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.
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.
Stuart, Elizabeth A; Perry, Deborah F; Le, Huynh-Nhu; Ialongo, Nicholas S
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.
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
Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.
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…
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...
Karki, Suyen; Pietila, Anna-Maija; Lansimies-Antikainen, Helena; Varjoranta, Pirjo; Pirskanen, Marjatta; Laukkanen, Eila
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…
O'Rourke, Holly P; MacKinnon, David P
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.
Lauersen, Jeppe Bo; Bertelsen, Ditte Marie; Andersen, Lars Bo
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....
Nguyen, Vu H.; Wang, Ze; Waigandt, Alexander C.
Background: Osteoporosis prevention education interventions have been found to be ineffective. Purpose: To determine the effectiveness of a developed intervention based on the health belief model, which emphasized its visible severity and proximal time of onset. Method: A sample of 109 college women were randomly assigned to either a treatment or…
Fernandes,Luciana Magnani; Caliri,Maria Helena Larcher; Haas,Vanderlei José
OBJECTIVE: The aim was to evaluate the effect of the educative interventions on nursing staff knowledge about pressure ulcer prevention in Intensive Care Centers (ICC). It is a descriptive-comparative study. METHODS: Data were collected from nursing team members before and after educative interventions using a knowledge test with true-false questions related to pressure ulcer prevention and description as a research instrument. RESULTS: Seven registered nurses participated in the pre-interven...
Pillhofer, M.; Schoellhorn, A.; Jungmann, T.; Eickhorst, A.; Schuengel, C.
In Germany early intervention has not been systematically implemented in the regular service delivery and the existing programs have not been profoundly evaluated. Due to serious child protection cases the German Federal Ministry for Family Affairs, Senior Citizens, Women and Youth participated in a
Kersten, L.E.; Hosman, C.M.H.; Riksen-Walraven, J.M.A.; Doesum, K.T.M. van; Hoefnagels, C.C.J.
Improving depressed mothers' sensitivity is assumed to be a key element in preventing adverse outcomes for children of such mothers. This meta-analysis examines the short-term effectiveness of preventive interventions in terms of enhancing depressed mothers' sensitivity toward their child and
King, Keith A.; Vidourek, Rebecca A.
Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…
Kumar G Anil
Full Text Available Abstract Background Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. Methods Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY saved as a measure of cost-effectiveness of each type of HIV prevention intervention. Results The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. Conclusions The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India.
Beauchamp, A; Backholer, K; Magliano, D; Peeters, A
Obesity prevention is a major public health priority. It is important that all groups benefit from measures to prevent obesity, but we know little about the differential effectiveness of such interventions within particular population subgroups. This review aimed to identify interventions for obesity prevention that evaluated a change in adiposity according to socioeconomic position (SEP) and to determine the effectiveness of these interventions across different socioeconomic groups. A systematic search of published and grey literature was conducted. Studies that described an obesity prevention intervention and reported anthropometric outcomes according to a measure of SEP were included. Evidence was synthesized using narrative analysis. A total of 14 studies were analysed, representing a range of study designs and settings. All studies were from developed countries, with eight conducted among children. Three studies were shown to have no effect on anthropometric outcomes and were not further analysed. Interventions shown to be ineffective in lower SEP participants were primarily based on information provision directed at individual behaviour change. Studies that were shown to be effective in lower SEP participants primarily included community-based strategies or policies aimed at structural changes to the environment. Interventions targeting individual-level behaviour change may be less successful in lower SEP populations. It is essential that our efforts to prevent obesity do not leave behind the most disadvantaged members of society. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.
Fitzgibbon, M. L.; Stolley, M. R.; Schiffer, L.; Braunschweig, C. L.; Gomez, S. L.; Van Horn, L.; Dyer, A.
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
Full Text Available Background: Prevalence rates in breast cancer have now reached epidemic levels. One of the main reasons behind onset of breast cancer is poor preventive beliefs and behavior of women towards cancer prevention. We examined the effectiveness of health education intervention in two communities of South Greece.Objective: The study investigates the effectiveness of a brief health education intervention on women’s beliefs and behaviour changes concerning breast cancer prevention.Methodology: A 90-minute, one-off encounter, health education study was designed for 300 women from Peloponissos, South Greece. A Health Belief Model questionnaire, was used before the intervention, immediately after and 6-months after the intervention.Results: Despite certain perception-related barriers (embarrassment, anxiety, ect women’s overall beliefs towards breast cancer prevention (perceived susceptibility, perceived benefits and perceived barriers changed positively after the health education intervention and this change was sustained at 6-month follow up. However, specific barriers (embarrassment, fear of pain, anxiety when anticipating tests’ results were not maintained at the same level of post-intervention during the same follow up. During the follow up period, women performed breast self-examination every month (73% and 55.10% had breast examination by a clinician and underwent a mammography.Conclusions: Short, low cost, health education interventions for breast cancer prevention to women can be effective in changing beliefs and behaviour. Tailored interventions are necessary to overcome relapsing of specific barriers. Emphasis should be given on the importance of doctor/nurse role in breast screening.
Full Text Available Background: Women’s beliefs are one of the main reasons for not undergoing Pap-test for cervical cancer prevention. Health education programs could help change these beliefs and motivate women to adopt a preventive health behavior.Objectives: This study aims to assess the modification in women’s beliefs and behavior about cervical cancer prevention after the implementation of a health education intervention.Methodology: A health education intervention for cervical cancer prevention was implemented to 300 women in two prefectures of southern Greece. The experimental group received a 120-minute health education intervention, based on the Health Beliefs Model (HBM including a lecture, discussion and leaflets. The hypotheses were a will this brief intervention change women’s beliefs (perceived susceptibility to cervical cancer, benefits and barriers ofundergoing the Pap-test? b will this change in beliefs sustain in six months follow-up period? and c will women undergo pap-test in six months period? The women filled in an anonymous questionnaire, based on the Health Belief Model (HBM, before, immediately after and six months after the program.Results: The health education intervention significantly modified women’s beliefs and behaviors towards pap-test. The greater changes in women’s beliefs were observed in their sense of susceptibility towards the disease and the benefits of prevention which were sustained or improved after six months. Perceived barriers to undergo the Paptest, pain, embarrassment, and worry for the results decreased immediately after the program but started relapsingin the six month follow up period. Moreover, 88.1% of the women answered that they had underwent a Pap-test during the following six months.Conclusions: This health education intervention modified women’s beliefs and behavior about cervical cancer prevention. Short, low cost, health education interventions for breast cancer prevention to women can be
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.
Jalilian, Farzad; Allahverdipour, Hamid; Moeini, Babak; Moghimbeigi, Abbas
Background: Use of anabolic androgenic steroids (AAS) has been associated with adversephysical and psychiatric effects and it is known as rising problem among youth people. Thisstudy was conducted to evaluate anabolic steroids preventative intervention efficiency amonggym users in Iran and theory of planned behaviour was applied as theoretical framework.Methods: Overall, 120 male gym users participated in this study as intervention and controlgroup. This was a longitudinal randomized pretest ...
Jalilian, Farzad; Allahverdipour, Hamid; Moeini, Babak; Moghimbeigi, Abbas
Use of anabolic androgenic steroids (AAS) has been associated with adverse physical and psychiatric effects and it is known as rising problem among youth people. This study was conducted to evaluate anabolic steroids preventative intervention efficiency among gym users in Iran and theory of planned behaviour was applied as theoretical framework. Overall, 120 male gym users participated in this study as intervention and control group. This was a longitudinal randomized pretest - posttest series control group design panel study to implement a behaviour modification based intervention to prevent AAS use. Cross -tabulation and t-test by using SPSS statistical package, version 13 was used for the statistical analysis. It was found significant improvements in average response for knowledge about side effects of AAS (Pgym users and ado-lescences would be effective to improve adolescents' healthy behaviors and intend them not to use AAS.
Polanin, Joshua R.; Espelage, Dorothy L.; Pigott, Therese D.
This meta-analysis synthesized bullying prevention programs' effectiveness at increasing bystander intervention in bullying situations. Evidence from 12 school-based programs, involving 12,874 students, indicated that overall the programs were successful (Hedges's g = 0.20, 95% confidence interval [CI] = 0.11 to 0.29, p = 0.001), with larger…
N.H.J. van Veen (Natasja); P. McNamee (McNamee); J.H. Richardus (Jan Hendrik); W.C.S. Smith (Cairns)
textabstractBackground: Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and
Posthumus, Jocelyne A.; Raaijmakers, Maartje A. J.; Maassen, Gerard H.; van Engeland, Herman; Matthys, Walter
The present study evaluated preventive effects of the Incredible Years program for parents of preschool children who were at risk for a chronic pattern of conduct problems, in the Netherlands. In a matched control design, 72 parents of children with conduct problems received the Incredible Years program. These families (intervention group) were…
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
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.
Vercruysse, Sien; Haerens, Leen; Verhagen, Evert; Goossens, Lennert; De Clercq, Dirk
Physical education (PE) teachers are at a high risk of musculoskeletal sports or work-related injuries because of the physical activity as inherent part of their profession. Such injuries have a negative impact on work and leisure time activities, and effective injury prevention interventions are needed. The present study aimed at testing the effectiveness of an injury prevention intervention that was developed and optimized according to PE teachers' wishes and values. Fifty-five PE teachers were randomly assigned to intervention or control group. Intervention group teachers engaged in two days of training during which they familiarized with eight injury prevention strategies (seven intrinsic and one extrinsic). A special feature of the intervention was that the way of delivery was based on the self-determination theory in order to stimulate participants' motivation to adhere to the proposed strategies. Prospective registrations during one school year were conducted concerning injuries and preventive behaviours. Results showed that the intervention group teachers had a lower number of injuries per 1000 h time of exposure (TOE) than the controls (INT: 0.49, CON: 1.14 injuries/1000 h TOE, OR: 2.32, 95% CI: 1.06-5.07), and applied a broader variety of strategies including dynamic and static stretching, core stability, balance and strength training, when compared to the controls who mainly engaged in warming-up. In conclusion, with the same amount of time, an injury reduction was found in PE teachers through a more balanced use of provided preventive strategies.
Gómez-Gascón, Tomás; Martín-Fernández, Jesús; Gálvez-Herrer, Macarena; Tapias-Merino, Ester; Beamud-Lagos, Milagros; Mingote-Adán, José Carlos
Burnout syndrome is an important health problem that affects many professionals and must be addressed globally, with both organizational measures and personal interventions. Burnout of health professionals can be prevented in order to avoid personal, familial, and social consequences, as well as repercussions for patients. This work describes a protocol for a controlled, pragmatic, randomized clinical trial in 2 parallel groups: intervention and control. All health professionals from 7 health care centers will form the intervention group, and all health professionals from 7 different health care centers will form the control group. The intervention group will receive 16 hours of training at their work place. The Maslach's burnout inventory, the Cuestionario de Desgaste Profesional Médico or the Cuestionario de Desgaste Profesional de Enfermería, and the 28-item Goldberg's General Health Questionnaire, validated for our setting, will be used as measurement tools. Change in the average scores from the Maslach's burnout inventory emotional exhaustion scale will be compared between the intervention and control groups, measured as intention-to-treat, and the intervention will be considered effective if a minimum decrease of 20% is achieved. Due to the deleterious consequences of burnout syndrome for people suffering from it and for the organization where they work, it is necessary to evaluate the effectiveness of certain interventions for its prevention. Organizational measures are important for preventing burnout syndrome, but so is providing professionals with coping strategies, as this group intervention intends to do. ClinicalTrials.gov processed this record on June 10, 2013. ClinicalTrials.gov Identifier: NCT01870154.
Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M; Ohls, Olivia C
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.
Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M.; Ohls, Olivia C.
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
Tolan, Patrick; Gorman-Smith, Deborah; Henry, David
Four hundred twenty-four families who resided in inner-city neighborhoods and had a child entering 1st grade were randomly assigned to a control condition or to a family-focused preventive intervention combined with academic tutoring. SAFEChildren, which was developed from a developmental-ecological perspective, emphasizes developmental tasks and community factors in understanding risk and prevention. Tracking of linear-growth trends through 6 months after intervention indicated an overall effect of increased academic performance and better parental involvement in school. High-risk families had additional benefits for parental monitoring, child-problem behaviors, and children's social competence. High-risk youth showed improvement in problem behaviors and social competence. Results support a family-focused intervention that addresses risk in low-income communities as managing abnormal challenges.
Facompré, Christopher R; Bernard, Kristin; Waters, Theodore E A
Disorganized attachment is associated with a host of negative developmental outcomes, leading to a growing interest in preventative interventions targeting the attachment relationship in infancy. The objective of this meta-analysis was to assess the effectiveness of interventions that aimed to prevent or reduce rates of disorganization among children at risk. We performed a literature search using PsycINFO, MEDLINE, and ProQuest databases for studies published between January 1989 and August 2016. All 16 studies (N = 1,360) included a control condition and reported postintervention rates of organized and disorganized attachments assessed by the Strange Situation Procedure. Results showed that, overall, interventions were effective in increasing rates of organized attachment compared to control conditions (d = 0.35, 95% CI [0.10-0.61]). Moderator analyses demonstrated that interventions were more effective (a) in more recently published studies than in older studies, (b) for maltreated samples than nonmaltreated samples, and (c) as children increased in age. These results have important implications for future development, tailoring, and implementation of attachment-based intervention programs.
Zhao, Yuqin; Wood, Daniel T; Kojouharov, Hristo V; Kuang, Yang; Dimitrov, Dobromir T
Mechanistic mathematical models are increasingly used to evaluate the effectiveness of different interventions for HIV prevention and to inform public health decisions. By focusing exclusively on the impact of the interventions, the importance of the demographic processes in these studies is often underestimated. In this paper, we use simple deterministic models to assess the effectiveness of pre-exposure prophylaxis in reducing the HIV transmission and to explore the influence of the recruitment mechanisms on the epidemic and effectiveness projections. We employ three commonly used formulas that correspond to constant, proportional and logistic recruitment and compare the dynamical properties of the resulting models. Our analysis exposes substantial differences in the transient and asymptotic behavior of the models which result in 47 % variation in population size and more than 6 percentage points variation in HIV prevalence over 40 years between models using different recruitment mechanisms. We outline the strong influence of recruitment assumptions on the impact of HIV prevention interventions and conclude that detailed demographic data should be used to inform the integration of recruitment processes in the models before HIV prevention is considered.
Hu, Yan; He, Jian-Rong; Liu, Fang-Hua; Li, Wei-Dong; Lu, Jin-Hua; Xing, Yan-Fei; Lin, Sui-Fang; Liu, Xian; Bartington, Suzanne; Feng, Qiong; Xia, Hui-Min; Lam, Kin Bong Hubert; Cheng, Kar Keung; Qiu, Xiu
Interventions to prevent childhood obesity targeting school age children have mostly reported limited effectiveness, suggesting such prevention programs may need to start at an earlier age, but evidence has been scarce. We reported a pilot study aiming to demonstrate the feasibility of a multifaceted intervention for preschool children and to provide a preliminary assessment of the effectiveness. This nonrandomized controlled trial recruited children aged 3 to 6 years from 6 kindergartens in Guangzhou, China. Based on the preference of the School and Parents Committees, 4 kindergartens (648 children) received a 3-component intervention (training of kindergarten staff, initiating healthy curriculum for children, and close collaboration between families and kindergartens) over 12 months, while the other 2 kindergartens (336 children), serving as controls, received routine health care provision. Outcome measures were the changes in BMI z score between baseline and the end of 12 months, and the prevalence of postintervention children who were overweight or obese. By 12 months, children within the intervention group had a smaller BMI z score increase (0.24) compared to the control (0.41), with a difference of -0.31 (95% CI -0.47 to -0.15). The prevalence of overweight or obesity was also lower among the intervention group at the end of the study (OR: 0.43, 95% CI 0.19 to 0.96), adjusted for baseline status. Our results indicated a multicomponent health behavior intervention might be effective in reducing the prevalence of obesity, but the longer term effects will need confirmation from randomized controlled trials. Copyright © 2017 by the American Academy of Pediatrics.
Pelleboer-Gunnink, Hannah A; Van der Valk, Inge E; Branje, Susan J T; Van Doorn, Muriel D; Deković, Maja
Children of divorced parents have an increased risk of a variety of problems in comparison to children from intact families. Therefore, several intervention programs have been developed directed at children of divorced parents. Yet, empirical data on the effectiveness of these interventions are limited. This study evaluated the school-based, child-directed prevention program Kids In Divorce Situations (KIDS) using a randomized controlled trial. The sample consisted of 156 children randomly assigned at the school level into an experimental (80 children) and control condition (76 children). In addition, 131 mothers and 76 fathers participated in the study. Four assessments took place: a pretest, a posttest, and two follow-up assessments conducted 6 months and 1 year after finishing KIDS. Latent growth analyses demonstrated that the intervention significantly reduced child-reported emotional problems and enhanced child-reported communication with the father and mother-reported communication with the child. The effect sizes ranged from .30-.63. Few moderation effects of gender, time since divorce, or perceived parental conflict on the intervention effects were found. After parental divorce, a limited school-based intervention for children can be efficacious in promoting children's emotional well-being and parent-child communication. (c) 2015 APA, all rights reserved).
Full Text Available Background: Use of anabolic androgenic steroids (AAS has been associated with adversephysical and psychiatric effects and it is known as rising problem among youth people. Thisstudy was conducted to evaluate anabolic steroids preventative intervention efficiency amonggym users in Iran and theory of planned behaviour was applied as theoretical framework.Methods: Overall, 120 male gym users participated in this study as intervention and controlgroup. This was a longitudinal randomized pretest - posttest series control group design panelstudy to implement a behaviour modification based intervention to prevent AAS use. Cross -tabulation and t-test by using SPSS statistical package, version 13 was used for the statisticalanalysis.Results: It was found significant improvements in average response for knowledge about sideeffects of AAS (P<0.001, attitude toward, and intention not to use AAS. Additionally afterintervention, the rate of AAS and supplements use was decreased among intervention group.Conclusion: Comprehensive implementation against AAS abuse among gym users and adolescenceswould be effective to improve adolescents’ healthy behaviors and intend them notto use AAS.
Felix A Achana
Full Text Available There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a "usual care or no intervention" which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i Medicines only, ii Other household products only, iii Poisons (both medicines and non-medicines, iv Poisonous plants; and v Possession of poison control centre (PCC telephone number in households with children.Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model.28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00 while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13, safe storage of poisons (11.10, 1.60 to 141.50 and possession of PCC number (38.82, 2.19 to 687.10. No one intervention package was more effective than the others in promoting safe storage of poisonous plants.The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the
Achana, Felix A; Sutton, Alex J; Kendrick, Denise; Wynn, Persephone; Young, Ben; Jones, David R; Hubbard, Stephanie J; Cooper, Nicola J
There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a "usual care or no intervention" which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children. Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model. 28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants. The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison
Weber-Gasparoni, Karin; Reeve, Johnmarshall; Ghosheh, Natalie; Warren, Joh J.; Drake, David R.; Kramer, Katherine W.O.; Dawson, Deborah V.
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
Hagan, Melissa J.; Tein, Jenn-Yun; Sandler, Irwin N.; Wolchik, Sharlene A.; Ayers, Tim S.; Luecken, Linda J.
This study tested the effect of the Family Bereavement Program (FBP), a preventive intervention for bereaved families, on effective parenting (e.g., caregiver warmth, consistent discipline) 6 years after program completion. Families (n = 101; 69% female caregivers; 77% Caucasian, 11% Hispanic) with children between ages 8 and 16 who had…
Janssen, Meriam M; Mathijssen, Jolanda J P; van Bon-Martens, Marja J H; van Oers, Hans A M; Garretsen, Henk F L
Alcohol education aims to increase knowledge on the harm related to alcohol, and to change attitudes and drinking behaviour. However, little (lasting) evidence has been found for alcohol education, in changing alcohol-related attitudes and behaviour. Social marketing uses marketing techniques to achieve a social or healthy goal, and can be used in alcohol education. Social marketing consists of eight principles: customer orientation, insight, segmentation, behavioural goals, exchange, competition, methods mix, and is theory based. This review investigates the application of social marketing in alcohol prevention interventions, and whether application of social marketing influences alcohol-related attitudes or behaviour. A literature search was conducted in PubMed, PsychInfo, Cochrane and Scopus. Inclusion criteria were that original papers had to describe the effects of an alcohol prevention intervention developed according to one or more principles of social marketing. No limits were set on the age of the participants or on the kind of alcohol prevention intervention. The abstracts of the 274 retrieved studies were reviewed and the full texts of potentially relevant studies were screened. Six studies met the inclusion criteria and were included in this review. These six studies showed associations for the application of social marketing techniques on alcohol-related attitudes or behaviour; one study relates to participation in a drinking event, four to alcohol drinking behaviour, two to driving a car while under the influence of alcohol, two to recognition of campaign messages or campaign logo, and one to awareness of the campaign. However, no associations were also found. In addition, the studies had several limitations related to a control group, response rate and study methodology. Based on this review, the effect of applying the principles of social marketing in alcohol prevention in changing alcohol-related attitudes or behaviour could not be assessed. More
Kaufman, Z A; Spencer, T S; Ross, D A
Interest in sport as a tool for behavioral HIV prevention has grown substantially in the past decade. With dozens of organisations now using sport-based HIV prevention (SBHP) approaches and upcoming randomized controlled trials in South Africa and Zimbabwe, there is a pressing need to synthesize previous evaluation findings and identify gaps in existing research. A systematic review on the effectiveness of SBHP interventions was carried out, identifying both published and unpublished studies on SBHP interventions that measured effectiveness quantitatively. Study quality was scored using an adapted Newcastle-Ottawa Scale. Random-effects meta-analyses were carried out across studies for effects on six categories of HIV-related outcomes. The review identified 952 publications, 21 of which met inclusion criteria. No randomised controlled trials on SBHP interventions and no studies assessing biological outcomes were identified. Mean study quality score was 5.1 (SD 3.1) out of 20 points. Overall strong evidence was observed for positive effects on HIV-related knowledge (RR = 1.26, 95 % CI = 1.15-1.37), stigma (RR = 1.13, 95 % CI = 1.02-1.24), self-efficacy (RR = 1.22, 95 % CI = 1.02-1.41), reported communication (RR = 1.24, 95 % CI = 1.06-1.41), and reported recent condom use (RR = 1.29, 95 % CI = 1.00-1.59). Generally, the review found encouraging evidence for some short-term effects but relied predominantly on low-quality studies. More rigorous research on SBHP is needed to objectively assess effectiveness. Randomised controlled trials could play an important role in guiding policies, strategies, and funding related to SBHP.
Shroufi, Amir; Chowdhury, Rajiv; Anchala, Raghupathy; Stevens, Sarah; Blanco, Patricia; Han, Tha; Niessen, Louis; Franco, Oscar H
While there is good evidence to show that behavioural and lifestyle interventions can reduce cardiovascular disease risk factors in affluent settings, less evidence exists in lower income settings.This study systematically assesses the evidence on cost-effectiveness for preventive cardiovascular interventions in low and middle-income settings. Systematic review of economic evaluations on interventions for prevention of cardiovascular disease. PubMed, Web of Knowledge, Scopus and Embase, Opensigle, the Cochrane database, Business Source Complete, the NHS Economic Evaluations Database, reference lists and email contact with experts. we included economic evaluations conducted in adults, reporting the effect of interventions to prevent cardiovascular disease in low and middle income countries as defined by the World Bank. The primary outcome was a change in cardiovascular disease occurrence including coronary heart disease, heart failure and stroke. After selection of the studies, data were extracted by two independent investigators using a previously constructed tool and quality was evaluated using Drummond's quality assessment score. From 9731 search results we found 16 studies, which presented economic outcomes for interventions to prevent cardiovascular disease in low and middle income settings, with most of these reporting positive cost effectiveness results.When the same interventions were evaluated across settings, within and between papers, the likelihood of an intervention being judged cost effective was generally lower in regions with lowest gross national income. While population based interventions were in most cases more cost effective, cost effectiveness estimates for individual pharmacological interventions were overall based upon a stronger evidence base. While more studies of cardiovascular preventive interventions are needed in low and mid income settings, the available high-level of evidence supports a wide range of interventions for the prevention
Gonzálvez, María Teresa; Espada, José Pedro; Orgilés, Mireia; Sussman, Steve
Project EX is a classroom-based smoking prevention and cessation intervention program that has been well evaluated and designed for assessing the prevention and cessation effects among adolescents in Spain. However, its long-term efficacy is still unknown. This study deals with the outcomes of a 2-year follow-up evaluation of Project EX. The intervention was tested using a clustered randomized controlled trial involving 1,546 Spanish students from 3 program schools and 3 control schools. At the end of the 2-year follow-up period, 722 subjects had completed the questionnaires (266 in the control condition and 456 in the program condition) administered to them. Compared to the control condition, the program condition revealed a greater reduction in nicotine dependence (p = 0.04), smoking intention (p = 0.02), and in the number of cigarettes smoked during the previous month (p = 0.03). The CO monitor repeated assessments revealed a significant decrease of ppm levels in the program group (p smoking prevention and cessation among adolescents in Spain. © 2017 S. Karger AG, Basel.
Mercken, L.; Moore, L.; Crone, M. R.; De Vries, H.; De Bourdeaudhuij, I.; Lien, N.; Fagiano, F.; Vitoria, P. D.; Van Lenthe, F. J.
Preventing smoking initiation among adolescents of lower socio-economic groups is crucial for the reduction of socio-economic inequalities in health. The aim of the present study was to examine whether effective smoking prevention interventions in Europe are equally effective among adolescents of low- and high-socio-economic status (SES). As part…
This report describes the implementation and short-term results of a peer group intervention for HIV prevention on the HIV-related attitudes, knowledge and behaviours of primary school teachers in Malawi. The intervention, based on the social-cognitive learning model, took place in 2000 at two teacher training colleges ...
... who did recommended physical activity in the same group. Conclusion: The present work showed that interventions promoting healthy lifestyles should be maintained. Developing countries should be encouraged and supported to design, conduct, and evaluate robust preventive interventions. Keywords: Schools, lifestyle, ...
Grau, Lauretta E; Green, Traci C; Singer, Merrill; Bluthenthal, Ricky N; Marshall, Patricia A; Heimer, Robert
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.
Rimland, Joseph M.; Abraha, Iosief; Dell’Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Soiza, Roy; Gudmusson, Adalsteinn; Petrovic, Mirko; O’Mahony, Denis; Todd, Chris; Cherubini, Antonio
Background Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making. Objectives To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals. Methods We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions. Results Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis. Conclusions The aim of this overview of
Stice, Eric; Presnell, Katherine; Gau, Jeff; Shaw, Heather
The authors investigated mediators hypothesized to account for the effects of 2 eating disorder prevention programs using data from 355 adolescent girls who were randomized to a dissonance or a healthy weight intervention or an active control condition. The dissonance intervention produced significant reductions in outcomes (body…
Medley, Amy; Kennedy, Caitlin; O'Reilly, Kevin; Sweat, Michael
Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of…
Hagan, Melissa J.; Tein, Jenn-Yun; Sandler, Irwin N.; Wolchik, Sharlene A.; Ayers, Tim S.; Luecken, Linda J.
This study tested the effect of the Family Bereavement Program (FBP), a preventive intervention for bereaved families, on effective parenting (e.g. caregiver warmth, consistent discipline) six years after program completion. Families (n=101; 69% female caregivers; 77% Caucasian, 11% Hispanic) with children between ages 8–16 who had experienced the death of one parent were randomized to the FBP (n=54) or a literature control condition (n=47). Multiple regression analyses conducted within a mul...
Full Text Available A set of mediation analyses were carried out in this study using data from It’s Your Game. . .Keep It Real (IYG, a successful HIV/STI/pregnancy prevention program. The IYG study evaluated a skill and normbased. HIV/STI/pregnancy prevention program that was implemented from 2004 to 2007 among 907 urban low-income middle school youth in Houston, TX, USA. Analyses were carried out to investigate the degree to which a set of proposed psychosocial measures of behavioral knowledge, perceived self-efficacy, behavioral, and normative beliefs, and perceived risky situations, all targeted by the intervention, mediated the intervention’s effectiveness in reducing initiation of sex. The mediation process was assessed by examining the significance and size of the estimated effects from the mediating pathways. The findings from this study provide evidence that the majority of the psychosocial mediators targeted by the IYG intervention are indeed related to the desired behavior and provide evidence that the conceptual theory underlying the targeted psychosocial mediators in the intervention is appropriate. Two of the psychosocial mediators significantly mediated the intervention effect, knowledge of STI signs and symptoms and refusal self-efficacy. This study suggests that the underlying causal mechanisms of action of these interventions are complex and warrant further analyses.
Crittenden, Kathleen S; Kaponda, Chrissie P N; Jere, Diana L; McCreary, Linda L; Norr, Kathleen F
This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n = 415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more
José Luis GALLEGO ORTEGA
Full Text Available Language is an essential tool for personal and social development of children and it is perceived as the most important learning that children undertake in the early years of their lives. It is generally accepted that from birth to the age of three-four years old, children achieve a basic repertory of skills in different linguistic dimensions which allow them to communicate effectively with their environment. However, research has shown that phonemic disorders, morphosyntactic dysfunctions and semantic poverty figure prominently in the overall oral language disorders in infancy. In this respect, the review of literature informs us of the abundance of work aimed at rehabiliting the conditions already set in childlike expression, but there are significant gaps in regard to systematic prevention programs to prevent such evolutionary disorders which can become operational because of an early intervention in the field of communication. According to the above, it was developed a research project designed to establish the differential impact of a program to develop language skills in preschoolers. We worked with a sample of 32 children (5 years old in a pretest-posttest design. The data analysis shows that the magnitude of change is significant when comparing the results obtained by the experimental and the control group before and after program implementation. The overall effect of the program allowed to determine its effectiveness to increase language skills in the morph syntactic level.
Gorini, Giuseppe; Carreras, Giulia; Bosi, Sandra; Tamelli, Marco; Monti, Claudia; Storani, Simone; Martini, Andrea; Allara, Elias; Angelini, Paola; Faggiano, Fabrizio
We assessed the effectiveness of the Luoghi di Prevenzione-Prevention Grounds school-based smoking prevention programme. We undertook a cluster randomized controlled trial of 989 students aged 14-15 years in 13 secondary schools located in Reggio Emilia, Italy. The intervention consisted of the "Smoking Prevention Tour" (SPT) out-of-school workshop, one in-depth lesson on one Smoking Prevention Tour topic, a life-skills peer-led intervention, and enforcement surveillance of school antismoking policy. Self-reported past 30-day smoking of ≥ 20 or 1-19 days of cigarette smoking (daily or frequent smoking, respectively) was recorded in 2 surveys administered immediately before and 18 months after the beginning of the programme. Analysis was by intention to treat. The effect of the intervention was evaluated using random effects logistic regression and propensity score-matching analyses. Past 30-day smoking and daily cigarette use at eighteen months follow-up were 31% and 46% lower, respectively, for intervention students compared to control students. Taking into account non-smokers at baseline only, daily smoking at eighteen months follow-up was 59% lower in intervention students than in controls. Past 30-day smoking in school areas was 62% lower in intervention students compared to controls. The Luoghi di Prevenzione-Prevention Grounds programme was effective in reducing daily smokers and in reducing smoking in school areas. Copyright © 2014 Elsevier Inc. All rights reserved.
Lombard, Catherine B; Harrison, Cheryce L; Kozica, Samantha L; Zoungas, Sophia; Keating, Catherine; Teede, Helena J
To impact on the obesity epidemic, interventions that prevent weight gain across populations are urgently needed. However, even the most efficacious interventions will have little impact on obesity prevention unless they are successfully implemented in diverse populations and settings. Implementation research takes isolated efficacy studies into practice and policy and is particularly important in obesity prevention where there is an urgent need to accelerate the evidence to practice cycle. Despite the recognised need, few obesity prevention interventions have been implemented in real life settings and to our knowledge rarely target rural communities. Here we describe the rationale, design and implementation of a Healthy Lifestyle Program for women living in small rural communities (HeLP-her Rural). The primary goal of HeLP-her Rural is to prevent weight gain using a low intensity, self-management intervention. Six hundred women from 42 small rural communities in Australia will be randomised as clusters (n-21 control towns and n = 21 intervention towns). A pragmatic randomised controlled trial methodology will test efficacy and a comprehensive mixed methods community evaluation and cost analysis will inform effectiveness and implementation of this novel prevention program. Implementing population interventions to prevent obesity is complex, costly and challenging. To address these barriers, evidence based interventions need to move beyond isolated efficacy trials and report outcomes related to effectiveness and implementation. Large pragmatic trials provide an opportunity to inform both effectiveness and implementation leading to potential for greater impact at the population level. Pragmatic trials should incorporate both effectiveness and implementation outcomes and a multidimensional methodology to inform scale-up to population level. The learnings from this trial will impact on the design and implementation of population obesity prevention strategies
Isaranuwatchai, Wanrudee; Perdrizet, Johnna; Markle-Reid, Maureen; Hoch, Jeffrey S
Falls among older adults can cause serious morbidity and pose economic burdens on society. Older age is a known risk factor for falls and age has been shown to influence the effectiveness of fall prevention programs. To our knowledge, no studies have explicitly investigated whether cost-effectiveness of a multifactorial fall prevention intervention (the intervention) is influenced by age. This economic evaluation explores: 1) the cost-effectiveness of a multifactorial fall prevention intervention compared to usual care for community-dwelling adults ≥ 75 years at risk of falling in Canada; and 2) the influence of age on the cost-effectiveness of the intervention. Net benefit regression was used to examine the cost-effectiveness of the intervention with willingness-to-pay values ranging from $0-$50,000. Effects were measured as change in the number of falls, from baseline to 6-month follow-up. Costs were measured using a societal perspective. The cost-effectiveness analysis was conducted for both the total sample and by age subgroups (75-84 and 85+ years). For the total sample, the intervention was not economically attractive. However, the intervention was cost-effective at higher willingness-to-pay (WTP) (≥ $25,000) for adults 75-84 years and at lower WTP (adults 85+ years. The cost-effectiveness of the intervention depends on age and decision makers' WTP to prevent falls. Understanding the influence of age on the cost-effectiveness of an intervention may help to target resources to those who benefit most. Retrospectively registered. Clinicaltrials.gov identifier: NCT00463658 (18 April 2007).
Full Text Available Abstract Background Type 2 diabetes mellitus (T2D poses a large worldwide burden for health care systems. One possible tool to decrease this burden is primary prevention. As it is unethical to wait until perfect data are available to conclude whether T2D primary prevention intervention programmes are cost-effective, we need a model that simulates the effect of prevention initiatives. Thus, the aim of this study is to investigate the long-term cost-effectiveness of lifestyle intervention programmes for the prevention of T2D using a Markov model. As decision makers often face difficulties in applying health economic results, we visualise our results with health economic tools. Methods We use four-state Markov modelling with a probabilistic cohort analysis to calculate the cost per quality-adjusted life year (QALY gained. A one-year cycle length and a lifetime time horizon are applied. Best available evidence supplies the model with data on transition probabilities between glycaemic states, mortality risks, utility weights, and disease costs. The costs are calculated from a societal perspective. A 3% discount rate is used for costs and QALYs. Cost-effectiveness acceptability curves are presented to assist decision makers. Results The model indicates that diabetes prevention interventions have the potential to be cost-effective, but the outcome reveals a high level of uncertainty. Incremental cost-effectiveness ratios (ICERs were negative for the intervention, ie, the intervention leads to a cost reduction for men and women aged 30 or 50 years at initiation of the intervention. For men and women aged 70 at initiation of the intervention, the ICER was EUR27,546/QALY gained and EUR19,433/QALY gained, respectively. In all cases, the QALYs gained were low. Cost-effectiveness acceptability curves show that the higher the willingness-to-pay threshold value, the higher the probability that the intervention is cost-effective. Nonetheless, all curves are
Banstola, Amrit; Mytton, Julie
The objective of this study was to identify, critically appraise, summarize, and synthesize evidence from cost-effectiveness analyses (CEAs) of interventions aimed at preventing road traffic injuries (RTIs) in low- and middle-income countries (LMICs) by age group and road users targeted. A search strategy was applied to 12 electronic databases for studies published between May 2002 and August 2015 that met prespecified inclusion criteria. Additional studies were identified by contacting authors and searching bibliographies. Included studies were critically appraised against published criteria and a narrative synthesis was conducted including a use of the strength of evidence criteria. Five studies were included in the final review that reported 9 interventions. Only 2 out of 9 interventions (drink-drive legislation with enforcement via breath testing campaign and combined interventions for reducing RTIs) showed moderate evidence of being cost-effective, whereas the evidence of cost-effectiveness of other interventions was weak. Only 2 interventions (bicycle and motorcycle helmet use legislation and enforcement) were explicitly targeted to children, young people and vulnerable road users such as pedestrians and cyclists. The cost-effectiveness of interventions to prevent RTIs in LMICs ranged from US$4.14 per disability-adjusted life years (DALYs) averted for building speed bumps at the most dangerous junctions that caused 10% of junction deaths in the area studied to US$3,403 per DALYs averted for legislation and enforcement of helmet use by motorcyclists in the World Health Organization (WHO) sub-Saharan Africa region. Evidence of cost-effectiveness of interventions to prevent RTIs in LMICs is limited, particularly for children, young people, and vulnerable road users. Evaluation of the effectiveness and cost-effectiveness of a larger number of possible road safety interventions in a variety of LMIC settings is warranted to generate the evidence base for effective
Cianelli, Rosina; Ferrer, Lilian; Norr, Kathleen F; Miner, Sarah; Irarrazabal, Lisette; Bernales, Margarita; Peragallo, Nilda; Levy, Judith; Norr, James L; McElmurry, Beverly
The impact of a professionally facilitated peer group intervention for HIV prevention among 400 low-income Chilean women was examined using a quasiexperimental design. At 3 months postintervention, the intervention group had higher HIV-related knowledge, more positive attitudes toward people living with HIV, fewer perceived condom use barriers, greater self- efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. They did not, however, have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries.
Lochman, John E; Baden, Rachel E; Boxmeyer, Caroline L; Powell, Nicole P; Qu, Lixin; Salekin, Karen L; Windle, Michel
Booster interventions have been presumed to be important methods for maintaining the effects of evidence-based programs for children with behavioral problems, but there has been remarkably little empirical attention to this assumption. The present study examines the effect of a child-oriented booster preventive intervention with children who had previously received an abbreviated version (24 child sessions, 10 parent sessions) of the Coping Power targeted prevention program. Two hundred and forty-one children (152 boys, 89 girls) were screened as having moderate to high levels of aggressive behavior in 4th grade, then half were randomly assigned to receive the abbreviated Coping Power program in 5th grade, and half of the preventive intervention children were then randomly assigned to a Booster condition in 6th grade. The Booster sessions consisted of brief monthly individual contacts, and were primarily with the children. Five assessments across 4 years were collected from teachers, providing a three-year follow-up for all children who participated in the project. Results indicated that the abbreviated Coping Power program (one-third shorter than the full intervention) had long-term effects in reducing children's externalizing problem behaviors, proactive and reactive aggression, impulsivity traits and callous-unemotional traits. The Booster intervention did not augment these prevention effects. These findings indicate that a briefer and more readily disseminated form of an evidence-based targeted preventive intervention was effective. The findings have potential implications for policy and guidelines about possible intervention length and booster interventions.
Avery, Kerry N L; Donovan, Jenny L; Horwood, Jeremy; Lane, J Athene
Theory-based approaches are now recommended to design and enact dietary interventions, but their use in cancer trials is unknown. This systematic review examined application of behavior theory to dietary interventions aimed at preventing cancer to improve the design and interpretation of trials. Electronic databases were searched (inception-July 2011). Data were synthesized and a theory coding scheme (TCS) used to describe and assess how behavior theory informed interventions. Studies not reporting a dietary behavior intervention informed by a specified behavior change model(s) were excluded. Of 237 potentially eligible studies, only 40 (16.9 %) were relevant, mostly RCTs (34, 85.0 %). Twenty-one interventions targeted diet alone (52.5 %) or integrated diet into a lifestyle intervention (19, 47.5 %). Most (24, 60.0 %) invoked several behavior change models, but only 10 (25.0 %) interventions were reported as explicitly theory-informed and none comprehensively targeted or measured theoretical constructs or tested theoretical assumptions. The 10 theory-informed interventions were more effective at improving diet. Dietary interventions for cancer prevention improved diet more effectively if they were informed by behavior theory. While behavior theory was often applied to these dietary interventions, they were rarely implemented or described thoroughly. Accurate intervention reporting is essential to assess theoretical quality and facilitate implementation effective behavior change techniques. Guidelines regarding the application and reporting of behavior theory for complex interventions, for example, proposed by the National Institutes of Health and Medical Research Council, should be revised accordingly. Failure to adequately ground dietary interventions in behavior theory may hinder establishing their effectiveness and relationships between diet and cancer.
Xu, Fei; Ware, Robert S.; Leslie, Eva; Tse, Lap Ah; Wang, Zhiyong; Li, Jiequan; Wang, Youfa
Background Childhood obesity has been increasing rapidly worldwide. There is limited evidence for effective lifestyle interventions to prevent childhood obesity worldwide, especially in developing countries like China. The objective of this study was to assess the effectiveness of a school-based multi-component lifestyle childhood obesity prevention program (the CLICK-Obesity study) in Mainland China. Methods A cluster randomized controlled trial was developed among grade 4 students from 8 ur...
Tolli, M. V.
Peer education remains a popular strategy for health promotion and prevention, but evidence of its effectiveness is still limited. This article presents a systematic review of peer education interventions in the European Union that were published between January 1999 and May 2010. The objective of the review is to determine the effectiveness of…
Conejo-Cerón, Sonia; Moreno-Peral, Patricia; Rodríguez-Morejón, Alberto; Motrico, Emma; Navas-Campaña, Desirée; Rigabert, Alina; Martín-Pérez, Carlos; Rodríguez-Bayón, Antonina; Ballesta-Rodríguez, María Isabel; Luna, Juan de Dios; García-Campayo, Javier; Roca, Miquel; Bellón, Juan Ángel
Although evidence exists for the efficacy of psychosocial interventions to prevent the onset of depression, little is known about its prevention in primary care. We aimed to evaluate the effectiveness of psychological and educational interventions to prevent depression in primary care. We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs) examining the effect of psychological and educational interventions to prevent depression in nondepressed primary care attendees. We searched MEDLINE, PsycINFO, Web of Science, OpenGrey Repository, Cochrane Central Register of Controlled Trials, and other sources up to May 2016. At least 2 reviewers independently evaluated the eligibility criteria, extracted data, and assessed the risk of bias. We calculated standardized mean differences (SMD) using random-effects models. We selected 14 studies (7,365 patients) that met the inclusion criteria, 13 of which were valid to perform a meta-analysis. Most of the interventions had a cognitive-behavioral orientation, and in only 4 RCTs were the intervention clinicians primary care staff. The pooled SMD was -0.163 (95%CI, -0.256 to -0.070; P = .001). The risk of bias and the heterogeneity (I 2 = 20.6%) were low, and there was no evidence of publication bias. Meta-regression detected no association between SMD and follow-up times or SMD and risk of bias. Subgroup analysis suggested greater effectiveness when the RCTs used care as usual as the comparator compared with those using placebo. Psychological and educational interventions to prevent depression had a modest though statistically significant preventive effect in primary care. Further RCTs using placebo or active comparators are needed. © 2017 Annals of Family Medicine, Inc.
Lakestani, Nelly; Donaldson, Morag L.
This study aimed to investigate whether preschool children can learn how to interpret dogs’ behaviours, with the purpose of helping avoid dog bites. Three- to five-year-old children (N = 70) were tested on their ability to answer questions about dogs’ emotional states before and after participating in either an educational intervention about dog behaviour (intervention group) or an activity about wild animals (control group). Children who had received training about dog behaviour (intervention group) were significantly better at judging the dogs’ emotional states after the intervention compared to before. The frequency with which they referred to relevant behaviours in justifying their judgements also increased significantly. In contrast, the control group’s performance did not differ significantly between the two testing times. These results indicate that preschool children can be taught how to correctly interpret dogs’ behaviours. This implies that incorporating such training into prevention programmes may contribute to reducing dog bite incidents. PMID:26287686
Kawahito, Junko; Hori, Masashi; Otsuka, Yasumasa
The present study developed an intervention program for self-complexity (SC; Linville, 1987), and examined the effects of this program on college students. Participants (N=40) were randomly assigned to an intervention group or a control group. The intervention group received one session of psycho-education about SC, and kept daily records of self-aspects (social roles, interpersonal relationships, specific events/behaviors, traits, abilities, etc.) for one week. All participants were asked to...
Bauer, Andrea; Schmitt, Jochen; Bennett, Cathy; Coenraads, Pieter-Jan; Elsner, Peter; English, John; Williams, Hywel C.
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
Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J
Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (pinterventions had clinically meaningful associations with reduced stage III and IV HAPU incidence rates in 55 academic medical centers. These QI interventions can be used in support of an evidence-based prevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.
Hendrie, Gilly A.; Brindal, Emily; Corsini, Nadia; Gardner, Claire; Baird, Danielle; Golley, Rebecca K.
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…
Otero, Patricia; Vázquez, Fernando L; Hermida, Elisabet; Díaz, Olga; Torres, Ángela
Activities designed to be performed outside of the intervention are considered an essential aspect of the effectiveness of cognitive-behavioral therapy. However, these have received little attention in interventions aimed at individuals with subclinical depressive symptoms who do not yet meet diagnostic criteria for depression (indicated prevention). In this study, the completion of tasks given as homework and their relationship with post-treatment depressive symptoms was with relation to an indicated prevention of depression intervention. Eighty-nine female non-professional caregivers recruited from an official registry completed an intervention involving 11 homework tasks. Tasks performed were recorded and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Among caregivers, 80.9% completed 9-11 tasks. The number of tasks performed was associated with post-treatment depressive symptoms, with 9 being optimal for clinically significant improvement. These findings highlight the relationship between homework and post-treatment depressive symptoms.
Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wout; Sorgdrager, Bas
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
Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina
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
Çelik, Seçil; Arikan, Azru; Diken, Ibrahim H.; Aksoy, Funda; Çolak, Aysun; Tomris, Gözde
Preventing antisocial behaviors appearing at an early age--before they become chronic--through effective early intervention programs, has become an important issue in recent years. In Turkey, the increase in the number of children at risk of antisocial behavior makes it necessary to get these behaviors under control at an early age through some…
Belgrave, Faye Z.; Corneille, Maya; Hood, Kristina; Foster-Woodson, Julia; Fitzgerald, Angela
The enormous HIV/AIDS disparity among African American women and women in other ethnic groups dictates the need to implement the most effective HIV prevention interventions. This study examined the impact of perceived group support on HIV protective behaviors (i.e., attitudes and behaviors related to condom use, alcohol, and drugs) of African…
Despite the widespread implementation of sports-based crime prevention programs, there is little known about the effectiveness of these interventions and the validity of underlying theoretical assumptions. This dissertation consists of four studies. First, a meta-analysis on the relation between
Ruiz-Perez, Isabel; Murphy, Matthew; Pastor-Moreno, Guadalupe; Rojas-García, Antonio; Rodríguez-Barranco, Miguel
Surveys in the United States and Europe have shown a plateau of new HIV cases, with certain regions and populations disproportionately affected by the disease. Ethnic minority women and socioeconomically disadvantaged groups are disproportionately affected by HIV. Previous reviews have focused on prevention interventions targeting ethnic minority men who have sex with men, have not accounted for socioeconomic status, or have included only interventions carried out in clinical settings. To review and assess the effectiveness of HIV prevention interventions targeting socioeconomically disadvantaged ethnic minority women in member states of the Organisation for Economic Co-operation and Development (OECD). On March 31, 2014, we executed a search using a strategy designed for the MEDLINE (Ovid), CINAHL, Embase, Scopus, and Web of Knowledge databases. Additional searches were conducted through the Cochrane Library, CRD Databases, metaRegister of Controlled Trials, EURONHEED, CEA Registry, and the European Action Program for Health Inequities as well as in gray literature sources. No language or date restrictions were applied. We selected studies assessing the effectiveness of interventions to prevent HIV among ethnic minority women of low socioeconomic status in which at least 80% of participants were reported to belong to an ethnic minority group and to have a low income or be unemployed. We included only studies that were conducted in OECD member states and were randomized controlled trials or quasi-experimental investigations with a comparison group. A data extraction form was developed for the review and used to collect relevant information from each study. We summarized results both qualitatively and quantitatively. The main outcomes were categorized into 3 groups: improved knowledge regarding transmission of HIV, behavior changes related to HIV transmission, and reductions in the incidence of sexually transmitted infections (STIs). We then performed meta
Zatzick, Douglas F; Koepsell, Thomas; Rivara, Frederick P
The population impact of a preventive intervention depends on two factors: what proportion of the full population at risk receives the intervention and how large a reduction in risk occurs among those who receive it. We sought to illustrate how information from a cognitive behavioral psychotherapy (CBT) trial and stepped collaborative care (CC) trial could be used to estimate the population impact of two contrasting approaches to PTSD prevention. We first specified trauma center target populations represented by participants in each trial. Patient characteristics were compared, as were effect size and reach indices and population-level reductions in PTSD incidence. The CBT trial demonstrated a larger effect size (50% PTSD prevention), but minimal reach (27/10,000), while the CC trial demonstrated a smaller effect size (7% PTSD prevention) but greater reach (1762/10,000). Modeling of the population impact suggested that a 9.5-fold greater cumulative reduction in the incidence of PTSD would result from the dissemination of the CC broad reach prevention strategy. A reciprocal relationship between effect size and reach was evident in these two trials. By specifying a target population, effect size and reach could be combined to project the overall population impact of each PTSD prevention approach.
On average, 2,500 young people (15-24 years) get infected with HIV every day; 80% of which live in sub-Saharan Africa. Since no cure or vaccine is available, reducing sexual risk behaviour in this group is crucial in tackling the epidemic. The general objective of this doctoral study was to improve the effectiveness of HIV prevention interventions for young people in sub-Saharan Africa. First, we assessed the overall effectiveness of such interventions (systematic literature review, meta-analysis). Secondly, we evaluated a school-based peer-led HIV prevention interventions in Rwanda (longitudinal, non-randomized controlled trial), to get insight into how interventions are developed, implemented and evaluated. While the first two objectives demonstrated limited effectiveness, the third objective aimed to identify reasons for this limited effectiveness: a) baseline characteristics of respondents that predict participation were identified (using data from objective 2); b) we studied determinants of young people’s sexual behavior using a qualitative ‘mailbox study’ that assessed the spontaneous thoughts of Rwandan adolescents on sexuality; c) we assessed the role of one specific structural factor: education (literature review and analysis of existing datasets); d) we assessed the theoretical underpinnings of existing HIV prevention interventions for young people in sub-Saharan Africa (literature review). Based on these studies, we discuss two main reasons for the observed limited effectiveness: factors associated with the intervention (strong focus on cognitions and moral, and implementation issues), and with evaluation (design, power, indicators). Recommendations for improving interventions, evaluations and for further research are provided. PMID:24753945
Hagan, Melissa J; Tein, Jenn-Yun; Sandler, Irwin N; Wolchik, Sharlene A; Ayers, Tim S; Luecken, Linda J
This study tested the effect of the Family Bereavement Program (FBP), a preventive intervention for bereaved families, on effective parenting (e.g., caregiver warmth, consistent discipline) 6 years after program completion. Families (n = 101; 69% female caregivers; 77% Caucasian, 11% Hispanic) with children between ages 8 and 16 who had experienced the death of one parent were randomized to the FBP (n = 54) or a literature control condition (n = 47). Multiple regression analyses conducted within a multilevel framework indicated that the FBP had a significant positive impact on a multirater, multimeasure assessment of parenting at 6-year follow-up, controlling for pretest levels of parenting and child mental health problems. Mediation analyses showed that short-term program effects on parenting, including caregiver warmth and effective discipline, significantly mediated the impact of the FBP on effective parenting 6 years later. These findings indicate that a relatively cost-effective brief intervention for families who experienced a major stressor resulted in sustained effects on caregiver warmth and consistent discipline 6 years following the program.
Pitangueira, Jacqueline Costa Dias; Rodrigues Silva, Luciana; Costa, Priscila Ribas de Farias
This study aims to conduct a literature review to evaluate the effectiveness of intervention programs in the prevention and control of obesity in children and to map the locations where the studies were carried out. A systematic review using the PubMed / MEDLINE and LILACS databases to trace the published literature on intervention programs for prevention and control of obesity in the period of January 2004 to October 2013. The initial search was conducted using the terms "body mass index", " Intervention" and "children" or "adolescent" and only articles published in English, Spanish or Portuguese were selected. We found that interventions based only on advice had modest results in identifying changes in the anthropometric indicators of children and adolescents over time, although they appear to be effective in promoting positive changes in the eating habits of this population. Among the studies identified, 77.8 % were conducted in high-income countries, 22.2 % in middle to high income countries and no intervention studies were found in middle to low income countries. Intervention programs based only on counseling are effective in promoting changes in dietary patterns, but show poor results in the changes of anthropometric parameters of children and adolescents. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Christopher, Caroline; Wolchik, Sharlene; Tein, Jenn-Yun; Carr, Colleen; Mahrer, Nicole E; Sandler, Irwin
This study examined whether the New Beginnings Program (NBP), a parenting preventive intervention for divorced mothers that was designed to reduce children's postdivorce mental health problems, reduced painful feelings about divorce in young adults whose families had participated 15 years earlier. This study also explored whether NBP participation reduced the relations between young adults' painful feelings about divorce and their concurrent internalizing, externalizing, and substance use problems. Participants (M = 25.6 years; 50% female; 88% Caucasian) were from 240 families that had been recruited into a randomized experimental trial (NBP vs. literature control). Data from the pretest and 15-year follow-up were used. NBP participants reported less feelings of seeing life through a filter of divorce (e.g., thinking about how the divorce causes continued struggles for them) than those in the control condition. Program effects on maternal blame and acceptance of the divorce were moderated by pretest risk, a composite of divorce-related stressors and externalizing problems. NBP participants with elevated risk at program entry had lower levels of maternal blame. Program participation was associated with higher acceptance for those with elevated risk at program entry but lower acceptance for those with low risk at program entry. Program participation decreased the relations between maternal blame, acceptance of the divorce and filter of divorce and some, but not all, of the adjustment outcomes. These findings suggest that programs designed to help families after divorce have benefits in terms of long-term feelings about parental divorce as well as their relations with adjustment problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Bruijn, G.J. de; Spaans, P.; Jansen, B.; Riet, J.P. van 't
Adolescent hearing loss is a public health problem that has eluded effective intervention. A persuasive message strategy was tested for its effectiveness on adolescents’ intention to listen to music at a reduced volume. The messages manipulated both type of message frame [positive consequences of
Turawa, Eunice B; Musekiwa, Alfred; Rohwer, Anke C
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
Bérubé, Mélanie; Gélinas, Céline; Choinière, Manon; Feeley, Nancy; Martorella, Géraldine; Parent, Stefan; Streiner, David L
Numerous psychological risk and protective factors have been identified as contributing to or preventing the development of the prevalent issue of chronic pain. Systematic reviews of studies on psychological interventions that tackle these factors have shown limited effects on chronic pain. Therefore, implementing psychological interventions before pain becomes chronic has been put forward. However, the efficacy of such interventions in preventing the transition from acute to chronic pain has not yet been systematically assessed. The aims of this systematic review are to assess the effects of psychological interventions applied in the acute pain phase on pain severity as well as on physical, psychological, and social functions at 3 months and beyond. Randomized controlled trials including psychological intervention as a treatment of primary interest and participants with pain of less than 3 months duration will be considered. The following comparisons will be undertaken: psychological interventions with (1) standard treatment, (2) information, (3) waiting-list, and (4) active treatment. The primary outcome will be pain severity using indicators such the presence or absence of pain and self-report measures such as the numeric pain intensity rating scale. Secondary outcomes will include pain-related disability, mood, coping with pain, quality of life, health care utilization, and work capability. A systematic review of English and French articles in MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials will be conducted without date restriction. Extracted data will include demographics and clinical characteristics, sample size, intervention and control group types, assessment tools used, time interval of measurement, fidelity of the intervention, and attrition rate. Standardized mean differences (SMD) and risk ratios with 95% confidence intervals (CI) will be used to assess treatment effects. This systematic review is the first
Kaufman, Z A; Welsch, R L; Erickson, J D; Craig, S; Adams, L V; Ross, D A
Previous observational and quasi-experimental studies in sub-Saharan Africa have suggested the effectiveness of youth-targeted HIV prevention interventions using sport as an educational tool. No studies have yet assessed the effect of similar programs in the Caribbean. A quasi-experimental trial was conducted to assess the effectiveness of a sports-based intervention in six migrant settlements in the Puerto Plata Province of the Dominican Republic. A total of 397 structured interviews were conducted with 140 adolescents prior to, immediately following, and four months following 10-hour interventions using the Grassroot Soccer curriculum. Interview responses were coded, aggregated into composite scores, and analyzed using logistic regression, adjusting for baseline differences as well as age, sex, community, and descent. At post-intervention, significant differences were observed between groups in HIV-related knowledge (adjOR = 13.02, 95% CI = 8.26, 20.52), reported attitudes (adjOR = 12.01, 95% CI = 7.61, 18.94), and reported communication (adjOR = 3.13, 95% CI = 1.91, 5.12). These differences remained significant at four-month follow-up, though declines in post-intervention knowledge were observed in the Intervention group while gains in knowledge and reported attitudes were observed in the Control group. Results suggest that this sports-based intervention could play a valuable role in HIV prevention efforts in the Caribbean, particularly those targeting early adolescents. Further evaluation of sports-based interventions should include indicators assessing behavioral and biological outcomes, longer-term follow-up, a larger sample, randomization of study participants, and strenuous efforts to minimize loss-to-follow-up.
Sheridan Stacey L
Full Text Available Abstract Background Efficacious strategies for the primary prevention of coronary heart disease (CHD are underused, and, when used, have low adherence. Existing efforts to improve use and adherence to these efficacious strategies have been so intensive that they are impractical for clinical practice. Methods We conducted a randomized trial of a CHD prevention intervention (including a computerized decision aid and automated tailored adherence messages at one university general internal medicine practice. After obtaining informed consent and collecting baseline data, we randomized patients (men and women age 40-79 with no prior history of cardiovascular disease to either the intervention or usual care. We then saw them for two additional study visits over 3 months. For intervention participants, we administered the decision aid at the primary study visit (1 week after baseline visit and then mailed 3 tailored adherence reminders at 2, 4, and 6 weeks. We assessed our outcomes (including the predicted likelihood of angina, myocardial infarction, and CHD death over 10 years (CHD risk and self-reported adherence between groups at 3 month follow-up. Data collection occurred from June 2007 through December 2009. All study procedures were IRB approved. Results We randomized 160 eligible patients (81 intervention; 79 control and followed 96% to study conclusion. Mean predicted CHD risk at baseline was 11.3%. The intervention increased self-reported adherence to chosen risk reducing strategies by 25 percentage points (95% CI 8% to 42%, with the biggest effect for aspirin. It also changed predicted CHD risk by -1.1% (95% CI -0.16% to -2%, with a larger effect in a pre-specified subgroup of high risk patients. Conclusion A computerized intervention that involves patients in CHD decision making and supports adherence to effective prevention strategies can improve adherence and reduce predicted CHD risk. Clinical trials registration number Clinical
Kawahito, Junko; Hori, Masashi; Otsuka, Yasumasa
The present study developed an intervention program for self-complexity (SC; Linville, 1987), and examined the effects of this program on college students. Participants (N = 40) were randomly assigned to an intervention group or a control group. The intervention group received one session of psycho-education about SC, and kept daily records of self-aspects (social roles, interpersonal relationships, specific events/behaviors, traits, abilities, etc.) for one week. All participants were asked to complete a self-report questionnaire three times (pre, post, and follow-up). The questionnaire was comprised of items evaluating depression (The Center for Epidemiologic Studies Depression Scale), SC, positive self-complexity (P-SC), and negative self-complexity (N-SC). The results indicated that P-SC at the post-test was significantly increased and P-SC at the follow-up test was marginally increased in the intervention group, compared with the control group. Furthermore, structured equation modeling revealed that in the intervention group, high P-SC was related to low level of depressed mood after the program.
Wasantha P. Jayawardene, MD, PhD
Full Text Available Empirical evidence suggested that mind-body interventions can be effectively delivered online. This study aimed to examine whether preventive online mindfulness interventions (POMI for non-clinical populations improve short- and long-term outcomes for perceived-stress (primary and mindfulness (secondary. Systematic search of four electronic databases, manuscript reference lists, and journal content lists was conducted in 2016, using 21 search-terms. Eight randomized controlled trials (RCTs evaluating effects of POMI in non-clinical populations with adequately reported perceived-stress and mindfulness measures pre- and post-intervention were included. Random-effects models utilized for all effect-size estimations with meta-regression performed for mean age and %females. Participants were volunteers (adults; predominantly female from academic, workplace, or community settings. Most interventions utilized simplified Mindfulness-Based Stress Reduction protocols over 2–12 week periods. Post-intervention, significant medium effect found for perceived-stress (g = 0.432, with moderate heterogeneity and significant, but small, effect size for mindfulness (g = 0.275 with low heterogeneity; highest effects were for middle-aged individuals. At follow-up, significant large effect found for perceived-stress (g = 0.699 with low heterogeneity and significant medium effect (g = 0.466 for mindfulness with high heterogeneity. No publication bias was found for perceived-stress; publication bias found for mindfulness outcomes led to underestimation of effects, not overestimation. Number of eligible RCTs was low with inadequate data reporting in some studies. POMI had substantial stress reduction effects and some mindfulness improvement effects. POMI can be a more convenient and cost-effective strategy, compared to traditional face-to-face interventions, especially in the context of busy, hard-to-reach, but digitally-accessible populations.
Combariza, Juan F; Toro, Luis F; Orozco, John J; Arango, Marcos
Invasive Aspergillosis (IA) is a serious problem among hematological patients and it is associated with high mortality. This situation can worsen at times of hospital construction, however there are several preventive measures available. This work aims to define the cost-effectiveness of some of these interventions. A decision tree model was used, it was divided into four arms according to each 1 of the interventions performed. A cost-effectiveness incremental analysis comparing environmental control measures, high efficiency particulate absorption (HEPA) filter installation and prophylaxis with posaconazole was done. Probabilistic and deterministic sensitivity analyses were also carried out. Among 86 patients with 175 hospitalization episodes, the incidence of IA with environmental protection measures, antifungal prophylaxis and hospitalization in rooms with HEPA filters was 14.4%, 6.3% and 0%, respectively. An Incremental Cost Effectiveness Ratio analysis was performed and it was found that HEPA filtered rooms and environmental protection measures are cost saving interventions when compared with posaconazole prophylaxis (-$2665 vs -$4073 vs $42 531 US dollars, respectively) for IA episode prevented. The isolation of inpatients with acute leukemia during hospital construction periods in HEPA filtered rooms could reduce the incidence of IA and might be a cost-effective prevention strategy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Awa, Wendy L; Plaumann, Martina; Walter, Ulla
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.
Peters, Janne A; Zwerver, Johannes; Diercks, Ronald L; Elferink-Gemser, Marije T; van den Akker-Scheek, Inge
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.
Chen, Chia-Chi; Hsiao, Fei-Yuan; Shen, Li-Jiuan; Wu, Chien-Chih
Medication errors may lead to adverse drug events (ADEs), which endangers patient safety and increases healthcare-related costs. The on-ward deployment of clinical pharmacists has been shown to reduce preventable ADEs, and save costs. The purpose of this study was to evaluate the ADEs prevention and cost-saving effects by clinical pharmacist deployment in a nephrology ward.This was a retrospective study, which compared the number of pharmacist interventions 1 year before and after a clinical pharmacist was deployed in a nephrology ward. The clinical pharmacist attended ward rounds, reviewed and revised all medication orders, and gave active recommendations of medication use. For intervention analysis, the numbers and types of the pharmacist's interventions in medication orders and the active recommendations were compared. For cost analysis, both estimated cost saving and avoidance were calculated and compared.The total numbers of pharmacist interventions in medication orders were 824 in 2012 (preintervention), and 1977 in 2013 (postintervention). The numbers of active recommendation were 40 in 2012, and 253 in 2013. The estimated cost savings in 2012 and 2013 were NT$52,072 and NT$144,138, respectively. The estimated cost avoidances of preventable ADEs in 2012 and 2013 were NT$3,383,700 and NT$7,342,200, respectively. The benefit/cost ratio increased from 4.29 to 9.36, and average admission days decreased by 2 days after the on-ward deployment of a clinical pharmacist.The number of pharmacist's interventions increased dramatically after her on-ward deployment. This service could reduce medication errors, preventable ADEs, and costs of both medications and potential ADEs.
Ride, Jemimah; Lorgelly, Paula; Tran, Thach; Wynter, Karen; Rowe, Heather; Fisher, Jane
Objectives Postnatal maternal mental health problems, including depression and anxiety, entail a significant burden globally, and finding cost-effective preventive solutions is a public policy priority. This paper presents a cost-effectiveness analysis of the intervention, What Were We Thinking (WWWT), for the prevention of postnatal maternal mental health problems. Design The economic evaluation, including cost-effectiveness and cost-utility analyses, was conducted alongside a cluster-randomised trial. Setting 48 Maternal and Child Health Centres in Victoria, Australia. Participants Participants were English-speaking first-time mothers attending participating Maternal and Child Health Centres. Full data were collected for 175 participants in the control arm and 184 in the intervention arm. Intervention WWWT is a psychoeducational intervention targeted at the partner relationship, management of infant behaviour and parental fatigue. Outcome measures The evaluation considered public sector plus participant out-of-pocket costs, while outcomes were expressed in the 30-day prevalence of depression, anxiety and adjustment disorders, and quality-adjusted life years (QALYs). Incremental costs and outcomes were estimated using regression analyses to account for relevant sociodemographic, prognostic and clinical characteristics. Results The intervention was estimated to cost $A118.16 per participant. The analysis showed no statistically significant difference between the intervention and control groups in costs or outcomes. The incremental cost-effectiveness ratios were $A36 451 per QALY gained and $A152 per percentage-point reduction in 30-day prevalence of depression, anxiety and adjustment disorders. The estimate lies under the unofficial cost-effectiveness threshold of $A55 000 per QALY; however, there was considerable uncertainty surrounding the results, with a 55% probability that WWWT would be considered cost-effective at that threshold. Conclusions The results
Summerbell, C D; Waters, E; Edmunds, L D; Kelly, S; Brown, T; Campbell, K J
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
Spoth, Richard; Trudeau, Linda; Redmond, Cleve; Shin, Chungyeol
This brief report summarizes a replication and extension of a developmental outcome modeling study, by examining whether delayed substance initiation during adolescence, resulting from universal middle school preventive interventions, reduces problematic use in young adults Ages 25 and 27, up to 14.5 years after baseline. Participants were middle school students from 36 Iowa schools randomly assigned to the Strengthening Families Program plus Life Skills Training (SFP 10-14 + LST), LST-only, or a control condition. Self-report questionnaires originally were collected at 11 time points, through Age 22. A subsequent grant allowed for assessments at Ages 25 and 27, including measures of drunkenness, alcohol-related problems, cigarette use, illicit drug use (lifetime and frequency), marijuana use and prescription drug misuse. These outcomes were modeled as variables influenced by growth factors describing substance initiation during adolescence. Models included the effects of baseline risk, intervention condition assignment, and their interaction; risk-related moderation effects were examined and relative reduction rates were calculated for dichotomous variables. Model fits were good. Analyses showed significant or marginally significant indirect intervention effects on all outcomes, through effects on adolescent substance initiation growth factors. Intervention × Risk interaction effects favored the higher risk subsample, replicating earlier findings. Additional direct effects on young adult use were observed only for cigarette frequency. Relative reduction rates were larger for the higher risk subsamples, ranging from 3.9% to 36.2%. Universal preventive interventions implemented during early adolescence have the potential to decrease the rates of substance misuse and associated problems into young adulthood. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Full Text Available Childhood obesity has been increasing rapidly worldwide. There is limited evidence for effective lifestyle interventions to prevent childhood obesity worldwide, especially in developing countries like China. The objective of this study was to assess the effectiveness of a school-based multi-component lifestyle childhood obesity prevention program (the CLICK-Obesity study in Mainland China.A cluster randomized controlled trial was developed among grade 4 students from 8 urban primary schools (638 students in intervention, 544 as control in Nanjing City, China. Students were randomly allocated to the control or intervention group at school-level. A one-year multi-component intervention program (classroom curriculum, school environment support, family involvement and fun programs/events together with routine health education was provided to the intervention group, while the control group received routine health education only. The main outcome variables assessed were changes in body mass index, obesity occurrence, obesity-related lifestyle behaviors and knowledge.Overall, 1108 (93.7% of the 1182 enrolled students completed the intervention study. The intervention group had a larger marginal reduction than did the control group in overall mean BMI value (-0.32±1.36 vs. -0.29±1.40, p = 0.09, although this was not significant. Compared with the control group, the intervention group was more likely to decrease their BMI (OR = 1.44, 95%CI = 1.10, 1.87 by 0.5 kg/m2 or above, increase the frequency of jogging/running (OR = 1.55, 95%CI = 1.18, 2.02, decrease the frequency of TV/computer use (OR = 1.41, 95%CI = 1.09, 1.84 and of red meat consumption (OR = 1.50, 95%CI = 1.15, 1.95, change commuting mode to/from school from sedentary to active mode (OR = 2.24, 95%CI = 1.47, 3.40, and be aware of the harm of selected obesity risk factors.The school-based lifestyle intervention program was practical and effective in improving health behaviors and obesity
Brotman, Laurie Miller; Gouley, Kathleen Kiely; Huang, Keng-Yen; Rosenfelt, Amanda; O'Neal, Colleen; Klein, Rachel G; Shrout, Patrick
This article presents long-term effects of a preventive intervention for young children at high risk for antisocial behavior. Ninety-two children (M age = 4 years) were randomly assigned to an 8-month family intervention or no-intervention control condition and assessed 4 times over a 24-month period. Intent-to-treat analyses revealed significant intervention effects on observed child physical aggression, and significant intervention effects found at the end of the program were maintained at follow-up for responsive parenting, harsh parenting and stimulation for learning. Parent ratings of child aggression did not show significant effects of intervention.
Kwon, Jin-Won; Park, Hae-Young; Kim, Ye Jee; Moon, Seong-Hwan; Kang, Hye-Young
Background To assess the cost-effectiveness of drug therapy to prevent osteoporotic fractures in postmenopausal women with osteopenia in Korea. Methods A Markov cohort simulation was conducted for lifetime with a hypothetical cohort of postmenopausal women with osteopenia and without prior fractures. They were assumed to receive calcium/vitamin D supplements only or drug therapy (i.e., raloxifene or risedronate) along with calcium/vitamin D for 5 years. The Markov model includes fracture-spec...
Ride, Jemimah; Lorgelly, Paula; Tran, Thach; Wynter, Karen; Rowe, Heather; Fisher, Jane
Postnatal maternal mental health problems, including depression and anxiety, entail a significant burden globally, and finding cost-effective preventive solutions is a public policy priority. This paper presents a cost-effectiveness analysis of the intervention, What Were We Thinking (WWWT), for the prevention of postnatal maternal mental health problems. The economic evaluation, including cost-effectiveness and cost-utility analyses, was conducted alongside a cluster-randomised trial. 48 Maternal and Child Health Centres in Victoria, Australia. Participants were English-speaking first-time mothers attending participating Maternal and Child Health Centres. Full data were collected for 175 participants in the control arm and 184 in the intervention arm. WWWT is a psychoeducational intervention targeted at the partner relationship, management of infant behaviour and parental fatigue. The evaluation considered public sector plus participant out-of-pocket costs, while outcomes were expressed in the 30-day prevalence of depression, anxiety and adjustment disorders, and quality-adjusted life years (QALYs). Incremental costs and outcomes were estimated using regression analyses to account for relevant sociodemographic, prognostic and clinical characteristics. The intervention was estimated to cost $A118.16 per participant. The analysis showed no statistically significant difference between the intervention and control groups in costs or outcomes. The incremental cost-effectiveness ratios were $A36 451 per QALY gained and $A152 per percentage-point reduction in 30-day prevalence of depression, anxiety and adjustment disorders. The estimate lies under the unofficial cost-effectiveness threshold of $A55 000 per QALY; however, there was considerable uncertainty surrounding the results, with a 55% probability that WWWT would be considered cost-effective at that threshold. The results suggest that, although WWWT shows promise as a preventive intervention for postnatal
Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W
The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.
Brotman, Laurie Miller; Gouley, Kathleen Kiely; Huang, Keng-Yen; Rosenfelt, Amanda; O'Neal, Colleen; Klein, Rachel G.; Shrout, Patrick
This article presents long-term effects of a preventive intervention for young children at high risk for antisocial behavior. Ninety-two children (M age = 4 years) were randomly assigned to an 8-month family intervention or no-intervention control condition and assessed 4 times over a 24-month period. Intent-to-treat analyses revealed significant…
Weber-Gasparoni, Karin; Warren, John J.; Reeve, Johnmarshall; Drake, David R.; Kramer, Katherine W.O.; Marshall, Teresa A.; Dawson, Deborah V.
Purpose The purpose was to compare whether mothers exposed to an autonomy-supportive psychoeducational videotaped message, informed by self-determination theory (SDT), demonstrated greater changes in behavior concerning their children's oral health 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 regarding their child's dietary/oral hygiene habits. Chi-square, Wilcoxon Signed Rank, Mann-Whitney, and McNemar tests were used to analyze data (P<0.05). Results Significantly more positive changes were observed for dietary/oral hygiene behaviors among the intervention group mothers at one- and six-month follow-ups than for the controls. Significantly fewer mothers in the intervention group shared dining ware with their child at both one- (P=0.0046) and six-month follow-ups (P<0.0001); this practice was decreased only at six-months for the control group mothers (P=0.05). Restricting consideration only to mothers who were not checking for white spot lesions at baseline, a significantly greater proportion of mothers in the intervention group performed this behavior at six-months (P=0.0044). Conclusions Data provided evidence of the effectiveness of the SDT videotaped oral health message relative to a neutral brochure. PMID:23756309
Huisman, A.; Pirkis, J; Robinson, J.
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
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 ...
Mikton, Christopher; Maguire, Holly; Shakespeare, Tom
Persons with disabilities make up some 15% of the world's population and are at higher risk of violence. Yet there is currently no systematic review of the effectiveness of interventions to prevent violence against them. Thus the aim of this review was to systematically search for, appraise the quality of, and synthesize the evidence for the effectiveness of interventions to prevent and mitigate the consequences of all the main forms of interpersonal violence against people with all types of disabilities. The method used consisted of searches of eleven electronic databases, hand searches of three journals, scanning of reference lists of review articles, contact with experts, appraisal of risk of bias using the Quality Assessment Tool for Quantitative Studies, and narrative synthesis of results. This resulted in 736 titles being identified, 10 of which met the inclusion criteria and 6 and 2 addressed people with intellectual disabilities and developmental disabilities, respectively. Only one was from a low- and middle-income country. All studies received a weak rating on the quality assessment tool and none could be considered effective after taking risk of bias into account. In sum, the current evidence base offers little guidance to policy makers, program commissioners, and persons with disabilities for selecting interventions. More and higher quality research is required, particularly from low- and middle-income countries and on other forms of disability such as physical impairments, sensory impairments, and mental health conditions. © The Author(s) 2014.
Full Text Available Background: Training programs and providing essential information such as preborn educational programs for women, unmarried girls are essential as the most important prevention methods for control and prevention of health outcomes and disability. The current study conducted to assess the training effectiveness of Prevention Disability Package in high school girls in a community trail.Materials and Methods: A community trial executed among 1,339 high school girls in Qom, Iran. Subjects were the students that training in 10th and 11th years of education. All of students in each class from all majors were included in the study. According to sampling framework, 55 classes selected randomly assigned to lecture (1264 girls [94.4%], 4 (3% girls to CD-based group and 35 (2.6% girls to control group. Data collection was conducted by a standard and valid questionnaire. Analysis of variance test was used to compare the mean of knowledge score among three groups. Analysis of covariance (ANCOVA used to control the confounding variables.Results: There were significant differences among three groups according to the total score of awareness of disability. Therefore, the mean score of in handicap, musculoskeletal diseases, pregnancy dimensions, and total knowledge about disability causes was higher than in lecture group than CD-based and control groups (P
Roberto, Anthony J; Eden, Jen; Deiss, Douglas M; Savage, Matthew W; Ramos-Salazar, Leslie
This study experimentally evaluated the short-term effects of the Arizona Attorney General's cybersafety promotion presentation, a key component of which is cyberbullying prevention. Fifty-one parents of children attending a middle school in the southwestern United States participated in the study. Results reveal parents who viewed the presentation believed their children to be more susceptible to cyberbullying, and indicated that they were more likely to talk to their children about saving evidence, not retaliating, and telling an adult compared to parents who had not viewed the presentation. The theoretical and practical implications of these results are discussed.
Roberto, Anthony J.; Eden, Jen; Deiss, Douglas M.; Savage, Matthew W.; Ramos-Salazar, Leslie
This study experimentally evaluated the short-term effects of the Arizona Attorney General’s cybersafety promotion presentation, a key component of which is cyberbullying prevention. Fifty-one parents of children attending a middle school in the southwestern United States participated in the study. Results reveal parents who viewed the presentation believed their children to be more susceptible to cyberbullying, and indicated that they were more likely to talk to their children about saving evidence, not retaliating, and telling an adult compared to parents who had not viewed the presentation. The theoretical and practical implications of these results are discussed. PMID:28891936
Rijpkema, G.; Adang, E.M.M.; Dicke, H.C.; Naber, A.H.J.; Swart, B.J.M. de; Disselhorst, L.; Goluke-Willemse, G.; Olde Rikkert, M.G.M.
BACKGROUND: In order to reduce protein-energy malnutrition in older people during hospitalisation an early interdisciplinary intervention is needed. We developed a protocol which includes screening for malnutrition, dysphagia and dehydration on admission, followed by immediate interventions.
Full Text Available Background: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. Methods: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prevent falls in community-dwelling adults aged 60 and over. Combined odds ratio (OR and 95% credible interval (95% CrI were calculated. Results: A total of 49 trials involving 27,740 participants and 9271 fallers were included. Compared to usual care, multifactorial interventions (MFI demonstrated the greatest efficacy (OR: 0.64, 95% CrI: 0.53 to 0.77 followed by interventions combining education and exercise (EDU + EXC (OR: 0.65, 95% CrI: 0.38 to 1.00 and interventions combining exercise and hazard assessment and modification (EXC + HAM (OR: 0.66, 95% CrI: 0.40 to 1.04. The effect of medical care performed the worst (OR: 1.02, 95% CrI: 0.78 to 1.34. Model fit was good, inconsistency was low, and publication bias was considered absent. The overall quality of included trials was high. The pooled odds ratios and ranking probabilities remained relatively stable across all sensitivity analyses. Conclusions: MFI and exercise appear to be effective to reduce falls among older adults, and should be considered first as service delivery options. Further investigation is necessary to verify effectiveness and suitableness of the strategies to at-risk populations.
Child Development, 2011
The impact of the Fast Track intervention on externalizing disorders across childhood was examined. Eight hundred-ninety-one early-starting children (69% male; 51% African American) were randomly assigned by matched sets of schools to intervention or control conditions. The 10-year intervention addressed parent behavior-management, child social…
Moshki, Mahdi; Baloochi Beydokhti, Tahereh; Cheravi, Khadijeh
To assess the effectiveness of application of health locus of control in pregnant women for prevention of postpartum depression in Iran. Nearly 10-15% of women suffer postnatal depression by the end of the second week after delivery, which creates problems in caring for the child that may affect child's future learning and concentration. Pre-post experimental design. Two hundred and thirty volunteer women were randomly divided into experimental and control groups. The data collection tools included a demographic questionnaire, the Multidimensional Health Locus of Control Scale and the Edinburg Depression Scale. Based on the associations found in the pretest, intervention programme was planned and carried out in the focused group discussion method. Data were collected after the end of scheduled sessions, immediately and one month later. The data were analysed with SPSS-16 using statistical methods including anova, chi-square test, Student's t-test and paired t-test. Chance health locus of control significantly reduced and internal health locus of control significantly increased, immediately after intervention. Also, a month after intervention, a significant difference was observed between the two groups in reducing postpartum depression. The planned participatory intervention led to empowerment and increased awareness and internalisation of health control beliefs and less tendency towards external health control beliefs, especially chance, improvement in general health leading to improved psychological health for prevention of postpartum depression in mothers. Clinicians might assess chance and internal health locus of control to identify the women at risk of developing depression during their pregnancy and to develop prevention and treatment plans. © 2013 John Wiley & Sons Ltd.
Full Text Available Behailu Merdekios1, Adebola A Adedimeji2 1College of Medicine and Health Sciences, Arba Minch University, Ethiopia; 2Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, New York, USA Background: In Ethiopia, Progress in Reducing Mother-to-Child-Transmission (PMTCT of human immunodeficiency virus (HIV is being curtailed by behavioral and cultural factors that continue to put unborn children at risk, and mother-to-child transmission is responsible for more than 90% of HIV infection in children. The objective of this study was to assess PMTCT services by examining knowledge about reducing vertical transmission among pregnant women. Methods: A multistaged sampling institution-based survey was conducted in 113 pregnant women in Arba Minch. Qualitative and quantitative data were obtained. Results: Of the 113 respondents, 89.4% were from Arba Minch, 43.4% were at least 25 years of age, 73.4% had formal education at primary level or above, 100% reported acceptance of voluntary counseling and testing, 92.0% were knowledgeable about mother-to-child transmission, and 90.3% were aware of the availability of the PMTCT service in the health facility. Of 74 HIV-positive women in PMTCT, only three (4.1% had had skilled birth attendants at delivery. There was an unacceptable degree of loss of women from PMTCT. Maternal educational level had a statistical association with income (P < 0.001 and voluntary counseling and testing for pregnant women (P < 0.05. Factors that determined use of PMTCT included culture, socioeconomic status, and fear of stigma and discrimination. Conclusion: In the area studied, intervention to reduce mother-to-child transmission of HIV is failing to reach its goal. This is an alarming discovery requiring quick reconsideration and strengthening of preventive strategies at all levels. Keywords: human immunodeficiency virus, mother-to-child transmission, pregnant women, Ethiopia
Alegría-Flores, Kei; Raker, Kelli; Pleasants, Robert K; Weaver, Mark A; Weinberger, Morris
Sexual assault, stalking, dating violence, and intimate partner violence, herein collectively termed interpersonal violence (IV), are public health problems affecting 20% to 25% of female college students. Currently, One Act is one of the few IV prevention training programs at universities that teach students bystander skills to intervene in low- and high-risk IV situations. The objectives of this study were 1) to evaluate One Act's effects on date rape attitudes and behaviors, and bystanders' confidence, willingness to help, and behavior, and 2) to compare the effects on bystander skills between One Act and Helping Advocates for Violence Ending Now (HAVEN), an IV response training program with similar participants. Data were collected over 2 years, before and after One Act and HAVEN trainings. We measured outcomes with four scales: College Date Rape Attitudes and Behaviors, Bystander Confidence, Willingness to Help, and Bystander Behavior. The analysis compared within- and between-group mean differences in scale scores pre- and post-trainings using linear mixed models. One Act showed improvements for date rape attitudes and behaviors (p < .001), bystander's confidence (p < .001), and willingness to help (p < .001). One Act participants' bystander confidence improved more (p = .006), on average, than HAVEN's. The differences in the two trainings' effects on bystander willingness to help and behavior had similar patterns but were not statistically significant. We found a larger positive impact on bystander confidence among students who participated in the bystander prevention training compared with the response training. Further research is needed to improve the measures for bystander behavior and measure the bystander trainings' larger impact on the community. © The Author(s) 2015.
Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L
Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. Copyright © 2014 Elsevier Inc. All rights reserved.
Clausen, Jesper Hedegaard; Madsen, Henry; Murrell, Kenneth Darwin
interventions was reduced 91.7% compared to before interventions. The intensity of FZT was also significantly lower in the pond management group, compared to the drug treatment group and the control group after interventions. The results demonstrate that improving farm and pond management practices can......Fish-borne zoonotic trematodes (FZT) are a major public health problem. It is estimated that in Vietnam 26,366 "disability-adjusted life years" (DALYs) are lost due to FZT. Fish from aquaculture are a main source of protein and of great economic importance in both rural and urban areas...... with two intervention groups; a drug treatment of human and animal groups and a farm management group (control of snail vectors and fecal pollution of pond). A third group (non-intervention) served as control. Fish were examined for FZT metacercariae prevalence and intensity before and after interventions...
The impact of the Fast Track intervention on externalizing disorders across childhood was examined. Eight hundred-ninety-one early-starting children (69% male; 51% African American) were randomly assigned by matched sets of schools to intervention or control conditions. The 10-year intervention addressed parent behavior-management, child social cognitive skills, reading, home visiting, mentoring, and classroom curricula. Outcomes included psychiatric diagnoses after grades 3, 6, 9, and 12 for...
Te Brinke, Lysanne W; Deković, Maja; Stoltz, Sabine E M J; Cillessen, Antonius H N
Over time, developmental theories and empirical studies have gradually started to adopt a bidirectional viewpoint. The area of intervention research is, however, lagging behind in this respect. This longitudinal study examined whether bidirectional associations between (changes in) parenting and (changes in) aggressive child behavior over time differed in three conditions: a child intervention condition, a child + parent intervention condition and a control condition. Participants were 267 children (74 % boys, 26 % girls) with elevated levels of aggression, their mothers and their teachers. Reactive aggression, proactive aggression and perceived parenting were measured at four measurement times from pretest to one-year after intervention termination. Results showed that associations between aggressive child behavior and perceived parenting are different in an intervention context, compared to a general developmental context. Aggressive behavior and perceived parenting were unrelated over time for children who did not receive an intervention. In an intervention context, however, decreases in aggressive child behavior were related to increases in perceived positive parenting and decreases in perceived overreactivity. These findings underscore the importance of addressing child-driven processes in interventions aimed at children, but also in interventions aimed at both children and their parents.
Full Text Available In response to India's growing tobacco epidemic, strategies are needed to decrease tobacco use among Indian youth, particularly among those who are economically disadvantaged. The objective of this study was to assess the effectiveness of a school-based life-skills tobacco control program for youth of low socio-economic status in Mumbai and the surrounding state of Maharashtra. We hypothesized that compared to youth in control schools, youth exposed to the program would have greater knowledge of effects of tobacco use; be more likely to take action to prevent others from using tobacco; demonstrate more positive life skills and attitudes; and be less likely to report tobacco use.Using a quasi-experimental design, we assessed program effectiveness by comparing 8(th and 9(th grade students in intervention schools to 8(th grade students in comparable schools that did not receive the program. Across all schools, 1851 students completed a survey that assessed core program components in early 2010. The program consisted of activities focused on building awareness about the hazards of tobacco, developing life skills, and advocacy development. The primary outcome measure was self-reported tobacco use in the last 30 days. Findings indicate that 4.1% of 8(th grade intervention students (OR = 0.51 and 3.6% of 9(th grade intervention students (OR = 0.33 reported using tobacco at least once in the last 30 days, compared to 8.7% of students in the control schools. Intervention group students were also significantly more knowledgeable about tobacco and related legislation, reported more efforts to prevent tobacco use among others, and reported stronger life skills and self-efficacy than students in control schools. Limitations to the study include schools not being randomly assigned to condition and tobacco use being measured by self-report.This program represents an effective model of school-based tobacco use prevention that low-income schools in India
Mita, Tatsuo; Nakai, Takashi; Murakami, Masaya; Kitamura, Noboru; Nishino, Naoki.
In an attempt to prevent psychological distress, such as discomfort, anxiety and fear, during magnetic resonance imaging (MRI), the following psychological measures were conducted: (1) improving psychological support to the patient by MRI technicians; (2) providing sufficient information to the patient about MRI imager and the purpose of MRI examination; (3) reassuring the patient by telling him or her that he or she can stop MRI examination at any time; (4) modifying the environment (such as music, paintings, and plants) for relaxation. The effectiveness of these psychological support items was evaluated in all MRI patients. The questionnaire was filled out by 143 patients (mean age, 49.4 years) before MRI and by 105 patients (mean age, 48.4 years) after MRI. Psychological distress during MRI was significantly reduced from 64.3% to 50.5% after the implementation of psychological measures. This was noticeable in female patients aged 60 years or older and patients undergoing MRI for the first time. The reported incidence of distress tended to decrease. The reported complaints of long examination time and palpitation during MRI were significantly reduced. These results indicated that the psychological measures (particularly, the shortening of MRI examination time) are useful in reducing psychological distress during MRI. (N.K.)
Lee, Ming-Shinn; Zi-Pei, Wu; Svanström, Leif; Dalal, Koustuv
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.
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.
Liu, Hui; Shen, Jun; Xiao, Lily Dongxia
Falls are highly prevalent in hospitalized older people. Although many factors contribute to this, registered nurses (RNs) lack of knowledge about how to prevent hospitalized older people falls was identified as one of the major factors. This study explored the effects of an educational intervention on improving knowledge level of RNs on prevention of falls in hospitalized older people. It was a randomized controlled trial. 374 RNs from 4 acute care hospitals in ChongQing were recruited to the study. Data were collected before the intervention and at the 3-month follow-up. After the intervention, knowledge scores increased significantly from baseline in the intervention group and significant differences were detected between the scores of the two groups at the 3-month follow-up. The results reflected that the educational intervention was an effective strategy for improving knowledge level of RNs on prevention of falls in hospitalized older people. Copyright © 2011 Elsevier Ltd. All rights reserved.
Klein, Marcus O; Hammerich, Sünje; Eggert, Paul; Ankermann, Tobias
Individual Motivational Interventions after alcohol-related event treated in Hospital - Effective Option for Secondary Prevention in Adolescence? In a prospective, randomized, single-blind study 48 adolescents between 13 and 17 years answered a standardized questionnaire about their behavior of alcohol-consumption after an alcohol-related event with hospitalization. They were divided in 2 groups by randomization: Group A (n=28) took part in an individual motivational intervention (HaLT-Präventionsprojekt), Group B (n=20) did not get any intervention. Six and 12 weeks after the hospitalization the same questionnaire was answered again by telephone-based interviews. The interviewer did not know to which group the interview-partner belonged. 58% (n=28) of all adolescents drank less alcohol or in a lower frequency than before the alcohol-related event. 17% (n=8) did not drink any alcohol in that period of 12 weeks. 54% (n=26) explained, that they had no events of drunkenness in that period. 38% (n=18) did not change their behavior in consumption of alcohol. 6% (n=3) drank more or in higher frequency than before. We could not find any significant difference in the behavior of alcohol-consumption of both groups: 58% (A) resp. 65% (B) drank less than the time before the alcohol-related event (χ²=0,6269; p=0,4285). An influence of the individual motivational intervention could not be shown. Further studies should include interventions for parents and peers. © Georg Thieme Verlag KG Stuttgart · New York.
Enns, Eva Andrea; Kao, Szu-Yu; Kozhimannil, Katy Backes; Kahn, Judith; Farris, Jill; Kulasingam, Shalini L
Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process. We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions. The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)]. While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.
Maklebust, JoAnn; Magnan, Morris A
The two-fold purpose of the Detroit Medical Center (DMC) Braden Scale Training Module is to teach nurses to use the Braden Scale to correctly assess pressure ulcer risk and to effectively plan risk-based prevention interventions. A pre-test, post-test, two-group, quasi-experimental study was conducted to evaluate the effect of web-based DMC Braden Scale Training on staff nurses' ability to correctly endorse the use or non-use of 10 commonly-used risk-based pressure ulcer preventive interventions for patients at different levels of risk for pressure ulceration. "Regular" or "new" users of the Braden Scale from three hospitals assessed 102 patients. On eight out of 10 preventive interventions, the percentages of correct endorsements were higher for patients at extreme levels of risk (generally not at risk or high/very high risk) than they were for patients at midlevels of risk. Correct endorsement of prevention interventions was unaffected by group membership. Training substantially improved ability to correctly endorse interventions, but for new user only. Importantly, patients at midlevels of risk may be more vulnerable to pressure ulceration than their risk assessments indicate simply because nurses have great difficulty determining which preventive interventions should be implemented for this group of patients. Alternative approaches to training are needed to ensure that regular users of the Braden Scale are adequately prepared to use risk-based information to effectively plan pressure ulcer prevention.
Results: In the intervention group, the prevalence of school children who reported to be eating 5 fruits and vegetable sdaily increased significantly from .... their consent and they were able to refuse participation. We used an ... and sex (table 3). Table 2: Evaluation of eating habits among children participating in the study in.
Wöhl, C; Richter, S; Blättner, B
The strengthening of cognitive resources is considered to be a preventive field of action within inpatient care. The aim is to evaluate the effectiveness of such interventions on cognitive performance in nursing home residents. A systematic literature search was carried out in the databases MEDLINE, the Cochrane Library, EMBASE, CINAHL and PsycINFO, as well as searches in trial registries and a screening of reference lists. The combined results were based on meta-analyses in random-effects models. By including 10 primary studies, participating in cognitive activities showed a statistically significant greater cognitive performance compared to controls (standardized mean difference SMD = 0.46, 95% confidence interval CI 0.06-0.87, p = 0.0252). Subgroup analyses suggest a superiority of individually oriented cognitive activities with longer training periods and that especially nursing home residents with a better initial level of cognitive performance might benefit from cognitive interventions. However, due to the high risk of bias in the included studies and the presence of substantial heterogeneity, the results must be interpreted with caution. The findings imply that cognitive activities implemented in nursing homes might be effective. Considering the low-quality evidence, performance of high-quality studies is essential in order to verify our results.
Majumder, M. S.; Gute, D.; Faruque, A. S.
Every year, 3 to 5 million individuals contract cholera, an acute diarrheal infection that is caused by the ingestion of food or water containing the Vibrio cholerae bacterium. Because cholera is a waterborne disease, it can be transmitted quickly in environments with inadequate water and sanitation systems where infected waste can easily pollute drinking water. Today, Bangladesh continues to struggle with endemic cholera. Donor organizations address water and sanitation via localized initiatives, including the installation of community water collection sites (i.e. tubewells; water-boiling points; etc.). At this small-scale level, water quality and sanitation accessibility can be improved independently of one another, and when resources are limited, donors must invest in the most effective disease prevention options. This study used laboratory-confirmed cholera incidence data (2000-2009) collected by the International Centre of Diarrheal Disease Research, Bangladesh at their on-site hospital to compare the efficacy of interventions addressing water quality versus sanitation accessibility in Dhaka, Bangladesh. Data regarding use of sanitary latrines and boiling of drinking water were extracted from sequential patient interviews conducted at the Dhaka facility and used as surrogate variables for sanitation accessibility and water quality respectively. Our analysis indicates that boiling water is 10 times more effective at preventing cholera than the use of a sanitary latrine. This finding suggests that regulating water quality is perhaps more critical to cholera prevention than increasing sanitation accessibility in an urban environment like that of Dhaka. At present, WaterAid - one of Bangladesh's most significant water and sanitation donor organizations - invests the majority of its budget on improving sanitation accessibility. The World Health Organization and the United Nations Millennium Development Goals also prioritize sanitation accessibility. However, in
Pasalich, Dave S; Fleming, Charles B; Oxford, Monica L; Zheng, Yao; Spieker, Susan J
Multiple placement changes disrupt continuity in caregiving and undermine well-being in children in child welfare. This study conducted secondary data analysis of a randomized controlled trial to examine whether a relationship-based intervention, Promoting First Relationships(©) (PFR), reduced risk for a maladaptive cascade from placement instability to less secure attachment to elevated externalizing problems. Participants included caregivers (birth or foster/kin) of toddlers (10-24 months) recently transitioned to their care because of child welfare placement decisions. Although main effects of PFR on security and externalizing problems were not previously observed, this study's results revealed that PFR attenuated the association between multiple placement changes (baseline) and less security (postintervention) and that the indirect effect of placement instability on greater externalizing problems (6-month follow-up) via less security was evident only in toddlers in the comparison condition. These findings shed light on how a history of multiple caregiver changes may influence toddlers' risk for poor adjustment in subsequent placements, and the promise of supporting caregivers through a parenting intervention to prevent such risk. © The Author(s) 2016.
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…
Lardon, Arnaud; Girard, Marie-Pier; Zaïm, Chérine; Lemeunier, Nadège; Descarreaux, Martin; Marchand, Andrée-Anne
Aim The purpose of this systematic literature review is to assess the benefits of workplace-based occupational therapies and interventions, including acute and preventive medication, on headache intensity and frequency, related disability as well as work-related outcomes. Methods A search of the literature was conducted in PubMed, MEDLINE, Cochrane library, CINAHL and Embase using terms related to headache, workplace and occupational health. The Cochrane Collaboration's risk of bias assessment tool was used on individual studies to assess internal validity and the Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Results Fifteen articles were included in the systematic review. None of them were classified as low risk of bias according to the Cochrane Collaboration's tool for assessing risk of bias. This systematic review found preliminary low-quality evidence suggesting that exercise and acupuncture can reduce workers' headache pain intensity, frequency and related disability. Conclusion Although this systematic review provided preliminary low evidence in favour of work-based intervention, studies with more rigorous designs and methodologies are needed to provide further evidence of the effectiveness of workplace-based headache management strategies.
van der Molen, Henk F; Basnet, Prativa; Hoonakker, Peter Lt; Lehtola, Marika M; Lappalainen, Jorma; Frings-Dresen, Monique Hw; Haslam, Roger; Verbeek, Jos H
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
Ricardo E Gürtler
Full Text Available Dengue has propagated widely through the Americas. Most countries have not been able to maintain permanent larval mosquito control programs, and the long-term effects of control actions have rarely been documented.The study design was based on a before-and-after citywide assessment of Aedes aegypti larval indices and the reported incidence of dengue in Clorinda, northeastern Argentina, over 2003-2007. Interventions were mainly based on focal treatment with larvicides of every mosquito developmental site every four months (14 cycles, combined with limited source reduction efforts and ultra-low-volume insecticide spraying during emergency operations. The program conducted 120,000 house searches for mosquito developmental sites and 37,000 larvicide applications.Random-effects regression models showed that Breteau indices declined significantly in nearly all focal cycles compared to pre-intervention indices clustered by neighborhood, after allowing for lagged effects of temperature and rainfall, baseline Breteau index, and surveillance coverage. Significant heterogeneity between neighborhoods was revealed. Larval indices seldom fell to 0 shortly after interventions at the same blocks. Large water-storage containers were the most abundant and likely to be infested. The reported incidence of dengue cases declined from 10.4 per 10,000 in 2000 (by DEN-1 to 0 from 2001 to 2006, and then rose to 4.5 cases per 10,000 in 2007 (by DEN-3. In neighboring Paraguay, the reported incidence of dengue in 2007 was 30.6 times higher than that in Clorinda.Control interventions exerted significant impacts on larval indices but failed to keep them below target levels during every summer, achieved sustained community acceptance, most likely prevented new dengue outbreaks over 2003-2006, and limited to a large degree the 2007 outbreak. For further improvement, a shift is needed towards a multifaceted program with intensified coverage and source reduction efforts, lids or
Johnston, Stephen S; Salkever, David S; Ialongo, Nicholas S; Slade, Eric P; Stuart, Elizabeth A
When candidates for school-based preventive interventions are heterogeneous in their risk of poor outcomes, an intervention's expected economic net benefits may be maximized by targeting candidates for whom the intervention is most likely to yield benefits, such as those at high risk of poor outcomes. Although increasing amounts of information about candidates may facilitate more accurate targeting, collecting information can be costly. We present an illustrative example to show how cost-benefit analysis results from effective intervention demonstrations can help us to assess whether improved targeting accuracy justifies the cost of collecting additional information needed to make this improvement.
Young, Jami F.; Gallop, Robert; Mufson, Laura
This article reports on mother-child conflict as an outcome and moderator of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a preventive intervention for depression. Forty-one adolescents (average age = 13.37, SD = 1.19) with elevated depression symptoms were randomized to receive IPT-AST or school counseling (SC). Adolescents…
Van Eerd, D; Munhall, C; Irvin, E; Rempel, D; Brewer, S; van der Beek, A J; Dennerlein, J T; Tullar, J; Skivington, K; Pinion, C; Amick, B
The burden of disabling musculoskeletal pain and injuries (musculoskeletal disorders, MSDs) arising from work-related causes in many workplaces remains substantial. There is little consensus on the most appropriate interventions for MSDs. Our objective was to update a systematic review of workplace-based interventions for preventing and managing upper extremity MSD (UEMSD). We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis. 6 electronic databases were searched (January 2008 until April 2013 inclusive) yielding 9909 non-duplicate references. 26 high-quality and medium-quality studies relevant to our research question were combined with 35 from the original review to synthesise the evidence on 30 different intervention categories. There was strong evidence for one intervention category, resistance training, leading to the recommendation: Implementing a workplace-based resistance training exercise programme can help prevent and manage UEMSD and symptoms. The synthesis also revealed moderate evidence for stretching programmes, mouse use feedback and forearm supports in preventing UEMSD or symptoms. There was also moderate evidence for no benefit for EMG biofeedback, job stress management training, and office workstation adjustment for UEMSD and symptoms. Messages are proposed for both these and other intervention categories. PMID:26552695
Smith, L.V.H.; Ladelund, S.; Borch-Johnsen, K.
on the development in physical activity when compared with group C. This was regardless of baseline physical activity level. At 36-month follow-up there was no significant difference between groups A and B. There was no intervention effect among women. CONCLUSIONS: Only men seemed to benefit from the intervention.......AIM: To examine the effect of a randomized multiple risk factor intervention study for prevention of ischaemic heart disease (IHD) on the development in physical activity over a 36-month period. METHODS: Two random samples (high intensity intervention, group A, n=11,708; low intensity intervention......, group B, n=1,308) were invited for a health examination, an assessment of absolute risk of developing IHD, and an individualized lifestyle intervention. The participation rate was 52.5%. High-risk persons in group A were also offered diet/physical activity and/or smoking cessation group counselling...
von Huth Smith, Lisa; Ladelund, Steen; Borch-Johnsen, Knut
AIM: To examine the effect of a randomized multiple risk factor intervention study for prevention of ischaemic heart disease (IHD) on the development in physical activity over a 36-month period. METHODS: Two random samples (high intensity intervention, group A, n=11,708; low intensity intervention....... High-risk persons in group B were referred to their GP. High-risk persons were re-counselled after 12 and 36 months. The control group (group C, n=5,264, response rate=61.3%) answered a mailed questionnaire. Data were analysed using longitudinal linear regression models with random effects. MAIN...... OUTCOME: Change in physical activity from baseline to 12-and 36-month follow-up. RESULTS: In men, the high-intensity (group A) intervention had a beneficial effect at 12-month follow-up, whereas after 36 months both the high-intensity and the low-intensity (group B) intervention had a beneficial effect...
Joling, Karlijn J.; Bosmans, Judith E.; van Marwijk, Harm W. J.; van der Horst, Henriëtte E.; Scheltens, Philip; MacNeil Vroomen, Janet L.; van Hout, Hein P. J.
Dementia imposes a heavy burden on health and social care systems as well as on family caregivers who provide a substantial portion of the care. Interventions that effectively support caregivers may prevent or delay patient institutionalization and hence be cost-effective. However, evidence about
Joling, K.J.; Bosmans, J.E.; van Marwijk, H.W.J.; van der Horst, H.E.; Scheltens, P.; Vroomen, J.L.M.; van Hout, H.P.J.
Background: Dementia imposes a heavy burden on health and social care systems as well as on family caregivers who provide a substantial portion of the care. Interventions that effectively support caregivers may prevent or delay patient institutionalization and hence be cost-effective. However,
Baker, Philip R A; Francis, Daniel P; Hairi, Noran N; Othman, Sajaratulnisah; Choo, Wan Yuen
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
Mancipe Navarrete, Jenny Alejandra; Garcia Villamil, Shanen Samanta; Correa Bautista, Jorge Enrique; Meneses-Echávez, José Francisco; González-Jiménez, Emilio; Schmidt Rio-Valle, Jacqueline
Overweight and obesity are serious public health problem, which is specially among children populations. To determine the effectiveness of educational interventions conducted in Latino America for the prevention of overweight and obesity in scholar children from 6 to 17 years old. Metodology: MEDLINE, LILACS and EMBASE were searched between february and may 2014 to retrieve randomized controlled trials and longitudinal studies that evaluated the effects of educational interventions intended to retrieve randomized controlled trials and longitudinal studies aiming to prevent overweight and obesity among Latinoamerican children. Risk of bias was evaluated using the PEDro scale and the CASPe tool. Twenty one studies were included (n=12,092). Different types of educational interventions were identified, such as nutritional campaigns, physical activity practice and environmental changes. Mixed approaches combining nutritional campaigns, physical activity promotion and enviromental changes were the most effective interventions, since their results produced the largest improvements in the overweight and obesity of children. None evidence of reporting bias was observed. Educational interventions performed in the educational environment that combined an adequate nutrition and the promotion of physical activity practice, are more effective for preventing overweight and obesity in Latino American children, although familiar interventions are also encouraged approach, associated with better responses on the behavioral change in scholar children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Oringanje, Chioma; Meremikwu, Martin M; Eko, Hokehe; Esu, Ekpereonne; Meremikwu, Anne; Ehiri, John E
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
Cheung, Kei Long; Schwabe, Inga; Walthouwer, Michel J L; Oenema, Anke; Lechner, Lilian; de Vries, Hein
Computer-tailored programs may help to prevent overweight and obesity, which are worldwide public health problems. This study investigated (1) the 12-month effectiveness of a video- and text-based computer-tailored intervention on energy intake, physical activity, and body mass index (BMI), and (2) the role of educational level in intervention effects. A randomized controlled trial in The Netherlands was conducted, in which adults were allocated to a video-based condition, text-based condition, or control condition, with baseline, 6 months, and 12 months follow-up. Outcome variables were self-reported BMI, physical activity, and energy intake. Mixed-effects modelling was used to investigate intervention effects and potential interaction effects. Compared to the control group, the video intervention group was effective regarding energy intake after 6 months (least squares means (LSM) difference = -205.40, p = 0.00) and 12 months (LSM difference = -128.14, p = 0.03). Only video intervention resulted in lower average daily energy intake after one year (d = 0.12). Educational role and BMI did not seem to interact with this effect. No intervention effects on BMI and physical activity were found. The video computer-tailored intervention was effective on energy intake after one year. This effect was not dependent on educational levels or BMI categories, suggesting that video tailoring can be effective for a broad range of risk groups and may be preferred over text tailoring.
Kei Long Cheung
Full Text Available Computer-tailored programs may help to prevent overweight and obesity, which are worldwide public health problems. This study investigated (1 the 12-month effectiveness of a video- and text-based computer-tailored intervention on energy intake, physical activity, and body mass index (BMI, and (2 the role of educational level in intervention effects. A randomized controlled trial in The Netherlands was conducted, in which adults were allocated to a video-based condition, text-based condition, or control condition, with baseline, 6 months, and 12 months follow-up. Outcome variables were self-reported BMI, physical activity, and energy intake. Mixed-effects modelling was used to investigate intervention effects and potential interaction effects. Compared to the control group, the video intervention group was effective regarding energy intake after 6 months (least squares means (LSM difference = −205.40, p = 0.00 and 12 months (LSM difference = −128.14, p = 0.03. Only video intervention resulted in lower average daily energy intake after one year (d = 0.12. Educational role and BMI did not seem to interact with this effect. No intervention effects on BMI and physical activity were found. The video computer-tailored intervention was effective on energy intake after one year. This effect was not dependent on educational levels or BMI categories, suggesting that video tailoring can be effective for a broad range of risk groups and may be preferred over text tailoring.
Steenbock, B; Pischke, C R; Schönbach, J; Pöttgen, S; Brand, T
During their preschool years children establish nutritional and physical activity (PA) habits that may contribute to the development of overweight and obesity. To examine the evidence for effective interventions promoting healthy eating and PA in childcare settings. We searched PubMed, the Cochrane Library, and Campbell Collaboration for systematic reviews published between 2007 and 2014. Ten systematic reviews and three meta-analyses met the inclusion criteria, including a total of 22 intervention studies. Intervention studies were conducted in North America (N = 14), Europe (N = 5), Asia (N = 2), and Australia (N = 1). Half of these addressed ethnic minority groups or socially disadvantaged children. We extracted information about the effects regarding anthropometric measures, eating habits, and physical activity, as well as the characteristics of effective interventions, and summarized them narratively. Evidence for intervention effects on anthropometric measurements was inconclusive. Seven out of nine studies showed beneficial effects on diet-related outcomes. Only isolated effects were reported on improvements in PA. Reviews indicated that interventions which comprised (1) the development of skills and competencies, (2) medium to high parental involvement, and (3) information on behavior-health links for parents were more effective. Preschool-based interventions showed some early improvements in eating habits and PA. Evidence is limited by the small number of studies, a lack of methodological quality, and inconsistencies among outcome measures. Evidence regarding anthropometric measurements is still inconclusive.
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
Handoll, Helen Hg; Rowe, Brian H; Quinn, Kathryn M; de Bie, Rob
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
Handoll, H H; Rowe, B H; Quinn, K M; de Bie, R
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
Fitó, Montserrat; Melander, Olle; Martínez, José Alfredo; Toledo, Estefanía; Carpéné, Christian; Corella, Dolores
Intervention with Mediterranean diet (MedDiet) has provided a high level of evidence in primary prevention of cardiovascular events. Besides enhancing protection from classical risk factors, an improvement has also been described in a number of non-classical ones. Benefits have been reported on biomarkers of oxidation, inflammation, cellular adhesion, adipokine production, and pro-thrombotic state. Although the benefits of the MedDiet have been attributed to its richness in antioxidants, the mechanisms by which it exercises its beneficial effects are not well known. It is thought that the integration of omics including genomics, transcriptomics, epigenomics, and metabolomics, into studies analyzing nutrition and cardiovascular diseases will provide new clues regarding these mechanisms. However, omics integration is still in its infancy. Currently, some single-omics analyses have provided valuable data, mostly in the field of genomics. Thus, several gene-diet interactions in determining both intermediate (plasma lipids, etc.) and final cardiovascular phenotypes (stroke, myocardial infarction, etc.) have been reported. However, few studies have analyzed changes in gene expression and, moreover very few have focused on epigenomic or metabolomic biomarkers related to the MedDiet. Nevertheless, these preliminary results can help to better understand the inter-individual differences in cardiovascular risk and dietary response for further applications in personalized nutrition. PMID:27598147
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 ...
Tzeng, Huey-Ming; Yin, Chang-Yi
There is an urgent need to prioritize the risk factors for injurious falls and effective interventions in nursing practice. Registered nurses perceived that the most frequently observed risk factors were confusion, gait problems, Alzheimer disease, disorientation, and inability to follow safety instructions. The most effective interventions were keeping hospital bed brakes locked, keeping floor surfaces clean/dry, using appropriate footwear for patients, maintaining a call light within reach, and reducing tripping hazards.
The effect of a translating research into practice intervention to promote use of evidence-based fall prevention interventions in hospitalized adults: A prospective pre-post implementation study in the U.S.
Titler, Marita G; Conlon, Paul; Reynolds, Margaret A; Ripley, Robert; Tsodikov, Alex; Wilson, Deleise S; Montie, Mary
Falls are a major public health problem internationally. Many hospitals have implemented fall risk assessment tools, but few have implemented interventions to mitigate patient-specific fall risks. Little research has been done to examine the effect of implementing evidence-based fall prevention interventions to mitigate patient-specific fall risk factors in hospitalized adults. To evaluate the impact of implementing, in 3 U.S. hospitals, evidence-based fall prevention interventions targeted to patient-specific fall risk factors (Targeted Risk Factor Fall Prevention Bundle). Fall rates, fall injury rates, types of fall injuries and adoption of the Targeted Risk Factor Fall Prevention Bundle were compared prior to and following implementation. A prospective pre-post implementation cohort design. Thirteen adult medical-surgical units from three community hospitals in the Midwest region of the U.S. Nurses who were employed at least 20hours/week, provided direct patient care, and licensed as an RN (n=157 pre; 140 post); and medical records of patients 21years of age or older, who received care on the study unit for more than 24hours during the designated data collection period (n=390 pre and post). A multi-faceted Translating Research Into Practice Intervention was used to implement the Targeted Risk Factor Fall Prevention Bundle composed of evidence-based fall prevention interventions designed to mitigate patient-specific fall risks. Dependent variables (fall rates, fall injury rates, fall injury type, use of Targeted Risk Factor Fall Prevention Bundle) were collected at baseline, and following completion of the 15month implementation phase. Nurse questionnaires included the Stage of Adoption Scale, and the Use of Research Findings in Practice Scale to measure adoption of evidence-based fall prevention practices. A Medical Record Abstract Form was used to abstract data about use of targeted risk-specific fall prevention interventions. Number of falls, and number and
Full Text Available Background: Radial artery (RA occlusion (RAO is not rare in patients undergoing coronary intervention by transradial approach (TRCI. Predictors of and prevention from RAO have not been systematically studied. This study aimed to analyze the risk factors of the weakness of RA pulsation (RAP and its predictive value for RAO after TRCI, and simultaneously to describe a feasible and effective approach to maintain RA patency. Methods: Between June 2006 and March 2010, all patients who underwent TRCI were classified according to the weakness of RAP after removing compression bandage with confirmation by Doppler ultrasound for the first 30 consecutive patients. Among a total of 2658 patients studied, 187 (7% patients having a weaker RAP were prospectively monitored. At 1 h after bandage removal, the ulnar artery in puncture side of all patients was blocked with manual compression to favor brachial and collateral artery blood flow through the RA until a good RAP was restored. The primary analysis was the occurrence of RAO. Results: Doppler ultrasound demonstrated the significant reduction of both systolic velocity (61.24 ± 3.95 cm/s vs. 72.31 ± 3.57 cm/s and diastolic velocity (1.83 ± 0.32 cm/s vs. 17.77 ± 3.97 cm/s in RA at access side as compared to the contralateral RA (all P < 0.001, but these velocities in ipsilateral ulnar artery (81.2 ± 2.16 cm/s and 13.1 ± 2.86 cm/s, respectively increased profoundly. The average time of ulnar artery compression was 4.1 ± 1.2 h (ranged 2.5-6.5 h. There were two patients experienced persistent RAO with a success rate of 98.9% and RAO in 0.075% of patients after ulnar artery compression was applied. The pulsation of the ulnar artery after compression was removed had not been influenced by the compression. Conclusions: After intervention using TRCI approach, the presence of a weaker RAP is an indicator of imminent RAO. The continuing compression of ipsilateral ulnar artery is an effective approach to
Sanabria-Martínez, G; García-Hermoso, A; Poyatos-León, R; Álvarez-Bueno, C; Sánchez-López, M; Martínez-Vizcaíno, V
It is commonly accepted that pregnancy-related physiological changes (circulatory, respiratory, and locomotor) negatively influence the daily physical activity of pregnant women. The aim of this study is to conduct a meta-analysis of randomised controlled trials (RCTs) for assessing the effectiveness of physical exercise interventions during pregnancy to prevent gestational diabetes mellitus and excessive maternal weight gain. Keywords were used to conduct a computerised search in six databases: Cochrane Library Plus, Science Direct, EMBASE, PubMed, Web of Science, and ClinicalTrials.gov. Healthy pregnant women who were sedentary or had low levels of physical activity were selected for RCTs that included an exercise programme. Two independent reviewers extracted data and assessed the quality of the included studies. Of 4225 articles retrieved, 13 RCTs (2873 pregnant women) met the inclusion criteria. Pooled relative risk (RR) or weighted mean differences (WMDs) (depending on the outcome measure) were calculated using a random-effects model. Overall, physical exercise programmes during pregnancy decreased the risk of gestational diabetes mellitus (RR = 0.69; P = 0.009), particularly when the exercise programme was performed throughout pregnancy (RR = 0.64; P = 0.038). Furthermore, decreases were also observed in maternal weight (WMD = -1.14 kg; 95% CI -1.50 to -0.78; P physical exercise programmes during pregnancy decrease the risk of gestational diabetes mellitus and diminish maternal weight gain, and seem to be safe for the mother and the neonate; however, further studies are needed to establish recommendations. © 2015 Royal College of Obstetricians and Gynaecologists.
Lemieux, Anthony F; Fisher, Jeffrey D; Pratto, Felicia
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.
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...
Full Text Available Background Obesity causes depression and undermines mental health in adolescents. It is also related to adulthood diseases and mortality. The current study drew upon an educational intervention to modify some Health Belief Model constructs to preventing overweight and obesity among adolescents. Materials and Methods: In this quasi-experimental study 100 boy students recruited from selected boys junior high schools in Isfahan. They were randomly assigned to intervention (n=50 and control (n=50 groups. In 4 training sessions, a nutritionist introduced different types of healthy foods and explained how to consume them. A sports coach also taught how to do physical exercises well in 4 sessions (each one 90 minutes in terms of nutrition and physical activity. Data of pretest and posttest gathered from demographic and a valid questionnaire were fed into the SPSS software, version 20.0 and analyzed using relevant statistical tests. Results: The independent t-test revealed that, before the intervention, there was no significant difference between the two groups in the mean scores of knowledge, perceived benefits, perceived barriers, physical activity, and nutrition behavior (P>0.05; but, after the intervention, this difference between the two groups was significant (P
Seoane-Lestón, Juan; Velo-Noya, Jose; Warnakulasuriya, Samann; Varela-Centelles, Pablo; Gonzalez-Mosquera, Antonio; Villa-Vigil, Manuel-Alfonso; Rodríguez-Lozano, Francisco; Diz-Dios, Pedro
To assess the knowledge and preventive attitudes that Spanish dentists have towards oral cancer, before and after an educational intervention. A quasi-experimental study based on a nationwide intervention. All Spanish dentists were offered an on-site course on oral cancer. An individual questionnaire was administered before and after attending the course. The main outcome measures were systematic examination of the oral cavity, promotion of healthy habits and knowledge of clinical aspects. 440 GDPs entered the study. Age: 40.7+/-10.7, range 21-74. Professional experience: 13.9+/-8.9 years, range 0-45. Of those who participated in the study, 53.1% had never attended a course on oral cancer, 72.4% stated that they perform a systematic examination of the oral mucosa, 88.2% provided systematic counselling on tobacco cessation, and 54.7% reported that they did the same for alcohol. In addition, 32.3% advised patients to eat fruits and vegetables high in antioxidants. Professional experience was significantly associated with oral mucosa systematic examination (t= 2.9; p=0.003), advice on alcohol consumption (t=5.0; p=0.000), and on fruit and vegetable intake (t=5.1; pcancer. All areas of knowledge examined showed statistically significant improvement after the educational intervention. The intervention appears to have improved the GDP s knowledge, confirming the importance of this national campaign.
Amirkhanian, Yuri A; Kelly, Jeffrey A; Takacs, Judit; McAuliffe, Timothy L; Kuznetsova, Anna V; Toth, Tamas P; Mocsonaki, Laszlo; DiFranceisco, Wayne J; Meylakhs, Anastasia
To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections. A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling. St. Petersburg, Russia and Budapest, Hungary. Eighteen 'seeds' from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen three-ring sociocentric networks (mean size = 35 members, n = 626) were recruited. Empirically identified network leaders were trained and guided to convey HIV prevention advice to other network members. Changes in sexual behavior from baseline to 3-month and 12-month follow-up, with composite HIV/STD incidence, measured at 12 months to corroborate behavior changes. There were significant reductions between baseline, first follow-up, and second follow-up in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (UAI) (P = 0.04); UAI with a nonmain partner (P = 0.04); and UAI with multiple partners (P = 0.002). The mean percentage of unprotected anal intercourse acts significantly declined (P = 0.001), as well as the mean number of UAI acts among men who initially had multiple partners (P = 0.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks. Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks.
Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Rubio-Valera, Maria; Fernández, Anna; Navas-Campaña, Desirée; Rodríguez-Morejón, Alberto; Motrico, Emma; Rigabert, Alina; Luna, Juan de Dios; Martín-Pérez, Carlos; Rodríguez-Bayón, Antonina; Ballesta-Rodríguez, María Isabel; Luciano, Juan Vicente; Bellón, Juan Ángel
To our knowledge, no systematic reviews or meta-analyses have been conducted to assess the effectiveness of preventive psychological and/or educational interventions for anxiety in varied populations. To evaluate the effectiveness of preventive psychological and/or educational interventions for anxiety in varied population types. A systematic review and meta-analysis was conducted based on literature searches of MEDLINE, PsycINFO, Web of Science, EMBASE, OpenGrey, Cochrane Central Register of Controlled Trials, and other sources from inception to March 7, 2017. A search was performed of randomized clinical trials assessing the effectiveness of preventive psychological and/or educational interventions for anxiety in varying populations free of anxiety at baseline as measured using validated instruments. There was no setting or language restriction. Eligibility criteria assessment was conducted by 2 of us. Data extraction and assessment of risk of bias (Cochrane Collaboration's tool) were performed by 2 of us. Pooled standardized mean differences (SMDs) were calculated using random-effect models. Heterogeneity was explored by random-effects meta-regression. Incidence of new cases of anxiety disorders or reduction of anxiety symptoms as measured by validated instruments. Of the 3273 abstracts reviewed, 131 were selected for full-text review, and 29 met the inclusion criteria, representing 10 430 patients from 11 countries on 4 continents. Meta-analysis calculations were based on 36 comparisons. The pooled SMD was -0.31 (95% CI, -0.40 to -0.21; P educational interventions had a small but statistically significant benefit for anxiety prevention in all populations evaluated. Although more studies with larger samples and active comparators are needed, these findings suggest that anxiety prevention programs should be further developed and implemented.
Bus, S A; Valk, G D; van Deursen, R W; Armstrong, D G; Caravaggi, C; Hlavácek, P; Bakker, K; Cavanagh, P R
Footwear and offloading techniques are commonly used in clinical practice for the prevention and treatment of foot ulcers in diabetes, but the evidence base to support this use is not well known. The goal of this review was to systematically assess the literature and to determine the available evidence on the use of footwear and offloading interventions for ulcer prevention, ulcer treatment, and plantar pressure reduction in the diabetic foot. A search was made for reports on the effectiveness of footwear and offloading interventions in preventing or healing foot ulcers or reducing plantar foot pressure in diabetic patients published prior to May 2006. Both controlled and uncontrolled studies were included. Assessment of the methodological quality of studies and data extraction was independently performed by two reviewers. Interventions were assigned into four subcategories: casting, footwear, surgical offloading and other offloading techniques. Of 1651 articles identified in the baseline search, 21 controlled studies were selected for grading following full text review. Another 108 uncontrolled and cross-sectional studies were examined. The evidence to support the use of footwear and surgical interventions for the prevention of ulceration is meagre. Evidence was found to support the use of total contact casts and other non-removable modalities for treatment of neuropathic plantar ulcers. More studies are needed to support the use of surgical offloading techniques for ulcer healing. Plantar pressure reduction can be achieved by several modalities including casts, walkers, and therapeutic footwear, but the diversity in methods and materials used limits the comparison of study results. This systematic review provides support for the use of non-removable devices for healing plantar foot ulcers. Furthermore, more high-quality studies are urgently needed to confirm the promising effects found in both controlled and uncontrolled studies of footwear and offloading
Jeihooni, Ali Khani; Rakhshani, Tayebeh
Skin cancer is one of the most common cancers in Iran. Farmers are exposed to the sun's ultraviolet radiation due to their job and are susceptible to skin cancer. The aim of this study is to survey the effect of educational intervention based on health belief model and social support on promoting skin cancer preventive behaviors in farmers of Fasa City, Fars province, Iran. In this quasi-experimental study, 200 farmers (100 in experimental group and 100 in control group) in Fasa City, Fars, Iran, were selected in 2017. The educational intervention for the experimental group consisted of eight training sessions (introduction to skin cancer, risk factors, complications, benefits and barriers to proper use of sunscreen, UV sunglasses and physical protection, self-efficacy in applying preventive behaviors, role of social support). A questionnaire consisting of demographic information, knowledge, HBM constructs (perceived susceptibility, severity, benefits, barriers, self-efficacy and cues to action), and social support was used to measure skin cancer preventive behaviors before, 3 months after the intervention, and 6 months later. Data were analyzed using SPSS-22 via chi-squared, independent samples t test, Mann-Whitney, and repeated measures ANOVA at a significance level of 0.5. The mean age of the farmers was 42.21 ± 10.52 years in the experimental group and 44.28 ± 10.16 years in the control group. Three months after the intervention and 6 months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, cues to action, social support, and skin cancer preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the HBM constructs and social support in adoption of skin cancer preventive behaviors in 3 and 6 months post intervention in farmers. Hence, these models can act as a
Clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for falls prevention in older people: a multicentre cohort randomised controlled trial (the REducing Falls with ORthoses and a Multifaceted podiatry intervention trial).
Cockayne, Sarah; Rodgers, Sara; Green, Lorraine; Fairhurst, Caroline; Adamson, Joy; Scantlebury, Arabella; Corbacho, Belen; Hewitt, Catherine E; Hicks, Kate; Hull, Robin; Keenan, Anne-Maree; Lamb, Sarah E; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony; Richardson, Zoe; Vernon, Wesley; Watson, Judith; Torgerson, David J
Falls are a serious cause of morbidity and cost to individuals and society. Evidence suggests that foot problems and inappropriate footwear may increase the risk of falling. Podiatric interventions could help reduce falls; however, there is limited evidence regarding their clinical effectiveness and cost-effectiveness. To determine the clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for preventing falls in community-dwelling older people at risk of falling, relative to usual care. A pragmatic, multicentred, cohort randomised controlled trial with an economic evaluation and qualitative study. Nine NHS trusts in the UK and one site in Ireland. In total, 1010 participants aged ≥ 65 years were randomised (intervention, n = 493; usual care, n = 517) via a secure, remote service. Blinding was not possible. All participants received a falls prevention leaflet and routine care from their podiatrist and general practitioner. The intervention also consisted of footwear advice, footwear provision if required, foot orthoses and foot- and ankle-strengthening exercises. The primary outcome was the incidence rate of falls per participant in the 12 months following randomisation. The secondary outcomes included the proportion of fallers and multiple fallers, time to first fall, fear of falling, fracture rate, health-related quality of life (HRQoL) and cost-effectiveness. The primary analysis consisted of 484 (98.2%) intervention and 507 (98.1%) usual-care participants. There was a non-statistically significant reduction in the incidence rate of falls in the intervention group [adjusted incidence rate ratio 0.88, 95% confidence interval (CI) 0.73 to 1.05; p = 0.16]. The proportion of participants experiencing a fall was lower (50% vs. 55%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00; p = 0.05). No differences were observed in key secondary outcomes. No serious, unexpected and related adverse events were reported. The
Messiah, Sarah E.; Lopez-Mitnik, Gabriela; Almon, Marie; Agatston, Arthur S.
Objectives. We assessed the effects of a school-based obesity prevention intervention that included dietary, curricula, and physical activity components on body mass index (BMI) percentiles and academic performance among low-income elementary school children. Methods. The study had a quasi-experimental design (4 intervention schools and 1 control school; 4588 schoolchildren; 48% Hispanic) and was conducted over a 2-year period. Data are presented for the subset of the cohort who qualified for free or reduced-price school lunches (68% Hispanic; n = 1197). Demographic and anthropometric data were collected in the fall and spring of each year, and academic data were collected at the end of each year. Results. Significantly more intervention than control children stayed within normal BMI percentile ranges both years (P = .02). Although not significantly so, more obese children in the intervention (4.4%) than in the control (2.5%) decreased their BMI percentiles. Overall, intervention schoolchildren had significantly higher math scores both years (P < .001). Hispanic and White intervention schoolchildren were significantly more likely to have higher math scores (P < .001). Although not significantly so, intervention schoolchildren had higher reading scores both years. Conclusions. School-based interventions can improve health and academic performance among low-income schoolchildren. PMID:20167892
Avşar, Pınar; Karadağ, Ayişe
A reduction in tissue tolerance promotes the development of pressure ulcers (PUs) and incontinence-associated dermatitis (IAD). To determine the cost-effectiveness and efficacy of evidence-based (EB) nursing interventions on increasing tissue tolerance by maintaining tissue integrity. The study involved 154 patients in two intensive care units (77 patients, control group; 77 patients, intervention group). Data were collected using the following: patient characteristics form, Braden PU risk assessment scale, tissue integrity monitoring form, PU identification form, IAD and severity scale, and a cost table of the interventions. Patients in the intervention group were cared for by nurses trained in the use of the data collection tools and in EB practices to improve tissue tolerance. Routine nursing care was given to the patients in the control group. The researcher observed all patients in terms of tissue integrity and recorded the care-related costs. Deterioration of tissue integrity was observed in 18.2% patients in the intervention group compared to 54.5% in the control group (p prevention in the intervention and control groups was X¯ = $204.34 ± 41.07 and X¯ = $138.90 ± 1.70, respectively. It is recommended that EB policies and procedures are developed to improve tissue tolerance by maintaining tissue integrity. Although the cost of EB preventive initiatives is relatively high compared to those that are not EB, the former provide a significant reduction in the prevalence of tissue integrity deterioration. © 2017 Sigma Theta Tau International.
A. Shroufi (Amir); R. Chowdhury (Rajiv); R. Anchala (Raghupathy); S. Stevens (Sarah); P. Blanco (Patricia); T. Han (Tha); L.W. Niessen (Louis Wilhelmus); O.H. Franco (Oscar)
textabstractBackground: While there is good evidence to show that behavioural and lifestyle interventions can reduce cardiovascular disease risk factors in affluent settings, less evidence exists in lower income settings.This study systematically assesses the evidence on cost-effectiveness for
Sharafkhani, Naser; Khorsandi, Mahboobeh; Shamsi, Mohsen; Ranjbaran, Mehdi
Study Design Randomized controlled trial. Objective The purpose of this study was to identify the effect of a theory-based educational intervention program on the level of knowledge and Health Belief Model (HBM) constructs among nurses in terms of the adoption of preventive behaviors. Methods This pretest/posttest quasi-experimental study was conducted on 100 nurses who were recruited through the multistage sampling method. The nurses were randomly assigned to intervention and control groups. The participants were evaluated before and 3 months after the educational intervention. A multidimensional questionnaire was prepared based on the theoretical structures of the HBM to collect the data. Data analysis was performed using descriptive and inferential statistics. Results There was no significant difference in the mean values of HBM constructs prior to the intervention between the intervention and control groups. However, after the administration of the educational program, the mean scores of knowledge and HBM constructs significantly increased in the intervention group when compared with the control group (p health educational strategies are suggested as an effective alternative to traditional educational interventions.
Müller, Sina; Stice, Eric
To investigate factors hypothesized to moderate the effects of a dissonance-based eating disorder prevention program, including initial elevations in thin-ideal internalization, body dissatisfaction, eating disorders symptoms, and older participant age. Adolescent female high school and college students with body image concerns (N=977; M age=18.6) were randomized to a dissonance-based thin-ideal internalization reduction program or an assessment-only control condition in three prevention trials. The intervention produced (a) significantly stronger reductions in thin-ideal internalization for participants with initial elevations in thin-ideal internalization and a threshold/subthreshold DSM-5 eating disorder at baseline, (b) significantly greater reductions in eating disorder symptoms for participants with versus without a DSM-5 eating disorder at baseline, and (c) significantly stronger reductions in body dissatisfaction for late adolescence/young adulthood versus mid-adolescent participants. Baseline body dissatisfaction did not moderate the intervention effects. Overall, intervention effects tended to be amplified for individuals with initial elevations in risk factors and a DSM-5 eating disorder at baseline. Results suggest that this prevention program is effective for a broad range of individuals, but is somewhat more beneficial for the subgroups identified in the moderation analyses. Copyright © 2012 Elsevier Ltd. All rights reserved.
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....
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
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
Full Text Available Abstract Background While the HIV epidemic is levelling off in sub-Saharan Africa, it remains at an unacceptably high level. Young people aged 15-24 years remain particularly vulnerable, resulting in a regional HIV prevalence of 1.4% in young men and 3.3% in young women. This study assesses the effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda on young people’s sexual behavior, HIV knowledge and attitudes. Methods In a non-randomized longitudinal controlled trial, fourteen schools were selected in two neighboring districts in Rwanda Bugesera (intervention and Rwamagana (control. Students (n = 1950 in eight intervention and six control schools participated in three surveys (baseline, six and twelve months in the intervention. Analysis was done using linear and logistic regression using generalized estimation equations adjusted for propensity score. Results The overall retention rate was 72%. Time trends in sexual risk behavior (being sexually active, sex in last six months, condom use at last sex were not significantly different in students from intervention and control schools, nor was the intervention associated with increased knowledge, perceived severity or perceived susceptibility. It did significantly reduce reported stigma. Conclusions Analyzing this and other interventions, we identified several reasons for the observed limited effectiveness of peer education: 1 intervention activities (spreading information are not tuned to objectives (changing behavior; 2 young people prefer receiving HIV information from other sources than peers; 3 outcome indicators are not adequate and the context of the relationship in which sex occurs and the context in which sex occurs is ignored. Effectiveness of peer education may increase through integration in holistic interventions and redefining peer educators’ role as focal points for sensitization and referral to experts and services. Finally, we argue that a
JUANITA HENAO ESCOBAR
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.
McElwaine Kathleen M
Full Text Available Abstract Background The primary behavioural risks for the most common causes of mortality and morbidity in developed countries are tobacco smoking, poor nutrition, risky alcohol use, and physical inactivity. Evidence, guidelines and policies support routine clinician delivery of care to prevent these risks within primary care settings. Despite the potential afforded by community health services for the delivery of such preventive care, the limited evidence available suggests it is provided at suboptimal levels. This study aims to assess the effectiveness of a multi-strategic practice change intervention in increasing clinician's routine provision of preventive care across a network of community health services. Methods/Design A multiple baseline study will be conducted involving all 56 community health facilities in a single health district in New South Wales, Australia. The facilities will be allocated to one of three administratively-defined groups. A 12 month practice change intervention will be implemented in all facilities in each group to facilitate clinician risk assessment of eligible clients, and clinician provision of brief advice and referral to those identified as being 'at risk'. The intervention will be implemented in a non-random sequence across the three facility groups. Repeated, cross-sectional measurement of clinician provision of preventive care for four individual risks (smoking, poor nutrition, risky alcohol use, and physical inactivity will occur continuously for all three facility groups for 54 months via telephone interviews. The interviews will be conducted with randomly selected clients who have visited a community health facility in the last two weeks. Data collection will commence 12 months prior to the implementation of the intervention in the first group, and continue for six months following the completion of the intervention in the last group. As a secondary source of data, telephone interviews will be undertaken
Gilmore, Brynne; McAuliffe, Eilish
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
Omi, Yorikatsu; Sugimoto, Dai; Kuriyama, Setsurou; Kurihara, Tomohisa; Miyamoto, Kenji; Yun, Songjo; Kawashima, Tatsuhiro; Hirose, Norikazu
Programs to prevent anterior cruciate ligament (ACL) injuries in female basketball players are scarce. Also, ACL injury prevention training that focuses on hip joint function has not been reported. To determine the effectiveness of a hip-focused ACL injury prevention program in female basketball players. Cohort study; Level of evidence, 2. A prospective intervention study was conducted for 12 years. Incidence rates of ACL injuries were collected in the first 4 years (observation period) from college female basketball players. After the observation period, a hip-focused ACL injury prevention program was implemented for 8 years (intervention period). A total of 309 players (mean ± SD age, 19.6 ± 1.2 years; height, 163.7 ± 5.6 cm; weight, 59.1 ± 5.1 kg; body mass index, 22.0 ± 1.4) were tracked in the observation period and compared with 448 players (age, 19.6 ± 1.1 years; height, 162.6 ± 5.8 cm; weight, 58.0 ± 5.7 kg; body mass index, 21.9 ± 1.5) who participated in the intervention period. Athlete-exposures (AEs), ACL numbers and mechanisms of injury (MOIs), relative risk (RR), absolute risk reduction (ARR), numbers needed to treat (NNT), and compliance were analyzed. There were 16 ACL injuries (13 noncontact MOIs) in the 4-year observation period, whereas 9 ACL injuries (8 noncontact MOIs) were recorded in the 8-year intervention period. The overall ACL injury incidence was 0.25/1000 AEs in the 4-year observation period compared with 0.10/1000 AEs in the 8-year intervention period, respectively. Compared with the 4-year observation period, significant RR reduction was observed (0.38; 95% CI, 0.17-0.87; P = .017) with ARR and NNT of 0.032 (95% CI, 0.027-0.037) and 31.6 (95% CI, 27.1-37.7), respectively, in the 8-year intervention period. The noncontact ACL injury incidence was 0.21 per 1000 AEs during the 4-year observation period compared with 0.08/1000 AEs in the 8-year intervention period, which also showed significant RR reduction (0.37; 95% CI, 0
Walker, Sharon L; Smith, Donald J
Violence impacts the lives of children on a daily basis. In their communities, they witness drive-by shootings, drug deals, and violence in their schools while many endure abuse, neglect, and violent behavior in their homes. Because the traumatizing impact of such exposure disrupts a child's ability to concentrate and learn, the Dallas Independent School District (ISD) sought content expertise to develop a training vehicle for school district professionals. The program aimed to raise the awareness of educators to problems related to domestic violence and the myriad of circumstances at home and in the community that lead to exposure to violence. Approximately 15,000 faculty and staff of Dallas ISD were educated in the identification, intervention, and prevention of exposure to violence. Referrals and inquiries related to abuse have increased (approximately 70%) while the city of Dallas has witnessed a drop in the number of domestic violence and child abuse offenses.
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.
Buntrock, C.; Ebert, D. D.; Lehr, D.
-employee contributions). Participants included 406 self-selected adults with subthreshold depression (Centre for Epidemiologic Studies Depression Scale score≥16, no current MDD according to Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition, Text Revision] criteria). INTERVENTIONS All participants had...... AND MEASURES The primary outcome was time to onset of MDD in the intervention group relative to the control group over a 12-month follow-up period as assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6-and 12-month follow......Importance Evidence-based treatments for major depressive disorder (MDD) are not very successful in improving functional and health outcomes. Attention has increasingly been focused on the prevention of MDD. OBJECTIVE To evaluate the effectiveness of a web-based guided self-help intervention...
Krist, Lilian; Lotz, Fabian; Bürger, Christin; Ströbele-Benschop, Nanette; Roll, Stephanie; Rieckmann, Nina; Müller-Nordhorn, Jacqueline; Willich, Stefan N; Müller-Riemenschneider, Falk
In Germany, the smoking prevalence among adolescents is among the highest in Europe. Our aim was to evaluate the long-term effectiveness of a combined student-parent and a student-only smoking prevention programme to reduce the smoking prevalence among 7th grade students in Berlin. Three-armed cluster-randomized controlled trial (RCT). Schools as cluster units were randomized into (i) student intervention, (ii) combined student-parent intervention or (iii) control group, with follow-up after 12 and 24 months. High schools and integrated secondary schools in Berlin, Germany. Seventh grade students aged 11-16 years. We included 47 schools, 161 classes and 2801 students [50.1% girls, mean age ± standard deviation (SD) = 13.0 ± 0.6 years]. The primary outcome was self-reported regular smoking (at least one cigarette per day) after 24 months (point prevalence). Further self-reported outcomes were other smoking behaviours as well as parental rules and attitudes towards smoking. Comparisons were calculated as odds ratios (OR) with 95% confidence intervals (CI). At baseline, 2.3% of the students reported that they smoked regularly. After 24 months, 7.8% and 7.0% were regular smokers in the student-only intervention and the student-parent intervention, respectively, compared with 10.1% in the control group. The OR for being a regular smoker was 0.81 (0.34-1.92) for the student-parent intervention versus control, 0.95 (CI = 0.41-2.22) for the student-only intervention versus control and 0.85 (0.38-1.89) for student-parent intervention versus student-only intervention. A combined student-parent smoking prevention intervention delivered via secondary schools in Berlin, Germany did not result in a statistically significant reduction in regular smoking compared with a control group or a student-only intervention. The student-only intervention did not result in a significant reduction in regular smoking compared with the control group. © 2016 Society for the Study
Mobley, Connie C.; Stadler, Diane D.; Staten, Myrlene A; ghormli, Laure El; Gillis, Bonnie; Hartstein, Jill; Siega-Riz, Anna Maria; Virus, Amy
BACKGOUND The HEALTHY primary prevention trial developed an integrated multi-component intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program (NSLP), and a la carte venues are compared to the experience of control schools. METHODS The intervention was implemented in 21 middle schools from winter 2007 through spring 2009 (following a cohort of students from sixth through eighth grades); 21 schools acted as observed controls. The nutrition component targeted school food service environmental change. Data identifying foods and nutrients served (selected by students for consumption) were collected over a 20-day period at baseline and end of study. Analysis compared end of study values for intervention versus control schools. RESULTS Intervention schools more successfully limited dessert and snack food portion size in NSLP and a la carte and lowered fat content of foods served. Servings of high fiber grain-based foods and/or legumes were improved in SBP but not NSLP. Intervention and control schools eliminated >1% fat milk and sugar added beverages in SBP, but intervention schools were more successful in NSLP and a la carte. CONCLUSION The HEALTHY program demonstrated significant changes in the nutritional quality of foods and beverages served in the SBP, NSLP, and a la carte venues, as part of an effort to decrease childhood obesity and support beneficial effects in some secondary HEALTHY study outcomes. PMID:22239133
Spink, Martin J; Menz, Hylton B; Fotoohabadi, Mohammad R; Wee, Elin; Landorf, Karl B; Hill, Keith D; Lord, Stephen R
To determine the effectiveness of a multifaceted podiatry intervention in preventing falls in community dwelling older people with disabling foot pain. Parallel group randomised controlled trial. University health sciences clinic in Melbourne, Australia. 305 community dwelling men and women (mean age 74 (SD 6) years) with disabling foot pain and an increased risk of falling. 153 were allocated to a multifaceted podiatry intervention and 152 to routine podiatry care, with 12 months' follow-up. Multifaceted podiatry intervention consisting of foot orthoses, advice on footwear, subsidy for footwear ($A100 voucher; £65; €74), a home based programme of foot and ankle exercises, a falls prevention education booklet, and routine podiatry care for 12 months. The control group received routine podiatry care for 12 months. Proportion of fallers and multiple fallers, falling rate, and injuries resulting from falls during follow-up. Overall, 264 falls occurred during the study. 296 participants returned all 12 calendars: 147 (96%) in the intervention group and 149 (98%) in the control group. Adherence was good, with 52% of the participants completing 75% or more of the requested three exercise sessions weekly, and 55% of those issued orthoses reporting wearing them most of the time. Participants in the intervention group (n=153) experienced 36% fewer falls than participants in the control group (incidence rate ratio 0.64, 95% confidence interval 0.45 to 0.91, P=0.01). The proportion of fallers and multiple fallers did not differ significantly between the groups (relative risk 0.85, 0.66 to 1.08, P=0.19 and 0.63, 0.38 to 1.04, P=0.07). One fracture occurred in the intervention group and seven in the control group (0.14, 0.02 to 1.15, P=0.07). Significant improvements in the intervention group compared with the control group were found for the domains of strength (ankle eversion), range of motion (ankle dorsiflexion and inversion/eversion), and balance (postural sway on the
Bellón, Juan Ángel; Moreno-Peral, Patricia; Motrico, Emma; Rodríguez-Morejón, Alberto; Fernández, Ana; Serrano-Blanco, Antoni; Zabaleta-del-Olmo, Edurne; Conejo-Cerón, Sonia
To determine the effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression. Systematic review of systematic reviews and meta-analyses (SR/MA). We searched PubMed, PsycINFO, Cochrane Database of Systematic Reviews, OpenGrey, and PROSPERO from their inception until February 2014. Two reviewers independently evaluated the eligibility criteria of all SR/MA, abstracted data, and determined bias risk (AMSTAR). Twelve SR/MA (156 non-repeated trials and 56,158 participants) were included. Of these, 142 (91%) were randomized-controlled, 13 (8.3%) controlled trials, and 1 (0.6%) had no control group. Five SR/MA focused on children and adolescents, four on specific populations (women after childbirth, of low socioeconomic status, or unfavorable circumstances; patients with severe traumatic physical injuries or stroke) and three addressed the general population. Nine (75%) SR/MA concluded that interventions to prevent depression were effective. Of the 156 trials, 137 (87.8%) reported some kind of effect size calculation. Effect sizes were small in 45 (32.8%), medium in 26 (19.1%), and large in 25 (18.2%) trials; 41 (29.9%) trials were not effective. Of the 141 trials for which follow-up periods were available, only 34 (24.1%) exceeded 12 months. Psychological and/or educational interventions to prevent onset of episodes of depression were effective, although most had small or medium effect sizes. Copyright © 2014. Published by Elsevier Inc.
Sarna, Avina; Luchters, Stanley; Musenge, Eustasius; Okal, Jerry; Chersich, Matthew; Tun, Waimar; Mall, Sabine; Kingola, Nzioki; Kalibala, Sam
We report effectiveness of an HIV-prevention intervention delivered by community health workers (CHWs) in Mombasa, Kenya, to PLHIV who have not initiated or who have discontinued ART-an often difficult-to-reach population because they fall outside the ambit of health care and prevention services. A 2-arm cohort study assessed a structured risk-reduction intervention involving at least 4 one-to-one counseling sessions and personalized support. The control group received standard prevention services. CHWs recruited treatment-naïve people living with HIV (PLHIV) or those who had previously taken antiretroviral drugs. Data were analyzed using a Propensity Score Matched (PSM)-sample to control for baseline differences between the groups. 634 PLHIV were recruited and followed for 6 months. Median age was 35 years, and 74.3% were female. Participants in the intervention group reported reduced risky sexual behaviors both at endline compared with baseline and compared with the control group. At endline, in the PSM analysis, participants in the intervention arm were less likely than participants in the control group to report unprotected sex with a spouse (Odds Ratio [OR] = 0.08, 95% confidence interval [CI] = 0.03-0.24), and they reported fewer unprotected sex acts (12.3% versus 46.0%, respectively; OR = 0.16, 95% CI = 0.09-0.29; P<0.001). Further, 92.4% of participants in the intervention group reported zero unsafe sex acts (with partners of negative or unknown HIV status) compared with 70.8% in the control group (P<0.001), and more participants in the intervention arm were receiving ART (34.3% versus 12.7%, respectively; P<0.001). CHWs effectively reached PLHIV who had never received or who had discontinued ART, and they delivered a risk-reduction intervention that led to declines in reported sexual risk behaviors, as well as to increases in ART uptake. A scaled-up intervention warrants consideration.
Tikka, Christina; Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Ferrite, Silvia
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
Nuckols, Teryl K; Needleman, Jack; Grogan, Tristan R; Liang, Li-Jung; Worobel-Luk, Pamela; Anderson, Laura; Czypinski, Linda; Coles, Courtney; Walsh, Catherine M
The aim of this study is to evaluate the clinical effectiveness and incremental net cost of a fall prevention intervention that involved hourly rounding by RNs at 2 hospitals. Minimizing in-hospital falls is a priority, but little is known about the value of fall prevention interventions. We used an uncontrolled before-after design to evaluate changes in fall rates and time use by RNs. Using decision-analytical models, we estimated incremental net costs per hospital per year. Falls declined at 1 hospital (incidence rate ratio [IRR], 0.47; 95% confidence interval [CI], 0.26-0.87; P = .016), but not the other (IRR, 0.83; 95% CI, 0.59-1.17; P = .28). Cost analyses projected a 67.9% to 72.2% probability of net savings at both hospitals due to unexpected declines in the time that RNs spent in fall-related activities. Incorporating fall prevention into hourly rounds might improve value. Time that RNs invest in implementing quality improvement interventions can equate to sizable opportunity costs or savings.
Goldberg, Ronald B; Temprosa, Marinella G; Mather, Kieren J; Orchard, Trevor J; Kitabchi, Abbas E; Watson, Karol E
We evaluate whether lifestyle and metformin interventions used to prevent diabetes have durable effects on markers of inflammation and coagulation and whether the effects are influenced by the development of diabetes. The Diabetes Prevention Program was a controlled clinical trial of 3,234 subjects at high risk for diabetes who were randomized to lifestyle, metformin, or placebo interventions for 3.4 years. Diabetes was diagnosed semiannually by fasting glucose and annually by oral glucose tolerance testing. In addition to baseline testing, anthropometry was performed every 6 months; fasting insulin yearly; and hs-CRP, tissue plasminogen activator (tPA), and fibrinogen at 1 year and end of study (EOS). CRP and tPA levels were unchanged in the placebo group but fell in the lifestyle and metformin groups at 1 year and remained lower at EOS. These reductions were not seen in those who developed diabetes over the course of the study despite intervention. Fibrinogen was lower at 1 year in the lifestyle group. Differences in weight and weight change explained most of the influence of diabetes on the CRP response in the lifestyle group, but only partly in the placebo and metformin groups. Weight, insulin sensitivity, and hyperglycemia differences each accounted for the influence of diabetes on the tPA response. Lifestyle and metformin interventions have durable effects to lower hs-CRP and tPA. Incident diabetes prevented these improvements, and this was accounted for by differences in weight, insulin resistance, and glucose levels. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
Christensen, Helen; Batterham, Philip J; O'Dea, Bridianne
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.
Muktabhant, Benja; Lumbiganon, Pisake; Ngamjarus, Chetta; Dowswell, Therese
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
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.
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
Smaby, Marlow H.; Downing, Jerry
The purpose of this paper is twofold: it reviews current national research on adolescent suicide and successful intervention/prevention programs and it surveys the 17 Nevada school districts to determine the presence of successful suicide intervention/prevention programs in the state. Findings include the following: (1) the popular…
Muellmann, S; Landgraf-Rauf, K; Brand, T; Zeeb, H; Pischke, C R
Objective: To summarize the current evidence on the effectiveness of school-based interventions for the maintenance of mental health and the prevention of psychosocial problems among pupils. Methods: A systematic literature search of reviews published between 2007 and 2015 was carried out. Databases searched included Medline, PsycINFO, Campbell Library, Cochrane Library, NICE, ERIC, and Web of Science. Study selection, data extraction, and quality assessment (using AMSTAR criteria) were performed by 2 independent reviewers. Results: 6 reviews covering 331 primary studies were included in this review of reviews. Findings of three reviews with a focus on the maintenance and/or promotion of mental health and general well-being suggested that interventions aimed at changes in the social and the school environment were more effective than those that only targeted individual behavior change among pupils. Interventions for the reduction of mobbing/bullying were most effective if they comprised organizational changes at schools, such as playground and schoolyard supervision, and disciplinary measures. One review suggested strong evidence for the effectiveness of classroom management to reduce violent behavior among pupils. Conclusions: Participation in interventions promoting changes in the school environment, in addition to individual behavior change, appears to be associated with improved mental health among pupils and reductions in mobbing/bullying and violent behavior at schools. © Georg Thieme Verlag KG Stuttgart · New York.
Price, Amy; Verma, Arpana; Welfare, William
An estimated 129 million people are infected with urogenital schistosomiasis in sub-Saharan Africa. Current control recommendations endorse mass administration of praziquantel. Health education is an important component of effective schistosomiasis prevention and control, but there has been limited research on its effectiveness. This paper reviews the effectiveness of health education as an intervention in the prevention and control of urogenital schistosomiasis in sub-Saharan Africa. The outcomes of interest were prevalence, incidence or transmission of schistosomiasis, behaviour change associated with infection, or changes in knowledge of the disease. The findings from this review suggest that health education has a beneficial impact on knowledge and understanding of schistosomiasis within the target groups. However, further research is needed due to the poor quality of the included studies. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Collins, J; Porter, J
Malnutrition occurs frequently among patients in rehabilitation, leading to poorer outcomes. Evidence of the effects of interventions to prevent or treat malnutrition is required to guide clinical practice in this setting. This systematic review aimed to determine the effect of oral nutrition interventions implemented in rehabilitation on nutritional and functional outcomes. Five databases were searched to identify relevant publications; intervention trials of oral nutrition interventions (such as oral nutrition supplements, foodservice interventions, clinical care processes, enhanced eating environments) conducted with patients admitted for rehabilitation, reporting dietary intake, anthropometric, biochemical or functional outcomes. The reviewers determined study eligibility and assessed the included studies for risk of bias. Outcome data were combined narratively and by meta-analyses. From 1765 publications, 10 studies trialling oral nutrition supplements, foodservice interventions and clinical care processes (of neutral or positive quality) were identified. Compared to meals alone, oral nutritional supplements significantly improved energy and protein intake, with some evidence for improvements in anthropometry and length of stay. There was little evidence that speciality supplements were beneficial compared to standard versions. Meta-analyses demonstrated significantly greater energy [weighted mean difference (WMD) = 324 kcal, 212-436 kcal 95% confidence interval (CI)] and protein (WMD = 9.1 g, 0.2-17.9 g 95% CI) intake with energy dense meals. Opposing results were reported in studies investigating enhanced clinical care processes. The provision of oral nutrition supplements and energy dense meals improved energy and protein intake and therefore may comprise effective strategies for addressing malnutrition in rehabilitation. The effect of these strategies on other nutritional and functional outcomes should be explored further. © 2014 The British
Walker, Dilys; Gutierrez, Juan Pablo; Torres, Pilar; Bertozzi, Stefano M
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...
Perry, C L; Kelder, S H
The social influence models do provide some optimism for primary prevention efforts. Prevention programs appear most effective when 1) the target behavior of the intervention has received increasing societal disapproval (such as cigarette smoking), 2) multiple years of behavioral health education are planned, and 3) community-wide involvement or mass media complement a school-based peer-led program (45,46). Short-term programs and those involving alcohol use have had less favorable outcomes. Future research in primary prevention should address concerns of high-risk groups and high-risk countries, such as lower income populations in the United States or countries that have large adolescent homeless populations. The utilization of adolescent leaders for program dissemination might be particularly critical in these settings. A second major and global concern should focus upon alcohol use and alcohol-related problems. In many communities adolescent alcohol use is normative and even adult supported. Thus, young people are getting quite inconsistent messages on alcohol from their schools, from TV, from peers, and from parents. This inconsistency may translate into many tragic and avoidable deaths for young people. Clearly, in the area of alcohol-related problems, community-wide involvement may be necessary. A third direction for prevention research should involve issues of norms, access, and enforcement including policy interventions, such as involve the availability of cigarette vending machines or the ease of under-age buying or levels of taxation. These methods affect adolescents more acutely since their financial resources, for the most part, are more limited. These policy level methods also signify to adolescents what adults consider appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)
Ghaffari, M; Tavassoli, E; Esmaillzadeh, A; Hassanzadeh, A
Osteoporosis is a systemic skeletal disorder characterized by reduction of one mass, deterioration of bone structure, increasing bone fragility, and increasing fracture risk. Prevention of osteoporosis during childhood and adolescence is one of the most important issues in World Health Organization. The purpose of this study was to determine the effect of Health Belief Model based intervention on promoting nutritional behaviors about preventive osteoporosis among the second grade middle school girl students. This was an experimental intervention study, the research population being 130 students who were randomly divided into groups, experimental (66) and control (64). Before the educational program, Health Belief Model based standard questionnaire and Food Frequency Questionnaire (FFQ) questionnaire were filled up by both the groups. The standard questionnaire was completed three times (before, immediately, and 2 months after education) and FFQ questionnaire was completed two times (before and 2 months after education) by the students. After pre-test, four educational session classes in the experimental group were performed. Finally, data collected were analyzed by SPSS 18 computer software. The result of this study showed a significant increase in the mean score of knowledge, perceived susceptibility, seriousness, benefits, barriers, as well as taking health action among girl students in the experimental group. The findings of the present study confirmed the practicability and effectiveness of the Health Belief Model based educational program in promoting nutritional behaviors about prevention of osteoporosis.
Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don
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
Full Text Available The paper focuses on investigating the dropout phenomena and the need for its prevention and reduction within Serbian pre-university education. Understanding dropout as a multidimensional and system-level phenomenon, we offer a model for dropout prevention and intervention. The model considers the characteristics of schools in Serbia, together with the diversity of children under risk. Based on the findings from primary and secondary vocational schools2where the model was piloted, we focus on the model’s effectiveness as related to a reduction in the dropout rate, absenteeism, and grade repetition, together with the rise in students’ overall achievement at the school level. The results suggest the model is largely effective in the reduction of dropout rate, absenteeism, and grade repetition, with some ambiguous findings in regard to the rise of students’ achievement in primary schools.
Joling, Karlijn J; Bosmans, Judith E; van Marwijk, Harm W J; van der Horst, Henriëtte E; Scheltens, Philip; MacNeil Vroomen, Janet L; van Hout, Hein P J
Dementia imposes a heavy burden on health and social care systems as well as on family caregivers who provide a substantial portion of the care. Interventions that effectively support caregivers may prevent or delay patient institutionalization and hence be cost-effective. However, evidence about the cost-effectiveness of such interventions is scarce. The aim of this study was to evaluate the cost-effectiveness of a family meetings intervention for family caregivers of dementia patients in comparison with usual care over a period of 12 months. The economic evaluation was conducted from a societal perspective alongside a randomized trial of 192 primary caregivers with community-dwelling dementia patients. Outcome measures included the Quality Adjusted Life-Years (QALY) of caregivers and patients and the incidence of depression and anxiety disorders in caregivers. Missing cost and effect data were imputed using multiple imputations. Bootstrapping was used to estimate uncertainty around the cost-differences and the incremental cost-effectiveness ratio (ICER). The bootstrapped cost-effect pairs were plotted on a cost-effectiveness plane and used to estimate cost-effectiveness curves. No significant differences in costs and effects between the groups were found. At 12 months, total costs per patient and primary caregiver dyad were substantial: €77,832 for the intervention group and €75,201 for the usual care group (adjusted mean difference per dyad €4,149, 95% CI -13,371 to 21,956, ICER 157,534). The main cost driver was informal care (66% of total costs), followed by patients' day treatment and costs of hospital and long-term care facility admissions (23%). Based on the cost-effectiveness acceptability curves, the maximum probability that the intervention was considered cost-effective in comparison with usual care reached 0.4 for the outcome QALY per patient-caregiver dyad and 0.6 for the caregivers' incidence of depression and/or anxiety disorders regardless of
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.
Calear, A.L.; Christensen, H.; Freeman, A.; Fenton, K.; Grant, J.B.; van Spijker, B.; Donker, T.
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.
White, Wendi E; Carmody, Dianne
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.
Full Text Available Abstract Background While a number of preventive interventions delivered within schools have shown both short-term and long-term impact in epidemiologically based randomized field trials, programs are not often sustained with high-quality implementation over time. This study was designed to support two purposes. The first purpose was to test the effectiveness of a universal classroom-based intervention, the Whole Day First Grade Program (WD, aimed at two early antecedents to drug abuse and other problem behaviors, namely, aggressive, disruptive behavior and poor academic achievement. The second purpose--the focus of this paper--was to examine the utility of a multilevel structure to support high levels of implementation during the effectiveness trial, to sustain WD practices across additional years, and to train additional teachers in WD practices. Methods The WD intervention integrated three components, each previously tested separately: classroom behavior management; instruction, specifically reading; and family-classroom partnerships around behavior and learning. Teachers and students in 12 schools were randomly assigned to receive either the WD intervention or the standard first-grade program of the school system (SC. Three consecutive cohorts of first graders were randomized within schools to WD or SC classrooms and followed through the end of third grade to test the effectiveness of the WD intervention. Teacher practices were assessed over three years to examine the utility of the multilevel structure to support sustainability and scaling-up. Discussion The design employed in this trial appears to have considerable utility to provide data on WD effectiveness and to inform the field with regard to structures required to move evidence-based programs into practice. Trial Registration Clinical Trials Registration Number: NCT00257088
Robinson, L; Hutchings, D; Corner, L; Beyer, F; Dickinson, H; Vanoli, A; Finch, T; Hughes, J; Ballard, C; May, C; Bond, J
To determine the effectiveness and cost-effectiveness of non-pharmacological interventions (excluding subjective barriers) in the prevention of wandering in people with dementia, in comparison with usual care, and to evaluate through the review and a qualitative study the acceptability to stakeholders of such interventions and identify ethical issues associated with their use. Major electronic databases were searched up until 31 March 2005. Specialists in the field. Selected studies were assessed and analysed. The results of two of the efficacy studies that used similar interventions, designs and outcome measures were pooled in a meta-analysis; results for other studies which reported standard deviations were presented in a forest plot. Owing to a lack of cost-effectiveness data, a modelling exercise could not be performed. Four focus groups were carried out with relevant stakeholders (n = 19) including people with dementia and formal and lay carers to explore ethical and acceptability issues in greater depth. Transcripts were coded independently by two reviewers to develop a coding frame. Analysis was via a thematic framework approach. Ten studies met the inclusion criteria (multi-sensory environment, three; music therapy, one; exercise, one; special care units, two; aromatherapy, two; behavioural intervention, one). There was no robust evidence to recommend any non-pharmacological intervention to reduce wandering in dementia. There was some evidence, albeit of poor quality, for the effectiveness of exercise and multi-sensory environment. There were no relevant studies to determine the cost-effectiveness of the interventions. Findings from the narrative review and focus groups on acceptability and ethical issues were comparable. Exercise and distraction therapies were the most acceptable interventions and raised no ethical concerns. All other interventions were considered acceptable except for physical restraints, which were considered unacceptable. Considerable
du Roscoät, E; Beck, F
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.
Suzuki, T; Makizako, H; Doi, T; Park, H; Lee, S; Tsutsumimoto, K; Umemura, K; Maki, Y; Shimada, H
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.
Ye, Shaodong; Xiao, Yan; Jin, Canrui; Cassell, Holly; Blevins, Meridith; Sun, Jiangping; Vermund, Sten H; Qian, Han-Zhu
To examine the impacts of a multi-city HIV prevention public health program (China Global Fund Round 5 Project) on condom use and HIV infection, we analyzed four yearly cross-sectional surveys from 2006 through 2009 among 20,843 men who have sex with men (MSM) in 16 Chinese cities. Self-reported condom use at last sex with a male partner increased from 58% in 2006 to 81% in 2009 (trend test, P<0.001). HIV prevalence increased from 2.3% in 2006 to 5.3% in 2009 (P<0.001). Multivariable logistic regression analysis showed that self-reported receipt of interventions was an independent predictor of increased condom use at last sex with a male partner over time (adjusted odds ratio [aOR], 1.63 in 2006 to 2.33 in 2009; P<0.001), and lower HIV prevalence (aOR, 1.08 in 2006 to 0.45 in 2009; P<0.001). HIV prevalence increased from 2006-2009 for participants with no self-reported receipt of interventions (2.1% in 2006 to 10.3% in 2009) and less so for those with interventions (2.4% to 4.7%). This Chinese public health program had positive impacts on both behaviors and disease rate among MSM population. Escalation of the coverage and intensity of effective interventions is needed for further increasing condom use and for reversing the rising trend of HIV epidemic.
Mobley, Connie C; Stadler, Diane D; Staten, Myrlene A; El Ghormli, Laure; Gillis, Bonnie; Hartstein, Jill; Siega-Riz, Anna Maria; Virus, Amy
The HEALTHY primary prevention trial developed an integrated multicomponent intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program (NSLP), and à la carte venues are compared to the experience of control schools. The intervention was implemented in 21 middle schools from winter 2007 through spring 2009 (following a cohort of students from sixth through eighth grades); 21 schools acted as observed controls. The nutrition component targeted school food service environmental change. Data identifying foods and nutrients served (selected by students for consumption) were collected over a 20-day period at baseline and end of study. Analysis compared end of study values for intervention versus control schools. Intervention schools more successfully limited dessert and snack food portion size in NSLP and à la carte and lowered fat content of foods served. Servings of high-fiber grain-based foods and/or legumes were improved in SBP but not NSLP. Intervention and control schools eliminated >1% fat milk and added-sugar beverages in SBP, but intervention schools were more successful in NSLP and à la carte. The HEALTHY program demonstrated significant changes in the nutritional quality of foods and beverages served in the SBP, NSLP, and à la carte venues, as part of an effort to decrease childhood obesity and support beneficial effects in some secondary HEALTHY study outcomes. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.
Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine
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.
Effectiveness of a transdiagnostic individually tailored Internet-based and mobile-supported intervention for the indicated prevention of depression and anxiety (ICare Prevent) in Dutch college students: study protocol for a randomised controlled trial.
Bolinski, Felix; Kleiboer, Annet; Karyotaki, Eirini; Bosmans, Judith E; Zarski, Anna-Carlotta; Weisel, Kiona K; Ebert, David D; Jacobi, Corinna; Cuijpers, Pim; Riper, Heleen
Depression and anxiety are common and co-morbid disorders that affect a significant proportion of students. Innovative prevention strategies targeting both conditions are needed to reduce their health burden and costs. ICare Prevent is such an innovative strategy and contains a transdiagnostic individually tailored Internet-based and mobile-supported intervention. It addresses common risk factors of depression and anxiety as part of a large EU-funded multi-country project* (ICare). Little is known about the clinical and cost-effectiveness of this type of intervention compared to care as usual (CAU) for college students. We hypothesize that ICare Prevent will be more (cost-)effective than CAU in the reduction of symptoms of depression and anxiety. A three-arm, parallel, randomized controlled superiority trial will be conducted comparing a guided and an unguided version of ICare Prevent with a control group receiving CAU. The trial will be open-label but outcome assessors will be blinded. A total of 252 college students (age ≥ 16 years) with subclinical symptoms of depression defined as a score ≥ 16 on the Center for Epidemiological Studies Depression Scale (CES-D), and/or anxiety, defined as a score ≥ 5 on the Generalized Anxiety Disorder scale (GAD-7), will be included. Those meeting diagnostic criteria for a depressive or anxiety disorder will be excluded. The primary outcome is change in disorder specific symptom severity from baseline to post-intervention. Secondary endpoints include self-reported depression and anxiety symptoms as well as time to onset of a mood or anxiety disorder until 12-month follow-up. Societal costs and quality of life will be assessed to estimate the intervention's cost-effectiveness compared to CAU. Transdiagnostic individually tailored Internet-based prevention could be a (cost-)effective approach to tackle the disease burden of depression and anxiety among college students. Dutch trial register, NTR 6562
Fatemehsadat Seyed Nematollah Roshan
Results: At baseline, independent T-test showed no significant difference between the two groups in the perceived susceptibility, perceived severity, and self efficacy, all of which could be regarded as empowerment process components (P>0.05. However, significant differences were observed after intervention. Also, the paired T-test showed a significant difference before and after the intervention in the test group in means of the perceived susceptibility, perceived severity, self efficacy and, in the grand scheme, adolescent girls' empowerment (P
Grock, Shira; Ku, Jeong-Hee; Kim, Julie; Moin, Tannaz
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.
Haire-Joshu, Debra; Tabak, Rachel
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.
Lipscomb, Hester J; Nolan, James; Patterson, Dennis; Dement, John M
Nail guns are responsible for a significant injury burden in residential construction. Risk, based on hours of work, is particularly high among apprentice carpenters due in part to more frequent exposure to tool use. Nail gun injuries were evaluated over 3 years among carpenters enrolled in two apprenticeship programs in the Midwest (2.3 million residential work hours observed) following initiation of training and a voluntary ANSI standard change calling for safer sequential triggers on framing nailers. Injury rates, based on hours of tool use, were calculated yearly. Rates and adjusted rate ratios were calculated with Poisson regression. Attributable risk percent (AR%) and population attributable risk (PAR%) were calculated yearly for modifiable independent risk factors for injury including lack of training in tool use and type of trigger mechanism on tools being used. As apprentices received training and safer trigger mechanisms became more widespread, injury rates decreased significantly (31%). While school training and hands-on mentoring were both important, injury rates were lowest among apprentices who received both. Although injury rates changed over the observation period, the relative risk comparing trigger mechanisms did not; contact trip triggers consistently carried a twofold risk. Although training and safer trigger use both increased, because of the relative prevalence of training and trigger exposures in this population, the engineering solution consistently had the potential to make more difference in population risk. Our findings demonstrate the utility of observational methods including measures of population-based risk in monitoring intervention effectiveness and making recommendations that lead to injury reduction. Published 2008 Wiley-Liss, Inc.
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.
A notable feature of Australian drug policy is the limited public and professional attention given to the financial costs of drug abuse and to the levels and patterns of government expenditures incurred in preventing and responding to this. Since 1991, Collins and Lapsley have published scholarly reports documenting the social costs of drug abuse in Australia and their reports also contain estimates of governments' drug budgets: revenue and expenditures. They show that, in 2004-2005, Australian governments expended at least $5288 million on drug abuse, with 50% of the expenditure directed to preventing and dealing with alcohol-related problems, 45% to illicit drugs and just 5% to tobacco. Some 60% of the expenditure was directed at drug crime and 37% at health interventions. This pattern of resource allocation does not adequately reflect an evidence-informed policy orientation in that it largely fails to focus on the drug types that are the sources of the most harm (tobacco and alcohol rather than illicit drugs), and the sectors for which we have the strongest evidence of the cost-effectiveness of the available interventions (treatment and harm reduction rather than legislation and law enforcement). The 2010-2014 phase of Australia's National Drug Strategy should include incremental changes to the resource allocation mix, and not simply maintain the historical resource allocation formulae. © 2010 Australasian Professional Society on Alcohol and other Drugs.
Karol l. Kumpfer
Full Text Available Introduction. There is a need forwide-scale dissemination of effective family-focused skills trainingprograms for the prevention of multiple developmental problems and later substance misuse amonghigh-risk children. Independent reviews have found the author’s Strengthening Families Program (SFP tobe the most effective substance abuse prevention intervention. Cultural adaptations have resulted in successful SFP outcomes in many countries, including in Spain as detailed in the Orte article. This article reviews 30 year history of implementation and outcomes of SFP in different cultures with cultural adaptations. Methods: The SEM-tested Social Ecology Model (Kumpfer, Alvarado, &Whiteside, 2003 is presented and reveals that family factors (bonding, supervision, and communication are the most protective of later substanceuse.Hence, this causal theory served as the etiological theory behind the design of the 14-session SFP.Social cognitive behavior theory (Bandura, 1989 is the intervention theory. The Strengthening Families Program(SFP was the first family skills training program developed and found effective in a randomized control trial (RCT to improve outcomes for children of dug abusers.Many countries requested to replicate SFP; hence, staff training systems were developed and a cultural adaptation process. Results: Eight RCTs, four conducted by independent research teams, and hundreds of quasi-experimental studies in different countrieshave demonstrated SFP’s effectiveness in reducing substance use in adolescents with up to 10-yearfollow-ups. Comparative effectiveness reviews including ones using statistical meta-analysis by theOxford University Cochrane Collaboration Reviews, found SFP to be the most effective alcohol and drug prevention program (Foxcroft, et al., 2003. A cost-benefit analysis by Miller and Hendrie (2008 found SFP prevented the highest percentage of youth from using alcohol and drugs. Cultural adaptation is a mandated
Full Text Available Abstract Background Cardiovascular disease (CVD is the primary cause of mortality and morbidity in Argentina representing 34.2% of deaths and 12.6% of potential years of life lost (PYLL. The aim of the study was to estimate the burden of acute coronary heart disease (CHD and stroke and the cost-effectiveness of preventative population-based and clinical interventions. Methods An epidemiological model was built incorporating prevalence and distribution of high blood pressure, high cholesterol, hyperglycemia, overweight and obesity, smoking, and physical inactivity, obtained from the Argentine Survey of Risk Factors dataset. Population Attributable Fraction (PAF of each risk factor was estimated using relative risks from international sources. Total fatal and non-fatal events, PYLL and Disability Adjusted Life Years (DALY were estimated. Costs of event were calculated from local utilization databases and expressed in international dollars (I$. Incremental cost-effectiveness ratios (ICER were estimated for six interventions: reducing salt in bread, mass media campaign to promote tobacco cessation, pharmacological therapy of high blood pressure, pharmacological therapy of high cholesterol, tobacco cessation therapy with bupropion, and a multidrug strategy for people with an estimated absolute risk > 20% in 10 years. Results An estimated total of 611,635 DALY was lost due to acute CHD and stroke for 2005. Modifiable risk factors explained 71.1% of DALY and more than 80% of events. Two interventions were cost-saving: lowering salt intake in the population through reducing salt in bread and multidrug therapy targeted to persons with an absolute risk above 20% in 10 years; three interventions had very acceptable ICERs: drug therapy for high blood pressure in hypertensive patients not yet undergoing treatment (I$ 2,908 per DALY saved, mass media campaign to promote tobacco cessation amongst smokers (I$ 3,186 per DALY saved, and lowering cholesterol with
Kynoch, Kate; Wu, Chiung-Jung Jo; Chang, Anne M
Violence in healthcare has been widely reported and healthcare workers, particularly nurses in the acute care setting, are ill-equipped to manage patients who exhibit aggressive traits. An initial search of the Cochrane Library and the Joanna Briggs Institute did not reveal any published systematic reviews recommending strategies to manage aggressive and/or violent behaviours in patients admitted to an acute hospital setting. This systematic review aims to establish best practice in the prevention and management of aggressive behaviours in patients admitted to an acute hospital setting. A three-step search strategy was utilised during this review. Major databases searched included: MEDLINE, CINAHL, PsycINFO, Health source, Web of science, EMBASE, the Cochrane library and Database of abstracts of reviews of effects (DARE) as well as PubMed. The search included published and unpublished studies and papers in English from 1990-2007. This review considered any randomised controlled trials (RCT) that evaluated the effectiveness of interventions in the prevention and management of patients who exhibit aggressive behaviours in an acute hospital setting. In the absence of RCT's, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion in the narrative summary to enable the identification of current approaches and possible future strategies for preventing and managing patient aggression in acute care areas. Each included study was assessed by two independent reviewers using the appropriate appraisal checklist developed by the Joanna Briggs Institute. Data was extracted from the papers included in this review using the standardised data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics: Assessment and Review Instrument (JBI-MAStARI) package. The studies included in this review were not suitable for meta-analysis and therefore the results are presented in narrative form. Twelve
Daniels, Joseph; Komárek, Arnošt; Makusha, Tawanda; Van Heerden, Alastair; Gray, Glenda; Chingono, Alfred; Mbwambo, Jessie K K; Coates, Thomas; Richter, Linda
There is increased focus on HIV prevention with African men who report experiencing childhood sexual (CSA) or physical abuse (CPA). To better understand the effects of a community-based intervention (Project Accept HPTN 043) on HIV prevention behaviors among men who report CSA or CPA experiences. Project Accept compared a community-based voluntary mobile counseling and testing (CBVCT) intervention with standard VCT. The intervention employed individual HIV risk reduction planning with motivational interviewing in 34 African communities (16 communities at 2 sites in South Africa, 10 in Tanzania, and 8 in Zimbabwe). Communities were randomized unblinded in matched pairs to CBVCT or SVCT, delivered over 36 months. The post-intervention assessment was conducted using a single, cross-sectional random survey of 18-32 year-old community members (total N = 43,292). We analyzed the effect of the intervention on men with reported CSA or CPA across the African sites. Men were identified with a survey question asking about having experienced CSA or CPA across the lifespan. The effect of intervention on considered outcomes of the preventive behavior was statistically evaluated using the logistic regression models. Across the sites, the rates of CSA or CPA among men indicated that African men reflected the global prevalence (20%) with a range of 13-24%. The statistically significant effect of the intervention among these men was seen in their increased effort to receive their HIV test results (OR 2.71; CI: (1.08, 6.82); P: 0.034). The intervention effect on the other designated HIV prevention behaviors was less pronounced. The effect of the intervention on these men showed increased motivation to receive their HIV test results. However, more research is needed to understand the effects of community-based interventions on this group, and such interventions need to integrate other keys predictors of HIV including trauma, coping strategies, and intimate partner violence.
Full Text Available There is increased focus on HIV prevention with African men who report experiencing childhood sexual (CSA or physical abuse (CPA.To better understand the effects of a community-based intervention (Project Accept HPTN 043 on HIV prevention behaviors among men who report CSA or CPA experiences.Project Accept compared a community-based voluntary mobile counseling and testing (CBVCT intervention with standard VCT. The intervention employed individual HIV risk reduction planning with motivational interviewing in 34 African communities (16 communities at 2 sites in South Africa, 10 in Tanzania, and 8 in Zimbabwe. Communities were randomized unblinded in matched pairs to CBVCT or SVCT, delivered over 36 months. The post-intervention assessment was conducted using a single, cross-sectional random survey of 18-32 year-old community members (total N = 43,292. We analyzed the effect of the intervention on men with reported CSA or CPA across the African sites. Men were identified with a survey question asking about having experienced CSA or CPA across the lifespan. The effect of intervention on considered outcomes of the preventive behavior was statistically evaluated using the logistic regression models.Across the sites, the rates of CSA or CPA among men indicated that African men reflected the global prevalence (20% with a range of 13-24%. The statistically significant effect of the intervention among these men was seen in their increased effort to receive their HIV test results (OR 2.71; CI: (1.08, 6.82; P: 0.034. The intervention effect on the other designated HIV prevention behaviors was less pronounced.The effect of the intervention on these men showed increased motivation to receive their HIV test results. However, more research is needed to understand the effects of community-based interventions on this group, and such interventions need to integrate other keys predictors of HIV including trauma, coping strategies, and intimate partner violence.
Espada, José P.; Gonzálvez, María T.; Guillén-Riquelme, Alejandro; Sun, Ping; Sussman, Steve
Tobacco use is of high prevalence among Spanish adolescents. Programming to counteract tobacco use has been needed. There is a lack of knowledge on the efficacy of teen tobacco use cessation programming. The current study provides an immediate outcome evaluation of the Project EX tobacco use prevention and cessation program among Spanish…
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
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.
de Vries, L.A.
Evidence-based interventions are crucial for preventing that at-risk youth will develop a persistent criminal carreer. This dissertation includes a meta-analysis of the effectiveness of youth crime prevention, and an evaluation of the Dutch youth intervention ‘New Perspectives’ (NP). At-risk youth
Christofferson, Dana E; Hamlett-Berry, Kim; Augustson, Erik
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.
Fianu, Adrian; Bourse, Léa; Naty, Nadège; Le Moullec, Nathalie; Lepage, Benoît; Lang, Thierry; Favier, François
In type 2 diabetes (T2D) prevention research, evidence for maintenance of risk factor reduction after three years of follow-up is needed. The objective of this study was to evaluate the long-term effectiveness of a combined lifestyle intervention aiming at controlling body weight (BW) and waist circumference (WC) in non-diabetic, overweight/obese adults living in a low socio-economic community. On Reunion Island, 445 adults living in deprived areas, aged 18–40 and at high-risk for T2D, were included in an intervention versus control trial for primary prevention (2001–2002). The intervention promoted a healthy diet and moderate regular physical activity, through actions strengthening individuals or community and improving living conditions. The control group received a one-shot medical information and nutritional advices. After the end of the trial (2003), 259 of the subjects participated in a follow-up study (2010–2011). The outcomes were the nine-year changes from baseline in BW, body mass index (BMI) and WC measurements, separately. Statistical analyses were performed on an intention-to-treat basis, using available and imputed datasets. At inclusion, T2D risk factors were prevalent: family history of diabetes in first-degree relatives (42%), women with a personal history of gestational diabetes (11%), total obesity (43%, median BMI 29.1 kg/m²) and central obesity (71%). At follow-up, the adjusted effect on imputed dataset was significant for WC -2.4 cm (95% confidence interval: -4.7 to -0.0 cm, p = 0.046), non-significant for BW -2.2 kg (-4.6 to +0.2 kg, p = 0.073) and BMI -0.81 kg/m² (-1.69 to +0.08 kg/m², p = 0.074). A specific long-term effect was the increased likelihood of reduction in adiposity: BW loss, BMI reduction, and WC reduction were more frequent in the intervention group. In the context of low socio-economic communities, our data support the assumption of long-term effect of lifestyle interventions targeting total obesity and central
Vassall, Anna; Chandrashekar, Sudhashree; Pickles, Michael; Beattie, Tara S.; Shetty, Govindraj; Bhattacharjee, Parinita; Boily, Marie-Claude; Vickerman, Peter; Bradley, Janet; Alary, Michel; Moses, Stephen; Watts, Charlotte
Background Most HIV prevention for female sex workers (FSWs) focuses on individual behaviour change involving peer educators, condom promotion and the provision of sexual health services. However, there is a growing recognition of the need to address broader societal, contextual and structural factors contributing to FSW risk behaviour. We assess the cost-effectiveness of adding community mobilisation (CM) and empowerment interventions (eg. community mobilisation, community involvement in programme management and services, violence reduction, and addressing legal policies and police practices), to core HIV prevention services delivered as part of Avahan in two districts (Bellary and Belgaum) of Karnataka state, Southern India. Methods An ingredients approach was used to estimate economic costs in US$ 2011 from an HIV programme perspective of CM and empowerment interventions over a seven year period (2004–2011). Incremental impact, in terms of HIV infections averted, was estimated using a two-stage process. An ‘exposure analysis’ explored whether exposure to CM was associated with FSW’s empowerment, risk behaviours and HIV/STI prevalence. Pathway analyses were then used to estimate the extent to which behaviour change may be attributable to CM and to inform a dynamic HIV transmission model. Findings The incremental costs of CM and empowerment were US$ 307,711 in Belgaum and US$ 592,903 in Bellary over seven years (2004–2011). Over a 7-year period (2004–2011) the mean (standard deviation, sd.) number of HIV infections averted through CM and empowerment is estimated to be 1257 (308) in Belgaum and 2775 (1260) in Bellary. This translates in a mean (sd.) incremental cost per disability adjusted life year (DALY) averted of US$ 14.12 (3.68) in Belgaum and US$ 13.48 (6.80) for Bellary - well below the World Health Organisation recommended willingness to pay threshold for India. When savings from ART are taken into account, investments in CM and empowerment are
Tonani,Marcela; Carvalho,Emilia Campos de
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...
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.
Krossbakken, Elfrid; Torsheim, Torbjørn; Mentzoni, Rune Aune; King, Daniel Luke; Bjorvatn, Bjørn; Lorvik, Ingjerd Meen; Pallesen, Ståle
Background and aims Excessive use of video games among children and adolescents is a growing concern. The aim of this study was to investigate the effectiveness of a brief parental guide with advices and strategies for regulating video gaming in children. Methods A random sample of guardians of children between the age of 8-12 years old (N = 5,864) was drawn from the Norwegian Population Registry and equally randomized into an intervention and a control condition. A parental guide based on clinical and research literature was distributed by postal mail to those in the intervention condition. A 4-month follow-up survey comprising questions about problematic video gaming, gaming behavior, sleep activity, and parental video game regulation behavior was administered. Results Independent t-tests revealed no significant differences between the two conditions (N = 1,657, response rate 30.1%) on any outcome measure. An ANOVA with planned comparisons showed that respondents who reported that they had read and followed the parental guide reported more video game problems and used more parental mediation strategies than those who did not read and follow the guide. Conclusions We found no evidence for the effectiveness of the psychoeducational parental guide on preventing problematic video gaming in children. However, the guide was read and positively assessed by a significant proportion of guardians. Differences between those who studied the guide and those who did not may indicate that parental guides are better aimed at providing important information to those who already have problems rather than as a mean of primary prevention.
Full Text Available Objectives. Despite the availability of services to prevent mother-to-child transmission (PMTCT of HIV, socio-cultural, health system and operational factors constrain many pregnant women from accessing services or returning for followup thereby increasing the risk of vertical transmission of HIV to newborns. We highlight and describe unique contextual factors contributing to low utilization of PMTCT services in Arba-Minch, Ethiopia. Methods. Qualitative research design was utilized to obtain data through focus group discussions and in-depth interviews with antenatal clinic attendees, health workers health facilities in the study area. Results. Awareness of PMTCT services and knowledge of its benefits was nearly universal, although socioeconomic, cultural and health system factors, including stigma and desire to prevent knowledge of serostatus, impede access to and utilization of services. Health system factors—lack of appropriate followup mechanisms, inadequate access to ARV drugs and poorly equipped manpower also contribute to low utilization of services. Conclusion. Reducing mother-to-child transmission of HIV in sub-Saharan Africa will be more effective when unique contextual factors are identified and addressed. Effectiveness of PMTCT interventions rests on a well functioning health system that recognize the importance of social, economic, cultural contexts that HIV positive pregnant women live in.
Sagarra, R; Costa, B; Cabré, J J; Solà-Morales, O; Barrio, F
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.
Kelders, Saskia Marion; Oskam, Maarten-Jan; Bohlmeijer, Ernst Thomas; van Gemert-Pijnen, Julia E.W.C.
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.
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.
Bak, Jesper; Brandt-Christensen, Anne Mette; Sestoft, Dorte Maria
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....
Krishnaratne, Shari; Hensen, Bernadette; Cordes, Jillian; Enstone, Joanne; Hargreaves, James R
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
Moessner, Markus; Minarik, Carla; Ozer, Fikret; Bauer, Stephanie
Only little is known about costs and effects (i.e., success) of dissemination strategies, although cost-effective dissemination strategies are crucial for the transfer of interventions into routine care. This study investigates the effects and cost-effectiveness of five school-based dissemination strategies for an Internet-based intervention for the prevention and early intervention of eating disorders. Three-hundred ninety-five schools were randomly assigned to one of five dissemination strategies. Strategies varied with respect to intensity from only sending advertisement materials and asking the school to distribute them among students to organizing presentations and workshops at schools. Effects were defined as the number of page visits, the number of screenings conducted, and the number of registrations to the Internet-based intervention. More expensive strategies proved to be more cost-effective. Cost per page visit ranged from 2.83€ (introductory presentation plus workshop) to 20.37€ (dissemination by student representatives/peers). Costs per screening ranged from 3.30€ (introductory presentation plus workshop) to 75.66€ (dissemination by student representatives/peers), and costs per registration ranged from 6.86€ (introductory presentation plus workshop) to 431.10€ (advertisement materials only). Dissemination of an Internet-based intervention for prevention and early intervention is challenging and expensive. More intense, expensive strategies with personal contact proved to be more cost-effective. The combination of an introductory presentation on eating disorders and a workshop in the high school was most effective and had the best cost-effectiveness ratio. The sole distribution of advertisement materials attracted hardly any participants to the Internet-based program.
Bayliss, Susan E; Davenport, Clare F; Pennant, Mary E
This case study documents the experience of searching for information on the effectiveness of population-level multi-factor interventions for the prevention of cardiovascular disease (CVD) to inform guidance from NICE (National Institute for Health and Care Excellence). To compare suitability of different databases for searches on a medical public health topic and performance of sensitive versus specific strategies. A sensitive search strategy identified 34 CVD programmes (reference standard) and sensitivity, precision and number needed to read (NNTR) were compared across seven databases. Two alternative strategies were developed to improve precision while minimising the impact on sensitivity. MEDLINE alone retrieved 91% (31/34) relevant programme citations. Four databases (MEDLINE, CENTRAL, ASSIA and PsycINFO) were required to identify all 34 programmes. In the alternative strategies, greater use of MeSH rather than text and focus on terms directed at population-level interventions resulted in a more precise search on MEDLINE. MEDLINE alone provided a better yield than anticipated. Additional databases improved sensitivity by 9% but to the detriment of precision. Retrospective searching would provide additional insight into the performance of both databases and strategies. How the medical nature of this public health topic affected yield across databases also requires further investigation. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Journal.
Full Text Available Objective: The aim of this study was the Study of effectiveness of Marlaat’s cognitive behavior intervention and group treatment based on change stages for recovery and relapse rates in male heroin crack addictions. Method: In a experimental research design, 45 men addictions, who were diagnosed as the dependence of the heroin crack on the basis of DSM-IV-TR criteria, were chosen after successfully detoxified. They were divided two experimental groups (30 participants and a control group (15 participants that have been selected by random sampling. The first experimental group was undergone group treatment based on change stages underwent 16 sessions of 1.5 hours, totally 24 hours and the second experimental groups who were undergone Marlaat’s cognitive behavior intervention has been held 15 sessions of 2 hours, totally 24 hours. The control group were just received MMT without any psychotherapy. All participants were assessed by structured interview, urine test, before treatment, after treatment and after 3 months follow up. Results: Results showed that both psychotherapy treatments were affected on recovery and relapse rates. Conclusion: It seems that psychological problems and conflicts before addiction and after addiction could be caused for individuals’ tendency to narcotics consumption. Therefore, applying of psychotherapy could be useful in relapse prevention.
Shepherd, J; Kavanagh, J; Picot, J; Cooper, K; Harden, A; Barnett-Page, E; Jones, J; Clegg, A; Hartwell, D; Frampton, G K; Price, A
To assess the effectiveness and cost-effectiveness of schools-based skills-building behavioural interventions to encourage young people to adopt and maintain safer sexual behaviour and to prevent them from acquiring sexually transmitted infections (STIs). Electronic bibliographic databases (e.g. MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, CINAHL, PsycINFO, CCRCT, NHS EED and DARE) were searched for the period 1985 to March 2008. Bibliographies of systematic reviews and related papers were screened and experts contacted to identify additional published and unpublished references. A systematic review of effectiveness and economic evaluation of cost-effectiveness were carried out. A descriptive map of studies that met inclusion criteria was produced, and keywords were developed and systematically applied to these studies to identify a policy-relevant subset of studies for the systematic review. Outcome data for variables including sexual behaviour were extracted. An economic model was developed to compare the costs and consequences of the behavioural interventions. A Bernoulli statistical model was constructed to describe the probability of STI infection. There were few significant differences between the interventions and comparators in terms of changes in sexual behaviour outcomes, although there were some significant differences for knowledge and some measures of self-efficacy. The studies included in this review conducted relatively short follow-up assessments at a time when many young people were becoming sexually active. It is therefore possible that favourable behaviour change may have occurred, and become more cost-effective, with time, as sexual activity becomes more routine in young people's lives. The quality of the intervention provider influenced whether or not young people found the interventions to be acceptable and engaging; enthusiasm and considerable expertise were important for effective class management and delivery of skills
Slater, Amy; Bowen, Jane; Corsini, Nadia; Gardner, Claire; Golley, Rebecca; Noakes, Manny
To identify parents' concerns and attitudes towards children's diets, activity habits and weight status. Computer-assisted telephone interviewing administration of a 37-item survey. Data were weighted for parental education level. Descriptive results are presented, and comparisons are made by the age, gender and parental characteristics of the child. Online research panel of Australian parents. A total of 1202 randomly selected parents of children aged 2-16 years, broadly representative of the Australian population. Parents were concerned about their child's education (reported by 35 % of respondents), child's health and well-being (25 %), and violence, drugs and alcohol (20 %). Concern about nutrition was indicated by 14 % of respondents and concern about fitness/exercise was indicated by 3 % of the sample. Factors perceived as making a healthy diet difficult to achieve for their child were child resistance (89 %), the availability of healthy food (72 %), a busy lifestyle (67 %) and the influence of food advertising (63 %). Ninety-two per cent of parents thought that it was realistic for their child to be active for at least 1 h/d, with 75 % of parents feeling that it was realistic for their child to have less than 2 h recreational screen time per d. Despite this, common barriers to achieving the activity guidelines were lack of time, weather and keeping children occupied. Insights into parental concerns from the current study may be useful in guiding development of interventions to improve children's nutrition and physical activity habits by framing messages in a way that are most likely to resonate with parents.
Snoeijs, S.P.; Boerma, W.G.W.; Baltag, V.; Schellevis, F.G.
Background: Organising effective responses to the growing problem of noncommunicable diseases (NCD) is among the biggest challenges of (primary) health care systems. In particular tackling, cardiovascular diseases (CVDs) and diabetes mellitus type 2 (DM2) requires coordinated approaches close to
Mobley, Connie C.; Stadler, Diane D.; Staten, Myrlene A.; El Ghormli, Laure; Gillis, Bonnie; Hartstein, Jill; Siega-Riz, Anna Maria; Virus, Amy
Background: The HEALTHY primary prevention trial developed an integrated multicomponent intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program…
Bacchieri, Giancarlo; Barros, Aluísio J D; Santos, Janaína V dos; Gonçalves, Helen; Gigante, Denise P
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.
Full Text Available Background. Early retirement of teachers due to burnout is frequent in Germany. In this study short- and medium-term effects of AFA breathing therapy were evaluated. Methods. This study was designed as a longitudinal controlled intervention design with four points of measurements: before assessment (T1, after intervention (T2, three months (follow up 1 (T3 after intervention, and six months (follow up 2 after intervention (T4. The intervention lasted a total of 11 weeks (weekly group therapy for eight weeks and three weeks of individual breathing session. The effects of intervention were measured with the questionnaire “work-related behaviour and experience Patterns” (AVEM at four times. Results. In the intervention group 64 teachers and in the self-selected control group 27 teachers were included. The AVEM scales “subjective significance of work” and “professional ambition” changed over time and within both groups (interaction effect. Significant improvements over the four measurements were observed in the intervention group in two AVEM scales: “emotional distancing” (F=6.3; P<0.01 and “balance and mental stability” (F=4.4; P<0.02. Conclusions. AFA breathing therapy showed short- and medium-term effects in the intervention group over four points of measurements. It may be assumed that breath therapy supports teachers in resisting occupational demand.
Owczarzak, Jill; Dickson-Gomez, Julia
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…
Pratt, B M; Woolfenden, S R
/or electronic mail. Randomised controlled trials (RCT) with a major focus on eating disorder prevention programs for children and adolescents, where there is no known DSM-IV diagnosis of an eating disorder, are eligible for inclusion in the review. Trials must include a control group and at least one objective outcome measure (eg. BMI) or a standardised psychological measure used with the intervention and control group, pre- and post-intervention. A total of 1379 titles have been identified through the search to date. 13 studies were located that reported use of a randomised controlled trial methodology and were critically appraised by two independent reviewers. Five (5) studies were excluded as data were not reported in a useable form or useable data could not be obtained from the trial authors, one dissertation could not be obtained, one study had no "true" no-treatment or usual treatment control group, and one study did not use a pre-test outcome measure. Eight (8) studies met the selection criteria outlined above. Only one of eight pooled comparisons of two or more studies using similar outcome measures and similar intervention types demonstrated the statistically significant effect of a particular type of eating disorder prevention program for children and adolescents. Combined data from two eating disorder prevention programs based on a media literacy and advocacy approach indicate a reduction in the internalisation or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (Kusel, unpublished; Neumark-Sztainer2000) [SMD -0.28, -0.51 to -0.05, 95% CI]. However, there is insufficient evidence to conclude that this approach also demonstrated a significant impact on awareness of societal standards relating to appearance. There is insufficient evidence to support the effect of four programs designed to address eating attitudes and behaviours and other adolescent issues on body weight, eating disorder symptoms, associated eating disorder
To be effective, a medical intervention must improve one's health by targeting a disease. The concept of disease, though, is controversial. Among the leading accounts of disease-naturalism, normativism, hybridism, and eliminativism-I defend a version of hybridism. A hybrid account of disease holds that for a state to be a disease that state must both (i) have a constitutive causal basis and (ii) cause harm. The dual requirement of hybridism entails that a medical intervention, to be deemed effective, must target either the constitutive causal basis of a disease or the harms caused by the disease (or ideally both). This provides a theoretical underpinning to the two principle aims of medical treatment: care and cure. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gillen, Patricia A; Sinclair, Marlene; Kernohan, W George; Begley, Cecily M; Luyben, Ans G
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
Sweat, Michael; Kerrigan, Deanna; Moreno, Luis; Rosario, Santo; Gomez, Bayardo; Jerez, Hector; Weiss, Ellen; Barrington, Clare
Behavior change communication often focuses on individual-level variables such as knowledge, perceived risk, self-efficacy, and behavior. A growing body of evidence suggests, however, that structural interventions to change the policy environment and environmental interventions designed to modify the physical and social environment further bolster impact. Little is known about the cost-effectiveness of such comprehensive intervention programs. In this study we use standard cost analysis methods to examine the incremental cost-effectiveness of two such interventions conducted in the Dominican Republic in sex establishments. In Santo Domingo the intervention was environmental; in Puerto Plata it was both environmental and structural (levying financial sanctions on sex establishment owners who failed to follow the intervention). The interventions in both sites included elements found in more conventional behavior change communication (BCC) programs (e.g., community mobilization, peer education, educational materials, promotional stickers). One key aim was to examine whether the addition of policy regulation was cost-effective. Data for the analysis were gleaned from structured behavioral questionnaires administered to female sex workers and their male regular paying partners in 41 sex establishments conducted pre- and post-intervention (1 year follow-up); data from HIV sentinel surveillance, STI screening results conducted for the intervention; and detailed cost data we collected. We estimated the number of HIV infections averted from each of the two intervention models and converted these estimates to the number of disability life years saved as compared with no intervention. One-way, two-way, three-way, and multivariate sensitivity analysis were conducted on model parameters. We examine a discount rate of 0%, 3% (base case), and 6% for future costs and benefits. The intervention conducted in Santo Domingo (community mobilization, promotional media, and interpersonal
Effectiveness of an implementation optimisation intervention aimed at increasing parent engagement in HENRY, a childhood obesity prevention programme - the Optimising Family Engagement in HENRY (OFTEN) trial: study protocol for a randomised controlled trial.
Bryant, Maria; Burton, Wendy; Cundill, Bonnie; Farrin, Amanda J; Nixon, Jane; Stevens, June; Roberts, Kim; Foy, Robbie; Rutter, Harry; Hartley, Suzanne; Tubeuf, Sandy; Collinson, Michelle; Brown, Julia
Family-based interventions to prevent childhood obesity depend upon parents' taking action to improve diet and other lifestyle behaviours in their families. Programmes that attract and retain high numbers of parents provide an enhanced opportunity to improve public health and are also likely to be more cost-effective than those that do not. We have developed a theory-informed optimisation intervention to promote parent engagement within an existing childhood obesity prevention group programme, HENRY (Health Exercise Nutrition for the Really Young). Here, we describe a proposal to evaluate the effectiveness of this optimisation intervention in regard to the engagement of parents and cost-effectiveness. The Optimising Family Engagement in HENRY (OFTEN) trial is a cluster randomised controlled trial being conducted across 24 local authorities (approximately 144 children's centres) which currently deliver HENRY programmes. The primary outcome will be parental enrolment and attendance at the HENRY programme, assessed using routinely collected process data. Cost-effectiveness will be presented in terms of primary outcomes using acceptability curves and through eliciting the willingness to pay for the optimisation from HENRY commissioners. Secondary outcomes include the longitudinal impact of the optimisation, parent-reported infant intake of fruits and vegetables (as a proxy to compliance) and other parent-reported family habits and lifestyle. This innovative trial will provide evidence on the implementation of a theory-informed optimisation intervention to promote parent engagement in HENRY, a community-based childhood obesity prevention programme. The findings will be generalisable to other interventions delivered to parents in other community-based environments. This research meets the expressed needs of commissioners, children's centres and parents to optimise the potential impact that HENRY has on obesity prevention. A subsequent cluster randomised controlled pilot
Our purpose was to test whether interventions based on theory, multiple theories, or a formal planning process were more effective in changing fruit and vegetable (FV) consumption among children than interventions with no behavioral theoretical foundation or no formal planning. The authors conducted...
Tso, Lai Sze; Tang, Weiming; Li, Haochu; Yan, H Yanna; Tucker, Joseph D
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.
Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina
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
Walker, Dilys; Gutierrez, Juan Pablo; Torres, Pilar; Bertozzi, Stefano M
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.
Morales, Eduardo S
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
van Holland, Berry J; Soer, Remko; de Boer, Michiel R; Reneman, Michiel F; Brouwer, Sandra
To investigate the effectiveness of occupational health interventions in the meat processing industry on work and health-related outcomes. A systematic literature review was performed. PubMed, Embase, and The Cochrane Library were searched. Studies were included when they reported on an intervention among employees in the meat processing industry and with outcomes related to work or health. Studies were assessed on risk of bias, and data were synthesized by type of intervention. A total of 13 articles reporting on two randomized controlled trials and nine non-randomized intervention studies were retrieved. Studies were categorized into three topics: ergonomics programs, skin protection, and Q fever vaccination. All studies had high risk of bias. Based on four studies, there was limited evidence for workplace health and safety programs showing reductions in musculoskeletal injury severity, reduction of lost work days, and reduction of costs and claims for several musculoskeletal disorders. There was limited evidence for added rest breaks resulting in improved productivity at the end of a workday and in reductions of perceived discomfort in various body regions at the end of the workday. One study on skin protection showed reductions of eczema prevalence, although evidence was moderate. Based on four studies, there was high-quality evidence for strong effectiveness of Q fever vaccination. This review presents evidence for the effectiveness of a variety of workplace interventions. There was limited evidence for effectiveness of ergonomic interventions, moderate evidence of a skin protection intervention, and strong evidence for Q fever vaccination.
Lintvedt, Ove K; Griffiths, Kathleen M; Eisemann, Martin; Waterloo, Knut
Background: Depression is common and treatable with cognitive behavior therapy (CBT), for example. However, access to this therapy is limited. Internet-based interventions have been found to be effective in reducing symptoms of depression. The International Society for Research on Internet Interventions has highlighted the importance of translating effective Internet programs into multiple languages to enable worldwide dissemination. Objective: The aim of the current study was to determine...
EMMA ELISE ROBERTS
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...
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
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
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.
Jahanfar, Shayesteh; Howard, Louise M; Medley, Nancy
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
Full Text Available Kazumi Asakawa1, Katsuhiro Koyama2, Zentaro Yamagata31Department of Fundamental and Clinical Nursing, 2Department of Health and Physical Education, 3Department of Health Science, University of Yamanashi, Chuo, Yamanashi, JapanBackground: The objective of this study was to determine whether or not educational intervention using the Internet, to prevent osteoporosis, is able to increase bone strength in young women.Methods: Subjects were 253 healthy female university and junior college students aged 18–25 years. After initial measurements of bone stiffness index, a bone formation marker, and a bone absorption marker, the minimization method was used to allocate the subjects to an intervention group (n = 126 or a control group (n = 127 according to whether the measurements were above or below average. Subjects in the intervention group were instructed to perform osteoporosis prevention activities, ie, jump on the spot as high as possible ten times per day and increase calcium intake by 300 mg per day to a total of 800 mg or more per day on average. In addition, they were instructed to report the implementation status of the recommended measures via email. The researcher sent out information on osteoporosis and preventive behaviors to the subjects five times via email.Results: A total of 182 subjects, comprising 87 (69.0% in the intervention group and 95 (74.8% in the control group, underwent remeasurement 6 months later. Of the subjects in the intervention group, 54 (42.9% reported their daily additional calcium intake amount and number of jumps via email. The mean amount of additional calcium taken was 216.3 ± 85.9 mg per day, and mean number of jumps performed was 6.4 ± 4.2 per day. Subjects in the intervention group were further divided into an implementation group (n = 54, consisting of subjects who sent in reports and a nonimplementation group (n = 72 who did not. No significant difference was found among the groups for rate of change in
Reilly, John J
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.
Reilly, John J.
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
Saraf, Deepika Singh; Gupta, Sanjeev Kumar; Pandav, Chandrakant S; Nongkinrih, Baridalyne; Kapoor, Suresh Kumar; Pradhan, Shishir Kumar; Krishnan, Anand
To assess the effectiveness of a multi-component school based intervention in improving knowledge and behavioral practices regarding diet, physical activity and tobacco use in middle schoolchildren of rural-Ballabgarh, North-India. A total of 40 middle schools were grouped into two, based on geographic proximity and randomly assigned to the intervention or control group in a cluster randomized controlled trial. The target population consisted of 2,348 children studying in 6th and 7th grades in these schools. The intervention consisted of a school component (policies), a classroom component (activities) and a family component [Information Education & Communication (IEC) material]. The main outcome measures were knowledge and behavioral changes in physical activity, diet and tobacco which were self- reported. Post-intervention, a significant number of intervention schools adopted the tobacco policy (16/19), physical activity policy (6/19) and healthy food policy (14/19) as compared to the control schools (n = 21). Knowledge about physical activity, diet and tobacco improved significantly in the intervention group as compared to the control group. Proportion of students attending Physical Training (PT) classes for five or more days in a week in the intervention group compared to the control group increased significantly (17.8%; p schools is feasible and effective in improving knowledge and behavioral practices of non-communicable diseases (NCD) risk factors in adolescents in rural India.
Sun, Yu; Zhao, Hong
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with substantially elevated risk of adverse health outcomes for both mothers and offspring. This quasi-experimental trial was conducted to assess whether a lifestyle intervention in early pregnancy can reduce the incidence of GDM and excessive gestational weight (GWG) gain among Chinese overweight women. Convenience samples of 74 women in gestational weeks 8-12 with a BMI ≥ 24 kg/m(2) were enrolled. They were divided into intervention (N=37) or control group (N=37) according to the time sequence of seeing the doctor. The intervention group was provided with exercise, dietary, weight gain counseling and detailed plans at weeks 8-12 and every month in the second trimester. In addition, each counseling session included a personalized feedback based on their 5-day-records. Follow-up phone calls or emails were conducted every week between antenatal visits. The control group was just provided with exercise, dietary and weight gain counseling at weeks 8-12, besides the usual health education provided at the O&G outpatient department. The lifestyle intervention resulted in a lower incidence of gestational diabetes in the intervention group (9/32, 28.1%) compared with the control group (19/34, 55.9%), p=0.023. Women in the intervention group gained much less weight (6.86 ± 2.31 versus 10.08 ± 3.84 kg, p=0.000) at the end of second trimester. Lifestyle intervention in early pregnancy can reduce the incidence of GDM and prevent excessive maternal weight gain in overweight and obese pregnant women. Copyright © 2015 Elsevier Inc. All rights reserved.
Khavjou, Olga A.; Bradley, Christina; Neuwahl, Simon; Hoerger, Thomas J.; Bellard, David; Cash, Amanda J.
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
Amirkhanian, Yuri A.; Kelly, Jeffrey A.; Takacs, Judit; McAuliffe, Timothy L.; Kuznetsova, Anna V.; Toth, Tamas P.; Mocsonaki, Laszlo; DiFranceisco, Wayne J.; Meylakhs, Anastasia
Objective To test a novel social network HIV risk reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections. Design A 2-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling. Setting St. Petersburg, Russia and Budapest, Hungary. Participants 18 “seeds” from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen 3-ring sociocentric networks (mean size=35 members, n=626) were recruited. Intervention Empirically-identified network leaders were trained and guided to convey HIV prevention advice to other network members. Main Outcome and Measures Changes in sexual behavior from baseline to 3- and 12-month followup, with composite HIV/STD incidence measured at 12-months to corroborate behavior changes. Results There were significant reductions between baseline, first followup, and second followup in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (P=.04); UAI with a nonmain partner (P=.04); and UAI with multiple partners (P=.002). The mean percentage of unprotected AI acts significantly declined (P=.001), as well as the mean number of UAI acts among men who initially had multiple partners (P=.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks. Conclusions Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks. PMID:25565495
Reed, Monique; Wilbur, JoEllen; Schoeny, Michael
In the U.S., overweight/obesity among African American (AA) girls has become epidemic. Since parental factors may be associated with improved weight status, it is important to understand the empirical evidence for including parents in obesity prevention interventions with AA girls. The purpose of this integrative review was to identify effectiveness and characteristics of obesity prevention interventions for AA girls (6-17 years) and their parent. Included interventions addressed physical activity (PA), dietary/eating behaviors, and body composition. Of 708 studies published through March 2014, eight met inclusion criteria. Though effects were in the intended direction for most, statistically significant effects were found only for dietary intake and eating behavior. Interventions were characterized by exclusion of girls ages 13-17, failure to link parent involvement to child outcomes, the absence of family systems theory, and modest effects. Further research is needed to ascertain the effectiveness of daughter/parent obesity prevention interventions.
Arshad, Ahmed; Salam, Rehana A; Lassi, Zohra S; Das, Jai K; Naqvi, Imama; Bhutta, Zulfiqar A
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.
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
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.
Hoogeveen, Ruben C; Dorresteijn, Johannes A N; Kriegsman, Didi M W; Valk, Gerlof D.
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.
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 ...
Langer, Gero; Fink, Astrid
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.
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
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.
Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012
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…
Meijel, Berno van
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
Hays, Laura M; Finch, Emily A; Saha, Chandan; Marrero, David G; Ackermann, Ronald T
Objective. Weight loss is the most effective approach to reducing diabetes risk. It is a research priority to identify factors that may enhance weight loss success, particularly among those at risk for diabetes. This analysis explored the relationships between self-efficacy, weight loss, and dietary fat intake among adults at risk for developing type 2 diabetes. Methods. This pilot, site-randomized trial was designed to compare group-based Diabetes Prevention Program lifestyle intervention delivery by YMCA staff to brief counseling alone (control) in 92 adults at risk for diabetes (BMI ≥ 24 kg/m(2), ≥ 2 diabetes risk factors, and a random capillary blood glucose of 110-199 mg/dl). Self-efficacy was measured using the Weight Efficacy Lifestyle questionnaire. Data were collected at baseline, 6 months, and 12 months. A paired t test was used to determine within-group changes in self-efficacy and weight at 6 and 12 months. Using a fitted model, we estimated how much of an increase in self-efficacy was related to a 5% weight reduction at 6 and 12 months. Results. Self-efficacy was associated with a 5% reduction in baseline weight at 6 and 12 months but was not related to fat intake. Conclusion. These findings suggest that it is important to assess the level of self-efficacy when counseling adults at high risk for diabetes about weight loss. Certain aspects of self-efficacy seem to play a greater role, depending on the stage of weight loss.
Effect of a community intervention programme promoting social interactions on functional disability prevention for older adults: propensity score matching and instrumental variable analyses, JAGES Taketoyo study.
Hikichi, Hiroyuki; Kondo, Naoki; Kondo, Katsunori; Aida, Jun; Takeda, Tokunori; Kawachi, Ichiro
The efficacy of promoting social interactions to improve the health of older adults is not fully established due to residual confounding and selection bias. The government of Taketoyo town, Aichi Prefecture, Japan, developed a resident-centred community intervention programme called 'community salons', providing opportunities for social interactions among local older residents. To evaluate the impact of the programme, we conducted questionnaire surveys for all older residents of Taketoyo. We carried out a baseline survey in July 2006 (prior to the introduction of the programme) and assessed the onset of functional disability during March 2012. We analysed the data of 2421 older people. In addition to the standard Cox proportional hazard regression, we conducted Cox regression with propensity score matching (PSM) and an instrumental variable (IV) analysis, using the number of community salons within a radius of 350 m from the participant's home as an instrument. In the 5 years after the first salon was launched, the salon participants showed a 6.3% lower incidence of functional disability compared with non-participants. Even adjusting for sex, age, equivalent income, educational attainment, higher level activities of daily living and depression, the Cox adjusted HR for becoming disabled was 0.49 (95% CI 0.33 to 0.72). Similar results were observed using PSM (HR 0.52, 95% CI 0.33 to 0.83) and IV-Cox analysis (HR 0.50, 95% CI 0.34 to 0.74). A community health promotion programme focused on increasing social interactions among older adults may be effective in preventing the onset of disability. 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.
Lintvedt, Ove K; Griffiths, Kathleen M; Eisemann, Martin; Waterloo, Knut
Depression is common and treatable with cognitive behavior therapy (CBT), for example. However, access to this therapy is limited. Internet-based interventions have been found to be effective in reducing symptoms of depression. The International Society for Research on Internet Interventions has highlighted the importance of translating effective Internet programs into multiple languages to enable worldwide dissemination. The aim of the current study was to determine if it would be cost effective to translate an existing English-language Internet-based intervention for use in a non-English-speaking country. This paper reports an evaluation of a trial in which a research group in Norway translated two English-language Internet-based interventions into Norwegian (MoodGYM and BluePages) that had previously been shown to reduce symptoms of depression. The translation process and estimates of the cost-effectiveness of such a translation process is described. Estimated health effect was found by using quality-adjusted life years (QALY). Conservative estimates indicate that for every 1000 persons treated, 16 QALYs are gained. The investment is returned 9 times and the cost-effectiveness ratio (CER) is 3432. The costs of the translation project totaled to approximately 27% of the estimated original English-language version development costs. The economic analysis shows that the cost-effectiveness of the translation project was substantial. Hopefully, these results will encourage others to do similar analyses and report cost-effectiveness data in their research reports.
Lakerveld, J.; Bot, S.D.M.; Chin A Paw, M.J.M.; van Tulder, M.W.; Kingo, L.; Nijpels, G.
Effective, cost-effective, safe, and feasible interventions to improve lifestyle behavior in at-risk populations are needed in primary care. In the Hoorn Prevention Study, the authors implemented a theory-based lifestyle intervention in which trained practice nurses used an innovative combination of
Miller-Day, Michelle; Hecht, Michael L.
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
Guralnick, Michael J., Ed.
This book reviews research on the effectiveness of early intervention for children with disabilities or who are at risk. Program factors for children at risk and with disabilities, the effects of early intervention on different types of disabilities, and the outcomes of early intervention are explored. Chapters include: "Second-Generation Research…
El-Jardali, Fadi; Akl, Elie A; Fadlallah, Racha; Oliver, Sandy; Saleh, Nadine; El-Bawab, Lamya; Rizk, Rana; Farha, Aida; Hamra, Rasha
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
Fedewa, Allison; Moran, Margaret; O’Brien, Matthew; Ackermann, Ronald; Kullgren, Jeffrey T.
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
Lintvedt, Ove K; Griffiths, Kathleen M; Sørensen, Kristian; Østvik, Andreas R; Wang, Catharina E A; Eisemann, Martin; Waterloo, Knut
The Internet has the potential to increase the capacity and accessibility of mental health services. This study aimed to investigate whether an unguided Internet-based self-help intervention delivered without human support or guidance can reduce symptoms of depression in young people at risk of depression. The study also aimed to explore the usage of such sites in a real-life setting, to estimate the effects of the intervention for those who received a meaningful intervention dose and to evaluate user satisfaction. Young adults were recruited by means of a screening survey sent to all students at the University of Tromsø. Of those responding to the survey, 163 students (mean age 28.2 years) with elevated psychological distress were recruited to the trial and randomized to an Internet intervention condition or the waiting list control group. The Internet condition comprised a depression information website and a self-help Web application delivering automated cognitive behavioural therapy. The participants in the waiting list condition were free to access formal or informal help as usual. Two-thirds of the users who completed the trial initially reported an unmet need for help. The findings demonstrated that an unguided intervention was effective in reducing symptoms of depression and negative thoughts and in increasing depression literacy in young adults. Significant improvements were found at 2-month follow up. Internet-based interventions can be effective without tracking and thus constitute a minimal cost intervention for reaching a large number of people. User satisfaction among participants was high. Copyright © 2011 John Wiley & Sons, Ltd.
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.
Gulliford, Martin C; Bhattarai, Nawaraj; Charlton, Judith; Rudisill, Caroline
A healthy diet is associated with reduced risk of diabetes, cardiovascular disease and cancer. The study aimed to evaluate the cost-effectiveness of a universal strategy to promote healthy diet through brief intervention in primary care. The research was informed by a systematic review of randomised trials which found that brief interventions in primary care may be associated with a 0.5 portion per day increase in fruit and vegetable consumption. A Markov model that included five long-term conditions (diabetes, coronary heart disease, stroke, colorectal cancer and depression) was developed. Empirical data from a large cohort of United Kingdom-based participants sampled from the Clinical Practice Research Datalink populated the model. Simulations compared an intervention promoting healthy diet over 5 years in healthy adults, and standard care in which there was no intervention. The annual cost of intervention, in the base case, was one family practice consultation per participant year. Health service costs were included and the model adopted a lifetime perspective. The primary outcome was net health benefit in quality adjusted life years (QALYs). A cohort of 262,704 healthy participants entered the model. Intervention was associated with an increase in life years lived free from physical disease of 41.9 (95% confidence interval -17.4 to 101.0) per 1,000 participants entering the model (probability of increase 88.0%). New incidences of disease states were reduced by 28.4 (18.7 to 75.8) per 1,000, probability reduced 84.6%. Discounted incremental QALYs were 4.3 (-8.8 to 18.0) per 1,000, while incremental costs were £139,755 (£60,466 to 220,059) per 1,000. Net health benefits at £30,000 per QALY were -0.32 (-13.8 to 13.5) QALYs per 1,000 participants (probability cost-effective 47.9%). When the intervention was restricted to adults aged 50 to 74 years, net health benefits were 2.94 (-21.3 to 26.4) QALYs per 1000, probability increased 59.0%. A universal strategy to
Ilesanmi, Rose Ekama; Olabisi, Prisca
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.
Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy
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
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.
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.
Bates, Geoff; Begley, Emma; Tod, David; Jones, Lisa; Leavey, Conan; McVeigh, Jim
We examined intervention effectiveness of strategies to prevent image- and performance-enhancing drug use. Comprehensive searches identified 14 interventions that met review inclusion criteria. Interventions were predominantly educational and delivered within school sport settings, but targeted a wide range of mediating factors. Identification of effective components was limited across studies by brief or imprecise descriptions of intervention content, lack of behavioural outcome measures and short-term follow-up times. However, studies with components in addition to information provision may be more promising. Interventions outside of sport settings are required to reflect the transition of this form of substance use to the general population.
Full Text Available Abstract Background Despite sub-Saharan Africa [SSA] constituting just 12% of the world’s population, the region has the highest burden of HIV with 70% of HIV infection in general and 80% of new infections among young people occuring in the region. Diverse intervention programmes have been implemented among young people but with minimal translation to behavior change. A systematic review of Behavior Change Interventions [BCI] targeting adolescents in SSA was therefore conducted with the objective of delineating this intervention vis-a-vis efficacy gap. Methods From April to July 2015 searches were made from different journals online. Databases searched included MEDLINE, EBSCOhost, PsychINFO, Cochrane, and Google Scholar; Cambridge and Oxford journal websites, UNAIDS and WHO for studies published between 2000 and 2015. After excluding other studies by review of titles and then abstracts, the studies were reduced to 17. Three of these were randomized trials and five quasi-experimental. Overall interventions included those prescribing life skills, peer education [n = 6] and community collaborative programmes. The main study protocol was approved by the University of Malawi College of Medicine Ethics Committee on 30th June 2016 [ref #: P.01/16/1847. The review was registered with PROSPERO [NIH] in 2015. Results The review yielded some 200 titles and abstracts, 20 full text articles were critically analysed and 17 articles reviewed reflecting a dearth in published studies in the area of psychosocial BCI interventions targeting adolescents in SSA. Results show that a number of reviewed interventions [n = 8] registered positive outcomes in both knowledge and sexual practices. Conclusions The review demonstrates a paucity of psychosocial BCI studies targeting adolescents in SSA. There are however mixed findings about the effectiveness of psychosocial BCI targeting adolescents in SSA. Other studies portray intervention effectiveness and others
van Holland, Berry J.; Soer, Remko; de Boer, Michiel R.; Reneman, Michiel F.; Brouwer, Sandra
OBJECTIVE: To investigate the effectiveness of occupational health interventions in the meat processing industry on work and health-related outcomes. METHODS: A systematic literature review was performed. PubMed, Embase, and The Cochrane Library were searched. Studies were included when they
van Holland, B.J.; Soer, R.; de Boer, M.R.; Reneman, M.F.; Brouwer, S.
Objective: To investigate the effectiveness of occupational health interventions in the meat processing industry on work and health-related outcomes. Methods: A systematic literature review was performed. PubMed, Embase, and The Cochrane Library were searched. Studies were included when they
Lakerveld, J.; Bot, S.D.M.; van der Ploeg, H.P.; Nijpels, G.
Objective: This study set out to assess the short- and long-term effects of a primary care-based lifestyle intervention on different domains of leisure-time sedentary behaviors in Dutch adults at risk of type 2 diabetes and cardiovascular diseases. Methods: Between 2007 and 2009, adults (n=622) at
Shepherd, Emily; Gomersall, Judith C; Tieu, Joanna; Han, Shanshan; Crowther, Caroline A; Middleton, Philippa
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
Tikka, Christina; Verbeek, Jos H; Kateman, Erik; Morata, Thais C; Dreschler, Wouter A; Ferrite, Silvia
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
Miovský, Michal; Voňková, Hana; Gabrhelík, Roman; Šťastná, Lenka
This study aims to examine the effect of school-based preventive intervention on cannabis use in Czech adolescents with different levels of risk factors and provide evidence of its universality. A randomized controlled prevention trial with six waves was conducted over a period of 33 months. We used a two-level logistic random-intercept model for panel data; we first looked at the statistical significance of the effect of the intervention on cannabis use, controlling for the characteristics of the children and time dummies. Then we analyzed the effects of the interactions between the intervention and the characteristics of the children on cannabis use and related it to the definition of universal preventive interventions. The setting for the study was in basic schools in the Czech Republic in the years 2007-2010. A total of 1,874 sixth-graders (mean age 11.82 years) who completed the baseline testing. According to our results, the prevention intervention was effective. We found all the selected characteristics of the children to be relevant in relation to cannabis use, except their relationships with their friends. We showed empirically that the intervention is universal in two dimensions for the selected characteristics of the children. First, all adolescents who undergo the intervention are expected to benefit. Second, with respect to the effect of the intervention on cannabis use, the total level of individual risk of cannabis use is superior to the composition of the risk factors in the individual risk profile. We present indicative evidence that the drug prevention intervention may be considered a true universal preventive intervention.
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.
Komiya, Masami; Fujii, Gen; Takahashi, Mami; Iigo, Masaaki; Mutoh, Michihiro
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.
Diana B Cunha
Full Text Available To evaluate the effectiveness of a school-based intervention involving the families and teachers that aimed to promote healthy eating habits in adolescents; the ultimate aim of the intervention was to reduce the increase in body mass index (BMI of the students.Paired cluster randomized school-based trial conducted with a sample of fifth graders.Twenty classes were randomly assigned into either an intervention group or a control group.From a total of 574 eligible students, 559 students participated in the study (intervention: 10 classes with 277 participants; control: 10 classes with 282 participants. The mean age of students was 11 years.Students attended 9 nutritional education sessions during the 2010 academic year. Parents/guardians and teachers received information on the same subjects.Changes in BMI and percentage of body fat.Intention-to-treat analysis showed that changes in BMI were not significantly different between the 2 groups (β = 0.003; p = 0.75. There was a major reduction in the consumption of sugar-sweetened beverages and cookies in the intervention group; students in this group also consumed more fruits.Encouraging the adoption of healthy eating habits promoted important changes in the adolescent diet, but this did not lead to a reduction in BMI gain. Strategies based exclusively on the quality of diet may not reduce weight gain among adolescents.Clinicaltrials.gov NCT01046474.
Pontoppidan, Maiken W.
Background: Infancy is an important period in a child’s life, with rapid growth and development. Early experiences shape the developing brain, and adverse experiences can have both an immediate and lifelong impact on health and wellbeing. Parenting interventions offered to parents of newborns can....... Discussion: This is the first RCT of the Incredible Years Parents and Babies Program, and one of the first rigorous evaluations of a universally offered preventive intervention for parents with infants. The trial will provide important information on the effectiveness of a relatively brief, universally...
Reavley, Nicola; Jorm, Anthony F
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.
Prevention-Plus interventions for primary care offer a venue to intervene with both children and parents for child obesity treatment. Such interventions can promote effective parenting practices that encourage healthy eating, physical activity (PA), and lower TV use among children. Test for feasibil...
Fawole, Olufunmilayo I.; Ajuwon, Ademola J.; Osungbade, Kayode O.
Purpose: This intervention project targeted one vulnerable group, female apprentices in Ibadan, Nigeria, to evaluate the effectiveness of multiple interventions aimed at preventing violence against women (VAW). Design/methodology/approach: A baseline survey was conducted through face-to-face interviews with 350 young women recruited from…
Crone, M; Reijneveld, S; Willemsen, M; van Leerdam, F J M; Spruijt, R; Sing, R
Objective: To assess the effect of an antismoking intervention focusing on adolescents in lower education. Students with lower education smoke more often and perceive more positive norms, and social pressure to smoke, than higher educated students. An intervention based on peer group pressure and social influence may therefore be useful to prevent smoking among these students.
Berkowitz, Steven J.; Stover, Carla Smith; Marans, Steven R.
Objective: This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE). Method: One-hundred seventy-six 7…
Kapungu, Chisina T.; Nappi, Carla N.; Thakral, Charu; Miller, Steven A.; Devlin, Catharine; McBride, Cami; Hasselquist, Emily; Coleman, Gloria; Drozd, Derek; Barve, Chinmayee; Donenberg, Geri; DiClemente, Ralph; Brown, Larry
The purpose of this study was to examine the effectiveness of evidence-based recruitment and retention strategies for a longitudinal, family-based HIV prevention intervention study targeting adolescents in psychiatric care by (1) determining consent rate (recruitment), rate of participation at the first intervention session (retention), and…
Moore, Ida M; Hockenberry, Marilyn J; Anhalt, Cynthia; McCarthy, Kathy; Krull, Kevin R
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.
Reilly, John J; Martin, Anne; Hughes, Adrienne R
To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make suggestions for more informative future intervention trials. Completed and ongoing intervention trials have had fairly modest effects, have been limited largely to high-income countries, and have used relatively short-term interventions and outcomes. Comparison of the evidence from completed prevention trials with the evidence from systematic reviews of behavioral risk factors shows that some life-course stages have been neglected (pre-conception and toddlerhood), and that interventions have neglected to target some important behavioral risk factors (maternal smoking during pregnancy, infant and child sleep). Finally, while obesity prevention interventions aim to modify body composition, few intervention trials have used body composition measures as outcomes, and this has limited their sensitivity to detect intervention effects. The new WHO Healthy Lifestyles Trajectory (HeLTI) initiative should address some of these weaknesses. Future early obesity prevention trials should be much more ambitious. They should, ideally: extend their interventions over the first 1000 days; have longer-term (childhood) outcomes, and improved outcome measures (body composition measures in addition to proxies for body composition such as the BMI for age); have greater emphasis on maternal smoking and child sleep; be global.
Lakerveld, Jeroen; Bot, Sandra D M; van der Ploeg, Hidde P; Nijpels, Giel
This study set out to assess the short- and long-term effects of a primary care-based lifestyle intervention on different domains of leisure-time sedentary behaviors in Dutch adults at risk of type 2 diabetes and cardiovascular diseases. Between 2007 and 2009, adults (n=622) at risk were randomly assigned to a counseling intervention aimed at adopting healthy lifestyle behaviors, or a control group that only received health brochures. Follow-up measures were done after 6, 12 and 24months. Linear regression analysis was used to examine between-group differences in self-report minutes per day sedentary behaviors, adjusted for baseline values. Stratified analyses were performed for sex and educational attainment. Seventy-nine percent (n=490) of participants completed the last follow-up. Mean baseline sedentary behaviors were 254.6min per day (SD=136.2). Intention-to-treat analyses showed no significant differences in overall or domain-specific sedentary behaviors between the two groups at follow-up. Stratified analyses for educational attainment revealed a small and temporary between-group difference in favor of the intervention group, in those who finished secondary school. A primary care-based general lifestyle intervention was not more effective in reducing leisure-time sedentary behaviors than providing brochures in adults at risk for chronic diseases. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Type 2 diabetes is an important preventable disease and a growing public health problem. Based on information provided by clinical trials, we know that Type 2 diabetes can be prevented or delayed by lifestyle intervention. In view of translating the findings of diabetes prevention research into real-life it is necessary to carry out community-based evaluations so as to learn about the feasibility and effectiveness of locally designed and implemented programmes. The aim of this project was to assess the effectiveness of an active real-life primary care strategy in high-risk individuals for developing diabetes, and then evaluate its efficiency. Methods/Design Cost-Effectiveness analysis of the DE-PLAN (Diabetes in Europe - Prevention using Lifestyle, physical Activity and Nutritional intervention project when applied to a Mediterranean population in Catalonia (DE-PLAN-CAT. Multicenter, longitudinal cohort assessment (4 years conducted in 18 primary health-care centres (Catalan Health Institute. Individuals without diabetes aged 45-75 years were screened using the Finnish Diabetes Risk Score - FINDRISC - questionnaire and a 2-h oral glucose tolerance test. All high risk tested individuals were invited to participate in either a usual care intervention (information on diet and cardiovascular health without individualized programme, or the intensive DE-PLAN educational program (individualized or group periodically reinforced. Oral glucose tolerance test was repeated yearly to determine diabetes incidence. Besides measuring the accumulated incidence of diabetes, information was collected on economic impact of the interventions in both cohorts (using direct and indirect cost questionnaires and information on utility measures (Quality Adjusted Life Years. A cost-utility and a cost-effectiveness analysis will be performed and data will be modelled to predict long-term cost-effectiveness. Discussion The project was intended to evidence
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...
Shih, Sophy T F; Davis-Lameloise, Nathalie; Janus, Edward D.
Background: The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial (RCT) that aims to assess the effectiveness of a structured diabetes prevention intervention for women who had gestational diabetes.Methods/Design: The original...
Peltonen, Kirsi; Punamäki, Raija-Leena
Increasing research is available on the preconditions for child mental health and optimal development in traumatic conditions, whereas less is known how to translate the findings into effective interventions to help traumatized children. This literature review analyses the effectiveness of psychosocial preventive interventions and treatments and their theoretical bases among children traumatized in the context of armed conflicts (war, military violence, terrorism and refugee). The first aim is to evaluate the effectiveness of preventive interventions in preventing emotional distress and impairment and promoting optimal emotional-cognitive and social development. The second task is to analyze the nature of the underlying mechanisms for the success of preventive interventions, and the theoretical premises of the choice of intervention techniques, procedures and tools. We found 16 relevant published studies, but an examination of them revealed that only four of them had experimental designs strong enough that they could be included in the meta-analysis. While the subjective reports of the researchers suggested that systematic preventive interventions were effective in decreasing PTSD and depressive symptoms among children traumatized due to armed conflict, the more objective results of the meta-analysis and the weaknesses in designs uncovered during the meta-analysis undermine such a conclusion. Additionally, a majority of the reported preventive interventions focused only on children's biased cognitive processes and negative emotions, while only a few aimed at influencing multiple domains of child development and improving developmental functioning on emotional, social and psychophysiological levels. It is concluded that substantial additional work needs to be done in developing effective preventive interventions and treatments for children traumatized by exposure to war and violence. (c) 2009 Wiley-Liss, Inc.
Ames, Genevieve M.; Bennett, Joel B.
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
de Vries, L.A.
Evidence-based interventions are crucial for preventing that at-risk youth will develop a persistent criminal carreer. This dissertation includes a meta-analysis of the effectiveness of youth crime prevention, and an evaluation of the Dutch youth intervention ‘New Perspectives’ (NP). At-risk youth (N = 101) aged 12 to 19 years were randomly assigned to NP and care as usual (CAU). New Perspectives proved not to be more effective than other existing youth care services. However, the time to re-...
Ha, Mei; Hu, Jie; Petrini, Marcia A; McCoy, Thomas P
Prevalence of osteoporosis (OP) is high among Chinese adults with diabetes. Assessment of OP and fracture risk as well as patient education should be included as part of the management of diabetes. The purpose of this pilot study was to test the effectiveness of an educational self-efficacy intervention on knowledge about OP, dietary calcium intake, the importance of physical activity (PA), and glycemic control among Chinese adults with type 2 diabetes residing in Wuhan, China. A quasi-experimental design with repeated measures was employed. Participants were assigned to either the intervention (n = 23) or the control group (n = 23). Intervention participants attended 6 weekly 1-hr educational sessions comprising presentations, demonstration, and discussions. Control participants received standard care. Data were collected via questionnaires at pre- and postintervention and at 3-month follow-up, and blood was drawn at preintervention and 3-month follow-up. Participants in the intervention group had significant improvement in OP knowledge, F(2, 43) = 11.504, p self-efficacy, F(2, 43) = 6.915, p = .003; dietary calcium intake, F(2, 43) = 7.856, p = .002; level of PA, F(2, 43) = 4.787, p = .011; diabetes self-care activities, F(2, 43) = 14.009, p diabetes self-efficacy, F(2, 43) = 19.722, p self-efficacy theory among Chinese adults with type 2 diabetes. © The Author(s) 2014.
Shamliyan, Tatyana A; Wyman, Jean F; Ping, Ryan; Wilt, Timothy J; Kane, Robert L
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.
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.
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
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.
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
Sutherland, Jennifer; Barnard, Sharmani; Wynne, Aileen; Rezel, Emma; Doel, Andrew; Grigsby-Duffy, Lily; Edwards, Suzanne; Russell, Sophie; Hotopf, Ellie; Perel, Pablo; Free, Caroline
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
Full Text Available ABSTRACTIntroduction:Scientific evidence supports the sinergy between biomedical and behavioral interventions aimed at preventing the transmission of HIV as a strategy to eradicate AIDS.Objective:To characterize comparatively the benefits from biomedical and behavioral interventions to prevent HIV transmission.Methods:Narrative review. We performed a comparative analysis of the benefits of studied interventions by means of estimating the number needed to treat (NNT. Evaluated interventions: counseling activities for behavior change to prevent exposure to HIV; antiretroviral pre-exposure prophylaxis (PrEP and antiretroviral post-exposure prophylasis (PEP for HIV and treatment of serodiscordant couples as a strategy for prevention of HIV transmission (TasP.Results:counseling interventions and TasP have smaller NNTs, equal to, respectively, 11 (95%CI 9 - 18 at 12 months and 34 (95%CI 23 - 54 in 42 months comparatively to PrEP interventions, that resulted in 41 (95%CI 28 - 67 individuals receiving antiretrovirals in order to prevent one case of HIV infection at 36 months for men and serodiscordant couples. PEP interventions are associated with protective effects estimated at 81%. Lack of trials evaluating PEP prevents estimate of NNT.Conclusion:The estimate of the NNT can be a helpful parameter in the comparison between the effectiveness of different behavioral and biomedical HIV prevention strategies. Studies evaluating the benefit and safety of combined behavioral and biomedical interventions are needed, especially considering the attributable fraction of each component. Integration of behavioral and biomedical interventions is required to achieve complete suppression of the virus, and thus reducing viral replication, infectivity and the number of cases.
Han, Claire Jungyoun; Lee, Young Ji; Demiris, George
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.
Amos, Taryn; Stein, Dan J; Ipser, Jonathan C
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
Narváez, Santiago; Tobar, Angela M; López, Diego M
Stress-related disorders have become one of the main problems of public health in many countries and of worldwide organizations, and they are expected to become more common in the forthcoming decades. This article aims at providing a systematic review and a descriptive evaluation of the interventions supported by ICT for the prevention and treatment of occupational stress. A systematic review of five databases (EBSCO, The Cochrane Library, PubMed, ScienceDirect and IEEEXplorer) was carried out. This article provides a quantitative and qualitative description of 21 studies about occupational stress interventions supported by ICT. The following factors were considered for the analysis: impact of the intervention, design of the study, type of intervention, purpose of the intervention, type of instrument for the measurement of occupational stress, and type of ICT used. The systematic review demonstrated that interventions supported by ICT for the prevention and treatment of occupational stress are scarce but effective.
Hays, Laura M.; Finch, Emily A.; Saha, Chandan; Marrero, David G.; Ackermann, Ronald T.
Abstract Objective. Weight loss is the most effective approach to reducing diabetes risk. It is a research priority to identify factors that may enhance weight loss success, particularly among those at risk for diabetes. This analysis explored the relationships between self-efficacy, weight loss, and dietary fat intake among adults at risk for developing type 2 diabetes. Methods. This pilot, site-randomized trial was designed to compare group-based Diabetes Prevention Program lifestyle interv...
Sreevatsava, Meghana; Narayan, K M Venkat; Cunningham, Solveig A
Childhood obesity is on the rise worldwide and its increasing prevalence in low and middle income countries is well-known. Obesity interventions have the potential to prevent adverse health outcomes; however, large gaps in research and knowledge about the efficacy and sustainability of such interventions remain. The objectives of this article were to review the evidence for interventions to prevent and control obesity among children and adolescents, evaluate their applicability in India, and discuss the challenges to sustain such interventions. The authors reviewed published research focusing on childhood obesity interventions, especially in India and other lower-resource countries. Nine observational and 10 interventional studies were reviewed. Most studies identified were from developed countries and took place at day-care settings, schools, and after school programs. Nineteen reported studies were grouped into categories: diet (2), physical activity (4), childcare programs (2), media-based programs (2), parental involvement (2), multi-component studies (1), and screen time (6). Most interventions were effective in reducing BMI, decreasing sedentary behaviors, and increasing physical activity. Sustainability of these interventions was not evaluated. While there is no one method or simple intervention to address obesity, multi-component approaches involving home and school environments are promising and warrant evaluation in India. Literature on obesity prevention and control in India and in lower-resource countries, however, is sparse. Existing gaps in knowledge about obesity should be addressed by conducting research in India and carrying out interventions to determine what strategies will be successful and sustainable locally.
Lazarus, Jeff; Sihvonen-Riemenschneider, Henna; Laukamm-Josten, Ulrich
To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STIs), including HIV, among young people in the European Union.......To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STIs), including HIV, among young people in the European Union....
Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.
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
Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.
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
Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.
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
Slavkin, Michael L.
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…
Morata, Thais C.; Meinke, Deanna
Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. PMID:27397968
Ginsburg, Golda S
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
Grais, Rebecca F.; Isanaka, I; Langendorf, C; Roederer, T
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)
Espelage, Dorothy L; Hong, Jun Sung
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.
Hong, Jun Sung
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
Effect of an integrated intervention package of preventive chemotherapy, community-led total sanitation and health education on the prevalence of helminth and intestinal protozoa infections in Côte d'Ivoire.
Hürlimann, Eveline; Silué, Kigbafori D; Zouzou, Fabien; Ouattara, Mamadou; Schmidlin, Thomas; Yapi, Richard B; Houngbedji, Clarisse A; Dongo, Kouassi; Kouadio, Bernadette A; Koné, Siaka; Bonfoh, Bassirou; N'Goran, Eliézer K; Utzinger, Jürg; Acka-Douabélé, Cinthia A; Raso, Giovanna
Preventive chemotherapy with donated anthelminthic drugs is the cornerstone for the control of helminthiases. However, reinfection can occur rapidly in the absence of clean water and sanitation coupled with unhygienic behaviour. The purpose of this study was to assess the effect of an integrated package of interventions, consisting of preventive chemotherapy, community-led total sanitation (CLTS) and health education, on the prevalence of helminth and intestinal protozoa infections and on participants' knowledge, attitude, practice and beliefs (KAPB) towards these diseases including water, sanitation and hygiene (WASH). A cross-sectional survey was carried out in nine communities of south-central Côte d'Ivoire to assess people's infection with helminths and intestinal protozoa and KAPB. Subsequently, interventions were targeted to five communities, while the remaining communities served as control. The intervention encouraged latrine construction and an evaluation was done 6-7 months later to determine open defecation status of the respective communities. Anthelminthic treatment was provided to all community members. A follow-up cross-sectional survey was conducted approximately one year later, using the same procedures. Overall, 810 people had complete baseline and follow-up data and were given anthelminthic treatment. The baseline prevalence of hookworm, Schistosoma haematobium, Trichuris trichiura, Schistosoma mansoni and Ascaris lumbricoides was 31.1%, 7.0%, 2.0%, 1.0% and 0.3%, respectively. Four of the five intervention communities were classified open-defecation free. For hookworm infection, we observed higher negative changes in terms of proportion of decrease (-0.10; 95% confidence interval (CI): - 0.16, -0.04) and higher egg reduction rate (64.9 vs 15.2%) when comparing intervention with control communities. For intestinal protozoa, prevalence reduction was higher in intervention compared to control communities (8.2 vs 2.6%) and WASH indicators and
Baker-Henningham, H; Walker, S
Based on extensive piloting work, we adapted the Incredible Years (IY) teacher-training programme to the Jamaican preschool setting and evaluated this adapted version through a cluster-randomised trial. Twenty-four community preschools in Kingston, Jamaica were randomly assigned to intervention (12 schools, 37 teachers) or control (12 schools, 36 teachers). The intervention involved training teachers in classroom management through eight full-day training workshops and four individual 1-h in-class support sessions. Outcome measurements included direct observation of teachers' positive and negative behaviours to the whole class and to high-risk children and four observer ratings: two measures of class-wide child behaviour and two measures of classroom atmosphere. Measures were repeated at a six-month follow-up. Significant benefits of intervention were found for teachers' positive [effect size (ES) = 3.35] and negative (ES = 1.29) behaviours to the whole class and to high-risk children (positive: ES = 0.83; negative: ES = 0.50) and for observer ratings of class-wide child behaviour (ES = 0.73), child interest and enthusiasm (ES = 0.98), teacher warmth (ES = 2.03) and opportunities provided to share and help (ES = 5.72). At 6-month follow-up, significant benefits of intervention were sustained: positive behaviours (ES = 2.70), negative behaviours (ES = 0.98), child behaviour (ES = 0.50), child interest and enthusiasm (ES = 0.78), teacher warmth (ES = 0.91), opportunities to share and help (ES = 1.42). The adapted IY teacher-training programme produced large benefits to teacher's behaviour and to class-wide measures of children's behaviour, which were sustained at 6-month follow-up. Benefits were of a similar magnitude to those found in a pilot study of the minimally adapted version that required significantly more in-class support for teachers.
Fernandez, Isabel Diana; Becerra, Adan; Chin, Nancy P
Worksites provide multiple advantages to prevent and treat obesity and to test environmental interventions to tackle its multiple causal factors. We present a literature review of group-randomized and non-randomized trials that tested worksite environmental, multiple component interventions for obesity prevention and control paying particular attention to the conduct of formative research prior to intervention development. The evidence on environmental interventions on measures of obesity appears to be strong since most of the studies have a low (4/8) and unclear (2/8) risk of bias. Among the studies reviewed whose potential risk of bias was low, the magnitude of the effect was modest and sometimes in the unexpected direction. None of the four studies describing an explicit formative research stage with clear integration of findings into the intervention was able to demonstrate an effect on the main outcome of interest. We present alternative explanation for the findings and recommendations for future research.
Atkinson, Ross A; Cullum, Nicky A
Narrative review. Pressure ulcers are a common complication in people with reduced sensation and limited mobility, occurring frequently in those who have sustained spinal cord injury. This narrative review summarises the evidence relating to interventions for the prevention and treatment of pressure ulcers, in particular from Cochrane systematic reviews. It also aims to highlight the degree to which people with spinal cord injury have been included as participants in randomised controlled trials included in Cochrane reviews of such interventions. Global. The Cochrane library (up to July 2017) was searched for systematic reviews of any type of intervention for the prevention or treatment of pressure ulcers. A search of PubMed (up to July 2017) was undertaken to identify other systematic reviews and additional published trial reports of interventions for pressure ulcer prevention and treatment. The searches revealed 38 published systematic reviews (27 Cochrane and 11 others) and 6 additional published trial reports. An array of interventions is available for clinical use, but few have been evaluated adequately in people with SCI. The effects of most interventions for preventing and treating pressure ulcers in people with spinal cord injury are highly uncertain. Existing evaluations of pressure ulcer interventions include very few participants with spinal cord injury. Subsequently, there is still a need for high-quality randomised trials of such interventions in this patient population.
Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy
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
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.
Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Valuck, Robert J
To enhance the learner's competence with knowledge about a framework of quality improvement (QI) interventions to implement evidence-based practices for pressure ulcer (PrU) prevention. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Summarize the process of creating and initiating the best-practice framework of QI for PrU prevention.2. Identify the domains and QI interventions for the best-practice framework of QI for PrU prevention. Pressure ulcer (PrU) prevention is a priority issue in US hospitals. The National Pressure Ulcer Advisory Panel endorses an evidence-based practice (EBP) protocol to help prevent PrUs. Effective implementation of EBPs requires systematic change of existing care units. Quality improvement interventions offer a mechanism of change to existing structures in order to effectively implement EBPs for PrU prevention. The best-practice framework developed by Nelson et al is a useful model of quality improvement interventions that targets process improvement in 4 domains: leadership, staff, information and information technology, and performance and improvement. At 2 academic medical centers, the best-practice framework was shown to physicians, nurses, and health services researchers. Their insight was used to modify the best-practice framework as a reference tool for quality improvement interventions in PrU prevention. The revised framework includes 25 elements across 4 domains. Many of these elements support EBPs for PrU prevention, such as updates in PrU staging and risk assessment. The best-practice framework offers a reference point to initiating a bundle of quality improvement interventions in support of EBPs. Hospitals and clinicians tasked with quality improvement efforts can use this framework to problem-solve PrU prevention and other critical issues.
Ward, Dianne S; Welker, Emily; Choate, Ashley; Henderson, Kathryn E; Lott, Megan; Tovar, Alison; Wilson, Amanda; Sallis, James F
2010-2015; INTERNATIONAL: Given the high levels of obesity in young children, numbers of children in out-of-home care, and data suggesting a link between early care and education (ECE) participation and overweight/obesity, obesity prevention in ECE settings is critical. As the field has progressed, a number of interventions have been reviewed yet there is a need to summarize the data using more sophisticated analyses to answer questions on the effectiveness of interventions. We conducted a systematic review of obesity prevention interventions in center-based ECE settings published between 2010 and 2015. Our goal was to identify promising intervention characteristics associated with successful behavioral and anthropometric outcomes. A rigorous search strategy resulted in 43 interventions that met inclusion criteria. We developed a coding strategy to assess intervention strength, used a validated study quality assessment tool, and presented detailed descriptive information about interventions (e.g., target behaviors, intervention strategies, and mode of delivery). Intervention strength was positively correlated with reporting of positive anthropometric outcomes for physical activity, diet, and combined interventions, and parent engagement components increased the strength of these relationships. Study quality was modestly related to percent successful healthy eating outcomes. Relationships between intervention strength and behavioral outcomes demonstrated negative relationships for all behavioral outcomes. Specific components of intervention strength (number of intervention strategies, potential impact of strategies, frequency of use, and duration of intervention) were correlated with some of the anthropometric and parent engagement outcomes. The review provided tentative evidence that multi-component, multi-level ECE interventions with parental engagement are most likely to be effective with anthropometric outcomes. Copyright © 2016 Elsevier Inc. All rights
Noar, Seth M; Black, Hulda G; Pierce, Larson B
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.
Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto
The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI's preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. The study provided important information about the ability of an Internet-based intervention to reduce young women's risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. © 2014 Sigma Theta Tau International.
Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto
Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI’s preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women’s risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. PMID:25410132
Martin, William Hal; Griest, Susan E; Sobel, Judith L; Howarth, Linda C
To evaluate the effectiveness of four NIHL prevention interventions at improving knowledge, attitudes, and intended behaviors regarding sound exposure and appropriate use of hearing protective strategies in children. A randomized trial of the four interventions with a non-intervention comparison group. Questionnaires were completed prior to, immediately after, and three months after each intervention. Interventions included: (1) A classroom presentation by older-peer educators, (2) A classroom presentation by health professionals, (3). Exploration of a museum exhibition, and (4). Exploration of an internet-based virtual museum. A comparison group received no intervention. Fifty-three fourth grade classrooms (1120 students) participated in the study. All interventions produced significant improvements but the number of improvements decreased over time. In terms of effectiveness, the classroom programs were more effective than the internet-based virtual exhibit, which was more effective than the visit to the museum exhibition. Self-reported exposures indicated that as many as 94.5% of participants were at risk for NIHL. Interpersonal, interactive educational interventions such as the classroom program are more effective and have longer impact than self-directed learning experiences for NIHL and tinnitus prevention, however each may have an important role in promoting hearing health in elementary school students.
Becker, Annette; Angerer, Peter; Müller, Andreas
Research shows that psychosocial factors play a significant role on the emergence of musculoskeletal complaints (MSC). The aim of this study was to determine whether a coaching intervention which was focussed on enabling better strategies for coping with work stressors is superior to physiotherapy alone in the reduction of MSC. 68 nurses were randomized to an intervention group (IG, n = 34) or a control group (CG, n = 34). The IG and CG completed a weekly individual physiotherapy unit (10 weeks). Additionally, the IG passed five coaching sessions (fortnightly), plus one opening and one closing session. The primary outcome was MSC, secondary outcomes were work ability and work-related wellbeing. Outcomes were obtained by physical examinations and questionnaires. Data were analyzed by t-test, Chi-Square test, ANOVA with repeated measurements, and multilevel analyzes. In respect of MSC, the IG compared to the CG showed a significant improvement in the pain severity of everyday movements, and trends towards an improvement of movement in the vertebral column as well as a reduction of the pain severity due to maximum degree movements. No effects were observed in respect to muscle strengths, and restrictions of everyday activities. The IG exhibited a significant improvement of work ability in reference to the physical working demands, and work-related wellbeing. Analysis indicates that improvements in the IG increased further in the 12 weeks after the intervention. The results suggest that the coaching, beyond physiotherapy, can support the reduction of MSC, the improvement of work ability and work-related wellbeing.
Pigeot, I; Baranowski, T; De Henauw, S
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.
Izard, Carroll E; Fine, Sarah; Mostow, Allison; Trentacosta, Christopher; Campbell, Jan
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.
Coker, Ann L; Bush, Heather M; Fisher, Bonnie S; Swan, Suzanne C; Williams, Corrine M; Clear, Emily R; DeGue, Sarah
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.
Esther Quirós Abajo
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...
Hart, Laura M; Cornell, Chelsea; Damiano, Stephanie R; Paxton, Susan J
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.
Dalal, Adam; Eskin-Schwartz, Marina; Mimouni, Daniel; Ray, Sujoy; Days, Walford; Hodak, Emmilia; Leibovici, Leonard; Paul, Mical
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
Bourgeois, Nicole; Brauer, Paula; Simpson, Janis Randall; Kim, Susie; Haines, Jess
Preventing childhood obesity is a public health priority, and primary care is an important setting for early intervention. Authors of a recent national guideline have identified a need for effective primary care interventions for obesity prevention and that parent perspectives on interventions are notably absent from the literature. Our objective was to determine the perspectives of primary care clinicians and parents of children 2-5 years of age on the implementation of an obesity prevention intervention within team-based primary care to inform intervention implementation. We conducted focus groups with interprofessional primary care clinicians (n = 40) and interviews with parents (n = 26). Participants were asked about facilitators and barriers to, and recommendations for implementing a prevention program in primary care. Data were recorded and transcribed, and we used directed content analysis to identify major themes. Barriers existed to addressing obesity-related behaviours in this age group and included a gap in well-child primary care between ages 18 months and 4-5 years, lack of time and sensitivity of the topic. Trust and existing relationships with primary care clinicians were facilitators to program implementation. Offering separate programs for parents and children, and addressing both general parenting topics and obesity-related behaviours were identified as desirable. Despite barriers to addressing obesity-related behaviours within well-child primary care, both clinicians and parents expressed interest in interventions in primary care settings. Next steps should include pilot studies to identify feasible strategies for intervention implementation.
Full Text Available “The Fire is Coming” film is an innovative HIV-prevention intervention contextualized to the Maasai people of Tanzania through use of a traditional Maasai story. The intervention was developed and implemented in partnership with Maasai Pastoralists for Education and Development (MAPED. Although there have been numerous Knowledge-Attitude-Practice (KAP surveys conducted among the Maasai, this is the first control-group comparison study designed to measure the effectiveness of an HIV-prevention intervention contextualized specifically to the Maasai people of Tanzania. We will first discuss the background and context in which the intervention was developed and methods used to develop the intervention. We will then discuss the evaluation methods, results, and implications of a retrospective Knowledge, Attitudes, Practices (KAP two-village comparison survey (n=200 for “The Fire is Coming” HIV-prevention intervention among Maasai people. There was a significant effect for HIV-related attitudes, t(16 = 2.77, p 0.05. Implications: Belief in one’s ability to do something is often the pivotal point for behavior change. The results of the survey denote a highly effective intervention in changing HIV-related attitudes and behaviors. It is promising for replication among other Maasai communities and for adaptation with indigenous people groups in other regions.
Buford, Thomas W; Miller, Michael E; Church, Timothy S; Gill, Thomas M; Henderson, Rebecca; Hsu, Fang-Chi; McDermott, Mary M; Nadkarni, Neelesh; Pahor, Marco; Stafford, Randall S; Carter, Christy S
This subgroup analysis of the Lifestyle Intervention and Independence for Elders trial evaluates the impact of a long-term physical activity (PA) intervention on rates of major mobility disability (MMD) among older adults according to their antihypertensive medication use. Lifestyle Intervention and Independence for Elders study participants were randomized to center-based PA or health education for a median of 2.7 years. Participants were sedentary men and women aged 70-89 years with objectively measured physical limitations. This analysis evaluated rates of MMD and persistent MMD among 1,633 participants, according to antihypertensive medication use. Participants were designated as either (i) an angiotensin-converting enzyme (ACE) inhibitor user (ACEi+), (ii) a user of other antihypertensives not including ACEi (ACEi-), or (iii) nonusers of antihypertensive medications (AHT-). Interactions were explored between antihypertensive use and randomized arm. Interaction terms for MMD (p = .214) and persistent MMD (p = .180) did not reach statistical significance. For MMD, PA displayed marginal effects among ACEi+ (hazard ratio [HR] = 0.76; 95% confidence interval [CI] = 0.57, 1.02) and ACEi- (HR = 0.76; 95% CI = 0.60, 0.97) but not AHT- (HR = 1.19; 95% CI = 0.75, 1.87). For persistent MMD, the effect of PA was greatest among ACEi+ (HR = 0.57; 95% CI = 0.39, 0.84) when compared to ACEi- (HR = 0.76; 95% CI = 0.55, 1.06) or AHT- (HR = 1.18; 95% CI = 0.59, 2.36). The effects of long-term PA on the incidence of MMD and persistent MMD were similar among three subgroups of older adults stratified by their antihypertensive medication use. However, though statistical interactions did not reach significance, several findings may warrant future study in other cohorts given the post hoc nature of this study. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
JHON J. SANABRIA
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.
Hyder, Adnan A; Alonge, Olakunle; He, Siran; Wadhwaniya, Shirin; Rahman, Fazlur; El Arifeen, Shams
Drowning is the commonest cause of injury-related deaths among under-five children worldwide, and 95% of deaths occur in low- and middle-income countries (LMICs) where there are implementation gaps in the drowning prevention interventions. This article reviews common interventions for drowning prevention, introduces a framework for effective implementation of such interventions, and describes the Saving of Lives from Drowning (SoLiD) Project in Bangladesh, which is based on this framework. A review of the systematic reviews on drowning interventions was conducted, and original research articles were pulled and summarized into broad prevention categories. The implementation framework builds upon two existing frameworks and categorizes the implementing process for drowning prevention interventions into four phases: planning, engaging, executing, and evaluating. Eleven key characteristics are mapped in these phases. The framework was applied to drowning prevention projects that have been undertaken in some LMICs to illustrate major challenges to implementation. The implementation process for the SoLiD Project in Bangladesh is used as an example to illustrate the practical utilization of the framework. Drowning interventions, such as pool fencing and covering of water hazards, are effective in high-income countries; however, most of these interventions have not been tested in LMICs. The critical components of the four phases of implementing drowning prevention interventions may include: (i) planning-global funding, political will, scale, sustainability, and capacity building; (ii) engaging-coordination, involvement of appropriate individuals; (iii) executing-focused action, multisectoral actions, quality of execution; and (iv) evaluating-rigorous monitoring and evaluation. Some of the challenges to implementing drowning prevention interventions in LMICs include insufficient funds, lack of technical capacity, and limited coordination among stakeholders and implementers
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 ...
Morris, Heather; Skouteris, Helen; Edwards, Susan; Rutherford, Leonie
Partnering early childhood education and care (ECEC) and the home together may be more effective in combating obesogenic risk factors in preschool children. Thus, an evaluation of ECEC obesity prevention interventions with a parental component was conducted, exploring parental engagement and its effect on obesity and healthy lifestyle outcomes. A…
Välimäki, Maritta; Yang, Min; Normand, Sharon-Lise; Lorig, Kate R; Anttila, Minna; Lantta, Tella; Pekurinen, Virve; Adams, Clive E
People admitted to psychiatric hospitals with a diagnosis of schizophrenia may display behavioural problems. These may require management approaches such as use of coercive practices, which impact the well-being of staff members, visiting families and friends, peers, as well as patients themselves. Studies have proposed that not only patients' conditions, but also treatment environment and ward culture may affect patients' behaviour. Seclusion and restraint could possibly be prevented with staff education about user-centred, more humane approaches. Staff education could also increase collaboration between patients, family members and staff, which may further positively affect treatment culture and lower the need for using coercive treatment methods. This is a single-blind, two-arm cluster randomised controlled trial involving 28 psychiatric hospital wards across Finland. Units will be randomised to receive either a staff educational programme delivered by the team of researchers, or standard care. The primary outcome is the incidence of use of patient seclusion rooms, assessed from the local/national health registers. Secondary outcomes include use of other coercive methods (limb restraint, forced injection, and physical restraint), service use, treatment satisfaction, general functioning among patients, and team climate and employee turn-over (nursing staff). The study, designed in close collaboration with staff members, patients and their relatives, will provide evidence for a co-operative and user-centred educational intervention aiming to decrease the prevalence of coercive methods and service use in the units, increase the functional status of patients and improve team climate in the units. We have identified no similar trials. ClinicalTrials.gov NCT02724748 . Registered on 25 th of April 2016.
Turhan, Abdullah; Onrust, Simone A; Ten Klooster, Peter M; Pieterse, Marcel E
To test the effectiveness of the Healthy School and Drugs (HSD) programme on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends upon subtypes of SE schools and the level of implementation. In a quasi-experimental design with baseline and post-treatment follow-up, 363 students were allocated arbitrarily or depending on teacher motivation to either intervention condition (n = 205) or usual curriculum (n = 158). Thirteen secondary SE schools spread throughout the Netherlands. Participants were recruited during the autumn of 2013 from three school subtypes: SE for adolescents with intellectual/physical disabilities (SEI; n = 13), behavioural/emotional difficulties (SEB; n = 136) and learning disabilities/developmental disorders (SEL; n = 214). Self-reported life-time smoking prevalence and life-time drinking frequency as outcomes, and school subtype (SEL/SEB) and implementation fidelity (high/low) as moderators. No significant differences were found at follow-up in life-time smoking [odds ratio (OR) = 1.52; 95% confidence interval (CI) = 0.74-3.12] and drinking frequency (d = 0.01; 95% CI = -0.16 to 0.18). Interaction analyses revealed adverse effects in SEB students for alcohol use (d = 0.43; 95% CI = 0.16-0.69). Effect on tobacco refusal self-efficacy was moderated positively by implementation fidelity (d = 0.35; 95% CI = 0.07-0.63). The Healthy School and Drugs programme adapted for secondary special education in the Netherlands lacked clear evidence for effects on all outcomes. This pilot study suggests further that, within special education, substance use interventions may need to be targeted at school subtypes, as these may have harmful effects among students with behavioural difficulties. Finally, limited evidence was found that programme effectiveness may depend upon implementation fidelity. © 2016 Society for the Study of Addiction.
Esther Quirós Abajo
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.
Navarro, A M; Senn, K L; Kaplan, R M; McNicholas, L; Campo, M C; Roppe, B
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.
Nathanielsz, Peter W; Ford, Stephen P; Long, Nathan M; Vega, Claudia C; Reyes-Castro, Luis A; Zambrano, Elena
Maternal obesity is a global epidemic affecting both developed and developing countries. Human and animal studies indicate that maternal obesity adversely programs the development of offspring, predisposing them to chronic diseases later in life. Several mechanisms act together to produce these adverse health effects. There is a consequent need for effective interventions that can be used in the management of human pregnancy to prevent these outcomes. The present review analyzes the dietary and exercise intervention studies performed to date in both altricial and precocial animals, rats and sheep, with the aim of preventing adverse offspring outcomes. The results of these interventions present exciting opportunities to prevent, at least in part, adverse metabolic and other outcomes in obese mothers and their offspring. © 2013 International Life Sciences Institute.
Werb, Dan; Buxton, Jane; Shoveller, Jeannie; Richardson, Chris; Rowell, Greg; Wood, Evan
Injection drug use has been identified as a key source of morbidity and mortality, primarily from overdose and the transmission of blood-borne diseases such as HIV. Experts have therefore called for the prioritization of resources toward the prevention of injection drug use. However, these strategies have not been systematically assessed. PRISMA guidelines were used to systematically review and extract findings from the peer-reviewed literature evaluating the effectiveness of interventions to prevent injecting initiation. We searched 10 English language electronic databases (PubMed, PsycINFO, EMBASE, Cochrane CENTRAL, CINAHL, Web of Science, TOXNET, AIDSLINE, AMED and ERIC), the Internet (Google, Google Scholar), and article reference lists, from database inception to June 1st, 2012. Overall, out of 384 studies identified in the initial search, eight met the inclusion criteria. Studies evaluated four different types of interventions: social marketing, peer-based behavior modification, treatment, and drug law enforcement. Four studies observed a significant effect of the intervention on reducing rates of injecting initiation. Peer-based behavior modification and addiction treatment interventions were found to be most effective. Two of three studies assessing the impact of drug law enforcement on patterns of injecting initiation found no impact on injecting initiation, while one study reported inconclusive results. There exists a limited scientific literature on strategies to prevent injecting initiation. Resources should be allocated toward increased research and development of effective interventions to prevent this phenomenon. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Ettema, Roelof G A; Van Koeven, Heleen; Peelen, Linda M; Kalkman, Cor J; Schuurmans, Marieke J
The literature on postoperative complications in cardiac surgery patients shows high incidences of postoperative complications such as delirium, depression, pressure ulcer, infection, pulmonary complications and atrial fibrillation. These complications are associated with functional and cognitive decline and a decrease in the quality of life after discharge. Several studies attempted to prevent one or more postoperative complications by preoperative interventions. Here we provide a comprehensive overview of both single and multiple component preadmission interventions designed to prevent postoperative complications. We systematically reviewed the literature following the PRISMA statement guidelines. Of 1335 initial citations, 31 were subjected to critical appraisal. Finally, 23 studies were included, of which we derived a list of interventions that can be applied in the preadmission period to effectively reduce postoperative depression, infection, pulmonary complications, atrial fibrillation, prolonged intensive care unit stay and hospital stay in older elective cardiac surgery patients. No high quality studies were found describing effective interventions to prevent postoperative delirium. We did not find studies specifically targeting the prevention of pressure ulcers in this patient population. Multi-component approaches that include different single interventions have the strongest effect in preventing postoperative depression, pulmonary complications, prolonged intensive care unit stay and hospital stay. Postoperative infection can be best prevented by disinfection with chlorhexidine combined with immune-enhancing nutritional supplements. Atrial fibrillation might be prevented by ingestion of N-3 polyunsaturated fatty acids. High quality studies are urgently needed to evaluate preadmission preventive strategies to reduce postoperative delirium or pressure ulcers in older elective cardiac surgery patients. Copyright © 2013 Elsevier Ltd. All rights reserved.
Kennedy, Suzanne; Bailey, Ryan; Jaffee, Katy; Markus, Anne; Gerstein, Maya; Stevens, David M; Lesch, Julie Kennedy; Malveaux, Floyd J; Mitchell, Herman
Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers. Children (aged 5-12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant's allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months. A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of -2.28; intervention, change of -3.27; difference, -0.99; P asthma in these high-need populations. Copyright © 2017 by the American Academy of Pediatrics.
Elliot, D; Goldberg, L
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.
Choi, Sang D; Guo, Liangjie; Kang, Donghun; Xiong, Shuping
Training balance and promoting physical activities in the elderly can contribute to fall-prevention. Due to the low adherence of conventional physical therapy, fall interventions through exergame technologies are emerging. The purpose of this review study is to synthesize the available research reported on exergame technology and interactive interventions for fall prevention in the older population. Twenty-five relevant papers retrieved from five major databases were critically reviewed and analyzed. Results showed that the most common exergaming device for fall intervention was Nintendo Wii, followed by Xbox Kinect. Even though the exergame intervention protocols and outcome measures for assessing intervention effectiveness varied, the accumulated evidences revealed that exergame interventions improved physical or cognitive functions in the elderly. However, it remains inconclusive whether or not the exergame-based intervention for the elderly fall prevention is superior to conventional physical therapy and the effect mechanism of the exergaming on elderly's balance ability is still unclear. Copyright © 2016 Elsevier Ltd. All rights reserved.
Kim, Min Jeong; Sung, Eunju; Choi, Eun Young; Ju, Young-Su; Park, Eal-Whan; Cheong, Yoo-Seock; Yoo, Sunmi; Park, Kyung Hee; Choi, Hyung Jin; Kim, Seolhye
The prevalence of childhood obesity in South Korea has increased owing to economic improvement and the prevailing Westernized dietary pattern. As the incidence of chronic diseases caused by obesity is also expected to increase, effective interventions to prevent childhood obesity are needed. Therefore, we conducted a Delphi study to determine the priorities of a potential intervention research on childhood obesity prevention and its adequacy and feasibility. The two-round Delphi technique was used with a panel of 10 childhood obesity experts. The panelists were asked to rate "priority populations," "methods of intervention," "measurement of outcomes," "future intervention settings," and "duration of intervention" by using a structured questionnaire. Finally, a portfolio analysis was performed with the adequacy and feasibility indexes as the two axes. For priority populations, the panel favored "elementary," "preschool," and "middle and high school" students in this order. Regarding intervention settings, the panelists assigned high adequacy and feasibility to "childcare centers" and "home" for preschool children, "school" and "home" for elementary school children, and "school" for adolescents in middle and high school. As the age of the target population increased, the panelists scored increasing numbers of anthropometric, clinical, and intermediate outcomes as highly adequate and feasible for assessing the effectiveness of the intervention. According to the results of the Delphi survey, the highest-priority population for the research on childhood obesity prevention was that of elementary school students. Various settings, methods, outcome measures, and durations for the different age groups were also suggested.
Implementing a patient education intervention about Methicillin-resistant Staphylococcus aureus prevention and effect on knowledge and behavior in veterans with spinal cord injuries and disorders: a pilot randomized controlled trial.
Evans, Charlesnika T; Hill, Jennifer N; Guihan, Marylou; Chin, Amy; Goldstein, Barry; Richardson, Michael S A; Anderson, Vicki; Risa, Kathleen; Kellie, Susan; Cameron, Kenzie A
To assess the feasibility and effect of a nurse-administered patient educational intervention about Methicillin-resistant Staphylococcus aureus (MRSA) prevention on knowledge and behavior of Veterans with spinal cord injuries and disorders (SCI/D). Blinded, block-randomized controlled pilot trial. Two Department of Veterans Affairs (VA) SCI Centers. Veterans were recruited March-September 2010 through referral by a healthcare provider from inpatient, outpatient, and residential care settings. Thirty participants were randomized to the nurse-administered intervention and 31 to the usual care group. The intervention included a brochure and tools to assist nurses in conducting the education. Pre- and post-intervention measurement of knowledge and behaviors related to MRSA and prevention strategies and feasibility measures related to implementation. Participants were primarily male (95.1%), white (63.9%), with tetraplegia (63.9%) and mean age and duration of injury of 64.3 and 20.5 years, respectively. The intervention groups mean knowledge score significantly increased between pre- and post-test (mean change score = 1.70, 95% confidence interval, CI 0.25-3.15) while the usual care groups score did not significantly change (mean change score = 1.45, 95% CI -0.08-2.98). However, the mean knowledge change between intervention and usual care groups was not significantly different (P = 0.81). Overall behavior scores did not significantly differ between treatment groups; however, the intervention group was more likely to report intentions to clean hands (90.0% vs. 64.5%, P = 0.03) and asking providers about MRSA status (46.7% vs. 16.1%, P = 0.01). Nurse educators reported that the quality of the intervention was high and could be implemented in clinical care. A targeted educational strategy is feasible to implement in SCI/D clinical practices and may improve some participants' knowledge about MRSA and increase intentions to improve hand hygiene and engagement with providers
Are work disability prevention interventions effective for the management of neck pain or upper extremity disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration.
Varatharajan, Sharanya; Côté, Pierre; Shearer, Heather M; Loisel, Patrick; Wong, Jessica J; Southerst, Danielle; Yu, Hainan; Randhawa, Kristi; Sutton, Deborah; van der Velde, Gabrielle; Mior, Silvano; Carroll, Linda J; Jacobs, Craig; Taylor-Vaisey, Anne
We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology. Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers' recovery from recent work-related neck and upper extremity complaints. At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions.
Stauffer, Sterling; Heath, Melissa Allen; Coyne, Sarah Marie; Ferrin, Scott
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…
Lodi, Giovanni; Franchini, Roberto; Warnakulasuriya, Saman; Varoni, Elena Maria; Sardella, Andrea; Kerr, Alexander R; Carrassi, Antonio; MacDonald, L C I; Worthington, Helen V
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.
Wang, Li Yan; Nichols, Lauren P; Austin, S Bryn
To assess the economic effect of the school-based obesity prevention program Planet Health on preventing disordered weight control behaviors and to determine the cost-effectiveness of the intervention in terms of its combined effect on prevention of obesity and disordered weight control behaviors. On the basis of the intervention's short-term effect on disordered weight control behaviors prevention, we projected the number of girls who were prevented from developing bulimia nervosa by age 17 years. We further estimated medical costs saved and quality-adjusted life years gained by the intervention over 10 years. As a final step, we compared the intervention costs with the combined intervention benefits from both obesity prevention (reported previously) and prevention of disordered weight control behaviors to determine the overall cost-effectiveness of the intervention. Middle schools. A sample of 254 intervention girls aged 10 to 14 years. The Planet Health program was implemented during the school years from 1995 to 1997 and was designed to promote healthful nutrition and physical activity among youth. Intervention costs, medical costs saved, quality-adjusted life years gained, and cost-effectiveness ratio. An estimated 1 case of bulimia nervosa would have been prevented. As a result, an estimated $33 999 in medical costs and 0.7 quality-adjusted life years would be saved. At an intervention cost of $46 803, the combined prevention of obesity and disordered weight control behaviors would yield a net savings of $14 238 and a gain of 4.8 quality-adjusted life years. Primary prevention programs, such as Planet Health, warrant careful consideration by policy makers and program planners. The findings of this study provide additional argument for integrated prevention of obesity and eating disorders.
Davoudi-Kiakalayeh, Ali; Mohammadi, Reza; Yousefzadeh-Chabok, Shahrokh
Background Drowning is a serious but neglected health problem in low-and middle-income countries. Objectives To describe the effectiveness of drowning prevention program on the reduction of drowning mortality rates in rural settings at the north of Iran, and guide its replication elsewhere. Patients and Methods This interventional design included pre- and post-intervention observations in the rural area of the Caspian Sea coastline without a comparison community. Cross-sectional data were col...
Full Text Available Background: The objective was to evaluate the cost-effectiveness of NEPA, an oral fixed combination netupitant (NETU, 300 mg and palonosetron (PA, 0.5 mg compared with aprepitant and palonosetron (APPA or palonosetron (PA alone, to prevent chemotherapy-induced nausea and vomiting (CINV in patients undergoing treatment with highly or moderately emetogenic chemotherapy (HEC or MEC in the UK. Scope: A systematic literature review and meta-analysis were undertaken to compare NEPA with currently recommended anti-emetics. Relative effectiveness was estimated over the acute (day 1 and overall treatment (days 1–5 phases, taking complete response (CR, no emesis and no rescue medication and complete protection (CP, CR and no more than mild nausea [VAS scale <25 mm] as primary efficacy outcomes. A three-health-state Markov cohort model, including CP, CR and incomplete response (no CR for HEC and MEC, was constructed. A five-day time horizon and UK NHS perspective were adopted. Transition probabilities were obtained by combining the response rates of CR and CP from NEPA trials and odds ratios from the meta-analysis. Utilities of 0.90, 0.70 and 0.24 were defined for CP, CR and incomplete response, respectively. Costs included medications and management of CINV-related events and were obtained from the British National Formulary and NHS Reference Costs. The expected budgetary impact of NEPA was also evaluated. Findings: In HEC patients, the NEPA strategy was more effective than APPA (quality-adjusted life days [QALDs] of 4.263 versus 4.053; incremental emesis-free and CINV-free days of +0.354 and +0.237, respectively and was less costly (£80 versus £124, resulting in NEPA being the dominant strategy. In MEC patients, NEPA was cost effective, cumulating in an estimated 0.182 extra QALDs at an incremental cost of £6.65 compared with PA. Conclusion: Despite study limitations (study setting, time horizon, utility measure, the results suggest NEPA is cost
Cawston, Helene; Bourhis, Francois; Eriksson, Jennifer; Ruffo, Pierfrancesco; D'Agostino, Paolo; Turini, Marco; Schwartzberg, Lee; McGuire, Alistair
The objective was to evaluate the cost-effectiveness of NEPA, an oral fixed combination netupitant (NETU, 300 mg) and palonosetron (PA, 0.5 mg) compared with aprepitant and palonosetron (APPA) or palonosetron (PA) alone, to prevent chemotherapy-induced nausea and vomiting (CINV) in patients undergoing treatment with highly or moderately emetogenic chemotherapy (HEC or MEC) in the UK. A systematic literature review and meta-analysis were undertaken to compare NEPA with currently recommended anti-emetics. Relative effectiveness was estimated over the acute (day 1) and overall treatment (days 1-5) phases, taking complete response (CR, no emesis and no rescue medication) and complete protection (CP, CR and no more than mild nausea [VAS scale <25 mm]) as primary efficacy outcomes. A three-health-state Markov cohort model, including CP, CR and incomplete response (no CR) for HEC and MEC, was constructed. A five-day time horizon and UK NHS perspective were adopted. Transition probabilities were obtained by combining the response rates of CR and CP from NEPA trials and odds ratios from the meta-analysis. Utilities of 0.90, 0.70 and 0.24 were defined for CP, CR and incomplete response, respectively. Costs included medications and management of CINV-related events and were obtained from the British National Formulary and NHS Reference Costs. The expected budgetary impact of NEPA was also evaluated. In HEC patients, the NEPA strategy was more effective than APPA (quality-adjusted life days [QALDs] of 4.263 versus 4.053; incremental emesis-free and CINV-free days of +0.354 and +0.237, respectively) and was less costly (£80 versus £124), resulting in NEPA being the dominant strategy. In MEC patients, NEPA was cost effective, cumulating in an estimated 0.182 extra QALDs at an incremental cost of £6.65 compared with PA. Despite study limitations (study setting, time horizon, utility measure), the results suggest NEPA is cost effective for preventing CINV associated with HEC
Kutcher, Stan; Wei, Yifeng; Behzadi, Pegah
Suicide in young people is a significant health concern, with numerous community- and school-based interventions promising to prevent suicide currently being applied across Canada. Before widespread application of any one of these, it is essential to determine its effectiveness and safety. We systematically reviewed the global literature on one of the most common community suicide prevention interventions in Canada and summarized data on 2 commonly applied school-based suicide prevention programmes. None of these has demonstrated effectiveness in preventing youth suicide or safety in application. Concurrently with their widespread distribution in Canada, the suicide rate in young women has increased-the first time in over 3 decades. Policy and regulatory implications of these findings are discussed.
Sanchez, Jorge; Lama, Javier R.; Peinado, Jesus; Paredes, Andres; Lucchetti, Aldo; Russell, Kevin; Kochel, Tadeusz; Sebastian, Jose L.
Background In the Andean Region, HIV and sexually transmitted infections (STI) are most prevalent among men who have sex with men (MSM), but incidence estimates and associated factors have never been prospectively assessed. Methods A cohort of 1056 high-risk HIV-negative MSM in Lima, Peru, was recruited during 1998–2000 (The ALASKA Cohort) and a nested case-control analysis conducted between seroconverters and non-seroconverters, matched 1:3 by age and duration of follow-up for comparison of risk behaviors, acute retroviral symptoms, circumcision, and STI. Results During average follow-up of 335 days, 34 men seroconverted, providing a HIV incidence estimate of 3.5/100 person-years (95% CI: 2.3–4.7). High syphilis (9.2/100 person-years, 95% CI: 6.7–10.1) and HSV-2 infection (10.4/100 person-years, 95% CI: 8.6–11.9) incidence estimates were obtained. HIV seroconverters were more likely than men who remained seronegative to report fever ≥3 days (46% vs. 7%), to seek medical care (62% vs. 27%), and to have ≥1 casual partner (86.2% vs. 74.1%) since their last visit. HIV seroconverters also were more likely to have acquired syphilis or HSV-2 infection (31% vs. 8% among initially HSV-2 seronegative men) while were less likely to be circumcised (4.2% vs. 20.6%, a non-significant difference). In multivariate analysis, incident syphilis or HSV-2 infection (OR: 5.9, 95% CI 1.5–22.7) and sex with any casual partner (OR: 4.8, 95% CI: 0.9–26.2) were associated with HIV seroconversion. Conclusions STI that may cause anogenital ulcers are important risk factors for HIV acquisition among high-risk MSM in Lima, a population with a very high HIV incidence estimate. Synergistic interventions focusing in preventing both HIV and HSV-2, like male circumcision, are warranted to be assessed, especially in MSM populations with low levels of circumcision and high incidence estimates of ulcerative STI. PMID:19384102
Bourdel-Marchasson, Isabelle; Rondeau, Virginie
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 ...
Shih, Sophy T.F.; Davis-Lameloise, Nathalie; Janus, Edward D.
Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with its onset or first recognition during pregnancy. Post-GDM women have a life-time risk exceeding 70% of developing type 2 diabetes mellitus (T2DM). Lifestyle modifications reduce the incidence of T2DM by up to 58......% for high-risk individuals. Methods/Design: The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial aiming to assess the effectiveness of a structured diabetes prevention intervention for post-GDM women. This trial has an intervention...... group participating in a diabetes prevention program (DPP), and a control group receiving usual care from their general practitioners during the same time period. The 12-month intervention comprises an individual session followed by five group sessions at two-week intervals, and two follow-up telephone...
Vind, Ane B; Andersen, Hanne E; Pedersen, Kirsten D
, mean age 74, 73.7%women, who had visited the emergency department or had been hospitalized due to a fall. INTERVENTION: Identification of general medical, cardiovascular, and physical risk factors for falls and individual intervention in the intervention group. Participants in the control group....... Followup exceeded 90.0%. A total of 422 falls were registered in the intervention group, 398 in the control group. Intention-to-treat analysis revealed no effect of the intervention on fall rates (relative risk=1.06, 95%confidence interval (CI)=0.75 -1.51), proportion with falls (odds ratio (OR)=1.20, 95......OBJECTIVES: To evaluate the effect of multifactorial fall prevention in community-dwelling people aged 65 and older in Denmark. DESIGN: Randomized, controlled clinical trial. SETTING: Geriatric outpatient clinic at Glostrup University Hospital. PARTICIPANTS: Three hundred ninety-two elderly people...
D. J. M. A. Beaujean
Full Text Available Abstract Background Lyme disease or Lyme borreliosis (LB is the most common tick-borne disease both in the United States and Europe. Children, in particular, are at high risk of contracting LB. Since child-specific educational tools on ticks, tick bites and LB are lacking, we developed an online educational video game. In this study, we compared the effectiveness of an online educational video game versus a newly developed leaflet aimed to improve prevention of tick bites and LB among Dutch schoolchildren. Methods A total of 887 children, aged 9–13 years and attending the two final years of primary schooling, were recruited from 25 primary schools in June and July 2012. They were assigned through cluster randomization to one of three intervention groups: ‘game’ (22.4%, ‘leaflet’ (35.6% or ‘control’ (41.9%. Prior to and directly following intervention, the children were asked to complete a short questionnaire. The main outcome measures were knowledge, perception (perceived susceptibility and importance and preventive behavior in relation to tick bites and LB. Generalized linear mixed models were used to analyze the data. Results In the game group, the leaflet group and the control group, knowledge about ticks and tick bites improved significantly. The game was also an effective tool for improving preventive behavior; the frequency of checking for ticks increased significantly. However, there were no significant differences in knowledge improvement between the interventions. The game outperformed the leaflet in terms of improving preventive behavior, whereas the frequency of tick checks increased significantly. But this frequency didn’t increase more than in the control group. Conclusions The positive knowledge effects observed in the control group suggests the presence of a mere measurement effect related to completion of the questionnaire. The game did not outperform the leaflet or control group on all outcome measures. Therefore
Beaujean, D J M A; Gassner, F; Wong, A; Steenbergen, J E; Crutzen, R; Ruwaard, D
Lyme disease or Lyme borreliosis (LB) is the most common tick-borne disease both in the United States and Europe. Children, in particular, are at high risk of contracting LB. Since child-specific educational tools on ticks, tick bites and LB are lacking, we developed an online educational video game. In this study, we compared the effectiveness of an online educational video game versus a newly developed leaflet aimed to improve prevention of tick bites and LB among Dutch schoolchildren. A total of 887 children, aged 9-13 years and attending the two final years of primary schooling, were recruited from 25 primary schools in June and July 2012. They were assigned through cluster randomization to one of three intervention groups: 'game' (22.4%), 'leaflet' (35.6%) or 'control' (41.9%). Prior to and directly following intervention, the children were asked to complete a short questionnaire. The main outcome measures were knowledge, perception (perceived susceptibility and importance) and preventive behavior in relation to tick bites and LB. Generalized linear mixed models were used to analyze the data. In the game group, the leaflet group and the control group, knowledge about ticks and tick bites improved significantly. The game was also an effective tool for improving preventive behavior; the frequency of checking for ticks increased significantly. However, there were no significant differences in knowledge improvement between the interventions. The game outperformed the leaflet in terms of improving preventive behavior, whereas the frequency of tick checks increased significantly. But this frequency didn't increase more than in the control group. The positive knowledge effects observed in the control group suggests the presence of a mere measurement effect related to completion of the questionnaire. The game did not outperform the leaflet or control group on all outcome measures. Therefore, the game may be of value as a complementary role, in addition to other media
Balfour, Julie; Abdulcadir, Jasmine; Say, Lale; Hindin, Michelle J
Studies on healthcare providers' awareness, knowledge and attitudes regarding female genital mutilation (FGM) have shown a lack of awareness of the prevalence, diagnosis, and management of FGM. Our objective was to systematically review the literature on interventions improving healthcare providers' capacities of prevention and treatment of FGM. Systematic review of the published and grey literature on interventions aimed at improving healthcare providers' capacities of prevention and treatment of FGM (1995-2015). Outcomes observed were knowledge and attitudes about FGM, medicalization, and prevention. Only two studies met our inclusion criteria. They reported on educational interventions aimed at increasing caregivers' knowledge on FGM. One was conducted with 59 providers, in Mali; the other one with 11 certified nurse-midwives in the United States. The studies report basic statistics regarding the improvement of healthcare professionals' knowledge, attitude on FGM and medicalization of the practice. Neither conducted multivariable analysis nor evaluated the training effects on the quality of the care offered, the clinical outcomes and the satisfaction of women attended, and prevention. As health care providers are essential in prevention and treatment of FGM, developing effective interventions is crucial.
Mugisa, Margaret; Muzoora, Abel
Malaria is a leading killer disease in Uganda and it accounts for significant morbidity in pregnant women and children. Pregnant women are more susceptible to malaria, which causes adverse effects including abortion, low birth weight and maternal anaemia. Children with severe malaria frequently develop one of these symptoms including: severe anaemia, respiratory distress, Prostration, convulsions and cerebral malaria. Due to the severity of the disease there is need for multiple interventions to reduce the disease burden. African Medical and Research Foundation (AMREF) adopted community based approaches to improve malaria prevention. Behavioral change communication (BCC) was fundamental at every process of Project implementation. This paper shares AMREF's experience in using BCC strategies amidst other interventions in malaria prevention approaches involving use of insecticide treated nets and environment management. AMREF through a Malaria project (2007-2010) in Nakasongola district supported BCC activities through training, community mobilization, mass media, health promotion and advocacy. Program performance was measured through baseline and evaluation surveys in 2007 and 2010. The final project evaluation indicated improvement from baseline values as follows: knowledge on prevention of malaria among school children from 76.6% to 90%, under five children sleeping under bed net the previous night from 51% to 74.7%, and from 24% to 78% among pregnant women. Mobilization of malaria prevention interventions can be successful once BCC approaches are adequately planned and coordinated. Malaria prevention through BCC strategies are likely to be more effective with integration of other malaria interventions, and involvement of community based structures.
Lein, Donald H., Jr.; Clark, Diane; Turner, Lori W.; Kohler, Connie L.; Snyder, Scott; Morgan, Sarah L.; Schoenberger, Yu-Mei M.
Purpose: The purpose of this study was to evaluate the effectiveness of a theory-based computer-tailored osteoporosis prevention program on calcium and vitamin D intake and osteoporosis health beliefs in young women. Additionally, this study tested whether adding bone density testing to the intervention improved the outcomes. Methods: One hundred…
Whitley, Jessica; Smith, J. David; Vaillancourt, Tracy
Teachers and other school staff play key roles as partners in the prevention, identification, and intervention of mental health difficulties among children and youth. However, it is essential that teachers are equipped with sufficient mental health literacy to engender effective practices in these areas. This article reviews the literature related…
Wolmer, Leo; Hamiel, Daniel; Laor, Nathaniel
Objective: The psychological outcomes that the exposure to mass trauma has on children have been amply documented in the past decades. The objective of this study is to describe the effects of a universal, teacher-based preventive intervention implemented with Israeli students before the rocket attacks that occurred during Operation Cast Lead,…
Oostdam, N.; Poppel, M.N.M. van; Wouters, M.G.A.J.; Mechelen, W. van
Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM is associated with increased risks for mother and child during pregnancy and in later life. The aim of this article is to systematically review literature on the effectiveness of interventions to prevent
Oostdam, N.; van Poppel, M.N.M.; Wouters, M.G.A.J.; van Mechelen, W.
Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM is associated with increased risks for mother and child during pregnancy and in later life. The aim of this article is to systematically review literature on the effectiveness of interventions to prevent
Mason, W. Alex; Kosterman, Rick; Hawkins, J. David; Haggerty, Kevin P.; Spoth, Richard L.; Redmond, Cleve
Preparing for the Drug Free Years (PDFY) is a preventive intervention that targets parenting behaviors, family interaction patterns, and adolescent substance use, factors that have been shown to predict depression among teenagers. Effects of PDFY on trajectories of self-reported adolescent depressive symptoms from 6th through 12th grade were…
A mixed methods study to assess the effectiveness of food-based interventions to prevent stunting among children under-five years in Districts Thatta and Sujawal, Sindh Province, Pakistan: study protocol
Full Text Available Abstract Background Maternal and child malnutrition is widely prevalent in low and middle income countries. In Pakistan, widespread food insecurity and malnutrition are the main contributors to poor health, low survival rates and the loss of human capital development. The nutritional status trends among children exhibit a continuous deteriorating with rates of malnutrition exceeding the WHO critical threshold. With the high prevalence of maternal and child malnutrition, it is important to identify effective preventative approaches, especially for reducing stunting in children under-five years of age. The primary aim of this study is to assess the effectiveness of food-based interventions to prevent stunting in children under-five years. Methods A mixed methods study design will be conducted to evaluate the effectiveness of food-based interventions to prevent stunting among children under-five years in districts Thatta and Sujawal, Sindh Province, Pakistan. The study will include cross sectional surveys, a community-based cluster randomized controlled trial and a process evaluation. The study participants will be pregnant women, lactating mothers and children under-five years. The cross-sectional surveys will be conducted with 7360 study participants at baseline and endline. For the randomized control trial, 5000 participants will be recruited and followed monthly for compliance of food-based supplements, dietary diversity, pregnancy outcomes, and maternal and child morbidity and mortality. Anthropometric measurements and hemoglobin levels will be measured at baseline, quarterly and at endline. The interventions will consist of locally produced lipid-based nutrient supplement (Wawamum for children 6–23 months, micronutrient powders for children 24–59 months, and wheat soya blends for pregnant and lactating mothers. Government lady health workers will deliver interventions to participants. The effectiveness of the project will be measured in
Elsman, E.B.M.; Leerlooijer, J.N.; Beek, ter J.; Duijzer, G.; Jansen, S.C.; Hiddink, G.J.; Feskens, E.J.M.; Haveman-Nies, A.
Background 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
Shepard, Stephanie A; Dickstein, Susan
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.
Mary V. Seeman
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.
Branscum, Paul; Sharma, Manoj
The purpose of this article was to review primary prevention interventions targeting childhood obesity implemented in the after school environment from 2006 and 2011. A total of 20 interventions were found from 25 studies. Children in the interventions ranged from kindergarten to middle schoolers, however a majority was in the 4th and 5th grades. Most of the interventions targeted both physical activity and dietary behaviors. Among those that focused on only one dimension, physical activity was targeted more than diet. The duration of the interventions greatly varied, but many were short-term or brief. Many interventions were also based on some behavioral theory, with social cognitive theory as the most widely used. Most of the interventions focused on short-term changes, and rarely did any perform a follow-up evaluation. A major limitation among after school interventions was an inadequate use of process evaluations. Overall, interventions resulted in modest changes in behaviors and behavioral antecedents, and results were mixed and generally unfavorable with regards to indicators of obesity. Recommendations for enhancing the effectiveness of after school based childhood obesity interventions are presented.
Full Text Available The purpose of this article was to review primary prevention interventions targeting childhood obesity implemented in the after school environment from 2006 and 2011. A total of 20 interventions were found from 25 studies. Children in the interventions ranged from kindergarten to middle schoolers, however a majority was in the 4th and 5th grades. Most of the interventions targeted both physical activity and dietary behaviors. Among those that focused on only one dimension, physical activity was targeted more than diet. The duration of the interventions greatly varied, but many were short-term or brief. Many interventions were also based on some behavioral theory, with social cognitive theory as the most widely used. Most of the interventions focused on short-term changes, and rarely did any perform a follow-up evaluation. A major limitation among after school interventions was an inadequate use of process evaluations. Overall, interventions resulted in modest changes in behaviors and behavioral antecedents, and results were mixed and generally unfavorable with regards to indicators of obesity. Recommendations for enhancing the effectiveness of after school based childhood obesity interventions are presented.
Reza Rahimi Moghaddam
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.
Sharp, Veronica; Giorgi, Sara; Wilson, David C
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.
Zhang, Xin-Yi; Shuai, Jian; Li, Li-Ping
Our study objective was to determine the effect of vision intervention and combinations of different intervention components on preventing falls and fall-related injuries among older people. Six electronic databases were searched to identify seven articles published before May, 2014. We conducted a systematic review of data from seven randomized controlled trails and identified eight regimens: vision intervention alone (V), vision plus exercise (referred to as physical exercise) interventions (V + E), vision plus home hazard interventions (V + HH), vision plus exercise plus home hazard interventions (V + E + HH), vision plus exercise plus sensation interventions (V + E + S), vision plus hearing interventions (V + H), vision plus various risk factor assessment and interventions (V + VRF), and the control group (C, no intervention group). The main outcome was the incidence of falls during the follow-up period. Seven papers included 2723 participants. Network meta-analysis of seven trials, using pairwise comparisons between each intervention, indicated there was no significant difference. However, there was a trend in which intervention incorporating V + VRF had more advantages than any other combination of interventions. In conclusion, V + VRF proves to be more effective than other V combination interventions in preventing falls in older people (≥65 years of age). V alone appears less effective in our network meta-analysis.
van Reijen, Miriam; Vriend, Ingrid; van Mechelen, Willem; Finch, Caroline F; Verhagen, Evert A
Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for. The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention. An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport- or physical activity-related injuries were included. Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented. Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.
Efectividad de las intervenciones cognitivas en la prevención del deterioro de la memoria en las personas mayores sanas Review of the effectiveness of cognitive interventions in preventing cognitive deterioration in healthy elderly individuals
Ana M. Novoa
Full Text Available Antecedentes: En los últimos años han aparecido diversas intervenciones no farmacológicas destinadas a prevenir el deterioro cognitivo asociado a la edad, concretamente los problemas de memoria, cuya efectividad no ha sido suficientemente evaluada. Objetivo: Establecer la efectividad de las intervenciones cognitivas en la prevención del deterioro de la memoria asociado a la edad mediante una revisión de la literatura científica. Métodos: Se realizó una búsqueda exhaustiva en PubMed. Se incluyeron los estudios publicados desde 1990 que evaluaran la efectividad de una intervención cognitiva sobre la memoria en personas mayores sin deterioro cognitivo leve ni demencia, y se clasificaron según su calidad. Se evaluaron los efectos, a corto y a largo plazo, sobre el rendimiento en tareas de memoria objetiva y subjetiva y la transferencia a otros dominios cognitivos. Resultados: Veinticinco estudios cumplieron los criterios de inclusión. Once (44% fueron considerados de elevada calidad, de los cuales todos excepto uno mejoraron algún indicador de memoria. El tipo de memoria más evaluada fue la memoria objetiva reciente verbal, que mejoró en 8 de 9 de los estudios de elevada calidad. La memoria objetiva reciente no verbal y de asociación, evaluadas principalmente por los estudios de calidad media, mejoraron en 4 de 7, y en 10 de 11 estudios, respectivamente. Los resultados referentes a memoria subjetiva fueron muy heterogéneos. La transferencia únicamente se observó en uno de 7 estudios de elevada calidad. Conclusiones: Los resultados sugieren que determinadas intervenciones cognitivas desarrolladas en personas mayores sanas son efectivas en la prevención del deterioro de la memoria, especialmente sobre la memoria reciente verbal.Background: In the last few years, several non-pharmacological interventions have been developed to prevent age-associated cognitive deterioration, specifically memory deterioration. The effectiveness of
Hamm, Julian; Money, Arthur G; Atwal, Anita; Paraskevopoulos, Ioannis
In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Burry, L. D.; Hutton, Brian; Guenette, M.
Background: Delirium is characterized by acute changes in mental status including inattention, disorganized thinking, and altered level of consciousness, and is highly prevalent in critically ill adults. Delirium has adverse consequences for both patients and the healthcare system; however......, at this time, no effective treatment exists. The identification of effective prevention strategies is therefore a clinical and research imperative. An important limitation of previous reviews of delirium prevention is that interventions were considered in isolation and only direct evidence was used. Our......-randomized trials of critically ill adults evaluating any pharmacological, non-pharmacological, or multi-component intervention for delirium prevention, administered in or prior to (i.e., peri-operatively) transfer to the ICU. Two authors will independently screen search results and extract data from eligible...
Verbeek, Jos H; Kateman, Erik; Morata, Thais C; Dreschler, Wouter A; Mischke, Christina
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 interrupted time-series of hearing loss prevention among workers exposed to noise. We included 19 studies with 82 794 participants evaluating effects of hearing loss prevention programs (HLPP). The overall quality of studies was low to very low, as rated using the GRADE approach. One study of stricter legislation showed a favorable effect on noise levels. Three studies, of which two RCTs, did not find an effect of a HLPP. Four studies showed that better use of hearing protection devices in HLPPs decreased the risk of hearing loss. In four other studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz (95% CI - 0.5 to 1.7) than non-exposed workers. In two similar studies there was a substantial risk of hearing loss in spite of a HLPP. Stricter enforcement of legislation and better implementation of HLPPs can reduce noise levels in workplaces. Better evaluations of technical interventions and long-term effects are needed.
Verbeek, Jos H.; Kateman, Erik; Morata, Thais C.; Dreschler, Wouter A.; Mischke, Christina
Objective To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions. Design We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and interrupted time-series of hearing loss prevention among workers exposed to noise. Study sample We included 19 studies with 82 794 participants evaluating effects of hearing loss prevention programs (HLPP). The overall quality of studies was low to very low, as rated using the GRADE approach. Results One study of stricter legislation showed a favorable effect on noise levels. Three studies, of which two RCTs, did not find an effect of a HLPP. Four studies showed that better use of hearing protection devices in HLPPs decreased the risk of hearing loss. In four other studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz (95% CI – 0.5 to 1.7) than non-exposed workers. In two similar studies there was a substantial risk of hearing loss in spite of a HLPP. Conclusions Stricter enforcement of legislation and better implementation of HLPPs can reduce noise levels in workplaces. Better evaluations of technical interventions and long-term effects are needed. PMID:24564697
Laver, S M; Van Den Borne, B; Kok, G; Woelk, G
End-point evaluations are still the most commonly used method of assessing the success or failure of interventions. This article describes how a process evaluation was used to measure "what happened" during an HIV/AIDS prevention program for farm workers in Zimbabwe. The intervention was developed according to the Paulo Freirian theory of Social Change and the Ecological Model for health promotion. The stages of the intervention were cyclical; in the first stage innovative methods were used to encourage appraisal of vulnerability to HIV/AIDS through activities which raised critical thinking and dialogue. In the next phase, emphasis was placed on developing cognitive and attitude change in the target group. Self-protective behavior was encouraged through condom use and an increase in self-efficacy with respect to negotiating safe sex, especially among women. In the last stage of the intervention, efforts were made to create a climate for maintenance of behavior and socially responsible action within the community. The process evaluation provided valuable insight into factors which, when aggregated, provided an overview of a program whose successes and failures may well have been determined by issues outside the scope of the intervention. The effect of seasonal fluctuations of labor, income, and farming activity on program activity, patterns of STD, and condom demand were marked. This leads back to the researchers' initial question: "Was the intervention implemented as planned?" and the answer-only partially.
Brown, Emma J.; Hill, Mary Angelique; Giroux, Stacey A.
Cocaine is a major problem in the rural South, but knowledge is limited regarding the impact on African American populations. Purpose: This study of 18-39-year-old black drug users assessed perceptions of contributing factors to drug use and possible interventions. The study design was qualitative-descriptive, utilizing 4 focus groups with 5 rural…
Full Text Available This article examines how the field of adolescent sexual health came to embrace evidence-based interventions (EBIs; whether or not this approach is effective in meeting the needs of adolescents, especially those at high risk for teen pregnancy; concerns related to the scaling up of EBIs; and identifies issues which must be resolved as we move forward.
Full Text Available Objective. To summarize key findings of economic evaluations of lifestyle interventions for the primary prevention of type 2 diabetes (T2D in high-risk subjects. Methods. We conducted a systematic review of peer-reviewed original studies published since January 2009 in English, French, and Spanish. Eligible studies were identified through relevant databases including PubMed, Medline, National Health Services Economic Evaluation, CINHAL, EconLit, Web of sciences, EMBASE, and the Latin American and Caribbean Health Sciences Literature. Studies targeting obesity were also included. Data were extracted using a standardized method. The BMJ checklist was used to assess study quality. The heterogeneity of lifestyle interventions precluded a meta-analysis. Results. Overall, 20 studies were retained, including six focusing on obesity control. Seven were conducted within trials and 13 using modeling techniques. T2D prevention by physical activity or diet or both proved cost-effective according to accepted thresholds, except for five inconclusive studies, three on diabetes prevention and two on obesity control. Most studies exhibited limitations in reporting results, primarily with regard to generalizability and justification of selected sensitivity parameters. Conclusion. This confirms that lifestyle interventions for the primary prevention of diabetes are cost-effective. Such interventions should be further promoted as sound investment in the fight against diabetes.
What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals? Study protocol for a randomised controlled trial.
Tiedemann, Anne; Paul, Serene; Ramsay, Elisabeth; O'Rourke, Sandra D; Chamberlain, Kathryn; Kirkham, Catherine; Merom, Dafna; Fairhall, Nicola; Oliveira, Juliana S; Hassett, Leanne; Sherrington, Catherine
Physical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to be urgently addressed as the population proportion of older people is rapidly rising. This trial aims to establish the impact of a combined physical activity and fall prevention intervention compared to an advice brochure on objectively measured physical activity participation and mobility-related goal attainment among people aged 60+. A randomised controlled trial involving 130 consenting community-dwelling older people will be conducted. Participants will be individually randomised to a control group (n = 65) and receive a fall prevention brochure, or to an intervention group (n = 65) and receive the brochure plus physical activity promotion and fall prevention intervention enhanced with health coaching and a pedometer. Primary outcomes will be objectively measured physical activity and mobility-related goal attainment, measured at both six and 12 months post randomisation. Secondary outcomes will include: falls, the proportion of people meeting the physical activity guidelines, quality of life, fear of falling, mood, and mobility limitation. Barriers and enablers to physical activity participation will be measured 6 months after randomisation. General linear models will be used to assess the effect of group allocation on the continuously-scored primary and secondary outcome measures, after adjusting for baseline scores. Between-group differences in goal attainment (primary outcome) will be analysed with ordinal regression. The number of falls per person-year will be analysed using negative binomial regression models to estimate the between-group difference in fall rates after one year (secondary outcome). Modified
Lennon, Olive; Galvin, Rose; Smith, Kathryn; Doody, Catherine; Blake, Catherine
Secondary prevention in ischaemic stroke and transient ischaemic attack (TIA) is dominated by pharmacological interventions with evidence for non-pharmacological interventions being less robust. This systematic review and meta-analysis examines the impact of lifestyle interventions on secondary prevention in stroke or TIA. A systematic literature search was performed. Randomised controlled trials (RCTs) examining the effectiveness of intervention packages incorporating any key component of health education/promotion/counselling on lifestyle and/or aerobic exercise compared to usual care ± a sham intervention in participants with ischaemic stroke or TIA were included. Outcomes of interest were mortality, cardiovascular disease (CVD) event rates, cardiovascular risk factors including blood pressure, lipid profiles and physical activity participation. Methodological quality was assessed. Statistical analyses determining treatment effect were conducted using Cochrane Review Manager Software. Seventeen RCTs were included. Data pooled from eight studies with a total of 2478 patients, demonstrated no effect in favour of lifestyle interventions compared to routine or sham interventions on mortality (risk ratio (RR) = 1.13 (95% confidence interval (CI), 0.85-1.52), I(2) = 0%). Data relating to CVD events were pooled from four studies (1013 patients), demonstrated non-significant findings (RR = 1.16 (95% CI, 0.80--1.71), I(2) = 0%). Similar results were reported for total cholesterol. Physical activity participation demonstrated significant improvement [SMD 0.24 (95% CI, 0.08-0.41), l (2) = 47%]. Blood pressure reductions were noted but were non-significant when corrected for multimodal packages including enhanced pharmacotherapy compliance. There is currently insufficient high quality research to support lifestyle interventions post-stroke or TIA on mortality, CVD event rates and cardio-metabolic risk factor profiles. Promising blood pressure reductions were noted in
Brotman, Laurie Miller; Dawson-McClure, Spring; Huang, Keng-Yen; Theise, Rachelle; Kamboukos, Dimitra; Wang, Jing; Petkova, Eva; Ogedegbe, Gbenga
To test the hypothesis that family intervention to promote effective parenting in early childhood affects obesity in preadolescence. Participants were 186 minority youth at risk for behavior problems who enrolled in long-term follow-up studies after random assignment to family intervention or control condition at age 4. Follow-up Study 1 included 40 girls at familial risk for behavior problems; Follow-up Study 2 included 146 boys and girls at risk for behavior problems based on teacher ratings. Family intervention aimed to promote effective parenting and prevent behavior problems during early childhood; it did not focus on physical health. BMI and health behaviors were measured an average of 5 years after intervention in Study 1 and 3 years after intervention in Study 2. Youth randomized to intervention had significantly lower BMI at follow-up relative to controls (Study 1 P = .05; Study 2 P = .006). Clinical impact is evidenced by lower rates of obesity (BMI ≥95th percentile) among intervention girls and boys relative to controls (Study 2: 24% vs 54%, P = .002). There were significant intervention-control group differences on physical and sedentary activity, blood pressure, and diet. Two long-term follow-up studies of randomized trials show that relative to controls, youth at risk for behavior problems who received family intervention at age 4 had lower BMI and improved health behaviors as they approached adolescence. Efforts to promote effective parenting and prevent behavior problems early in life may contribute to the reduction of obesity and health disparities.
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
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.
Jaime, Patricia Constante; Bandoni, Daniel Henrique; Sarno, Flávio
To evaluate the impact of a worksite intervention to prevent weight gain among adult workers. A controlled community trial was performed by dividing the workers into two groups: intervention group (IG) and control group (CG). The theoretical framework applied was Intervention Mapping Protocol and the intervention was implemented through interactive software for weight self-monitoring. To evaluate the impact of the intervention, the differences in weight, BMI and waist circumference between the IG and CG were assessed before and 6 months after the intervention by regression models. Additionally, the sustainability of the intervention was evaluated at 12 months after the intervention. Settings São Paulo, Brazil. Four companies; 281 workers for the analysis of effectiveness and 427 for the analysis of sustainability. The intervention resulted in significant reductions in weight, BMI and waist circumference in the IG compared with the CG. The impact of the intervention on IG individuals' body weight was -0·73 kg, while the weight of CG individuals increased. IG individuals with adequate initial weights did not show significant variations, while those who were overweight demonstrated a significant reduction in body weight. The intervention resulted in a reduction of 0·26 kg/m2 in BMI and 0·99 cm in waist circumference, and the sustainability analysis after 12 months showed a continued reduction in body weight (-0·72 kg). The behavioural intervention was effective, resulting in weight maintenance among participants with adequate initial weight and in significant reductions among those who were overweight. More research on longer-term weight maintenance is needed.
Bus, S. A.; Valk, G. D.; van Deursen, R. W.; Armstrong, D. G.; Caravaggi, C.; Hlavácek, P.; Bakker, K.; Cavanagh, P. R.
BACKGROUND: Footwear and offloading techniques are commonly used in clinical practice for the prevention and treatment of foot ulcers in diabetes, but the evidence base to support this use is not well known. The goal of this review was to systematically assess the literature and to determine the
Bruce, Julie; Ralhan, Shvaita; Sheridan, Ray; Westacott, Katharine; Withers, Emma; Finnegan, Susanne; Davison, John; Martin, Finbarr C; Lamb, Sarah E
This paper describes the design and development of a complex multifactorial falls prevention (MFFP) intervention for implementation and testing within the framework of a large UK-based falls prevention randomised controlled trial (RCT). A complex intervention was developed for inclusion within the Prevention of Falls Injury Trial (PreFIT), a multicentre pragmatic RCT. PreFIT aims to compare the clinical and cost-effectiveness of three alternative primary care falls prevention interventions (advice, exercise and MFFP), on outcomes of fractures and falls. Community-dwelling adults, aged 70 years and older, were recruited from primary care in the National Health Service (NHS), England. Development of the PreFIT MFFP intervention was informed by the existing evidence base and clinical guidelines for the assessment and management of falls in older adults. After piloting and modification, the final MFFP intervention includes seven falls risk factors: a detailed falls history interview with consideration of 'red flags'; assessment of balance and gait; vision; medication screen; cardiac screen; feet and footwear screen and home environment assessment. This complex intervention has been fully manualised with clear, documented assessment and treatment pathways for each risk factor. Each risk factor is assessed in every trial participant referred for MFFP. Referral for assessment is based upon a screening survey to identify those with a history of falling or balance problems. Intervention delivery can be adapted to the local setting. This complex falls prevention intervention is currently being tested within the framework of a large clinical trial. This paper adheres to TIDieR and CONSORT recommendations for the comprehensive and explicit reporting of trial interventions. Results from the PreFIT study will be published in due course. The effectiveness and cost-effectiveness of the PreFIT MFFP intervention, compared to advice and exercise, on the prevention of falls and
Anderson, Sarah-Jane; Ghys, Peter D; Ombam, Regina; Hallett, Timothy B
A strategic approach to the application of HIV prevention interventions is a core component of the UNAIDS Fast Track strategy to end the HIV epidemic by 2030. Central to these plans is a focus on high-prevalence geographies, in a bid to target resources to those in greatest need and maximize the reduction in new infections. Whilst this idea of geographical prioritization has the potential to improve efficiency, it is unclear how it should be implemented in practice. There are a range of prevention interventions which can be applied differentially across risk groups and locations, making allocation decisions complex. Here, we use mathematical modelling to compare the impact (infections averted) of a number of different approaches to the implementation of geographical prioritization of prevention interventions, similar to those emerging in policy and practice, across a range of prevention budgets. We use geographically specific mathematical models of the epidemic and response in 48 counties and major cities of Kenya to project the impact of the different geographical prioritization approaches. We compare the geographical allocation strategies with a nationally uniform approach under which the same interventions must be applied across all modelled locations. We find that the most extreme geographical prioritization strategy, which focuses resources exclusively to high-prevalence locations, may substantially restrict impact (41% fewer infections averted) compared to a nationally uniform approach, as opportunities for highly effective interventions for high-risk populations in lower-prevalence areas are missed. Other geographical allocation approaches, which intensify efforts in higher-prevalence areas whilst maintaining a minimum package of cost-effective interventions everywhere, consistently improve impact at all budget levels. Such strategies balance the need for greater investment in locations with the largest epidemics whilst ensuring higher-risk groups in lower
Lager, Kate E; Mistri, Amit K; Khunti, Kamlesh; Haunton, Victoria J; Sett, Aung K; Wilson, Andrew D
People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control, including patient adherence to prescribed medications, and the occurrence of secondary cardiovascular events. We searched the Cochrane Stroke Group Trials Register (April 2013), the Cochrane Effective Practice and Organisation of Care Group Trials Register (April 2013), CENTRAL (The Cochrane Library 2013, issue 3), MEDLINE (1950 to April 2013), EMBASE (1981 to April 2013) and 10 additional databases. We located further studies by searching reference lists of articles and contacting authors of included studies. We included randomised controlled trials (RCTs) that evaluated the effects of organisational or educational and behavioural interventions (compared with usual care) on modifiable risk factor control for secondary stroke prevention. Two review authors selected studies for inclusion and independently extracted data. One review author assessed the risk of bias for the included studies. We sought missing data from trialists. This review included 26 studies involving 8021 participants. Overall the studies were of reasonable quality, but one study was considered at high risk of bias. Fifteen studies evaluated predominantly organisational interventions and 11 studies evaluated educational and behavioural interventions for patients. Results were pooled where appropriate, although some clinical and methodological heterogeneity was present. The estimated effects of organisational interventions were compatible with improvements and no differences in the modifiable risk factors mean systolic blood pressure (mean difference (MD) -2.57 mmHg; 95% confidence
Bradbury, Thomas N; Lavner, Justin A
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.
Conley, Colleen S; Durlak, Joseph A; Shapiro, Jenna B; Kirsch, Alexandra C; Zahniser, Evan
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
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.
Frerichs, Leah M; Araz, Ozgur M; Huang, Terry T-K
Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may
Leah M Frerichs
Full Text Available Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1 to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2 to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively. Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally
Bardick, Angela D.; Bernes, Kerry B.; McCulloch, Ariana R. M.; Witko, Kim D.; Spriddle, Jennifer W.; Roest, Allison R.
School counselors are in daily contact with the highest risk group for developing eating disorders--children and adolescents. School counselors are in a position to identify at-risk individuals, implement effective school-based prevention programs, make appropriate referrals, and provide support for recovering individuals. An overview of a theory…
This had the effect of preventing reinfestation and modifying the insects' feeding practices such that they switched from human to chicken blood meals (chickens do not transmit the disease). This project will test the insect control program in selected border areas in the three countries where T. dimidiata is highly prevalent ...
Juan Manuel Laguna-Parras
Full Text Available Objetivos: identificar las principales causas por las que se producen las caídas y determinar qué medidas son efectivas y cuáles no en la prevención de caídas accidentales. Métodos: revisión sistemática sobre los diferentes estudios de caídas en el hospital. Esta revisión incluye ensayos clínicos, estudios de casos/controles, estudios de cohortes y estudios observacionales publicados desde la indexación de cada base de datos, hasta diciembre de 2009. Resultados: se revisó un total de 60 estudios, de los cuales 37 finalmente entraron en la revisión, previo examen de su calidad metodológica mediante el CASP. Las principales causas por las que se producen las caídas están relacionadas con la edad, patologías (Parkinson, demencias, Alzheimer, medicación y el pre/postoperatorio. De todos los estudios, hay diversas intervenciones que han demostrado ser efectivas y reducir el número de caídas. Conclusiones: todos los estudios, en general, han aplicado medidas de prevención en función del riesgo y/o enfermedad identificados por grupos de pacientes. Las medidas preventivas que han demostrado eficacia han sido el uso correcto de la colocación de medidas de protección, el establecimiento de unos parámetros para la identificación de los posibles factores de riesgo que puedan ocasionar una caída y evaluar la frecuencia de éstas, establecer una escala de atención de la dependencia y compararla con el modelo de factores de riesgo, analizar los factores de riesgo extrínsecos que las favorecen, realizar una puntuación para identificar a los pacientes con alto riesgo, establecer un programa de intervención de caídas y desarrollar estrategias para la prevención de éstas.Aims: to identify the main causes of falls and determine which interventions are effective to prevent accidental falls. Methods: Systematic review over studies of falls in the hospital. This review includes clinical trials, case/control, cohort and observational
Vind, Ane B; Andersen, Hanne E; Pedersen, Kirsten D; Jørgensen, Torben; Schwarz, Peter
To evaluate the effect of multifactorial fall prevention in community-dwelling people aged 65 and older in Denmark. Randomized, controlled clinical trial. Geriatric outpatient clinic at Glostrup University Hospital. Three hundred ninety-two elderly people, mean age 74, 73.7%women, who had visited the emergency department or had been hospitalized due to a fall. Identification of general medical, cardiovascular, and physical risk factors for falls and individual intervention in the intervention group. Participants in the control group received usual care. Falls were registered prospectively in falls diaries, with monthly telephone calls for collection of data. Outcomes were fall rates and proportion of participants with falls, frequent falls, and injurious falls in 12 months. Groups were comparable at baseline. Followup exceeded 90.0%. A total of 422 falls were registered in the intervention group, 398 in the control group. Intention-to-treat analysis revealed no effect of the intervention on fall rates (relative risk=1.06, 95%confidence interval (CI)=0.75 -1.51), proportion with falls (odds ratio (OR)=1.20, 95% CI 0.81-1.79), frequent falls (OR=0.97, 95% CI=0.60-1.56), or injurious falls (OR=0.97, 95% CI=0.57-1.62). A program of multifactorial fall prevention aimed at elderly Danish people experiencing at least one injurious fall was not effective in preventing further falls.
Philip J. Morgan
Full Text Available Internationally, childhood obesity is a major public health concern. Given the established difficulties in treating obesity, designing and evaluating effective obesity prevention interventions are research priorities. As parents play a crucial role in establishing positive health behaviours in children, they are a