, one study evaluated oral erythromycin (n = 32) and four studies assessed penicillin (n = 481). Treatment duration varied from six to 18 months, and two studies

  16. A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

    Directory of Open Access Journals (Sweden)

    Suzuki Yuriko

    2008-09-01

    Full Text Available Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals. Discussion The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. Trial registration UMIN Clinical Trials Registry (UMIN-CTR UMIN000000460.

  17. Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

    Science.gov (United States)

    Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

    2016-08-01

    Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

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

    Directory of Open Access Journals (Sweden)

    Peter Anderson

    2017-01-01

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

  19. The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico

    OpenAIRE

    Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; B?rnighausen, Till; Velasco-Mondrag?n, H?ctor Eduardo; Darney, Blair Grant

    2017-01-01

    Background The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. Methods We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the avai...

  20. Lay Health Workers' Experience of Delivering a Problem Solving Therapy Intervention for Common Mental Disorders Among People Living with HIV: A Qualitative Study from Zimbabwe.

    Science.gov (United States)

    Chibanda, Dixon; Cowan, Frances; Verhey, Ruth; Machando, Debra; Abas, Melanie; Lund, Crick

    2017-02-01

    There is growing evidence supporting the use of lay health workers (LHWs) to address the treatment gap for common mental disorders (CMD) through task-shifting. This study looks at the experience of LHWs delivering a problem solving therapy (PST) intervention for CMD for people living with HIV (PLWH) in a primary health care setting. Semi-structured interviews of LHWs (n = 7) and PLWH (10) who received PST were carried out using thematic content analysis. Over a 4 year period LHWs developed indigenous concepts of PST which were: Opening the mind (Kuvhura pfungwa), uplifting (kusimudzira), strengthening and strengthening further (kusimbisa and kusimbisisa) respectively. Using terms locally conceived through knowledge sharing amongst LHWs made it acceptable to deliver PST as part of their daily work. Indigenous terms conceived and developed by LWHs to describe components and processes of PST contribute to the therapy's acceptability and continued use in primary care facilities.

  1. The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.

    Science.gov (United States)

    Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; Bärnighausen, Till; Velasco-Mondragón, Héctor Eduardo; Darney, Blair Grant

    2017-08-03

    The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources. The comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P primary health care facilities. There is a shortage of health promoters in urban primary health facilities (P health promoters is lower than the ideal supply to deliver the guaranteed package of prevention and health promotion services. Policies must address the level and distribution of human resources in primary health facilities.

  2. Achievement of interventions on HIV infection prevention among ...

    African Journals Online (AJOL)

    A computerized literature search of the Chinese National Knowledge Infrastructure, Wan Fang, and PubMed databases was conducted to collect related articles published in China. Only self-control intervention studies or studies containing sections regarding self-control interventions wherein the method of intervention was ...

  3. Advancing novel HIV prevention intervention research with MSM--meeting report.

    Science.gov (United States)

    Grossman, Cynthia I; Forsyth, Andrew; Purcell, David W; Allison, Susannah; Toledo, Carlos; Gordon, Christopher M

    2011-01-01

    HIV continues to exact an enormous toll on society and to disproportionately affect gay and bisexual men and other men who have sex with men (MSM). Innovative prevention interventions are needed to reverse this trend. In August 2009, the U.S. National Institute of Mental Health and the Centers for Disease Control and Prevention convened a meeting of scientists, community representatives, advocates, and federal partners to discuss innovative prevention-intervention science. The meeting was structured to maximize discussion of (1) healthy sex interventions, (2) community and structural interventions, (3) integrated biomedical and behavioral interventions, and (4) interventions to improve uptake of HIV testing. Presentations and discussion focused on research gaps in designing risk-reducing and sexual health-promoting interventions for MSM, including interventions to address mental health, substance use, disclosure, and stigma. This article summarizes the meeting proceedings, highlights key points, and outlines future directions.

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

    Science.gov (United States)

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

    2016-09-06

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

  5. Evaluation of Physician and Nurse Dyad Training Procedures to Deliver a Palliative and End-of-Life Communication Intervention to Parents of Children with a Brain Tumor.

    Science.gov (United States)

    Hendricks-Ferguson, Verna L; Kane, Javier R; Pradhan, Kamnesh R; Shih, Chie-Schin; Gauvain, Karen M; Baker, Justin N; Haase, Joan E

    2015-01-01

    When a child's prognosis is poor, physicians and nurses (MDs/RNs) often struggle with initiating discussions about palliative and end-of-life care (PC/EOL) early in the course of illness trajectory. We describe evaluation of training procedures used to prepare MD/RN dyads to deliver an intervention entitled: Communication Plan: Early Through End of Life (COMPLETE) intervention. Our training was delivered to 5 pediatric neuro-oncologists and 8 pediatric nurses by a team of expert consultants (i.e., in medical ethics, communication, and PC/EOL) and parent advisors. Although half of the group received training in a 1-day program and half in a 2-day program, content for all participants included 4 modules: family assessment, goal-directed treatment planning, anticipatory guidance, and staff communication and follow-up. Evaluations included dichotomous ratings and qualitative comments on content, reflection, and skills practice for each module. Positive aspects of our training included parent advisers' insights, emphasis on hope and non-abandonment messages, written materials to facilitate PC/EOL communication, and an MD/RN dyad approach. Lessons learned and challenges related to our training procedures will be described. Overall, the MDs and RNs reported that our PC/EOL communication-training procedures were helpful and useful. Future investigators should carefully plan training procedures for PC/EOL communication interventions. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  6. Cognitive-behavioural interventions for preventing youth gang involvement for children and young people (7-16).

    Science.gov (United States)

    Fisher, H; Gardner, F E M; Montgomery, P

    2008-04-16

    Many studies document a robust and consistent relationship between gang membership and elevated delinquency, with gang members disproportionately involved in crime compared to non-gang peers. Research also indicates that both delinquent youth and youth who join gangs often show a wide range of deficient or distorted social-cognitive processes compared to non-delinquent peers. Cognitive-behavioural interventions are designed to address cognitive deficits in order to reduce maladaptive or dysfunctional behaviour, and studies have documented their positive impact on a number of behavioural and psychological disorders among children and youth. To determine the effectiveness of cognitive-behavioural interventions for preventing youth gang involvement for children and young people (ages 7-16). Electronic searches of ASSIA, CINAHL, CJA, Cochrane Library, Dissertations Abstracts A, EMBASE, ERIC, IBSS, LILACs, LexisNexis Butterworths, MEDLINE, NCJR Service Abstracts Database, PsycINFO, and Sociological Abstracts, to April 2007. Reviewers contacted relevant organisations, individuals, and list-servs and searched pertinent websites and reference lists. All randomised controlled trials or quasi-randomised controlled trials of interventions with a cognitive-behavioural intervention as the majority component, delivered to youth and children aged 7-16 not involved in a gang. Searching yielded 2,284 unduplicated citations, 2,271 of which were excluded as irrelevant based on title and abstract. One was excluded following personal communication with investigators. One citation, of a large randomised prevention trial, awaits assessment; personal communication with study authors yielded unpublished reports addressing gang outcomes, but insufficient detail precluded determining inclusion status. Seven remaining reports were excluded as irrelevant because they were narrative reviews or descriptions of programs without evaluations, did not address a gang prevention programme, or did not

  7. Multiple health behaviour change interventions for primary prevention of cardiovascular disease in primary care: systematic review and meta-analysis.

    Science.gov (United States)

    Alageel, Samah; Gulliford, Martin C; McDermott, Lisa; Wright, Alison J

    2017-06-15

    It is uncertain whether multiple health behaviour change (MHBC) interventions are effective for the primary prevention of cardiovascular disease (CVD) in primary care. A systematic review and a meta-analysis were performed to evaluate the effectiveness of MHBC interventions on CVD risk and CVD risk factors; the study also evaluated associations of theoretical frameworks and intervention components with intervention effectiveness. The search included randomised controlled trials of MHBC interventions aimed at reducing CVD risk in primary prevention population up to 2017. Theoretical frameworks and intervention components were evaluated using standardised methods. Meta-analysis with stratification and meta-regression were used to evaluate intervention effects. We identified 31 trials (36 484 participants) with a minimum duration of 12 months follow-up. Pooled net change in systolic blood pressure (16 trials) was -1.86 (95% CI -3.17 to -0.55; p=0.01) mm Hg; diastolic blood pressure (15 trials), -1.53 (-2.43 to -0.62; p=0.001) mm Hg; body mass index (14 trials), -0.13 (-0.26 to -0.01; p=0.04) kg/m 2 ; serum total cholesterol (14 trials), -0.13 (-0.19 to -0.07; p<0.001) mmol/L. There was no significant association between interventions with a reported theoretical basis and improved intervention outcomes. No association was observed between intervention intensity (number of sessions and intervention duration) and intervention outcomes. There was significant heterogeneity for some risk factor analyses, leading to uncertain validity of some pooled net changes. MHBC interventions delivered to CVD-free participants in primary care did not appear to have quantitatively important effects on CVD risk factors. Better reporting of interventions' rationale, content and delivery is essential to understanding their effectiveness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted

  8. Intervention and prevention of steroid use in adolescents.

    Science.gov (United States)

    Elliot, D; Goldberg, L

    1996-01-01

    Athletes with a higher intent to use anabolic steroids were similar to students who indicated no predisposition to use steroids on economic, academic, and physical measures. They had similar understandings of anabolic steroid effects, and their self-rated understandings of how to weight train and of sports nutrition were similar. In addition, the influence of the coaches and the media and the perceived prevalence of anabolic steroid use were not different between the higher- and lower-intent students. These results demonstrated several significant differences. Higher-intent students had higher levels of alcohol and marijuana use, which suggest that those items might be tackled concurrently. These athletes had higher hostility, impulsivity, and a win-at-all-costs attitude. Despite similar physical measures, they had a high body image, but were less satisfied with their current weight. These findings underscored the importance of using nutrition and appropriate training as effective alternatives to anabolic steroids. Higher-intent students had greater peer tolerance of drug use and less parental influence not to use drugs, which implies that a peer-led small group format might be important to dispel the perceived peer tolerance. Including a parent-based component, one that emphasizes a disapproval of drug use also could be effective. Higher-intent athletes had less ability to refuse an offer of steroids. The dynamics of turning down steroids may differ from that of other illicit substances so that training in refusal skills specific to steroids is needed. These differences provide a needs assessment to identify curricular components for an intervention to permit anabolic steroid use. The sports team may be a unique educational setting because it can capitalize on peer ties, the coach's influence, and an athletes' motivation to improve, to prevent drug use, and to promote healthy behaviors.

  9. Interventions for treating oral leukoplakia to prevent oral cancer.

    Science.gov (United States)

    Lodi, Giovanni; Franchini, Roberto; Warnakulasuriya, Saman; Varoni, Elena Maria; Sardella, Andrea; Kerr, Alexander R; Carrassi, Antonio; MacDonald, L C I; Worthington, Helen V

    2016-07-29

    participants because drop-out rates were similar between treatment and control groups. Surgical treatment for oral leukoplakia has not been assessed in an RCT that included a no treatment or placebo comparison. Nor has cessation of risk factors such as smoking been assessed. The available evidence on medical and complementary interventions for treating people with leukoplakia is very limited. We do not currently have evidence of a treatment that is effective for preventing the development of oral cancer. Treatments such as vitamin A and beta carotene may be effective in healing oral lesions, but relapses and adverse effects are common. Larger trials of longer duration are required to properly evaluate the effects of leukoplakia treatments on the risk of developing oral cancer. High-quality research is particularly needed to assess surgical treatment and to assess the effects of risk factor cessation in people with leukoplakia.

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

    Science.gov (United States)

    Breslin, Gavin; Brennan, Deirdre

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

    Background: Anxiety disorders in youth are among the most common psychiatric disorders, yet the majority of affected youth do not receive treatment. One approach to improving access to care is identification and intervention within the primary care setting. Objective: This manuscript presents data from a single group pre-post open trial of the…

  12. A Comparison of Speech Sound Intervention Delivered by Telepractice and Side-by-Side Service Delivery Models

    Science.gov (United States)

    Grogan-Johnson, Sue; Schmidt, Anna Marie; Schenker, Jason; Alvares, Robin; Rowan, Lynne E.; Taylor, Jacquelyn

    2013-01-01

    Telepractice has the potential to provide greater access to speech-language intervention services for children with communication impairments. Substantiation of this delivery model is necessary for telepractice to become an accepted alternative delivery model. This study investigated the progress made by school-age children with speech sound…

  13. Maintaining Treatment Fidelity of Mindfulness-Based Relapse Prevention Intervention for Alcohol Dependence: A Randomized Controlled Trial Experience

    Directory of Open Access Journals (Sweden)

    Aleksandra E. Zgierska

    2017-01-01

    Full Text Available Background. Treatment fidelity is essential to methodological rigor of clinical trials evaluating behavioral interventions such as Mindfulness Meditation (MM. However, procedures for monitoring and maintenance of treatment fidelity are inconsistently applied, limiting the strength of such research. Objective. To describe the implementation and findings related to fidelity monitoring of the Mindfulness-Based Relapse Prevention for Alcohol Dependence (MBRP-A intervention in a 26-week randomized controlled trial. Methods. 123 alcohol dependent adults were randomly assigned to MM (MBRP-A and home practice, adjunctive to usual care; N=64 or control (usual care alone; N=59. Treatment fidelity assessment strategies recommended by the National Institutes of Health Behavior Change Consortium for study/intervention design, therapist training, intervention delivery, and treatment receipt and enactment were applied. Results. Ten 8-session interventions were delivered. Therapist adherence and competence, assessed using the modified MBRP Adherence and Competence Scale, were high. Among the MM group participants, 46 attended ≥4 sessions; over 90% reported at-home MM practice at 8 weeks and 72% at 26 weeks. They also reported satisfaction with and usefulness of MM for maintaining sobriety. No adverse events were reported. Conclusions. A systematic approach to assessment of treatment fidelity in behavioral clinical trials allows determination of the degree of consistency between intended and actual delivery and receipt of intervention.

  14. Testing Mediators of Intervention Effects in Randomized Controlled Trials: An Evaluation of Three Depression Prevention Programs

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.

    2010-01-01

    Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB…

  15. Human Centered Development of a Web-based Intervention for the Prevention of Depression

    NARCIS (Netherlands)

    Kelders, Saskia Marion; Oskam, Maarten-Jan; Bohlmeijer, Ernst Thomas; van Gemert-Pijnen, Julia E.W.C.

    2012-01-01

    Web-based preventive interventions have shown to be effective for the prevention of depression, but high rates of non-use and drop-out, less than optimal implementation in the care organization and low acceptance rates cause interventions to be less effective in practice than in theory and research.

  16. Keeping Students on Track to Graduate: A Synthesis of School Dropout Trends, Prevention, and Intervention Initiatives

    Science.gov (United States)

    Ecker-Lyster, Meghan; Niileksela, Christopher

    2016-01-01

    This article reviews the literature on dropout trends, prevention, and intervention initiatives for school-aged children. Theoretical and consequential trends are highlighted to offer educators a perspective in which to view the dropout problem. This article also examines current trends in prevention and intervention initiatives aimed at reducing…

  17. Providers' Perceptions of and Receptivity toward Evidence-Based HIV Prevention Interventions

    Science.gov (United States)

    Owczarzak, Jill; Dickson-Gomez, Julia

    2011-01-01

    Since 1999, the Centers for Disease Control and Prevention have trained over 10,000 service providers from more than 5,000 agencies to implement evidence-based HIV prevention interventions through its Diffusion of Effective Behavioral Interventions DEBI) program. Based on in-depth, semistructured interviews with a convenience sample of 22 HIV…

  18. Interventions to reduce risky sexual behaviour for preventing HIV infection in workers in occupational settings.

    Science.gov (United States)

    Ojo, Olumuyiwa; Verbeek, Jos H; Rasanen, Kimmo; Heikkinen, Jarmo; Isotalo, Leena K; Mngoma, Nomusa; Ruotsalainen, Eija

    2011-12-07

    The workplace provides an important avenue to prevent HIV. To evaluate the effect of behavioral interventions for reducing HIV on high risk sexual behavior when delivered in an occupational setting. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO up until March 2011 and CINAHL, LILACS, DARE, OSH Update, and EPPI database up until October 2010. Randomised control trials (RCTs) in occupational settings or among workers at high risk for HIV that measured HIV, sexual transmitted diseases (STD), Voluntary Counseling and Testing (VCT), or risky sexual behaviour. Two reviewers independently selected studies for inclusion, extracted data and assessed risk of bias. We pooled studies that were similar. We found 8 RCTs with 11,164 participants but one study did not provide enough data. Studies compared VCT to no VCT and education to no intervention and to alternative education.VCT uptake increased to 51% when provided at the workplace compared to a voucher for VCT (RR=14.0 (95% CI 11.8 to16.7)). After VCT, self-reported STD decreased (RR = 0.10 (95% CI 0.01 to 0.73)) but HIV incidence (RR=1.4 (95% CI 0.7 to 2.7)) and unprotected sex (RR=0.71 (0.48 to 1.06)) did not decrease significantly. .Education reduced STDs (RR = 0.68 (95%CI 0.48 to 0.96)), unprotected sex (Standardised Mean Difference (SMD)= -0.17 (95% CI -0.29 to -0.05), sex with a commercial sex worker (RR = 0.88 (95% CI 0.81 to 0.96) but not multiple sexual partners (Mean Difference (MD) = -0.22 (95% CI -0.52 to 0.08) nor use of alcohol before sex (MD = -0.01 (95% CI of -0.11 to 0.08). Workplace interventions to prevent HIV are feasible. There is moderate quality evidence that VCT offered at the work site increases the uptake of testing. Even though this did no lower HIV-incidence, there was a decrease in self-reported sexual transmitted diseases and a decrease in risky sexual behaviour. There is low quality evidence that educational interventions decrease sexually

  19. A case study on a home-based caregiver-delivered music-with-movement intervention for people with early dementia

    Directory of Open Access Journals (Sweden)

    Daniel LL Lai

    2017-09-01

    Full Text Available Background: Music has been found to improve sleep and reduce anxiety. Purpose: This article reports a 78-year-old Chinese female who had been diagnosed with early dementia underwent an 8-week music-with-movement intervention delivered by her husband at home after being trained in a day care center. Methods: Both the patient and the husband’s data were collected through repeated interviews and regular observations. Conclusion: The results indicated signs of improvement of the patient in terms of sleep quality and depressive symptoms.

  20. Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review.

    Science.gov (United States)

    Lee, Eleanor W; Denison, Fiona C; Hor, Kahyee; Reynolds, Rebecca M

    2016-02-29

    Perinatal depression is strikingly common with a prevalence of 10-15%. The adverse effects of perinatal depression on maternal and child health are profound with considerable costs. Despite this, few women seek medical attention. E-health, providing healthcare via the Internet is an accessible and effective solution for the treatment of depression in the general population. We aimed to conduct a systematic review of web-based interventions for the prevention and treatment of mood disorders in the perinatal period, defined as the start of pregnancy to 1 year post-partum. Six databases were searched until 26(th) March 2015. Two researchers independently screened articles for eligibility. Of the 547 screened articles, four met the inclusion criteria. These included three randomised-controlled trials and one feasibility trial, with total data from 1274 participants. MOOSE and PRISMA guidelines were adhered to for the conduct and reporting of the systematic review. All studies were conducted in the post-partum period. All reported an improvement in maternal mood following intervention. A significant improvement in depressive symptoms was measured using validated rating scales, such as the Edinburgh Postnatal Depression Scale (EPDS), either at post-treatment or follow-up which ranged from 3 to 12 months post study completion. For the two RCTs utilising the EPDS, the EPDS score reductions were (mean ± SEM) 8.52 ± 0.22 (Range 19.46 to10.94) and 9.19 ± 0.63 (Range, 20.24 to 11.05) for treatment groups and 5.16 ± 0.25 (Range 19.44 to 14.28) and 6.81 ± 0.71 (Range 21.07 to 14.26) for comparator groups. However attrition within studies ranged from 13 to 61%. One study was rated as 'good' quality. Preliminary data suggests web-based therapies for perinatal depression delivered in the post-partum period may play a role in improving maternalmood but more studies are needed, particularly with interventions delivered antenatally. Further research is needed

  1. Treatment Protocols for Eating Disorders: Clinicians? Attitudes, Concerns, Adherence and Difficulties Delivering Evidence-Based Psychological Interventions

    OpenAIRE

    Waller, Glenn

    2016-01-01

    There are several protocols in existence that guide clinicians in the implementation of effective, evidence-based psychological interventions for eating disorders. These have been made accessible in the form of treatment manuals. However, relatively few clinicians use those protocols, preferring to offer more eclectic or integrative approaches. Following a summary of the research that shows that these evidence-based approaches can be used successfully in routine clinical settings, this review...

  2. Increasing resource allocation and research into tobacco control activities: a comprehensive approach including primary prevention, treatment and brief intervention.

    Science.gov (United States)

    Richmond, R

    1993-01-01

    The range of tobacco control activities should be viewed as essential parts of a complex multi-component puzzle. Intervention strategies designed to address tobacco control should be comprehensive and include both primary and secondary prevention activities and be multi-faceted and capable of bringing about change at both the individual and broader social and cultural levels. In this paper I argue for a mutually inclusive framework in which the various components contribute in important and different ways. I examine the prevalence of smoking and identify the high risk groups, then I examine the range of available strategies and present the evidence for their success. I discuss the primary prevention approaches such as warning labels, taxes, price increases, workplace bans, education in schools, mass media and self-help materials, as well as brief interventions and treatment strategies which are conducted at the worksite, general practice and specialized cessation clinics. The areas for future research are delineated for increased resource allocation and include: the best ways to disseminate brief interventions to smokers, methods to motivate smokers; training of health professionals to deliver brief interventions; enhancing quitting and access to existing treatment resources among specific disadvantaged minority groups, e.g. migrants, unemployed youth, the effect on smoking prevalence of warning labels on cigarette packets and price rises on cigarettes.

  3. Interventions to prevent occupational noise-induced hearing loss: a Cochrane systematic review

    NARCIS (Netherlands)

    Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina

    2014-01-01

    To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions. We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and

  4. The Effects of Interventions to Prevent Substance Use among Adolescents: A Systematic Review

    Science.gov (United States)

    Karki, Suyen; Pietila, Anna-Maija; Lansimies-Antikainen, Helena; Varjoranta, Pirjo; Pirskanen, Marjatta; Laukkanen, Eila

    2012-01-01

    The aim of this systematic review is to describe and evaluate the effects of interventions used for preventing or reducing substance use among adolescents under 18 years of age. Studies (N = 27) available in CINAHL and PubMed from 2007 to 2010 were included. Results showed that family-based interventions and combined interventions have significant…

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Preventing anxiety and depression in adolescents: A randomised controlled trial of two school based Internet-delivered cognitive behavioural therapy programmes

    Directory of Open Access Journals (Sweden)

    Nora Wong

    2014-04-01

    Full Text Available The aims of the current study were to 1 establish the efficacy of two Internet-based prevention programmes to reduce anxiety and depressive symptoms in adolescents; and 2 investigate the distribution of psychological symptoms in a large sample of Australian adolescents prior to the implementation of the intervention. A cluster randomised controlled trial was conducted with 976 Year 9–10 students from twelve Australian secondary schools in 2009. Four schools were randomly allocated to the Anxiety Internet-based prevention programme (n = 372, five schools to the Depression Internet-based prevention programme (n = 380 and three to their usual health classes (n = 224. The Thiswayup Schools for Anxiety and Depression prevention courses were presented over the Internet and consist of 6–7 evidence-based, curriculum consistent lessons to improve the ability to manage anxiety and depressive symptoms. Participants were assessed at baseline and post-intervention. Data analysis was constrained by both study attrition and data corruption. Thus post-intervention data were only available for 265/976 students. Compared to the control group, students in the depression intervention group showed a significant improvement in anxiety and depressive symptoms at the end of the course, whilst students in the anxiety intervention demonstrated a reduction in symptoms of anxiety. No significant differences were found in psychological distress. The Thiswayup Schools Depression and Anxiety interventions appear to reduce anxiety and depressive symptoms in adolescents using a curriculum based, blended online and offline cognitive behavioural therapy programme that was implemented by classroom teachers. Given the study limitations, particularly the loss of post-intervention data, these findings can only be considered preliminary and need to be replicated in future research.

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

    Science.gov (United States)

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

    2015-10-16

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

  8. Happy Despite Pain: A Randomized Controlled Trial of an 8-Week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients With Chronic Pain.

    Science.gov (United States)

    Peters, Madelon L; Smeets, Elke; Feijge, Marion; van Breukelen, Gerard; Andersson, Gerhard; Buhrman, Monica; Linton, Steven J

    2017-11-01

    There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program. A randomized controlled trial was carried out with 3 conditions: an internet-delivered positive psychology program, an internet-delivered cognitive-behavioral program and waitlist control. A total of 276 patients were randomized to 1 of the 3 conditions and posttreatment data were obtained from 206 patients. Primary outcomes were happiness, depression, and physical impairments at posttreatment and at 6-month follow-up. Intention-to-treat analyses were carried out using mixed regression analyses. Both treatments led to significant increases in happiness and decreases in depression. Physical impairments did not significantly decrease compared with waitlist. Improvements in happiness and depression were maintained until 6-month follow-up. There were no overall differences in the efficacy of the 2 active interventions but effects seemed to be moderated by education. Patients with a higher level of education profited slightly more from the positive psychology intervention than from the cognitive-behavioral program. The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs.

  9. Interventions Aimed at the Prevention of Childhood Injuries in the Indigenous Populations in Canada, Australia and New Zealand in the Last 20 Years: A Systematic Review.

    Science.gov (United States)

    Margeson, Alyssa; Gray, Selena

    2017-06-02

    Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed at preventing injury in Indigenous children in the hope that it guides future strategies. To the best of the authors' knowledge, no prior systematic reviews exist looking at interventions specifically aimed at preventing injury in Indigenous child populations in the three chosen countries. Electronic databases were systematically searched for relevant childhood interventions aimed at the prevention of injuries in Indigenous populations based in Canada, Australia and New Zealand from 1996 to 2016. A manual search of the reference lists of relevant articles and a manual search of relevant websites were also completed. After 191 records were screened, six interventions were identified meeting the criteria for inclusion. Eligible papers underwent a quality appraisal using adapted assessment checklists and key information was extracted. Findings were then synthesized using a narrative approach. The interventions mainly promoted child safety through activities focusing on education and awareness. Only three of the six studies measured changes in injury hospitalization rates, all but one evaluation reporting a significant decrease. Studies which measured awareness all demonstrated positive changes. Results suggest that interventions delivered in a culturally appropriate manner acted as a main success factor. Barriers identified as hindering intervention success included lack of cohesion within the intervention due to staff turnover and lack of experienced staff with Indigenous knowledge. This review revealed a limited amount of evaluated interventions for the prevention of Indigenous childhood injuries. Conclusive evidence of the effectiveness of existing interventions is

  10. Impact of health education intervention on malaria prevention ...

    African Journals Online (AJOL)

    ... can be significantly improved in rural areas, if the caregivers are adequately empowered through appropriate health education intervention though change in attitude and belief may require a longer and persistent effort. Keywords: Health education intervention, knowledge, malaria, nursing mothers, practice, rural Nigeria

  11. A WIC-Based Intervention to Prevent Early Childhood Overweight

    Science.gov (United States)

    Whaley, Shannon E.; McGregor, Samar; Jiang, Lu; Gomez, Judy; Harrison, Gail; Jenks, Eloise

    2010-01-01

    Objective: To evaluate the impact of a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-based intervention on the food and beverage intake, physical activity, and television watching of children ages 1-5. Design: Longitudinal surveys of intervention and control participants at baseline, 6 months, and 12 months.…

  12. A primary preventative mental health intervention in a culturally ...

    African Journals Online (AJOL)

    The Ububele Baby Mat Service is a community-based, parent–infant mental health intervention offered at five primary health care clinics in Alexandra Township, in Johannesburg. The aim of the intervention is to promote healthy caregiver-infant attachments. There has been a steady increase in the number of mother-baby ...

  13. A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders

    DEFF Research Database (Denmark)

    Van Der Beek, Allard J.; Dennerlein, Jack T.; Huysmans, Maaike A.

    2017-01-01

    Objectives Work-related musculoskeletal disorders (MSD) are highly prevalent and put a large burden on (working) society. Primary prevention of work-related MSD focuses often on physical risk factors (such as manual lifting and awkward postures) but has not been too successful in reducing the MSD...... thereby strengthening the development and implementation of preventive interventions. Our objective was to define and describe such a framework for multi-disciplinary research on work-related MSD prevention. Methods We described a framework for MSD prevention research, partly based on frameworks from......) evaluation, and (vi) implementation of preventive intervention(s). Conclusions In the present framework for optimal work-related MSD prevention, research disciplines are linked. This framework can thereby help to improve theories and strengthen the development and implementation of prevention strategies...

  14. A Psycho-Educational HIV/STI Prevention Intervention for Internally Displaced Women in Leogane, Haiti: Results from a Non-Randomized Cohort Pilot Study

    OpenAIRE

    Logie, Carmen H.; Daniel, CarolAnn; Newman, Peter A.; Weaver, James; Loutfy, Mona R.

    2014-01-01

    BACKGROUND: Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI) prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo) (Women Taking Action For Their Health) study examined the effectiveness of a peer health worker (PHW) delivered psycho-educational HIV/STI ...

  15. A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours.

    Science.gov (United States)

    Gibbs, Andrew; Jacobson, Jessica; Kerr Wilson, Alice

    Intimate partner violence (IPV) and HIV are co-occurring global epidemics, with similar root causes of gender and economic inequalities. Economic interventions have become a central approach to preventing IPV and HIV. We undertook a comprehensive scoping review of published evaluations of economic interventions that sought to prevent IPV and/or HIV risk behaviours. Forty-five separate analyses of interventions met our criteria. Broadly, unconditional cash transfer interventions showed either flat or positive outcomes; economic strengthening interventions had mixed outcomes, with some negative, flat and positive results reported; interventions combining economic strengthening and gender transformative interventions tended to have positive outcomes. The review highlighted a number of gaps. Specifically, there were limited studies evaluating the impact of economic interventions on female sex workers, young women, and men. In addition, there were missed opportunities, with many evaluations only reporting either IPV- or HIV-related outcomes, rather than both, despite overlaps.

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Effectiveness of nurse-practitioner-delivered brief motivational intervention for young adult alcohol and drug use in primary care in South Africa: a randomized clinical trial.

    Science.gov (United States)

    Mertens, Jennifer R; Ward, Catherine L; Bresick, Graham F; Broder, Tina; Weisner, Constance M

    2014-01-01

    To assess the effectiveness of brief motivational intervention for alcohol and drug use in young adult primary care patients in a low-income population and country. A randomized controlled trial in a public-sector clinic in Delft, a township in the Western Cape, South Africa recruited 403 patients who were randomized to either single-session, nurse practitioner-delivered Brief Motivational Intervention plus referral list or usual care plus referral list, and followed up at 3 months. Although rates of at-risk alcohol use and drug use did not differ by treatment arm at follow-up, patients assigned to the Brief Motivational Intervention had significantly reduced scores on ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) for alcohol-the most prevalent substance. Brief Motivational Intervention may be effective at reducing at-risk alcohol use in the short term among low-income young adult primary care patients; additional research is needed to examine long-term outcomes. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

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

    Science.gov (United States)

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

    2013-11-01

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

  20. Podiatry intervention versus usual care to prevent falls in care homes: pilot randomised controlled trial (the PIRFECT study).

    Science.gov (United States)

    Wylie, Gavin; Menz, Hylton B; McFarlane, Sarah; Ogston, Simon; Sullivan, Frank; Williams, Brian; Young, Zoe; Morris, Jacqui

    2017-07-12

    Common foot problems are independent risk factors for falls in older people. There is evidence that podiatry can prevent falls in community-dwelling populations. The feasibility of implementing a podiatry intervention and trial in the care home population is unknown. To inform a potential future definitive trial, we performed a pilot randomised controlled trial to assess: (i) the feasibility of a trial of a podiatry intervention to reduce care home falls, and (ii) the potential direction and magnitude of the effect of the intervention in terms of number of falls in care home residents. Informed by Medical Research Council guidance on developing and evaluating complex interventions, we conducted a single blind, pilot randomised controlled trial in six care homes in the East of Scotland. Participants were randomised to either: (i) a three month podiatry intervention comprising core podiatry care, foot and ankle exercises, orthoses and footwear provision or (ii) usual care. Falls-related outcomes (number of falls, time to first fall) and feasibility-related outcomes (recruitment, retention, adherence, data collection rates) were collected. Secondary outcomes included: generic health status, balance, mobility, falls efficacy, and ankle joint strength. 474 care home residents were screened. 43 (9.1%) participants were recruited: 23 to the intervention, 20 to control. Nine (21%) participants were lost to follow-up due to declining health or death. It was feasible to deliver the trial elements in the care home setting. 35% of participants completed the exercise programme. 48% reported using the orthoses 'all or most of the time'. Completion rates of the outcome measures were between 93% and 100%. No adverse events were reported. At the nine month follow-up period, the intervention group per-person fall rate was 0.77 falls vs. 0.83 falls in the control group. A podiatry intervention to reduce falls can be delivered to care home residents within a pilot randomised

  1. A process evaluation of a social cognitive theory-based childhood obesity prevention intervention: the Comics for Health program.

    Science.gov (United States)

    Branscum, Paul; Sharma, Manoj; Wang, Lihshing Leigh; Wilson, Bradley; Rojas-Guyler, Liliana

    2013-03-01

    Process evaluations are an often overlooked yet essential component of health promotion interventions. This study reports the results of a comprehensive process evaluation for the "Comics for Health" program, a childhood obesity prevention intervention implemented at 12 after-school programs. Qualitative and quantitative process data were collected using surveys, field notes, and open-item questionnaires, which assessed program fidelity, dose delivered, dose received, reach, recruitment, and context. Triangulation of methods was also employed to better understand how the program was implemented and received by the facilitator, staff members, and children in the program. Results indicated that program implementation had an almost perfect rate of fidelity with most lessons recording 100% tasks completed. Lessons were implemented in their intended order and lasted approximately 30 minutes as planned. After-school staff members reported that the program was well received by children, and this program should be replicated in the future. Attendance records showed that a majority of the children attended each lesson on the initial day of delivery (70.4%) and informal make-up lessons were implemented to compensate for the other children. Finally, several known sources of contamination were found such as past and concurrent exposure to similar health promotion interventions, which could potentially influence study outcomes. These findings will be used to help explain the results of this intervention and make recommendations for future intervention efforts.

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

    Science.gov (United States)

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

    2014-11-30

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

  3. High School Teachers' Perceptions of Cyberbullying Prevention and Intervention Strategies

    Science.gov (United States)

    Stauffer, Sterling; Heath, Melissa Allen; Coyne, Sarah Marie; Ferrin, Scott

    2012-01-01

    Recent meta-analyses indicate that bully prevention programs produce minimal change in student behavior. This study examined 66 high school teachers' perceptions regarding the effect of cyberbullying on students, which intervening strategies teachers would use when dealing with cyberbullying, and which prevention strategies would assist in…

  4. The effectiveness of exercise interventions to prevent sports injuries

    DEFF Research Database (Denmark)

    Lauersen, Jeppe Bo; Bertelsen, Ditte Marie; Andersen, Lars Bo

    2014-01-01

    Physical activity is important in both prevention and treatment of many common diseases, but sports injuries can pose serious problems.......Physical activity is important in both prevention and treatment of many common diseases, but sports injuries can pose serious problems....

  5. Workplace Interventions to Prevent Type 2 Diabetes Mellitus: a Narrative Review

    Science.gov (United States)

    Fedewa, Allison; Moran, Margaret; O’Brien, Matthew; Ackermann, Ronald; Kullgren, Jeffrey T.

    2017-01-01

    Purpose of review This study aims to summarize the recent peer-reviewed literature on workplace interventions for prevention of type 2 diabetes mellitus (T2DM), including studies that translate the Diabetes Prevention Program (DPP) curriculum to workplace settings (n = 10) and those that use different intervention approaches to achieve the specific objective of T2DM prevention among employees (n = 3). Recent findings Weight reduction was achieved through workplace interventions to prevent T2DM, though such interventions varied substantially in their effectiveness. The greatest weight loss was reported among intensive lifestyle interventions (i.e., at least 4 months in duration) that implemented the structured DPP curriculum (n = 3). Weight reduction was minimal among less intensive interventions, including those that substantially modified the DPP curriculum (n = 2) and those that used non-DPP intervention approaches to prevent T2DM (n = 3). Most studies (n = 12) reported increased levels of physical activity following the intervention. Summary Implementation of the DPP in workplaces may be an effective strategy to prevent T2DM among employees. PMID:28150162

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

    Science.gov (United States)

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

    2017-03-03

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

  7. Clinician-led, peer-led, and internet-delivered dissonance-based eating disorder prevention programs: Acute effectiveness of these delivery modalities.

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Shaw, Heather; Gau, Jeff M

    2017-09-01

    Because independent trials have provided evidence for the efficacy and effectiveness of the dissonance-based Body Project eating disorder prevention program, the present trial tested whether clinicians produce the largest intervention effects, or whether delivery can be task-shifted to less expensive undergraduate peer educators or to Internet delivery without effect size attenuation, focusing on acute effects. In this study, 680 young women (M age = 22.2 years, SD = 7.1) recruited at colleges in 2 states were randomized to clinician-led Body Project groups, peer-led Body Project groups, the Internet-based eBody Project, or an educational video control condition. Participants in all 3 variants of the Body Project intervention showed significantly greater reductions in eating disorder risk factors and symptoms than did educational video controls. Participants in clinician-led and peer-led Body Project groups showed significantly greater reductions in risk factors than did eBody Project participants, but effects for the 2 types of groups were similar. Eating disorder onset over 7-month follow-up was significantly lower for peer-led Body Project group participants versus eBody Project participants (2.2% vs. 8.4%) but did not differ significantly between other conditions. The evidence that all 3 dissonance-based prevention programs outperformed an educational video condition, that both group-based interventions outperformed the Internet-based intervention in risk factor reductions, and that the peer-led groups showed lower eating disorder onset over follow-up than did the Internet-based intervention is novel. These acute-effects data suggest that both group-based interventions produce superior eating disorder prevention effects than does the Internet-based intervention and that delivery can be task-shifted to peer leaders. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Debriefing interventions for the prevention of psychological trauma in women following childbirth.

    Science.gov (United States)

    Bastos, Maria Helena; Furuta, Marie; Small, Rhonda; McKenzie-McHarg, Kirstie; Bick, Debra

    2015-04-10

    -analysis was conducted where there were more than two trials examining the same outcomes. We included seven trials (eight articles) from three countries (UK, Australia and Sweden) that fulfilled the inclusion criteria. The number of women contributing data to each outcome varied from 102 to 1745. Methodological quality was variable and most of the studies were of low quality. The quality of evidence for the prevalence of psychological trauma (primary outcome) and the prevalence of depression symptoms was rated low or very low, based on few studies (ranging from a single study to three studies) with high risk of bias in main domains such as performance bias, random sequence generation, allocation concealment and incomplete outcome data. The quality of evidence for the remaining outcomes (that is prevalence of anxiety, prevalence of fear of childbirth, prevalence of general psychological morbidity, health service utilization and attrition from treatment) was not assessed as data were not available.Among women who had a high level of obstetric intervention during labour and birth, we found no difference between standard postnatal care with debriefing and standard postnatal care without debriefing on psychological trauma symptoms within three months postpartum (RR 0.61; 95% CI 0.28 to 1.31; n = 425) or at three to six months postpartum (RR 0.62; 95% CI 0.27 to 1.42; n = 246). The results were based on two trials, respectively. Among women who experienced a distressing or traumatic birth, there was no evidence of an effect of psychological debriefing on the prevention of PTSD (measured by the MINI-PTSD) at four to six weeks postpartum (RR 1.15; 95% CI 0.66 to 2.01; n = 102) or at six months (RR 0.35; 95% CI 0.10 to 1.23; n = 103). The results were based on one small trial. One trial involving low-risk women who delivered healthy infants at or near term reported no significant difference between the intervention group and the control group in the proportion of women who met the

  9. Treatment Protocols for Eating Disorders: Clinicians' Attitudes, Concerns, Adherence and Difficulties Delivering Evidence-Based Psychological Interventions.

    Science.gov (United States)

    Waller, Glenn

    2016-04-01

    There are several protocols in existence that guide clinicians in the implementation of effective, evidence-based psychological interventions for eating disorders. These have been made accessible in the form of treatment manuals. However, relatively few clinicians use those protocols, preferring to offer more eclectic or integrative approaches. Following a summary of the research that shows that these evidence-based approaches can be used successfully in routine clinical settings, this review considers why there is such poor uptake of these therapies in such settings. This review focuses on the role of service culture and on clinicians' own attitudes, beliefs and emotions. Possible means of enhancing uptake are considered, but these cannot be considered to be ideal solutions at present.

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

    Science.gov (United States)

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

    2014-02-01

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

  11. Types of Interventions for Smoking Prevention and Cessation in Children and Adolescents.

    Science.gov (United States)

    Nădăşan, Valentin; Chirvăsuţă, Radu; Ábrám, Zoltan; Mihăicuţă, Ştefan

    2015-01-01

    Smoking among children and adolescents is a pressing public health issue that demands the development, improvement and implementation of programmes aimed at the prevention and cessation of smoking on a global scale. The objective of our article is to review the main types of interventions for smoking prevention and cessation among children and adolescents. These interventions are based on a wide variety of approaches and include school-based programmes, primary and secondary care-based interventions, programmes targeting parents and family, community-based programmes, social marketing programmes and media campaigns, legislative interventions and computer and other IT-based interventions. Generally, there is still a paucity of low level evidence regarding the efficacy of most smoking prevention and cessation programmes for children and adolescents except for a few particular types of interventions that are reasonably well documented.

  12. Nutritional intervention trials for preventing and treating pressure ulcer.

    OpenAIRE

    Bourdel-Marchasson, Isabelle; Rondeau, Virginie

    2001-01-01

    The purpose of this study was to assess the effect of nutritional supplementation on dietary intake and on pressure ulcer development in critically ill older patients. The multi-center trial involved 19 wards stratified according to specialty and recruitment for critically ill older patients; 9 wards were randomly selected for nutritional intervention (nutritional intervention group), consisting of the daily distribution of two oral supplements, with each supplement containg 200 kcal, for 15 ...

  13. Provision of relapse prevention interventions in UK NHS Stop Smoking Services: a survey

    Directory of Open Access Journals (Sweden)

    McEwen Andy

    2010-07-01

    Full Text Available Abstract Background UK NHS Stop Smoking Services provide cost effective smoking cessation interventions but, as yet, there has been no assessment of their provision of relapse prevention interventions. Methods Electronic questionnaire survey of 185 UK Stop Smoking Services Managers. Results Ninety six Stop Smoking Service managers returned completed questionnaires (52% response rate. Of these, 58.3% (n = 56 ran NHS Stop Smoking Services which provided relapse prevention interventions for clients with the most commonly provided interventions being behavioural support: telephone (77%, group (73%, and individual (54%. Just under half (48%, n = 27 offered nicotine replacement therapy (NRT, 21.4% (n = 12 bupropion; 19.6% (n = 11 varenicline. Over 80% of those providing relapse prevention interventions do so for over six months. Nearly two thirds of all respondents thought it was likely that they would either continue to provide or commence provision of relapse prevention interventions in their services. Of the remaining respondents, 66.7% (n = 22 believed that the government focus on four-week quit rates, and 42.9% (14 services believed that inadequate funding for provision of relapse prevention interventions, were major barriers to introducing these interventions into routine care. Conclusions Just over half of UK managers of NHS Stop Smoking Services who responded to the questionnaire reported that, in their services, relapse prevention interventions were currently provided for clients, despite, at that time, there being a weak evidence base for their effectiveness. The most commonly provided relapse prevention interventions were those for which there was least evidence. If these interventions are found to be effective, barriers would need to be removed before they would become part of routine care.

  14. Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial.

    Science.gov (United States)

    Tighe, Joseph; Shand, Fiona; Ridani, Rebecca; Mackinnon, Andrew; De La Mata, Nicole; Christensen, Helen

    2017-01-27

    Rates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia. Remote and very remote communities in the Kimberley region of North Western Australia. Indigenous Australians aged 18-35 years. 61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks. The primary outcome was the Depressive Symptom Inventory-Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11). Although preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use. Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

  17. Reasons for Testing Mediation in the Absence of an Intervention Effect: A Research Imperative in Prevention and Intervention Research.

    Science.gov (United States)

    O'Rourke, Holly P; MacKinnon, David P

    2018-03-01

    Mediation models are used in prevention and intervention research to assess the mechanisms by which interventions influence outcomes. However, researchers may not investigate mediators in the absence of intervention effects on the primary outcome variable. There is emerging evidence that in some situations, tests of mediated effects can be statistically significant when the total intervention effect is not statistically significant. In addition, there are important conceptual and practical reasons for investigating mediation when the intervention effect is nonsignificant. This article discusses the conditions under which mediation may be present when an intervention effect does not have a statistically significant effect and why mediation should always be considered important. Mediation may be present in the following conditions: when the total and mediated effects are equal in value, when the mediated and direct effects have opposing signs, when mediated effects are equal across single and multiple-mediator models, and when specific mediated effects have opposing signs. Mediation should be conducted in every study because it provides the opportunity to test known and replicable mediators, to use mediators as an intervention manipulation check, and to address action and conceptual theory in intervention models. Mediators are central to intervention programs, and mediators should be investigated for the valuable information they provide about the success or failure of interventions.

  18. Assessment of common interventions and perceived barriers to pressure ulcer prevention in southwest Nigeria.

    Science.gov (United States)

    Ilesanmi, Rose Ekama; Olabisi, Prisca

    2014-01-01

    We examined the interventions used by nurses to prevent pressure ulcers in 3 hospitals in south west Nigeria and perceived barriers to effective nursing pressure ulcer prevention interventions. One hundred ninety-three nurses were purposively selected from neurological, orthopedic, intensive care, and accident and emergency units of participating hospitals. Study sites were 3 teaching hospitals in south west Nigeria (Lagos State University Teaching Hospital, Lagos; University College Hospital, Ibadan; and Obafemi Awolowo Teaching Hospital Ile-Ife). Data were collected via a structured questionnaire designed for this study. It included 3 sections: demographic information, practices used for pressure ulcer prevention, and perceived barriers to prevention. Sections of the questionnaire that queried interventions and perceived barriers to pressure ulcer prevention were evaluated for face and content validity. Reliability was evaluated via internal consistency; the split half reliability was 0.82. Similar practices regarding pressure ulcer prevention were found across the 3 hospitals. The most commonly used intervention was patient repositioning every 2 hours; the least used intervention was completion of a validated pressure ulcer risk scale. Nurses described using interventions that have not proved effective for pressure ulcer prevention such as massaging bony prominences and application of talcum powder. Nurses identified 2 principal factors that act as barriers to successful prevention of pressure ulcers: inadequate manpower and inadequate supply of linens on the wards. Nurses use a combination of evidence-based interventions, along with interventions that have not proved effective for pressure ulcer prevention. We recommend development of national standards for pressure ulcer prevention in Nigeria that are based on current best evidence and consistent with current international guidelines.

  19. Implementation of a "County-Township-Village" Allied HIV Prevention and Control Intervention in Rural China.

    Science.gov (United States)

    Yu, Jun; Zhang, Yi; Jiang, Junjun; Lu, Qinglin; Liang, Bingyu; Liu, Deping; Fang, Keyong; Huang, Jiegang; He, Yang; Ning, Chuanyi; Liao, Yanyan; Lai, Jingzhen; Wei, Wudi; Qin, Fengxiang; Ye, Li; Geng, Wenkui; Liang, Hao

    2017-09-01

    In China, rural areas are a weak link of HIV/AIDS prevention and control. From September 2011, an innovative "county-township-village" allied intervention was implemented in Longzhou County, Guangxi, which assigned the tasks of HIV/AIDS prevention and control to the county Centers for Disease Control and Prevention (CDC), township hospitals, and village clinics, respectively, instead of traditional intervention in which the county CDC undertook the entire work. A 6-year consecutive cross-sectional survey, including 3-year traditional intervention (2009-2011) and 3-year innovative intervention (2012-2014), was conducted to evaluate the effects of the new intervention. Compared to traditional intervention, the innovative intervention achieved positive effects in decreasing risky behaviors. Among female sex workers, condom use rate in the last month increased from 72.06% to 96.82% (p risk ratio of HIV infection during innovative intervention was 0.631 (95% confidence interval 0.549-0.726) compared with traditional one. Cost-effectiveness analysis indicates that innovative intervention restores each disability-adjusted life year costing an average of $124.26. Taken together, Longzhou's innovative intervention has achieved good effects on HIV/AIDS prevention and control and provides a good reference for rural China.

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

    Directory of Open Access Journals (Sweden)

    Marit Skogstad

    2018-02-01

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

  1. Nursing assessment: impact on type and cost of interventions to prevent pressure ulcers.

    Science.gov (United States)

    Richardson, G M; Gardner, S; Frantz, R A

    1998-11-01

    To describe pressure ulcer preventive interventions and their cost, and to compare the preventive intervention use and cost with level of risk. Comparative, descriptive design. A large midwestern Veteran's Affairs Medical Center with 260 long-term care beds. Thirty-one chair- or bed-bound residents from 1 long-term care unit comprised the study sample. The outcome variables included demographic information (patient record), Braden Risk Assessment score, institutional risk assessment score (Pressure Ulcer Risk Tool), type and frequency of preventive interventions, and the related costs. Subjects were assessed on a weekly basis for type and frequency of preventive intervention and for the development of a pressure ulcer. Each subject was observed until death, discharge, pressure ulcer formation, or the end of the 3-month study period. The 3-month pressure ulcer incidence rate was 13%. All subjects were at risk for pressure ulcer development according to Braden scores; whereas only 74% were assessed at risk with use of the facility's risk assessment tool. Preventive measures included regular repositioning (87%); 67% were placed on mattress support surfaces. There was no relationship between level of risk (facility risk tool score) and type of prevention used. The total cost of pressure ulcer prevention to the nursing unit was $14,926, representing a mean of $497 per subject, and $5.55 per subject per day. As compared with previous studies, the higher cost of prevention described in this study may be attributed to inadequate linkage of preventive interventions to risk level.

  2. Low back pain prevention for nursing students: a kettlebell intervention

    OpenAIRE

    Peltoniemi, Gabriella

    2014-01-01

    The purpose of this thesis is to educate and provide information to promote nursing students to take action in Low Back Pain (LBP) prevention. LBP is a high risk in nursing and prevention measures are recommended prior to starting the work. LBP is a debilitating musculoskeletal condition which affects all parts of the world. Prevention measures are many and this thesis aims to promote the Kettlebell training as one of them. The Kettlebell is a cast-iron ball with a handle. It has become incre...

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

    Directory of Open Access Journals (Sweden)

    Jeffrey David Lambert

    2015-10-01

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

  4. Testing the feasibility of a briefer school-based preventive intervention with aggressive children: A hybrid intervention with face-to-face and internet components.

    Science.gov (United States)

    Lochman, John E; Boxmeyer, Caroline L; Jones, Shannon; Qu, Lixin; Ewoldsen, David; Nelson, W Michael

    2017-06-01

    This study describes the results from a feasibility study of an innovative indicated prevention intervention with hybrid face-to-face and web-based components for preadolescent youth. This intervention includes a considerably briefer set of face-to-face sessions from the evidence-based Coping Power program an