WorldWideScience

Sample records for web-based self-help intervention

  1. Effectiveness of a web-based self-help smoking cessation intervention: protocol of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Brunsting Suzanne

    2009-01-01

    Full Text Available Abstract Background Cigarette smoking is a major risk factor for many chronic and fatal illnesses. Stopping smoking directly reduces those risks. The aim of this study is to investigate the effectiveness of a web-based interactive self-help programme for smoking cessation, known as the StopSite, by comparing it to an online self-help guide. Both interventions were based on cognitive-behavioural and self-control principles, but the former provided exercises, feedback and interactive features such as one-to-one chatrooms and a user forum, which facilitated mutual support and experience sharing. Methods and design We conducted a randomised controlled trial to compare the interactive intervention with the self-help guide. The primary outcome measure was prolonged abstinence from smoking. Secondary outcomes were point-prevalence abstinence, number of cigarettes smoked, and incidence of quit attempts reported at follow-up assessments. Follow-up assessments took place three and six months after a one-month grace period for starting the intervention after baseline. Analyses were based on intention-to-treat principles using a conservative imputation method for missing data, whereby non-responders were classified as smokers. Discussion The trial should add to the body of knowledge on the effectiveness of web-based self-help smoking cessation interventions. Effective web-based programmes can potentially help large numbers of smokers to quit, thus having a major public health impact. Trial registration ISRCTN74423766

  2. Effectiveness of a web-based self-help smoking cessation intervention: protocol of a randomised controlled trial

    NARCIS (Netherlands)

    Kramer, J.; Willemsen, M.C.; Conijn, B.; van Emst, A.J.; Brunsting, S.; Riper, H.

    2009-01-01

    BACKGROUND: Cigarette smoking is a major risk factor for many chronic and fatal illnesses. Stopping smoking directly reduces those risks. The aim of this study is to investigate the effectiveness of a web-based interactive self-help programme for smoking cessation, known as the StopSite, by

  3. A four-year experience with a Web-based self-help intervention for depressive symptoms in Mexico

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    María Asunción Lara

    2014-06-01

    Full Text Available OBJECTIVE: To describe a four-year descriptive, naturalistic study monitoring the use of HDep (Help for Depression or Ayuda para depression (ADepin Spanish, an open-access/free Web-based, psycho-education, cognitive-behavioral intervention program produced in Mexico consisting of seven self-help modules that include feedback-generating assessments of depressive symptoms, vignettes, recorded messages, a relaxation exercise, a personal workbook, blogs, and user discussion forums. METHODS: Data were collected on all individuals who entered the HDep site since the program's launching in 2009. Those who entered the site two or more times and also registered as "users" or "participants." The user data consisted of 1 user profiles; 2 scores for the CES-D (Center for Epidemiological Studies Depression Scale, for users who completed the feedback-generating assessments of depressive symptoms; 3 user evaluations of the usefulness of HDep; and 4 transcripts of HDep discussion forum posts. The raw user data were obtained through Moodle (Modular Object-Oriented Dynamic Learning Environment, a free software e-learning platform and analyzed quantitatively (using SPSS and qualitatively (using ATLAS.ti. RESULTS: A total of 28 078 individuals accessed HDep and 17 318 of those (61.6% qualified as users. Of all users, 84.4% were women, 64.6% used the workbook, and 60.9% entered the discussion forums (of whom 16.3% added a post. Depressive symptoms (CES-D score ≥ 16 were observed in 97.1% of the users who completed the feedback-generating assessment (n = 16 564. User retention dropped across the seven modules (from 12 366 users for Module 1 to 626 for Module 7. However, all seven modules were rated very high for "helpfulness/usefulness," with mean scores all above 4 on a 1 - 5 scale. The HDep discussion forums showed a rich social interaction. Predictors of entering at least one module (based on stepwise logistic regression analysis included being a woman, being

  4. Long-Term Results of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial

    OpenAIRE

    Geraedts, Anna S; Kleiboer, Annet M; Twisk, Jos; Wiezer, Noortje M; van Mechelen, Willem; Cuijpers, Pim

    2014-01-01

    Background Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms via the Internet before they report sick from work could be beneficial and cost saving. Objective In this study, we tested the effectiveness over the period of 1 year of a Web-based guided self-help intervention, called Happy...

  5. Long-term results of a web-based guided self-help intervention for employees with depressive symptoms: randomized controlled trial.

    Science.gov (United States)

    Geraedts, Anna S; Kleiboer, Annet M; Twisk, Jos; Wiezer, Noortje M; van Mechelen, Willem; Cuijpers, Pim

    2014-07-09

    Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms via the Internet before they report sick from work could be beneficial and cost saving. In this study, we tested the effectiveness over the period of 1 year of a Web-based guided self-help intervention, called Happy@Work, for employees with depressive symptoms who were not on sick leave. A two-arm randomized controlled trial comparing a worker-directed, Web-based, guided self-help intervention to care as usual (CAU) was carried out. We recruited employees from 6 companies via the company's Intranet and by putting up posters. The inclusion criteria were elevated depressive symptoms as measured by a score ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D) and not being on sick leave. The intervention contained 6 lessons and consisted of problem-solving treatment and cognitive therapy. Participants were asked to submit weekly assignments via the website after completion of a lesson and they received feedback from a coach via the website. Self-report questionnaires on depressive symptoms (CES-D; primary outcome), burnout (Maslach Burnout Inventory, MBI), work performance (Health and Work Performance Questionnaire, HPQ), duration of absenteeism, and anxiety (Hospital Anxiety and Depression Scale, HADS; secondary outcomes), were completed at baseline, posttreatment, and at 6-, and 12-month follow-up. Several subgroup and per-protocol analyses were performed. A total of 231 employees were randomized to either the intervention group (n=116) or to CAU (n=115). Completion of assessments varied between 54%-74%. Improvement in depressive symptoms between baseline and posttreatment was shown in all participants and these effects sustained over time. However, there were no differences between the 2

  6. Development of a Self-Help Web-Based Intervention Targeting Young Cancer Patients With Sexual Problems and Fertility Distress in Collaboration With Patient Research Partners.

    Science.gov (United States)

    Winterling, Jeanette; Wiklander, Maria; Obol, Claire Micaux; Lampic, Claudia; Eriksson, Lars E; Pelters, Britta; Wettergren, Lena

    2016-04-12

    The Internet should be suitable for delivery of interventions targeting young cancer patients. Young people are familiar with the technologies, and this patient group is small and geographically dispersed. Still, only few psycho-educational Web-based interventions are designed for this group. Young cancer patients consider reproductive health, including sexuality, an area of great importance and approximately 50% report sexual problems and fertility-related concerns following cancer treatment. Therefore, we set out to develop a self-help Web-based intervention, Fex-Can, to alleviate such problems. To improve its quality, we decided to involve patients and significant others as research partners. The first 18 months of our collaboration are described in this paper. The intervention will subsequently be tested in a feasibility study followed by a randomized controlled trial. The study aims to describe the development of a Web-based intervention in long-term collaboration with patient research partners (PRPs). Ten former cancer patients and two significant others participated in building the Web-based intervention, using a participatory design. The development process is described according to the design step in the holistic framework presented by van Gemert-Pijnen et al and evaluates the PRPs' impact on the content, system, and service quality of the planned intervention. The collaboration between the research group and the PRPs mainly took place in the form of 1-day meetings to develop the key components of the intervention: educational and behavior change content, multimedia (pictures, video vignettes, and audios), interactive online activities (eg, self-monitoring), and partial feedback support (discussion forum, tailored feedback from experts). The PRPs influenced the intervention's content quality in several ways. By repeated feedback on prototypes, the information became more comprehensive, relevant, and understandable. The PRPs gave suggestions concerning the

  7. User-experiences with a web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion: a qualitative study

    Directory of Open Access Journals (Sweden)

    Nadine Köhle

    2017-02-01

    Full Text Available Abstract Background Partners of cancer patients are the cornerstone of supportive cancer care. They assume different roles and responsibilities that optimally support the patient. Such support is highly demanding, and many partners report (mental health problems. However, many of them do not use professional supportive care themselves. Offering a Web-based self-help intervention based on Acceptance and Commitment Therapy (ACT and self-compassion could be an important resource to support this group. This qualitative study aimed to examine user-experiences with a Web-based self-help intervention based on ACT and self-compassion among partners of cancer patients. Methods Individual in-depth interviews, about partners’ appreciation of the intervention and lessons learned, were conducted with 14 partners of cancer patients who used the Web-based self-help intervention. Interviews were audio-recorded, transcribed verbatim and analyzed by three independent coders both deductively and inductively. Results In general, partners appreciated the intervention, however, they also expressed ambivalent feelings towards peer support, the content of the feedback of their counselor, and the ‘tunneled’ structure of the intervention. The majority of the partners reported being more self-compassionate accepting that they experienced negative thoughts and feelings, they reported that they learned to increase the distance between their thoughts and themselves, they indicated being more aware of their personal values, and they thought that they were better able to commit to those values. They also reported other (non-specific helpful processes such as insight and acknowledgement, positivity, the possibility to tell their story, time for themselves, and feeling closer and more connected with their partner (the patient. Conclusions Partners of cancer patients indicated to appreciate the Web-based self-help intervention based on ACT and self-compassion. They felt

  8. Effectiveness of a Web-Based Guided Self-help Intervention for Outpatients With a Depressive Disorder: Short-term Results From a Randomized Controlled Trial.

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    Kenter, Robin Maria Francisca; Cuijpers, Pim; Beekman, Aartjan; van Straten, Annemieke

    2016-03-31

    Research has convincingly demonstrated that symptoms of depression can be reduced through guided Internet-based interventions. However, most of those studies recruited people form the general population. There is insufficient evidence for the effectiveness when delivered in routine clinical practice in outpatient clinics. The objective of this randomized controlled trial was to study patients with a depressive disorder (as defined by the Diagnostic and Statistical Manual of Disorders, fourth edition), as assessed by trained interviewers with the Composite International Diagnostic Interview, who registered for treatment at an outpatient mental health clinic. We aimed to examine the effectiveness of guided Internet-based self-help before starting face-to-face treatment. We recruited 269 outpatients, aged between 18 and 79 years, from outpatient clinics and randomly allocated them to Internet-based problem solving therapy (n=136), with weekly student support, or to a control condition, who remained on the waitlist with a self-help booklet (control group; n=133). Participants in both conditions were allowed to take up face-to-face treatment at the outpatient clinics afterward. We measured the primary outcome, depressive symptoms, by Center for Epidemiological Studies Depression scale (CES-D). Secondary outcome measures were the Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), Insomnia Severity Index questionnaire (ISI), and EuroQol visual analog scale (EQ-5D VAS). All outcomes were assessed by telephone at posttest (8 weeks after baseline). Posttest measures were completed by 184 (68.4%) participants. We found a moderate to large within-group effect size for both the intervention (d=0.75) and the control (d=0.69) group. However, the between-group effect size was very small (d=0.07), and regression analysis on posttreatment CES-D scores revealed no significant differences between the groups (b=1.134, 95% CI -2.495 to 4.763). The per-protocol analysis (

  9. Long-Term Results of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial

    NARCIS (Netherlands)

    Geraedts, A.S.; Kleiboer, A.M.; Twisk, J.; Wiezer, N.M.; van Mechelen, W.; Cuijpers, P.

    2014-01-01

    Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms via the Internet before they report

  10. Effect of a web-based guided self-help intervention for prevention of major depression in adults with subthreshold depression

    DEFF Research Database (Denmark)

    Buntrock, C.; Ebert, D. D.; Lehr, D.

    2016-01-01

    for the prevention of MDD. DESIGN, SETTING, AND PARTICIPANTS Two-group randomized clinical trial conducted between March 1, 2013, and March 4, 2015. Participants were recruited in Germany from the general population via a large statutory health insurance company (ie, insurance funded by joint employer......-up, covering the period to the previous assessment. RESULTS Among 406 randomized patients (mean age, 45 years; 73.9%women), 335 (82%) completed the telephone follow-up at 12 months. Fifty-five participants (27%) in the intervention group experienced MDD compared with 84 participants (41%) in the control group...

  11. Development and preliminary testing of a web-based, self-help application for disaster-affected families.

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    Yuen, Erica K; Gros, Kirstin; Welsh, Kyleen E; McCauley, Jenna; Resnick, Heidi S; Danielson, Carla K; Price, Matthew; Ruggiero, Kenneth J

    2016-09-01

    Technology-based self-help interventions have the potential to increase access to evidence-based mental healthcare, especially for families affected by natural disasters. However, development of these interventions is a complex process and poses unique challenges. Usability testing, which assesses the ability of individuals to use an application successfully, can have a significant impact on the quality of a self-help intervention. This article describes (a) the development of a novel web-based multi-module self-help intervention for disaster-affected adolescents and their parents and (b) a mixed-methods formal usability study to evaluate user response. A total of 24 adolescents were observed, videotaped, and interviewed as they used the depressed mood component of the self-help intervention. Quantitative results indicated an above-average user experience, and qualitative analysis identified 120 unique usability issues. We discuss the challenges of developing self-help applications, including design considerations and the value of usability testing in technology-based interventions, as well as our plan for widespread dissemination. © The Author(s) 2015.

  12. Web-based interventions in nursing.

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    Im, Eun-Ok; Chang, Sun Ju

    2013-02-01

    With recent advances in computer and Internet technologies and high funding priority on technological aspects of nursing research, researchers at the field level began to develop, use, and test various types of Web-based interventions. Despite high potential impacts of Web-based interventions, little is still known about Web-based interventions in nursing. In this article, to identify strengths and weaknesses of Web-based nursing interventions, a literature review was conducted using multiple databases with combined keywords of "online," "Internet" or "Web," "intervention," and "nursing." A total of 95 articles were retrieved through the databases and sorted by research topics. These articles were then analyzed to identify strengths and weaknesses of Web-based interventions in nursing. A strength of the Web-based interventions was their coverage of various content areas. In addition, many of them were theory-driven. They had advantages in their flexibility and comfort. They could provide consistency in interventions and require less cost in the intervention implementation. However, Web-based intervention studies had selected participants. They lacked controllability and had high dropouts. They required technical expertise and high development costs. Based on these findings, directions for future Web-based intervention research were provided.

  13. Print-based self-help interventions for smoking cessation.

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    Hartmann-Boyce, Jamie; Lancaster, Tim; Stead, Lindsay F

    2014-06-03

    Many smokers give up smoking on their own, but materials giving advice and information may help them and increase the number who quit successfully. The aims of this review were to determine: the effectiveness of different forms of print-based self-help materials, compared with no treatment and with other minimal contact strategies; the effectiveness of adjuncts to print-based self help, such as computer-generated feedback, telephone hotlines and pharmacotherapy; and the effectiveness of approaches tailored to the individual compared with non-tailored materials. We searched the Cochrane Tobacco Addiction Group trials register. Date of the most recent search April 2014. We included randomized trials of smoking cessation with follow-up of at least six months, where at least one arm tested a print-based self-help intervention. We defined self help as structured programming for smokers trying to quit without intensive contact with a therapist. We extracted data in duplicate on the participants, the nature of the self-help materials, the amount of face-to-face contact given to intervention and to control conditions, outcome measures, method of randomization, and completeness of follow-up.The main outcome measure was abstinence from smoking after at least six months follow-up in people smoking at baseline. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates when available. Where appropriate, we performed meta-analysis using a fixed-effect model. We identified 74 trials which met the inclusion criteria. Many study reports did not include sufficient detail to judge risk of bias for some domains. Twenty-eight studies (38%) were judged at high risk of bias for one or more domains but the overall risk of bias across all included studies was judged to be moderate, and unlikely to alter the conclusions.Thirty-four trials evaluated the effect of standard, non-tailored self-help materials. Pooling 11 of these trials in which there

  14. Predicting successful treatment outcome of web-based self-help for problem drinkers: secondary analysis from a randomized controlled trial.

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    Riper, Heleen; Kramer, Jeannet; Keuken, Max; Smit, Filip; Schippers, Gerard; Cuijpers, Pim

    2008-11-22

    Web-based self-help interventions for problem drinking are coming of age. They have shown promising results in terms of cost-effectiveness, and they offer opportunities to reach out on a broad scale to problem drinkers. The question now is whether certain groups of problem drinkers benefit more from such Web-based interventions than others. We sought to identify baseline, client-related predictors of the effectiveness of Drinking Less, a 24/7, free-access, interactive, Web-based self-help intervention without therapist guidance for problem drinkers who want to reduce their alcohol consumption. The intervention is based on cognitive-behavioral and self-control principles. We conducted secondary analysis of data from a pragmatic randomized trial with follow-up at 6 and 12 months. Participants (N = 261) were adult problem drinkers in the Dutch general population with a weekly alcohol consumption above 210 g of ethanol for men or 140 g for women, or consumption of at least 60 g (men) or 40 g (women) one or more days a week over the past 3 months. Six baseline participant characteristics were designated as putative predictors of treatment response: (1) gender, (2) education, (3) Internet use competence (sociodemographics), (4) mean weekly alcohol consumption, (5) prior professional help for alcohol problems (level of problem drinking), and (6) participants' expectancies of Web-based interventions for problem drinking. Intention-to-treat (ITT) analyses, using last-observation-carried-forward (LOCF) data, and regression imputation (RI) were performed to deal with loss to follow-up. Statistical tests for interaction terms were conducted and linear regression analysis was performed to investigate whether the participants' characteristics as measured at baseline predicted positive treatment responses at 6- and 12-month follow-ups. At 6 months, prior help for alcohol problems predicted a small, marginally significant positive treatment outcome in the RI model only (beta = .18

  15. Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial.

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    Kok, Robin N; van Straten, Annemieke; Beekman, Aartjan T F; Cuijpers, Pim

    2014-09-29

    Internet-based guided self-help has been successfully used in the general population, but it is unknown whether this method can be effectively used in outpatient clinics for patients waiting for face-to-face psychotherapy for phobias. The aim was to assess the clinical effectiveness of Phobias Under Control, an Internet-based intervention based on exposure therapy with weekly guidance. We conducted a randomized controlled trial, recruiting 212 outpatients scheduled to receive face-to-face psychotherapy for any type of phobia at an outpatient clinic. Participants suffering from at least 1 DSM-IV or ICD-10 classified phobia (social phobia, agoraphobia with or without panic disorder, and/or specific phobia as ascertained by a telephone interview at baseline) were randomly allocated to either a 5-week Internet-based guided self-help program based on exposure therapy with weekly student support followed by face-to-face psychotherapy (n=105) or a wait-list control group followed by face-to-face psychotherapy (n=107). Primary outcome was the Fear Questionnaire (FQ). Secondary outcomes were the Beck Anxiety Inventory (BAI) and Center of Epidemiological Studies-Depression scale (CES-D). Assessments took place by telephone at baseline (T0) and on the Internet at posttest (T1, self-assessment at 5 weeks after baseline). Missing data at T1 were imputed. At posttest, analysis of covariance on the intention-to-treat sample showed significant but small effect sizes between intervention and control groups on the FQ (d=0.35, P=.02), CES-D (d=0.34, P=.03), and a nonsignificant effect size on the BAI (d=0.28. P=.05). Although initial acceptance was good, high nonresponse was observed, with 86 of 212 participants (40.5%) lost to follow-up at T1 and only 14 of 105 (13.3%) intervention participants finishing all 5 weeks. Phobias Under Control is modestly effective in lowering phobic and depressive symptoms in a relatively short period and may be clinically beneficial when implemented in

  16. Web-based interventions for traumatized people in mainland China

    Directory of Open Access Journals (Sweden)

    Jian-Ping Wang

    2014-12-01

    Full Text Available Background: The Internet is now becoming a new channel for delivering psychological interventions. Method: This paper reported a first application of web-based intervention in mainland China. It first summarized primary barriers to mental health help-seeking behavior in Chinese society. Then, it introduced the current utilization of the Internet within mental health services in mainland China and discussed how the Internet would help to improve people's help-seeking behaviors. More importantly, it presented main empirical findings from a randomized controlled trial (RCT which investigated the efficacy of a web-based self-help intervention program (Chinese My Trauma Recovery website, CMTR for 103 urban and 93 rural traumatized Chinese persons. Results: The data revealed that 59% urban and 97% rural participants completed the posttest. In the urban sample, data showed a significant group×time interaction in Posttraumatic Diagnostic Scale (PDS scores (F1,88=7.65, p=0.007. CMTR reduced posttraumatic symptoms significantly with high effect size after intervention (F1,45=15.13, Cohen's d=0.81, p<0.001 and the reduction was sustained over a 3-month follow-up (F1,45=17.29, Cohen's d=0.87, p<0.001. In the rural sample, the group×time interaction was also significant in PDS scores (F1,91=5.35, p=0.02. Posttraumatic symptoms decreased significantly after intervention (F1,48=43.97, Cohen's d=1.34, p<0.001 and during the follow-up period (F1,48=24.22, Cohen's d=0.99, p<0.001. Conclusions: These findings give preliminary support for the short-term efficacy of CMTR in the two Chinese populations. Finally, some implications are given for the future application of web-based interventions for PTSD in mainland China.

  17. Short-term effectiveness of web-based guided self-help for phobic outpatients: Randomized controlled trial.

    NARCIS (Netherlands)

    Kok, R.N.; van Straten, A.; Beekman, A.T.F.; Cuijpers, P.

    2014-01-01

    Background: Internet-based guided self-help has been successfully used in the general population, but it is unknown whether this method can be effectively used in outpatient clinics for patients waiting for face-to-face psychotherapy for phobias. Objective: The aim was to assess the clinical

  18. Snow Control - An RCT protocol for a web-based self-help therapy to reduce cocaine consumption in problematic cocaine users

    Directory of Open Access Journals (Sweden)

    Sullivan Robin

    2011-09-01

    Full Text Available Abstract Background Cocaine use has increased in most European countries, including Switzerland, and many states worldwide. The international literature has described treatment models that target the general population. In addition to supplying informative measures at the level of primary and secondary prevention, the literature also offers web-based self-help tools for problematic substance users, which is in line with tertiary prevention. Such programs, however, have been primarily tested on individuals with problematic alcohol and cannabis consumption, but not on cocaine-dependent individuals. Methods/Design This paper presents the protocol of a randomised clinical trial to test the effectiveness of a web-based self-help therapy to reduce cocaine use in problematic cocaine users. The primary outcome is severity of cocaine dependence. Secondary outcome measures include cocaine craving, consumption of cocaine and other substances of abuse in the past month, and changes in depression characteristics. The therapy group will receive a 6-week self-help therapy to reduce cocaine consumption based on methods of Cognitive Behavioural Therapy, principles of Motivational Interviewing and self-control practices. The control group will be presented weekly psycho-educative information with a quiz. The predictive validity of participant characteristics on treatment retention and outcome will be explored. Discussion To the best of our knowledge, this will be the first randomised clinical trial to test the effectiveness of online self-help therapy to reduce or abstain from cocaine use. It will also investigate predictors of outcome and retention. This trial is registered at Current Controlled Trials and is traceable as NTR-ISRCTN93702927.

  19. Alcohol e-Help: study protocol for a web-based self-help program to reduce alcohol use in adults with drinking patterns considered harmful, hazardous or suggestive of dependence in middle-income countries.

    Science.gov (United States)

    Schaub, Michael P; Tiburcio, Marcela; Martinez, Nora; Ambekar, Atul; Balhara, Yatan Pal Singh; Wenger, Andreas; Monezi Andrade, André Luiz; Padruchny, Dzianis; Osipchik, Sergey; Gehring, Elise; Poznyak, Vladimir; Rekve, Dag; Souza-Formigoni, Maria Lucia Oliveira

    2018-02-01

    Given the scarcity of alcohol prevention and alcohol use disorder treatments in many low and middle-income countries, the World Health Organization launched an e-health portal on alcohol and health that includes a Web-based self-help program. This paper presents the protocol for a multicentre randomized controlled trial (RCT) to test the efficacy of the internet-based self-help intervention to reduce alcohol use. Two-arm randomized controlled trial (RCT) with follow-up 6 months after randomization. Community samples in middle-income countries. People aged 18+, with Alcohol Use Disorders Identification Test (AUDIT) scores of 8+ indicating hazardous alcohol consumption. Offer of an internet-based self-help intervention, 'Alcohol e-Health', compared with a 'waiting list' control group. The intervention, adapted from a previous program with evidence of effectiveness in a high-income country, consists of modules to reduce or entirely stop drinking. The primary outcome measure is change in the Alcohol Use Disorders Identification Test (AUDIT) score assessed at 6-month follow-up. Secondary outcomes include self-reported the numbers of standard drinks and alcohol-free days in a typical week during the past 6 months, and cessation of harmful or hazardous drinking (AUDIT world-wide is considerable. © 2017 Society for the Study of Addiction.

  20. Practical guidelines for development of web-based interventions.

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    Chee, Wonshik; Lee, Yaelim; Chee, Eunice; Im, Eun-Ok

    2014-10-01

    Despite a recent high funding priority on technological aspects of research and a high potential impact of Web-based interventions on health, few guidelines for the development of Web-based interventions are currently available. In this article, we propose practical guidelines for development of Web-based interventions based on an empirical study and an integrative literature review. The empirical study aimed at development of a Web-based physical activity promotion program that was specifically tailored to Korean American midlife women. The literature review included a total of 202 articles that were retrieved through multiple databases. On the basis of the findings of the study and the literature review, we propose directions for development of Web-based interventions in the following steps: (1) meaningfulness and effectiveness, (2) target population, (3) theoretical basis/program theory, (4) focus and objectives, (5) components, (6) technological aspects, and (7) logistics for users. The guidelines could help promote further development of Web-based interventions at this early stage of Web-based interventions in nursing.

  1. Effectiveness of E-self-help interventions for curbing adult problem drinking: A meta-analysis.

    NARCIS (Netherlands)

    Riper, H.; Spek, V.; Boon, B.; Conijn, B.; Kramer, J.; Martin-Abello, K.; Smit, H.F.E.

    2011-01-01

    Background: Self-help interventions without professional contact to curb adult problem drinking in the community are increasingly being delivered via the Internet. Objective: The objective of this meta-analysis was to assess the overall effectiveness of these eHealth interventions. Methods: In all,

  2. Self-help interventions for depressive disorders and depressive symptoms: a systematic review

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2008-08-01

    Full Text Available Abstract Background Research suggests that depressive disorders exist on a continuum, with subthreshold symptoms causing considerable population burden and increasing individual risk of developing major depressive disorder. An alternative strategy to professional treatment of subthreshold depression is population promotion of effective self-help interventions that can be easily applied by an individual without professional guidance. The evidence for self-help interventions for depressive symptoms is reviewed in the present work, with the aim of identifying promising interventions that could inform future health promotion campaigns or stimulate further research. Methods A literature search for randomised controlled trials investigating self-help interventions for depressive disorders or depressive symptoms was performed using PubMed, PsycINFO and the Cochrane Database of Systematic Reviews. Reference lists and citations of included studies were also checked. Studies were grouped into those involving participants with depressive disorders or a high level of depressive symptoms, or non-clinically depressed participants not selected for depression. A number of exclusion criteria were applied, including trials with small sample sizes and where the intervention was adjunctive to antidepressants or psychotherapy. Results The majority of interventions searched had no relevant evidence to review. Of the 38 interventions reviewed, the ones with the best evidence of efficacy in depressive disorders were S-adenosylmethionine, St John's wort, bibliotherapy, computerised interventions, distraction, relaxation training, exercise, pleasant activities, sleep deprivation, and light therapy. A number of other interventions showed promise but had received less research attention. Research in non-clinical samples indicated immediate beneficial effects on depressed mood for distraction, exercise, humour, music, negative air ionisation, and singing; while potential

  3. A Review of Web Based Interventions Focusing on Alcohol Use ...

    African Journals Online (AJOL)

    Alcohol continues to be a major contributor to morbidity and mortality globally. Despite the scientific advances, alcohol use related problems continue to pose a major challenge to medicine and public health. Internet offers a new mode to provide health care interventions. Web based interventions (WBIs) provide the health ...

  4. Effectiveness of self-help psychological interventions for treating and preventing postpartum depression: a meta-analysis.

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    Lin, Ping-Zhen; Xue, Jiao-Mei; Yang, Bei; Li, Meng; Cao, Feng-Lin

    2018-04-04

    Previous studies have reported different effect sizes for self-help interventions designed to reduce postpartum depression symptoms; therefore, a comprehensive quantitative review of the research was required. A meta-analysis was conducted to examine the effectiveness of self-help interventions designed to treat and prevent postpartum depression, and identified nine relevant randomized controlled trials. Differences in depressive symptoms between self-help interventions and control conditions, changes in depressive symptoms following self-help interventions, and differences in postintervention recovery and improvement rates between self-help interventions and control conditions were assessed in separate analyses. In treatment trials, depression scores continued to decrease from baseline to posttreatment and follow-up assessment in treatment subgroups. Changes in treatment subgroups' depression scores from baseline to postintervention assessment were greater relative to those observed in prevention subgroups. Self-help interventions produced larger overall effects on postpartum depression, relative to those observed in control conditions, in posttreatment (Hedges' g = 0.51) and follow-up (Hedges' g = 0.32) assessments; and self-help interventions were significantly more effective, relative to control conditions, in promoting recovery from postpartum depression. Effectiveness in preventing depression did not differ significantly between self-help interventions and control conditions.The findings suggested that self-help interventions designed to treat postpartum depression reduced levels of depressive symptoms effectively and decreased the risk of postpartum depression.

  5. A controlled trial of an expert system and self-help manual intervention based on the stages of change versus standard self-help materials in smoking cessation.

    Science.gov (United States)

    Aveyard, Paul; Griffin, Carl; Lawrence, Terry; Cheng, K K

    2003-03-01

    To examine the population impact and effectiveness of the Pro-Change smoking cessation course based on the Transtheoretical Model (TTM) compared to standard self-help smoking cessation literature. Randomized controlled trial. Sixty-five West Midlands general practices. Randomly sampled patients recorded as smokers by their general practitioners received an invitation letter and 2471 current smokers agreed. Responders were randomized to one of four interventions. The control group received standard self-help literature. In the Manual intervention group, participants received the Pro-Change system, a self-help workbook and three questionnaires at 3-monthly intervals, which generated individually tailored feedback. In the Phone intervention group, participants received the Manual intervention plus three telephone calls. In the Nurse intervention group, participants received the Manual intervention plus three visits to the practice nurse. Biochemically confirmed point prevalence of being quit and 6-month sustained abstinence, 12 months after study commencement. A total of 9.1% of registered current smokers participated, of whom 83.0% were not ready to quit. Less than half of participants returned questionnaires to generate second and third individualized feedback. Telephone calls reached 75% of those scheduled, but few participants visited the nurse. There were small differences between the three Pro-Change arms. The odds ratio (95% confidence intervals) for all Pro-Change arms combined versus the control arm were 1.50 (0.85-2.67) and 1.53 (0.76-3.10), for point prevalence and 6-month abstinence, respectively. This constitutes 2.1% of the TTM group versus 1.4% of the control group achieving confirmed 6-month sustained abstinence. There was no statistically significant benefit of the intervention apparent in this trial and the high relapse of quitters means that any population impact is small.

  6. Internet-Based Self-Help Intervention for ICD-11 Adjustment Disorder: Preliminary Findings.

    Science.gov (United States)

    Eimontas, Jonas; Rimsaite, Zivile; Gegieckaite, Goda; Zelviene, Paulina; Kazlauskas, Evaldas

    2018-06-01

    Adjustment disorder is one of the most diagnosed mental disorders. However, there is a lack of studies of specialized internet-based psychosocial interventions for adjustment disorder. We aimed to analyze the outcomes of an internet-based unguided self-help psychosocial intervention BADI for adjustment disorder in a two armed randomized controlled trial with a waiting list control group. In total 284 adult participants were randomized in this study. We measured adjustment disorder as a primary outcome, and psychological well-being as a secondary outcome at pre-intervention (T1) and one month after the intervention (T2). We found medium effect size of the intervention for the completer sample on adjustment disorder symptoms. Intervention was effective for those participants who used it at least one time in 30-day period. Our results revealed the potential of unguided internet-based self-help intervention for adjustment disorder. However, high dropout rates in the study limits the generalization of the outcomes of the intervention only to completers.

  7. Evaluation Methods for Assessing Users' Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review.

    Science.gov (United States)

    Feather, Jacqueline Susan; Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-06-30

    The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users' experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic

  8. Measuring participant rurality in Web-based interventions

    Directory of Open Access Journals (Sweden)

    McKay H Garth

    2007-08-01

    Full Text Available Abstract Background Web-based health behavior change programs can reach large groups of disparate participants and thus they provide promise of becoming important public health tools. Data on participant rurality can complement other demographic measures to deepen our understanding of the success of these programs. Specifically, analysis of participant rurality can inform recruitment and social marketing efforts, and facilitate the targeting and tailoring of program content. Rurality analysis can also help evaluate the effectiveness of interventions across population groupings. Methods We describe how the RUCAs (Rural-Urban Commuting Area Codes methodology can be used to examine results from two Randomized Controlled Trials of Web-based tobacco cessation programs: the ChewFree.com project for smokeless tobacco cessation and the Smokers' Health Improvement Program (SHIP project for smoking cessation. Results Using RUCAs methodology helped to highlight the extent to which both Web-based interventions reached a substantial percentage of rural participants. The ChewFree program was found to have more rural participation which is consistent with the greater prevalence of smokeless tobacco use in rural settings as well as ChewFree's multifaceted recruitment program that specifically targeted rural settings. Conclusion Researchers of Web-based health behavior change programs targeted to the US should routinely include RUCAs as a part of analyzing participant demographics. Researchers in other countries should examine rurality indices germane to their country.

  9. Web-based interventions for menopause: A systematic integrated literature review.

    Science.gov (United States)

    Im, Eun-Ok; Lee, Yaelim; Chee, Eunice; Chee, Wonshik

    2017-01-01

    Advances in computer and Internet technologies have allowed health care providers to develop, use, and test various types of Web-based interventions for their practice and research. Indeed, an increasing number of Web-based interventions have recently been developed and tested in health care fields. Despite the great potential for Web-based interventions to improve practice and research, little is known about the current status of Web-based interventions, especially those related to menopause. To identify the current status of Web-based interventions used in the field of menopause, a literature review was conducted using multiple databases, with the keywords "online," "Internet," "Web," "intervention," and "menopause." Using these keywords, a total of 18 eligible articles were analyzed to identify the current status of Web-based interventions for menopause. Six themes reflecting the current status of Web-based interventions for menopause were identified: (a) there existed few Web-based intervention studies on menopause; (b) Web-based decision support systems were mainly used; (c) there was a lack of detail on the interventions; (d) there was a lack of guidance on the use of Web-based interventions; (e) counselling was frequently combined with Web-based interventions; and (f) the pros and cons were similar to those of Web-based methods in general. Based on these findings, directions for future Web-based interventions for menopause are provided. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Web-Based and Mobile Stress Management Intervention for Employees

    DEFF Research Database (Denmark)

    Heber, E.; Lehr, D.; Ebert, D. D.

    2016-01-01

    Background: Work-related stress is highly prevalent among employees and is associated with adverse mental health consequences. Web-based interventions offer the opportunity to deliver effective solutions on a large scale; however, the evidence is limited and the results conflicting. Objective......: This randomized controlled trial evaluated the efficacy of guided Web-and mobile-based stress management training for employees. Methods: A total of 264 employees with elevated symptoms of stress (Perceived Stress Scale-10, PSS-10 >= 22) were recruited from the general working population and randomly assigned...... to an Internet-based stress management intervention (iSMI) or waitlist control group. The intervention (GET. ON Stress) was based on Lazarus's transactional model of stress, consisted of seven sessions, and applied both well-established problem solving and more recently developed emotion regulation strategies...

  11. Mediating mechanisms of a military Web-based alcohol intervention.

    Science.gov (United States)

    Williams, Jason; Herman-Stahl, Mindy; Calvin, Sara L; Pemberton, Michael; Bradshaw, Michael

    2009-03-01

    This study explored the mediating mechanisms of two Web-based alcohol interventions in a sample of active duty United States military personnel. Personnel were recruited from eight bases and received the Drinker's Check-Up (N=1483), Alcohol Savvy (N=688), or served as controls (N=919). The interventions drew on motivational interviewing and social learning theory and targeted multiple mediators including social norms, perceived risks and benefits, readiness to change, and coping strategies. Baseline data were collected prior to the intervention and follow-up data on alcohol consumption were gathered 1 month and 6 months after program completion. Two mediation models were examined: (1) a longitudinal two-wave model with outcomes and mediators assessed concurrently at the 1-month follow-up; and (2) a three-wave model in which the causal chain was fully lagged. Results indicated strong support for the role of perceived descriptive norms in transmitting the effects of the Drinker's Check-Up, with consistent mediation across the majority of alcohol outcome measures for both the concurrent and fully lagged mediation models. These results suggest that web-based interventions that are effective in lowering perceived norms about the frequency and quantity of drinking may be a viable strategy for reducing alcohol consumption in military populations. The results did not support program mediation by the other targeted variables, indicating the need for future research on the effective components of alcohol interventions. The mediation models also suggest reasons why program effects were not found for some outcomes or were different across programs.

  12. Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

    Science.gov (United States)

    Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-01-01

    Background The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. Objective This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. Methods A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Results Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. Conclusions There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main

  13. Program Use and Outcome Change in a Web-Based Trauma Intervention: Individual and Social Factors.

    Science.gov (United States)

    Wang, Zhiyun; Wang, Jianping; Maercker, Andreas

    2016-09-09

    Insight into user adherence to Web-based intervention programs and into its relationship to intervention effect is needed. The objective of this study was to examine use of a Web-based self-help intervention program, the Chinese version of My Trauma Recovery (CMTR), among Chinese traumatized individuals, and to investigate the relationship between program use and user characteristics before the intervention and change in outcomes after the intervention and at 3-months' follow-up. The sample consisted of 56 urban survivors of different trauma types and 90 rural survivors of the 2008 Sichuan earthquake, who used the CMTR in 1 month on their own or guided by volunteers in a counseling center. Predictors were demographics (sex, age, highest education, marital status, and annual family income), health problems (trauma duration, posttraumatic symptoms, and depression), psychological factors (coping self-efficacy), and social factors (social functioning impairment and social support). Program use was assessed by general program usage (eg, number of visiting days) and program adherence (eg, webpages completed in modules). Outcome measures were the Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy scale (CSE), Crisis Support Scale (CSS), and Social Functioning Impairment questionnaire (SFI) adopted from the CMTR. (1) Program use: rural participants had a larger total number of visiting days (F1,144=40.50, Psocial factors at pretest. (3) Program use and outcomes change: in general, use of the triggers and self-talk modules showed a consistent positive association with improvement in PDS, SCL-D, SFI, and CSE. The relaxation module was associated with positive change in PDS, but with negative change in CSS and SFI. The professional help module was associated with positive change in SCL-D, but its use on the first day was associated with negative change in CSS and CSE. The unhelpful coping module was associated with

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  15. Predictors of treatment dropout in self-guided web-based interventions for depression: an 'individual patient data' meta-analysis.

    Science.gov (United States)

    Karyotaki, E; Kleiboer, A; Smit, F; Turner, D T; Pastor, A M; Andersson, G; Berger, T; Botella, C; Breton, J M; Carlbring, P; Christensen, H; de Graaf, E; Griffiths, K; Donker, T; Farrer, L; Huibers, M J H; Lenndin, J; Mackinnon, A; Meyer, B; Moritz, S; Riper, H; Spek, V; Vernmark, K; Cuijpers, P

    2015-10-01

    It is well known that web-based interventions can be effective treatments for depression. However, dropout rates in web-based interventions are typically high, especially in self-guided web-based interventions. Rigorous empirical evidence regarding factors influencing dropout in self-guided web-based interventions is lacking due to small study sample sizes. In this paper we examined predictors of dropout in an individual patient data meta-analysis to gain a better understanding of who may benefit from these interventions. A comprehensive literature search for all randomized controlled trials (RCTs) of psychotherapy for adults with depression from 2006 to January 2013 was conducted. Next, we approached authors to collect the primary data of the selected studies. Predictors of dropout, such as socio-demographic, clinical, and intervention characteristics were examined. Data from 2705 participants across ten RCTs of self-guided web-based interventions for depression were analysed. The multivariate analysis indicated that male gender [relative risk (RR) 1.08], lower educational level (primary education, RR 1.26) and co-morbid anxiety symptoms (RR 1.18) significantly increased the risk of dropping out, while for every additional 4 years of age, the risk of dropping out significantly decreased (RR 0.94). Dropout can be predicted by several variables and is not randomly distributed. This knowledge may inform tailoring of online self-help interventions to prevent dropout in identified groups at risk.

  16. Factors Associated with High Use of a Workplace Web-Based Stress Management Program in a Randomized Controlled Intervention Study

    Science.gov (United States)

    Hasson, H.; Brown, C.; Hasson, D.

    2010-01-01

    In web-based health promotion programs, large variations in participant engagement are common. The aim was to investigate determinants of high use of a worksite self-help web-based program for stress management. Two versions of the program were offered to randomly selected departments in IT and media companies. A static version of the program…

  17. Persuasive system design does matter : a systematic review of adherence to web-based interventions

    NARCIS (Netherlands)

    Kelders, Saskia M.; Kok, Robin N.; Ossebaard, Hans C.; van Gemert-Pijnen, Julia E.W.C.

    2012-01-01

    Background: Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology

  18. Development and Pilot Testing of an Internet-Based Self-Help Intervention for Depression for Indian Users.

    Science.gov (United States)

    Mehrotra, Seema; Sudhir, Paulomi; Rao, Girish; Thirthalli, Jagadisha; Srikanth, T K

    2018-03-22

    There is a dearth of published research on uptake and utility of mental health apps in India, despite a rising global trend in the application of technology in the field of mental health. We describe the development and pilot testing of a self-help intervention for depression, PUSH-D (Practice and Use Self-Help for Depression) for urban Indians. This guided self-help app, with essential and optional zone sections, was developed to provide a comprehensive coverage of therapeutic strategies drawn from cognitive behavior therapy, interpersonal therapy, supportive psychotherapy, and positive psychology. Pilot testing was carried out using a single group pre-, post- and follow-up design in 78 eligible participants. Participants were typically young adults with major depression or dysthymia and significant impairment in functioning. Almost two-thirds of the participants had never sought professional mental health help. Significant reductions in depression and improvement in the functioning and well-being were notedon standardized measures in participants completing all 10 essential zone sections. These gains were maintained at follow-up. The results were similar for partial completers, who completed fiveout of the 10 essential sections. PUSH-D is one of the first indigenously developed self-help apps for depression and it shows promise in reducing the treatment gap for depression in India.

  19. Development and Pilot Testing of an Internet-Based Self-Help Intervention for Depression for Indian Users

    Directory of Open Access Journals (Sweden)

    Seema Mehrotra

    2018-03-01

    Full Text Available There is a dearth of published research on uptake and utility of mental health apps in India, despite a rising global trend in the application of technology in the field of mental health. We describe the development and pilot testing of a self-help intervention for depression, PUSH-D (Practice and Use Self-Help for Depression for urban Indians. This guided self-help app, with essential and optional zone sections, was developed to provide a comprehensive coverage of therapeutic strategies drawn from cognitive behavior therapy, interpersonal therapy, supportive psychotherapy, and positive psychology. Pilot testing was carried out using a single group pre-, post- and follow-up design in 78 eligible participants. Participants were typically young adults with major depression or dysthymia and significant impairment in functioning. Almost two-thirds of the participants had never sought professional mental health help. Significant reductions in depression and improvement in the functioning and well-being were notedon standardized measures in participants completing all 10 essential zone sections. These gains were maintained at follow-up. The results were similar for partial completers, who completed fiveout of the 10 essential sections. PUSH-D is one of the first indigenously developed self-help apps for depression and it shows promise in reducing the treatment gap for depression in India.

  20. Couples with Intimate Partner Violence Seeking Relationship Help: Associations and Implications for Self-Help and Online Interventions.

    Science.gov (United States)

    Roddy, McKenzie K; Georgia, Emily J; Doss, Brian D

    2017-04-20

    In-person conjoint treatments for relationship distress are effective at increasing relationship satisfaction, and newly developed online programs are showing promising results. However, couples reporting even low levels intimate partner violence (IPV) are traditionally excluded from these interventions. To improve the availability of couple-based treatment for couples with IPV, the present study sought to determine whether associations with IPV found in community samples generalized to couples seeking help for their relationship and whether web-based interventions for relationship distressed worked equally well for couples with IPV. In the first aim, in a sample of 2,797 individuals who were seeking online help for their relationship, the levels and correlates of both low-intensity and clinically significant IPV largely matched what is found in community samples. In the second aim, in a sample of 300 couples who were randomly assigned to a web-based intervention or a waitlist control group, low-impact IPV did not moderate the effects of the intervention for relationship distress. Therefore, web-based interventions may be an effective (and easily accessible) intervention for relationship distress for couples with low-intensity IPV. © 2017 Family Process Institute.

  1. How to increase rearch and adherence of web-based interventions : a design research viewpoint

    NARCIS (Netherlands)

    Ludden, Geke D.S.; van Rompay, Thomas J.L.; Kelders, Saskia M.; van Gemert-Pijnen, Julia E.W.C.

    2015-01-01

    Nowadays, technology is increasingly used to increase people’s well-being. For example, many mobile and Web-based apps have been developed that can support people to become mentally fit or to manage their daily diet. However, analyses of current Web-based interventions show that many systems are

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

    Science.gov (United States)

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

    2015-01-01

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

  3. The Use of Intervention Mapping to Develop a Tailored Web-Based Intervention, Condom-HIM.

    Science.gov (United States)

    Miranda, Joyal; Côté, José

    2017-04-19

    Many HIV (human immunodeficiency virus) prevention interventions are currently being implemented and evaluated, with little information published on their development. A framework highlighting the method of development of an intervention can be used by others wanting to replicate interventions or develop similar interventions to suit other contexts and settings. It provides researchers with a comprehensive development process of the intervention. The objective of this paper was to describe how a systematic approach, intervention mapping, was used to develop a tailored Web-based intervention to increase condom use among HIV-positive men who have sex with men. The intervention was developed in consultation with a multidisciplinary team composed of academic researchers, community members, Web designers, and the target population. Intervention mapping involved a systematic process of 6 steps: (1) needs assessment; (2) identification of proximal intervention objectives; (3) selection of theory-based intervention methods and practical strategies; (4) development of intervention components and materials; (5) adoption, implementation, and maintenance; and (6) evaluation planning. The application of intervention mapping resulted in the development of a tailored Web-based intervention for HIV-positive men who have sex with men, called Condom-HIM. Using intervention mapping as a systematic process to develop interventions is a feasible approach that specifically integrates the use of theory and empirical findings. Outlining the process used to develop a particular intervention provides clarification on the conceptual use of experimental interventions in addition to potentially identifying reasons for intervention failures. ©Joyal Miranda, José Côté. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 19.04.2017.

  4. Complementary medicine, self-help, and lifestyle interventions for obsessive compulsive disorder (OCD) and the OCD spectrum: a systematic review.

    Science.gov (United States)

    Sarris, Jerome; Camfield, David; Berk, Michael

    2012-05-01

    In Obsessive Compulsive Disorder (OCD) current standard pharmacotherapies may be of limited efficacy. Non-conventional interventions such as Complementary and Alternative Medicine (CAM), self-help techniques, and lifestyle interventions are commonly used by sufferers of OCD, however to date no systematic review of this specific area exists. We conducted a systematic review of studies using CAM, self-help, and lifestyle interventions for treatment of OCD and trichotillomania (TTM). PubMed, PsycINFO, China Academic Journals Full-text Database, The Cochrane Library and CINAHL were searched (up to Jan 11th 2011), for controlled clinical trials using non-conventional interventions for OCD. A quality analysis using a purpose-designed scale and an estimation of effect sizes (Cohen's d) where data was available, were also calculated. The literature search revealed 14 studies that met inclusion criteria. Methodological quality of nutraceutical studies (nutrients and herbal medicines) were rated as high (mean 8.6/10), whereas mind-body or self-help studies were poorer (mean 6.1/10). In OCD, tentative evidentiary support from methodologically weak studies was found for mindfulness meditation (d=0.63), electroacupuncture (d=1.16), and kundalini yoga (d=1.61). Better designed studies using the nutrient glycine (d=1.10), and traditional herbal medicines milk thistle (insufficient data for calculating d) and borage (d=1.67) also revealed positive results. A rigorous study showed that N-acetylcysteine (d=1.31) was effective in TTM, while self-help technique "movement decoupling" also demonstrated efficacy (d=0.94). Mixed evidence was found for myo-inositol (mean d=0.98). Controlled studies suggest that St John's wort, EPA, and meridian-tapping are ineffective in treating OCD. While several studies were positive, these were un-replicated and commonly used small samples. This precludes firm confidence in the strength of clinical effect. Preliminary evidence however is encouraging

  5. The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial.

    NARCIS (Netherlands)

    Fledderus, M.; Bohlmeijer, Ernst Thomas; Fox, Gerardus J.A.; Schreurs, Karlein Maria Gertrudis; Spinhoven, Philip

    2013-01-01

    This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail

  6. Internet-based self-help therapy with FearFighter™ versus no intervention for anxiety disorders in adults

    DEFF Research Database (Denmark)

    Fenger, Morten; Lindschou, Jane; Gluud, Christian

    2016-01-01

    BACKGROUND: Internet-based self-help psychotherapy (IBT) could be an important alternative or supplement to ordinary face-to-face therapy. The findings of randomised controlled trials indicate that the effects of various IBT programmes for anxiety disorders seem better than no intervention...... and in some instances are equivalent to usual therapy. In Denmark, IBT is part of future treatment plans in mental health care services, but the verification level of the current clinical scientific knowledge is insufficient. The objective of this trial is feasibility assessment of benefits and harms...

  7. Documenting clinical pharmacist intervention before and after the introduction of a web-based tool.

    Science.gov (United States)

    Nurgat, Zubeir A; Al-Jazairi, Abdulrazaq S; Abu-Shraie, Nada; Al-Jedai, Ahmed

    2011-04-01

    To develop a database for documenting pharmacist intervention through a web-based application. The secondary endpoint was to determine if the new, web-based application provides any benefits with regards to documentation compliance by clinical pharmacists and ease of calculating cost savings compared with our previous method of documenting pharmacist interventions. A tertiary care hospital in Saudi Arabia. The documentation of interventions using a web-based documentation application was retrospectively compared with previous methods of documentation of clinical pharmacists' interventions (multi-user PC software). The number and types of interventions recorded by pharmacists, data mining of archived data, efficiency, cost savings, and the accuracy of the data generated. The number of documented clinical interventions increased from 4,926, using the multi-user PC software, to 6,840 for the web-based application. On average, we observed 653 interventions per clinical pharmacist using the web-based application, which showed an increase compared to an average of 493 interventions using the old multi-user PC software. However, using a paired Student's t-test there was no statistical significance difference between the two means (P = 0.201). Using a χ² test, which captured management level and the type of system used, we found a strong effect of management level (P educational level and the number of interventions documented (P = 0.045). The mean ± SD time required to document an intervention using the web-based application was 66.55 ± 8.98 s. Using the web-based application, 29.06% of documented interventions resulted in cost-savings, while using the multi-user PC software only 4.75% of interventions did so. The majority of cost savings across both platforms resulted from the discontinuation of unnecessary drugs and a change in dosage regimen. Data collection using the web-based application was consistently more complete when compared to the multi-user PC software

  8. Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

    Science.gov (United States)

    Kok, Robin N; Ossebaard, Hans C; Van Gemert-Pijnen, Julia EWC

    2012-01-01

    Background Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are

  9. Web-based health interventions for family caregivers of elderly individuals: A Scoping Review.

    Science.gov (United States)

    Wasilewski, Marina B; Stinson, Jennifer N; Cameron, Jill I

    2017-07-01

    For the growing proportion of elders globally, aging-related illnesses are primary causes of morbidity causing reliance on family members for support in the community. Family caregivers experience poorer physical and mental health than their non-caregiving counterparts. Web-based interventions can provide accessible support to family caregivers to offset declines in their health and well-being. Existing reviews focused on web-based interventions for caregivers have been limited to single illness populations and have mostly focused on the efficacy of the interventions. We therefore have limited insight into how web-based interventions for family caregiver have been developed, implemented and evaluated across aging-related illness. To describe: a) theoretical underpinnings of the literature; b) development, content and delivery of web-based interventions; c) caregiver usage of web-based interventions; d) caregiver experience with web-based interventions and e) impact of web-based interventions on caregivers' health outcomes. We followed Arksey and O'Malley's methodological framework for conducting scoping reviews which entails setting research questions, selecting relevant studies, charting the data and synthesizing the results in a report. Fifty-three publications representing 32 unique web-based interventions were included. Over half of the interventions were targeted at dementia caregivers, with the rest targeting caregivers to the stroke, cancer, diabetes and general frailty populations. Studies used theory across the intervention trajectory. Interventions aimed to improve a range of health outcomes for caregivers through static and interactive delivery methods Caregivers were satisfied with the usability and accessibility of the websites but usage was generally low and declined over time. Depression and caregiver burden were the most common outcomes evaluated. The interventions ranged in their impact on health and social outcomes but reductions in perception of

  10. A Pilot Randomized Controlled Trial of a Guided Self-Help Intervention to Manage Chronic Orofacial Pain.

    Science.gov (United States)

    Goldthorpe, Joanna; Lovell, Karina; Peters, Sarah; McGowan, Linda; Nemeth, Imola; Roberts, Christopher; Aggarwal, Vishal R

    2017-01-01

    To conduct a pilot trial to test the feasibility of a guided self-help intervention for chronic orofacial pain. A pilot randomized controlled trial was conducted to compare the intervention with usual treatment. A total of 37 patients with chronic orofacial pain were randomized into either the intervention group (n = 19) or the usual treatment (control) group (n = 18). Validated outcome measures were used to measure the potential effectiveness of the intervention over a number of domains: physical and mental functioning (Short Form 36 [SF-36]); anxiety and depression (Hospital Anxiety and Depression Scale [HADS]); pain intensity and interference with life (Brief Pain Inventory [BPI]); disability (Manchester Orofacial Pain Disability Scale [MOPDS]); and illness behavior (Revised Illness Perceptions Questionnaire [IPQr]). Bootstrap confidence intervals were computed for the treatment effect (ES) posttreatment and at 3 months follow-up and adjusted for baseline values of the outcome measure by using analysis of covariance. At posttreatment and the 3-month follow-up, 11 participants in the intervention group and 7 in the control group failed to complete outcome measures. The intervention was acceptable and could be feasibly delivered face to face or over the telephone. Although the pilot trial was not powered to draw conclusions about the effectiveness, it showed significant (P orofacial pain. It showed potential effectiveness on outcome domains related to functioning and illness perception. Further research is needed to understand the cost effectiveness of the intervention for chronic orofacial pain.

  11. Feasibility and Effectiveness of a Web-Based Physical Activity Intervention for Working Mothers.

    Science.gov (United States)

    Mailey, Emily L; Huberty, Jennifer; Irwin, Brandon C

    2016-08-01

    The purpose of this study was to examine the feasibility and effectiveness of a web-based intervention to promote physical activity and self-worth among working mothers. Participants (N = 69) were randomly assigned to receive a standard web-based intervention or an enhanced intervention that included group dynamics strategies to promote engagement. The 8-week intervention was guided by self-determination theory. Each week, participants were instructed to complete 3 tasks: listen to a podcast related to well-being, complete a workbook assignment, and communicate with other participants on a discussion board. Participants in the enhanced condition received an additional weekly task to enhance group cohesion. Data were collected at baseline, week 8, and week 16. Physical activity (P working mothers. Group dynamics strategies only minimally enhanced user engagement, and future studies are needed to optimize web-based intervention designs.

  12. Web-based rehabilitation interventions for people with rheumatoid arthritis: A systematic review.

    Science.gov (United States)

    Srikesavan, Cynthia; Bryer, Catherine; Ali, Usama; Williamson, Esther

    2018-01-01

    Background Rehabilitation approaches for people with rheumatoid arthritis include joint protection, exercises and self-management strategies. Health interventions delivered via the web have the potential to improve access to health services overcoming time constraints, physical limitations, and socioeconomic and geographic barriers. The objective of this review is to determine the effects of web-based rehabilitation interventions in adults with rheumatoid arthritis. Methods Randomised controlled trials that compared web-based rehabilitation interventions with usual care, waiting list, no treatment or another web-based intervention in adults with rheumatoid arthritis were included. The outcomes were pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge, physical activity and adverse effects. Methodological quality was assessed using the Cochrane Risk of Bias tool and quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation approach. Results Six source documents from four trials ( n = 567) focusing on self-management, health information or physical activity were identified. The effects of web-based rehabilitation interventions on pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge and physical activity are uncertain because of the very low quality of evidence mostly from small single trials. Adverse effects were not reported. Conclusion Large, well-designed trials are needed to evaluate the clinical and cost-effectiveness of web-based rehabilitation interventions in rheumatoid arthritis.

  13. Tailored Web-Based Interventions for Pain: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Martorella, Geraldine; Boitor, Madalina; Berube, Melanie; Fredericks, Suzanne; Le May, Sylvie; Gélinas, Céline

    2017-11-10

    Efforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated. The primary aim of this systematic review was to answer the following research question: What is the effect of tailored Web-based pain management interventions for adults on pain intensity compared with usual care, face-to-face interventions, and standardized Web-based interventions? A secondary aim was to examine the effects of these interventions on physical and psychological functions. We conducted a systematic review of articles published from January 2000 to December 2015. We used the DerSimonian-Laird random effects models with 95% confidence intervals to calculate effect estimates for all analyses. We calculated standardized mean differences from extracted means and standard deviations, as outcome variables were measured on different continuous scales. We evaluated 5 different outcomes: pain intensity (primary outcome), pain-related disability, anxiety, depression, and pain catastrophizing. We assessed effects according to 3 time intervals: short term (Web-based intervention showed benefits immediately after, with small effect sizes (Web-based interventions did not prove to be more efficacious than standardized Web-based interventions in terms of pain intensity, pain-related disability, anxiety, and depression. An interesting finding was that some efficacy was shown on pain

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

    Science.gov (United States)

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

    2017-06-28

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

  15. Web-Based Mindfulness Interventions for People With Physical Health Conditions: Systematic Review.

    Science.gov (United States)

    Toivonen, Kirsti I; Zernicke, Kristin; Carlson, Linda E

    2017-08-31

    Mindfulness-based interventions (MBIs) are becoming increasingly popular for helping people with physical health conditions. Expanding from traditional face-to-face program delivery, there is growing interest in Web-based application of MBIs, though Web-based MBIs for people with physical health conditions specifically have not been thoroughly reviewed to date. The objective of this paper was to review Web-based MBIs for people with physical health conditions and to examine all outcomes reported (eg, efficacy or effectiveness for physical changes or psychological changes; feasibility). Databases PubMed, PsycINFO, Science Direct, CINAHL Plus, and Web of Science were searched. Full-text English papers that described any Web-based MBI, examining any outcome, for people with chronic physical health conditions were included. Randomized, nonrandomized, controlled, and uncontrolled trials were all included. Extracted data included intervention characteristics, population characteristics, outcomes, and quality indicators. Intervention characteristics (eg, synchronicity and guidance) were examined as potential factors related to study outcomes. Of 435 publications screened, 19 published papers describing 16 studies were included. They examined Web-based MBIs for people with cancer, chronic pain or fibromyalgia, irritable bowel syndrome (IBS), epilepsy, heart disease, tinnitus, and acquired brain injury. Overall, most studies reported positive effects of Web-based MBIs compared with usual care on a variety of outcomes including pain acceptance, coping measures, and depressive symptoms. There were mixed results regarding the effectiveness of Web-based MBIs compared with active control treatment conditions such as cognitive behavioral therapy. Condition-specific symptoms (eg, cancer-related fatigue and IBS symptoms) targeted by treatment had the largest effect size improvements following MBIs. Results are inconclusive regarding physical variables. Preliminary evidence suggests

  16. Development of a web-based intervention for the indicated prevention of depression

    Science.gov (United States)

    2013-01-01

    Background To reduce the large public health burden of the high prevalence of depression, preventive interventions targeted at people at risk are essential and can be cost-effective. Web-based interventions are able to provide this care, but there is no agreement on how to best develop these applications and often the technology is seen as a given. This seems to be one of the main reasons that web-based interventions do not reach their full potential. The current study describes the development of a web-based intervention for the indicated prevention of depression, employing the CeHRes (Center for eHealth Research and Disease Management) roadmap. The goals are to create a user-friendly application which fits the values of the stakeholders and to evaluate the process of development. Methods The employed methods are a literature scan and discussion in the contextual inquiry; interviews, rapid prototyping and a requirement session in the value specification stage; and user-based usability evaluation, expert-based usability inspection and a requirement session in the design stage. Results The contextual inquiry indicated that there is a need for easily accessible interventions for the indicated prevention of depression and web-based interventions are seen as potentially meeting this need. The value specification stage yielded expected needs of potential participants, comments on the usefulness of the proposed features and comments on two proposed designs of the web-based intervention. The design stage yielded valuable comments on the system, content and service of the web-based intervention. Conclusions Overall, we found that by developing the technology, we successfully (re)designed the system, content and service of the web-based intervention to match the values of stakeholders. This study has shown the importance of a structured development process of a web-based intervention for the indicated prevention of depression because: (1) it allows the development team to

  17. Development of a web-based intervention for the indicated prevention of depression.

    Science.gov (United States)

    Kelders, Saskia M; Pots, Wendy T M; Oskam, Maarten Jan; Bohlmeijer, Ernst T; van Gemert-Pijnen, Julia E W C

    2013-02-20

    To reduce the large public health burden of the high prevalence of depression, preventive interventions targeted at people at risk are essential and can be cost-effective. Web-based interventions are able to provide this care, but there is no agreement on how to best develop these applications and often the technology is seen as a given. This seems to be one of the main reasons that web-based interventions do not reach their full potential. The current study describes the development of a web-based intervention for the indicated prevention of depression, employing the CeHRes (Center for eHealth Research and Disease Management) roadmap. The goals are to create a user-friendly application which fits the values of the stakeholders and to evaluate the process of development. The employed methods are a literature scan and discussion in the contextual inquiry; interviews, rapid prototyping and a requirement session in the value specification stage; and user-based usability evaluation, expert-based usability inspection and a requirement session in the design stage. The contextual inquiry indicated that there is a need for easily accessible interventions for the indicated prevention of depression and web-based interventions are seen as potentially meeting this need. The value specification stage yielded expected needs of potential participants, comments on the usefulness of the proposed features and comments on two proposed designs of the web-based intervention. The design stage yielded valuable comments on the system, content and service of the web-based intervention. Overall, we found that by developing the technology, we successfully (re)designed the system, content and service of the web-based intervention to match the values of stakeholders. This study has shown the importance of a structured development process of a web-based intervention for the indicated prevention of depression because: (1) it allows the development team to clarify the needs that have to be met

  18. Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants

    NARCIS (Netherlands)

    Samoocha, D.; Snels, I.A.K.; Bruinvels, D.J.; Anema, J.R.; Kowalczyk, W.J.; van der Beek, A.J.

    2011-01-01

    Background: The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention http://www.wiagesprek.nl. This intervention was aimed at empowerment of disability claimants, prior

  19. Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants

    NARCIS (Netherlands)

    Samoocha, David; Snels, Ingrid A. K.; Bruinvels, David J.; Anema, Johannes R.; Kowalczyk, Wojtek; van der Beek, Allard J.

    2011-01-01

    The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention http://www.wiagesprek.nl. This intervention was aimed at empowerment of disability claimants, prior to the

  20. Human Centered Development of a Web-based Intervention for the Prevention of Depression

    NARCIS (Netherlands)

    Kelders, Saskia Marion; Oskam, Maarten-Jan; Bohlmeijer, Ernst Thomas; van Gemert-Pijnen, Julia E.W.C.

    2012-01-01

    Web-based preventive interventions have shown to be effective for the prevention of depression, but high rates of non-use and drop-out, less than optimal implementation in the care organization and low acceptance rates cause interventions to be less effective in practice than in theory and research.

  1. Evaluation of social-cognitive versus stage-matched, self-help physical activity interventions at the workplace.

    Science.gov (United States)

    Griffin-Blake, C Shannon; DeJoy, David M

    2006-01-01

    To compare the effectiveness of stage-matched vs. social-cognitive physical activity interventions in a work setting. Both interventions were designed as minimal-contact, self-help programs suitable for large-scale application. Randomized trial. Participants were randomized into one of the two intervention groups at baseline; the follow-up assessment was conducted 1 month later. A large, public university in the southeastern region of the United States. Employees from two academic colleges within the participating institution were eligible to participate: 366 employees completed the baseline assessment; 208 of these completed both assessments (baseline and follow-up) and met the compliance criteria. Printed, self-help exercise booklets (12 to 16 pages in length) either (1) matched to the individual's stage of motivational readiness for exercise adoption at baseline or (2) derived from social-cognitive theory but not matched by stage. Standard questionnaires were administered to assess stage of motivational readiness for physical activity; physical activity participation; and exercise-related processes of change, decisional balance, self-efficacy, outcome expectancy, and goal satisfaction. The two interventions were equally effective in moving participants to higher levels of motivational readiness for regular physical activity. Among participants not already in maintenance at baseline, 34.9% in the stage-matched condition progressed, while 33.9% in the social-cognitive group did so (chi2 = not significant). Analyses of variance showed that the two treatment groups did not differ in terms of physical activity participation, cognitive and behavioral process use, decisional balance, or the other psychological constructs. For both treatment groups, cognitive process use remained high across all stages, while behavioral process use increased at the higher stages. The pros component of decisional balance did not vary across stage, whereas cons decreased significantly

  2. Finding Web-Based Anxiety Interventions on the World Wide Web: A Scoping Review.

    Science.gov (United States)

    Ashford, Miriam Thiel; Olander, Ellinor K; Ayers, Susan

    2016-06-01

    One relatively new and increasingly popular approach of increasing access to treatment is Web-based intervention programs. The advantage of Web-based approaches is the accessibility, affordability, and anonymity of potentially evidence-based treatment. Despite much research evidence on the effectiveness of Web-based interventions for anxiety found in the literature, little is known about what is publically available for potential consumers on the Web. Our aim was to explore what a consumer searching the Web for Web-based intervention options for anxiety-related issues might find. The objectives were to identify currently publically available Web-based intervention programs for anxiety and to synthesize and review these in terms of (1) website characteristics such as credibility and accessibility; (2) intervention program characteristics such as intervention focus, design, and presentation modes; (3) therapeutic elements employed; and (4) published evidence of efficacy. Web keyword searches were carried out on three major search engines (Google, Bing, and Yahoo-UK platforms). For each search, the first 25 hyperlinks were screened for eligible programs. Included were programs that were designed for anxiety symptoms, currently publically accessible on the Web, had an online component, a structured treatment plan, and were available in English. Data were extracted for website characteristics, program characteristics, therapeutic characteristics, as well as empirical evidence. Programs were also evaluated using a 16-point rating tool. The search resulted in 34 programs that were eligible for review. A wide variety of programs for anxiety, including specific anxiety disorders, and anxiety in combination with stress, depression, or anger were identified and based predominantly on cognitive behavioral therapy techniques. The majority of websites were rated as credible, secure, and free of advertisement. The majority required users to register and/or to pay a program access

  3. A randomized controlled trial of a smoking cessation self-help intervention for dual users of tobacco cigarettes and E-cigarettes: Intervention development and research design.

    Science.gov (United States)

    Meltzer, Lauren R; Simmons, Vani N; Sutton, Steven K; Drobes, David J; Quinn, Gwendolyn P; Meade, Cathy D; Unrod, Marina; Brandon, Karen O; Harrell, Paul T; Eissenberg, Thomas; Bullen, Christopher R; Brandon, Thomas H

    2017-09-01

    Electronic Nicotine Delivery Systems, also called electronic cigarettes or e-cigarettes, have been available for over a decade and use has been increasing dramatically. The primary reported reasons for use are to aid smoking cessation or reduction, yet a significant proportion appear to be long-term users of both products ("dual users"). Dual users may be motivated to quit smoking and might benefit from a behavioral intervention for smoking cessation. This paper describes the intervention development, as well as the design, methods, and data analysis plans for an ongoing randomized controlled trial (RCT). Formative research and learner verification were conducted to create a usable, understandable, and acceptable self-help intervention targeting dual users. The efficacy is being tested in an RCT with current dual users (N=2900) recruited nationally and randomized to one of three conditions. The Assessment Only (ASSESS) group only completes assessments. The Generic Self-Help (GENERIC) group receives non-targeted smoking cessation booklets and supplemental materials sent monthly over 18months. The e-cigarette Targeted Self-Help (eTARGET) group receives the newly developed intervention (targeted booklets and supplemental materials) sent over the same period. All participants complete self-report surveys every 3months over 2years. The primary study outcome is self-reported 7-day point prevalence abstinence. Cost-effectiveness metrics for the GENERIC and eTARGET interventions will also be calculated. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Meinert, Marina; König, Mirjam; Jaschinski, Wolfgang

    2013-01-01

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

  5. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation.

    Science.gov (United States)

    Heffner, Jaimee L; Wyszynski, Christopher M; Comstock, Bryan; Mercer, Laina D; Bricker, Jonathan

    2013-10-01

    Web-based behavioral interventions for substance use are being developed at a rapid pace, yet there is a dearth of information regarding the most effective methods for recruiting participants into web-based intervention trials. In this paper, we describe our successful recruitment of participants into a pilot trial of web-based Acceptance and Commitment Therapy (ACT) for smoking cessation and compare traditional and web-based methods of recruitment in terms of their effects on baseline participant characteristics, association with study retention and treatment outcome, yield, and cost-effectiveness. Over a 10-week period starting June 15, 2010, we recruited 222 smokers for a web-based smoking cessation study using a variety of recruitment methods. The largest portion of randomized participants were recruited through Google AdWords (36%), followed by medical Internet media (23%), standard media (14%), word of mouth (12%), broadcast emails (11%), and social media (6%). Recruitment source was not related to baseline participant characteristics, 3-month data retention, or 30-day point prevalence smoking abstinence at the 3-month outcome assessment. Cost per randomized participant ranged from $5.27/participant for word of mouth to $172.76/participant for social media, with a mean cost of $42.48/participant. Our diversified approach to recruitment, including both traditional and web-based methods, enabled timely enrollment of participants into the study. Because there was no evidence of a substantive difference in baseline characteristics, retention, or outcomes based on recruitment channel, the yield and cost-effectiveness of recruitment methods may be the more critical considerations in developing a feasible recruitment plan for a web-based smoking cessation intervention study. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Bounce Back Now! Protocol of a population-based randomized controlled trial to examine the efficacy of a Web-based intervention with disaster-affected families.

    Science.gov (United States)

    Ruggiero, Kenneth J; Davidson, Tatiana M; McCauley, Jenna; Gros, Kirstin Stauffacher; Welsh, Kyleen; Price, Matthew; Resnick, Heidi S; Danielson, Carla Kmett; Soltis, Kathryn; Galea, Sandro; Kilpatrick, Dean G; Saunders, Benjamin E; Nissenboim, Josh; Muzzy, Wendy; Fleeman, Anna; Amstadter, Ananda B

    2015-01-01

    Disasters have far-reaching and potentially long-lasting effects on youth and families. Research has consistently shown a clear increase in the prevalence of several mental health disorders after disasters, including depression and posttraumatic stress disorder. Widely accessible evidence-based interventions are needed to address this unmet need for youth and families, who are underrepresented in disaster research. Rapid growth in Internet and Smartphone access, as well as several Web based evaluation studies with various adult populations has shown that Web-based interventions are likely to be feasible in this context and can improve clinical outcomes. Such interventions also are generally cost-effective, can be targeted or personalized, and can easily be integrated in a stepped care approach to screening and intervention delivery. This is a protocol paper that describes an innovative study design in which we evaluate a self-help Web-based resource, Bounce Back Now, with a population-based sample of disaster affected adolescents and families. The paper includes description and justification for sampling selection and procedures, selection of assessment measures and methods, design of the intervention, and statistical evaluation of critical outcomes. Unique features of this study design include the use of address-based sampling to recruit a population-based sample of disaster-affected adolescents and parents, telephone and Web-based assessments, and development and evaluation of a highly individualized Web intervention for adolescents. Challenges related to large-scale evaluation of technology-delivered interventions with high-risk samples in time-sensitive research are discussed, as well as implications for future research and practice. Published by Elsevier Inc.

  7. Effectiveness of web-based interventions on patient empowerment: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Samoocha, David; Bruinvels, David J.; Elbers, Nieke A.; Anema, Johannes R.; van der Beek, Allard J.

    2010-01-01

    Patient empowerment is growing in popularity and application. Due to the increasing possibilities of the Internet and eHealth, many initiatives that are aimed at empowering patients are delivered online. Our objective was to evaluate whether Web-based interventions are effective in increasing

  8. Feasibility of a Web-Based Cross-Over Paleolithic Diet Intervention in the General Population

    NARCIS (Netherlands)

    Nederhof, Esther; Bikker, Esther

    2017-01-01

    Introduction: The primary aim was to investigate feasibility of a web-based cross-over Paleolithic diet intervention in the general population. The secondary aim was to calculate the sample size needed to reach a statistically significant difference in effect of a Paleolithic-like diet on

  9. Using a transdiagnostic, psychodynamic online self-help intervention to maintain inpatient psychosomatic treatment effects: Study protocol of a feasibility study

    Directory of Open Access Journals (Sweden)

    Jan Becker

    2016-09-01

    Conclusion: We expect insight into the usefulness and acceptance of an online self-help intervention used to maintain inpatient treatment effects. Furthermore, we await both groups to benefit from the participation in the intervention. Pre- post and between subject differences will be used as estimate effect sizes to calculate the necessary sample size for a larger efficacy trial.

  10. Development of an open-source web-based intervention for Brazilian smokers - Viva sem Tabaco.

    Science.gov (United States)

    Gomide, H P; Bernardino, H S; Richter, K; Martins, L F; Ronzani, T M

    2016-08-02

    Web-based interventions for smoking cessation available in Portuguese do not adhere to evidence-based treatment guidelines. Besides, all existing web-based interventions are built on proprietary platforms that developing countries often cannot afford. We aimed to describe the development of "Viva sem Tabaco", an open-source web-based intervention. The development of the intervention included the selection of content from evidence-based guidelines for smoking cessation, the design of the first layout, conduction of 2 focus groups to identify potential features, refinement of the layout based on focus groups and correction of content based on feedback provided by specialists on smoking cessation. At the end, we released the source-code and intervention on the Internet and translated it into Spanish and English. The intervention developed fills gaps in the information available in Portuguese and the lack of open-source interventions for smoking cessation. The open-source licensing format and its translation system may help researchers from different countries deploying evidence-based interventions for smoking cessation.

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

    Science.gov (United States)

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

    2018-02-01

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

  12. Persuasive Features in Web-Based Alcohol and Smoking Interventions: A Systematic Review of the Literature

    Science.gov (United States)

    2011-01-01

    Background In the past decade, the use of technologies to persuade, motivate, and activate individuals’ health behavior change has been a quickly expanding field of research. The use of the Web for delivering interventions has been especially relevant. Current research tends to reveal little about the persuasive features and mechanisms embedded in Web-based interventions targeting health behavior change. Objectives The purpose of this systematic review was to extract and analyze persuasive system features in Web-based interventions for substance use by applying the persuasive systems design (PSD) model. In more detail, the main objective was to provide an overview of the persuasive features within current Web-based interventions for substance use. Methods We conducted electronic literature searches in various databases to identify randomized controlled trials of Web-based interventions for substance use published January 1, 2004, through December 31, 2009, in English. We extracted and analyzed persuasive system features of the included Web-based interventions using interpretive categorization. Results The primary task support components were utilized and reported relatively widely in the reviewed studies. Reduction, self-monitoring, simulation, and personalization seem to be the most used features to support accomplishing user’s primary task. This is an encouraging finding since reduction and self-monitoring can be considered key elements for supporting users to carry out their primary tasks. The utilization of tailoring was at a surprisingly low level. The lack of tailoring may imply that the interventions are targeted for too broad an audience. Leveraging reminders was the most common way to enhance the user-system dialogue. Credibility issues are crucial in website engagement as users will bind with sites they perceive credible and navigate away from those they do not find credible. Based on the textual descriptions of the interventions, we cautiously

  13. Persuasive system design does matter: a systematic review of adherence to web-based interventions.

    Science.gov (United States)

    Kelders, Saskia M; Kok, Robin N; Ossebaard, Hans C; Van Gemert-Pijnen, Julia E W C

    2012-11-14

    Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p=.004), setup (psystem (p=.003) and peers (p=.017), duration (F=6.068, p=.004), adherence (F=4.833, p=.010) and the number of primary task support elements (F=5.631, p=.005

  14. Motivational interviewing in a Web-based physical activity intervention with an avatar: randomized controlled trial.

    Science.gov (United States)

    Friederichs, Stijn; Bolman, Catherine; Oenema, Anke; Guyaux, Janneke; Lechner, Lilian

    2014-02-13

    Developing Web-based physical activity (PA) interventions based on motivational interviewing (MI) could increase the availability and reach of MI techniques for PA promotion. Integrating an avatar in such an intervention could lead to more positive appreciation and higher efficacy of the intervention, compared to an intervention that is purely text-based. The present study aims to determine whether a Web-based PA intervention based on MI with an avatar results in more positive appreciation and higher effectiveness of the intervention, when compared to an intervention that is purely text-based. A three-arm randomized controlled trial was conducted, containing the following research conditions: (1) a Web-based PA intervention based on MI with an avatar, (2) a content-identical intervention without an avatar, and (3) a control condition that received no intervention. Measurements included PA behavior and process variables, measured at baseline, directly following the intervention and 1 month post intervention. Both interventions significantly increased self-reported PA at 1 month, compared to the control condition (beta(AVATARvsCONTROL)=.39, P=.011; beta(TEXTvsCONTROL)=.44, P=.006). No distinctions were found regarding intervention effect on PA between both interventions. Similarly, the results of the process evaluation did not indicate any significant differences between both interventions. Due to the limited relational skills of the avatar in this study, it probably did not succeed in forming a stronger relationship with the user, over and above text alone. The findings suggest that avatars that do not strengthen the social relationship with the user do not enhance the intervention impact. Future research should determine whether Web-based PA interventions based on MI could benefit from inclusion of a virtual coach capable of more complex relational skills than used in the current study, such as responding in gesture to the user's state and input. Dutch Trial

  15. Guided self-help concreteness training as an intervention for major depression in primary care: a Phase II randomized controlled trial

    DEFF Research Database (Denmark)

    Watkins, E R; Taylor, R S; Baeyens, C

    2012-01-01

    major depression in primary care, although the effect was not significantly different from an existing active treatment (RT) matched for structural and common factors. Because of its relative brevity and distinct format, it may have value as an additional innovative approach to increase......Background The development of widely accessible, effective psychological interventions for depression is a priority. This randomized trial provides the first controlled data on an innovative cognitive bias modification (CBM) training guided self-help intervention for depression. Method One hundred...... and twenty-one consecutively recruited participants meeting criteria for current major depression were randomly allocated to treatment as usual (TAU) or to TAU plus concreteness training (CNT) guided self-help or to TAU plus relaxation training (RT) guided self-help. CNT involved repeated practice at mental...

  16. Web-based interventions for caregivers of cancer patients: A review of literatures

    Directory of Open Access Journals (Sweden)

    Winnie PY Tang

    2014-06-01

    Full Text Available Diagnosed with cancer is a traumatic event; it does not only affect the diagnosed patients, but also their caregivers. It brings along negative impacts on biopsychosocial health to the caregivers. Supportive interventions are essential for the caregivers to go through the cancer trajectory. In the past, interventions were being delivered in either face-to-face format or delivering written documents. Although Internet becomes a popular platform for delivering interventions given its substantial growth in usage, the effectiveness of this mode of intervention delivery is unclear. The aim of this review is to review existing literatures regarding efficacy of web-based interventions in psychological outcomes of cancer caregivers. A Literature search was performed in December 2012 from seven databases, including, Ovid MEDLINE, EMBASE, PsycINFO, CINHAL, ERIC, British Nursing Index and EBM Reviews. The following keywords were used in the search but were not limited to "paediatric", "parent", "caregiver", "cancer", "web-based", and "psycho education". Totally 4668 citations were identified, after excluding the duplicated and irrelevant citations; finally six studies were included in this review. A review of the literatures identified that the web-based interventions including either online support group only or a combination of informational website and online support group significantly improved coping skills, in a way reduced anxiety, stress, depression, burden, as well as negative mood and perceived bonding in cancer caregivers. It is concluded that a web-based format as a potential platform for delivering intervention to the caregivers of cancer patients for its unique advantage of easy accessibility, and no geographic or time barriers.

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

    Science.gov (United States)

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

    2016-10-01

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

  18. Analyzing engagement in a web-based intervention platform through visualizing log-data.

    Science.gov (United States)

    Morrison, Cecily; Doherty, Gavin

    2014-11-13

    Engagement has emerged as a significant cross-cutting concern within the development of Web-based interventions. There have been calls to institute a more rigorous approach to the design of Web-based interventions, to increase both the quantity and quality of engagement. One approach would be to use log-data to better understand the process of engagement and patterns of use. However, an important challenge lies in organizing log-data for productive analysis. Our aim was to conduct an initial exploration of the use of visualizations of log-data to enhance understanding of engagement with Web-based interventions. We applied exploratory sequential data analysis to highlight sequential aspects of the log data, such as time or module number, to provide insights into engagement. After applying a number of processing steps, a range of visualizations were generated from the log-data. We then examined the usefulness of these visualizations for understanding the engagement of individual users and the engagement of cohorts of users. The visualizations created are illustrated with two datasets drawn from studies using the SilverCloud Platform: (1) a small, detailed dataset with interviews (n=19) and (2) a large dataset (n=326) with 44,838 logged events. We present four exploratory visualizations of user engagement with a Web-based intervention, including Navigation Graph, Stripe Graph, Start-Finish Graph, and Next Action Heat Map. The first represents individual usage and the last three, specific aspects of cohort usage. We provide examples of each with a discussion of salient features. Log-data analysis through data visualization is an alternative way of exploring user engagement with Web-based interventions, which can yield different insights than more commonly used summative measures. We describe how understanding the process of engagement through visualizations can support the development and evaluation of Web-based interventions. Specifically, we show how visualizations

  19. Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review.

    Science.gov (United States)

    Brown, Menna; O'Neill, Noelle; van Woerden, Hugo; Eslambolchilar, Parisa; Jones, Matt; John, Ann

    2016-08-24

    Adherence to effective Web-based interventions for common mental disorders (CMDs) and well-being remains a critical issue, with clear potential to increase effectiveness. Continued identification and examination of "active" technological components within Web-based interventions has been called for. Gamification is the use of game design elements and features in nongame contexts. Health and lifestyle interventions have implemented a variety of game features in their design in an effort to encourage engagement and increase program adherence. The potential influence of gamification on program adherence has not been examined in the context of Web-based interventions designed to manage CMDs and well-being. This study seeks to review the literature to examine whether gaming features predict or influence reported rates of program adherence in Web-based interventions designed to manage CMDs and well-being. A systematic review was conducted of peer-reviewed randomized controlled trials (RCTs) designed to manage CMDs or well-being and incorporated gamification features. Seven electronic databases were searched. A total of 61 RCTs met the inclusion criteria and 47 different intervention programs were identified. The majority were designed to manage depression using cognitive behavioral therapy. Eight of 10 popular gamification features reviewed were in use. The majority of studies utilized only one gamification feature (n=58) with a maximum of three features. The most commonly used feature was story/theme. Levels and game leaders were not used in this context. No studies explicitly examined the role of gamification features on program adherence. Usage data were not commonly reported. Interventions intended to be 10 weeks in duration had higher mean adherence than those intended to be 6 or 8 weeks in duration. Gamification features have been incorporated into the design of interventions designed to treat CMD and well-being. Further research is needed to improve understanding

  20. The Use of Web Based Expert System Application for Identification and Intervention of Children with Special Needs in Inclusive School

    Directory of Open Access Journals (Sweden)

    Dian Atnantomi Wiliyanto

    2017-11-01

    Full Text Available This research is conducted to determine the effectiveness of web based expert system application for identification and intervention of children with special needs in inclusive school. 40 teachers of inclusive school in Surakarta participated in this research. The result showed that: (1 web based expert system application was suitable with the needs of teachers/officers, had 50% (excellence criteria, (2 web based expert system application was worthwhile for identification of children with special needs, had 50% (excellence criteria, (3 web based expert system application was easy to use, had 52.5% (good criteria, and (4 web based expert system application had result accuracy in making decision, had 52.5% (good criteria. It shows that the use of web based expert system application is effective to be used by teachers in inclusive school in conducting identification and intervention with percentage on average was more than 50%.

  1. How to Increase Reach and Adherence of Web-Based Interventions: A Design Research Viewpoint.

    Science.gov (United States)

    Ludden, Geke D S; van Rompay, Thomas J L; Kelders, Saskia M; van Gemert-Pijnen, Julia E W C

    2015-07-10

    Nowadays, technology is increasingly used to increase people's well-being. For example, many mobile and Web-based apps have been developed that can support people to become mentally fit or to manage their daily diet. However, analyses of current Web-based interventions show that many systems are only used by a specific group of users (eg, women, highly educated), and that even they often do not persist and drop out as the intervention unfolds. In this paper, we assess the impact of design features of Web-based interventions on reach and adherence and conclude that the power that design can have has not been used to its full potential. We propose looking at design research as a source of inspiration for new (to the field) design approaches. The paper goes on to specify and discuss three of these approaches: personalization, ambient information, and use of metaphors. Central to our viewpoint is the role of positive affect triggered by well-designed persuasive features to boost adherence and well-being. Finally, we discuss the future of persuasive eHealth interventions and suggest avenues for follow-up research.

  2. Features Predicting Weight Loss in Overweight or Obese Participants in a Web-Based Intervention: Randomized Trial

    OpenAIRE

    Brindal, Emily; Freyne, Jill; Saunders, Ian; Berkovsky, Shlomo; Smith, Greg; Noakes, Manny

    2012-01-01

    Background Obesity remains a serious issue in many countries. Web-based programs offer good potential for delivery of weight loss programs. Yet, many Internet-delivered weight loss studies include support from medical or nutritional experts, and relatively little is known about purely web-based weight loss programs. Objective To determine whether supportive features and personalization in a 12-week web-based lifestyle intervention with no in-person professional contact affect retention and we...

  3. A guided self-help intervention targeting psychological distress among head and neck cancer and lung cancer patients: motivation to start, experiences and perceived outcomes.

    Science.gov (United States)

    Krebber, Anne-Marie H; van Uden-Kraan, Cornelia F; Melissant, Heleen C; Cuijpers, Pim; van Straten, Annemieke; Becker-Commissaris, Annemarie; Leemans, C René; Verdonck-de Leeuw, Irma M

    2017-01-01

    Recent results of a randomized clinical trial showed that a guided self-help intervention (based on problem-solving therapy) targeting psychological distress among head and neck cancer and lung cancer patients is effective. This study qualitatively explored motivation to start, experiences with and perceived outcomes of this intervention. Data were collected from semi-structured interviews of 16 patients. All interviews were audio-recorded and transcribed verbatim. Data were analyzed individually by two coders and coded into key issues and themes. Patients participated in the intervention for intrinsic (e.g. to help oneself) and for extrinsic reasons (e.g. being asked by a care professional or to help improve health care). Participants indicated positive and negative experiences with the intervention. Several participants appreciated participating as being a pleasant way to work on oneself, while others described participating as too confrontational. Some expressed their disappointment as they felt the intervention had brought them nothing or indicated that they felt worse temporarily, but most participants perceived positive outcomes of the intervention (e.g. feeling less distressed and having learned what matters in life). Cancer patients have various reasons to start a guided self-help intervention. Participants appreciated the guided self-help as intervention to address psychological distress, but there were also concerns. Most participants reported the intervention to be beneficial. The results suggest the need to identify patients who might benefit most from guided self-help targeting psychological distress and that interventions should be further tailored to individual cancer patients' requirements.

  4. Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial

    OpenAIRE

    Heber, Elena; Lehr, Dirk; Ebert, David Daniel; Berking, Matthias; Riper, Heleen

    2016-01-01

    Background: Work-related stress is highly prevalent among employees and is associated with adverse mental health consequences. Web-based interventions offer the opportunity to deliver effective solutions on a large scale; however, the evidence is limited and the results conflicting. Objective: This randomized controlled trial evaluated the efficacy of guided Web-and mobile-based stress management training for employees. Methods: A total of 264 employees with elevated symptoms of stress (Perce...

  5. An Internet-based self-help intervention for people with HIV and depressive symptoms: study protocol for a randomized controlled trial.

    Science.gov (United States)

    van Luenen, Sanne; Kraaij, Vivian; Spinhoven, Philip; Garnefski, Nadia

    2016-03-31

    Many people living with HIV suffer from depressive symptoms. In a previous pilot study, self-help cognitive behavioral therapy (in booklet format) was found to be effective in treating depressive symptoms in people with HIV. We developed an online self-help program in Dutch and English (based on the booklet) for people with HIV and depressive symptoms. Besides the main question regarding the effectiveness of the program aimed at lowering depressive symptoms, sub-questions will focus on the moderators of treatment success (for which patients is the program especially beneficial?) and the mechanisms of change underlying the treatment outcome (which mediators affect the outcome of treatment?). In this paper, the protocol of the study will be described. The effectiveness of the program will be investigated by comparing the intervention group with a waiting list-control group in a randomized controlled design, by including a pretest and three post-tests. The self-help program contains four main components: activation, relaxation, changing maladaptive cognitions, and goal attainment. Participants with mild to moderate depressive symptoms will work on the program for 6 to 10 weeks, during which a coach will provide motivational support by telephone once a week. Participants in the control condition will receive weekly minimal support from a coach for 8 weeks, and after the second post-test, they can gain access to the self-help program. Depressive symptoms and possible mediators (e.g., activation, cognitive coping, self-efficacy, and goal adjustment) will be assessed by self-report three times during the intervention/waiting period and at the pretest and first post-test. The proposed study aims to evaluate the effectiveness of an online self-help intervention for people with HIV and depressive symptoms. If the intervention is shown to be effective, the program will be implemented. Consequently, many patients with HIV could be reached, and their psychological care may be

  6. A Web-based course on infection control for physicians in training: an educational intervention.

    Science.gov (United States)

    Fakih, Mohamad G; Enayet, Iram; Minnick, Steven; Saravolatz, Louis D

    2006-07-01

    To evaluate the effectiveness of a Web-based course on infection control accessed by physicians in training. Educational intervention. A 607-bed urban teaching hospital. A total of 55 physicians in training beginning their first postgraduate year (the iPGY1 group) and 59 physicians completing their first, second, or third postgraduate year (the oPGY group). Individuals in the iPGY1 group took a Web-based course on infection control practices. Persons in the iPGY1 group who took the Web-based course completed an evaluation test consisting of 15 multiple-choice questions (total possible score, 15 points). The same test was given to persons in the oPGY group, who did not take the Web-based course. We compared scores of the Web-based test taken by subjects in the iPGY1 group immediately after the course with scores of the test they took 3 months after the course and with test scores of subjects in the oPGY group. The mean score (+/-SD) for subjects in the iPGY1 group who took the Web-based course was 10.6+/-2.2, compared with 8.0+/-2.5 for subjects in the oPGY group (P<.001). The mean score (+/-SD) for subjects in the iPGY1 group 3 months after completing the course decreased to 8.0+/-2.4 (P<.001 by the paired t test). For the oPGY group, significant differences were found between the scores (+/-SD) for subjects in the internal medicine (9.9+/-2.3), emergency medicine (8.4+/-1.7), pediatrics (7.0+/-1.7), and family medicine (5.8+/-1.6) residency programs (P<.001); there were no significant differences in scores according to the year of residency. Web-based infection control courses are an attractive teaching tool for physicians in training and need to be considered for teaching infection control. The evaluation of information retention will help identify physicians in training who require further training.

  7. Active Involvement of End Users When Developing Web-Based Mental Health Interventions

    Directory of Open Access Journals (Sweden)

    Derek de Beurs

    2017-05-01

    Full Text Available BackgroundAlthough many web-based mental health interventions are being released, the actual uptake by end users is limited. The marginal level of engagement of end users when developing these interventions is recognized as an important cause for uptake problems. In this paper, we offer our perceptive on how to improve user engagement. By doing so, we aim to stimulate a discourse on user involvement within the field of online mental health interventions.MethodsWe shortly describe three different methods (the expert-driven method, intervention mapping, and scrum that were currently used to develop web-based health interventions. We will focus to what extent the end user was involved in the developmental phase, and what the additional challenges were. In the final paragraph, lessons learned are summarized, and recommendations provided.ResultsEvery method seems to have its trade-off: if end users are highly involved, availability of end users and means become problematic. If end users are less actively involved, the product may be less appropriate for the end user. Other challenges to consider are the funding of the more active role of technological companies, and the time it takes to process the results of shorter development cycles.ConclusionThinking about user-centered design and carefully planning, the involvement of end users should become standard in the field of web-based (mental health. When deciding on the level of user involvement, one should balance the need for input from users with the availability of resources such as time and funding.

  8. Lessons learned: the effect of prior technology use on Web-based interventions.

    Science.gov (United States)

    Carey, Joanne C; Wade, Shari L; Wolfe, Christopher R

    2008-04-01

    This study examined the role of regular prior technology use in treatment response to an online family problem-solving (OFPS) intervention and an Internet resource intervention (IRI) for pediatric traumatic brain injury (TBI). Participants were 150 individuals in 40 families of children with TBI randomly assigned to OFPS intervention or an IRI. All families received free computers and Internet access to TBI resources. OFPS families received Web-based sessions and therapist-guided synchronous videoconferences focusing on problem solving, communication skills, and behavior management. All participants completed measures of depression, anxiety, and computer usage. OFPS participants rated treatment satisfaction, therapeutic alliance, and Web site and technology comfort. With the OFPS intervention, depression and anxiety improved significantly more among technology using parents (n = 14) than nontechnology users (n = 6). Technology users reported increasing comfort with technology over time, and this change was predictive of depression at followup. Satisfaction and ease-of-use ratings did not differ by technology usage. Lack of regular prior home computer usage and nonadherence were predictive of anxiety at followup. The IRI was not globally effective. However, controlling for prior depression, age, and technology at work, there was a significant effect of technology at home for depression. Families with technology experience at home (n = 11) reported significantly greater improvements in depression than families without prior technology experience at home (n = 8). Although Web-based OFPS was effective in improving caregiver functioning, individuals with limited computer experience may benefit less from an online intervention due to increased nonadherence.

  9. Changing implicit attitudes toward smoking: results from a web-based approach-avoidance practice intervention.

    Science.gov (United States)

    Macy, Jonathan T; Chassin, Laurie; Presson, Clark C; Sherman, Jeffrey W

    2015-02-01

    Implicit attitudes have been shown to predict smoking behaviors. Therefore, an important goal is the development of interventions to change these attitudes. This study assessed the effects of a web-based intervention on implicit attitudes toward smoking and receptivity to smoking-related information. Smokers (N = 284) were recruited to a two-session web-based study. In the first session, baseline data were collected. Session two contained the intervention, which consisted of assignment to the experimental or control version of an approach-avoidance task and assignment to an anti-smoking or control public service announcement (PSA), and post-intervention measures. Among smokers with less education and with plans to quit, implicit attitudes were more negative for those who completed the approach-avoidance task. Smokers with more education who viewed the anti-smoking PSA and completed the approach-avoidance task spent more time reading smoking-related information. An approach-avoidance task is a potentially feasible strategy for changing implicit attitudes toward smoking and increasing receptivity to smoking-related information.

  10. Web-Based Intervention for Nutritional Management in Cystic Fibrosis: Development, Usability, and Pilot Trial.

    Science.gov (United States)

    Stark, Lori J; Opipari-Arrigan, Lisa; Filigno, Stephanie S; Simon, Stacey L; Leonard, Amanda; Mogayzel, Peter J; Rausch, Joseph; Zion, Cynthia; Powers, Scott W

    2016-06-01

    Usability and pilot testing of a web intervention (BeInCharge.org [BIC]) of behavior plus nutrition intervention for children with cystic fibrosis (CF) ages 4-9 years. Think Aloud methodology was used with five mothers to assess usability and refine the intervention. A pilot trial was then conducted with 10 mothers of children with CF ages 4-9 years randomized to the web-based BIC or a Standard Care Control (STC). Change in weight gain for each group was compared in a pre-to-post design. Mothers rated the usability and clarity of BIC highly. The pilot trial showed children of mothers who received BIC had a significant change in weight pre-to-post-treatment (0.67 kg, p = .04). Change for the STC was not significant (0.41 kg, p = .10). A web-based behavior plus nutrition intervention appears promising in increasing weight gain in children with CF. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Participation, Retention, and Utilization of a Web-Based Chronic Disease Self-Management Intervention Among Older Adults.

    Science.gov (United States)

    Portz, Jennifer Dickman; LaMendola, Walter F

    2018-05-21

    Web-based self-management (web-based SM) interventions provide a potential resource for older adults to engage in their own chronic disease management. The purpose of this study is to investigate the effect of age on participation, retention, and utilization of a web-based SM intervention. This study reports the results of a secondary data analysis of the effects of age in a randomized trial of a web-based diabetes SM intervention. Participation, reasons for nonenrollment, retention, reasons for disenrollment, and website utilization were examined by age using discriminant function, survival analysis, and multivariate analysis of variance as appropriate. Website utilization by all participants dropped after 6 months but did not vary significantly with age. Though older adults (>60 of age) were less likely to choose to participate (F = 57.20, p Web-based SM offers a feasible approach for older adults with chronic disease to engage in their health management, but it needs to be improved. Those older adults who passed the rigorous screens for this experiment and chose to participate may have been more likely than younger participants to utilize web-based SM intervention tools. They were more persistent in their use of the web-based SM to try to improve health outcomes and formed definitive opinions about its utility before termination.

  12. The Potential of Web-based Interventions for Heart Disease Self-Management: A Mixed Methods Investigation

    OpenAIRE

    Kerr, C.; Murray, E.; Noble, L.; Morris, R.; Bottomley, C.; Stevenson, F.; Patterson, D.; Peacock, R.; Turner, I.; Jackson, K.; Nazareth, I.

    2010-01-01

    Background: Existing initiatives to support patient self-management of heart disease do not appear to be reaching patients most in need. Providing self-management programs over the Internet (web-based interventions) might help reduce health disparities by reaching a greater number of patients. However, it is unclear whether they can achieve this goal and whether their effectiveness might be limited by the digital divide.Objective: To explore the effectiveness of a web-based intervention in de...

  13. The Potential of Web-based Interventions for Heart Disease Self-Management: A Mixed Methods Investigation

    OpenAIRE

    Kerr, Cicely; Murray, Elizabeth; Noble, Lorraine; Morris, Richard; Bottomley, Christian; Stevenson, Fiona; Patterson, David; Peacock, Richard; Turner, Indra; Jackson, Keith; Nazareth, Irwin

    2010-01-01

    Background: Existing initiatives to support patient self-management of heart disease do not appear to be reaching patients most in need. Providing self-management programs over the Internet (web-based interventions) might help reduce health disparities by reaching a greater number of patients. However, it is unclear whether they can achieve this goal and whether their effectiveness might be limited by the digital divide. Objective: To explore the effectiveness of a web-based intervention in d...

  14. Effect of a web-based intervention to promote physical activity and improve health among physically inactive adults

    DEFF Research Database (Denmark)

    Hansen, Andreas Wolff; Grønbæk, Morten; Helge, Jørn Wulff

    2012-01-01

    Many people in Western countries do not follow public health physical activity (PA) recommendations. Web-based interventions provide cost- and time-efficient means of delivering individually targeted lifestyle modification at a population level.......Many people in Western countries do not follow public health physical activity (PA) recommendations. Web-based interventions provide cost- and time-efficient means of delivering individually targeted lifestyle modification at a population level....

  15. Does Brief Telephone Support Improve Engagement With a Web-Based Weight Management Intervention? Randomized Controlled Trial

    OpenAIRE

    Dennison, Laura; Morrison, Leanne; Lloyd, Scott; Phillips, Dawn; Stuart, Beth; Williams, Sarah; Bradbury, Katherine; Roderick, Paul; Murray, Elizabeth; Michie, Susan; Little, Paul; Yardley, Lucy

    2014-01-01

    Background Recent reviews suggest Web-based interventions are promising approaches for weight management but they identify difficulties with suboptimal usage. The literature suggests that offering some degree of human support to website users may boost usage and outcomes. Objective We disseminated the POWeR (“Positive Online Weight Reduction”) Web-based weight management intervention in a community setting. POWeR consisted of weekly online sessions that emphasized self-monitoring, goal-settin...

  16. Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol for a pilot randomised controlled trial.

    Science.gov (United States)

    Bennett, Sophie; Heyman, Isobel; Coughtrey, Anna; Simmonds, Jess; Varadkar, Sophia; Stephenson, Terence; DeJong, Margaret; Shafran, Roz

    2016-11-04

    Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions. A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and

  17. The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure.

    Science.gov (United States)

    Kim, Kim B; Han, Hae-Ra; Huh, Boyun; Nguyen, Tam; Lee, Hochang; Kim, Miyong T

    2014-09-01

    Great strides have been made in improving heart health in the United States during the last 2 decades, yet these strides have not encompassed many ethnic minority populations. There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions. In particular, many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy. The effect of a multimodal Self-Help Intervention Program on the Control of High Blood Pressure (HBP) was tested in a community-based clinical trial for Korean American seniors. Of 440 seniors enrolled, 369 completed the study (184 in the intervention group and 185 in the control group; mean age = 70.9±5.3 years). The intervention group received 6 weekly educational sessions on HBP management skill building, including health literacy training, followed by telephone counseling and home blood pressure (BP) monitoring for 12 months. Findings support that the Self-Help Intervention Program on the Control of HBP was effective in controlling BP in this ethnic/linguistic minority population. The BP control rates for the intervention and control groups were 49.5% vs. 43.2% at baseline, 58.5% vs. 42.4% at 6 months, 67.9% vs. 52.5% at 12 months, and 54.3% vs. 53.0% at 18 months. Significant changes were observed over time in some psychobehavioral outcomes, including self-efficacy for BP control, medication adherence behavior, HBP knowledge, and depression. The study findings suggest that the multimodal Self-Help Intervention Program on the Control of HBP is effective at promoting optimal HBP control for this ethnic/linguistic minority population. NCT00406614. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial.

    Science.gov (United States)

    Fledderus, Martine; Bohlmeijer, Ernst T; Fox, Jean-Paul; Schreurs, Karlein M G; Spinhoven, Philip

    2013-03-01

    This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail support (n=250), or to a waiting list control group (n=126). All participants completed measures before and after the intervention to assess depression, anxiety and psychological flexibility. Participants in the experimental condition also completed these measures during the intervention (after three and six weeks) and at a three-month follow-up. With multilevel modelling, it was shown that the effects of the intervention on psychological distress were stronger for participants with higher levels of psychological flexibility. Furthermore, our study showed that improved psychological flexibility mediated the effects of the ACT intervention. With a cross-lagged panel design, it was shown that especially improvements in psychological flexibility in the last three sessions of the intervention were important for further reductions in anxiety. To conclude, our study showed the importance of targeting psychological flexibility during an ACT intervention for a reduction in depressive and anxiety symptoms. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions

    Science.gov (United States)

    2011-01-01

    Background Web-based and mobile health interventions (also called “Internet interventions” or "eHealth/mHealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The Consolidated Standards of Reporting Trials (CONSORT) statement was developed to improve the suboptimal reporting of randomized controlled trials (RCTs). While the CONSORT statement can be applied to provide broad guidance on how eHealth and mHealth trials should be reported, RCTs of web-based interventions pose very specific issues and challenges, in particular related to reporting sufficient details of the intervention to allow replication and theory-building. Objective To develop a checklist, dubbed CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), as an extension of the CONSORT statement that provides guidance for authors of eHealth and mHealth interventions. Methods A literature review was conducted, followed by a survey among eHealth experts and a workshop. Results A checklist instrument was constructed as an extension of the CONSORT statement. The instrument has been adopted by the Journal of Medical Internet Research (JMIR) and authors of eHealth RCTs are required to submit an electronic checklist explaining how they addressed each subitem. Conclusions CONSORT-EHEALTH has the potential to improve reporting and provides a basis for evaluating the validity and applicability of eHealth trials. Subitems describing how the intervention should be reported can also be used for non-RCT evaluation reports. As part of the development process, an evaluation component is essential; therefore, feedback from authors will be solicited, and a before-after study will evaluate whether reporting has been improved

  20. A Web-Based Psychoeducational Intervention for Adolescent Depression: Design and Development of MoodHwb.

    Science.gov (United States)

    Bevan Jones, Rhys; Thapar, Anita; Rice, Frances; Beeching, Harriet; Cichosz, Rachel; Mars, Becky; Smith, Daniel J; Merry, Sally; Stallard, Paul; Jones, Ian; Thapar, Ajay K; Simpson, Sharon A

    2018-02-15

    Depression is common in adolescence and leads to distress and impairment in individuals, families and carers. Treatment and prevention guidelines highlight the key role of information and evidence-based psychosocial interventions not only for individuals but also for their families and carers. Engaging young people in prevention and early intervention programs is a challenge, and early treatment and prevention of adolescent depression is a major public health concern. There has been growing interest in psychoeducational interventions to provide accurate information about health issues and to enhance and develop self-management skills. However, for adolescents with, or at high risk of depression, there is a lack of engaging Web-based psychoeducation programs that have been developed with user input and in line with research guidelines and targeted at both the individual and their family or carer. There are also few studies published on the process of development of Web-based psychoeducational interventions. The aim of this study was to describe the process underlying the design and development of MoodHwb (HwbHwyliau in Welsh): a Web-based psychoeducation multimedia program for young people with, or at high risk of, depression and their families, carers, friends, and professionals. The initial prototype was informed by (1) a systematic review of psychoeducational interventions for adolescent depression; (2) findings from semistructured interviews and focus groups conducted with adolescents (with depressive symptoms or at high risk), parents or carers, and professionals working with young people; and (3) workshops and discussions with a multimedia company and experts (in clinical, research, and multimedia work). Twelve interviews were completed (four each with young people, parents or carers, and professionals) and six focus groups (three with young people, one with parents and carers, one with professionals, and one with academics). Key themes from the interviews and

  1. Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants

    Directory of Open Access Journals (Sweden)

    Anema Johannes R

    2011-02-01

    Full Text Available Abstract Background The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention http://www.wiagesprek.nl. This intervention was aimed at empowerment of disability claimants, prior to the assessment of disability by an insurance physician. Methods Reach was determined by registering claimants exposed to the study's invitation brochures, and by comparing trial participant characteristics with non-participants and nationwide claimant data. Compliance was registered by analyzing weblogs, which were automatically collected during the period of the trial. This made it possible to analyze individual use of the intervention. Appreciation, usage barriers, and users' perceived effectiveness were assessed using an online questionnaire that was sent to participants from the intervention group, 6 weeks after enrolment. Results Only 9% of the target population enrolled in the internet program. Because of selective enrolment, more females, higher educated claimants, and less ethnical minorities were reached. Compliance was ambiguous: out of the 123 participants randomized into the intervention group, a significant proportion (33% did not use the intervention at all, while, at the same time, many participants (32% used the intervention for more than two hours (i.e. in approximately two weeks. Overall satisfaction with the intervention was good. Claimants perceived the intervention most effective in increasing knowledge, while also a fair amount of users perceived the intervention effective in gaining right expectations or being able to communicate better with their physician. Conclusions The uptake of the intervention http://www.wiagesprek.nl was disappointing. Specifically, the poor reach and compliance of the intervention resulted in a small proportion of the target population using the intervention as intended. Improvements in the

  2. A web-based intervention for health professionals and patients to decrease cardiovascular risk attributable to physical inactivity: development process.

    Science.gov (United States)

    Sassen, Barbara; Kok, Gerjo; Mesters, Ilse; Crutzen, Rik; Cremers, Anita; Vanhees, Luc

    2012-12-14

    Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity. In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the "black box" of Web-based intervention development and to support future Web-based intervention development. The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables. The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk-reduction behavior of patients with

  3. A Web-Based Intervention for Health Professionals and Patients to Decrease Cardiovascular Risk Attributable to Physical Inactivity: Development Process

    Science.gov (United States)

    2012-01-01

    Background Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity. Objective In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the “black box” of Web-based intervention development and to support future Web-based intervention development. Methods The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables. Results The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk

  4. The Feasibility, Acceptability, and Efficacy of Delivering Internet-Based Self-Help and Guided Self-Help Interventions for Generalized Anxiety Disorder to Indian University Students: Design of a Randomized Controlled Trial.

    Science.gov (United States)

    Kanuri, Nitya; Newman, Michelle G; Ruzek, Josef I; Kuhn, Eric; Manjula, M; Jones, Megan; Thomas, Neil; Abbott, Jo-Anne M; Sharma, Smita; Taylor, C Barr

    2015-12-11

    Generalized anxiety disorder (GAD) is one of the most common mental disorders among university students; however, many students go untreated due to treatment costs, stigma concerns, and limited access to trained mental health professionals. These barriers are heightened in universities in India, where there are scant mental health care services and severe stigma surrounding help seeking. To evaluate the feasibility, acceptability, and efficacy of Internet-based, or "online," cognitive behavioral therapy (CBT)-based unguided and guided self-help interventions (using the programs GAD Online and Lantern, respectively) to reduce GAD symptoms in students with clinical and subthreshold GAD and, ultimately, reduce the prevalence and incidence of GAD among the student population. Students will be recruited via 3 colleges in Hyderabad, India, and referred for a campus-wide online screening. Self-report data will be collected entirely online. A total of 300 qualifying students will be randomized in a 1:1:1 ratio to receive GAD Online, Lantern, or to be in a wait-list control condition, stratified by clinical and subthreshold GAD symptomatology. Students will complete a postintervention assessment after 3 months and a follow-up assessment 6 months later, at which point students in the wait-list control condition will receive one of the programs. The primary outcome is GAD symptom severity at 3 months postintervention. Secondary outcomes include GAD caseness at 9 months, other anxiety and depression symptoms, self-efficacy, and functional measures (eg, sleep, social functioning) at 3 and 9 months, respectively. Primary analyses will be differences between each of the intervention groups and the wait-list control group, analyzed on an intention-to-treat (ITT) basis using mixed-design ANOVA. The study commenced in February 2015. The sample was recruited over a 3-week period at each college. The trial is expected to end in December 2015. This trial will be the first to evaluate

  5. The Feasibility, Acceptability, and Efficacy of Delivering Internet-Based Self-Help and Guided Self-Help Interventions for Generalized Anxiety Disorder to Indian University Students: Design of a Randomized Controlled Trial

    Science.gov (United States)

    Newman, Michelle G; Ruzek, Josef I; Kuhn, Eric; Manjula, M; Jones, Megan; Thomas, Neil; Abbott, Jo-Anne M; Sharma, Smita; Taylor, C. Barr

    2015-01-01

    Background Generalized anxiety disorder (GAD) is one of the most common mental disorders among university students; however, many students go untreated due to treatment costs, stigma concerns, and limited access to trained mental health professionals. These barriers are heightened in universities in India, where there are scant mental health care services and severe stigma surrounding help seeking. Objective To evaluate the feasibility, acceptability, and efficacy of Internet-based, or “online,” cognitive behavioral therapy (CBT)-based unguided and guided self-help interventions (using the programs GAD Online and Lantern, respectively) to reduce GAD symptoms in students with clinical and subthreshold GAD and, ultimately, reduce the prevalence and incidence of GAD among the student population. Methods Students will be recruited via 3 colleges in Hyderabad, India, and referred for a campus-wide online screening. Self-report data will be collected entirely online. A total of 300 qualifying students will be randomized in a 1:1:1 ratio to receive GAD Online, Lantern, or to be in a wait-list control condition, stratified by clinical and subthreshold GAD symptomatology. Students will complete a postintervention assessment after 3 months and a follow-up assessment 6 months later, at which point students in the wait-list control condition will receive one of the programs. The primary outcome is GAD symptom severity at 3 months postintervention. Secondary outcomes include GAD caseness at 9 months, other anxiety and depression symptoms, self-efficacy, and functional measures (eg, sleep, social functioning) at 3 and 9 months, respectively. Primary analyses will be differences between each of the intervention groups and the wait-list control group, analyzed on an intention-to-treat (ITT) basis using mixed-design ANOVA. Results The study commenced in February 2015. The sample was recruited over a 3-week period at each college. The trial is expected to end in December 2015

  6. Beyond the Trial: Systematic Review of Real-World Uptake and Engagement With Digital Self-Help Interventions for Depression, Low Mood, or Anxiety.

    Science.gov (United States)

    Fleming, Theresa; Bavin, Lynda; Lucassen, Mathijs; Stasiak, Karolina; Hopkins, Sarah; Merry, Sally

    2018-06-06

    Digital self-help interventions (including online or computerized programs and apps) for common mental health issues have been shown to be appealing, engaging, and efficacious in randomized controlled trials. They show potential for improving access to therapy and improving population mental health. However, their use in the real world, ie, as implemented (disseminated) outside of research settings, may differ from that reported in trials, and implementation data are seldom reported. This study aimed to review peer-reviewed articles reporting user uptake and/or ongoing use, retention, or completion data (hereafter usage data or, for brevity, engagement) from implemented pure self-help (unguided) digital interventions for depression, anxiety, or the enhancement of mood. We conducted a systematic search of the Scopus, Embase, MEDLINE, and PsychINFO databases for studies reporting user uptake and/or usage data from implemented digital self-help interventions for the treatment or prevention of depression or anxiety, or the enhancement of mood, from 2002 to 2017. Additionally, we screened the reference lists of included articles, citations of these articles, and the titles of articles published in Internet Interventions, Journal of Medical Internet Research (JMIR), and JMIR Mental Health since their inception. We extracted data indicating the number of registrations or downloads and usage of interventions. After the removal of duplicates, 970 papers were identified, of which 10 met the inclusion criteria. Hand searching identified 1 additional article. The included articles reported on 7 publicly available interventions. There was little consistency in the measures reported. The number of registrants or downloads ranged widely, from 8 to over 40,000 per month. From 21% to 88% of users engaged in at least minimal use (eg, used the intervention at least once or completed one module or assessment), whereas 7-42% engaged in moderate use (completing between 40% and 60% of

  7. Internet-based self-help smoking cessation and alcohol moderation interventions for cancer survivors: a study protocol of two RCTs.

    Science.gov (United States)

    Mujcic, Ajla; Blankers, Matthijs; Boon, Brigitte; Engels, Rutger; van Laar, Margriet

    2018-04-02

    Brief interventions for smoking cessation and alcohol moderation may contribute considerably to the prevention of cancer among populations at risk, such as cancer survivors, in addition to improving their general wellbeing. There is accumulating evidence for the effectiveness of internet-based brief health behaviour interventions. The objective of this study is to assess the effectiveness, patient-level cost-effectiveness and cost-utility of two new online theory-based self-help interventions among adult cancer survivors in the Netherlands. One of the interventions focuses on alcohol moderation, the other on smoking cessation. Both interventions are tailored to cancer survivors. Effectiveness will be assessed in two separate, nearly identical 2-armed RCTs: alcohol moderation (AM RCT) and smoking cessation (SC RCT). Participants are randomly allocated to either the intervention groups or the control groups. In the intervention groups, participants have access to one of the newly developed interventions. In the control groups, participants receive an online static information brochure on alcohol (AM RCT) or smoking (SC RCT). Main study outcome parameters are the number of drinks post-randomisation (AM RCT) and tobacco abstinence (SC RCT). In addition, cost-data and possible effect moderators and mediators will be assessed. Both treatments are internet-based minimally guided self-help interventions: MyCourse - Moderate Drinking (in Dutch: MijnKoers - Minderen met Drinken) and MyCourse - Quit Smoking (MijnKoers - Stoppen met Roken). They are based on cognitive behaviour therapy (CBT), motivational interviewing (MI) and acceptance and commitment therapy (ACT). Both interventions are optimized in collaboration with the target population of cancer survivors in focus groups and interviews, and in collaboration with several experts on eHealth, smoking cessation, alcohol misuse and cancer survivorship. The present study will add to scientific knowledge on the (cost

  8. Using Community Engagement to Develop a Web-Based Intervention for Latinos about the HPV Vaccine.

    Science.gov (United States)

    Maertens, Julie A; Jimenez-Zambrano, Andrea M; Albright, Karen; Dempsey, Amanda F

    2017-04-01

    Human papillomavirus (HPV) infection is pervasive among sexually active women and men, and Hispanic women are at particularly high risk as they have higher rates of invasive cervical cancer compared to other racial or ethnic groups in the United States. There is a need for interventions to increase HPV vaccination among this high-risk population. This study investigated how to modify a previously developed web-based intervention that provided individually tailored information about HPV to improve its use among the Latino population. A community-oriented modification approach incorporated feedback from a community advisory committee, and focus groups among the Latino population, to modify the intervention. Several themes emerged including a need for basic information about HPV and HPV vaccination, changes to make the intervention appear less clinical, and incorporation of information addressing barriers specific to the Latino community. This work was done in preparation for a randomized trial to assess the impact of this modified intervention on HPV vaccination attitudes and uptake among Latino young adults and parents of adolescents. If effective, our intervention could be a resource for reducing HPV vaccination concerns, improving immunization rates, and educating Latinos about HPV and the HPV vaccine outside of the time boundaries of the traditional clinical encounter.

  9. An internet-based self-help intervention for older adults after marital bereavement, separation or divorce: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Brodbeck, Jeannette; Berger, Thomas; Znoj, Hans Joerg

    2017-01-13

    Marital bereavement and separation or divorce are among the most stressful critical life events in later life. These events require a dissolution of social and emotional ties, adjustments in daily routine and changes in identity and perspectives for the future. After a normative grief or distress reaction, most individuals cope well with the loss. However, some develop a prolonged grief reaction. Internet-based self-help interventions have proved beneficial for a broad range of disorders, including complicated grief. Based on the task model and the dual-process model of coping with bereavement, we developed a guided internet-based self-help intervention for individuals who experienced marital bereavement, separation or divorce at least 6 months prior to enrolment. The intervention consists of 10 text-based self-help sessions and one supportive email a week. The primary purpose of this study is the evaluation of the feasibility and efficacy of the intervention compared with a waiting control group. The secondary purpose is to compare the effects in bereaved and separated participants. Furthermore, we aim to analyze other predictors, moderators and mediators of the outcome, such as age, psychological distress and intensity of use of the intervention. The design is a randomized controlled trial with a waiting control condition of 12 weeks and a 24-weeks follow-up. At least 72 widowed or separated participants will be recruited via our study website and internet forums. Primary outcomes are reductions in grief symptoms, depression and psychological distress. Secondary outcome measures are related to loneliness, satisfaction with life, embitterment and the sessions. The trial will provide insights into the acceptance and efficacy of internet-based interventions among adults experiencing grief symptoms, psychological distress and adaptation problems in daily life after spousal bereavement, separation or divorce. Findings will add to existing knowledge by (1) evaluating

  10. Evaluating a Web-Based Social Anxiety Intervention Among University Students: Randomized Controlled Trial.

    Science.gov (United States)

    McCall, Hugh Cameron; Richardson, Chris G; Helgadottir, Fjola Dogg; Chen, Frances S

    2018-03-21

    Treatment rates for social anxiety, a prevalent and potentially debilitating condition, remain among the lowest of all major mental disorders today. Although computer-delivered interventions are well poised to surmount key barriers to the treatment of social anxiety, most are only marginally effective when delivered as stand-alone treatments. A new, Web-based cognitive behavioral therapy (CBT) intervention called Overcome Social Anxiety was recently created to address the limitations of prior computer-delivered interventions. Users of Overcome Social Anxiety are self-directed through various CBT modules incorporating cognitive restructuring and behavioral experiments. The intervention is personalized to each user's symptoms, and automatic email reminders and time limits are used to encourage adherence. The purpose of this study was to conduct a randomized controlled trial to investigate the effectiveness of Overcome Social Anxiety in reducing social anxiety symptoms in a nonclinical sample of university students. As a secondary aim, we also investigated whether Overcome Social Anxiety would increase life satisfaction in this sample. Following eligibility screening, participants were randomly assigned to a treatment condition or a wait-list control condition. Only those assigned to the treatment condition were given access to Overcome Social Anxiety; they were asked to complete the program within 4 months. The social interaction anxiety scale (SIAS), the fear of negative evaluation scale (FNE), and the quality of life enjoyment and satisfaction questionnaire-short form (Q-LES-Q-SF) were administered to participants from both conditions during baseline and 4-month follow-up lab visits. Over the course of the study, participants assigned to the treatment condition experienced a significant reduction in social anxiety (SIAS: Psocial anxiety in the 2 conditions over the course of the study showed that those assigned to the treatment condition experienced significantly

  11. Development of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury.

    Science.gov (United States)

    Wilde, Mary H; Fairbanks, Eileen; Parshall, Robert; Zhang, Feng; Miner, Sarah; Thayer, Deborah; Harrington, Brian; Brasch, Judith; McMAHON, James M

    2015-11-01

    While Web-based interventions have proliferated recently, information in the literature is often lacking about how the intervention was developed. In response to that gap, this is a report of the development of a Web-based self-management intervention for intermittent urinary catheter users and pretesting with four adults with spinal cord injury living in the community. Two Web sites were created, one for recruitment and the other for the intervention itself. The intervention involved developing new Web-based technology, including an interactive urinary diary (with fluid intake/urine output and a journal), extensive catheter products information, three intervention nurse phone call consultations, and user-community discussion forums. Study participants completed an online survey and were interviewed twice about the enrollment process and their perceptions of their involvement in the intervention. Suggestions from the pretesting participants were used to revise the Web site applications prior to the next stage of research (a feasibility study). Numerous recommendations and comments were received related to content, interactivity of components, and usability. This article provides a description of how the Web sites were developed (including the technology and software programs used), issues encountered and what was done to address them, and how the Web-based intervention was modified for improvements.

  12. Effectiveness of a Web-Based Intervention to Reduce Alcohol Consumption among French Hazardous Drinkers: A Randomized Controlled Trial

    Science.gov (United States)

    Guillemont, Juliette; Cogordan, Chloé; Nalpas, Bertrand; Nguyen-Thanh, Vi?t; Richard, Jean-Baptiste; Arwidson, Pierre

    2017-01-01

    This study aims to evaluate the effectiveness of a web-based intervention to reduce alcohol consumption among hazardous drinkers. A two-group parallel randomized controlled trial was conducted among adults identified as hazardous drinkers according to the Alcohol Use Disorders Identification Test. The intervention delivers personalized normative…

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

    Science.gov (United States)

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

    2015-05-01

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

  14. Evaluating the effectiveness and efficacy of unguided internet-based self-help intervention for the prevention of depression: a randomized controlled trial.

    Science.gov (United States)

    Lintvedt, Ove K; Griffiths, Kathleen M; Sørensen, Kristian; Østvik, Andreas R; Wang, Catharina E A; Eisemann, Martin; Waterloo, Knut

    2013-01-01

    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.

  15. Preventing Depression in Adults With Subthreshold Depression: Health-Economic Evaluation Alongside a Pragmatic Randomized Controlled Trial of a Web-Based Intervention.

    Science.gov (United States)

    Buntrock, Claudia; Berking, Matthias; Smit, Filip; Lehr, Dirk; Nobis, Stephanie; Riper, Heleen; Cuijpers, Pim; Ebert, David

    2017-01-04

    Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD) in people with subthreshold depression (sD). A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web-based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs) were assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6- and 12-month follow-up, covering the period to the previous assessment. Costs were self-assessed through a questionnaire. Costs measured from a societal and health care perspective were related to DFYs and quality-adjusted life years (QALYs). In total, 406 participants were enrolled in the trial. The mean treatment duration was 5.84 (SD 4.37) weeks. On average, participants completed 4.93 of 6 sessions. Significantly more DFYs were gained in the intervention group (0.82 vs 0.70). Likewise, QALY health gains were in favor of the intervention, but only statistically significant when measured with the more sensitive SF-6D. The incremental per-participant costs were €136 (£116). Taking the health care perspective and assuming a willingness-to-pay of €20,000 (£17,000), the intervention's likelihood of being cost-effective was 99% for gaining a DFY and 64% or 99% for gaining an EQ-5D or a SF-6D QALY. Our study supports guidelines recommending Web-based treatment for s

  16. The Use of Intervention Mapping to Develop a Tailored Web-Based Intervention, Condom-HIM

    OpenAIRE

    Miranda, Joyal; C?t?, Jos?

    2017-01-01

    Background Many HIV (human immunodeficiency virus) prevention interventions are currently being implemented and evaluated, with little information published on their development. A framework highlighting the method of development of an intervention can be used by others wanting to replicate interventions or develop similar interventions to suit other contexts and settings. It provides researchers with a comprehensive development process of the intervention. Objective The objective of this pap...

  17. Quality of Web-Based Educational Interventions for Clinicians on Human Papillomavirus Vaccine: Content and Usability Assessment.

    Science.gov (United States)

    Rosen, Brittany L; Bishop, James M; McDonald, Skye L; Kahn, Jessica A; Kreps, Gary L

    2018-02-16

    Human papillomavirus (HPV) vaccination rates fall far short of Healthy People 2020 objectives. A leading reason is that clinicians do not recommend the vaccine consistently and strongly to girls and boys in the age group recommended for vaccination. Although Web-based HPV vaccine educational interventions for clinicians have been created to promote vaccination recommendations, rigorous evaluations of these interventions have not been conducted. Such evaluations are important to maximize the efficacy of educational interventions in promoting clinician recommendations for HPV vaccination. The objectives of our study were (1) to expand previous research by systematically identifying HPV vaccine Web-based educational interventions developed for clinicians and (2) to evaluate the quality of these Web-based educational interventions as defined by access, content, design, user evaluation, interactivity, and use of theory or models to create the interventions. Current HPV vaccine Web-based educational interventions were identified from general search engines (ie, Google), continuing medical education search engines, health department websites, and professional organization websites. Web-based educational interventions were included if they were created for clinicians (defined as individuals qualified to deliver health care services, such as physicians, clinical nurses, and school nurses, to patients aged 9 to 26 years), delivered information about the HPV vaccine and how to increase vaccination rates, and provided continuing education credits. The interventions' content and usability were analyzed using 6 key indicators: access, content, design, evaluation, interactivity, and use of theory or models. A total of 21 interventions were identified, out of which 7 (33%) were webinars, 7 (33%) were videos or lectures, and 7 (33%) were other (eg, text articles, website modules). Of the 21 interventions, 17 (81%) identified the purpose of the intervention, 12 (57%) provided the

  18. Efficacy of a web-based intervention with and without guidance for employees with risky drinking: results of a three-arm randomized controlled trial.

    Science.gov (United States)

    Boß, Leif; Lehr, Dirk; Schaub, Michael Patrick; Paz Castro, Raquel; Riper, Heleen; Berking, Matthias; Ebert, David Daniel

    2018-04-01

    To test the efficacy of a web-based alcohol intervention with and without guidance. Three parallel groups with primary end-point after 6 weeks. Open recruitment in the German working population. Adults (178 males/256 females, mean age 47 years) consuming at least 21/14 weekly standard units of alcohol (SUA) and scoring ≥ 8/6 on the Alcohol Use Disorders Identification Test. Five web-based modules including personalized normative feedback, motivational interviewing, goal setting, problem-solving and emotion regulation during 5 weeks. One intervention group received an unguided self-help version (n=146) and the second received additional adherence-focused guidance by eCoaches (n=144). Controls were on a waiting list with full access to usual care (n=144). Primary outcome was weekly consumed SUA after 6 weeks. SUA after 6 months was examined as secondary outcome, next to numbers of participants drinking within the low-risk range, and general and work-specific mental health measures. All groups showed reductions of mean weekly SUA after 6 weeks (unguided: -8.0; guided: -8.5; control: -3.2). There was no significant difference between the unguided and guided intervention (P=0.324). Participants in the combined intervention group reported significantly fewer SUA than controls [B=-4.85, 95% confidence interval (CI)=-7.02 to -2.68, P < 0.001]. The intervention groups also showed significant reductions in SUA consumption after 6 months (B=-5.72, 95% CI=-7.71 to -3.73, P < 0.001) and improvements regarding general and work-related mental health outcomes after 6 weeks and 6 months. A web-based alcohol intervention, administered with or without personal guidance, significantly reduced mean weekly alcohol consumption and improved mental health and work-related outcomes in the German working population. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  19. Effectiveness of a web-based intervention for injured claimants: a randomized controlled trial.

    Science.gov (United States)

    Elbers, Nieke A; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

    2013-07-20

    There is considerable evidence showing that injured people who are involved in a compensation process show poorer physical and mental recovery than those with similar injuries who are not involved in a compensation process. One explanation for this reduced recovery is that the legal process and the associated retraumatization are very stressful for the claimant. The aim of this study was to empower injured claimants in order to facilitate recovery. Participants were recruited by three Dutch claims settlement offices. The participants had all been injured in a traffic crash and were involved in a compensation process. The study design was a randomized controlled trial. An intervention website was developed with (1) information about the compensation process, and (2) an evidence-based, therapist-assisted problem-solving course. The control website contained a few links to already existing websites. Outcome measures were empowerment, self-efficacy, health status (including depression, anxiety, and somatic symptoms), perceived fairness, ability to work, claims knowledge and extent of burden. The outcomes were self-reported through online questionnaires and were measured four times: at baseline, and at 3, 6, and 12 months. In total, 176 participants completed the baseline questionnaire after which they were randomized into either the intervention group (n=88) or the control group (n=88). During the study, 35 participants (20%) dropped out. The intervention website was used by 55 participants (63%). The health outcomes of the intervention group were no different to those of the control group. However, the intervention group considered the received compensation to be fairer (Pwebsite was evaluated positively. Although the web-based intervention was not used enough to improve the health of injured claimants in compensation processes, it increased the perceived fairness of the compensation amount. Netherlands Trial Register NTR2360.

  20. An experimental test of assessment reactivity within a web-based brief alcohol intervention study for college students.

    Science.gov (United States)

    Fazzino, Tera L; Rose, Gail L; Helzer, John E

    2016-01-01

    Web-based brief alcohol intervention (WBI) programs have efficacy in a wide range of college students and have been widely disseminated to universities to address heavy alcohol use. In the majority of efficacy studies, web-based research assessments were conducted before the intervention. Web-based research assessments may elicit reactivity, which could inflate estimates of WBI efficacy. The current study tested whether web-based research assessments conducted in combination with a WBI had additive effects on alcohol use outcomes, compared to a WBI only. Undergraduate students (n=856) from universities in the United States and Canada participated in this online study. Eligible individuals were randomized to complete 1) research assessments+WBI or 2) WBI-only. Alcohol consumption, alcohol-related problems, and protective behaviors were assessed at one-month follow up. Multiple regression using 20 multiply imputed datasets indicated that there were no significant differences at follow up in alcohol use, alcohol-related problems, or protective behaviors used when controlling for variables with theoretical and statistical relevance. A repeated measures analysis of covariance revealed a significant decrease in peak estimated blood alcohol concentration in both groups, but no differential effects by randomized group. There were no significant moderating effects from gender, hazardous alcohol use, or motivation to change drinking. Web-based research assessments combined with a web-based alcohol intervention did not inflate estimates of intervention efficacy when measured within-subjects. Our findings suggest universities may be observing intervention effects similar to those cited in efficacy studies, although effectiveness trials are needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy : a protocol of a randomized controlled trial

    NARCIS (Netherlands)

    Kohle, Nadine; Drossaert, Constance H. C.; Schreurs, Karlein M. G.; Hagedoorn, Mariet; Verdonck-de Leeuw, Irma M.; Bohlmeijer, Ernst T.

    2015-01-01

    Background: There is a growing recognition that cancer not only affects the lives of the patients, but also the lives of their partners. Partners of cancer patients are highly involved in the illness trajectory by providing informal care and they often experience distress. However, supporting

  2. Web-Based Interventions Supporting Adolescents and Young People With Depressive Symptoms: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Välimäki, Maritta; Anttila, Katriina; Anttila, Minna; Lahti, Mari

    2017-12-08

    Although previous studies on information and communication technology (ICT)-based intervention on mental health among adolescents with depressive symptoms have already been combined in a number of systematic reviews, coherent information is still missing about interventions used, participants' engagement of these interventions, and how these interventions work. We conducted a systematic review and meta-analysis of trials to describe the effectiveness of Web-based interventions to support adolescents with depression or depressive symptoms, anxiety, and stress. We also explored the content of the interventions, as there has previously been a lack of coherent understanding of the detailed content of the Web-based interventions for these purposes. We included parallel randomized controlled trials targeted at adolescents, or young people in the age range of 10 and 24 years, with symptoms or diagnoses of depression and anxiety. The interventions were from original studies aimed to support mental health among adolescents, and they were delivered via Web-based information and communication technology. Out of 2087 records identified, 27 papers (22 studies) met the inclusion criteria. On the basis of a narrative analysis of 22 studies, a variety of Web-based interventions were found; the most commonly used intervention was based on cognitive behavioral therapy. Meta-analysis was further conducted with 15 studies (4979 participants). At the end of the intervention, a statistically significant improvement was found in the intervention group (10 studies) regarding depressive symptoms (P=.02, median 1.68, 95% CI 3.11-0.25) and after 6 months (3 studies; P=.01, median 1.78, 95% CI 3.20-0.37). Anxiety symptoms (8 studies; Pstress scores. However, adolescents in the intervention group left the study early more often, both in short-term studies (11 studies; P=.007, median 1.31, 95% CI 1.08-1.58) and mid-term studies (3 studies; P=.02, median 1.65, 95% CI 1.09-2.49). We did not find

  3. A web-based dietary intervention for people with type 2 diabetes: development, implementation, and evaluation.

    Science.gov (United States)

    Ramadas, Amutha; Chan, Carina Ka Yee; Oldenburg, Brian; Hussien, Zanariah; Quek, Kia Fatt

    2015-06-01

    Diabetes is becoming a very important health issue in rapidly developing nations and there is an urgent need to improve overall diabetes self-management education in these countries. Although e-health is an emerging theme, only a few successful web-based studies on diabetes self-management have been reported. We describe the development, implementation, and process evaluation of an Internet-delivered dietary intervention program (myDIDeA) for diabetic patients in a developing country. Specific dietary components to be included in the intervention module were first identified through a comprehensive review of literature and guidelines. The lesson plans and the study website were then developed based on the evidence, Transtheoretical Model's Stages of Change and user-centered design approach. Finally, the effectiveness of the website was tested through a randomized-controlled trial to promote dietary change in patients with type 2 diabetes. The participants in the intervention group (n = 66) were given access to myDIDeA for 6 months. Process evaluation in form of intervention adherence and program reception were conducted at post intervention. The response rate for the process evaluation was 89%. On average, each participant logged in at least once for each lesson plan and spent almost 12 min on the site. The participants' content satisfaction, acceptability, and usability scores were satisfactory. The primary outcome of the trial, Dietary Knowledge, Attitude, and Behavior score was strongly correlated with content satisfaction (r = 0.826, p social media, and other means to stimulate the interest of participants can be explored.

  4. Web-based alcohol screening and brief intervention for university students: a randomized trial.

    Science.gov (United States)

    Kypri, Kypros; Vater, Tina; Bowe, Steven J; Saunders, John B; Cunningham, John A; Horton, Nicholas J; McCambridge, Jim

    2014-03-26

    Unhealthy alcohol use is a leading contributor to the global burden of disease, particularly among young people. Systematic reviews suggest efficacy of web-based alcohol screening and brief intervention and call for effectiveness trials in settings where it could be sustainably delivered. To evaluate a national web-based alcohol screening and brief intervention program. A multisite, double-blind, parallel-group, individually randomized trial was conducted at 7 New Zealand universities. In April and May of 2010, invitations containing hyperlinks to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening test were e-mailed to 14,991 students aged 17 to 24 years. Participants who screened positive (AUDIT-C score ≥4) were randomized to undergo screening alone or to 10 minutes of assessment and feedback (including comparisons with medical guidelines and peer norms) on alcohol expenditure, peak blood alcohol concentration, alcohol dependence, and access to help and information. A fully automated 5-month follow-up assessment was conducted that measured 6 primary outcomes: consumption per typical occasion, drinking frequency, volume of alcohol consumed, an academic problems score, and whether participants exceeded medical guidelines for acute harm (binge drinking) and chronic harm (heavy drinking). A Bonferroni-corrected significance threshold of .0083 was used to account for the 6 comparisons and a sensitivity analysis was used to assess possible attrition bias. Of 5135 students screened, 3422 scored 4 or greater and were randomized, and 83% were followed up. There was a significant effect on 1 of the 6 prespecified outcomes. Relative to control participants, those who received intervention consumed less alcohol per typical drinking occasion (median 4 drinks [interquartile range {IQR}, 2-8] vs 5 drinks [IQR 2-8]; rate ratio [RR], 0.93 [99.17% CI, 0.86-1.00]; P = .005) but not less often (RR, 0.95 [99.17% CI, 0.88-1.03]; P = .08) or less

  5. Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review.

    Science.gov (United States)

    Lee, Eleanor W; Denison, Fiona C; Hor, Kahyee; Reynolds, Rebecca M

    2016-02-29

    Perinatal depression is strikingly common with a prevalence of 10-15%. The adverse effects of perinatal depression on maternal and child health are profound with considerable costs. Despite this, few women seek medical attention. E-health, providing healthcare via the Internet is an accessible and effective solution for the treatment of depression in the general population. We aimed to conduct a systematic review of web-based interventions for the prevention and treatment of mood disorders in the perinatal period, defined as the start of pregnancy to 1 year post-partum. Six databases were searched until 26(th) March 2015. Two researchers independently screened articles for eligibility. Of the 547 screened articles, four met the inclusion criteria. These included three randomised-controlled trials and one feasibility trial, with total data from 1274 participants. MOOSE and PRISMA guidelines were adhered to for the conduct and reporting of the systematic review. All studies were conducted in the post-partum period. All reported an improvement in maternal mood following intervention. A significant improvement in depressive symptoms was measured using validated rating scales, such as the Edinburgh Postnatal Depression Scale (EPDS), either at post-treatment or follow-up which ranged from 3 to 12 months post study completion. For the two RCTs utilising the EPDS, the EPDS score reductions were (mean ± SEM) 8.52 ± 0.22 (Range 19.46 to10.94) and 9.19 ± 0.63 (Range, 20.24 to 11.05) for treatment groups and 5.16 ± 0.25 (Range 19.44 to 14.28) and 6.81 ± 0.71 (Range 21.07 to 14.26) for comparator groups. However attrition within studies ranged from 13 to 61%. One study was rated as 'good' quality. Preliminary data suggests web-based therapies for perinatal depression delivered in the post-partum period may play a role in improving maternalmood but more studies are needed, particularly with interventions delivered antenatally. Further research is needed

  6. A community-based group-guided self-help intervention for low mood and stress: study protocol for a randomized controlled trial.

    Science.gov (United States)

    McClay, Carrie-Anne; Morrison, Jill; McConnachie, Alex; Williams, Christopher

    2013-11-19

    Depression is a mental health condition which affects millions of people each year, with worldwide rates increasing. Cognitive behavioral therapy (CBT) is recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of depression. However, waiting lists can cause delays for face-to-face therapy. Also a proportion of people decline to present for help through the health service - the so-called treatment gap. Self-referral to CBT using community-based group interventions delivered by a voluntary sector organization may serve to resolve this problem. The aim of this randomized controlled trial (RCT) is to determine the efficacy of such a guided CBT self-help course, the 'Living Life to the Full' (LLTTF) classes delivered by the charity Action on Depression (AOD). The primary outcome is level of depression at 6 months assessed using the patient health questionnaire-9 (PHQ9) depression scale. Secondary measures include levels of anxiety and social functioning. Participants with symptoms of low mood will be recruited from the community through newspaper adverts and also via the AOD website. Participants will receive either immediate or delayed access to guided CBT self-help classes - the eight session LLTTF course. The primary endpoint will be at 6 months at which point the delayed group will be offered the intervention. Levels of depression, anxiety and social functioning will be assessed and an economic analysis will be carried out. This RCT will test whether the LLTTF intervention is effective and/or cost-effective. If the LLTTF community-based classes are found to be cost effective, they may be helpful as both an intervention for those already seeking care in the health service, as well as those seeking help outside that setting, widening access to psychological therapy. Current Controlled Trials ISRCTN86292664.

  7. "Effects of a Web-Based Intervention on Family Functioning Following Pediatric Traumatic Brain Injury"

    Science.gov (United States)

    Minich, Nori; Taylor, H. Gerry; Kirkwood, Michael; Brown, Tanya Maines; Stancin, Terry; Wade, Shari L

    2015-01-01

    Objective Investigate effectiveness of an online Counselor-Assisted Problem-Solving (CAPS) intervention on family functioning after traumatic brain injury (TBI). Methods Participants were randomized to CAPS (n = 65) or internet resource comparison (IRC; n = 67). CAPS is a counselor-assisted web-based program. IRC was given access to online resources. Outcomes were examined 6 months, 12 months, and 18 months after baseline. Injury severity, age, and SES were examined as moderators. Results A main effect of time was noted for teen-reported conflict and parent-reported problem solving. CAPS had decreased parent-reported conflict and a reduction in parental effective communication. Effects were specific to subsets of the sample. Conclusions CAPS, a family-based problem-solving intervention designed to address problem behaviors, had modest effects on some aspects of family functioning, when compared to IRC. Effects were generally limited to subsets of the families and were not evident across all follow-up assessments. PMID:26461100

  8. Web-based tailored intervention for preparation of parents and children for outpatient surgery (WebTIPS): development.

    Science.gov (United States)

    Kain, Zeev N; Fortier, Michelle A; Chorney, Jill MacLaren; Mayes, Linda

    2015-04-01

    As a result of cost-containment efforts, preparation programs for outpatient surgery are currently not available to the majority of children and parents. The recent dramatic growth in the Internet presents a unique opportunity to transform how children and their parents are prepared for surgery. In this article, we describe the development of a Web-based Tailored Intervention for Preparation of parents and children undergoing Surgery (WebTIPS). A multidisciplinary taskforce agreed that a Web-based tailored intervention consisting of intake, matrix, and output modules was the preferred approach. Next, the content of the various intake variables, the matrix logic, and the output content was developed. The output product has a parent component and a child component and is described in http://surgerywebtips.com/about.php. The child component makes use of preparation strategies such as information provision, modeling, play, and coping skills training. The parent component of WebTIPS includes strategies such as information provision, coping skills training, and relaxation and distraction techniques. A reputable animation and Web design company developed a secured Web-based product based on the above description. In this article, we describe the development of a Web-based tailored preoperative preparation program that can be accessed by children and parents multiple times before and after surgery. A follow-up article in this issue of Anesthesia & Analgesia describes formative evaluation and preliminary efficacy testing of this Web-based tailored preoperative preparation program.

  9. Supporting the running and analysis of trials of web-based behavioural interventions: the LifeGuide

    OpenAIRE

    Yang, Yang; Osmond, Adrian; Chen, Xiaoyu; Weal, Mark; Wills, Gary; De Roure, David; Joseph, Judith; Yardley, Lucy

    2009-01-01

    Behavioural interventions - packages of advice and support for behaviour change - are one of the most important methodologies and technologies employed by social scientists for understanding and changing behaviour. A typical web-based behavioural intervention study includes the designing, deploying, piloting and trialling of the intervention as well as data analysis. We have developed a research environment named LifeGuide, which covers the full scope of this process, enabling social scientis...

  10. Participants, Usage, and Use Patterns of a Web-Based Intervention for the Prevention of Depression Within a Randomized Controlled Trial

    NARCIS (Netherlands)

    Kelders, Saskia Marion; Bohlmeijer, Ernst Thomas; van Gemert-Pijnen, Julia E.W.C.

    2013-01-01

    Background: Although Web-based interventions have been shown to be effective, they are not widely implemented in regular care. Nonadherence (ie, participants not following the intervention protocol) is an issue. By studying the way Web-based interventions are used and whether there are differences

  11. Improving couples' quality of life through a Web-based prostate cancer education intervention.

    Science.gov (United States)

    Song, Lixin; Rini, Christine; Deal, Allison M; Nielsen, Matthew E; Chang, Hao; Kinneer, Patty; Teal, Randall; Johnson, David C; Dunn, Mary W; Mark, Barbara; Palmer, Mary H

    2015-03-01

    To evaluate the feasibility and acceptability of a newly developed web-based, couple-oriented intervention called Prostate Cancer Education and Resources for Couples (PERC). Quantitative, qualitative, mixed-methods approach. Oncology outpatient clinics at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center at UNC–Chapel Hill. 26 patients with localized prostate cancer (PCa) and their partners. Pre- and postpilot quantitative assessments and a postpilot qualitative interview were conducted. General and PCa-specific symptoms, quality of life, psychosocial factors, PERC’s ease of use, and web activities. Improvement was shown in some PCa-specific and general symptoms (small effect sizes for patients and small-to-medium effect sizes for partners), overall quality of life, and physical and social domains of quality of life for patients (small effect sizes). Web activity data indicated high PERC use. Qualitative and quantitative analyses indicated that participants found PERC easy to use and understand,as well as engaging, of high quality, and relevant. Overall, participants were satisfied with PERC and reported that PERC improved their knowledge about symptom management and communication as a couple. PERC was a feasible, acceptable method of reducing the side effects of PCa treatment–related symptoms and improving quality of life. PERC has the potential to reduce the negative impacts of symptoms and enhance quality of life for patients with localized PCa and their partners, particularly for those who live in rural areas and have limited access to post-treatment supportive care.

  12. A Web-Based and Print-Based Computer-Tailored Physical Activity Intervention for Prostate and Colorectal Cancer Survivors: A Comparison of User Characteristics and Intervention Use.

    Science.gov (United States)

    Golsteijn, Rianne Henrica Johanna; Bolman, Catherine; Peels, Denise Astrid; Volders, Esmee; de Vries, Hein; Lechner, Lilian

    2017-08-23

    Physical activity (PA) is beneficial in improving negative physical and psychological effects of cancer. The rapidly increasing number of cancer survivors, resulting from aging and improved cancer care, emphasizes the importance to develop and provide low cost, easy accessible PA programs. Such programs could be provided through the Internet, but that could result in the exclusion of cancer survivors not familiar with the Internet. Therefore, we developed a computer-tailored PA intervention for prostate and colorectal cancer survivors in which both Web-based and print materials are provided, and participants can choose their own preferred delivery mode. The aim of this study was to assess participants' characteristics related to delivery mode and use of intervention materials. We studied characteristics of participants using Web-based and printed intervention materials in a randomized controlled trial (RCT). Prostate and colorectal cancer survivors recruited from hospitals were randomized to OncoActive (computer-tailored PA intervention) or a usual-care control group. OncoActive participants received both Web-based and printed materials. Participants were classified into initial print- or Web-based participants based on their preferred mode of completion of the first questionnaire, which was needed for the computer-tailored PA advice. Intervention material use during the remainder of the intervention was compared for initial print- or Web-based participants. Additionally, participants were classified into those using only print materials and those using Web-based materials. Differences in participant characteristics and intervention material use were studied through analysis of variance (ANOVAs), chi-square tests, and logistic regressions. The majority of the participants in the intervention group were classified as initial Web-based participants (170/249, 68.3%), and 84.9% (191/249) used Web-based intervention materials. Dropout was low (15/249, 6.0%) and differed

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

    Science.gov (United States)

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

    2016-06-23

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

  14. Changes in Physical Activity and Psychological Variables Following a Web-Based Motivational Interviewing Intervention: Pilot Study.

    Science.gov (United States)

    Karnes, Sasha L; Meyer, Barbara B; Berger, Lisa M; Brondino, Michael J

    2015-10-29

    Web-based interventions for enhancing physical activity participation are in demand for application in health care settings. Recent research suggests Web-based interventions that are based on motivational interviewing are effective to increase physical activity. It is unclear whether motivational interviewing can influence targeted psychological variables such as perceived readiness, willingness, and ability to participate in physical activity. The aims of this study were to determine whether there were changes in physical activity and psychological variables associated with readiness, willingness, and perceived ability to participate in physical activity following completion of a novel Web-based intervention. The goal of the motivational interviewing-based intervention was to increase physical activity. Twenty-three underactive or inactive urban dwelling adults were recruited at a medical office for participation in a 4-session Web-based intervention lasting approximately 15 minutes per week. Sessions were based on principles of motivational interviewing. Assessment of physical activity was conducted using pedometers immediately prior to intervention participation (pre) and immediately post intervention (post1). Self-report assessments of physical activity and psychological variables were conducted using online surveys at pre, post1, and again at one month following intervention participation (post2). Comparisons of pre and post1 pedometer recordings revealed significant increases in steps per day (t22=2.09, P=.049). There were also significant changes in total physical activity energy expenditure per week (χ(2) 2=8.4, P=.02) and in moderate intensity physical activity energy expenditure per week (χ(2) 2=13.9, Ptool to promote physical activity in health care settings. Additional research is needed to test the effectiveness of motivational interviewing compared to a control condition and to refine content by considering mediation by psychological variables in a

  15. Web-based surveillance of public information needs for informing preconception interventions.

    Directory of Open Access Journals (Sweden)

    Angelo D'Ambrosio

    Full Text Available The risk of adverse pregnancy outcomes can be minimized through the adoption of healthy lifestyles before pregnancy by women of childbearing age. Initiatives for promotion of preconception health may be difficult to implement. Internet can be used to build tailored health interventions through identification of the public's information needs. To this aim, we developed a semi-automatic web-based system for monitoring Google searches, web pages and activity on social networks, regarding preconception health.Based on the American College of Obstetricians and Gynecologists guidelines and on the actual search behaviors of Italian Internet users, we defined a set of keywords targeting preconception care topics. Using these keywords, we analyzed the usage of Google search engine and identified web pages containing preconception care recommendations. We also monitored how the selected web pages were shared on social networks. We analyzed discrepancies between searched and published information and the sharing pattern of the topics.We identified 1,807 Google search queries which generated a total of 1,995,030 searches during the study period. Less than 10% of the reviewed pages contained preconception care information and in 42.8% information was consistent with ACOG guidelines. Facebook was the most used social network for sharing. Nutrition, Chronic Diseases and Infectious Diseases were the most published and searched topics. Regarding Genetic Risk and Folic Acid, a high search volume was not associated to a high web page production, while Medication pages were more frequently published than searched. Vaccinations elicited high sharing although web page production was low; this effect was quite variable in time.Our study represent a resource to prioritize communication on specific topics on the web, to address misconceptions, and to tailor interventions to specific populations.

  16. Effectiveness of a Web-Based Screening and Fully Automated Brief Motivational Intervention for Adolescent Substance Use

    DEFF Research Database (Denmark)

    Arnaud, Nicolas; Baldus, Christiane; Elgán, Tobias H.

    2016-01-01

    ).Conclusions: Although the study is limited by a large drop-out, significant between-group effects for alcohol use indicate that targeted brief motivational intervention in a fully automated Web-based format can be effective to reduce drinking and lessen existing substance use service barriers for at...... of substance use among college students. However, the evidence is sparse among adolescents with at-risk use of alcohol and other drugs. Objective: This study evaluated the effectiveness of a targeted and fully automated Web-based brief motivational intervention with no face-to-face components on substance use......, and polydrug use. All outcome analyses were conducted with and without Expectation Maximization (EM) imputation of missing follow-up data. Results: In total, 2673 adolescents were screened and 1449 (54.2%) participants were randomized to the intervention or control group. After 3 months, 211 adolescents (14...

  17. Effectiveness of a Web-Based Screening and Fully Automated Brief Motivational Intervention for Adolescent Substance Use

    DEFF Research Database (Denmark)

    Arnaud, Nicolas; Baldus, Christiane; Elgán, Tobias H.

    2016-01-01

    of substance use among college students. However, the evidence is sparse among adolescents with at-risk use of alcohol and other drugs. Objective: This study evaluated the effectiveness of a targeted and fully automated Web-based brief motivational intervention with no face-to-face components on substance use...... methods and screened online for at-risk substance use using the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) screening instrument. Participants were randomized to a single session brief motivational intervention group or an assessment-only control group but not blinded. Primary outcome......).Conclusions: Although the study is limited by a large drop-out, significant between-group effects for alcohol use indicate that targeted brief motivational intervention in a fully automated Web-based format can be effective to reduce drinking and lessen existing substance use service barriers for at...

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

    Science.gov (United States)

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

    2012-12-17

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

  19. Implementation of a Web-Based Organ Donation Educational Intervention: Development and Use of a Refined Process Evaluation Model

    Science.gov (United States)

    Harker, Laura; Bamps, Yvan; Flemming, Shauna St. Clair; Perryman, Jennie P; Thompson, Nancy J; Patzer, Rachel E; Williams, Nancy S DeSousa; Arriola, Kimberly R Jacob

    2017-01-01

    Background The lack of available organs is often considered to be the single greatest problem in transplantation today. Internet use is at an all-time high, creating an opportunity to increase public commitment to organ donation through the broad reach of Web-based behavioral interventions. Implementing Internet interventions, however, presents challenges including preventing fraudulent respondents and ensuring intervention uptake. Although Web-based organ donation interventions have increased in recent years, process evaluation models appropriate for Web-based interventions are lacking. Objective The aim of this study was to describe a refined process evaluation model adapted for Web-based settings and used to assess the implementation of a Web-based intervention aimed to increase organ donation among African Americans. Methods We used a randomized pretest-posttest control design to assess the effectiveness of the intervention website that addressed barriers to organ donation through corresponding videos. Eligible participants were African American adult residents of Georgia who were not registered on the state donor registry. Drawing from previously developed process evaluation constructs, we adapted reach (the extent to which individuals were found eligible, and participated in the study), recruitment (online recruitment mechanism), dose received (intervention uptake), and context (how the Web-based setting influenced study implementation) for Internet settings and used the adapted model to assess the implementation of our Web-based intervention. Results With regard to reach, 1415 individuals completed the eligibility screener; 948 (67.00%) were determined eligible, of whom 918 (96.8%) completed the study. After eliminating duplicate entries (n=17), those who did not initiate the posttest (n=21) and those with an invalid ZIP code (n=108), 772 valid entries remained. Per the Internet protocol (IP) address analysis, only 23 of the 772 valid entries (3.0%) were

  20. Implementation of a Web-Based Organ Donation Educational Intervention: Development and Use of a Refined Process Evaluation Model.

    Science.gov (United States)

    Redmond, Nakeva; Harker, Laura; Bamps, Yvan; Flemming, Shauna St Clair; Perryman, Jennie P; Thompson, Nancy J; Patzer, Rachel E; Williams, Nancy S DeSousa; Arriola, Kimberly R Jacob

    2017-11-30

    The lack of available organs is often considered to be the single greatest problem in transplantation today. Internet use is at an all-time high, creating an opportunity to increase public commitment to organ donation through the broad reach of Web-based behavioral interventions. Implementing Internet interventions, however, presents challenges including preventing fraudulent respondents and ensuring intervention uptake. Although Web-based organ donation interventions have increased in recent years, process evaluation models appropriate for Web-based interventions are lacking. The aim of this study was to describe a refined process evaluation model adapted for Web-based settings and used to assess the implementation of a Web-based intervention aimed to increase organ donation among African Americans. We used a randomized pretest-posttest control design to assess the effectiveness of the intervention website that addressed barriers to organ donation through corresponding videos. Eligible participants were African American adult residents of Georgia who were not registered on the state donor registry. Drawing from previously developed process evaluation constructs, we adapted reach (the extent to which individuals were found eligible, and participated in the study), recruitment (online recruitment mechanism), dose received (intervention uptake), and context (how the Web-based setting influenced study implementation) for Internet settings and used the adapted model to assess the implementation of our Web-based intervention. With regard to reach, 1415 individuals completed the eligibility screener; 948 (67.00%) were determined eligible, of whom 918 (96.8%) completed the study. After eliminating duplicate entries (n=17), those who did not initiate the posttest (n=21) and those with an invalid ZIP code (n=108), 772 valid entries remained. Per the Internet protocol (IP) address analysis, only 23 of the 772 valid entries (3.0%) were within Georgia, and only 17 of those

  1. Systematic development of a self-help and motivational enhancement intervention to promote sexual health in HIV-positive men who have sex with men.

    Science.gov (United States)

    Van Kesteren, Nicole M C; Kok, Gerjo; Hospers, Harm J; Schippers, Jan; De Wildt, Wencke

    2006-12-01

    The objective of this study was to describe the application of a systematic process-Intervention Mapping-to developing a theory- and evidence-based intervention to promote sexual health in HIV-positive men who have sex with men (MSM). Intervention Mapping provides a framework that gives program planners a systematic method for decision-making in each phase of intervention development. In Step 1, we focused on the improvement of two health-promoting behaviors: satisfactory sexual functioning and safer sexual behavior. These behaviors were then linked with selected personal and external determinants, such as attitudes and social support, to produce a set of proximal program objectives. In Step 2, theoretical methods were identified to influence the proximal program objectives and were translated into practical strategies. Although theoretical methods were derived from various theories, self-regulation theory and a cognitive model of behavior change provided the main framework for selecting the intervention methods. The main strategies chosen were bibliotherapy (i.e., the use of written material to help people solve problems or change behavior) and motivational interviewing. In Step 3, the theoretical methods and practical strategies were applied in a program that comprised a self-help guide, a motivational interviewing session and a motivational interviewing telephone call, both delivered by specialist nurses in HIV treatment centers. In Step 4, implementation was anticipated by developing a linkage group to ensure involvement of program users in the planning process and conducting additional research to understand how to implement our program better. In Step 5, program evaluation was anticipated based on the planning process from the previous Intervention Mapping steps.

  2. Web-based family intervention for overweight children: a pilot study.

    Science.gov (United States)

    Delamater, Alan M; Pulgaron, Elizabeth R; Rarback, Sheah; Hernandez, Jennifer; Carrillo, Adriana; Christiansen, Steven; Severson, Herbert H

    2013-02-01

    Research has shown the efficacy of family-based behavioral interventions for overweight children, but a major difficulty is access to effective treatment programs. The objective of this study was to develop and test the initial feasibility and efficacy of a web-based family program for overweight 8- to 12-year-old children. A website was created using concepts from effective family-based behavioral programs and input from focus groups with overweight children, parents, and pediatricians. The website provided information about obesity and healthy lifestyles, assessment of dietary and physical activity habits, interactive dietary and physical activity games, and instruction in goal-setting and monitoring of goals. Children selected a dietary and physical activity goal and a daily step goal with pedometers. Feasibility and pilot testing over 4 weeks was conducted with 24 overweight children referred by a physician. Outcomes were z-BMI, healthy eating and physical activity, and intrinsic motivation and self-efficacy for weight control. Mean number of logins over the study period was 11.4 for the study sample. Eighteen families (75%) returned for the follow-up assessment. Pre-post analyses for these participants showed improvements in intrinsic motivation, (p=0.05), self-efficacy (p=0.025), physical activity (p=0.005), and healthy lifestyle behaviors (p=0.001). Comparisons between high and low users of the program indicated that high users reduced their BMI while low users increased their BMI over time (p=0.02); high users also improved their dietary intake relative to low users (p=0.04). Consumer satisfaction ratings were high. These pilot findings suggest this is a feasible approach for treatment of overweight children and that children who used the web program frequently improved their BMI and dietary intake.

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

    Science.gov (United States)

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Cremers Henricus-Paul

    2012-06-01

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

  5. Cancer-Related Fatigue in Post-Treatment Cancer Survivors: Theory-Based Development of a Web-Based Intervention.

    Science.gov (United States)

    Corbett, Teresa; Walsh, Jane C; Groarke, AnnMarie; Moss-Morris, Rona; Morrissey, Eimear; McGuire, Brian E

    2017-07-04

    Cancer-related fatigue (CrF) is the most common and disruptive symptom experienced by cancer survivors. We aimed to develop a theory-based, interactive Web-based intervention designed to facilitate self-management and enhance coping with CrF following cancer treatment. The aim of our study was to outline the rationale, decision-making processes, methods, and findings which led to the development of a Web-based intervention to be tested in a feasibility trial. This paper outlines the process and method of development of the intervention. An extensive review of the literature and qualitative research was conducted to establish a therapeutic approach for this intervention, based on theory. The psychological principles used in the development process are outlined, and we also clarify hypothesized causal mechanisms. We describe decision-making processes involved in the development of the content of the intervention, input from the target patient group and stakeholders, the design of the website features, and the initial user testing of the website. The cocreation of the intervention with the experts and service users allowed the design team to ensure that an acceptable intervention was developed. This evidence-based Web-based program is the first intervention of its kind based on self-regulation model theory, with the primary aim of targeting the representations of fatigue and enhancing self-management of CrF, specifically. This research sought to integrate psychological theory, existing evidence of effective interventions, empirically derived principles of Web design, and the views of potential users into the systematic planning and design of the intervention of an easy-to-use website for cancer survivors. ©Teresa Corbett, Jane C Walsh, AnnMarie Groarke, Rona Moss-Morris, Eimear Morrissey, Brian E McGuire. Originally published in JMIR Cancer (http://cancer.jmir.org), 04.07.2017.

  6. Dissemination strategies and adherence predictors for web-based interventions-how efficient are patient education sessions and email reminders?

    Science.gov (United States)

    Schweier, R; Romppel, M; Richter, C; Grande, G

    2016-06-01

    The Internet offers the potential to efficaciously deliver health interventions at a low cost and with a low threshold across any distance. However, since many web-based interventions are confronted with low use and adherence, proactive dissemination strategies are needed. We, therefore, tested the efficacy of a 1-h patient education session as part of a rehabilitation program and an email reminder 4 weeks later on the publicity and use of a web-based intervention aimed at lifestyle changes in patients with either coronary heart disease or chronic back pain (CBP) and examined adherence predictors. The website www.lebensstil-aendern.de is a cost-free, German-language website providing more than 1000 patient narratives about successful lifestyle changes. To test the efficacy of the dissemination strategies and to examine adherence predictors, we conducted a sequential controlled trial with heart and CBP patients recruited from German inpatient rehabilitation centers. The dissemination strategies were found to be efficient. Use rates, however, remained low. The email reminder and internal health locus of control emerged as notable factors in motivating patients to participate in the web-based intervention. Other factors that have been suggested to be related to nonuse, e.g. sociodemographic characteristics and medical condition, did not predict use or adherence. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Use and Effectiveness of a Video- and Text-Driven Web-Based Computer-Tailored Intervention: Randomized Controlled Trial.

    Science.gov (United States)

    Walthouwer, Michel Jean Louis; Oenema, Anke; Lechner, Lilian; de Vries, Hein

    2015-09-25

    Many Web-based computer-tailored interventions are characterized by high dropout rates, which limit their potential impact. This study had 4 aims: (1) examining if the use of a Web-based computer-tailored obesity prevention intervention can be increased by using videos as the delivery format, (2) examining if the delivery of intervention content via participants' preferred delivery format can increase intervention use, (3) examining if intervention effects are moderated by intervention use and matching or mismatching intervention delivery format preference, (4) and identifying which sociodemographic factors and intervention appreciation variables predict intervention use. Data were used from a randomized controlled study into the efficacy of a video and text version of a Web-based computer-tailored obesity prevention intervention consisting of a baseline measurement and a 6-month follow-up measurement. The intervention consisted of 6 weekly sessions and could be used for 3 months. ANCOVAs were conducted to assess differences in use between the video and text version and between participants allocated to a matching and mismatching intervention delivery format. Potential moderation by intervention use and matching/mismatching delivery format on self-reported body mass index (BMI), physical activity, and energy intake was examined using regression analyses with interaction terms. Finally, regression analysis was performed to assess determinants of intervention use. In total, 1419 participants completed the baseline questionnaire (follow-up response=71.53%, 1015/1419). Intervention use declined rapidly over time; the first 2 intervention sessions were completed by approximately half of the participants and only 10.9% (104/956) of the study population completed all 6 sessions of the intervention. There were no significant differences in use between the video and text version. Intervention use was significantly higher among participants who were allocated to an

  8. Text messaging as an adjunct to a web-based intervention for college student alcohol use: A preliminary study.

    Science.gov (United States)

    Tahaney, Kelli D; Palfai, Tibor P

    2017-10-01

    Brief, web-based motivational interventions have shown promising results for reducing alcohol use and associated harm among college students. However, findings regarding which alcohol use outcomes are impacted are mixed and effects tend to be small to moderate, with effect sizes decreasing over longer-term follow-up periods. As a result, these interventions may benefit from adjunctive strategies to bolster students' engagement with intervention material and to extend interventions beyond initial contacts into student's daily lives. This study tested the efficacy of text messaging as an adjunct to a web-based intervention for heavy episodic drinking college students. One-hundred and thirteen undergraduate student risky drinkers recruited from an introductory psychology class were randomly assigned to one of three conditions-assessment only (AO), web intervention (WI), and web intervention plus text messaging (WI+TXT). Heavy drinking episodes (HDEs), weekend quantity per occasion, and alcohol-related consequences were assessed at baseline and one month follow-up. Univariate analysis of covariance (ANCOVA) was used to assess the influence of condition assignment on 1-month outcomes, controlling for baseline variables. Planned contrasts showed that those in the WI+TXT condition showed significantly less weekend drinking than those in the AO and WI conditions. Although those in the WI+TXT condition showed significantly fewer HDEs compared to AO, it was not significantly different than the WI only condition. No differences were observed on alcohol-related problems. These findings provide partial support for the view that text messaging may be a useful adjunct to web-based interventions for reducing alcohol consumption among student drinkers. Copyright © 2017. Published by Elsevier Ltd.

  9. What are the working mechanisms of a web-based workplace sitting intervention targeting psychosocial factors and action planning?

    Science.gov (United States)

    De Cocker, Katrien; De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel

    2017-05-03

    Office workers demonstrate high levels of sitting on workdays. As sitting is positively associated with adverse health risks in adults, a theory-driven web-based computer-tailored intervention to influence workplace sitting, named 'Start to Stand,' was developed. The intervention was found to be effective in reducing self-reported workplace sitting among Flemish employees. The aim of this study was to investigate through which mechanisms the web-based computer-tailored intervention influenced self-reported workplace sitting. Employees (n = 155) participated in a clustered randomised controlled trial and reported socio-demographics (age, gender, education), work-related (hours at work, employment duration), health-related (weight and height, workplace sitting and physical activity) and psychosocial (knowledge, attitudes, self-efficacy, social support, intention regarding (changing) sitting behaviours) variables at baseline and 1-month follow-up. The product-of-coefficients test of MacKinnon based on multiple linear regression analyses was conducted to examine the mediating role of five psychosocial factors (knowledge, attitudes, self-efficacy, social support, intention). The influence of one self-regulation skill (action planning) in the association between the intervention and self-reported workplace sitting time was investigated via moderation analyses. The intervention had a positive influence on knowledge (p = 0.040), but none of the psychosocial variables did mediate the intervention effect on self-reported workplace sitting. Action planning was found to be a significant moderator (p workplace sitting only occurred in the group completing an action plan. Future interventions aimed at reducing employees' workplace sitting are suggested to focus on self-regulatory skills and promote action planning when using web-based computer-tailored advice. Clinicaltrials.gov NCT02672215 ; (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02672215 ).

  10. The effect of a web-based depression intervention on suicide ideation : secondary outcome from a randomised controlled trial in a helpline

    NARCIS (Netherlands)

    Christensen, Helen; Farrer, Louise; Batterham, Philip J.; Mackinnon, Andrew; Griffiths, Kathleen M.; Donker, Tara

    2013-01-01

    OBJECTIVES: The effect of web-based interventions for depression on suicide ideation in callers to helplines is not known. The aim of this study was to determine if web-based Cognitive Behaviour Therapy (CBT) with and without telephone support is effective in reducing suicide ideation in callers to

  11. The effect of a web-based depression intervention on suicide ideation : Secondary outcome from a randomised controlled trial in a helpline

    NARCIS (Netherlands)

    Christensen, Helen; Farrer, Louise; Batterham, Philip J.; Mackinnon, Andrew; Griffiths, Kathleen M.; Donker, Tara

    2013-01-01

    Objectives: The effect of web-based interventions for depression on suicide ideation in callers to helplines is not known. The aim of this study was to determine if web-based Cognitive Behaviour Therapy (CBT) with and without telephone support is effective in reducing suicide ideation in callers to

  12. A web-based lifestyle intervention for women with recent gestational diabetes mellitus: a randomized controlled trial.

    Science.gov (United States)

    Nicklas, Jacinda M; Zera, Chloe A; England, Lucinda J; Rosner, Bernard A; Horton, Edward; Levkoff, Sue E; Seely, Ellen W

    2014-09-01

    To test the feasibility and effectiveness of a Web-based lifestyle intervention based on the Diabetes Prevention Program modified for women with recent gestational diabetes mellitus to reduce postpartum weight retention. We randomly allocated 75 women with recent gestational diabetes mellitus to either a Web-based lifestyle program (Balance after Baby) delivered over the first postpartum year or to a control group. Primary outcomes were change in body weight at 12 months from 1) first postpartum measured weight; and 2) self-reported prepregnancy weight. There were no significant differences in baseline characteristics between groups including age, body mass index, race, and income status. Women assigned to the Balance after Baby program (n=36, three lost to follow-up) lost a mean of 2.8 kg (95% confidence interval -4.8 to -0.7) from 6 weeks to 12 months postpartum, whereas the control group (n=39, one lost to follow-up) gained a mean of 0.5 kg (-1.4 to +2.4) (P=.022). Women in the intervention were closer to prepregnancy weight at 12 months postpartum (mean change -0.7 kg; -3.5 to +2.2) compared with women in the control arm (+4.0 kg; +1.3 to +6.8) (P=.035). A Web-based lifestyle modification program for women with recent gestational diabetes mellitus decreased postpartum weight retention. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01158131. I.

  13. Web-Based Intervention to Reduce Substance Abuse and Depressive Symptoms in Mexico: Development and Usability Test.

    Science.gov (United States)

    Tiburcio, Marcela; Lara, Ma Asunción; Aguilar Abrego, Araceli; Fernández, Morise; Martínez Vélez, Nora; Sánchez, Alejandro

    2016-09-29

    The development of Web-based interventions for substance abuse in Latin America is a new field of interest with great potential for expansion to other Spanish-speaking countries. This paper describes a project aimed to develop and evaluate the usability of the Web-based Help Program for Drug Abuse and Depression (Programa de Ayuda para Abuso de Drogas y Depresión, PAADD, in Spanish) and also to construct a systematic frame of reference for the development of future Web-based programs. The PAADD aims to reduce substance use and depressive symptoms with cognitive behavioral techniques translated into Web applications, aided by the participation of a counselor to provide support and guidance. This Web-based intervention includes 4 steps: (1) My Starting Point, (2) Where Do I Want to Be? (3) Strategies for Change, and (4) Maintaining Change. The development of the program was an interactive multistage process. The first stage defined the core structure and contents, which were validated in stage 2 by a group of 8 experts in addiction treatment. Programming of the applications took place in stage 3, taking into account 3 types of end users: administrators, counselors, and substance users. Stage 4 consisted of functionality testing. In stage 5, a total of 9 health professionals and 20 drug users currently in treatment voluntarily interacted with the program in a usability test, providing feedback about adjustments needed to improve users' experience. The main finding of stage 2 was the consensus of the health professionals about the cognitive behavioral strategies and techniques included in PAADD being appropriate for changing substance use behaviors. In stage 5, the health professionals found the functionalities easy to learn; their suggestions were related to the page layout, inclusion of confirmation messages at the end of activities, avoiding "read more" links, and providing feedback about every activity. On the other hand, the users said the information presented

  14. The effect of reminders in a web-based intervention study

    DEFF Research Database (Denmark)

    Svensson, M.; Svensson, T.; Hansen, A. W.

    2012-01-01

    Knowledge on effective strategies to encourage participation in epidemiological web-based research is scant. We studied the effects of reminders on overall participation. 3,876 employees were e-mailed a baseline web-based lifestyle questionnaire. Nine months later, a follow-up questionnaire...... was sent. To encourage study participation, 4-5 and 11 e-mail reminders were sent at baseline and follow-up, respectively. Additional reminders (media articles, flyers, SMS etc) were also administered. Reminders (e-mails + additional) were given in low (a parts per thousand currency sign6 reminders......). About 29 % responded before any e-mail reminder, following 26 and 45 % after 1 respective a parts per thousand yen 2 e-mail reminders. Participant characteristics were not related to when the participants responded. The 4-5 e-mail reminders increased total response rate by 15 %, the eleven by 21...

  15. Large multi-centre pilot randomized controlled trial testing a low-cost, tailored, self-help smoking cessation text message intervention for pregnant smokers (MiQuit).

    Science.gov (United States)

    Naughton, Felix; Cooper, Sue; Foster, Katharine; Emery, Joanne; Leonardi-Bee, Jo; Sutton, Stephen; Jones, Matthew; Ussher, Michael; Whitemore, Rachel; Leighton, Matthew; Montgomery, Alan; Parrott, Steve; Coleman, Tim

    2017-07-01

    To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial. Multi-centre, parallel-group, single-blinded, individual randomized controlled trial. Sixteen antenatal clinics in England. Four hundred and seven participants were randomized to the intervention (n = 203) or usual care (n = 204). Eligible women were 5 pre-pregnancy), were able to receive and understand English SMS texts and were not already using text-based cessation support. All participants received a smoking cessation leaflet; intervention participants also received a 12-week programme of individually tailored, automated, interactive, self-help smoking cessation text messages (MiQuit). Seven smoking outcomes, including validated continuous abstinence from 4 weeks post-randomization until 36 weeks gestation, design parameters for a future trial and cost-per-quitter. Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62). There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  16. A cluster randomized control field trial of the ABRACADABRA web-based literacy intervention: Replication and extension of basic findings.

    Directory of Open Access Journals (Sweden)

    Noella Angele Piquette

    2014-12-01

    Full Text Available The present paper reports a cluster randomized control trial evaluation of teaching using ABRACADABRA (ABRA, an evidence-based and web-based literacy intervention (http://abralite.concordia.ca with 107 kindergarten and 96 grade 1 children in 24 classes (12 intervention 12 control classes from all 12 elementary schools in one school district in Canada. Children in the intervention condition received 10-12 hours of whole class instruction using ABRA between pre- and post-test. Hierarchical linear modeling of post-test results showed significant gains in letter-sound knowledge for intervention classrooms over control classrooms. In addition, medium effect sizes were evident for three of five outcome measures favoring the intervention: letter-sound knowledge (d = +.66, phonological blending (d = +.52, and word reading (d = +.52, over effect sizes for regular teaching. It is concluded that regular teaching with ABRA technology adds significantly to literacy in the early elementary years.

  17. Program completion of a web-based tailored lifestyle intervention for adults: differences between a sequential and a simultaneous approach.

    Science.gov (United States)

    Schulz, Daniela N; Schneider, Francine; de Vries, Hein; van Osch, Liesbeth A D M; van Nierop, Peter W M; Kremers, Stef P J

    2012-03-08

    Unhealthy lifestyle behaviors often co-occur and are related to chronic diseases. One effective method to change multiple lifestyle behaviors is web-based computer tailoring. Dropout from Internet interventions, however, is rather high, and it is challenging to retain participants in web-based tailored programs, especially programs targeting multiple behaviors. To date, it is unknown how much information people can handle in one session while taking part in a multiple behavior change intervention, which could be presented either sequentially (one behavior at a time) or simultaneously (all behaviors at once). The first objective was to compare dropout rates of 2 computer-tailored interventions: a sequential and a simultaneous strategy. The second objective was to assess which personal characteristics are associated with completion rates of the 2 interventions. Using an RCT design, demographics, health status, physical activity, vegetable consumption, fruit consumption, alcohol intake, and smoking were self-assessed through web-based questionnaires among 3473 adults, recruited through Regional Health Authorities in the Netherlands in the autumn of 2009. First, a health risk appraisal was offered, indicating whether respondents were meeting the 5 national health guidelines. Second, psychosocial determinants of the lifestyle behaviors were assessed and personal advice was provided, about one or more lifestyle behaviors. Our findings indicate a high non-completion rate for both types of intervention (71.0%; n = 2167), with more incompletes in the simultaneous intervention (77.1%; n = 1169) than in the sequential intervention (65.0%; n = 998). In both conditions, discontinuation was predicted by a lower age (sequential condition: OR = 1.04; P simultaneous condition: OR = 1.04; P sequential condition: OR = 0.86; P = .01; CI = 0.76-0.97; simultaneous condition: OR = 0.49; P sequential intervention, being male (OR = 1.27; P = .04; CI = 1.01-1.59) also predicted dropout

  18. Effectiveness and acceptance of a web-based depression intervention during waiting time for outpatient psychotherapy: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Grünzig, Sasha-Denise; Baumeister, Harald; Bengel, Jürgen; Ebert, David; Krämer, Lena

    2018-05-22

    Due to limited resources, waiting periods for psychotherapy are often long and burdening for those in need of treatment and the health care system. In order to bridge the gap between initial contact and the beginning of psychotherapy, web-based interventions can be applied. The implementation of a web-based depression intervention during waiting periods has the potential to reduce depressive symptoms and enhance well-being in depressive individuals waiting for psychotherapy. In a two-arm randomized controlled trial, effectiveness and acceptance of a guided web-based intervention for depressive individuals on a waitlist for psychotherapy are evaluated. Participants are recruited in several German outpatient clinics. All those contacting the outpatient clinics with the wish to enter psychotherapy receive study information and a depression screening. Those adults (age ≥ 18) with depressive symptoms above cut-off (CES-D scale > 22) and internet access are randomized to either intervention condition (treatment as usual and immediate access to the web-based intervention) or waiting control condition (treatment as usual and delayed access to the web-based intervention). At three points of assessment (baseline, post-treatment, 3-months-follow-up) depressive symptoms and secondary outcomes, such as quality of life, attitudes towards psychotherapy and web-based interventions and adverse events are assessed. Additionally, participants' acceptance of the web-based intervention is evaluated, using measures of intervention adherence and satisfaction. This study investigates a relevant setting for the implementation of web-based interventions, potentially improving the provision of psychological health care. The results of this study contribute to the evaluation of innovative and resource-preserving health care models for outpatient psychological treatment. This trial has been registered on 13 February 2017 in the German clinical trials register (DRKS); registration

  19. The potential of Web-based interventions for heart disease self-management: a mixed methods investigation.

    Science.gov (United States)

    Kerr, Cicely; Murray, Elizabeth; Noble, Lorraine; Morris, Richard; Bottomley, Christian; Stevenson, Fiona; Patterson, David; Peacock, Richard; Turner, Indra; Jackson, Keith; Nazareth, Irwin

    2010-12-02

    Existing initiatives to support patient self-management of heart disease do not appear to be reaching patients most in need. Providing self-management programs over the Internet (web-based interventions) might help reduce health disparities by reaching a greater number of patients. However, it is unclear whether they can achieve this goal and whether their effectiveness might be limited by the digital divide. To explore the effectiveness of a web-based intervention in decreasing inequalities in access to self-management support in patients with coronary heart disease (CHD). Quantitative and qualitative methods were used to explore use made of a web-based intervention over a period of 9 months. Patients with CHD, with or without home Internet access or previous experience using the Internet, were recruited from primary care centers in diverse socioeconomic and ethnic areas of North London, UK. Patients without home Internet were supported in using the intervention at public Internet services. Only 10.6% of eligible patients chose to participate (N=168). Participants were predominantly Caucasian well-educated men, with greater proportions of male and younger CHD patients among participants than were registered at participating primary care practices. Most had been diagnosed with CHD a number of years prior to the study. Relatively few had been newly diagnosed or had experienced a cardiac event in the previous 5 years. Most had home Internet access and prior experience using the Internet. A greater use of the intervention was observed in older participants (for each 5-year age increase, OR 1.25 for no, low or high intervention use, 95% CI, 1.06-1.47) and in those that had home Internet access and prior Internet experience (OR 3.74, 95% CI, 1.52-9.22). Less use was observed in participants that had not recently experienced a cardiac event or diagnosis (≥ 5 years since cardiac event or diagnosis; OR 0.69, 95% CI, 0.50-0.95). Gender and level of education were not

  20. Web-Based Intervention to Teach Developmentally Supportive Care to Parents of Preterm Infants: Feasibility and Acceptability Study.

    Science.gov (United States)

    Luu, Thuy Mai; Xie, Li Feng; Peckre, Perrine; Cote, Sylvana; Karsenti, Thierry; Walker, Claire-Dominique; Gosselin, Julie

    2017-11-30

    Preterm birth affects 8% to 11% of the population and conveys a significant risk of developmental delays. Intervention programs that support child development have been shown to have a positive impact on early motor and cognitive development and on parental well-being. However, these programs are often difficult to implement in a real-life setting due to lack of resources. Hence, our multidisciplinary team developed Mieux Agir au Quotidien (MAQ) to teach developmentally supportive care to parents of preterm infants with the goal of improving child development and parental outcomes. Our intervention included 3 in-person workshops that occurred prior to hospital discharge and a Web-based platform with written and videotaped materials that addressed 5 main themes: (1) infant behavioral cues, (2) flexion positioning; (3) oral feeding support, (4) parent-infant interactions, and (5) anticipation of developmental milestones. This study aimed to test the feasibility and acceptability of the intervention by parents of preterm infants and assess clinical benefits on child neurodevelopment and parental outcomes during the first year of life. A total of 107 infants born at children and investigate how Web-based technologies can efficiently complement individualized intervention to alleviate the burden on health care resources. ©Thuy Mai Luu, Li Feng Xie, Perrine Peckre, Sylvana Cote, Thierry Karsenti, Claire-Dominique Walker, Julie Gosselin. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 30.11.2017.

  1. Guided self-help cognitive-behaviour Intervention for VoicEs (GiVE): Results from a pilot randomised controlled trial in a transdiagnostic sample.

    Science.gov (United States)

    Hazell, Cassie M; Hayward, Mark; Cavanagh, Kate; Jones, Anna-Marie; Strauss, Clara

    2017-10-12

    Few patients have access to cognitive behaviour therapy for psychosis (CBTp) even though at least 16 sessions of CBTp is recommended in treatment guidelines. Briefer CBTp could improve access as the same number of therapists could see more patients. In addition, focusing on single psychotic symptoms, such as auditory hallucinations ('voices'), rather than on psychosis more broadly, may yield greater benefits. This pilot RCT recruited 28 participants (with a range of diagnoses) from NHS mental health services who were distressed by hearing voices. The study compared an 8-session guided self-help CBT intervention for distressing voices with a wait-list control. Data were collected at baseline and at 12weeks with post-therapy assessments conducted blind to allocation. Voice-impact was the pre-determined primary outcome. Secondary outcomes were depression, anxiety, wellbeing and recovery. Mechanism measures were self-esteem, beliefs about self, beliefs about voices and voice-relating. Recruitment and retention was feasible with low study (3.6%) and therapy (14.3%) dropout. There were large, statistically significant between-group effects on the primary outcome of voice-impact (d=1.78; 95% CIs: 0.86-2.70), which exceeded the minimum clinically important difference. Large, statistically significant effects were found on a number of secondary and mechanism measures. Large effects on the pre-determined primary outcome of voice-impact are encouraging, and criteria for progressing to a definitive trial are met. Significant between-group effects on measures of self-esteem, negative beliefs about self and beliefs about voice omnipotence are consistent with these being mechanisms of change and this requires testing in a future trial. Copyright © 2017. Published by Elsevier B.V.

  2. Efficacy of a web-based intervention with mobile phone support in treating depressive symptoms in adults with type 1 and type 2 diabetes: a randomized controlled trial

    NARCIS (Netherlands)

    Nobis, S.; Lehr, D.; Ebert, D.D.; Baumeister, H.; Snoek, F.J.; Riper, H.; Berking, M.

    2015-01-01

    OBJECTIVE: Depression is common in diabetes and linked to adverse health outcomes. This study evaluated the efficacy of a guided web-based intervention in reducing depression in adults with type 1 and type 2 diabetes.

  3. Responding to personalised social norms feedback from a web-based alcohol reduction intervention for students: Analysis of think-aloud verbal protocols.

    Science.gov (United States)

    Marley, S; Bekker, H L; Bewick, B M

    2016-09-01

    Web-based interventions enable organisations to deliver personalised individually tailored brief feedback to individuals without the need of a third party. Web-based interventions are effective in reducing alcohol consumption among university students. There is a paucity of evidence to indicate those who access web-based personalised feedback interventions respond in a way consistent with hypothesised active ingredients. This research uses the think-aloud technique to explore how students respond to instant web-based personalised normative feedback. Between-subjects experimental design employing qualitative methods. Twenty-one UK university students generated think-aloud transcripts while completing a web-based intervention (Unitcheck). This was followed by a semi-structured interview. One coding frame was developed to classify all utterances. Narrative synthesis revealed five meta-themes: active thinking about alcohol use; comparisons with others; beliefs and knowledge about alcohol consumption; inter-relationship between personal codes and context; and engagement with Unitcheck. Students willingly engaged with the online assessment and personalised feedback. Students consciously engaged with the intervention and this engagement prompted students to actively consider their own behaviour, knowledge, perceptions, and to reflect on future behaviour. The ability of web-based personalised feedback interventions to effect change in individual's behaviours is likely related to their ability to encourage cognitive engagement and active processing of the information provided.

  4. The Effectiveness of a Web-Based Computer-Tailored Intervention on Workplace Sitting: A Randomized Controlled Trial.

    Science.gov (United States)

    De Cocker, Katrien; De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel

    2016-05-31

    Effective interventions to influence workplace sitting are needed, as office-based workers demonstrate high levels of continued sitting, and sitting too much is associated with adverse health effects. Therefore, we developed a theory-driven, Web-based, interactive, computer-tailored intervention aimed at reducing and interrupting sitting at work. The objective of our study was to investigate the effects of this intervention on objectively measured sitting time, standing time, and breaks from sitting, as well as self-reported context-specific sitting among Flemish employees in a field-based approach. Employees (n=213) participated in a 3-group randomized controlled trial that assessed outcomes at baseline, 1-month follow-up, and 3-month follow-up through self-reports. A subsample (n=122) were willing to wear an activity monitor (activPAL) from Monday to Friday. The tailored group received an automated Web-based, computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting. The generic group received an automated Web-based generic advice with tips. The control group was a wait-list control condition, initially receiving no intervention. Intervention effects were tested with repeated-measures multivariate analysis of variance. The tailored intervention was successful in decreasing self-reported total workday sitting (time × group: Pleisure time sitting (time × group: P=.03), and in increasing objectively measured breaks at work (time × group: P=.07); this was not the case in the other conditions. The changes in self-reported total nonworkday sitting, sitting during transport, television viewing, and personal computer use, objectively measured total sitting time, and sitting and standing time at work did not differ between conditions. Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion, as the effects of the tailored condition

  5. What are the working mechanisms of a web-based workplace sitting intervention targeting psychosocial factors and action planning?

    Directory of Open Access Journals (Sweden)

    Katrien De Cocker

    2017-05-01

    Full Text Available Abstract Background Office workers demonstrate high levels of sitting on workdays. As sitting is positively associated with adverse health risks in adults, a theory-driven web-based computer-tailored intervention to influence workplace sitting, named ‘Start to Stand,’ was developed. The intervention was found to be effective in reducing self-reported workplace sitting among Flemish employees. The aim of this study was to investigate through which mechanisms the web-based computer-tailored intervention influenced self-reported workplace sitting. Methods Employees (n = 155 participated in a clustered randomised controlled trial and reported socio-demographics (age, gender, education, work-related (hours at work, employment duration, health-related (weight and height, workplace sitting and physical activity and psychosocial (knowledge, attitudes, self-efficacy, social support, intention regarding (changing sitting behaviours variables at baseline and 1-month follow-up. The product-of-coefficients test of MacKinnon based on multiple linear regression analyses was conducted to examine the mediating role of five psychosocial factors (knowledge, attitudes, self-efficacy, social support, intention. The influence of one self-regulation skill (action planning in the association between the intervention and self-reported workplace sitting time was investigated via moderation analyses. Results The intervention had a positive influence on knowledge (p = 0.040, but none of the psychosocial variables did mediate the intervention effect on self-reported workplace sitting. Action planning was found to be a significant moderator (p < 0.001 as the decrease in self-reported workplace sitting only occurred in the group completing an action plan. Conclusions Future interventions aimed at reducing employees’ workplace sitting are suggested to focus on self-regulatory skills and promote action planning when using web-based computer-tailored advice. Trial

  6. Content validity and satisfaction with a caregiver-integrated web-based rehabilitation intervention for persons with stroke.

    Science.gov (United States)

    Blanton, Sarah; Dunbar, Sandra; Clark, Patricia C

    2018-04-01

    Background Family members provide valuable contributions during rehabilitation after stroke, but frequently report higher incidences of burden, depression, and social isolation during caregiving. Thus, effective interventions to reduce stroke impact on the family are needed. Objectives To evaluate the content validity and satisfaction of a caregiver-focused web-based intervention designed to improve stroke survivor physical function while reducing caregiver negative outcomes. Methods Caregivers of individuals with stroke (N = 6) and expert rehabilitation researchers (N = 4) were presented with a novel, web-based intervention (CARE-CITE) designed to foster problem-solving and skill-building while facilitating caregiver involvement during constraint-induced movement therapy. Caregivers rated CARE-CITE for usefulness, ease of use, acceptability, and time to complete. Rehabilitation experts evaluated content for accuracy, feasibility, acceptability, problem relevance and ease of use. Ratings were assessed using a five-point Likert-type response scales (1 = strongly disagree to 5 = strongly agree). Results On average, all caregivers agreed or strongly agreed that the modules were useful (4.42), easy to use (4.60), and acceptable (4.41). Mean total satisfaction score was 4.45, and average review time was 15 min per module. Expert reviewers agreed or strongly agreed that each module was accurate (4.95), feasible (4.8), easy to use (4.86), acceptable (4.96), and had appropriate problem relevance (4.65). Conclusions The CARE-CITE intervention may be a viable program for caregivers of patients with stroke. Currently a pilot study is underway to evaluate the impact of the intervention on caregiver mental health, family conflict around stroke recovery and stroke survivor upper extremity function.

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

    Science.gov (United States)

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

    2015-10-16

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

  8. A Web-based self-management exercise and diet intervention for breast cancer survivors: pilot randomized controlled trial.

    Science.gov (United States)

    Lee, Myung Kyung; Yun, Young Ho; Park, Hyeoun-Ae; Lee, Eun Sook; Jung, Kyung Hae; Noh, Dong-Young

    2014-12-01

    Regular exercise and dietary practices have been shown to affect the health-related quality of life (HRQOL) and survival of breast cancer patients. The current study aimed to investigate whether the WSEDI was a feasible and primarily effective method for promoting exercise and dietary behaviours for breast cancer patients. A 12-week randomized, controlled trial. Oncology outpatient treatment clinics at 3 university hospitals and 1 National Cancer Center in South Korea. Fifty-nine breast cancer patients who had received curative surgery and completed primary cancer treatment within 12 months prior to the study and who had been diagnosed with stage 0-III cancers within 2 years prior to the study were recruited. Participants were randomly assigned to either the intervention group, which used a Web-based self-management exercise and diet intervention program incorporating transtheoretical model (TTM)-based strategies (n=29), or to the control group, which used a 50-page educational booklet on exercise and diet (n=28). The intervention efficacy was measured at the baseline and 12 weeks via a Web-based survey that addressed the promotion of exercise and consumption of 5 servings of fruits and vegetables (F&V) per day, dietary quality, HRQOL, anxiety, depression, fatigue, motivational readiness, and self-efficacy. The proportion of subjects who performed at least moderate-intensity aerobic exercise for at least 150 min per week; ate 5 servings of F&V per day; and had overall improvements in dietary quality, physical functioning and appetite loss (HRQOL), fatigue, and motivational readiness was greater in the intervention group than in the control group. The self-efficacy with respect to exercise and F&V consumption was greater in the intervention group than in the control group. A Web-based program that targets changes in exercise and dietary behaviours might be effective for breast cancer survivors if the TTM theory has been used to inform the program strategy, although

  9. Utilization of services in a randomized trial testing phone- and web-based interventions for smoking cessation.

    Science.gov (United States)

    Zbikowski, Susan M; Jack, Lisa M; McClure, Jennifer B; Deprey, Mona; Javitz, Harold S; McAfee, Timothy A; Catz, Sheryl L; Richards, Julie; Bush, Terry; Swan, Gary E

    2011-05-01

    Phone counseling has become standard for behavioral smoking cessation treatment. Newer options include Web and integrated phone-Web treatment. No prior research, to our knowledge, has systematically compared the effectiveness of these three treatment modalities in a randomized trial. Understanding how utilization varies by mode, the impact of utilization on outcomes, and predictors of utilization across each mode could lead to improved treatments. One thousand two hundred and two participants were randomized to phone, Web, or combined phone-Web cessation treatment. Services varied by modality and were tracked using automated systems. All participants received 12 weeks of varenicline, printed guides, an orientation call, and access to a phone supportline. Self-report data were collected at baseline and 6-month follow-up. Overall, participants utilized phone services more often than the Web-based services. Among treatment groups with Web access, a significant proportion logged in only once (37% phone-Web, 41% Web), and those in the phone-Web group logged in less often than those in the Web group (mean = 2.4 vs. 3.7, p = .0001). Use of the phone also was correlated with increased use of the Web. In multivariate analyses, greater use of the phone- or Web-based services was associated with higher cessation rates. Finally, older age and the belief that certain treatments could improve success were consistent predictors of greater utilization across groups. Other predictors varied by treatment group. Opportunities for enhancing treatment utilization exist, particularly for Web-based programs. Increasing utilization more broadly could result in better overall treatment effectiveness for all intervention modalities.

  10. Development and evaluation of two web-based interventions for the promotion of physical activity in older adults: study protocol for a community-based controlled intervention trial.

    Science.gov (United States)

    Muellmann, Saskia; Bragina, Inna; Voelcker-Rehage, Claudia; Rost, Eric; Lippke, Sonia; Meyer, Jochen; Schnauber, Jochen; Wasmann, Merlin; Toborg, Merle; Koppelin, Frauke; Brand, Tilman; Zeeb, Hajo; Pischke, Claudia R

    2017-05-25

    Regular physical activity (PA) is a key contributor to healthy ageing. However, despite known health benefits, only one third of older adults in Germany reach the PA levels recommended for persons aged 65 years and above by the World Health Organization. The aim of the current study is to evaluate the effectiveness of two web-based interventions for the initiation and maintenance of regular PA (i.e., intervention groups 1 and 2) compared to a delayed intervention control group of older adults aged 65 to 75 years. Study participants will be randomly assigned to one of three study arms in five communities in the Bremen-Oldenburg metropolitan region: a) Participants in the first arm will receive access to a web-based intervention for 10 weeks allowing them to track their weekly PA (subjective self-monitoring, intervention group 1); b) participants in the second arm will receive access to the web-based intervention for 10 weeks and, in addition, track PA using Fitbit Zips (objective self-monitoring, intervention group 2); c) participants in the delayed intervention control group will receive access to the intervention implemented in the first study arm after completion of the 12-week follow-up in the other two groups within each community. In addition, weekly group meetings in the communities will be offered to study participants in the intervention groups providing the opportunity to address questions related to the use of the website and to practice PA in groups (e.g., neighborhood walks, strength and balance exercises). To evaluate short-term effects of the intervention on physical and psychological health, PA, physical fitness, and cognitive and psychological variables will be assessed at baseline and 12-week follow-up. This study will provide answers regarding acceptance and effectiveness of web-based interventions promoting uptake and maintenance of regular PA in persons aged 65-75 years. Study findings will contribute to a growing body of evidence in

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

    Science.gov (United States)

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

    2016-11-03

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

  12. Healthy Beyond Pregnancy, a Web-Based Intervention to Improve Adherence to Postpartum Care: Randomized Controlled Feasibility Trial.

    Science.gov (United States)

    Himes, Katherine Park; Donovan, Heidi; Wang, Stephanie; Weaver, Carrie; Grove, Jillian Rae; Facco, Francesca Lucia

    2017-10-10

    During the postpartum visit, health care providers address issues with short- and long-term implications for maternal and child health. Women with Medicaid insurance are less likely to return for a postpartum visit compared with women with private insurance. Behavioral economics acknowledges that people do not make exclusively rational choices, rather immediate gratification, cognitive and psychological biases, and social norms influence decision making. Drawing on insights from decision science, behavioral economists have examined how these biases can be modulated through carefully designed interventions. We have developed a Web-based tool, Healthy Beyond Pregnancy, that incorporates empirically derived concepts of behavioral economics to improve adherence rates to the postpartum visit. The primary objectives of this pilot study were to (1) refine and assess the usability of Healthy Beyond Pregnancy and (2) assess the feasibility of a randomized controlled trial (RCT) of the intervention. We used a multistep process and multidisciplinary team of maternal-fetal medicine physicians, a behavioral economist, and researchers with expertise in behavioral interventions to design Healthy Beyond Pregnancy. We assessed the usability of the program with the Post-Study System Usability Questionnaire (PSSUQ), a validated 7-point scale, and semistructured interviews with postpartum women. We then conducted a feasibility trial to determine the proportion of eligible women who were willing to participate in an RCT of Healthy Beyond Pregnancy and the proportion of women willing to complete the Web-based program. Exploratory outcomes of the pilot trial included attendance at the postpartum visit, uptake of long-acting reversible contraception, and uptake of any contraception. The median PSSUQ score for Healthy Beyond Pregnancy was 6.5 (interquartile range: 6.1-7) demonstrating high usability. Semistructured interviews (n=10) provided in-depth comments about users' experience and

  13. Features predicting weight loss in overweight or obese participants in a web-based intervention: randomized trial.

    Science.gov (United States)

    Brindal, Emily; Freyne, Jill; Saunders, Ian; Berkovsky, Shlomo; Smith, Greg; Noakes, Manny

    2012-12-12

    Obesity remains a serious issue in many countries. Web-based programs offer good potential for delivery of weight loss programs. Yet, many Internet-delivered weight loss studies include support from medical or nutritional experts, and relatively little is known about purely web-based weight loss programs. To determine whether supportive features and personalization in a 12-week web-based lifestyle intervention with no in-person professional contact affect retention and weight loss. We assessed the effect of different features of a web-based weight loss intervention using a 12-week repeated-measures randomized parallel design. We developed 7 sites representing 3 functional groups. A national mass media promotion was used to attract overweight/obese Australian adults (based on body mass index [BMI] calculated from self-reported heights and weights). Eligible respondents (n = 8112) were randomly allocated to one of 3 functional groups: information-based (n = 183), supportive (n = 3994), or personalized-supportive (n = 3935). Both supportive sites included tools, such as a weight tracker, meal planner, and social networking platform. The personalized-supportive site included a meal planner that offered recommendations that were personalized using an algorithm based on a user's preferences for certain foods. Dietary and activity information were constant across sites, based on an existing and tested 12-week weight loss program (the Total Wellbeing Diet). Before and/or after the intervention, participants completed demographic (including self-reported weight), behavioral, and evaluation questionnaires online. Usage of the website and features was objectively recorded. All screening and data collection procedures were performed online with no face-to-face contact. Across all 3 groups, attrition was high at around 40% in the first week and 20% of the remaining participants each week. Retention was higher for the supportive sites compared to the information-based site only

  14. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    Science.gov (United States)

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  15. Web-based KAP Intervention on Office Ergonomics: A Unique Technique for Prevention of Musculoskeletal Discomfort in Global Corporate Offices.

    Science.gov (United States)

    Madhwani, Kishore P; Nag, P K

    2017-01-01

    The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics - a unique method for prevention of musculoskeletal discomfort (MSD) - in corporate offices that influences behavior modification. With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study. To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible. An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions - baseline evaluation ( n = 240) and a follow-up evaluation after 3 months ( n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment. Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test. Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain

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

    Science.gov (United States)

    2014-01-01

    Background This article describes the systematic development of the I Move intervention: a web-based computer tailored physical activity promotion intervention, aimed at increasing and maintaining physical activity among adults. This intervention is based on the theoretical insights and practical applications of self-determination theory and motivational interviewing. Methods/design Since developing interventions in a systemically planned way increases the likelihood of effectiveness, we used the Intervention Mapping protocol to develop the I Move intervention. In this article, we first describe how we proceeded through each of the six steps of the Intervention Mapping protocol. After that, we describe the content of the I Move intervention and elaborate on the planned randomized controlled trial. Discussion By integrating self-determination theory and motivational interviewing in web-based computer tailoring, the I Move intervention introduces a more participant-centered approach than traditional tailored interventions. Adopting this approach might enhance computer tailored physical activity interventions both in terms of intervention effectiveness and user appreciation. We will evaluate this in an randomized controlled trial, by comparing the I Move intervention to a more traditional web-based computer tailored intervention. Trial registration NTR4129 PMID:24580802

  17. Usage of a generic web-based self-management intervention for breast cancer survivors: substudy analysis of the BREATH trial

    NARCIS (Netherlands)

    Berg, S.W. van den; Peters, E.J.; Kraaijeveld, J.F.; Gielissen, M.F.M.; Prins, J.B.

    2013-01-01

    BACKGROUND: Generic fully automated Web-based self-management interventions are upcoming, for example, for the growing number of breast cancer survivors. It is hypothesized that the use of these interventions is more individualized and that users apply a large amount of self-tailoring. However,

  18. The effect of goal setting on fruit and vegetable consumption and physical activity level in a Web-based intervention.

    Science.gov (United States)

    O'Donnell, Stephanie; Greene, Geoffrey W; Blissmer, Bryan

    2014-01-01

    To explore the relationship between goal setting and fruit and vegetable (FV) consumption and physical activity (PA) in an intervention for college students. Secondary data analysis of intervention group participants from a 10-week online intervention with complete weekly data (n = 724). Outcomes (cups of FV per day and minutes of PA per week) and goals for both behaviors were reported online each week. Weekly differences between goals and behaviors were calculated, as well as the proportion meeting individual goals and meeting recommendations for behaviors. There were significant (P goal setting on both behaviors and of goal group (tertile of meeting weekly goals) on behavior, as well as meeting recommendations for both behaviors. There was an increase in FV consumption (P Goal setting as part of a Web-based intervention for college students was effective, but results differed for FV and PA. Goal setting for maintaining behavior may need to differ from goal setting for changing behavior. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  19. A web-based group course intervention for 15-25-year-olds whose parents have substance use problems or mental illness: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Tobias H. Elgán

    2016-09-01

    Full Text Available Abstract Background Depending on the definitions used, between 5 and 20 % of all Swedish children grow up with at least one parent suffering from alcohol problems, while 6 % have at least one parent who has received inpatient psychiatric care, conditions that may affect the children negatively. Nine out of ten Swedish municipalities therefore provide support resources, but less than 2 % of these children are reached by such support. Delivering intervention programs via the Internet is a promising strategy. However, web-based programs targeting this at-risk group of children are scarce. We have previously developed a 1.5-h-long web-based self-help program, Alcohol & Coping, which appears to be effective with regards to adolescents’ own alcohol consumption. However, there is a need for a more intense program, and therefore we adapted Kopstoring, a comprehensive Dutch web-based psycho-educative prevention program, to fit the Swedish context. The purpose of the program, which in Swedish has been called Grubbel, is to strengthen protective factors, such as coping skills and psychological well-being, prevent the development of psychological disorders, and reduce alcohol consumption. Methods/design The aim of the current study is to evaluate the effectiveness of Grubbel, which targets 15–25-year-olds whose parents have substance use problems and/or mental illness. Specific research questions relate to the participants’ own coping strategies, mental health status and substance use. The study was initiated in the spring of 2016 and uses a two-armed RCT design. Participants will be recruited via social media and also through existing agencies that provide support to this target group. The assessment will consist of a baseline measurement (t0 and three follow-ups after six (t1, 12 (t2, and 24 months (t3. Measures include YSR, CES-DC, Ladder of Life, Brief COPE, AUDIT-C, and WHOQOL-BREF. Discussion Studies have revealed that the majority of

  20. An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children.

    Science.gov (United States)

    Wald, Ellen R; Ewing, Linda J; Moyer, Stacey C L; Eickhoff, Jens C

    2018-05-01

    This prospective, randomized, controlled trial for parents of overweight and obese 3- to 7-year-olds was performed to assess the feasibility of a program promoting healthy eating and lifestyle by targeting parents as agents of change. The intervention was composed of 6-in-person group sessions and a customized website over 12 months. The control group received customary care. The primary outcome was feasibility of the intervention to promote healthy behavior change measured by attendance. The secondary outcome was effectiveness assessed by attaining reduced body mass index (BMI) z scores, healthy behavior changes and increased parent self-efficacy. Seventy-three child-parent dyads were enrolled; 14 parents never attended any sessions. Participation in follow-up assessments did not meet the hypothesized level. Ultimate BMI z scores did not differ between control and intervention groups. Parenting skills did not improve in the intervention group. This intervention to achieve healthy lifestyle changes in children via their parents as "change agents" was unsuccessful.

  1. Web-Based and Mobile Suicide Prevention Interventions for Young People: A Systematic Review

    Science.gov (United States)

    Perry, Yael; Werner-Seidler, Aliza; Calear, Alison L.; Christensen, Helen

    2016-01-01

    Objective: Suicide is a significant public health issue, and is especially concerning in adolescents and young adults, who are over-represented both in attempts and completed suicide. Emerging technologies represent a promising new approach to deliver suicide prevention interventions to these populations. The current systematic review aims to identify online and mobile psychosocial suicide prevention interventions for young people, and evaluate the effectiveness of these interventions. Method: PsycINFO, Medline, Embase and The Cochrane Library were electronically searched for all articles published between January, 2000 and May, 2015. Peer-reviewed journal articles reporting on interventions for young people aged 12–25 years with suicidality as a primary outcome were eligible for inclusion. No exclusions were placed on study design. Results: One study met inclusion criteria, and found significant reductions in the primary outcome of suicidal ideation, as well as depression and hopelessness. Two relevant protocol papers of studies currently underway were also identified. Conclusions: There is a paucity of current evidence for online and mobile interventions for suicide prevention in youth. More high quality empirical evidence is required to determine the effectiveness of these novel approaches to improving suicide outcomes in young people. PMID:27274742

  2. Developing a Web-Based Intervention to Prevent Drug Use among Adolescent Girls

    Science.gov (United States)

    Schwinn, Traci Marie; Hopkins, Jessica Elizabeth; Schinke, Steven Paul

    2016-01-01

    Objectives: Girls' rates of drug use have met up with and, in some instances, surpassed boys' rates. Although girls and boys share risk and protective factors associated with drug use, girls also have gender-specific risks. Interventions to prevent girls' drug use must be tailored to address the dynamics of female adolescence. Methods: One such…

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Discrete Trial Teaching Interventions for Students with Autism: Web-Based Video Modeling for Paraprofessionals

    Science.gov (United States)

    Cardinal, Jennifer R.; Gabrielsen, Terisa P.; Young, Ellie L.; Hansen, Blake D.; Kellems, Ryan; Hoch, Hannah; Nicksic-Springer, Taryn; Knorr, James

    2017-01-01

    Delivering individualized learning interventions to students with autism spectrum disorder (ASD) is daunting for education professionals already stretched to capacity meeting needs of all of their students. Paraprofessionals (paraeducators) can assume integral roles in classroom support and management, but they may not be consistently trained in…

  5. Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention.

    Science.gov (United States)

    Owen, Jason E; Curran, Michaela; Bantum, Erin O'Carroll; Hanneman, Robert

    2016-06-01

    Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (φ = 0.56-0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08-1.84, ps < 0.001) and total time of intervention (Ds = 1.13-1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement.

  6. Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention

    Science.gov (United States)

    Curran, Michaela; Bantum, Erin O'Carroll; Hanneman, Robert

    2016-01-01

    Abstract Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (φ = 0.56–0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08–1.84, ps < 0.001) and total time of intervention (Ds = 1.13–1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement. PMID:27327066

  7. Web-based smoking cessation intervention that transitions from inpatient to outpatient: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Harrington Kathleen F

    2012-08-01

    Full Text Available Abstract Background E-health tools are a new mechanism to expand patient care, allowing supplemental resources to usual care, including enhanced patient-provider communication. These applications to smoking cessation have yet to be tested in a hospitalized patient sample. This project aims to evaluate the effectiveness and cost-effectiveness of a tailored web-based and e-message smoking cessation program for current smokers that, upon hospital discharge, transitions the patient to continue a quit attempt when home (Decide2Quit. Design A randomized two-arm follow-up design will test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post-hospitalization. Methods A total of 1,488 patients aged 19 or older, who smoked cigarettes in the previous 30 days, are being recruited from 27 patient care areas of a large urban university hospital. Study-eligible hospitalized patients receiving usual tobacco cessation usual care are offered study referral. Trained hospital staff assist the 744 patients who are being randomized to the intervention arm with registration and orientation to the intervention website. This e-mail and web-based program offers tailored messages as well as education, self-assessment and planning aids, and social support to promote tobacco use cessation. Condition-blind study staff assess participants for tobacco use history and behaviors, tobacco use cost-related information, co-morbidities and psychosocial factors at 0, 3, 6, and 12 months. The primary outcome is self-reported 30-day tobacco abstinence at 6 months follow-up. Secondary outcomes include 7-day point prevalence quit rates at 3-, 6-, and 12-month follow-up, 30-day point prevalence quit rates at 3 and 12 months, biologically confirmed tobacco abstinence at 6-month follow-up, and multiple point-prevalence quit rates based on self-reported tobacco abstinence rates at each follow-up time period. Healthcare utilization and quality

  8. Web-Based Alcohol Intervention in First-Year College Students: Efficacy of Full-Program Administration Prior to Second Semester.

    Science.gov (United States)

    Gilbertson, Rebecca J; Norton, Tina R; Beery, Susan H; Lee, Kassandra R

    2018-05-12

    Commercially available, web-based interventions for the prevention of alcohol use are being adopted for universal use with first-year college students, yet few have received empirical evaluation. This randomized controlled trial investigated the effectiveness of a novel, commercially available, personalized web-based alcohol intervention, Alcohol-Wise (version 4.0, 3 rd Millennium Classrooms), on multiple measures of alcohol consumption, alcohol consequences, alcohol expectancies, academic achievement, and adaptation to college in first-year students. Participants received Alcohol-Wise either prior to first semester or were waitlisted and received the intervention second semester. As longitudinal effectiveness was of interest, follow-up surveys were conducted 10 weeks (n = 76) and 24 weeks (n = 64) following the web-based alcohol intervention. Completion of Alcohol-Wise had effects on academic achievement. Specifically, at the 24 week follow-up, academic achievement was higher in participants who received the intervention first semester of their freshman year as compared to the waitlist control. The incremental rise in heavy episodic drinking during the first semester of college was also reduced in waitlisted participants by Alcohol-Wise administration prior to second semester. Conclusion/Importance: Implications for the timing of web-based alcohol interventions to include administration prior to both first and second semesters of the freshman year are discussed.

  9. Internet-based treatment for Romanian adults with panic disorder: protocol of a randomized controlled trial comparing a Skype-guided with an unguided self-help intervention (the PAXPD study).

    Science.gov (United States)

    Ciuca, Amalia Maria; Berger, Thomas; Crişan, Liviu George; Miclea, Mircea

    2016-01-14

    Efficacy of self-help internet-based cognitive behavior therapy (ICBT) for anxiety disorders has been confirmed in several randomized controlled trials. However, the amount and type of therapist guidance needed in ICBT are still under debate. Previous studies have shown divergent results regarding the role of therapist guidance and its impact on treatment outcome. This issue is central to the development of ICBT programs and needs to be addressed directly. The present study aims to compare the benefits of regular therapist guidance via online real-time audio-video communication (i.e. Skype) to no therapist guidance during a 12-week Romanian self-help ICBT program for Panic Disorder. Both treatments are compared to a waiting-list control group. A parallel group randomized controlled trial is proposed. The participants, 192 Romanian adults fulfilling diagnostic criteria for panic disorder according to a diagnostic interview, conducted via secured Skype or telephone, are randomly assigned to one of the three conditions: independent use of the internet-based self-help program PAXonline, the same self-help treatment with regular therapist support via secured Skype, and waiting-list control group. The primary outcomes are severity of self-report panic symptoms (PDSS-SR) and diagnostic status (assessors are blind to group assignment), at the end of the intervention (12 weeks) and at follow-up (months 3 and 6). The secondary measures address symptoms of comorbid anxiety disorders, depression, quality of life, adherence and satisfaction with ICBT. Additional measures of socio-demographic characteristics, personality traits, treatment expectancies, catastrophic cognitions, body vigilance and working alliance are considered as potential moderators and/ or mediators of treatment outcome. To the best of our knowledge, the present study is the first effort to investigate the efficacy of a self-help internet-based intervention with therapist guidance via real-time video

  10. Information Architecture of Web-Based Interventions to Improve Health Outcomes: Systematic Review.

    Science.gov (United States)

    Pugatch, Jillian; Grenen, Emily; Surla, Stacy; Schwarz, Mary; Cole-Lewis, Heather

    2018-03-21

    The rise in usage of and access to new technologies in recent years has led to a growth in digital health behavior change interventions. As the shift to digital platforms continues to grow, it is increasingly important to consider how the field of information architecture (IA) can inform the development of digital health interventions. IA is the way in which digital content is organized and displayed, which strongly impacts users' ability to find and use content. While many information architecture best practices exist, there is a lack of empirical evidence on the role it plays in influencing behavior change and health outcomes. Our aim was to conduct a systematic review synthesizing the existing literature on website information architecture and its effect on health outcomes, behavioral outcomes, and website engagement. To identify all existing information architecture and health behavior literature, we searched articles published in English in the following databases (no date restrictions imposed): ACM Digital Library, CINAHL, Cochrane Library, Google Scholar, Ebsco, and PubMed. The search terms used included information terms (eg, information architecture, interaction design, persuasive design), behavior terms (eg, health behavior, behavioral intervention, ehealth), and health terms (eg, smoking, physical activity, diabetes). The search results were reviewed to determine if they met the inclusion and exclusion criteria created to identify empirical research that studied the effect of IA on health outcomes, behavioral outcomes, or website engagement. Articles that met inclusion criteria were assessed for study quality. Then, data from the articles were extracted using a priori categories established by 3 reviewers. However, the limited health outcome data gathered from the studies precluded a meta-analysis. The initial literature search yielded 685 results, which was narrowed down to three publications that examined the effect of information architecture on

  11. The relationship between persuasive technology principles, adherence and effect of web-Based interventions for mental health: A meta-analysis.

    Science.gov (United States)

    Wildeboer, Gina; Kelders, Saskia M; van Gemert-Pijnen, Julia E W C

    2016-12-01

    Research has shown that web-based interventions concerning mental health can be effective, although there is a broad range in effect sizes. Why some interventions are more effective than others is not clear. Persuasive technology is one of the aspects which has a positive influence on changing attitude and/or behavior, and can contribute to better outcomes. According to the Persuasive Systems Design Model there are various principles that can be deployed. It is unknown whether the number and combinations of principles used in a web-based intervention affect the effectiveness. Another issue in web-based interventions is adherence. Little is known about the relationship of adherence on the effectiveness of web-based interventions. This study examines whether there is a relationship between the number and combinations of persuasive technology principles used in web-based interventions and the effectiveness. Also the influence of adherence on effectiveness of web-based interventions is investigated. This study elaborates on the systematic review by [37] and therefore the articles were derived from that study. Only web-based interventions were included that were intended to be used on more than one occasion and studies were excluded when no information on adherence was provided. 48 interventions targeted at mental health were selected for the current study. A within-group (WG) and between-group (BG) meta-analysis were performed and subsequently subgroup analyses regarding the relationship between the number and combinations of persuasive technology principles and effectiveness. The influence of adherence on the effectiveness was examined through a meta-regression analysis. For the WG meta-analysis 40 treatment groups were included. The BG meta-analysis included 19 studies. The mean pooled effect size in the WG meta-analysis was large and significant (Hedges' g=0.94), while for the BG meta-analysis this was moderate to large and significant (Hedges' g=0.78) in favor of

  12. Web-Based Intervention for Women With Type 1 Diabetes in Pregnancy and Early Motherhood: Critical Analysis of Adherence to Technological Elements and Study Design.

    Science.gov (United States)

    Berg, Marie; Linden, Karolina; Adolfsson, Annsofie; Sparud Lundin, Carina; Ranerup, Agneta

    2018-05-02

    Numerous Web-based interventions have been implemented to promote health and health-related behaviors in persons with chronic conditions. Using randomized controlled trials to evaluate such interventions creates a range of challenges, which in turn can influence the study outcome. Applying a critical perspective when evaluating Web-based health interventions is important. The objective of this study was to critically analyze and discuss the challenges of conducting a Web-based health intervention as a randomized controlled trial. The MODIAB-Web study was critically examined using an exploratory case study methodology and the framework for analysis offered through the Persuasive Systems Design model. Focus was on technology, study design, and Web-based support usage, with special focus on the forum for peer support. Descriptive statistics and qualitative content analysis were used. The persuasive content and technological elements in the design of the randomized controlled trial included all four categories of the Persuasive Systems Design model, but not all design principles were implemented. The study duration was extended to a period of four and a half years. Of 81 active participants in the intervention group, a maximum of 36 women were simultaneously active. User adherence varied greatly with a median of 91 individual log-ins. The forum for peer support was used by 63 participants. Although only about one-third of the participants interacted in the forum, there was a fairly rich exchange of experiences and advice between them. Thus, adherence in terms of social interactions was negatively affected by limited active participation due to prolonged recruitment process and randomization effects. Lessons learned from this critical analysis are that technology and study design matter and might mutually influence each other. In Web-based interventions, the use of design theories enables utilization of the full potential of technology and promotes adherence. The

  13. Effectiveness and user experience of web-based interventions for increasing physical activity in people with multiple sclerosis: a comprehensive systematic review protocol.

    Science.gov (United States)

    Dennett, Rachel; Coulter, Elaine; Paul, Lorna; Freeman, Jennifer

    2016-11-01

    The overall aim of this comprehensive systematic review is to explore the use of web-based interventions for increasing physical activity levels in people with a diagnosis of multiple sclerosis (MS).The quantitative objectives are to identify:The qualitative objectives are to.

  14. Effect of a web-based audit and feedback intervention with outreach visits on the clinical performance of multidisciplinary teams: a cluster-randomized trial in cardiac rehabilitation

    NARCIS (Netherlands)

    Gude, Wouter T.; van Engen-Verheul, Mariëtte M.; van der Veer, Sabine N.; Kemps, Hareld M. C.; Jaspers, Monique W. M.; de Keizer, Nicolette F.; Peek, Niels

    2016-01-01

    The objective of this study was to assess the effect of a web-based audit and feedback (A&F) intervention with outreach visits to support decision-making by multidisciplinary teams. We performed a multicentre cluster-randomized trial within the field of comprehensive cardiac rehabilitation (CR) in

  15. Adherence to a Web-Based Physical Activity Intervention for Patients With Knee and/or Hip Osteoarthritis: A Mixed Method Study

    NARCIS (Netherlands)

    Bossen, D.; Buskermolen, M.; Veenhof, C.; de Bakker, D.H.; Dekker, J.

    2013-01-01

    Background: Web-based interventions show promise in promoting a healthy lifestyle, but their effectiveness is hampered by high rates of nonusage. Predictors and reasons for (non)usage are not well known. Identifying which factors are related to usage contributes to the recognition of subgroups who

  16. Evaluation of the web-based computer-tailored FATaintPHAT intervention to promote energy balance among adolescents: Results from a school cluster randomized trial

    NARCIS (Netherlands)

    N.P.M. Ezendam (Nicole); J. Brug (Hans); A. Oenema (Anke)

    2012-01-01

    textabstractObjective: To evaluate the short- and long-term results of FATaintPHAT, a Web-based computer-tailored intervention aiming to increase physical activity, decrease sedentary behavior, and promote healthy eating to contribute to the prevention of excessive weight gain among adolescents.

  17. Evaluation of the Web-Based Computer-Tailored FATaintPHAT Intervention to Promote Energy Balance Among Adolescents Results From a School Cluster Randomized Trial

    NARCIS (Netherlands)

    Ezendam, N.P.M.; Brug, J.; Oenema, A.

    2012-01-01

    Objective: To evaluate the short- and long-term results of FATaintPHAT, a Web-based computer-tailored intervention aiming to increase physical activity, decrease sedentary behavior, and promote healthy eating to contribute to the prevention of excessive weight gain among adolescents. Design: Cluster

  18. A Web-based, educational, quality-of-life intervention for patients with a chronic skin disease: feasibility and acceptance in routine dermatological practice

    NARCIS (Netherlands)

    van Cranenburgh, Oda D.; Smets, Ellen M. A.; de Rie, Menno A.; Sprangers, Mirjam A. G.; de Korte, John

    2015-01-01

    Chronic skin diseases have a negative impact on patients' health-related quality of life (HRQoL). Patient education might contribute to HRQoL improvement. We developed a web-based, educational, HRQoL intervention for patients with a chronic skin disease. We aimed to assess 1) the feasibility of

  19. Web-Based Evidence Based Practice Educational Intervention to Improve EBP Competence among BSN-Prepared Pediatric Bedside Nurses: A Mixed Methods Pilot Study

    Science.gov (United States)

    Laibhen-Parkes, Natasha

    2014-01-01

    For pediatric nurses, their competence in EBP is critical for providing high-quality care and maximizing patient outcomes. The purpose of this pilot study was to assess and refine a Web-based EBP educational intervention focused on improving EBP beliefs and competence in BSN-prepared pediatric bedside nurses, and to examine the feasibility,…

  20. A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors

    NARCIS (Netherlands)

    Kuijpers, W.; Groen, W.G.; Aaronson, N.K.; van Harten, W.H.

    2013-01-01

    Background: Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such

  1. A Systematic Review of Web-Based Interventions for Patient Empowerment and Physical Activity in Chronic Diseases : Relevance for Cancer Survivors

    NARCIS (Netherlands)

    Kuijpers, W.; Groen, W.G.; Aaronson, N.K.; van Harten, Willem H.

    2013-01-01

    Background: Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such

  2. Efficacy of a web-based intervention with mobile phone support in treating depressive symptoms in adults with type 1 and type 2 diabetes

    DEFF Research Database (Denmark)

    Nobis, Stephanie; Lehr, Dirk; Ebert, David D aniel

    2015-01-01

    OBJECTIVE: Depression is common in diabetes and linked to adverse health outcomes. This study evaluated the efficacy of a guided web-based intervention in reducing depression in adults with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 260 participants with diabetes and elev...

  3. Web-based, self-management enhancing interventions with e-diaries and personalized feedback for persons with chronic illness: a tale of three studies.

    NARCIS (Netherlands)

    Nes, A.A.G.; Eide, H.; Kristjánsdóttir, O.B.; Dulmen, S. van

    2013-01-01

    Objective: Chronic illness places high demands on patients. Interventions supporting self-management and providing personalized feedback might help patients to gain new perspectives and enhance use of constructive self-management strategies. We developed three comparable web-based CBT-grounded

  4. Process evaluation of a blended web-based intervention on return to work for sick-listed employees with common mental health problems in the occupational health setting

    NARCIS (Netherlands)

    Volker, D; Zijlstra-Vlasveld, M C; Brouwers, E.P.M.; van der Feltz-Cornelis, C M

    2017-01-01

    Purpose A blended web-based intervention, "eHealth module embedded in collaborative occupational health care" (ECO), aimed at return to work, was developed and found effective in sick-listed employees with common mental disorders. In order to establish the feasibility of ECO, a process evaluation

  5. Short term effectiveness and experiences of a peer guided web-based self-management intervention for young adults with juvenile idiopathic arthritis

    NARCIS (Netherlands)

    J. Ammerlaan (Judy); H. van Os-Medendorp (Harmieke); de Boer-Nijhof, N. (Nienke); Scholtus, L. (Lieske); A.A. Kruize (Aike); P.A. van Pelt (Philomine); B.J. Prakken (Berent); J.W.J. Bijlsma (Hans)

    2017-01-01

    textabstractBackground: A web-based self-management intervention guided by peer-trainers was developed to support young adults' self-management in coping with Juvenile Idiopathic Arthritis (JIA). To investigate its effectiveness, a randomized controlled trial (RCT) was conducted. In addition, the

  6. Adherence to the Mediterranean diet among employees in South West England: Formative research to inform a web-based, work-place nutrition intervention

    Directory of Open Access Journals (Sweden)

    Angeliki Papadaki

    2015-01-01

    Conclusion: Improvement in the consumption of several Mediterranean diet components is needed to increase adherence in this sample of adults. The findings have the potential to inform the development of a web-based intervention that will focus on these foods to promote the Mediterranean diet in work-place settings in South West England.

  7. A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study.

    Science.gov (United States)

    Bjorvatn, Bjørn; Fiske, Eldbjørg; Pallesen, Ståle

    2011-12-01

    The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

  8. Web-based nursing intervention for self-management of pain after cardiac surgery: pilot randomized controlled trial.

    Science.gov (United States)

    Martorella, Géraldine; Côté, José; Racine, Mélanie; Choinière, Manon

    2012-12-14

    Most adults undergoing cardiac surgery suffer from moderate to severe pain for up to 6 days after surgery. Individual barriers and attitudes regarding pain and its relief make patients reluctant to report their pain and ask for analgesic medication, which results in inadequate pain management. More innovative educational interventions for postoperative pain relief are needed. We developed a Web-based nursing intervention to influence patient's involvement in postoperative pain management. The intervention (SOULAGE-TAVIE) includes a preoperative 30-minute Web-based session and 2 brief face-to-face postoperative booster sessions. The Web application generates reflective activities and tailored educational messages according to patients' beliefs and attitudes. The messages are transmitted through videos of a virtual nurse, animations, stories, and texts. The aim of this single-blinded pilot randomized trial was to investigate the preliminary effects of a virtual nursing intervention (SOULAGE-TAVIE) to improve pain relief in patients undergoing cardiac surgery. Participants (N = 60) were adults scheduled for their first cardiac surgery. They were randomly assigned to the experimental group using SOULAGE-TAVIE (n = 30) or the control group using usual care, including an educational pamphlet and postoperative follow-up (n = 30). Data were collected through questionnaires at the time of admission and from day 1 to day 7 after surgery with the help of a blinded research assistant. Outcomes were pain intensity, pain interference with daily activities, patients' pain barriers, tendency to catastrophize in face of pain, and analgesic consumption. The two groups were comparable at baseline across all demographic measures. Results revealed that patients in the experimental group did not experience less intense pain, but they reported significantly less pain interference when breathing/coughing (P = .04). A severe pain interference with breathing/coughing (pain ranked ≥ 7

  9. The Gestational Diabetes Management System (GooDMomS): development, feasibility and lessons learned from a patient-informed, web-based pregnancy and postpartum lifestyle intervention

    OpenAIRE

    Nicholson, Wanda K.; Beckham, A. Jenna; Hatley, Karen; Diamond, Molly; Johnson, La-Shell; Green, Sherri L.; Tate, Deborah

    2016-01-01

    Background Gestational diabetes mellitus (GDM) contributes to the epidemic of diabetes and obesity in mothers and their offspring. The primary objective of this pilot study was to: 1) refine the GDM Management System (GooDMomS), a web-based pregnancy and postpartum behavioral intervention and 2) assess the feasibility of the intervention. Methods In phase 1, ten semi-structured interviews were conducted with women experiencing current or recent GDM mellitus GDM to garner pilot data on the web...

  10. A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors.

    Science.gov (United States)

    Kuijpers, Wilma; Groen, Wim G; Aaronson, Neil K; van Harten, Wim H

    2013-02-20

    Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such interventions are still uncommon for cancer survivors. The objective of this study was to systematically review the literature regarding interactive Web-based interventions. We focused on interventions aimed at increasing patient empowerment and physical activity for various chronic conditions, and explored their possible relevance for cancer survivors. Searches were performed in PubMed, Embase, and Scopus to identify peer-reviewed papers reporting on randomized controlled trials that studied the effects of Web-based interventions. These interventions were developed for adults with diabetes, cardiovascular disease, chronic obstructive pulmonary disease, heart failure, or cancer. Intervention characteristics, effects on patient empowerment and physical activity, information on barriers to and facilitators of intervention use, users' experiences, and methodological quality were assessed. Results were summarized in a qualitative way. We used the recommendations of the Institute of Medicine (IOM) regarding cancer survivorship care to explore the relevance of the interventions for cancer survivors. We included 19 papers reporting on trials with 18 unique studies. Significant, positive effects on patient empowerment were reported by 4 studies and 2 studies reported positive effects on physical activity. The remaining studies yielded mixed results or no significant group differences in these outcomes (ie, no change or improvement for all groups). Although the content, duration, and frequency of interventions varied considerably across studies, commonly used elements included education, self-monitoring, feedback/tailored information, self-management training, personal exercise program, and

  11. What do service users with bipolar disorder want from a web-based self-management intervention? A qualitative focus group study.

    Science.gov (United States)

    Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A

    2013-01-01

    Bipolar disorder (BD) is a chronic and recurrent severe mental health problem. A web-based self-management intervention provides the opportunity to widen access to psychological interventions. This qualitative study aims to identify what an ideal web-based intervention would look like for service users with BD. Twelve service users with BD were recruited in the UK and took part in a series of focus groups to inform and refine the development of a web-based self-management intervention. Reported here is a subset analysis of data gathered with the primary aim of identifying the needs and desires of service users for such an intervention for BD. We analysed service users' responses to questions about content, outcomes, format, barriers and support. Focus groups were transcribed verbatim, and thematic analysis was employed. The data were ordered into four key themes: (1) gaining an awareness of and managing mood swings; (2) not just about managing mood swings: the importance of practical and interpersonal issues; (3) managing living within mood swings without losing the experience; (4) internet is the only format: freely accessible, instant and interactive; (5) professional and peer support to overcome low motivation and procrastination difficulties. The small group of participants are not representative of those living with BD. These findings have significantly enhanced our understanding of what service users with BD want from a web-based self-management intervention and have clear implications for the future development of such approaches. Service users desire a web-based self-management approach that gives them the techniques they need to not only manage their moods but also manage their lives alongside the disorder, including interpersonal and practical issues. Service users describe their primary outcome, not as a cure or reduction in their symptoms, but instead being able to live a fulfilling life alongside their condition. Service users see the internet as their

  12. Factors Associated With Engagement With a Web-Based Lifestyle Intervention Following Provision of Coronary Heart Disease Risk: Mixed Methods Study.

    Science.gov (United States)

    Usher-Smith, Juliet A; Winther, Laura R; Shefer, Guy S; Silarova, Barbora; Payne, Rupert A; Griffin, Simon J

    2017-10-16

    Web-based interventions provide the opportunity to combine the tailored approach of face-to-face interventions with the scalability and cost-effectiveness of public health interventions. This potential is often limited by low engagement. A number of studies have described the characteristics of individuals who engage more in Web-based interventions but few have explored the reasons for these variations. We aimed to explore individual-level factors associated with different degrees of engagement with a Web-based behavior change intervention following provision of coronary heart disease (CHD) risk information, and the barriers and facilitators to engagement. This study involved the secondary analysis of data from the Information and Risk Modification Trial, a randomized controlled trial of a Web-based lifestyle intervention alone, or alongside information on estimated CHD risk. The intervention consisted of three interactive sessions, each lasting up to 60 minutes, delivered at monthly intervals. Participants were characterized as high engagers if they completed all three sessions. Thematic analysis of qualitative data from interviews with 37 participants was combined with quantitative data on usage of the Web-based intervention using a mixed-methods matrix, and data on the views of the intervention itself were analyzed across all participants. Thirteen participants were characterized as low engagers and 24 as high engagers. There was no difference in age (P=.75), gender (P=.95), or level of risk (P=.65) between the groups. Low engagement was more often associated with: (1) reporting a negative emotional reaction in response to the risk score (P=.029), (2) perceiving that the intervention did not provide any new lifestyle information (P=.011), and (3) being less likely to have reported feeling an obligation to complete the intervention as part of the study (P=.019). The mixed-methods matrix suggested that there was also an association between low engagement and less

  13. The development of a web-based brief alcohol intervention in reducing heavy drinking among college students: an Intervention Mapping approach.

    Science.gov (United States)

    Voogt, Carmen V; Poelen, Evelien A P; Kleinjan, Marloes; Lemmers, Lex A C J; Engels, Rutger C M E

    2014-12-01

    In the Netherlands, young adults' drinking practices have become an issue of public concern since their drinking levels are high. Heavy drinking can place young adults at an increased risk for developing short- and long-term health-related problems. Current national alcohol prevention programmes focus mainly on adolescents and their parents and paying less systematic attention to young adults. The present study describes the theory and evidence-based development of a web-based brief alcohol intervention entitled What Do You Drink (WDYD). We applied the Intervention Mapping (IM) protocol to combine theory and evidence in the development and implementation of WDYD. The WDYD intervention aims to detect and reduce heavy drinking of young adults who are willing to decrease their alcohol consumption, preferably below the Dutch guidelines of low-risk drinking. According to the IM protocol, the development of WDYD resulted in a structured intervention. Reducing heavy drinking to low-risk drinking was proposed as the behavioural outcome. Motivational interviewing principles and parts of the I-Change Model were used as methods in the development of WDYD, whereas computer tailoring was selected as main strategy. An effect and a process evaluation of the intervention will be conducted. IM was found to be a practical instrument for developing the WDYD intervention tailored to a specific target population in the area of alcohol prevention. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. PNF 2.0? Initial evidence that gamification can increase the efficacy of brief, web-based personalized normative feedback alcohol interventions.

    Science.gov (United States)

    Boyle, Sarah C; Earle, Andrew M; LaBrie, Joseph W; Smith, Daniel J

    2017-04-01

    Gamified interventions exploit the motivational characteristics of a game in order to provide prevention information and promote behavior change. Despite the modest effect sizes observed in increasingly popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how gamification might be used to enhance efficacy. This study examines whether a novel, gamified PNF intervention format, which includes a point-based reward system, the element of chance, and personal icons to visually represent users, is more effective in reducing short-term alcohol use than the standard web-based style of PNF currently used on college campuses. Two-hundred and thirty-seven college students were randomly assigned to receive either a standard brief, web-based PNF alcohol intervention or the same alcohol intervention components delivered within a Facebook-connected social game called CampusGANDR (Gamified Alcohol Norm Discovery and Readjustment). In both study conditions participants answered identical questions about their perceptions of peer drinking norms and own drinking and then received the same PNF slides. Two weeks following PNF delivery, participants again reported their perceptions of peers' alcohol use and own drinking. Students in the CampusGANDR condition reported significantly reduced peer drinking norms and alcohol use at the two-week follow-up relative to students who received identical PNF delivered by standard online survey. Further, a mediation model demonstrated that this effect was driven by larger reductions in perceived drinking norms among participants assigned to receive CampusGANDR, relative to control. As web-based PNF is becoming an increasingly universal prevention strategy, findings from this study suggest gamification may represent one method by which intervention efficacy could be substantially improved. The potential methodological and economic benefits associated with gamified

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

    Science.gov (United States)

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

    2015-10-09

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

  16. Long term effects of self-determination theory and motivational interviewing in a web-based physical activity intervention: randomized controlled trial.

    Science.gov (United States)

    Friederichs, Stijn A H; Oenema, Anke; Bolman, Catherine; Lechner, Lilian

    2015-08-18

    Our main objective in the current study was to evaluate the long-term effectiveness (12 months from baseline) of I Move (a web-based computer tailored physical activity intervention, based on self-determination theory and motivational interviewing). To this end, we compared I Move to a web-based computer tailored physical activity intervention based on traditional health behavior theories (Active Plus), and to a no-intervention control group. As a secondary objective, the present study aimed to identify participant characteristics that moderate the long term effects of I Move and Active Plus. A randomized controlled trial was conducted, comparing three research conditions: 1) the I Move condition, participants in this condition received I Move; 2) the Active Plus condition, participants in this condition received Active Plus; 3) the control condition; participants in this condition received no intervention and were placed on a waiting list. Main outcome measures were weekly minutes of moderate to vigorous physical activity and weekly days with minimal 30 min of physical activity. All measurements were taken by web-based questionnaires via the study website. Intervention effects were analyzed using multilevel linear regression analyses. At 12 months from baseline, I Move was found to be effective in increasing weekly minutes of moderate to vigorous physical activity (ES = .13), while Active Plus was not. In contrast, Active Plus was found to be effective in increasing weekly days with ≥ 30 min PA at 12 months (ES = .11), while I Move was not. No moderators of the effects of I Move were found. The results suggest that web-based computer tailored physical activity interventions might best include elements based on both self-determination theory/motivational interviewing and traditional health behavioral theories. To be more precise, it is arguable that the focus of the theoretical foundations, used in new web-based PA interventions should depend on the

  17. Do Web-based Mental Health Literacy Interventions Improve the Mental Health Literacy of Adult Consumers? Results From a Systematic Review.

    Science.gov (United States)

    Brijnath, Bianca; Protheroe, Joanne; Mahtani, Kamal Ram; Antoniades, Josefine

    2016-06-20

    Low levels of mental health literacy (MHL) have been identified as an important contributor to the mental health treatment gap. Interventions to improve MHL have used traditional media (eg, community talks, print media) and new platforms (eg, the Internet). Evaluations of interventions using conventional media show improvements in MHL improve community recognition of mental illness as well as knowledge, attitude, and intended behaviors toward people having mental illness. However, the potential of new media, such as the Internet, to enhance MHL has yet to be systematically evaluated. Study aims were twofold: (1) To systematically appraise the efficacy of Web-based interventions in improving MHL. (2) To establish if increases in MHL translated into improvement in individual health seeking and health outcomes as well as reductions in stigma toward people with mental illness. We conducted a systematic search and appraisal of all original research published between 2000 and 2015 that evaluated Web-based interventions to improve MHL. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to report findings. Fourteen studies were included: 10 randomized controlled trials and 4 quasi-experimental studies. Seven studies were conducted in Australia. A variety of Web-based interventions were identified ranging from linear, static websites to highly interactive interventions such as social media games. Some Web-based interventions were specifically designed for people living with mental illness whereas others were applicable to the general population. Interventions were more likely to be successful if they included "active ingredients" such as a structured program, were tailored to specific populations, delivered evidenced-based content, and promoted interactivity and experiential learning. Web-based interventions targeting MHL are more likely to be successful if they include active ingredients. Improvements in MHL see concomitant

  18. Impact of a Web-based intervention on maternal caries transmission and prevention knowledge, and oral health attitudes.

    Science.gov (United States)

    Albert, David; Barracks, Sharifa Z; Bruzelius, Emilie; Ward, Angela

    2014-09-01

    Poor oral health knowledge is thought to significantly contribute to the incidence of early childhood caries, the most common childhood disease in the U.S. This study assessed the effectiveness of a web-based educational program in increasing oral health and caries transmission knowledge, attitudes and planned behavior among mothers and primary caregivers. Study participants were recruited from subscribers to an online health information newsletter distributed by a national dental insurance company and from visitors to a health information website sponsored by the same company. Participants completed pre- and post-intervention surveys and viewed a brief educational program. Results were analyzed for pre- to post-test changes in knowledge and attitudes. Planned behavior change was also assessed. 459 participants completed pre-and post-test surveys. The sample was typically more insured (91.3 %), and college educated (76.9 %), than the general population. At baseline, respondents were knowledgeable about caries and its prevention; however, their specific knowledge about caries transmission was limited. There was a significant increase in caries knowledge from baseline to follow-up, particularly regarding caries transmission. At baseline less than half of the participants (48.8 %) knew that mothers/primary caregivers play a large role in passing cavity causing germs to children and 43.1 % knew that there is a defined period of time when the risk of transmission of cariogenic bacteria is greatest; however in post-testing 99.6 % and 98.3 % answered these question correctly respectively (p education to primary caregivers can be an effective and low cost strategy for promoting maternal and infant oral health.

  19. Mediterranean Diet Adherence and Genetic Background Roles within a Web-Based Nutritional Intervention: The Food4Me Study

    Directory of Open Access Journals (Sweden)

    Rodrigo San-Cristobal

    2017-10-01

    Full Text Available Mediterranean Diet (MedDiet adherence has been proven to produce numerous health benefits. In addition, nutrigenetic studies have explained some individual variations in the response to specific dietary patterns. The present research aimed to explore associations and potential interactions between MedDiet adherence and genetic background throughout the Food4Me web-based nutritional intervention. Dietary, anthropometrical and biochemical data from volunteers of the Food4Me study were collected at baseline and after 6 months. Several genetic variants related to metabolic risk features were also analysed. A Genetic Risk Score (GRS was derived from risk alleles and a Mediterranean Diet Score (MDS, based on validated food intake data, was estimated. At baseline, there were no interactions between GRS and MDS categories for metabolic traits. Linear mixed model repeated measures analyses showed a significantly greater decrease in total cholesterol in participants with a low GRS after a 6-month period, compared to those with a high GRS. Meanwhile, a high baseline MDS was associated with greater decreases in Body Mass Index (BMI, waist circumference and glucose. There also was a significant interaction between GRS and the MedDiet after the follow-up period. Among subjects with a high GRS, those with a high MDS evidenced a highly significant reduction in total carotenoids, while among those with a low GRS, there was no difference associated with MDS levels. These results suggest that a higher MedDiet adherence induces beneficial effects on metabolic outcomes, which can be affected by the genetic background in some specific markers.

  20. Web-based physical activity interventions: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Jahangiry, Leila; Farhangi, Mahdieh Abbasalizad; Shab-Bidar, Sakineh; Rezaei, Fatemeh; Pashaei, T

    2017-11-01

    It was estimated that approximately 60% of the world's population is classified as inactive or insufficiently active. This meta-analysis investigated the effect of web-based interventions on different types of physical activity (PA) measurements in general population and potential moderating variables. PubMed, CINAHL, EBSCOhost, PsycINFO, Scopus, Ovid, and ScienceDirect literature searches were conducted to identify studies investigating the effect of web-based interventions on PA. Randomized controlled trials on PA changes reported in moderate to vigorous intensity, walking, and step count in the intervention group in comparison with the control group were pooled with a fixed-effects model separately. A total of 22 studies comprising 16,476 and 14,475 subjects in intervention and control groups respectively were included. Web-based interventions had positive and significant effect on increasing PA. Of 14 trials reporting moderate to vigorous physical activity (MVPA), five showed a significant increase in the MVPA level after the intervention. There was significant heterogeneity between studies (P < 0.001 and I 2  = 67.8%). Of six trials that reported the number of steps by using the pedometer, three showed a significant increase for the step counts in intervention groups (P < 0.001 and I 2  = 93.3%), of 14 trials assessed PA level by reporting walking minutes per week, four studies showed a significant increase in walking minutes. There was significant heterogeneity between studies (P < 0.001, I 2  = 68.1%). Overall, the effect of web-based interventions seemed to be influenced by the characteristics of mean age of participants, trial duration, and study quality (P < 0.05). The web-based PA interventions had a positive significant effect on increasing all the three types of PA among the general population. However, the effects appear to depend on the design of the study, age, and duration of studies. Copyright © 2017 The Royal Society for Public

  1. Usage of a generic web-based self-management intervention for breast cancer survivors: substudy analysis of the BREATH trial.

    Science.gov (United States)

    van den Berg, Sanne W; Peters, Esmee J; Kraaijeveld, J Frank; Gielissen, Marieke F M; Prins, Judith B

    2013-08-19

    Generic fully automated Web-based self-management interventions are upcoming, for example, for the growing number of breast cancer survivors. It is hypothesized that the use of these interventions is more individualized and that users apply a large amount of self-tailoring. However, technical usage evaluations of these types of interventions are scarce and practical guidelines are lacking. To gain insight into meaningful usage parameters to evaluate the use of generic fully automated Web-based interventions by assessing how breast cancer survivors use a generic self-management website. Final aim is to propose practical recommendations for researchers and information and communication technology (ICT) professionals who aim to design and evaluate the use of similar Web-based interventions. The BREAst cancer ehealTH (BREATH) intervention is a generic unguided fully automated website with stepwise weekly access and a fixed 4-month structure containing 104 intervention ingredients (ie, texts, tasks, tests, videos). By monitoring https-server requests, technical usage statistics were recorded for the intervention group of the randomized controlled trial. Observed usage was analyzed by measures of frequency, duration, and activity. Intervention adherence was defined as continuous usage, or the proportion of participants who started using the intervention and continued to log in during all four phases. By comparing observed to minimal intended usage (frequency and activity), different user groups were defined. Usage statistics for 4 months were collected from 70 breast cancer survivors (mean age 50.9 years). Frequency of logins/person ranged from 0 to 45, total duration/person from 0 to 2324 minutes (38.7 hours), and activity from opening none to all intervention ingredients. 31 participants continued logging in to all four phases resulting in an intervention adherence rate of 44.3% (95% CI 33.2-55.9). Nine nonusers (13%), 30 low users (43%), and 31 high users (44%) were

  2. Participants, usage, and use patterns of a web-based intervention for the prevention of depression within a randomized controlled trial.

    Science.gov (United States)

    Kelders, Saskia M; Bohlmeijer, Ernst T; Van Gemert-Pijnen, Julia Ewc

    2013-08-20

    Although Web-based interventions have been shown to be effective, they are not widely implemented in regular care. Nonadherence (ie, participants not following the intervention protocol) is an issue. By studying the way Web-based interventions are used and whether there are differences between adherers (ie, participants that started all 9 lessons) and nonadherers, more insight can be gained into the process of adherence. The aims of this study were to (1) describe the characteristics of participants and investigate their relationship with adherence, (2) investigate the utilization of the different features of the intervention and possible differences between adherers and nonadherers, and (3) identify what use patterns emerge and whether there are differences between adherers and nonadherers. Data were used from 206 participants that used the Web-based intervention Living to the full, a Web-based intervention for the prevention of depression employing both a fully automated and human-supported format. Demographic and baseline characteristics of participants were collected by using an online survey. Log data were collected within the Web-based intervention itself. Both quantitative and qualitative analyses were performed. In all, 118 participants fully adhered to the intervention (ie, started all 9 lessons). Participants with an ethnicity other than Dutch were more often adherers (χ²₁=5.5, P=.02), and nonadherers used the Internet more hours per day on average (F₁,₂₀₃=3.918, P=.049). A logistic regression showed that being female (OR 2.02, 95% CI 1.01-4.04; P=.046) and having a higher need for cognition (OR 1.02; 95% CI 1.00-1.05; P=.02) increased the odds of adhering to the intervention. Overall, participants logged in an average of 4 times per lesson, but adherers logged in significantly more times per lesson than nonadherers (F₁,₂₀₄=20.710; Ppatterns, we saw that early nonadherers seemed to use fewer sessions and spend less time than late

  3. Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study

    Science.gov (United States)

    Boucher, Sara; Edwards, Olivia; Gray, Andrew; Nada-Raja, Shyamala; Lillis, Jason; Tylka, Tracy L

    2016-01-01

    Background Middle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]). Objectives This pilot study investigated the usage, acceptability, and feasibility of “Mind, Body, Food,” a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills. Methods Participants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention. Results Of the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated “Mind, Body, Food” as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2

  4. Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions.

    Science.gov (United States)

    Baumel, Amit; Faber, Keren; Mathur, Nandita; Kane, John M; Muench, Fred

    2017-03-21

    Studies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined. The aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects. As a first step, a comprehensive systematic review was performed to identify relevant quality rating criteria in line with the PRISMA statement. These criteria were then categorized to create Enlight. The second step involved testing Enlight on 42 mobile apps and 42 Web-based programs (delivery mediums) targeting modifiable behaviors related to medical illness or mental health (clinical aims). A total of 476 criteria from 99 identified sources were used to build Enlight. The rating measures were divided into two sections: quality assessments and checklists. Quality assessments included usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. The checklists included credibility, privacy explanation, basic security, and evidence-based program ranking. The quality constructs exhibited excellent interrater reliability (intraclass correlations=.77-.98, median .91) and internal consistency (Cronbach alphas=.83-.90, median .88), with similar results when separated into delivery mediums or clinical aims. Conditional probability analysis revealed that 100% of the programs that received a score of fair or above (≥3.0) in therapeutic persuasiveness or therapeutic alliance received the same range of scores in user engagement and content-a pattern that did not appear in the opposite direction. Preliminary

  5. Using ecological momentary assessment to test the effectiveness of a web-based brief alcohol intervention over time among heavy-drinking students: randomized controlled trial.

    Science.gov (United States)

    Voogt, Carmen; Kuntsche, Emmanuel; Kleinjan, Marloes; Poelen, Evelien; Engels, Rutger

    2014-01-08

    Web-based brief alcohol interventions are effective in reducing alcohol use among students when measured at limited follow-up time points. To date, no studies have tested Web-based brief alcohol intervention effectiveness over time by using a large number of measurements. Testing whether the What Do You Drink (WDYD) Web-based brief alcohol intervention can sustain a reduction in alcohol use among heavy-drinking students aged 18-24 years at 1-, 3-, and 6-month follow-up intervals. A purely Web-based, 2-arm, parallel-group randomized controlled trial applying an ecological momentary assessment approach with 30 weekly measurements was conducted in the Netherlands (2010-2011). Participants were recruited offline and online. A total of 907 participants were randomized into the experimental condition (n=456) including the single-session and fully automated WDYD intervention, or into the control condition (n=451) including assessment only. Weekly alcohol consumption and frequency of binge drinking were the self-assessed outcome measures. Attrition rates of the 907 participants were 110 (12.1%), 130 (14.3%), and 162 (17.9%) at 1-, 3-, and 6-month follow-up intervals, respectively. Latent growth curve analyses according to the intention-to-treat principle revealed that participants in the experimental condition had significantly lower weekly alcohol consumption compared to participants in the control condition that was sustained at 3-month follow-up (intercept=-2.60, Padmin/rctview.asp?TC=2665 (Archived by WebCite at http://webcitation.org/6LuQVn12M).

  6. Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective.

    Science.gov (United States)

    Trompetter, Hester R; Bohlmeijer, Ernst T; Lamers, Sanne M A; Schreurs, Karlein M G

    2016-01-01

    self-help ACT may not be allocated to chronic pain sufferers experiencing low levels of mental resilience resources such as self-acceptance, goals in life, and environmental mastery. Other subgroups are identified that potentially need specific tailoring of (web-based) ACT. Emotional and psychological wellbeing should receive much more attention in subsequent studies on chronic pain and illness.

  7. Positive psychological wellbeing is required for online self-help Acceptance & Commitment Therapy for chronic pain to be effective.

    Directory of Open Access Journals (Sweden)

    Hester R. Trompetter

    2016-03-01

    suggest that web-based self-help ACT may not be allocated to chronic pain sufferers experiencing low levels of mental resilience resources such as self-acceptance, goals in life, and environmental mastery. Other subgroups are identified that potentially need specific tailoring of (web-based ACT. Emotional and psychological wellbeing should receive much more attention in subsequent studies on chronic pain and illness.

  8. Self-Help Groups and Professional Helpers.

    Science.gov (United States)

    Balgopal, Pallassana R.; And Others

    1986-01-01

    Suggests innovative solutions for mutual benefits for self-help groups and the professionals. Through a derivative paradigm the role of the professional helper within self-help groups is presented. (Author/BL)

  9. The Impact of a Scaffolded Assessment Intervention on Students' Academic Achievement in Web-Based Peer Assessment Activities

    Science.gov (United States)

    Lee, Chien-I; Yang, Ya-Fei; Mai, Shin-Yi

    2016-01-01

    Web-based peer assessment has been considered an important process for learning. However, students may not offer constructive feedback due to lack of expertise knowledge. Therefore, this study proposed a scaffolded assessment approach accordingly. To evaluate the effectiveness of the proposed approach, the quasi-experimental design was employed to…

  10. My Activity Coach - using video-coaching to assist a web-based computer-tailored physical activity intervention: a randomised controlled trial protocol.

    Science.gov (United States)

    Alley, Stephanie; Jennings, Cally; Plotnikoff, Ronald C; Vandelanotte, Corneel

    2014-07-21

    There is a need for effective population-based physical activity interventions. The internet provides a good platform to deliver physical activity interventions and reach large numbers of people at low cost. Personalised advice in web-based physical activity interventions has shown to improve engagement and behavioural outcomes, though it is unclear if the effectiveness of such interventions may further be improved when providing brief video-based coaching sessions with participants. The purpose of this study is to determine the effectiveness, in terms of engagement, retention, satisfaction and physical activity changes, of a web-based and computer-tailored physical activity intervention with and without the addition of a brief video-based coaching session in comparison to a control group. Participants will be randomly assigned to one of three groups (tailoring + online video-coaching, tailoring-only and wait-list control). The tailoring + video-coaching participants will receive a computer-tailored web-based physical activity intervention ('My Activity Coach') with brief coaching sessions with a physical activity expert over an online video calling program (e.g. Skype). The tailoring-only participants will receive the intervention but not the counselling sessions. The primary time point's for outcome assessment will be immediately post intervention (week 9). The secondary time points will be at 6 and 12 months post-baseline. The primary outcome, physical activity change, will be assessed via the Active Australia Questionnaire (AAQ). Secondary outcome measures include correlates of physical activity (mediators and moderators), quality of life (measured via the SF-12v2), participant satisfaction, engagement (using web-site user statistics) and study retention. Study findings will inform researchers and practitioners about the feasibility and effectiveness of brief online video-coaching sessions in combination with computer-tailored physical activity advice

  11. Psychophysiological effects of a web-based stress management system: a prospective, randomized controlled intervention study of IT and media workers [ISRCTN54254861].

    Science.gov (United States)

    Hasson, Dan; Anderberg, Ulla Maria; Theorell, Töres; Arnetz, Bengt B

    2005-07-25

    The aim of the present study was to assess possible effects on mental and physical well-being and stress-related biological markers of a web-based health promotion tool. A randomized, prospectively controlled study was conducted with before and after measurements, involving 303 employees (187 men and 116 women, age 23-64) from four information technology and two media companies. Half of the participants were offered web-based health promotion and stress management training (intervention) lasting for six months. All other participants constituted the reference group. Different biological markers were measured to detect possible physiological changes. After six months the intervention group had improved statistically significantly compared to the reference group on ratings of ability to manage stress, sleep quality, mental energy, concentration ability and social support. The anabolic hormone dehydroepiandosterone sulphate (DHEA-S) decreased significantly in the reference group as compared to unchanged levels in the intervention group. Neuropeptide Y (NPY) increased significantly in the intervention group compared to the reference group. Chromogranin A (CgA) decreased significantly in the intervention group as compared to the reference group. Tumour necrosis factor alpha (TNFalpha) decreased significantly in the reference group compared to the intervention group. Logistic regression analysis revealed that group (intervention vs. reference) remained a significant factor in five out of nine predictive models. The results indicate that an automatic web-based system might have short-term beneficial physiological and psychological effects and thus might be an opportunity in counteracting some clinically relevant and common stress and health issues of today.

  12. Psychophysiological effects of a web-based stress management system: A prospective, randomized controlled intervention study of IT and media workers [ISRCTN54254861

    Directory of Open Access Journals (Sweden)

    Theorell Töres

    2005-07-01

    Full Text Available Abstract Background The aim of the present study was to assess possible effects on mental and physical well-being and stress-related biological markers of a web-based health promotion tool. Methods A randomized, prospectively controlled study was conducted with before and after measurements, involving 303 employees (187 men and 116 women, age 23–64 from four information technology and two media companies. Half of the participants were offered web-based health promotion and stress management training (intervention lasting for six months. All other participants constituted the reference group. Different biological markers were measured to detect possible physiological changes. Results After six months the intervention group had improved statistically significantly compared to the reference group on ratings of ability to manage stress, sleep quality, mental energy, concentration ability and social support. The anabolic hormone dehydroepiandosterone sulphate (DHEA-S decreased significantly in the reference group as compared to unchanged levels in the intervention group. Neuropeptide Y (NPY increased significantly in the intervention group compared to the reference group. Chromogranin A (CgA decreased significantly in the intervention group as compared to the reference group. Tumour necrosis factor α (TNFα decreased significantly in the reference group compared to the intervention group. Logistic regression analysis revealed that group (intervention vs. reference remained a significant factor in five out of nine predictive models. Conclusion The results indicate that an automatic web-based system might have short-term beneficial physiological and psychological effects and thus might be an opportunity in counteracting some clinically relevant and common stress and health issues of today.

  13. Efficacy and cost-effectiveness of a web-based intervention with mobile phone support to treat depressive symptoms in adults with diabetes mellitus type 1 and type 2: design of a randomised controlled trial.

    Science.gov (United States)

    Nobis, Stephanie; Lehr, Dirk; Ebert, David Daniel; Berking, Matthias; Heber, Elena; Baumeister, Harald; Becker, Annette; Snoek, Frank; Riper, Heleen

    2013-11-15

    A diagnosis of diabetes mellitus types 1 or 2 doubles the odds of a comorbid depressive disorder. The combined diseases have a wide range of adverse outcomes, such as a lower quality of life, poorer diabetes outcomes and increased healthcare utilisation. Diabetes patients with depression can be treated effectively with psychotherapy, but access to psychological care is limited. In this study we will examine the efficacy and cost-effectiveness of a newly developed web-based intervention (GET.ON Mood Enhancer Diabetes) for people with diabetes and comorbid depressive symptoms. A two-arm randomised controlled trial will be conducted. Adults with diabetes (type 1 or type 2) with increased depression scores (> 22 on the German version of the Center for Epidemiological Studies Depression Scale (CES-D)) will be included. Eligible participants will be recruited through advertisement in diabetes patient journals and via a large-scale German health insurance company. The participants will be randomly assigned to either a 6-week minimally guided web-based self-help program or an online psychoeducation program on depression. The study will include 260 participants, which will enable us to detect a statistically significant difference with a group effect size of d = 0.35 at a power of 80% and a significance level of p = 0.05. The primary outcome measure will be the level of depression as assessed by the CES-D. The secondary outcome measures will be: diabetes-specific emotional distress, glycaemic control, self-management behaviour and the participants' satisfaction with the intervention. Online self-assessments will be collected at baseline and after a 2 months period, with additional follow-up measurements 6 and 12 months after randomisation. The data will be analysed on an intention-to-treat basis and per protocol. In addition, we will conduct an economic evaluation from a societal perspective. If this intervention is shown to be cost-effective, it has considerable potential

  14. 'Care for Stroke', a web-based, smartphone-enabled educational intervention for management of physical disabilities following stroke: feasibility in the Indian context.

    Science.gov (United States)

    Sureshkumar, K; Murthy, G V S; Munuswamy, Suresh; Goenka, Shifalika; Kuper, Hannah

    2015-07-01

    Stroke rehabilitation is a process targeted towards restoration or maintenance of the physical, mental, intellectual and social abilities of an individual affected by stroke. Unlike high-income countries, the resources for stroke rehabilitation are very limited in many low-income and middle-income countries (LMICs). Provision of cost-effective, post-stroke multidisciplinary rehabilitation services for the stroke survivors therefore becomes crucial to address the unmet needs and growing magnitude of disability experienced by the stroke survivors in LMICs. In order to meet the growing need for post-stroke rehabilitation services in India, we developed a web-based Smartphone-enabled educational intervention for management of physical disabilities following a stroke. On the basis of the findings from the rehabilitation needs assessment study, guidance from the expert group and available evidence from systematic reviews, the framework of the intervention content was designed. Web-based application designing and development by Professional application developers were subsequently undertaken. The application is called 'Care for Stroke'. It is a web-based educational intervention for management of physical disabilities following a stroke. This intervention is developed for use by the Stroke survivors who have any kind of rehabilitation needs to independently participate in his/her family and social roles. 'Care for stroke' is an innovative intervention which could be tested not just for its feasibility and acceptability but also for its clinical and cost-effectiveness through rigorously designed, randomised clinical trials. It is very important to test this intervention in LMICs where the rehabilitation and information needs of the stroke survivors seem to be substantial and largely unmet.

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

    Science.gov (United States)

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

    2016-08-11

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

  16. Innovatively Supporting Teachers' Implementation of School-Based Sex Education: Developing A Web-Based Coaching Intervention From Problem to Solution.

    Science.gov (United States)

    Schutte, Lisette; van den Borne, Marieke; Kok, Gerjo; Meijer, Suzanne; Mevissen, Fraukje Ef

    2016-07-12

    Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. Teacher's implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher's actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching intervention was developed based on a concept

  17. Innovatively Supporting Teachers’ Implementation of School-Based Sex Education: Developing A Web-Based Coaching Intervention From Problem to Solution

    Science.gov (United States)

    Kok, Gerjo; Meijer, Suzanne; Mevissen, Fraukje EF

    2016-01-01

    Background Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. Objective The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. Methods The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. Results Teacher’s implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher’s actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching

  18. A comparison of live counseling with a web-based lifestyle and medication intervention to reduce coronary heart disease risk: a randomized clinical trial.

    Science.gov (United States)

    Keyserling, Thomas C; Sheridan, Stacey L; Draeger, Lindy B; Finkelstein, Eric A; Gizlice, Ziya; Kruger, Eliza; Johnston, Larry F; Sloane, Philip D; Samuel-Hodge, Carmen; Evenson, Kelly R; Gross, Myron D; Donahue, Katrina E; Pignone, Michael P; Vu, Maihan B; Steinbacher, Erika A; Weiner, Bryan J; Bangdiwala, Shrikant I; Ammerman, Alice S

    2014-07-01

    Most primary care clinicians lack the skills and resources to offer effective lifestyle and medication (L&M) counseling to reduce coronary heart disease (CHD) risk. Thus, effective and feasible CHD prevention programs are needed for typical practice settings. To assess the effectiveness, acceptability, and cost-effectiveness of a combined L&M intervention to reduce CHD risk offered in counselor-delivered and web-based formats. A comparative effectiveness trial in 5 diverse family medicine practices in North Carolina. Participants were established patients, aged 35 to 79 years, with no known cardiovascular disease, and at moderate to high risk for CHD (10-year Framingham Risk Score [FRS], ≥10%). Participants were randomized to counselor-delivered or web-based format, each including 4 intensive and 3 maintenance sessions. After randomization, both formats used a web-based decision aid showing potential CHD risk reduction associated with L&M risk-reducing strategies. Participants chose the risk-reducing strategies they wished to follow. The primary outcome was within-group change in FRS at 4-month follow-up. Other measures included standardized assessments of blood pressure, blood lipid levels, lifestyle behaviors, and medication adherence. Acceptability and cost-effectiveness were also assessed. Outcomes were assessed at 4 and 12 months. Of 2274 screened patients, 385 were randomized (192 counselor; 193 web): mean age, 62 years; 24% African American; and mean FRS, 16.9%. Follow-up at 4 and 12 months included 91% and 87% of the randomized participants, respectively. There was a sustained reduction in FRS at both 4 months (primary outcome) and 12 months for both counselor-based (-2.3% [95% CI, -3.0% to -1.6%] and -1.9% [95% CI, -2.8% to -1.1%], respectively) and web-based groups (-1.5% [95% CI, -2.2% to -0.9%] and -1.7% [95% CI, -2.6% to -0.8%] respectively). At 4 months, the adjusted difference in FRS between groups was -1.0% (95% CI, -1.8% to -0.1%) (P = .03

  19. User-experiences with a web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion : a qualitative study

    NARCIS (Netherlands)

    Köhle, Nadine; Drossaert, Constance H.C.; Jaran, Jasmijn; Schreurs, Karlein M.G.; Leeuw, Irma M.Verdonck de; Bohlmeijer, Ernst T.

    2017-01-01

    Background: Partners of cancer patients are the cornerstone of supportive cancer care. They assume different roles and responsibilities that optimally support the patient. Such support is highly demanding, and many partners report (mental) health problems. However, many of them do not use

  20. A Visualization Tool to Analyse Usage of Web-Based Interventions: The Example of Positive Online Weight Reduction (POWeR)

    Science.gov (United States)

    Smith, Emily; Bradbury, Katherine; Morrison, Leanne; Dennison, Laura; Michaelides, Danius; Yardley, Lucy

    2015-01-01

    Background Attrition is a significant problem in Web-based interventions. Consequently, this research aims to identify the relation between Web usage and benefit from such interventions. A visualization tool has been developed that enables researchers to more easily examine large datasets on intervention usage that can be difficult to make sense of using traditional descriptive or statistical techniques alone. Objective This paper demonstrates how the visualization tool was used to explore patterns in participants’ use of a Web-based weight management intervention, termed "positive online weight reduction (POWeR)." We also demonstrate how the visualization tool can be used to perform subsequent statistical analyses of the association between usage patterns, participant characteristics, and intervention outcome. Methods The visualization tool was used to analyze data from 132 participants who had accessed at least one session of the POWeR intervention. Results There was a drop in usage of optional sessions after participants had accessed the initial, core POWeR sessions, but many users nevertheless continued to complete goal and weight reviews. The POWeR tools relating to the food diary and steps diary were reused most often. Differences in participant characteristics and usage of other intervention components were identified between participants who did and did not choose to access optional POWeR sessions (in addition to the initial core sessions) or reuse the food and steps diaries. Reuse of the steps diary and the getting support tools was associated with greater weight loss. Conclusions The visualization tool provided a quick and efficient method for exploring patterns of Web usage, which enabled further analyses of whether different usage patterns were associated with participant characteristics or differences in intervention outcome. Further usage of visualization techniques is recommended to (1) make sense of large datasets more quickly and efficiently; (2

  1. Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention.

    Science.gov (United States)

    Musiat, Peter; Conrod, Patricia; Treasure, Janet; Tylee, Andre; Williams, Chris; Schmidt, Ulrike

    2014-01-01

    A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders. To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students. Students were recruited online (n=1047, age: M=21.8, SD=4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n=519) or a control intervention (n=528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes. Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (pmental disorders with a low-intensity intervention. ControlledTrials.com ISRCTN14342225.

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

    Science.gov (United States)

    Jacobs, Niels C L; Völlink, Trijntje; Dehue, Francine; Lechner, Lilian

    2014-04-24

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

  3. Targeted Prevention of Common Mental Health Disorders in University Students: Randomised Controlled Trial of a Transdiagnostic Trait-Focused Web-Based Intervention

    Science.gov (United States)

    Musiat, Peter; Conrod, Patricia; Treasure, Janet; Tylee, Andre; Williams, Chris; Schmidt, Ulrike

    2014-01-01

    Background A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders. Aims To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students. Method Students were recruited online (n = 1047, age: M = 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes. Results Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (pstudents at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating. Conclusions This study suggests that a transdiagnostic web-based intervention for

  4. Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention.

    Directory of Open Access Journals (Sweden)

    Peter Musiat

    Full Text Available BACKGROUND: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders. AIMS: To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students. METHOD: Students were recruited online (n=1047, age: M=21.8, SD=4.2 and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n=519 or a control intervention (n=528 using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225. Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9 and Generalised Anxiety Disorder Scale (GAD7. Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes. RESULTS: Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98] and anxiety scores by 2.87 (p=.018, 95%CI [1.31, 4.43] in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression and 0.42 (anxiety. In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating. CONCLUSIONS

  5. Effects of a stand-alone web-based electronic screening and brief intervention targeting alcohol use in university students of legal drinking age: A randomized controlled trial.

    Science.gov (United States)

    Ganz, Thomas; Braun, Michael; Laging, Marion; Schermelleh-Engel, Karin; Michalak, Johannes; Heidenreich, Thomas

    2018-02-01

    Many intervention efforts targeting student drinking were developed to address US college students, which usually involves underage drinking. It remains unclear, if research evidence from these interventions is generalizable to university and college students of legal drinking age, e.g., in Europe. To evaluate the effectiveness of a translated and adapted version of the eCHECKUP TO GO, applied as stand-alone web-based electronic screening and brief intervention (e-SBI), in German university students at risk for hazardous drinking. A fully automated web-based two-arm parallel-group randomized controlled trial was conducted. Participants were randomized to an e-SBI or assessment-only (AO) condition. The current paper analyzed students with baseline AUDIT-C scores ≥3 for women and ≥4 for men (sample at baseline: e-SBI [n=514], AO [n=467]; 3-month follow-up: e-SBI [n=194], AO [n=231]; 6-month follow-up: e-SBI [n=146], AO [n=200]). The primary outcome was prior four weeks' alcohol consumption. Secondary outcomes were frequency of heavy drinking occasions, peak blood alcohol concentration, and number of alcohol-related problems. Mixed linear model analyses revealed significant interaction effects between groups and time points on the primary outcome after 3 and 6months. Compared to students in the AO condition, students in the e-SBI condition reported consuming 4.11 fewer standard drinks during the previous four weeks after 3months, and 4.78 fewer standard drinks after 6months. Mixed results were found on secondary outcomes. The results indicate that evidence on and knowledge of web-based e-SBIs based on US college student samples is transferable to German university students of legal drinking age. However, knowledge of what motivates students to complete programs under voluntary conditions, although rare, is needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-04-11

    Web-based computer-tailored interventions for multiple health behaviors can improve the strength of behavior habits in people who want to reduce their cardiovascular risk. Nonetheless, few randomized controlled trials have tested this assumption to date. The study aim was to test an 8-week Web-based computer-tailored intervention designed to improve habit strength for physical activity and fruit and vegetable consumption among people who want to reduce their cardiovascular risk. In a randomized controlled design, self-reported changes in perceived habit strength, self-efficacy, and planning across different domains of physical activity as well as fruit and vegetable consumption were evaluated. This study was a randomized controlled trial involving an intervention group (n=403) and a waiting control group (n=387). Web-based data collection was performed in Germany and the Netherlands during 2013-2015. The intervention content was based on the Health Action Process Approach and involved personalized feedback on lifestyle behaviors, which indicated whether participants complied with behavioral guidelines for physical activity and fruit and vegetable consumption. There were three Web-based assessments: baseline (T0, N=790), a posttest 8 weeks after the baseline (T1, n=206), and a follow-up 3 months after the baseline (T2, n=121). Data analysis was conducted by analyzing variances and structural equation analysis. Significant group by time interactions revealed superior treatment effects for the intervention group, with substantially higher increases in self-reported habit strength for physical activity (F1,199=7.71, P=.006, Cohen's d=0.37) and fruit and vegetable consumption (F1,199=7.71, P=.006, Cohen's d=0.30) at posttest T1 for the intervention group. Mediation analyses yielded behavior-specific sequential mediator effects for T1 planning and T1 self-efficacy between the intervention and habit strength at follow-up T2 (fruit and vegetable consumption: beta=0.12, 95

  7. Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition.

    Science.gov (United States)

    O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C; Moynihan, Paula

    2016-08-03

    Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention

  8. Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition

    Science.gov (United States)

    O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C

    2016-01-01

    Background Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. Objective The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Methods Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. Results The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local

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

    Science.gov (United States)

    2014-01-01

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

  10. Reduction in Vegetable Intake Disparities With a Web-Based Nutrition Education Intervention Among Lower-Income Adults in Japan: Randomized Controlled Trial.

    Science.gov (United States)

    Nakamura, Saki; Inayama, Takayo; Harada, Kazuhiro; Arao, Takashi

    2017-11-24

    No existing Web-based nutrition education interventions have been evaluated in light of socioeconomic status just in Japan. The aim was to investigate the effect of a Web-based intervention program on reducing vegetable intake disparities between low- and middle-income Japanese adults. In this randomized controlled trial, participants were assessed at three time points-baseline, postintervention (5 weeks later), and a follow-up after 3 months-from October 2015 to March 2016. We collected data via a Japanese online research service company from 8564 adults aged 30 to 59 years. Participants were stratified according to national population statistics for gender and age, and randomly selected. They were then randomly allocated into intervention (n=900) and control (n=600) groups such that both groups contained an equal number of individuals with low and middle income. The intervention program encouraged behavior change using behavioral theories and techniques tailored to their assumed stage of change. The outcome was vegetable intake servings per day (1 serving being approximately 70 g). Out of 900 participants who started, 450 were from the middle income group (of which 386 or 85.7% completed the intervention), and 450 were from the low income group (of which 371 or 82.4% completed). In the intervention group, vegetable intake increased in the low-income participants from baseline to postintervention (0.42 servings, 95% CI 0.11-0.72). A two-way analysis of variance showed that low-income participants had significant main effects of group (η2=0.04, P=.01) and time (η2=0.01, Pincome participants also had a significant main effect of time (η2=0.01, P=.006) and a significant interaction (η2=0.01, P=.046). This Web-based nutritional education intervention could fill the vegetable intake gap between low- and middle-income adults in Japan, and is expected to prevent noncommunicable and lifestyle-related diseases. Further intervention program improvements are necessary to

  11. Outsmart HPV: Acceptability and short-term effects of a web-based HPV vaccination intervention for young adult gay and bisexual men.

    Science.gov (United States)

    McRee, Annie-Laurie; Shoben, Abigail; Bauermeister, Jose A; Katz, Mira L; Paskett, Electra D; Reiter, Paul L

    2018-01-10

    Effective interventions to promote human papillomavirus (HPV) vaccination are needed, particularly among populations at increased risk of HPV-related disease. We developed and pilot tested a web-based intervention, Outsmart HPV, to promote HPV vaccination among young gay and bisexual men (YGBM). In 2016, we recruited a national sample (n = 150) of YGBM ages 18-25 in the United States who had not received any doses of HPV vaccine. Participants were randomized to receive either standard HPV vaccination information (control) or population-targeted, individually-tailored content (Outsmart HPV intervention). We assessed between group differences in HPV vaccination attitudes and beliefs immediately following the intervention using multiple linear regression. There were no differences in HPV vaccination attitudes, beliefs and intentions between groups at baseline. Compared to participants in the control group, intervention participants reported: greater perception that men who have sex with men are at higher risk for anal cancer relative to other men (b = 0.34); greater HPV vaccination self-efficacy (b = 0.15); and fewer perceived harms of HPV vaccine (b = -0.34) on posttest surveys (all p HPV intervention (all > 4.4 on a 5-point scale). Findings from this study provide preliminary support for a brief, tailored web-based intervention in improving HPV vaccination attitudes and beliefs among YGBM. An important next step is to determine the effects of Outsmart HPV on HPV vaccine uptake. ClinicalTrials.gov identifier NCT02835755. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Exposure to a patient-centered, Web-based intervention for managing cancer symptom and quality of life issues: impact on symptom distress.

    Science.gov (United States)

    Berry, Donna L; Blonquist, Traci M; Patel, Rupa A; Halpenny, Barbara; McReynolds, Justin

    2015-06-03

    Effective eHealth interventions can benefit a large number of patients with content intended to support self-care and management of both chronic and acute conditions. Even though usage statistics are easily logged in most eHealth interventions, usage or exposure has rarely been reported in trials, let alone studied in relationship to effectiveness. The intent of the study was to evaluate use of a fully automated, Web-based program, the Electronic Self Report Assessment-Cancer (ESRA-C), and how delivery and total use of the intervention may have affected cancer symptom distress. Patients at two cancer centers used ESRA-C to self-report symptom and quality of life (SxQOL) issues during therapy. Participants were randomized to ESRA-C assessment only (control) or the ESRA-C intervention delivered via the Internet to patients' homes or to a tablet at the clinic. The intervention enabled participants to self-monitor SxQOL and receive self-care education and customized coaching on how to report concerns to clinicians. Overall and voluntary intervention use were defined as having ≥2 exposures, and one non-prompted exposure to the intervention, respectively. Factors associated with intervention use were explored with Fisher's exact test. Propensity score matching was used to select a sample of control participants similar to intervention participants who used the intervention. Analysis of covariance (ANCOVA) was used to compare change in Symptom Distress Scale (SDS-15) scores from pre-treatment to end-of-study by groups in the matched sample. Radiation oncology participants used the intervention, overall and voluntarily, more than medical oncology and transplant participants. Participants who were working and had more than a high school education voluntarily used the intervention more. The SDS-15 score was reduced by an estimated 1.53 points (P=.01) in the intervention group users compared to the matched control group. The intended effects of a Web-based, patient

  13. A Self-Paced, Web-Based, Positive Emotion Skills Intervention for Reducing Symptoms of Depression: Protocol for Development and Pilot Testing of MARIGOLD.

    Science.gov (United States)

    Cheung, Elaine O; Addington, Elizabeth L; Bassett, Sarah M; Schuette, Stephanie A; Shiu, Eva W; Cohn, Michael A; Leykin, Yan; Saslow, Laura R; Moskowitz, Judith T

    2018-06-05

    Living with elevated symptoms of depression can have debilitating consequences for an individual's psychosocial and physical functioning, quality of life, and health care utilization. A growing body of evidence demonstrates that skills for increasing positive emotion can be helpful to individuals with depression. Although Web-based interventions to reduce negative emotion in individuals with depression are available, these interventions frequently suffer from poor retention and adherence and do not capitalize on the potential benefits of increasing positive emotion. The aim of this study was to develop and test a Web-based positive emotion skills intervention tailored for individuals living with elevated depressive symptoms, as well as to develop and test enhancement strategies for increasing retention and adherence to that intervention. This study protocol describes the development and testing for Mobile Affect Regulation Intervention with the Goal of Lowering Depression (MARIGOLD), a Web-based positive emotion skills intervention, adapted for individuals with elevated depressive symptomatology. The intervention development is taking place in three phases. In phase 1, we are tailoring an existing positive emotion skills intervention for individuals with elevated symptoms of depression and are pilot testing the tailored version of the intervention in a randomized controlled trial with two control conditions (N=60). In phase 2, we are developing and testing three enhancements aimed at boosting retention and adherence to the Web-based intervention (N=75): facilitator contact, an online discussion board, and virtual badges. In phase 3, we are conducting a multifactorial, nine-arm pilot trial (N=600) to systematically test these enhancement strategies, individually and in combination. The primary outcome is depressive symptom severity. Secondary outcomes include positive and negative emotion, psychological well-being, and coping resources. The project was funded in

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

    Science.gov (United States)

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

    2014-05-16

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

  15. Economic evaluation of a web-based tailored lifestyle intervention for adults: findings regarding cost-effectiveness and cost-utility from a randomized controlled trial.

    Science.gov (United States)

    Schulz, Daniela N; Smit, Eline S; Stanczyk, Nicola E; Kremers, Stef P J; de Vries, Hein; Evers, Silvia M A A

    2014-03-20

    Different studies have reported the effectiveness of Web-based computer-tailored lifestyle interventions, but economic evaluations of these interventions are scarce. The objective was to assess the cost-effectiveness and cost-utility of a sequential and a simultaneous Web-based computer-tailored lifestyle intervention for adults compared to a control group. The economic evaluation, conducted from a societal perspective, was part of a 2-year randomized controlled trial including 3 study groups. All groups received personalized health risk appraisals based on the guidelines for physical activity, fruit intake, vegetable intake, alcohol consumption, and smoking. Additionally, respondents in the sequential condition received personal advice about one lifestyle behavior in the first year and a second behavior in the second year; respondents in the simultaneous condition received personal advice about all unhealthy behaviors in both years. During a period of 24 months, health care use, medication use, absenteeism from work, and quality of life (EQ-5D-3L) were assessed every 3 months using Web-based questionnaires. Demographics were assessed at baseline, and lifestyle behaviors were assessed at both baseline and after 24 months. Cost-effectiveness and cost-utility analyses were performed based on the outcome measures lifestyle factor (the number of guidelines respondents adhered to) and quality of life, respectively. We accounted for uncertainty by using bootstrapping techniques and sensitivity analyses. A total of 1733 respondents were included in the analyses. From a willingness to pay of €4594 per additional guideline met, the sequential intervention (n=552) was likely to be the most cost-effective, whereas from a willingness to pay of €10,850, the simultaneous intervention (n=517) was likely to be most cost-effective. The control condition (n=664) appeared to be preferred with regard to quality of life. Both the sequential and the simultaneous lifestyle

  16. Rebooting Kirkpatrick: Integrating Information System Theory Into the Evaluation of Web-based Continuing Professional Development Interventions for Interprofessional Education.

    Science.gov (United States)

    Shen, Nelson; Yufe, Shira; Saadatfard, Omid; Sockalingam, Sanjeev; Wiljer, David

    2017-01-01

    Information system research has stressed the importance of theory in understanding how user perceptions can motivate the use and adoption of technology such as web-based continuing professional development programs for interprofessional education (WCPD-IPE). A systematic review was conducted to provide an information system perspective on the current state of WCPD-IPE program evaluation and how current evaluations capture essential theoretical constructs in promoting technology adoption. Six databases were searched to identify studies evaluating WCPD-IPE. Three investigators determined eligibility of the articles. Evaluation items extracted from the studies were assessed using the Kirkpatrick-Barr framework and mapped to the Benefits Evaluation Framework. Thirty-seven eligible studies yielded 362 evaluation items for analysis. Most items (n = 252) were assessed as Kirkpatrick-Barr level 1 (reaction) and were mainly focused on the quality (information, service, and quality) and satisfaction dimensions of the Benefits Evaluation. System quality was the least evaluated quality dimension, accounting for 26 items across 13 studies. WCPD-IPE use was reported in 17 studies and its antecedent factors were evaluated in varying degrees of comprehensiveness. Although user reactions were commonly evaluated, greater focus on user perceptions of system quality (ie, functionality and performance), usefulness, and usability of the web-based platform is required. Surprisingly, WCPD-IPE use was reported in less than half of the studies. This is problematic as use is a prerequisite to realizing any individual, organizational, or societal benefit of WCPD-IPE. This review proposes an integrated framework which accounts for these factors and provides a theoretically grounded guide for future evaluations.

  17. Supporting health care professionals to improve the processes of shared decision making and self-management in a web-based intervention: randomized controlled trial.

    Science.gov (United States)

    Sassen, Barbara; Kok, Gerjo; Schepers, Jan; Vanhees, Luc

    2014-10-21

    Research to assess the effect of interventions to improve the processes of shared decision making and self-management directed at health care professionals is limited. Using the protocol of Intervention Mapping, a Web-based intervention directed at health care professionals was developed to complement and optimize health services in patient-centered care. The objective of the Web-based intervention was to increase health care professionals' intention and encouraging behavior toward patient self-management, following cardiovascular risk management guidelines. A randomized controlled trial was used to assess the effect of a theory-based intervention, using a pre-test and post-test design. The intervention website consisted of a module to help improve professionals' behavior, a module to increase patients' intention and risk-reduction behavior toward cardiovascular risk, and a parallel module with a support system for the health care professionals. Health care professionals (n=69) were recruited online and randomly allocated to the intervention group (n=26) or (waiting list) control group (n=43), and invited their patients to participate. The outcome was improved professional behavior toward health education, and was self-assessed through questionnaires based on the Theory of Planned Behavior. Social-cognitive determinants, intention and behavior were measured pre-intervention and at 1-year follow-up. The module to improve professionals' behavior was used by 45% (19/42) of the health care professionals in the intervention group. The module to support the health professional in encouraging behavior toward patients was used by 48% (20/42). The module to improve patients' risk-reduction behavior was provided to 44% (24/54) of patients. In 1 of every 5 patients, the guideline for cardiovascular risk management was used. The Web-based intervention was poorly used. In the intervention group, no differences in social-cognitive determinants, intention and behavior were found

  18. Web-based screening and brief intervention for poly-drug use among teenagers: study protocol of a multicentre two-arm randomized controlled trial.

    Science.gov (United States)

    Arnaud, Nicolas; Bröning, Sonja; Drechsel, Magdalena; Thomasius, Rainer; Baldus, Christiane

    2012-09-26

    Mid to late adolescence is characterised by a vulnerability to problematic substance use since the consumption of alcohol and illicit drugs is frequently initiated and increased in this life period. While the detrimental long- and short-term effects of problematic consumption patterns in adolescence pose a major public health concern, current prevention programs targeting alcohol- and other substance-using adolescents are scarce. The study described in this protocol will test the effectiveness of a web-based brief intervention aimed at reducing problematic alcohol use and promoting abstinence from illegal drugs in adolescents with risky substance use aged 16 to 18 years old in four EU-countries. To determine the effectiveness of our web-BI, we apply a two-arm randomized controlled trial (RCT) study design, with baseline assessment at study entry and a three month follow-up assessment. Adolescents aged 16 to 18 years from Belgium, the Czech Republic, Germany, and Sweden will be randomly assigned to either the fully electronically delivered brief intervention group (N = 400) or an assessment only control group (N = 400) depending on their screening for risky substance use (using the CRAFFT). Recruitment, informed consent, randomization, intervention and follow-up will be implemented online. Primary outcomes are reductions in frequency and quantity of use of alcohol and drugs other than alcohol over a 30 day period, as well as consumption per typical occasion. Secondary outcomes concern changes in substance use related cognitions including the constructs of the Theory of Planned Behaviour, implementation intentions, and stages of change. Moreover the study addresses a number of moderator variables, including age of first use, general psychopathology and quality of parent-child relationship. The trial is expected to contribute to the growing literature on theory- and web-based brief interventions for adolescents. We will explore the potential of using web-based

  19. Web-based screening and brief intervention for poly-drug use among teenagers: study protocol of a multicentre two-arm randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Arnaud Nicolas

    2012-09-01

    Full Text Available Abstract Background Mid to late adolescence is characterised by a vulnerability to problematic substance use since the consumption of alcohol and illicit drugs is frequently initiated and increased in this life period. While the detrimental long- and short-term effects of problematic consumption patterns in adolescence pose a major public health concern, current prevention programs targeting alcohol- and other substance-using adolescents are scarce. The study described in this protocol will test the effectiveness of a web-based brief intervention aimed at reducing problematic alcohol use and promoting abstinence from illegal drugs in adolescents with risky substance use aged 16 to 18 years old in four EU-countries. Methods/design To determine the effectiveness of our web-BI, we apply a two-arm randomized controlled trial (RCT study design, with baseline assessment at study entry and a three month follow-up assessment. Adolescents aged 16 to 18 years from Belgium, the Czech Republic, Germany, and Sweden will be randomly assigned to either the fully electronically delivered brief intervention group (N = 400 or an assessment only control group (N = 400 depending on their screening for risky substance use (using the CRAFFT. Recruitment, informed consent, randomization, intervention and follow-up will be implemented online. Primary outcomes are reductions in frequency and quantity of use of alcohol and drugs other than alcohol over a 30 day period, as well as consumption per typical occasion. Secondary outcomes concern changes in substance use related cognitions including the constructs of the Theory of Planned Behaviour, implementation intentions, and stages of change. Moreover the study addresses a number of moderator variables, including age of first use, general psychopathology and quality of parent–child relationship. Discussion The trial is expected to contribute to the growing literature on theory- and web-based brief interventions

  20. Effectiveness of a Web-Based Tailored Intervention With Virtual Assistants Promoting the Acceptability of HPV Vaccination Among Mothers of Invited Girls: Randomized Controlled Trial.

    Science.gov (United States)

    Pot, Mirjam; Paulussen, Theo Gwm; Ruiter, Robert Ac; Eekhout, Iris; de Melker, Hester E; Spoelstra, Maxine Ea; van Keulen, Hilde M

    2017-09-06

    In 2010, the human papillomavirus (HPV) vaccination was introduced in the Dutch National Immunization Program for 12-year-old girls, aiming to reduce the incidence of cervical cancer in women. HPV vaccination uptake turned out to be lower than expected: 61% versus 70%, respectively. Mothers were shown to play the most important role in the immunization decision about this vaccination. They had also expressed their need for interactive personal information about the HPV vaccination over and above the existing universal general information. To improve the effectiveness of the existing education about the HPV vaccination, we systematically developed a Web-based tailored intervention with virtual assistants providing mothers of girls to be invited with tailored feedback on their decision making about the HPV vaccination. The aim of this study was to evaluate the effectiveness of the Web-based tailored intervention for promoting HPV vaccination acceptance by means of a randomized controlled trial (RCT). Mothers were recruited via the Dutch vaccination register (Praeventis) (n=36,000) and three Web-based panels (n=2483). Those who gave informed consent (N=8062) were randomly assigned to the control (n=4067) or intervention condition (n=3995). HPV vaccination uptake, as registered by Praeventis once the HPV vaccination round was completed, was used as the primary outcome. Secondary outcomes were differential scores across conditions between baseline (before the provided access to the new tailored intervention) and follow-up (just before the first vaccination) regarding the mothers' degree of informed decision making (IDM), decisional conflict, and critical determinants of HPV vaccination uptake among which are intention, attitude, risk perception, and outcome beliefs. Intention-to-treat analysis (N=8062) showed a significant positive effect of the intervention on IDM, decisional conflict, and nearly all determinants of HPV vaccination uptake (Padmin/rctview.asp?TC=4935

  1. A randomized-controlled trial focusing on socio-economic status for promoting vegetable intake among adults using a web-based nutrition intervention programme: study protocol

    Directory of Open Access Journals (Sweden)

    Saki Nakamura

    2017-01-01

    Full Text Available Abstract Background Web-based nutritional education programmes appear to be comparable to those delivered face-to-face. However, no existing web-based nutrition education or similar programme has yet been evaluated with consideration of socio-economic status. The objective of a nutritional education programme of promoting vegetable intake designed a randomized controlled trial (RCT is to evaluate the results of intervention and to determine how socio-economic status influences the programme effects. Methods/Design Participants will be randomly sampled individuals (aged 30–59 stratified according national population statistics for sex, age, and household income. Participants were consented to survey participation (n = 1500, and will be randomly divided into intervention and control groups. The intervention period is 5 weeks with one step of diet-related education per week. The main outcome of the programme is dietary behaviour as eating vegetable (350 g per day, five small bowl. To encourage behavioural changes, the programme contents are prepared using behavioural theories and techniques tailored to the assumed group stages of behavioural change. In the first step, we employ the health belief model to encourage a shift from the pre-contemplative to the contemplative phase; in the second and third steps, social cognitive theory is used to encourage transition to the preparatory phase; in the fourth step, social cognitive theory and strengthening social support are used to promote progression to the execution phase; finally, in the fifth step, strengthening social capital and social support are used to promote the shift to the maintenance phase. The baseline, post intervention and follow-up survey was assessed using a self-administered questionnaire. For process evaluation, we use five items relating to programme participation and satisfaction. A follow-up survey of participants will be carried out 3 months after intervention completion

  2. Community-based randomized controlled trial of diabetes prevention study for high-risk individuals of type 2 diabetes: lifestyle intervention using web-based system.

    Science.gov (United States)

    Cha, Seon-Ah; Lim, Sun-Young; Kim, Kook-Rye; Lee, Eun-Young; Kang, Borami; Choi, Yoon-Hee; Yoon, Kun-Ho; Ahn, Yu-Bae; Lee, Jin-Hee; Ko, Seung-Hyun

    2017-05-05

    The trend of increasing numbers of patients with type 2 diabetes emphasizes the need for active screening of high-risk individuals and intensive lifestyle modification (LSM). The community-based Korean Diabetes Prevention Study (C-KDPS) is a randomized controlled clinical trial to prevent type 2 diabetes by intensive LSM using a web-based program. The two public healthcare centers in Korea are involved, and 420 subjects are being recruited for 6 months and will be followed up for 22 months. The participants are allocated randomly to intensive LSM (18 individual sessions for 24 weeks) and usual care (control group). The major goals of the C-KDPS lifestyle intervention program are: 1) a minimum of 5-7% loss of initial body weight in 6 months and maintenance of this weight loss, 2) increased physical activity (≥ 150 min/week of moderate intensity activity), 3) balanced healthy eating, and 4) quitting smoking and alcohol with stress management. The web-based program includes education contents, video files, visit schedules, and inter-communicable keeping track sites. Primary outcomes are the diagnoses of newly developed diabetes. A 75-g oral glucose tolerance test with hemoglobin A1c level determination and cardiovascular risk factor assessment is scheduled at 6, 12, 18, and 22 months. Active screening of high-risk individuals and an effective LSM program are an essential prerequisite for successful diabetes prevention. We hope that our C-KDPS program can reduce the incidence of newly developed type 2 diabetes and be implemented throughout the country, merging community-based public healthcare resources and a web-based system. Clinical Research Information Service (CRIS), Republic of Korea (No. KCT0001981 ). Date of registration; July 28, 2016.

  3. Community-based randomized controlled trial of diabetes prevention study for high-risk individuals of type 2 diabetes: lifestyle intervention using web-based system

    Directory of Open Access Journals (Sweden)

    Seon-Ah Cha

    2017-05-01

    Full Text Available Abstract Background The trend of increasing numbers of patients with type 2 diabetes emphasizes the need for active screening of high-risk individuals and intensive lifestyle modification (LSM. Methods/design The community-based Korean Diabetes Prevention Study (C-KDPS is a randomized controlled clinical trial to prevent type 2 diabetes by intensive LSM using a web-based program. The two public healthcare centers in Korea are involved, and 420 subjects are being recruited for 6 months and will be followed up for 22 months. The participants are allocated randomly to intensive LSM (18 individual sessions for 24 weeks and usual care (control group. The major goals of the C-KDPS lifestyle intervention program are: 1 a minimum of 5–7% loss of initial body weight in 6 months and maintenance of this weight loss, 2 increased physical activity (≥ 150 min/week of moderate intensity activity, 3 balanced healthy eating, and 4 quitting smoking and alcohol with stress management. The web-based program includes education contents, video files, visit schedules, and inter-communicable keeping track sites. Primary outcomes are the diagnoses of newly developed diabetes. A 75-g oral glucose tolerance test with hemoglobin A1c level determination and cardiovascular risk factor assessment is scheduled at 6, 12, 18, and 22 months. Discussion Active screening of high-risk individuals and an effective LSM program are an essential prerequisite for successful diabetes prevention. We hope that our C-KDPS program can reduce the incidence of newly developed type 2 diabetes and be implemented throughout the country, merging community-based public healthcare resources and a web-based system. Trial registration Clinical Research Information Service (CRIS, Republic of Korea (No. KCT0001981 . Date of registration; July 28, 2016.

  4. The Self-help Online against Suicidal thoughts (SOS) trial

    DEFF Research Database (Denmark)

    Mühlmann, Charlotte; Madsen, Trine; Hjorthøj, Carsten Rygaard

    2017-01-01

    -list assignment for 32 weeks. The primary outcomes are frequency and intensity of suicidal thoughts. Secondary outcome measures include depressive symptoms, hopelessness, worrying, quality of life, costs related to health care utilization and production loss. Number of deliberate self-harm episodes, suicides......BACKGROUND: Suicidal thoughts are common, causing distress for millions of people all over the world. However, people with suicidal thoughts might not access support due to financial restraints, stigma or a lack of available treatment offers. Self-help programs provided online could overcome...... these barriers, and previous efforts show promising results in terms of reducing suicidal thoughts. This study aims to examine the effectiveness of an online self-help intervention in reducing suicidal thoughts among people at risk of suicide. The Danish Self-help Online against Suicidal thoughts (SOS) trial...

  5. Comparing a Video and Text Version of a Web-Based Computer-Tailored Intervention for Obesity Prevention: A Randomized Controlled Trial.

    Science.gov (United States)

    Walthouwer, Michel Jean Louis; Oenema, Anke; Lechner, Lilian; de Vries, Hein

    2015-10-19

    Web-based computer-tailored interventions often suffer from small effect sizes and high drop-out rates, particularly among people with a low level of education. Using videos as a delivery format can possibly improve the effects and attractiveness of these interventions The main aim of this study was to examine the effects of a video and text version of a Web-based computer-tailored obesity prevention intervention on dietary intake, physical activity, and body mass index (BMI) among Dutch adults. A second study aim was to examine differences in appreciation between the video and text version. The final study aim was to examine possible differences in intervention effects and appreciation per educational level. A three-armed randomized controlled trial was conducted with a baseline and 6 months follow-up measurement. The intervention consisted of six sessions, lasting about 15 minutes each. In the video version, the core tailored information was provided by means of videos. In the text version, the same tailored information was provided in text format. Outcome variables were self-reported and included BMI, physical activity, energy intake, and appreciation of the intervention. Multiple imputation was used to replace missing values. The effect analyses were carried out with multiple linear regression analyses and adjusted for confounders. The process evaluation data were analyzed with independent samples t tests. The baseline questionnaire was completed by 1419 participants and the 6 months follow-up measurement by 1015 participants (71.53%). No significant interaction effects of educational level were found on any of the outcome variables. Compared to the control condition, the video version resulted in lower BMI (B=-0.25, P=.049) and lower average daily energy intake from energy-dense food products (B=-175.58, PWeb-based computer-tailored obesity prevention intervention was the most effective intervention and most appreciated. Future research needs to examine if the

  6. A Web-Based Psychoeducational Intervention Program for Depression and Anxiety in an Adult Community in Selangor, Malaysia: Protocol of a Randomized Controlled Trial.

    Science.gov (United States)

    Kader Maideen, Siti Fatimah; Mohd-Sidik, Sherina; Rampal, Lekhraj; Mukhtar, Firdaus; Ibrahim, Normala; Phang, Cheng-Kar; Tan, Kit-Aun; Ahmad, Rozali

    2016-06-21

    Mental disorders are a major public health problem and are debilitating in many nations throughout the world. Many individuals either do not or are not able to access treatment. The Internet can be a medium to convey to the community accessible evidenced-based interventions to reduce these burdens. The objective of this study is to investigate the effectiveness of 4 weeks of a Web-based psychoeducational intervention program for depressive and anxiety symptoms in the community of Selangor, Malaysia. A two-arm randomized controlled trial of a single-blind study will be conducted to meet the objective of this study. We aim to recruit 84 participants each for the intervention and control groups. The recruitment will be from participants who participated in the first phase of this research. The primary outcomes of this study are depressive and anxiety scores, which will be assessed using the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7, respectively. The secondary outcome includes mental health literacy of the participants, which will be assessed using the self-developed and adapted Mental Health Literacy Questionnaire. The psychoeducational intervention program consists of four sessions, which will be accessed each week. The depressive and anxiety symptoms will be compared between participants who participated in the psychoeducational program compared with the control group. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at follow-ups at week 5 and week 12, respectively. The psychoeducational intervention program consists of four sessions, which will be accessed at each week. The depressive and anxiety symptoms will be compared between the intervention and control groups using a series of mixed ANOVAs. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at two follow-ups at week 5 and week 12, respectively. To our knowledge, this study will be the first randomized

  7. A Web-Based Intervention to Reduce Distress After Prostate Cancer Treatment: Development and Feasibility of the Getting Down to Coping Program in Two Different Clinical Settings.

    Science.gov (United States)

    Cockle-Hearne, Jane; Barnett, Deborah; Hicks, James; Simpson, Mhairi; White, Isabel; Faithfull, Sara

    2018-04-30

    Distress after prostate cancer treatment is a substantial burden for up to one-third of men diagnosed. Physical and emotional symptoms and health service use can intensify, yet men are reticent to accept support. To provide accessible support that can be cost effectively integrated into care pathways, we developed a unique, Web-based, self-guided, cognitive-behavior program incorporating filmed and interactive peer support. To assess feasibility of the intervention among men experiencing distress after prostate cancer treatment. Demand, acceptability, change in distress and self-efficacy, and challenges for implementation in clinical practice were measured. A pre-post, within-participant comparison, mixed-methods research design was followed. Phase I and II were conducted in primary care psychological service and secondary care cancer service, respectively. Men received clinician-generated postal invitations: phase I, 432 men diagnosed Web-based. Men with mild and moderate distress were enrolled. Web-based assessment included demographic, disease, treatment characteristics; distress (General Health Questionnaire-28); depression (Patient Health Questionnaire-9); anxiety (General Anxiety Disorder Scale-7); self-efficacy (Self-Efficacy for Symptom Control Inventory); satisfaction (author-generated, Likert-type questionnaire). Uptake and adherence were assessed with reference to the persuasive systems design model. Telephone interviews explored participant experience (phase II, n=10); interviews with health care professionals (n=3) explored implementation issues. A total of 135 men consented (phase I, 61/432, 14.1%; phase II, 74/606, 12.2%); from 96 eligible men screened for distress, 32% (30/96) entered the intervention (phase I, n=10; phase II, n=20). Twenty-four completed the Web-based program and assessments (phase I, n=8; phase II, n=16). Adherence for phase I and II was module completion rate 63% (mean 2.5, SD 1.9) versus 92% (mean 3.7, SD 1.0); rate of

  8. Distress and quality of life after autologous stem cell transplantation: a randomized clinical trial to evaluate the outcome of a web-based stepped care intervention

    Directory of Open Access Journals (Sweden)

    Huijgens Peter C

    2010-07-01

    Full Text Available Abstract Background Psychological distress (i.e. depression and anxiety is a strong predictor of functional status and other aspects of quality of life in autologous stem cell transplantation following high-dose chemotherapy. Treatment of psychological distress is hypothesized to result in improvement of functional status and other aspects of quality of life. The aim is to evaluate the outcome of stepped care for psychological distress on functional status and other aspects of quality of life in patients with hematological malignancy treated with autologous stem cell transplantation. Methods/Design The study is designed as a randomized clinical trial with 2 treatment arms: a stepped care intervention program versus care as usual. Patients are randomized immediately pre transplant. Stepped care and care as usual are initiated after a 6 weeks buffer period. Outcome is evaluated at 13, 30, and 42 weeks post transplant. In the experimental group, the first step includes an Internet-based self-help program. If psychological distress persists after the self-help intervention, the second step of the program is executed, i.e. a diagnostic evaluation and a standardized interview, yielding a problem analysis. Based on this information, a contract is made with the patient and treatment is provided consisting of individual face-to-face counseling, medication, or referral to other services. Care as usual comprises an interview with the patient, on ad hoc basis; emotional support and advice, on ad hoc basis; if urgent problems emerge, the patient is referred to other services. Primary outcome variables are psychological distress and functional status. Data are analyzed according to the intention to treat-principle. Discussion This study has several innovative characteristics. First, the outcome of the intervention for psychological distress in patients with hematological malignancy treated with autologous stem cell transplantation is evaluated in a randomized

  9. Using intervention mapping for the development of a targeted secure web-based outreach strategy named SafeFriend, for Chlamydia trachomatis testing in young people at risk.

    Science.gov (United States)

    Theunissen, Kevin A T M; Hoebe, Christian J P A; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne K; van Bergen, Jan E A M; van der Sande, Marianne A B; Dukers-Muijrers, Nicole H T M

    2013-10-22

    Many young people at high risk for Chlamydia trachomatis (Ct) are not reached by current sexual health care systems, such as general practitioners and public sexual health care centres (sexually transmitted infection clinics).Ct is the most frequently diagnosed bacterial sexually transmitted infection (STI) among sexually active people and in particular young heterosexuals. Innovative screening strategies are needed to interrupt the transmission of Ct among young people and connect the hidden cases to care. Intervention Mapping (IM), a systematic approach to develop theory- and evidence-based interventions, was used to develop a strategy to target Ct testing towards young people who are currently hidden to care in The Netherlands. Both clinical users (i.e. sexual health care nurses) and public users (i.e., young people at risk for Ct) were closely involved in the IM process. A needs assessment study was carried out using semi-structured interviews among users (N = 21), a literature search and by taking lessons learned from existing screening programmes. Theoretical methods and practical applications to reach high risk young people and influence testing were selected and translated into specific programme components. The IM approach resulted in the development of a secure and web-based outreach Ct screening strategy, named SafeFriend. It is developed to target groups of high-risk young people who are currently hidden to care. Key methods include web-based Respondent Driven Sampling, starting from young Ct positive sexual health care centre clients, to reach and motivate peers (i.e., sex partners and friends) to get tested for Ct. Testing and the motivation of peers were proposed as the desired behavioural outcomes and the Precaution Adoption Process Model was chosen as theoretical framework. End users, i.e., young people and sexual health care nurses were interviewed and included in the development process to increase the success of implementation. IM proved useful

  10. Automated Management of Exercise Intervention at the Point of Care: Application of a Web-Based Leg Training System.

    Science.gov (United States)

    Dedov, Vadim N; Dedova, Irina V

    2015-11-23

    Recent advances in information and communication technology have prompted development of Web-based health tools to promote physical activity, the key component of cardiac rehabilitation and chronic disease management. Mobile apps can facilitate behavioral changes and help in exercise monitoring, although actual training usually takes place away from the point of care in specialized gyms or outdoors. Daily participation in conventional physical activities is expensive, time consuming, and mostly relies on self-management abilities of patients who are typically aged, overweight, and unfit. Facilitation of sustained exercise training at the point of care might improve patient engagement in cardiac rehabilitation. In this study we aimed to test the feasibility of execution and automatic monitoring of several exercise regimens on-site using a Web-enabled leg training system. The MedExercise leg rehabilitation machine was equipped with wireless temperature sensors in order to monitor its usage by the rise of temperature in the resistance unit (Δt°). Personal electronic devices such as laptop computers were fitted with wireless gateways and relevant software was installed to monitor the usage of training machines. Cloud-based software allowed monitoring of participant training over the Internet. Seven healthy participants applied the system at various locations with training protocols typically used in cardiac rehabilitation. The heart rates were measured by fingertip pulse oximeters. Exercising in home chairs, in bed, and under an office desk was made feasible and resulted in an intensity-dependent increase of participants' heart rates and Δt° in training machine temperatures. Participants self-controlled their activities on smart devices, while a supervisor monitored them over the Internet. Individual Δt° reached during 30 minutes of moderate-intensity continuous training averaged 7.8°C (SD 1.6). These Δt° were used as personalized daily doses of exercise with

  11. Short- and medium-term efficacy of a Web-based computer-tailored nutrition education intervention for adults including cognitive and environmental feedback: randomized controlled trial.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; de Vries, Hein; Candel, Math J J M; Oenema, Anke

    2015-01-19

    Web-based, computer-tailored nutrition education interventions can be effective in modifying self-reported dietary behaviors. Traditional computer-tailored programs primarily targeted individual cognitions (knowledge, awareness, attitude, self-efficacy). Tailoring on additional variables such as self-regulation processes and environmental-level factors (the home food environment arrangement and perception of availability and prices of healthy food products in supermarkets) may improve efficacy and effect sizes (ES) of Web-based computer-tailored nutrition education interventions. This study evaluated the short- and medium-term efficacy and educational differences in efficacy of a cognitive and environmental feedback version of a Web-based computer-tailored nutrition education intervention on self-reported fruit, vegetable, high-energy snack, and saturated fat intake compared to generic nutrition information in the total sample and among participants who did not comply with dietary guidelines (the risk groups). A randomized controlled trial was conducted with a basic (tailored intervention targeting individual cognition and self-regulation processes; n=456), plus (basic intervention additionally targeting environmental-level factors; n=459), and control (generic nutrition information; n=434) group. Participants were recruited from the general population and randomly assigned to a study group. Self-reported fruit, vegetable, high-energy snack, and saturated fat intake were assessed at baseline and at 1- (T1) and 4-months (T2) postintervention using online questionnaires. Linear mixed model analyses examined group differences in change over time. Educational differences were examined with group×time×education interaction terms. In the total sample, the basic (T1: ES=-0.30; T2: ES=-0.18) and plus intervention groups (T1: ES=-0.29; T2: ES=-0.27) had larger decreases in high-energy snack intake than the control group. The basic version resulted in a larger decrease in

  12. Sociological perspectives on self-help groups

    DEFF Research Database (Denmark)

    Adamsen, L; Rasmussen, J M

    2001-01-01

    and significance of self-help groups. FINDINGS: New empirical sociological evidence shows that health care professionals - nurses, psychologists, social workers - have become an integrated part and thus essential actors in self-help groups within as well as outside the framework of the formal health care system...... that it is necessary to introduce new aspects and themes for discussion in the health care debate and the work that goes beyond the predominantly individual orientated treatment and care function....

  13. Web-based nutrition education intervention improves self-efficacy and self-regulation related to increased dairy intake in college students.

    Science.gov (United States)

    Poddar, Kavita H; Hosig, Kathy W; Anderson, Eileen S; Nickols-Richardson, Sharon M; Duncan, Susan E

    2010-11-01

    Dairy consumption declines substantially during young adulthood. Interventions that incorporate theory-based nutrition education can provide insight into factors associated with dietary choices. The aim of this experimental study was to improve outcome expectations, self-efficacy, self-regulation, and behavior related to dairy intake in college students using social cognitive theory. Students (n=294) enrolled in a personal health class were randomized to intervention (n=148) or comparison group (n=146). The 5-week intervention (March 2006 to April 2006) was conducted using an online course system; components included e-mail messages, posted information, and behavior checklists with tailored feedback. Multivariate analysis of covariance with age and sex as covariates (Pself-regulatory strategies (P=0.038) and self-efficacy for consuming three servings/day of dairy products (P=0.049), but not in outcome expectations or consumption of dairy products. A Web-based intervention designed to change dairy intake in college students was effective in modifying some social cognitive theory constructs; strategies that positively impact outcome expectations and social support through online interventions require further development. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  14. Reducing patient delay in Acute Coronary Syndrome (RAPiD): research protocol for a web-based randomized controlled trial examining the effect of a behaviour change intervention.

    Science.gov (United States)

    Farquharson, Barbara; Johnston, Marie; Smith, Karen; Williams, Brian; Treweek, Shaun; Dombrowski, Stephan U; Dougall, Nadine; Abhyankar, Purva; Grindle, Mark

    2017-05-01

    To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text + visual and text-only) with usual care. Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for acute coronary syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions. A three-arm web-based, parallel randomized controlled trial of a theory-based intervention. The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n = 177 participants who have experienced acute coronary syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care, ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text + visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of acute coronary syndrome ≥15-minute duration, assessed using two randomized series of eight scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014. Positive results changing intentions would lead to a randomized controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms. Registered at ClinicalTrials.gov: NCT02820103. © 2016 John Wiley & Sons Ltd.

  15. Teen CHAT: Development and Utilization of a Web-Based Intervention to Improve Physician Communication with Adolescents About Healthy Weight

    Science.gov (United States)

    Bravender, Terrill; Tulsky, James A.; Farrell, David; Alexander, Stewart C.; Østbye, Truls; Lyna, Pauline; Dolor, Rowena J.; Coffman, Cynthia J.; Bilheimer, Alicia; Lin, Pao-Hwa; Pollak, Kathryn I.

    2013-01-01

    Objective To describe the theoretical basis, use, and satisfaction with Teen CHAT, an online educational intervention designed to improve physician-adolescent communication about healthy weight. Methods Routine health maintenance encounters between pediatricians and family practitioners and their overweight adolescent patients were audio recorded, and content was coded to summarize adherence with motivational interviewing techniques. An online educational intervention was developed using constructs from social cognitive theory and using personalized audio recordings. Physicians were randomized to the online intervention or not, and completed post-intervention surveys. Results Forty-six physicians were recruited, and 22 physicians were randomized to view the intervention website. The educational intervention took an average of 54 minutes to complete, and most physicians thought it was useful, that they would use newly acquired skills with their patients, and would recommend it to others. Fewer physicians thought it helped them address confidentiality issues with their adolescent patients. Conclusion The Teen CHAT online intervention shows potential for enhancing physician motivational interviewing skills in an acceptable and time-efficient manner. Practice Implications If found to be effective in enhancing motivational interviewing skills and changing adolescent weight-related behaviors, wide dissemination will be feasible and indicated. PMID:24021419

  16. What is needed to implement a web-based audit and feedback intervention with outreach visits to improve care quality: A concept mapping study among cardiac rehabilitation teams.

    Science.gov (United States)

    van Engen-Verheul, Mariëtte M; Peek, Niels; Haafkens, Joke A; Joukes, Erik; Vromen, Tom; Jaspers, Monique W M; de Keizer, Nicolette F

    2017-01-01

    Evidence on successful quality improvement (QI) in health care requires quantitative information from randomized clinical trials (RCTs) on the effectiveness of QI interventions, but also qualitative information from professionals to understand factors influencing QI implementation. Using a structured qualitative approach, concept mapping, this study determines factors identified by cardiac rehabilitation (CR) teams on what is needed to successfully implement a web-based audit and feedback (A&F) intervention with outreach visits to improve the quality of CR care. Participants included 49 CR professionals from 18 Dutch CR centres who had worked with the A&F system during a RCT. In three focus group sessions participants formulated statements on factors needed to implement QI successfully. Subsequently, participants rated all statements for importance and feasibility and grouped them thematically. Multi dimensional scaling was used to produce a final concept map. Forty-two unique statements were formulated and grouped into five thematic clusters in the concept map. The cluster with the highest importance was QI team commitment, followed by organisational readiness, presence of an adequate A&F system, access to an external quality assessor, and future use and functionalities of the A&F system. Concept mapping appeared efficient and useful to understand contextual factors influencing QI implementation as perceived by healthcare teams. While presence of a web-based A&F system and external quality assessor were seen as instrumental for gaining insight into performance and formulating QI actions, QI team commitment and organisational readiness were perceived as essential to actually implement and carry out these actions. These two sociotechnical factors should be taken into account when implementing and evaluating the success of QI implementations in future research. Copyright © 2016. Published by Elsevier Ireland Ltd.

  17. Effectiveness of web-based versus folder support interventions for young informal carers of persons with mental illness: a randomized controlled trial.

    Science.gov (United States)

    Ali, Lilas; Krevers, Barbro; Sjöström, Nils; Skärsäter, Ingela

    2014-03-01

    Compare the impact of two interventions, a web-based support and a folder support, for young persons who care for people who suffer from mental illness. This study was a randomized control trial, following the CONSORT statements, which compared the impact of two interventions. Primary outcome variable was stress, and secondary outcome variables were caring situation, general self-efficacy, well-being, health, and quality of life of young informal carers (N=241). Data were collected in June 2010 to April 2011, with self-assessment questionnaires, comparing the two interventions and also to detect changes. The stress levels were high in both groups at baseline, but decreased in the folder group. The folder group had improvement in their caring situation (also different from the web group), general self-efficacy, well-being, and quality of life. The web group showed increase in well-being. Young informal carers who take on the responsibility for people close to them; suffer consequences on their own health. They live in a life-situation characterized by high stress and low well-being. This signals a need for support. The non-significant differences show that each intervention can be effective, and that it depends upon the individual's preferences. This highlights the importance of adopting person-centered approach, in which young persons can themselves choose support strategy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. A Blended Web-Based Gaming Intervention on Changes in Physical Activity for Overweight and Obese Employees: Influence and Usage in an Experimental Pilot Study.

    Science.gov (United States)

    Kouwenhoven-Pasmooij, Tessa A; Robroek, Suzan Jw; Ling, Sui Wai; van Rosmalen, Joost; van Rossum, Elisabeth Fc; Burdorf, Alex; Hunink, M G Myriam

    2017-04-03

    Addressing the obesity epidemic requires the development of effective interventions aimed at increasing physical activity (PA). eHealth interventions with the use of accelerometers and gaming elements, such as rewarding or social bonding, seem promising. These eHealth elements, blended with face-to-face contacts, have the potential to help people adopt and maintain a physically active lifestyle. The aim of this study was to assess the influence and usage of a blended Web-based gaming intervention on PA, body mass index (BMI), and waist circumference among overweight and obese employees. In an uncontrolled before-after study, we observed 52 health care employees with BMI more than 25 kg/m 2 , who were recruited via the company's intranet and who voluntarily participated in a 23-week Web-based gaming intervention, supplemented (blended) with non-eHealth components. These non-eHealth components were an individual session with an occupational health physician involving motivational interviewing and 5 multidisciplinary group sessions. The game was played by teams in 5 time periods, aiming to gain points by being physically active, as measured by an accelerometer. Data were collected in 2014 and 2015. Primary outcome was PA, defined as length of time at MET (metabolic equivalent task) ≥3, as measured by the accelerometer during the game. Secondary outcomes were reductions in BMI and waist circumference, measured at baseline and 10 and 23 weeks after the start of the program. Gaming elements such as "compliance" with the game (ie, days of accelerometer wear), "engagement" with the game (ie, frequency of reaching a personal monthly target), and "eHealth teams" (ie, social influence of eHealth teams) were measured as potential determinants of the outcomes. Linear mixed models were used to evaluate the effects on all outcome measures. The mean age of participants was 48.1 years; most participants were female (42/51, 82%). The mean PA was 86 minutes per day, ranging from 6

  19. Long-term effectiveness and moderators of a web-based tailored intervention for cancer survivors on social and emotional functioning, depression, and fatigue: randomized controlled trial.

    Science.gov (United States)

    Willems, Roy A; Mesters, Ilse; Lechner, Lilian; Kanera, Iris M; Bolman, Catherine A W

    2017-12-01

    The web-based computer-tailored Kanker Nazorg Wijzer (Cancer Aftercare Guide) supports cancer survivors with psychosocial issues during cancer recovery. The current study investigates whether the 6-month effects in increasing emotional and social functioning and reducing depression and fatigue hold at 12 months from baseline. Moreover, it explores whether patient characteristics moderate the 6- and 12-month intervention effectiveness. Cancer survivors from 21 Dutch hospitals (November 2013-June 2014) were randomized to an intervention (n = 231) or a wait-list control group (n = 231). Intervention effects on emotional and social functioning (EORTC QLQ-C30), depression (HADS), and fatigue (CIS) were evaluated through multilevel linear regression analyses. At 12 months from baseline, the intervention group no longer differed from the control group in emotional and social functioning, depression, and fatigue. Moderator analyses indicated that, at 6 months, the intervention was effective in improving social functioning for men (d = 0.34), reducing fatigue for participants ≤56 years (d = 0.44), and reducing depression for participants who received chemotherapy (d = 0.36). At 12 months, participants with a medium educational level reported higher social functioning (d = 0.19), while participants with a low educational level reported lower social functioning (d = 0.22) than participants with a similar educational level in the control group. The intervention gave cancer patients a head start to psychological recovery after the end of cancer treatment. The control group caught up in the long run. The Cancer Aftercare Guide expedited recovery after cancer treatment. Being a low intensity, easy accessible, and relatively low cost intervention, it could serve as a relevant step in recovery and stepped care.

  20. Feasibility of a mobile and web-based intervention to support self-management in outpatients with cancer pain.

    Science.gov (United States)

    Hochstenbach, Laura M J; Zwakhalen, Sandra M G; Courtens, Annemie M; van Kleef, Maarten; de Witte, Luc P

    2016-08-01

    Cancer pain is a prevalent and distressing symptom. To enhance self-management in outpatients, a multi-component intervention was developed, integrating patient self-management and professional care through healthcare technology. This article describes feasibility of the intervention in everyday practice. Patients with moderate to severe cancer pain (n = 11) and registered nurses specialized in pain and palliative care (n = 3) participated in a four-week study. The intervention involved daily monitoring, graphical feedback, education, and advice by means of a mobile application for patients and a web application for nurses. Learnability, usability and desirability were measured in patients with a 20-item questionnaire (1-5 scale), higher scores indicating better feasibility. Patients' adherence was based on completion rates from server logs. Single semi-structured interviews with patients and a focus group interview with nurses provided insight into experiences. Questionnaire findings confirmed learnability (4.8), usability (4.8) and desirability (4.6) of the application for patients. Average completion rates were 76.8% for pain monitoring, 50.4% for medication monitoring and 100% for education sessions. Interviews revealed that patients were pleased with the simplicity of the mobile application and appreciated different components. Nurses agreed upon the added value and were mostly positive about the possibilities of the web application. Patients and nurses provided ideas for improvements relating to the content and technical performance of the intervention. Study results demonstrate feasibility of the intervention in everyday practice. Provided that content-related and technical adjustments are made, the intervention enables patients with cancer pain to practice self-management and nurses to remotely support these patients. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. The Gestational Diabetes Management System (GooDMomS): development, feasibility and lessons learned from a patient-informed, web-based pregnancy and postpartum lifestyle intervention.

    Science.gov (United States)

    Nicholson, Wanda K; Beckham, A Jenna; Hatley, Karen; Diamond, Molly; Johnson, La-Shell; Green, Sherri L; Tate, Deborah

    2016-09-21

    Gestational diabetes mellitus (GDM) contributes to the epidemic of diabetes and obesity in mothers and their offspring. The primary objective of this pilot study was to: 1) refine the GDM Management System (GooDMomS), a web-based pregnancy and postpartum behavioral intervention and 2) assess the feasibility of the intervention. In phase 1, ten semi-structured interviews were conducted with women experiencing current or recent GDM mellitus GDM to garner pilot data on the web based intervention interface, content, and to solicit recommendations from women about refinements to enhance the GooDMomS intervention site. Interviews were audiotaped, transcribed and independently reviewed to identify major themes with Atlas.ti v7.0. In phase 2, a single-arm feasibility study was conducted and 23 participants were enrolled in the GooDMomS program. Participants received web lessons, self-tracking of weight and glucose, automated feedback and access to a message board for peer support. The primary outcome was feasibility, including recruitment and retention and acceptability. Secondary outcomes included the proportion of women whose gestational weight gain (GWG) was within the Institute of Medicine (IOM) guidelines and who were able to return to their pre-pregnancy weight after delivery. Comments from semi-structured interviews focused on: 1) usability of the on-line self-monitoring diary and tracking system, 2) access to a safe, reliable social network for peer support and 3) ability of prenatal clinicians to access the on-line diary for clinical management. Overall, 21 (91 %) completed the pregnancy phase. 15/21 (71 %) of participants were within the Institute of Medicine (IOM) guidelines for GWG. Sixteen (70 %) completed the postpartum phase. 7/16 (43 %) and 9/16 (56 %) of participants returned to their pre-pregnancy weight at 6 and 30 weeks postpartum, respectively. This study documents the feasibility of the GooDMomS program. The results can have implications for web

  2. Efficacy and cost-effectiveness of a web-based and mobile stress-management intervention for employees: design of a randomized controlled trial.

    Science.gov (United States)

    Heber, Elena; Ebert, David Daniel; Lehr, Dirk; Nobis, Stephanie; Berking, Matthias; Riper, Heleen

    2013-07-15

    Work-related stress is associated with a variety of mental and emotional problems and can lead to substantial economic costs due to lost productivity, absenteeism or the inability to work. There is a considerable amount of evidence on the effectiveness of traditional face-to-face stress-management interventions for employees; however, they are often costly, time-consuming, and characterized by a high access threshold. Web-based interventions may overcome some of these problems yet the evidence in this field is scarce. This paper describes the protocol for a study that will examine the efficacy and cost-effectiveness of a web-based guided stress-management training which is based on problem solving and emotion regulation and aimed at reducing stress in adult employees. The study will target stressed employees aged 18 and older. A randomized controlled trial (RCT) design will be applied. Based on a power calculation of d=.35 (1-β of 80%, α = .05), 264 participants will be recruited and randomly assigned to either the intervention group or a six-month waitlist control group. Inclusion criteria include an elevated stress level (Cohen's Perceived Stress Scale-10 ≥ 22) and current employment. Exclusion criteria include risk of suicide or previously diagnosed psychosis or dissociative symptoms. The primary outcome will be perceived stress, and secondary outcomes include depression and anxiety. Data will be collected at baseline and seven weeks and six months after randomization. An extended follow up at 12 months is planned for the intervention group. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective and will include both direct and indirect health care costs. Data will be analyzed on an intention-to-treat basis and per protocol. The substantial negative consequences of work-related stress emphasize the necessity for effective stress-management trainings. If the proposed internet intervention proves to be (cost-) effective, a

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

    Science.gov (United States)

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

    2015-07-13

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

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

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; Oenema, Anke

    2014-01-17

    Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate and improve existing nutrition education interventions. This paper describes the development, design and evaluation protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable, high-energy snack and fat intake. This intervention innovates existing computer-tailored interventions by not only targeting motivational factors, but also volitional and self-regulation processes and environmental-level factors. The intervention development was guided by the Intervention Mapping protocol, ensuring a theory-informed and evidence-based intervention. Two versions of the intervention were developed: a basic version targeting knowledge, awareness, attitude, self-efficacy and volitional and self-regulation processes, and a plus version additionally addressing the home environment arrangement and the availability and price of healthy food products in supermarkets. Both versions consist of four modules: one for each dietary behavior, i.e. fruit, vegetables, high-energy snacks and fat. Based on the self-regulation phases, each module is divided into three sessions. In the first session, feedback on dietary behavior is provided to increase awareness, feedback on attitude and self-efficacy is provided and goals and action plans are stated. In the second session goal achievement is evaluated, reasons for failure are explored, coping plans are stated and goals can be adapted. In the third session, participants can again evaluate their behavioral change and tips for maintenance are provided. Both versions will be evaluated in a three-group randomized controlled trial with measurements at baseline, 1-month, 4-months and 9-months post-intervention, using online questionnaires. Both versions will be compared with a generic

  5. A web-based intervention to support self-management of patients with type 2 diabetes mellitus: effect on self-efficacy, self-care and diabetes distress.

    Science.gov (United States)

    Yu, Catherine H; Parsons, Janet A; Mamdani, Muhammad; Lebovic, Gerald; Hall, Susan; Newton, David; Shah, Baiju R; Bhattacharyya, Onil; Laupacis, Andreas; Straus, Sharon E

    2014-12-14

    Management of diabetes mellitus is complex and involves controlling multiple risk factors that may lead to complications. Given that patients provide most of their own diabetes care, patient self-management training is an important strategy for improving quality of care. Web-based interventions have the potential to bridge gaps in diabetes self-care and self-management. The objective of this study was to determine the effect of a web-based patient self-management intervention on psychological (self-efficacy, quality of life, self-care) and clinical (blood pressure, cholesterol, glycemic control, weight) outcomes. For this cohort study we used repeated-measures modelling and qualitative individual interviews. We invited patients with type 2 diabetes to use a self-management website and asked them to complete questionnaires assessing self-efficacy (primary outcome) every three weeks for nine months before and nine months after they received access to the website. We collected clinical outcomes at three-month intervals over the same period. We conducted in-depth interviews at study conclusion to explore acceptability, strengths and weaknesses, and mediators of use of the website. We analyzed the data using a qualitative descriptive approach and inductive thematic analysis. Eighty-one participants (mean age 57.2 years, standard deviation 12) were included in the analysis. The self-efficacy score did not improve significantly more than expected after nine months (absolute change 0.12; 95% confidence interval -0.028, 0.263; p = 0.11), nor did clinical outcomes. Website usage was limited (average 0.7 logins/month). Analysis of the interviews (n = 21) revealed four themes: 1) mediators of website use; 2) patterns of website use, including role of the blog in driving site traffic; 3) feedback on website; and 4) potential mechanisms for website effect. A self-management website for patients with type 2 diabetes did not improve self-efficacy. Website use was limited

  6. Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition: Results of the "Fitter na kanker" Randomized Controlled Trial.

    Science.gov (United States)

    Bruggeman-Everts, Fieke Z; Wolvers, Marije D J; van de Schoot, Rens; Vollenbroek-Hutten, Miriam M R; Van der Lee, Marije L

    2017-10-19

    Approximately one third of all patients who have been successfully treated for cancer suffer from chronic cancer-related fatigue (CCRF). Effective and easily accessible interventions are needed for these patients. The current paper reports on the results of a 3-armed randomized controlled trial investigating the clinical effectiveness of two different guided Web-based interventions for reducing CCRF compared to an active control condition. Severely fatigued cancer survivors were recruited via online and offline channels, and self-registered on an open-access website. After eligibility checks, 167 participants were randomized via an embedded automated randomization function into: (1) physiotherapist-guided Ambulant Activity Feedback (AAF) therapy encompassing the use of an accelerometer (n=62); (2) psychologist-guided Web-based mindfulness-based cognitive therapy (eMBCT; n=55); or (3) an unguided active control condition receiving psycho-educational emails (n=50). All interventions lasted nine weeks. Fatigue severity was self-assessed using the Checklist Individual Strength - Fatigue Severity subscale (primary outcome) six times from baseline (T0b) to six months (T2). Mental health was self-assessed three times using the Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule (secondary outcome). Treatment dropout was investigated. Multiple group latent growth curve analysis, corrected for individual time between assessments, showed that fatigue severity decreased significantly more in the AAF and eMBCT groups compared to the psycho-educational group. The analyses were checked by a researcher who was blind to allocation. Clinically relevant changes in fatigue severity were observed in 66% (41/62) of patients in AAF, 49% (27/55) of patients in eMBCT, and 12% (6/50) of patients in psycho-education. Dropout was 18% (11/62) in AAF, mainly due to technical problems and poor usability of the accelerometer, and 38% (21/55) in eMBCT, mainly due to

  7. Process evaluation of Project WebHealth: a nondieting Web-based intervention for obesity prevention in college students.

    Science.gov (United States)

    Dour, Colleen A; Horacek, Tanya M; Schembre, Susan M; Lohse, Barbara; Hoerr, Sharon; Kattelmann, Kendra; White, Adrienne A; Shoff, Suzanne; Phillips, Beatrice; Greene, Geoffrey

    2013-01-01

    To evaluate the motivational effect of the Project WebHealth study procedures and intervention components on weight-related health behavior changes in male and female college students. Process evaluation. Eight universities in the United States. Project WebHealth participants (n = 653; 29% men). Participants rated motivational effects of study procedures and intervention components. Participants were grouped into outcome-based health behavior categories based on achievement of desired targets for fruit and vegetable intake, physical activity, and/or body weight. Differences in motivation from each procedure and component were analyzed by gender- and outcome-based health behavior category. Women were generally more motivated than men. Compared to those who did not meet any target health behaviors, men with improved health outcomes (68%) were significantly more motivated by the skills to fuel the body lesson, goal setting, and research snippets. Their female counterparts (63%) were significantly more motivated by the lessons on body size and eating enjoyment, and by the suggested weekly activities. Specific study procedures and components of Project WebHealth motivated study participants to improve their weight-related health behaviors, and they differed by gender. Findings support the need for gender-tailored interventions in this population. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  8. The Effect of Social Support Features and Gamification on a Web-Based Intervention for Rheumatoid Arthritis Patients: Randomized Controlled Trial

    Science.gov (United States)

    Kostova, Zlatina; Nakamoto, Kent; Schulz, Peter Johannes

    2015-01-01

    Background Rheumatoid arthritis (RA) is chronic systematic disease that affects people during the most productive period of their lives. Web-based health interventions have been effective in many studies; however, there is little evidence and few studies showing the effectiveness of online social support and especially gamification on patients’ behavioral and health outcomes. Objective The aim of this study was to look into the effects of a Web-based intervention that included online social support features and gamification on physical activity, health care utilization, medication overuse, empowerment, and RA knowledge of RA patients. The effect of gamification on website use was also investigated. Methods We conducted a 5-arm parallel randomized controlled trial for RA patients in Ticino (Italian-speaking part of Switzerland). A total of 157 patients were recruited through brochures left with physicians and were randomly allocated to 1 of 4 experimental conditions with different types of access to online social support and gamification features and a control group that had no access to the website. Data were collected at 3 time points through questionnaires at baseline, posttest 2 months later, and at follow-up after another 2 months. Primary outcomes were physical activity, health care utilization, and medication overuse; secondary outcomes included empowerment and RA knowledge. All outcomes were self-reported. Intention-to-treat analysis was followed and multilevel linear mixed models were used to study the change of outcomes over time. Results The best-fit multilevel models (growth curve models) that described the change in the primary outcomes over the course of the intervention included time and empowerment as time-variant predictors. The growth curve analyses of experimental conditions were compared to the control group. Physical activity increased over time for patients having access to social support sections plus gaming (unstandardized beta coefficient

  9. The effect of social support features and gamification on a Web-based intervention for rheumatoid arthritis patients: randomized controlled trial.

    Science.gov (United States)

    Allam, Ahmed; Kostova, Zlatina; Nakamoto, Kent; Schulz, Peter Johannes

    2015-01-09

    Rheumatoid arthritis (RA) is chronic systematic disease that affects people during the most productive period of their lives. Web-based health interventions have been effective in many studies; however, there is little evidence and few studies showing the effectiveness of online social support and especially gamification on patients' behavioral and health outcomes. The aim of this study was to look into the effects of a Web-based intervention that included online social support features and gamification on physical activity, health care utilization, medication overuse, empowerment, and RA knowledge of RA patients. The effect of gamification on website use was also investigated. We conducted a 5-arm parallel randomized controlled trial for RA patients in Ticino (Italian-speaking part of Switzerland). A total of 157 patients were recruited through brochures left with physicians and were randomly allocated to 1 of 4 experimental conditions with different types of access to online social support and gamification features and a control group that had no access to the website. Data were collected at 3 time points through questionnaires at baseline, posttest 2 months later, and at follow-up after another 2 months. Primary outcomes were physical activity, health care utilization, and medication overuse; secondary outcomes included empowerment and RA knowledge. All outcomes were self-reported. Intention-to-treat analysis was followed and multilevel linear mixed models were used to study the change of outcomes over time. The best-fit multilevel models (growth curve models) that described the change in the primary outcomes over the course of the intervention included time and empowerment as time-variant predictors. The growth curve analyses of experimental conditions were compared to the control group. Physical activity increased over time for patients having access to social support sections plus gaming (unstandardized beta coefficient [B]=3.39, P=.02). Health care

  10. The Green Eating Project: web-based intervention to promote environmentally conscious eating behaviours in US university students.

    Science.gov (United States)

    Monroe, Jessica T; Lofgren, Ingrid E; Sartini, Becky L; Greene, Geoffrey W

    2015-09-01

    To investigate the effectiveness of an online, interactive intervention, referred to as the Green Eating (GE) Project, to motivate university students to adopt GE behaviours. The study was quasi-experimental and integrated into courses for credit/extra credit. Courses were randomly stratified into experimental or non-treatment control. The 5-week intervention consisted of four modules based on different GE topics. Participants completed the GE survey at baseline (experimental, n 241; control, n 367) and post (experimental, n 187; control, n 304). The GE survey has been previously validated and consists of Transtheoretical Model constructs including stage of change (SOC), decisional balance (DB: Pros and Cons) and self-efficacy (SE: School and Home) as well as behaviours for GE. Modules contained basic information regarding each topic and knowledge items to assess content learning. The GE Project took place at a public university in the north-eastern USA. Participants were full-time students between the ages of 18 and 24 years. The GE Project was effective in significantly increasing GE behaviours, DB Pros, SE School and knowledge in experimental compared with control, but did not reduce DB Cons or increase SE Home. Experimental participants were also more likely to be in later SOC for GE at post testing. The GE Project was effective in increasing GE behaviours in university students. Motivating consumers towards adopting GE could assist in potentially mitigating negative consequences of the food system on the environment. Future research could tailor the intervention to participant SOC to further increase the effects or design the modules for other participants.

  11. Healthy weight regulation and eating disorder prevention in high school students: a universal and targeted Web-based intervention.

    Science.gov (United States)

    Jones, Megan; Taylor Lynch, Katherine; Kass, Andrea E; Burrows, Amanda; Williams, Joanne; Wilfley, Denise E; Taylor, C Barr

    2014-02-27

    Given the rising rates of obesity in children and adolescents, developing evidence-based weight loss or weight maintenance interventions that can be widely disseminated, well implemented, and are highly scalable is a public health necessity. Such interventions should ensure that adolescents establish healthy weight regulation practices while also reducing eating disorder risk. This study describes an online program, StayingFit, which has two tracks for universal and targeted delivery and was designed to enhance healthy living skills, encourage healthy weight regulation, and improve weight/shape concerns among high school adolescents. Ninth grade students in two high schools in the San Francisco Bay area and in St Louis were invited to participate. Students who were overweight (body mass index [BMI] >85th percentile) were offered the weight management track of StayingFit; students who were normal weight were offered the healthy habits track. The 12-session program included a monitored discussion group and interactive self-monitoring logs. Measures completed pre- and post-intervention included self-report height and weight, used to calculate BMI percentile for age and sex and standardized BMI (zBMI), Youth Risk Behavior Survey (YRBS) nutrition data, the Weight Concerns Scale, and the Center for Epidemiological Studies Depression Scale. A total of 336 students provided informed consent and were included in the analyses. The racial breakdown of the sample was as follows: 46.7% (157/336) multiracial/other, 31.0% (104/336) Caucasian, 16.7% (56/336) African American, and 5.7% (19/336) did not specify; 43.5% (146/336) of students identified as Hispanic/Latino. BMI percentile and zBMI significantly decreased among students in the weight management track. BMI percentile and zBMI did not significantly change among students in the healthy habits track, demonstrating that these students maintained their weight. Weight/shape concerns significantly decreased among participants in

  12. The effect of web based depression interventions on self reported help seeking: randomised controlled trial [ISRCTN77824516

    Directory of Open Access Journals (Sweden)

    Mackinnon Andrew J

    2006-04-01

    Full Text Available Abstract Background To date, there has been very little work investigating behaviour changes induced by interventions that are designed to increase help seeking. The present paper examines the effects of two Internet depression websites on help seeking. Methods 414 individuals with elevated scores on a depression assessment scale were randomly allocated to a depression information website, a cognitive-behavioural skills training website (CBT or an attention control condition. Reports of help seeking for specific treatments, from specific sources and for categories of treatments were assessed. Results Relative to the control, the depression information site was associated with decreases in seeking support from friends and family, the use of music and of everyday treatments and no increase in seeking evidence based interventions. The CBT site was associated with the report of help seeking for CBT, massage and exercise. Conclusion Methods to encourage the use of evidence-based treatments need further research to determine whether the assistance sought is evidence based and whether there are unintended effects.

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

    Science.gov (United States)

    Boshoff, Kobie; Maher, Carol

    2018-01-01

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

  14. Effects of a web-based tailored multiple-lifestyle intervention for adults: a two-year randomized controlled trial comparing sequential and simultaneous delivery modes.

    Science.gov (United States)

    Schulz, Daniela N; Kremers, Stef P J; Vandelanotte, Corneel; van Adrichem, Mathieu J G; Schneider, Francine; Candel, Math J J M; de Vries, Hein

    2014-01-27

    Web-based computer-tailored interventions for multiple health behaviors can have a significant public health impact. Yet, few randomized controlled trials have tested this assumption. The objective of this paper was to test the effects of a sequential and simultaneous Web-based tailored intervention on multiple lifestyle behaviors. A randomized controlled trial was conducted with 3 tailoring conditions (ie, sequential, simultaneous, and control conditions) in the Netherlands in 2009-2012. Follow-up measurements took place after 12 and 24 months. The intervention content was based on the I-Change model. In a health risk appraisal, all respondents (N=5055) received feedback on their lifestyle behaviors that indicated whether they complied with the Dutch guidelines for physical activity, vegetable consumption, fruit consumption, alcohol intake, and smoking. Participants in the sequential (n=1736) and simultaneous (n=1638) conditions received tailored motivational feedback to change unhealthy behaviors one at a time (sequential) or all at the same time (simultaneous). Mixed model analyses were performed as primary analyses; regression analyses were done as sensitivity analyses. An overall risk score was used as outcome measure, then effects on the 5 individual lifestyle behaviors were assessed and a process evaluation was performed regarding exposure to and appreciation of the intervention. Both tailoring strategies were associated with small self-reported behavioral changes. The sequential condition had the most significant effects compared to the control condition after 12 months (T1, effect size=0.28). After 24 months (T2), the simultaneous condition was most effective (effect size=0.18). All 5 individual lifestyle behaviors changed over time, but few effects differed significantly between the conditions. At both follow-ups, the sequential condition had significant changes in smoking abstinence compared to the simultaneous condition (T1 effect size=0.31; T2 effect

  15. From Evidence-Based Research to Practice-Based Evidence: Disseminating a Web-Based Computer-Tailored Workplace Sitting Intervention through a Health Promotion Organisation

    Directory of Open Access Journals (Sweden)

    Katrien De Cocker

    2018-05-01

    Full Text Available Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users. The organisation systematically registered all the time and resources invested to promote the intervention. Website usage statistics (reach and descriptive statistics (website users’ attributes were also assessed. Online strategies (promotion on their homepage; sending e-mails, newsletters, Twitter, Facebook and LinkedIn posts to professional partners were the main dissemination methods. The total time investment was 25.6 h, which cost approximately 845 EUR in salaries. After sixteen months, 1599 adults had visited the website and 1500 (93.8% completed the survey to receive personalized sitting advice. This sample was 38.3 ± 11.0 years, mainly female (76.9%, college/university educated (89.0%, highly sedentary (88.5% sat >8 h/day and intending to change (93.0% their sitting. Given the small time and money investment, these outcomes are positive and indicate the potential for wide-scale dissemination. However, more efforts are needed to reach men, non-college/university educated employees, and those not intending behavioural change.

  16. A web-based programme for person-centred learning and support designed for preschool children with long-term illness: a pilot study of a new intervention.

    Science.gov (United States)

    Hellström, Anna-Lena; Simeonsdotter Svensson, Agneta; Pramling Samuelsson, Ingrid; Jenholt Nolbris, Margaretha

    2012-01-01

    For children living with long-term illness, school age is a risk period with regard to psychosocial ill health and poor compliance with treatment. There is a need for methods to promote health, well-being, and self-esteem. This study describes a new concept for supporting children, person-centred web-based learning and support, which has been tested in 12 preschool children and incorporates learning about feelings, relationships, and the right to integrity. SKYPE was used for conversations between the child and the web teacher. Methods. The programme was developed and tested in two steps. The conversations were tape-recorded and analysed using phenomenography. The questions addressed concerned the quality of the intervention process: accessibility of intervention, learning content and support, and identification of measurable items and patterns. Findings. The children found it interesting to communicate with their web teacher using SKYPE. The story about Max and Sara served as a good basis for discussion, and development was found in the learning process. The children were able to talk about relations and feelings and developed an understanding for use in new situations in their daily lives. Items and patterns that are useful for research and documentation were identified, for example, well-being, resources, needs, and wishes.

  17. From Evidence-Based Research to Practice-Based Evidence: Disseminating a Web-Based Computer-Tailored Workplace Sitting Intervention through a Health Promotion Organisation.

    Science.gov (United States)

    Cocker, Katrien De; Cardon, Greet; Bennie, Jason A; Kolbe-Alexander, Tracy; Meester, Femke De; Vandelanotte, Corneel

    2018-05-22

    Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users. The organisation systematically registered all the time and resources invested to promote the intervention. Website usage statistics (reach) and descriptive statistics (website users' attributes) were also assessed. Online strategies (promotion on their homepage; sending e-mails, newsletters, Twitter, Facebook and LinkedIn posts to professional partners) were the main dissemination methods. The total time investment was 25.6 h, which cost approximately 845 EUR in salaries. After sixteen months, 1599 adults had visited the website and 1500 (93.8%) completed the survey to receive personalized sitting advice. This sample was 38.3 ± 11.0 years, mainly female (76.9%), college/university educated (89.0%), highly sedentary (88.5% sat >8 h/day) and intending to change (93.0%) their sitting. Given the small time and money investment, these outcomes are positive and indicate the potential for wide-scale dissemination. However, more efforts are needed to reach men, non-college/university educated employees, and those not intending behavioural change.

  18. Women Empowerment Through Self-Help Groups

    NARCIS (Netherlands)

    Alemu, Sintayehu Hailu; Kempen, Van Luuk; Ruben, Ruerd

    2018-01-01

    This paper deals with the impact of self-help groups (SHGs) in apple production on empowering women in the Chencha district of Southern Ethiopia. Impact is traced on the basis of a cross-sectional survey among SHG members and nonmembers, using propensity score matching. Apart from the attitudinal

  19. The effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among adolescents aged 15 to 20 years with a low educational background: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Voogt Carmen V

    2012-06-01

    Full Text Available Abstract Background The serious negative health consequences of heavy drinking among adolescents is cause for concern, especially among adolescents aged 15 to 20 years with a low educational background. In the Netherlands, there is a lack of alcohol prevention programs directed to the drinking patterns of this specific target group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that aims to reduce alcohol use among heavy drinking adolescents aged 15 to 20 years with a low educational background. Methods/design The effectiveness of the What Do You Drink (WDYD web-based brief alcohol intervention will be tested among 750 low-educated, heavy drinking adolescents. It will use a two-arm parallel group cluster randomized controlled trial. Classes of adolescents from educational institutions will be randomly assigned to either the experimental (n = 375: web-based brief alcohol intervention or control condition (n = 375: no intervention. Primary outcomes measures will be: 1 the percentage of participants who drink within the normative limits of the Dutch National Health Council for low-risk drinking, 2 reductions in mean weekly alcohol consumption, and 3 frequency of binge drinking. The secondary outcome measures include the alcohol-related cognitions, attitudes, self-efficacy, and subjective norms, which will be measured at baseline and at one and six months after the intervention. Discussion This study protocol presents the study design of a two-arm parallel-group randomized controlled trial to evaluate the effectiveness of the WDYD web-based brief alcohol intervention. We hypothesized a reduction in mean weekly alcohol consumption and in the frequency of binge drinking in the experimental condition, resulting from the web-based brief alcohol intervention, compared to the control condition. Trial registration Netherlands Trial Register NTR2971

  20. The effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among adolescents aged 15 to 20 years with a low educational background: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Voogt, Carmen V; Poelen, Evelien A P; Lemmers, Lex A C J; Engels, Rutger C M E

    2012-06-15

    The serious negative health consequences of heavy drinking among adolescents is cause for concern, especially among adolescents aged 15 to 20 years with a low educational background. In the Netherlands, there is a lack of alcohol prevention programs directed to the drinking patterns of this specific target group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that aims to reduce alcohol use among heavy drinking adolescents aged 15 to 20 years with a low educational background. The effectiveness of the What Do You Drink (WDYD) web-based brief alcohol intervention will be tested among 750 low-educated, heavy drinking adolescents. It will use a two-arm parallel group cluster randomized controlled trial. Classes of adolescents from educational institutions will be randomly assigned to either the experimental (n = 375: web-based brief alcohol intervention) or control condition (n = 375: no intervention). Primary outcomes measures will be: 1) the percentage of participants who drink within the normative limits of the Dutch National Health Council for low-risk drinking, 2) reductions in mean weekly alcohol consumption, and 3) frequency of binge drinking. The secondary outcome measures include the alcohol-related cognitions, attitudes, self-efficacy, and subjective norms, which will be measured at baseline and at one and six months after the intervention. This study protocol presents the study design of a two-arm parallel-group randomized controlled trial to evaluate the effectiveness of the WDYD web-based brief alcohol intervention. We hypothesized a reduction in mean weekly alcohol consumption and in the frequency of binge drinking in the experimental condition, resulting from the web-based brief alcohol intervention, compared to the control condition. Netherlands Trial Register NTR2971.

  1. Web-based interventions for weight loss and weight maintenance among rural midlife and older women: protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Boeckner Linda S

    2011-06-01

    Full Text Available Abstract Background Weight loss is challenging and maintenance of weight loss is problematic among midlife and older rural women. Finding effective interventions using innovative delivery methods that can reach underserved and vulnerable populations of overweight and obese rural women is a public health challenge. Methods/Design This Women Weigh-In for Wellness (The WWW study randomized-controlled trial is designed to compare the effectiveness of theory-based behavior-change interventions using (1 website only, (2 website with peer-led support, or (3 website with professional email-counseling to facilitate initial weight loss (baseline to 6 months, guided continuing weight loss and maintenance (7-18 months and self-directed weight maintenance (19-30 months among rural women ages 45-69 with a BMI of 28-45. Recruitment efforts using local media will target 306 rural women who live within driving distance of a community college site where assessments will be conducted at baseline, 3, 6, 12, 18, 24 and 30 months by research nurses blinded to group assignments. Primary outcomes include changes in body weight, % weight loss, and eating and activity behavioral and biomarkers from baseline to each subsequent assessment. Secondary outcomes will be percentage of women achieving at least 5% and 10% weight loss without regain from baseline to 6, 18, and 30 months and achieving healthy eating and activity targets. Data analysis will use generalized estimating equations to analyze average change across groups and group differences in proportion of participants achieving target weight loss levels. Discussion The Women Weigh-In for Wellness study compares innovative web-based alternatives for providing lifestyle behavior-change interventions for promoting weight loss and weight maintenance among rural women. If effective, such interventions would offer potential for reducing overweight and obesity among a vulnerable, hard-to-reach, population of rural women

  2. The helpers’ stress: Effectiveness of a web-based intervention for professionals working with trauma survivors in reducing job burnout and improving work engagement

    Directory of Open Access Journals (Sweden)

    Anna Rogala

    2016-04-01

    Full Text Available Background: The study aimed at evaluating effectiveness of the web-based intervention, “The Helpers’ Stress,” in reducing job burnout and enhancing work engagement among professionals working with trauma survivors. Material and Methods: Participants were randomly allocated to 1 of the 3 intervention modules: 1 – the self-efficacy enhancement (N = 87, 2 – the social support enhancement (N = 85, or to 3 – the educational module (comparison group, N = 81. Participants completed the online questionnaires before the intervention (T1, immediately after (T2, and 4 weeks after the intervention (T3. Results: Due to high drop-out rate at T2 and T3 in social support enhancement module, we excluded from analysis participants assigned to this condition. Participants assigned to the self-efficacy enhancement module presented higher levels of self-efficacy (at T2 and T3, compared to those assigned to the educational module. Job burnout decreased significantly between T1 and T2, and between T2 and T3, and work engagement increased significantly between T1 and T2, and between T1 and T3, among participants assigned to both modules mentioned above. Self-efficacy (T2 mediated the relationship between the group assignment (educational module vs. self-efficacy enhancement module and respectively job burnout (T3 or work engagement (T3. Conclusions: The results of our study highlight the role of self-efficacy in reducing job burnout and increasing work engagement. Med Pr 2016;67(2:223–237

  3. Patients at the Centre: Methodological Considerations for Evaluating Evidence from Health Interventions Involving Patients Use of Web-Based Information Systems

    Science.gov (United States)

    Cummings, Elizabeth; Turner, Paul

    2010-01-01

    Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions. Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences. Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the ‘patient at the centre’ by engaging them in their own care and/or ‘empowering’ them through the use of information systems. This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients’ interests and outcomes are measured, defined and evaluated within health interventions that involve them using web-based

  4. Patients at the centre: methodological considerations for evaluating evidence from health interventions involving patients use of web-based information systems.

    Science.gov (United States)

    Cummings, Elizabeth; Turner, Paul

    2010-09-15

    Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions.Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences.Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the 'patient at the centre' by engaging them in their own care and/or 'empowering' them through the use of information systems.This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients' interests and outcomes are measured, defined and evaluated within health interventions that involve them using web-based information systems

  5. Evaluation of a Web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial.

    Science.gov (United States)

    Yardley, Lucy; Joseph, Judith; Michie, Susan; Weal, Mark; Wills, Gary; Little, Paul

    2010-12-15

    There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions. This study was designed as an evaluation of the usage and effects of the "Internet Doctor" website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change. Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use. The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline

  6. Comparison of trial participants and open access users of a web-based physical activity intervention regarding adherence, attrition, and repeated participation.

    Science.gov (United States)

    Wanner, Miriam; Martin-Diener, Eva; Bauer, Georg; Braun-Fahrländer, Charlotte; Martin, Brian W

    2010-02-10

    Web-based interventions are popular for promoting healthy lifestyles such as physical activity. However, little is known about user characteristics, adherence, attrition, and predictors of repeated participation on open access physical activity websites. The focus of this study was Active-online, a Web-based individually tailored physical activity intervention. The aims were (1) to assess and compare user characteristics and adherence to the website (a) in the open access context over time from 2003 to 2009, and (b) between trial participants and open access users; and (2) to analyze attrition and predictors of repeated use among participants in a randomized controlled trial compared with registered open access users. Data routinely recorded in the Active-online user database were used. Adherence was defined as: the number of pages viewed, the proportion of visits during which a tailored module was begun, the proportion of visits during which tailored feedback was received, and the time spent in the tailored modules. Adherence was analyzed according to six one-year periods (2003-2009) and according to the context (trial or open access) based on first visits and longest visits. Attrition and predictors of repeated participation were compared between trial participants and open access users. The number of recorded visits per year on Active-online decreased from 42,626 in 2003-2004 to 8343 in 2008-2009 (each of six one-year time periods ran from April 23 to April 22 of the following year). The mean age of users was between 38.4 and 43.1 years in all time periods and both contexts. The proportion of women increased from 49.5% in 2003-2004 to 61.3% in 2008-2009 (Popen access users. For open access users, adherence was similar during the first and the longest visits; for trial participants, adherence was lower during the first visits and higher during the longest visits. Of registered open access users and trial participants, 25.8% and 67.3% respectively visited Active

  7. Application of Behavior Change Techniques in a Personalized Nutrition Electronic Health Intervention Study: Protocol for the Web-Based Food4Me Randomized Controlled Trial

    Science.gov (United States)

    Macready, Anna L; Fallaize, Rosalind; Butler, Laurie T; Ellis, Judi A; Kuznesof, Sharron; Frewer, Lynn J; Celis-Morales, Carlos; Livingstone, Katherine M; Araújo-Soares, Vera; Fischer, Arnout RH; Stewart-Knox, Barbara J; Mathers, John C

    2018-01-01

    Background To determine the efficacy of behavior change techniques applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques that have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development, and most are not adapted for Web-based delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized Web-based techniques employed in a large-scale, internet-based intervention to change dietary behavior and physical activity. Objective The aims of this study were (1) to describe techniques embedded in the Food4Me study design and explain the selection rationale and (2) to demonstrate the use of behavior change technique taxonomies, develop standard operating procedures for training, and identify strengths and limitations of the Food4Me framework that will inform its use in future studies. Methods The 6-month randomized controlled trial took place simultaneously in seven European countries, with participants receiving one of four levels of personalized advice (generalized, intake-based, intake+phenotype–based, and intake+phenotype+gene–based). A three-phase approach was taken: (1) existing taxonomies were reviewed and techniques were identified a priori for possible inclusion in the Food4Me study, (2) a standard operating procedure was developed to maintain consistency in the use of methods and techniques across research centers, and (3) the Food4Me behavior change technique framework was reviewed and updated post intervention. An analysis of excluded techniques was also conducted. Results Of 46 techniques identified a priori as being applicable to Food4Me, 17 were embedded in the intervention design; 11 were from a dietary taxonomy, and 6 from a smoking cessation taxonomy. In addition, the four-category smoking cessation framework structure was adopted for clarity of

  8. Design of a Randomized Controlled Trial of a Web-Based Intervention to Reduce Cardiovascular Disease Risk Factors among Remote Reservation-Dwelling American Indian Adults with Type 2 Diabetes

    Science.gov (United States)

    Henderson, Jeffrey A.; Chubak, Jessica; O'Connell, Joan; Ramos, Maria C.; Jensen, Julie; Jobe, Jared B.

    2012-01-01

    We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation-dwelling adult American Indian men and women with type 2 diabetes…

  9. Use and appreciation of a web-based, tailored intervention (E-health4Uth) combined with counseling to promote adolescents' health in preventive youth health care: Survey and log-file analysis

    NARCIS (Netherlands)

    R. Bannink (Rienke); S.M.L. Broeren (Suzanne); E. Joosten-van Zwanenburg (Evelien); E. As, van (Elisabeth); P.M. van de Looij-Jansen (Petra); H. Raat (Hein)

    2014-01-01

    textabstractBackground: Health promotion for adolescents is important in the prevention of mental health problems and health-risk behaviors. We implemented two interventions in a preventive youth health care setting. Adolescents in the E-health4Uth group received Web-based, tailored messages on

  10. A Tailored Web-Based Intervention to Improve Parenting Risk and Protective Factors for Adolescent Depression and Anxiety Problems: Postintervention Findings From a Randomized Controlled Trial.

    Science.gov (United States)

    Yap, Marie Bee Hui; Mahtani, Shireen; Rapee, Ronald M; Nicolas, Claire; Lawrence, Katherine A; Mackinnon, Andrew; Jorm, Anthony F

    2018-01-19

    Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. A two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children's Anxiety Scale

  11. Drinker prototype alteration and cue reminders as strategies in a tailored web-based intervention reducing adults' alcohol consumption: randomized controlled trial.

    Science.gov (United States)

    van Lettow, Britt; de Vries, Hein; Burdorf, Alex; Boon, Brigitte; van Empelen, Pepijn

    2015-02-04

    Excessive alcohol use is a prevalent and worldwide problem. Excessive drinking causes a significant burden of disease and is associated with both morbidity and excess mortality. Prototype alteration and provision of a cue reminder could be useful strategies to enhance the effectiveness of online tailored interventions for excessive drinking. Through a Web-based randomized controlled trial, 2 strategies (ie, prototype alteration and cue reminders) within an existing online personalized feedback intervention (Drinktest) aimed to reduce adults' excessive drinking. It was expected that both strategies would add to Drinktest and would result in reductions in alcohol consumption by intrinsic motivation and the seizure of opportunities to act. Participants were recruited online and through printed materials. Excessive drinking adults (N=2634) were randomly assigned to 4 conditions: original Drinktest, Drinktest plus prototype alteration, Drinktest plus cue reminder, and Drinktest plus prototype alteration and cue reminder. Evaluation took place at 1-month posttest and 6-month follow-up. Differences in drinking behavior, intentions, and behavioral willingness (ie, primary outcomes) were assessed by means of longitudinal multilevel analyses using a last observation carried forward method. Measures were based on self-reports. All conditions showed reductions in drinking behavior and willingness to drink, and increased intentions to reduce drinking. Prototype alteration (B=-0.15, Pprototypes. Thus, prototype alteration and cue reminder usage may be feasible and simple intervention strategies to promote reductions in alcohol consumption among adults, with an effect up to 6 months. Nederlands Trial Register (NTR): 4169; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4169 (Archived by WebCite at http://www.webcitation.org/6VD2jnxmB).

  12. Drinker Prototype Alteration and Cue Reminders as Strategies in a Tailored Web-Based Intervention Reducing Adults’ Alcohol Consumption: Randomized Controlled Trial

    Science.gov (United States)

    2015-01-01

    Background Excessive alcohol use is a prevalent and worldwide problem. Excessive drinking causes a significant burden of disease and is associated with both morbidity and excess mortality. Prototype alteration and provision of a cue reminder could be useful strategies to enhance the effectiveness of online tailored interventions for excessive drinking. Objective Through a Web-based randomized controlled trial, 2 strategies (ie, prototype alteration and cue reminders) within an existing online personalized feedback intervention (Drinktest) aimed to reduce adults’ excessive drinking. It was expected that both strategies would add to Drinktest and would result in reductions in alcohol consumption by intrinsic motivation and the seizure of opportunities to act. Methods Participants were recruited online and through printed materials. Excessive drinking adults (N=2634) were randomly assigned to 4 conditions: original Drinktest, Drinktest plus prototype alteration, Drinktest plus cue reminder, and Drinktest plus prototype alteration and cue reminder. Evaluation took place at 1-month posttest and 6-month follow-up. Differences in drinking behavior, intentions, and behavioral willingness (ie, primary outcomes) were assessed by means of longitudinal multilevel analyses using a last observation carried forward method. Measures were based on self-reports. Results All conditions showed reductions in drinking behavior and willingness to drink, and increased intentions to reduce drinking. Prototype alteration (B=–0.15, Pprototypes. Thus, prototype alteration and cue reminder usage may be feasible and simple intervention strategies to promote reductions in alcohol consumption among adults, with an effect up to 6 months. Trial Registration Nederlands Trial Register (NTR): 4169; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4169 (Archived by WebCite at http://www.webcitation.org/6VD2jnxmB). PMID:25653199

  13. Impact of ENPP1 K121Q on change of insulin resistance after web-based intervention in Korean men with diabetes and impaired fasting glucose.

    Science.gov (United States)

    Kang, Ji Yeon; Sung, Sook Hee; Lee, Yeon Ju; Choi, Tae In; Choi, Seung Jin

    2014-10-01

    Ectoenzyme nucleotide pyrophosphate phosphodiesterase 1 (ENPP1) gene has been studied in relation to type 2 diabetes mellitus (T2DM) and insulin resistance (IR). We hypothesized that the difference in genotype may be one of the factors that affect the outcome of intervention. We genotyped 448 men with fasting glucose≥5.6 mM/L, including 371 in subjects with K allele (KK) (69 control group [CG]; and 302 intervention group [IG]) and 77 in subjects with Q allele (KQ+QQ) (13 CG and 64 IG). The web-based intervention based on a lifestyle modification was delivered by e-mail once a month for 10 months. In the KK, IG demonstrated significantly decreased levels of fasting serum insulin (FSI) as compared to CG and homeostasis model of assessment of insulin resistance (HOMA-IR). In the KQ+QQ IG group, hemoglobin A1c (HbA1c), FSI and HOMA-IR were significantly decreased, and showed further reduction in the HOMA-IR than KQ+QQ CG. After analysis of covariance, K121Q did significantly influence the change of HbA1c in CG after appropriate adjustment. In a multivariate model, BMI change predicted HOMA-IR change (adjusted β=0.801; P=0.022) in KK IG subjects with T2DM. ENPP1 K121Q did not influence the change in IR. However, individuals with T2DM carrying the K121 variant are very responsive to the effect of BMI reduction on HOMA-IR.

  14. Self-Guided Web-Based Interventions: Scoping Review on User Needs and the Potential of Embodied Conversational Agents to Address Them.

    Science.gov (United States)

    Scholten, Mark R; Kelders, Saskia M; Van Gemert-Pijnen, Julia Ewc

    2017-11-16

    Web-based mental health interventions have evolved from innovative prototypes to evidence-based and clinically applied solutions for mental diseases such as depression and anxiety. Open-access, self-guided types of these solutions hold the promise of reaching and treating a large population at a reasonable cost. However, a considerable factor that currently hinders the effectiveness of these self-guided Web-based interventions is the high level of nonadherence. The absence of a human caregiver apparently has a negative effect on user adherence. It is unknown to what extent this human support can be handed over to the technology of the intervention to mitigate this negative effect. The first objective of this paper was to explore what is known in literature about what support a user needs to stay motivated and engaged in an electronic health (eHealth) intervention that requires repeated use. The second objective was to explore the current potential of embodied conversational agents (ECAs) to provide this support. This study reviews and interprets the available literature on (1) support within eHealth interventions that require repeated use and (2) the potential of ECAs by means of a scoping review. The rationale for choosing a scoping review is that the subject is broad, diverse, and largely unexplored. Themes for (1) and (2) were proposed based on grounded theory and mapped on each other to find relationships. The results of the first part of this study suggest the presence of user needs that largely remain implicit and unaddressed. These support needs can be categorized as task-related support and emotion-related support. The results of the second part of this study suggest that ECAs are capable of engaging and motivating users of information technology applications in the domains of learning and behavioral change. Longitudinal studies must be conducted to determine under what circumstances ECAs can create and maintain a productive user relationship. Mapping the

  15. Development and usability testing of a web-based self-management intervention for oral cancer survivors and their family caregivers.

    Science.gov (United States)

    Badr, H; Lipnick, D; Diefenbach, M A; Posner, M; Kotz, T; Miles, B; Genden, E

    2016-09-01

    Oral cancer (OC) survivors experience debilitating side effects that affect their quality of life (QOL) and that of their caregivers. This study aimed to develop and evaluate a dyadic, web-based intervention to improve survivor self-management and survivor/caregiver QOL. A qualitative needs assessment (semi-structured interviews) with 13 OC survivors and 12 caregivers was conducted to discern information and support needs as well as preferences regarding website features and tools. Results using Grounded Theory analysis showed that OC survivors and caregivers: (1) want and need practical advice about managing side effects; (2) want to reach out to other survivors/caregivers for information and support; and (3) have both overlapping and unique needs and preferences regarding website features. Usability testing (N = 6 survivors; 5 caregivers) uncovered problems with the intuitiveness, navigation and design of the website that were subsequently addressed. Users rated the website favourably on the dimensions of attractiveness, controllability, efficiency, intuitiveness and learnability, and gave it a total usability score of 80/100. Overall, this study demonstrates that OC survivors and caregivers are interested in using an online programme to improve QOL, and that providing tailored website content and features based on the person's role as survivor or caregiver is important in this population. © 2015 John Wiley & Sons Ltd.

  16. Effectiveness of two web-based cognitive bias modification interventions targeting approach and attentional bias in gambling problems: study protocol for a pilot randomised controlled trial.

    Science.gov (United States)

    Boffo, Marilisa; Willemen, Ronny; Pronk, Thomas; Wiers, Reinout W; Dom, Geert

    2017-10-03

    Disordered gamblers have phenotypical and pathological similarities to those with substance use disorders (SUD), including exaggerated automatic cognitive processing of motivationally salient gambling cues in the environment (i.e., attentional and approach bias). Cognitive bias modification (CBM) is a family of computerised interventions that have proved effective in successfully re-training these automatic cognitive biases in SUD. CBM interventions can, in principle, be administered online, thus showing potential of being a low-cost, low-threshold addition to conventional treatments. This paper presents the design of a pilot randomised controlled trial exploring the effectiveness of two web-based CBM interventions targeting attentional and approach bias towards gambling cues in a sample of Dutch and Belgian problematic and pathological gamblers. Participants (N = 182) are community-recruited adults experiencing gambling problems, who have gambled at least twice in the past 6 months and are motivated to change their gambling behaviour. After a baseline assessment session, participants are randomly assigned to one of four experimental conditions (attentional or approach bias training, or the placebo version of the two trainings) and complete six sessions of training. At baseline and before each training session, participants receive automated personalised feedback on their gambling motives and reasons to quit or reduce gambling. The post-intervention, 1-month, and 3-month follow-up assessments will examine changes in gambling behaviour, with frequency and expenditure as primary outcomes, and depressive symptoms and gambling-related attentional and approach biases as secondary outcomes. Secondary analyses will explore possible moderators (interference control capacity and trait impulsivity) and mediators (change in cognitive bias) of training effects on the primary outcomes. This study is the first to explore the effectiveness of an online CBM intervention for

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

    Science.gov (United States)

    Schulz, Daniela N; Kremers, Stef P J; de Vries, Hein

    2012-05-17

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

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

    Directory of Open Access Journals (Sweden)

    Schulz Daniela N

    2012-05-01

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

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

    Science.gov (United States)

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

    2018-02-26

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

  20. A Web-Based Data Collection Platform for Multisite Randomized Behavioral Intervention Trials: Development, Key Software Features, and Results of a User Survey.

    Science.gov (United States)

    Modi, Riddhi A; Mugavero, Michael J; Amico, Rivet K; Keruly, Jeanne; Quinlivan, Evelyn Byrd; Crane, Heidi M; Guzman, Alfredo; Zinski, Anne; Montue, Solange; Roytburd, Katya; Church, Anna; Willig, James H

    2017-06-16

    Meticulous tracking of study data must begin early in the study recruitment phase and must account for regulatory compliance, minimize missing data, and provide high information integrity and/or reduction of errors. In behavioral intervention trials, participants typically complete several study procedures at different time points. Among HIV-infected patients, behavioral interventions can favorably affect health outcomes. In order to empower newly diagnosed HIV positive individuals to learn skills to enhance retention in HIV care, we developed the behavioral health intervention Integrating ENGagement and Adherence Goals upon Entry (iENGAGE) funded by the National Institute of Allergy and Infectious Diseases (NIAID), where we deployed an in-clinic behavioral health intervention in 4 urban HIV outpatient clinics in the United States. To scale our intervention strategy homogenously across sites, we developed software that would function as a behavioral sciences research platform. This manuscript aimed to: (1) describe the design and implementation of a Web-based software application to facilitate deployment of a multisite behavioral science intervention; and (2) report on results of a survey to capture end-user perspectives of the impact of this platform on the conduct of a behavioral intervention trial. In order to support the implementation of the NIAID-funded trial iENGAGE, we developed software to deploy a 4-site behavioral intervention for new clinic patients with HIV/AIDS. We integrated the study coordinator into the informatics team to participate in the software development process. Here, we report the key software features and the results of the 25-item survey to evaluate user perspectives on research and intervention activities specific to the iENGAGE trial (N=13). The key features addressed are study enrollment, participant randomization, real-time data collection, facilitation of longitudinal workflow, reporting, and reusability. We found 100% user

  1. Effectiveness of a Web-Based Tailored Intervention (E-health4Uth) and Consultation to Promote Adolescents’ Health: Randomized Controlled Trial

    Science.gov (United States)

    Bannink, Rienke; Broeren, Suzanne; Joosten-van Zwanenburg, Evelien; van As, Els; van de Looij-Jansen, Petra

    2014-01-01

    Background To promote well-being and health behaviors among adolescents, 2 interventions were implemented at 12 secondary schools. Adolescents in the E-health4Uth group received Web-based tailored messages focused on their health behaviors and well-being. Adolescents in the E-health4Uth and consultation group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems. Objective This study evaluated the effect of E-health4Uth and E-health4Uth and consultation on well-being (ie, mental health status and health-related quality of life) and health behaviors (ie, alcohol and drug use, smoking, safe sex). Methods A cluster randomized controlled trial was conducted among third- and fourth-year secondary school students (mean age 15.9, SD 0.69). School classes (clusters) were randomly assigned to (1) E-health4Uth group, (2) E-health4Uth and consultation group, or (3) control group (ie, care as usual). Adolescents completed a questionnaire at baseline and at 4-month follow-up assessing alcohol consumption, smoking, drug use, condom use, mental health via the Strengths and Difficulties Questionnaire (SDQ) and the Youth Self Report (YSR; only measured at follow-up), and health-related quality of life. Multilevel logistic, ordinal, and linear regression analyses were used to reveal differences in health behavior and well-being between the intervention groups and the control group at follow-up. Subsequently, it was explored whether demographics moderated the effects. Results Data from 1256 adolescents were analyzed. Compared to the control intervention, the E-health4Uth intervention, as a standalone intervention, showed minor positive results in health-related quality of life (B=2.79, 95% CI 0.72-4.87) and condom use during intercourse among adolescents of Dutch ethnicity (OR 3.59, 95% CI 1.71-7.55) not replicated in the E-health4Uth and consultation group. The E-health4Uth and

  2. Effectiveness of a Web-based tailored intervention (E-health4Uth) and consultation to promote adolescents' health: randomized controlled trial.

    Science.gov (United States)

    Bannink, Rienke; Broeren, Suzanne; Joosten-van Zwanenburg, Evelien; van As, Els; van de Looij-Jansen, Petra; Raat, Hein

    2014-05-30

    To promote well-being and health behaviors among adolescents, 2 interventions were implemented at 12 secondary schools. Adolescents in the E-health4Uth group received Web-based tailored messages focused on their health behaviors and well-being. Adolescents in the E-health4Uth and consultation group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems. This study evaluated the effect of E-health4Uth and E-health4Uth and consultation on well-being (ie, mental health status and health-related quality of life) and health behaviors (ie, alcohol and drug use, smoking, safe sex). A cluster randomized controlled trial was conducted among third- and fourth-year secondary school students (mean age 15.9, SD 0.69). School classes (clusters) were randomly assigned to (1) E-health4Uth group, (2) E-health4Uth and consultation group, or (3) control group (ie, care as usual). Adolescents completed a questionnaire at baseline and at 4-month follow-up assessing alcohol consumption, smoking, drug use, condom use, mental health via the Strengths and Difficulties Questionnaire (SDQ) and the Youth Self Report (YSR; only measured at follow-up), and health-related quality of life. Multilevel logistic, ordinal, and linear regression analyses were used to reveal differences in health behavior and well-being between the intervention groups and the control group at follow-up. Subsequently, it was explored whether demographics moderated the effects. Data from 1256 adolescents were analyzed. Compared to the control intervention, the E-health4Uth intervention, as a standalone intervention, showed minor positive results in health-related quality of life (B=2.79, 95% CI 0.72-4.87) and condom use during intercourse among adolescents of Dutch ethnicity (OR 3.59, 95% CI 1.71-7.55) not replicated in the E-health4Uth and consultation group. The E-health4Uth and consultation intervention showed minor

  3. An integrated web-based mental health intervention of assessment-referral-care to reduce stress, anxiety, and depression in hospitalized pregnant women with medically high-risk pregnancies: a feasibility study protocol of hospital-based implementation.

    Science.gov (United States)

    Kingston, Dawn; Janes-Kelley, Selikke; Tyrrell, Janie; Clark, Lorna; Hamza, Deena; Holmes, Penny; Parkes, Cheryl; Moyo, Nomagugu; McDonald, Sheila; Austin, Marie-Paule

    2015-01-16

    At prevalence rates of up to 40%, rates of depression and anxiety among women with medically complex pregnancies are 3 times greater than those in community-based samples of pregnant women. However, mental health care is not a component of routine hospital-based antenatal care for medically high-risk pregnant women. The purpose of this study is to evaluate the effectiveness and feasibility of the hospital-based implementation of a Web-based integrated mental health intervention comprising psychosocial assessment, referral, and cognitive behavioral therapy (CBT) for antenatal inpatients. This study is a quasi-experimental design. Pregnant women are eligible to participate if they are (1) 72 hours, (3) able to speak and read English or be willing to use a translation service to assist with completion of the questionnaires and intervention, (4) able to complete follow-up email questionnaires, (5) >16 years of age, and (6) not actively suicidal. Women admitted to the unit for induction (eg, care hospital. All women will complete a Web-based psychosocial assessment and 6 Web-based CBT modules. Results of the psychosocial assessment will be used by a Web-based clinical decision support system to generate a clinical risk score and clinician prompts to provide recommendations for the best treatment and referral options. The primary outcome is self-reported prenatal depression, anxiety, and stress symptoms at 6-8 weeks postrecruitment. Secondary outcomes are postpartum depression, anxiety, and stress symptoms; self-efficacy; mastery; self-esteem; sleep; relationship quality; coping; resilience; Apgar score; gestational age; birth weight; maternal-infant attachment; infant behavior and development; parenting stress/competence at 3-months postpartum; and intervention cost-effectiveness, efficiency, feasibility, and acceptability. All women will complete email questionnaires at 6-8 weeks postrecruitment and 3-months postpartum. Qualitative interviews with 10-15 health care

  4. Development of a Web-Based Health Care Intervention for Patients With Heart Disease: Lessons Learned From a Participatory Design Study.

    Science.gov (United States)

    Noergaard, Birgitte; Sandvei, Marianne; Rottmann, Nina; Johannessen, Helle; Wiil, Uffe; Schmidt, Thomas; Pedersen, Susanne S

    2017-05-17

    The use of telemedicine technologies in health care has increased substantially, together with a growing interest in participatory design methods when developing telemedicine approaches. We present lessons learned from a case study involving patients with heart disease and health care professionals in the development of a personalized Web-based health care intervention. We used a participatory design approach inspired by the method for feasibility studies in software development. We collected qualitative data using multiple methods in 3 workshops and analyzed the data using thematic analysis. Participants were 7 patients with diagnosis of heart disease, 2 nurses, 1 physician, 2 systems architects, 3 moderators, and 3 observers. We present findings in 2 parts. (1) Outcomes of the participatory design process: users gave valuable feedback on ease of use of the platforms' tracking tools, platform design, terminology, and insights into patients' monitoring needs, information and communication technologies skills, and preferences for self-management tools. (2) Experiences from the participatory design process: patients and health care professionals contributed different perspectives, with the patients using an experience-based approach and the health care professionals using a more attitude-based approach. The essential lessons learned concern planning and organization of workshops, including the finding that patients engaged actively and willingly in a participatory design process, whereas it was more challenging to include and engage health care professionals. ©Birgitte Noergaard, Marianne Sandvei, Nina Rottmann, Helle Johannessen, Uffe Wiil, Thomas Schmidt, Susanne S Pedersen. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 17.05.2017.

  5. Lymphoma InterVEntion (LIVE) - patient-reported outcome feedback and a web-based self-management intervention for patients with lymphoma: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Arts, Lindy P J; van de Poll-Franse, Lonneke V; van den Berg, Sanne W; Prins, Judith B; Husson, Olga; Mols, Floortje; Brands-Nijenhuis, Angelique V M; Tick, Lidwine; Oerlemans, Simone

    2017-04-28

    Patients with lymphoma are at risk of experiencing adverse physical and psychosocial problems from their cancer and its treatment. Regular screening of these symptoms by the use of patient-reported outcomes (PROs) could increase timely recognition and adequate symptom management. Moreover, self-management interventions intend to enhance knowledge and skills and empower patients to better manage their disease and related problems. The objective of the Lymphoma InterVEntion (LIVE) trial is to examine whether feedback to patients on their PROs and access to a web-based, self-management intervention named Living with lymphoma will increase self-management skills and satisfaction with information, and reduce psychological distress. The LIVE randomised controlled trial consists of three arms: (1) standard care, (2) PRO feedback, and (3) PRO feedback and the Living with lymphoma intervention. Patients who have been diagnosed with Hodgkin lymphoma, non-Hodgkin lymphoma, including chronic lymphocytic leukaemia, as registered in the Netherlands Cancer Registry in various hospitals will be selected for participation. Patients are invited via their haemato-oncologist 6 to 15 months after diagnosis. The PRO feedback includes a graphical overview of patients' own symptom and functioning scores and an option to compare their scores with those of other patients with lymphoma and a normative population of the same age and sex. The Living with lymphoma intervention is based on cognitive behavioural therapy components and includes information, assignments, assessments, and videos. Changes in outcomes from baseline to 16 weeks, 12, and 24 months post intervention will be measured. Primary outcomes are self-management skills, satisfaction with information, and psychological distress. Secondary outcomes are health-related quality of life, illness perceptions, fatigue, and health care use. The results of the LIVE trial will provide novel insights into whether access to PRO feedback

  6. A Web-Disseminated Self-Help and Peer Support Program Could Fill Gaps in Mental Health Care: Lessons From a Consumer Survey

    Science.gov (United States)

    Banschback, Kaitlin; Santorelli, Gennarina D; Constantino, Michael J

    2017-01-01

    Background Self-guided mental health interventions that are disseminated via the Web have the potential to circumvent barriers to treatment and improve public mental health. However, self-guided interventions often fail to attract consumers and suffer from user nonadherence. Uptake of novel interventions could be improved by consulting consumers from the beginning of the development process in order to assess their interest and their preferences. Interventions can then be tailored using this feedback to optimize appeal. Objective The aim of our study was to determine the level of public interest in a new mental health intervention that incorporates elements of self-help and peer counseling and that is disseminated via a Web-based training course; to identify predictors of interest in the program; and to identify consumer preferences for features of Web-based courses and peer support programs. Methods We surveyed consumers via Amazon’s Mechanical Turk to estimate interest in the self-help and peer support program. We assessed associations between demographic and clinical characteristics and interest in the program, and we obtained feedback on desired features of the program. Results Overall, 63.9% (378/592) of respondents said that they would try the program; interest was lower but still substantial among those who were not willing or able to access traditional mental health services. Female gender, lower income, and openness to using psychotherapy were the most consistent predictors of interest in the program. The majority of respondents, although not all, preferred romantic partners or close friends as peer counselors and would be most likely to access the program if the training course were accessed on a stand-alone website. In general, respondents valued training in active listening skills. Conclusions In light of the apparent public interest in this program, Web-disseminated self-help and peer support interventions have enormous potential to fill gaps in

  7. Development and evaluation of the efficacy of a web-based 'social norms'-intervention for the prevention and reduction of substance use in a cluster-controlled trial conducted at eight German universities.

    Science.gov (United States)

    Helmer, Stefanie M; Muellmann, Saskia; Zeeb, Hajo; Pischke, Claudia R

    2016-03-11

    Previous research suggests that perceptions of peer substance use are associated with personal use. Specifically, overestimating use in the peer group is predictive of higher rates of personal substance use. 'Social norms'-interventions are based on the premise that changing these misperceived social norms regarding substance use by providing feedback on actual norms is associated with a reduction in personal substance use. Studies conducted in the U.S.A. suggest that 'social norms'-feedback is an effective strategy for reducing substance use among university students. It is unknown whether the effects of a 'social norms'-feedback on substance use can be replicated in a sample of German university students. The objective of this article is to describe the study design and aims of the 'INternet-based Social norms-Intervention for the prevention of substance use among Students' (INSIST)-study, a cluster-controlled trial examining the effects of a web-based 'social norms'- intervention in students enrolled at four intervention universities with those enrolled at four delayed intervention control universities. The INSIST-study is funded by the German Federal Ministry of Health. Eight universities in four regions in Germany will take part in the study, four serving as intervention and four as delayed intervention control universities (randomly selected within a geographic region). Six hundred students will be recruited at each university and will be asked to complete a web-based survey assessing personal and perceived substance use/attitudes towards substance use at baseline. These data will be used to develop the web-based 'social norms'-feedback tailored to gender and university. Three months after the baseline survey, students at intervention universities will receive the intervention. Two months after the launch of the intervention, students of all eight universities will be asked to complete the follow-up questionnaires to assess changes in perceptions of

  8. Nurturing a Self-Help Group

    Directory of Open Access Journals (Sweden)

    Marsha A. Schubert

    2015-04-01

    Full Text Available In April 1987, the parent of a child who was both learning disabled and intellectually gifted and talented and a professional educator (the author founded Parents of Gifted and Learning-Disabled Students of Northern Virginia, a self-help group for people who were dealing with the challenges posed by such children. The article begins with a background explaining the need for such a group followed by a history of the group and a description of how it functioned. It then details ways in which the author and the group interacted over the course of 5 years. A major component of this interaction was the members’ partnering in a research study with the author—a process now known as participatory action research (PAR—and the outcomes of that partnership.

  9. Creating a Culturally Appropriate Web-Based Behavioral Intervention for American Indian/Alaska Native Women in Southern California: The Healthy Women Healthy Native Nation Study

    Science.gov (United States)

    Gorman, Jessica R.; Clapp, John D.; Calac, Daniel; Kolander, Chelsea; Nyquist, Corinna; Chambers, Christina D.

    2013-01-01

    Health disparities in fetal alcohol spectrum disorders (FASD) are of high importance to American Indian/Alaska Native (AI/AN) communities. We conducted focus groups and interviews with 21 AI/AN women and key informants in Southern California to modify a brief, Web-based program for screening and prevention of prenatal alcohol use. This process…

  10. Tanker self-help spill recovery systems

    Energy Technology Data Exchange (ETDEWEB)

    Smedley, J B; Wainwright, J G; Ehman, T K

    1991-12-01

    An investigation was conducted of the circumstances in which oil spills occur from tankers at sea by analyzing available historical oil spill data. A data base of marine oil spills greater than 134 tonnes occurring from 1974 and June 1990, included in an appendix, was among the information analyzed. The analysis showed that marine oil spills of 5,000 tonnes and greater account for 39.4% of the accidents yet 94.7% of the total spilled quantity; 84% of those spills occur in vessels of 20,000 deadweight tonnes and larger. Of spills over 5,000 tonnes, 78.5% occur outside of harbor or pier areas where spill response equipment may not be readily available. Over 50% of spills are caused by groundings or collisions where the vessel crew might be able to respond in mitigating and controlling the outflow of oil. The review suggested that tanker self-help systems warrant serious consideration. Potential self-help systems are described, ranging from additives such as bioremediation, dispersants, and solidifiers to equipment such as portable pumps, booms, and skimmers. Candidate systems were examined in terms of their safety, ease of operation, practicability, and effectiveness. Their possible performance was then assessed for the case of major marine oil spills that have occurred in Canadian waters. Four systems are identified as potential candidates for further evaluation and possible implementation: internal oil transfer, hydrostatic loading, external oil lightering, and contingency planning. A system design is evaluated and its benefits and possible implementation are outlined, based on integration of the preferred attributes of the above four options. Recommendations for implementation are also provided. 28 refs., 6 figs., 33 tabs.

  11. Development of a fully automated, web-based, tailored intervention promoting regular physical activity among insufficiently active adults with type 2 diabetes: integrating the I-change model, self-determination theory, and motivational interviewing components.

    Science.gov (United States)

    Moreau, Michel; Gagnon, Marie-Pierre; Boudreau, François

    2015-02-17

    Type 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that fewer than half of people with type 2 diabetes in Canada are sufficiently active to meet the recommendations, effective programs targeting the adoption of regular physical activity (PA) are in demand for this population. Many researchers argue that Web-based, tailored interventions targeting PA are a promising and effective avenue for sedentary populations like Canadians with type 2 diabetes, but few have described the detailed development of this kind of intervention. This paper aims to describe the systematic development of the Web-based, tailored intervention, Diabète en Forme, promoting regular aerobic PA among adult Canadian francophones with type 2 diabetes. This paper can be used as a reference for health professionals interested in developing similar interventions. We also explored the integration of theoretical components derived from the I-Change Model, Self-Determination Theory, and Motivational Interviewing, which is a potential path for enhancing the effectiveness of tailored interventions on PA adoption and maintenance. The intervention development was based on the program-planning model for tailored interventions of Kreuter et al. An additional step was added to the model to evaluate the intervention's usability prior to the implementation phase. An 8-week intervention was developed. The key components of the intervention include a self-monitoring tool for PA behavior, a weekly action planning tool, and eight tailored motivational sessions based on attitude, self-efficacy, intention, type of motivation, PA behavior, and other constructs and techniques. Usability evaluation, a step added to the program-planning model, helped to make several improvements to the intervention prior to the implementation phase. The intervention development cost was about CDN $59,700 and took approximately

  12. How US Smokers Refer to E-cigarettes: An Examination of User-Generated Posts From a Web-Based Smoking Cessation Intervention, 2008-2015.

    Science.gov (United States)

    Pearson, Jennifer L; Amato, Michael S; Wang, Xi; Zhao, Kang; Cha, Sarah; Cohn, Amy M; Papandonatos, George D; Graham, Amanda L

    2017-02-01

    A challenge in Electronic Nicotine Delivery System (ENDS) research is how to refer to these devices in ways that are meaningful to current or potential users. The objectives of this study were to: (1) describe the frequency of ENDS terms in a web-based smoking cessation intervention; and (2) determine whether terms vary by US geographic region and date. Data were drawn from public posts between 2008-2015 on http://BecomeAnEX.org and limited to US users. We conducted "exact" and "fuzzy" searches to find posts containing ENDS keywords using custom Python scripts, and extracted geocoding data and date for each post. We examined counts and frequencies of ENDS terms by unique user, by unique user and region, and by unique user and date. We identified 1023 unique US website users who had written a post containing one or more ENDS keywords. Posters were majority female (79%), educated (78% attended at least some college), and had a median age of 47 years. Overall, 92% of ENDS posters employed the term "e-cigarette" or a derivation. Derivations of "vape" became increasingly popular in 2013, whereas "NJoy" and "blu" were employed by fewer than 2% of posters. We found no variation in frequency of ENDS terms by US region. Researchers may have confidence that "e-cigarette" and "vape" are recognizable terms among US treatment-seeking smokers. Conversely, terms such as "ENDS," commonly employed by researchers and public health advocates, are not used by smokers and may be an impediment to tobacco control research. Researchers may have confidence that "e-cigarette," and, to a lesser extent, "vape" are recognizable terms among US adult smokers referring to ENDS (including accessories, brand names, and actions). Conversely, terms such as "electronic nicotine delivery systems," commonly employed by researchers and public health advocates, are not used by US smokers and may be an impediment to tobacco control research and practice. © The Author 2016. Published by Oxford University

  13. How US Smokers Refer to E-cigarettes: An Examination of User-Generated Posts From a Web-Based Smoking Cessation Intervention, 2008–2015

    Science.gov (United States)

    Amato, Michael S.; Wang, Xi; Zhao, Kang; Cha, Sarah; Cohn, Amy M.; Papandonatos, George D.; Graham, Amanda L.

    2017-01-01

    Introduction: A challenge in Electronic Nicotine Delivery System (ENDS) research is how to refer to these devices in ways that are meaningful to current or potential users. The objectives of this study were to: (1) describe the frequency of ENDS terms in a web-based smoking cessation intervention; and (2) determine whether terms vary by US geographic region and date. Methods: Data were drawn from public posts between 2008–2015 on http://BecomeAnEX.org and limited to US users. We conducted “exact” and “fuzzy” searches to find posts containing ENDS keywords using custom Python scripts, and extracted geocoding data and date for each post. We examined counts and frequencies of ENDS terms by unique user, by unique user and region, and by unique user and date. Results: We identified 1023 unique US website users who had written a post containing one or more ENDS keywords. Posters were majority female (79%), educated (78% attended at least some college), and had a median age of 47 years. Overall, 92% of ENDS posters employed the term “e-cigarette” or a derivation. Derivations of “vape” became increasingly popular in 2013, whereas “NJoy” and “blu” were employed by fewer than 2% of posters. We found no variation in frequency of ENDS terms by US region. Conclusions: Researchers may have confidence that “e-cigarette” and “vape” are recognizable terms among US treatment-seeking smokers. Conversely, terms such as “ENDS,” commonly employed by researchers and public health advocates, are not used by smokers and may be an impediment to tobacco control research. Implications: Researchers may have confidence that “e-cigarette,” and, to a lesser extent, “vape” are recognizable terms among US adult smokers referring to ENDS (including accessories, brand names, and actions). Conversely, terms such as “electronic nicotine delivery systems,” commonly employed by researchers and public health advocates, are not used by US smokers and may be

  14. Web Based Customized Design

    OpenAIRE

    Moi, Morten Benestad

    2013-01-01

    This thesis studies the methods needed to create a web based application to remotely customize a CAD model. This includes customizing a CAD model by using a graphical user interface to be able to remotely control the inputs to- and outputs from the model in NX, and to get the result sent back to the user. Using CAD systems such as NX requires intensive training, is often a slow process and gives a lot of room for errors. An intuitive, simple user interface will eliminate the need for CAD trai...

  15. Use of a web-based educational intervention to improve knowledge of healthy diet and lifestyle in women with Gestational Diabetes Mellitus compared to standard clinic-based education.

    Science.gov (United States)

    Sayakhot, Padaphet; Carolan-Olah, Mary; Steele, Cheryl

    2016-08-05

    This study introduced a web-based educational intervention for Australian women with gestational diabetes mellitus (GDM). The aim was to improve knowledge on healthy diet and lifestyle in GDM. Evaluation of the intervention explored women's knowledge and understanding of GDM, healthy diet, healthy food, and healthy lifestyle, after using the web-based program compared to women receiving standard clinic-based GDM education. A total of 116 women, aged 18-45 years old, newly diagnosed with GDM, participated (Intervention (n) = 56 and control (n) = 60). Women were randomly allocated to the intervention or control groups and both groups attended a standard GDM education class. Group 1(Intervention) additionally used an online touch screen/computer program. All women completed a questionnaire following the computer program and/or the education class. All questions evaluating levels of knowledge had more than one correct answer and scores were graded from 0 to 1, with each correct component receiving a score, eg. 0.25 per each correct answer in a 4 answer question. Chi-square test was performed to compare the two groups regarding knowledge of GDM. Findings indicated that the majority of women in the intervention group reported correct answers for "types of carbohydrate foods" for pregnant women with GDM, compared to the control group (62.5 % vs 58.3 %, respectively). Most women in both groups had an excellent understanding of "fruits and vegetables" (98.2 % vs 98.3 %), and the majority of women in the intervention group understood that they should exercise daily for 30 min, compared to the control group (92.9 % vs 91.7 %). Both groups had a good understanding across all categories, however, the majority of women in the intervention group scored all correct answers (score = 1) in term of foetal effects (17.9 % vs 13.3 %, respectively), maternal predictors (5.4 % vs 5 %), care requirements (39.3 % vs 23.3 %), GDM perceptions (48.2 % vs 46.7 %) and

  16. [Performance of self-help groups and their economic evaluation].

    Science.gov (United States)

    Engelhardt, H D; Trojan, A; Nickel, S

    2009-01-01

    Hoffmann von Fallersleben is quoted with the sentence "Self-help is worthwhile, because it does not demand anything from others". This sounds catchy; it is, however, wrong: Self-help groups ask for support, particularly for financial resources for the work of either individual, highly organized self-help associations or for general support of self-help groups via local contact and information centers ("contact points for self-help groups"). With this request for economic "investments" in self-help, the question arises whether this is profitable for the country, the local authority or the social health insurance. In principle, the initial answer to this is: yes, the work of self-help groups is worthwhile for a single person, but also for the larger community, as various kinds of services are provided by self-help groups and organizations. Despite many surveys of members or co-operation partners which show positive effects of self-help groups, the question remains whether services of self-help groups can be measured and economically evaluated. The socio- political question regarding funding is closely connected to the idea of an economic evaluation of self-help groups. The aim of this article is to summarize and discuss which empiric approaches and findings are available on this subject. The monetary value for the work done per member of self-help groups and year lies between approximately 700 and 900 EUR.

  17. Targeting young drinkers online: the effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among college students: study protocol of a two-arm parallel group randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Lemmers Lex ACJ

    2011-04-01

    Full Text Available Abstract Background The prevalence of heavy drinking among college students and its associated health related consequences highlights an urgent need for alcohol prevention programs targeting 18 to 24 year olds. Nevertheless, current alcohol prevention programs in the Netherlands pay surprisingly little attention to the drinking patterns of this specific age group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that is aimed at reducing alcohol use among heavy drinking college students aged 18 to 24 years old. Methods/Design The effectiveness of the What Do You Drink web-based brief alcohol intervention will be tested among 908 heavy drinking college students in a two-arm parallel group randomized controlled trial. Participants will be allocated at random to either the experimental (N = 454: web-based brief alcohol intervention or control condition (N = 454: no intervention. The primary outcome measure will be the percentage of participants who drink within the normative limits of the Dutch National Health Council for low-risk drinking. These limits specify that, for heavy alcohol use, the mean consumption cannot exceed 14 or 21 glasses of standard alcohol units per week for females and males, respectively, while for binge drinking, the consumption cannot exceed five or more glasses of standard alcohol units on one drinking occasion at least once per week within one month and six months after the intervention. Reductions in mean weekly alcohol consumption and frequency of binge drinking are also primary outcome measures. Weekly Ecological Momentary Assessment will measure alcohol-related cognitions, that is, attitudes, self-efficacy, subjective norms and alcohol expectancies, which will be included as the secondary outcome measures. Discussion This study protocol describes the two-arm parallel group randomized controlled trial developed to evaluate the effectiveness of a web-based brief

  18. Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review.

    Science.gov (United States)

    Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; McAiney, Carrie; Duggleby, Wendy; Bartholomew, Amy; Sherifali, Diana

    2017-07-28

    Most adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community. A rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention. A total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the

  19. The Feasibility and Acceptability of a Web-Based Alcohol Management Intervention in Community Sports Clubs: A Cross-Sectional Study.

    Science.gov (United States)

    McFadyen, Tameka; Wolfenden, Luke; Wiggers, John; Tindall, Jenny; Yoong, Sze Lin; Lecathelinais, Christophe; Gillham, Karen; Sherker, Shauna; Rowland, Bosco; McLaren, Nicola; Kingsland, Melanie

    2017-06-30

    The implementation of comprehensive alcohol management strategies can reduce excessive alcohol use and reduce the risk of alcohol-related harm at sporting venues. Supporting sports venues to implement alcohol management strategies via the Web may represent an effective and efficient means of reducing harm caused by alcohol in this setting. However, the feasibility and acceptability of such an approach is unknown. This study aimed to identify (1) the current access to and use of the Web and electronic devices by sports clubs; (2) the perceived usefulness, ease of use, and intention to use a Web-based program to support implementation of alcohol management policies in sports clubs; (3) the factors associated with intention to use such a Web-based support program; and (4) the specific features of such a program that sports clubs would find useful. A cross-sectional survey was conducted with club administrators of community football clubs in the state of New South Wales, Australia. Perceived usefulness, ease of use and intention to use a hypothetical Web-based alcohol management support program was assessed using the validated Technology Acceptance Model (TAM) instrument. Associations between intention to use a Web-based program and club characteristics as well as perceived ease of use and usefulness was tested using Fisher's exact test and represented using relative risk (RR) for high intention to use the program. Of the 73 football clubs that were approached to participate in the study, 63 consented to participate and 46 were eligible and completed the survey. All participants reported having access to the Web and 98% reported current use of electronic devices (eg, computers, iPads/tablets, smartphones, laptops, televisions, and smartboards). Mean scores (out of a possible 7) for the TAM constructs were high for intention to use (mean 6.25, SD 0.87), perceived ease of use (mean 6.00, SD 0.99), and perceived usefulness (mean 6.17, SD 0.85). Intention to use the Web-based

  20. Intrapersonal Resources and the Effectiveness of Self-Help Groups for Bereaved Older Adults.

    Science.gov (United States)

    Caserta, Michael S.; Lund, Dale A.

    1993-01-01

    Examined relative impact of 3 intrapersonal resources (self-esteem, competencies, and life satisfaction) and duration of self-help group intervention on levels of depression and grief over time among 295 recently widowed adults. Found that, in general, resources examined had greater direct influence on outcomes than did intervention. (Author/NB)

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

    Directory of Open Access Journals (Sweden)

    José Côté

    2017-01-01

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

  2. Brief Online Self-help Exercises for Postnatal Women to Improve Mood: A Pilot Study.

    Science.gov (United States)

    Ayers, Susan; Fitzgerald, Gemima; Thompson, Susan

    2015-11-01

    Giving birth and adjusting to a new baby can be difficult and stressful for new mothers. Negative mood may occur during this time and can affect women, their parenting and the infant's development. This pilot study evaluated a brief online self-help intervention designed to promote positive mood in mothers of babies and toddlers. Women in the UK who had given birth within the previous 18 months were randomly allocated to the online self-help intervention (n = 40) or active comparison group exercise (n = 40) which was matched for time and structure. Mood was measured before and after the intervention. Acceptability was examined at the end of the trial. The self-help intervention was acceptable to the majority of women and significantly increased positive mood compared to the comparison condition. This effect persisted after controlling for self-esteem, anxiety and depression. These results suggest that a simple self-help intervention focused on changing beliefs about oneself as a mother can have an immediate impact on women's mood. Further research is need to see whether these improvements continue long-term and what processes underlie these improvements.

  3. Positive Psychology for Overcoming Symptoms of Depression: A Pilot Study Exploring the Efficacy of a Positive Psychology Self-Help Book versus a CBT Self-Help Book.

    Science.gov (United States)

    Hanson, Katie

    2018-04-25

    Depression is an extremely common mental health disorder, with prevalence rates rising. Low-intensity interventions are frequently used to help meet the demand for treatment. Bibliotherapy, for example, is often prescribed via books on prescription schemes (for example 'Reading Well' in England) to those with mild to moderate symptomology. Bibliotherapy can effectively reduce symptoms of depression (Naylor et al., 2010). However, the majority of self-help books are based on cognitive behavioural therapy (CBT), which may not be suitable for all patients. Research supports the use of positive psychology interventions for the reduction of depression symptoms (Bolier et al., 2013) and as such self-help books from this perspective should be empirically tested. This study aimed to test the efficacy of 'Positive Psychology for Overcoming Depression' (Akhtar, 2012), a self-help book for depression that is based on the principles of positive psychology, in comparison with a CBT self-help book that is currently prescribed in England as part of the Reading Well books on prescription scheme. Participants (n = 115) who were not receiving treatment, but had symptoms of depression, read the positive psychology or the CBT self-help book for 8 weeks. Depression and well-being were measured at baseline, post-test and 1-month follow-up. Results suggest that both groups experienced a reduction in depression and an increase in well-being, with no differences noted between the two books. Future directions are discussed in terms of dissemination, to those with mild to moderate symptoms of depression, via books on prescription schemes.

  4. Turkish Migrant Women with Recurrent Depression: Results from Community-based Self-help Groups.

    Science.gov (United States)

    Siller, Heidi; Renner, Walter; Juen, Barbara

    2017-01-01

    The study focuses on psychosocial functioning of female Turkish immigrants in Austria with recurrent depressive disorder participating in self-help groups. Self-help groups guided by group leaders of Turkish descent should increase autonomy in participants, providing the opportunity to follow their ethnic health beliefs. Turkish immigrant women (n = 43) with recurrent depressive disorder participated in self-help groups over four months. Qualitative data of participants and group leaders, containing interviews, group protocols and supervision protocols of group leaders were analyzed using the qualitative content analysis for effects on psychosocial function, such as interaction with others, illness beliefs and benefit from self-help group. Women reported feelings of being neglected and violated by their husbands. They stated that they had gained strength and had emancipated themselves from their husbands. Self-help groups functioned as social resources and support for changes in participants' lives. Further interventions should integrate the functional value of depressive symptoms and focus on social support systems and social networks.

  5. Web-based cognitive behavioural therapy (W-CBT for diabetes patients with co-morbid depression: Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Pouwer Frans

    2008-02-01

    Full Text Available Abstract Background Depression is common among people with diabetes, negatively affecting quality of life, treatment adherence and diabetes outcomes. In routine clinical care, diabetes patients have limited access to mental health services and depression therefore often remains untreated. Web-based therapy could potentially be an effective way to improve the reach of psychological care for diabetes patients, at relatively low costs. This study seeks to test the effectiveness of a web-based self-help depression programme for people with diabetes and co-morbid depression. Methods/Design The effectiveness of a web-based self-help course for adults with diabetes with co-morbid depression will be tested in a randomised trial, using a wait-list controlled design. The intervention consists of an 8-week, moderated self-help course that is tailored to the needs of persons living with diabetes and is offered on an individual basis. Participants receive feedback on their homework assignments by e-mail from their coach. We aim to include 286 patients (143/143, as power analyses showed that this number is needed to detect an effect size of 0.35, with measurements at baseline, directly after completing the web-based intervention and at 1, 3, 4 and 6 months follow-up. Patients in the control condition are placed on a waiting list, and follow the course 12 weeks after randomisation. Primary outcomes are depressive symptoms and diabetes-specific emotional distress. Secondary outcomes are satisfaction with the course, perceived health status, self-care behaviours, glycaemic control, and days in bed/absence from work. Questionnaires are administered via the Internet. Discussion The intervention being trialled is expected to help improve mood and reduce diabetes-specific emotional distress in diabetes patients with depression, with subsequent beneficial effects on diabetes self-care and glycaemic outcomes. When proven efficacious, the intervention could be

  6. TrueNTH sexual recovery study protocol: a multi-institutional collaborative approach to developing and testing a web-based intervention for couples coping with the side-effects of prostate cancer treatment in a randomized controlled trial.

    Science.gov (United States)

    Wittmann, D; Mehta, A; Northouse, L; Dunn, R; Braun, T; Duby, A; An, L; Arab, L; Bangs, R; Bober, S; Brandon, J; Coward, M; Dunn, M; Galbraith, M; Garcia, M; Giblin, J; Glode, M; Koontz, B; Lowe, A; Mitchell, S; Mulhall, J; Nelson, C; Paich, K; Saigal, C; Skolarus, T; Stanford, J; Walsh, T; Pollack, C E

    2017-10-02

    Over half of men who receive treatment for prostate suffer from a range of sexual problems that affect negatively their sexual health, sexual intimacy with their partners and their quality of life. In clinical practice, however, care for the sexual side effects of treatment is often suboptimal or unavailable. The goal of the current study is to test a web-based intervention to support the recovery of sexual intimacy of prostate cancer survivors and their partners after treatment. The study team developed an interactive, web-based intervention, tailored to type of treatment received, relationship status (partnered/non-partnered) and sexual orientation. It consists of 10 modules, six follow the trajectory of the illness and four are theme based. They address sexual side effects, rehabilitation, psychological impacts and coaching for self-efficacy. Each includes a video to engage participants, psychoeducation and activities completed by participants on the web. Tailored strategies for identified concerns are sent by email after each module. Six of these modules will be tested in a randomized controlled trial and compared to usual care. Men with localized prostate cancer with partners will be recruited from five academic medical centers. These couples (N = 140) will be assessed prior to treatment, then 3 months and 6 months after treatment. The primary outcome will be the survivors' and partners' Global Satisfaction with Sex Life, assessed by a Patient Reported Outcome Measure Information Systems (PROMIS) measure. Secondary outcomes will include interest in sex, sexual activity, use of sexual aids, dyadic coping, knowledge about sexual recovery, grief about the loss of sexual function, and quality of life. The impact of the intervention on the couple will be assessed using the Actor-Partner Interaction Model, a mixed-effects linear regression model able to estimate both the association of partner characteristics with partner and patient outcomes and the association

  7. Standardized web-based cognitive behavioural therapy of mild to moderate depression: a randomized controlled trial with a long-term follow-up.

    NARCIS (Netherlands)

    Ruwaard, Jeroen; Schrieken, Bart; Schrijver, Menno; Broeksteeg, Janneke; Dekker, Jack; Vermeulen, Hans; Lange, Alfred

    2009-01-01

    Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment

  8. Standardized web-based CBT of mild to moderate depression: a randomized controlled trial with a long-term follow up

    NARCIS (Netherlands)

    Ruwaard, J.; Schrieken, B.; Schrijver, M.; Broeksteeg, J.; Dekker, J.; Vermeulen, H.; Lange, A.

    2009-01-01

    Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment

  9. Application of Behavior Change Techniques in a Personalized Nutrition Electronic Health Intervention Study: Protocol for the Web-Based Food4Me Randomized Controlled Trial

    NARCIS (Netherlands)

    Macready, Anna L.; Fallaize, Rosalind; Butler, Laurie T.; Ellis, Judi A.; Kuznesof, Sharron; Frewer, Lynn J.; Celis-Morales, Carlos; Livingstone, Katherine M.; Araújo-Soares, Vera; Fischer, Arnout R.H.; Stewart-Knox, Barbara J.; Mathers, John C.; Lovegrove, Julie A.

    2018-01-01

    Background: To determine the efficacy of behavior change techniques applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques that have been used during such interventions. Published frameworks used in dietary and smoking cessation

  10. Neurodharma Self-Help: Personalized Science Communication as Brain Management.

    Science.gov (United States)

    Eklöf, Jenny

    2017-09-01

    Over the past ten to fifteen years, medical interventions, therapeutic approaches and scientific studies involving mindfulness meditation have gained traction in areas such as clinical psychology, psychotherapy, and neuroscience. Simultaneously, mindfulness has had a very strong public appeal. This article examines some of the ways in which the medical and scientific meaning of mindfulness is communicated in public and to the public. In particular, it shows how experts in the field of mindfulness neuroscience seek to communicate to the public at large the imperative of brain fitness for the promotion of health, wellbeing and happiness. The study identifies claims being made in popular outlets that, by and large, bypass traditional mass media, such as self-help books, websites and online videos. By treating this material as a form of personalized science communication, this article contributes to the body of literature that understands science communication as a continuum and the boundary between science and popularized science as the outcome of human negotiations. The study finds that processes of personalization help to build bridges between scientific findings and their supposed application, that they infuse science with subjective meaning, and turn expert communication with the public into a moral vocation.

  11. THE ECONOMIC ROLE OF SELF-HELP GROUP

    OpenAIRE

    Dr. S. Selvendran

    2018-01-01

    “All for all” principle behind self-help group (SHG) concept. It is mainly concerned with poor people and it is for the people, by the people and of the people gandhian sarvodaya contained with this.

  12. Enhancing inpatient psychotherapeutic treatment with online self-help: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Zwerenz, Rüdiger; Becker, Jan; Knickenberg, Rudolf J; Hagen, Karin; Dreier, Michael; Wölfling, Klaus; Beutel, Manfred E

    2015-03-17

    Depression is one of the most debilitating and costly mental disorders. There is increasing evidence for the efficacy of online self-help in alleviating depression. Knowledge regarding the options of combining online self-help with inpatient psychotherapy is still limited. Therefore, we plan to evaluate an evidence-based self-help program (deprexis®; Gaia AG, Hamburg, Germany) to improve the efficacy of inpatient psychotherapy and to maintain treatment effects in the aftercare period. Depressed patients (n = 240) with private internet access aged between 18 and 65 are recruited during psychosomatic inpatient treatment. Participants are randomized to an intervention or control group at the beginning of inpatient treatment. The intervention group (n = 120) is offered an online self-help program with 12 weekly tasks, beginning during the inpatient treatment. The control group (n = 120) obtains access to an online platform with weekly updated information on depression for the same duration. Assessments are conducted at the beginning (T0) and the end of inpatient treatment (T1), at the end of intervention (T2) and 6 months after randomization (T3). The primary outcome is the depression score measured by the Beck Depression Inventory-II at T2. Secondary outcome measures include anxiety, self-esteem, quality of life, dysfunctional cognitions and work ability. We expect the intervention group to benefit from additional online self-help during inpatient psychotherapy and to maintain the benefits during follow-up. This could be an important approach to develop future concepts of inpatient psychotherapy. ClinicalTrials.gov Identifier: NCT02196896 (registered on 16 July 2014).

  13. Effect evaluation of a web-based coaching intervention to support implementation of sex education among secondary school teachers : randomized controlled trial

    NARCIS (Netherlands)

    Schutte, Lisette; Mevissen, Fraukje E F; Meijer, Suzanne; Paulussen, Theo; van Empelen, Pepijn; Kok, Gerjo

    2017-01-01

    BACKGROUND: The quality of implementation is important to ensure the effectiveness of behavioral change interventions in practice. Implementing such programs with completeness and adherence is not an automatic process and may require additional support. In school settings, the support teachers

  14. The Utility of a Brief Web-Based Prevention Intervention as a Universal Approach for Risky Alcohol Use in College Students: Evidence of Moderation by Family History

    Directory of Open Access Journals (Sweden)

    Zoe E. Neale

    2018-05-01

    Full Text Available Background: Alcohol use on college campuses is prevalent and contributes to problems that affect the health, emotional wellbeing, and academic success of college students. Risk factors, such as family history of alcohol problems, predict future alcohol problems, but less is known about their potential impact on intervention effectiveness. The purpose of this study was to examine the effect of an intervention implemented in a non-randomized sample of drinking and non-drinking college freshmen.Methods: Freshmen college students recruited for the intervention study (n = 153 completed a web-adaptation of the Brief Alcohol Screening and Intervention for College Students (BASICS at the start of spring semester. We compared their 30-days post-intervention alcohol initiation, number of drinking days (DAYS, drinks per occasion (DRINKS, maximum drinks in 24 h (MAX24 and alcohol use disorder symptoms (AUDsx to 151 comparison participants retrospectively matched on demographics and baseline alcohol use behaviors. We also tested baseline DRINKS, DAYS, AUDsx, MAX24, and parental family history (PFH of alcohol problems as moderators of the effect of the intervention.Results: At follow-up, intervention participants had lower rates of AUDsx than comparison participants, especially among baseline drinkers. Among participants drinking 3+ days/month at baseline, intervention participants showed fewer DAYS at follow-up than the comparison group participants. BASICS was also associated with a decreased likelihood of initiation among baseline non-drinkers. PFH significantly interacted with treatment group, with positive PFH intervention participants reporting significantly fewer AUDsx at follow-up compared to positive PFH comparison participants. We found no evidence for an effect of the intervention on DRINKS or MAX24 in our analyses.Conclusions: Results suggest some indication that novel groups, such as non-drinkers, regular drinkers, and PFH positive students may

  15. A comparison of online versus workbook delivery of a self-help positive parenting program.

    Science.gov (United States)

    Sanders, Matthew R; Dittman, Cassandra K; Farruggia, Susan P; Keown, Louise J

    2014-06-01

    A noninferiority randomized trial design compared the efficacy of two self-help variants of the Triple P-Positive Parenting Program: an online version and a self-help workbook. We randomly assigned families of 193 children displaying early onset disruptive behavior difficulties to the online (N = 97) or workbook (N = 96) interventions. Parents completed questionnaire measures of child behavior, parenting, child maltreatment risk, personal adjustment and relationship quality at pre- and post-intervention and again at 6-month follow up. The short-term intervention effects of the Triple P Online program were not inferior to the workbook on the primary outcomes of disruptive child behavior and dysfunctional parenting as reported by both mothers and fathers. Both interventions were associated with significant and clinically meaningful declines from pre- to post-intervention in levels of disruptive child behavior, dysfunctional parenting styles, risk of child maltreatment, and inter-parental conflict on both mother and father report measures. Intervention effects were largely maintained at 6-month follow up, thus supporting the use of self-help parenting programs within a comprehensive population-based system of parenting support to reduce child maltreatment and behavioral problems in children.

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

    Science.gov (United States)

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

    2017-07-26

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

  17. Written online situational feedback via mobile phone to support self-management of chronic widespread pain: a usability study of a Web-based intervention

    Directory of Open Access Journals (Sweden)

    Eide Erlend

    2011-02-01

    Full Text Available Abstract Background This pretrial study aimed to develop and test the usability of a four-week Internet intervention delivered by a Web-enabled mobile phone to support self-management of chronic widespread pain. Methods The intervention included daily online entries and individualized written feedback, grounded in a mindfulness-based cognitive behavioral approach. The participants registered activities, emotions and pain cognitions three times daily using the mobile device. The therapist had immediate access to this information through a secure Web site. The situational information was used to formulate and send a personalized text message to the participant with the aim of stimulating effective self-management of the current situation. Six women participated and evaluated the experience. Results The intervention was rated as supportive, meaningful and user-friendly by the majority of the women. The response rate to the daily registration entries was high and technical problems were few. Conclusion The results indicate a feasible intervention. Web-applications are fast becoming standard features of mobile phones and interventions of this kind can therefore be more available than before. Trial registration number ClinicalTrials.gov: NCT01236209

  18. Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition : Results of the "Fitter na kanker" Randomized Controlled Trial

    NARCIS (Netherlands)

    Bruggeman-Everts, Fieke Z; Wolvers, Marije D J; van de Schoot, Rens; Vollenbroek-Hutten, Miriam M R; Van der Lee, Marije L

    2017-01-01

    BACKGROUND: Approximately one third of all patients who have been successfully treated for cancer suffer from chronic cancer-related fatigue (CCRF). Effective and easily accessible interventions are needed for these patients. OBJECTIVE: The current paper reports on the results of a 3-armed

  19. Do Lessons Learned in a Training Intervention on Web-Based Health Care Resources Diffuse to Nonexposed Members in the Primary Care Setting? A Comparative Study

    Science.gov (United States)

    Homa, Karen; Schifferdecker, Karen E.; Reed, Virginia A.

    2009-01-01

    Objective The Internet offers a significant information resource for health professionals. A strategy to improve the use of these resources is for health care providers and staff to receive specific training. The aim of this study was to determine whether those who attended an Internet health care resource training intervention transferred knowledge and skills to others in the practice. Methods Twenty-four primary care practices participated in the study in which 64 providers and staff attended a training intervention and 288 did not. A preintervention questionnaire that assessed knowledge, skill, and Internet usage was compared with a postintervention questionnaire. The main effect of interest in the linear model was the group by time interaction term, to determine whether knowledge and skill improved for both groups. Results There were 41 attendees and 222 nonattendees that completed both pre- and postintervention questionnaires. There were 9 variables that showed a possible diffusion pattern, in which both attendees and nonattendees improved between pre- and postintervention. Overall, the training intervention seemed to have impacted knowledge and skills of the respondents and also reported improvements in the clinical area of patient education, but frequency of use for most Web resources for medical decision making did not improve. Conclusion An improvement strategy that depends on a training intervention for a few members in a practice may not necessarily transfer relative to all aspects of patient care. PMID:19020403

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  2. Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to improve early infant diagnosis in Kenya.

    Science.gov (United States)

    Finocchario-Kessler, S; Odera, I; Okoth, V; Bawcom, C; Gautney, B; Khamadi, S; Clark, K; Goggin, K

    2015-12-01

    Guided by the RE-AIM model, we describe preliminary data and lessons learned from multiple serial implementations of an eHealth intervention to improve early infant diagnosis (EID) of HIV in Kenya. We describe the reach, effectiveness, adoption, implementation and maintenance of the HITSystem, an eHealth intervention that links key stakeholders to improve retention and outcomes in EID. Our target community includes mother-infant pairs utilizing EID services and government health care providers and lab personnel. We also explore our own role as program and research personnel supporting the dissemination and scale up of the HITSystem in Kenya. Key findings illustrate the importance of continual adaptation of the HITSystem interface to accommodate varied stakeholders' workflows in different settings. Surprisingly, technology capacity and internet connectivity posed minimal short-term challenges. Early and sustained ownership of the HITSystem among stakeholders proved critical to reach, effectiveness and successful adoption, implementation and maintenance. Preliminary data support the ability of the HITSystem to improve EID outcomes in Kenya. Strong and sustained collaborations with stakeholders improve the quality and reach of eHealth public health interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-11-09

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

  4. Guide to Health: A Randomized Controlled Trial of the Effects of a Completely WEB-Based Intervention on Physical Activity, Fruit and Vegetable Consumption, and Body Weight.

    Science.gov (United States)

    Winett, Richard A; Anderson, Eileen S; Wojcik, Janet R; Winett, Sheila G; Moore, Shane; Blake, Chad

    2011-03-01

    Theory-based, efficacious, long-term, completely Internet-based interventions are needed to induce favorable shifts in health behaviors and prevent weight gain. To assess nutrition, physical activity, and, secondarily, body weight outcomes in the tailored, social cognitive theory Guide to Health ( WB-GTH ) program with all recruitment, assessment, and intervention performed on the Internet. The focus of the efficacy study was engaged participants who completed 3 or more program modules plus baseline, 6-months post and, 16-months follow-up assessments (n = 247). To be eligible, participants needed to be between 18-63 years of age, with a BMI between 23-39, sedentary to low-active but otherwise healthy. Participant had a mean age of 45.5 years (10.3), 86.2% were female, with 8.5% from minority groups, with a mean 17.5 (3.0) years of education, and had a median annual household income of about $85k. Nevertheless, about 83% were overweight or obese and about 75% were sedentary (i.e., <5000 steps/day) or had low levels of activity (i.e., 5,000 - 7499 steps/day). Participants were randomized to the WB-GTH-Basic intervention or WB-GTH-Enhanced intervention. Content, overall target behaviors, program goals and strategies were the same in the two interventions with the difference that Basic included a generic feedback and planning approach and Enhanced included a highly tailored planning and feedback approach. Participants reported at assessments pedometer step counts to assess physical activity, bodyweight from a scale provided, and fruit and vegetable (F&V) servings were assessed from food frequency questionnaires completed online. Participants in both Basic and Enhanced at follow-up increased physical activity by about 1400 steps/day, lost about 3% of bodyweight, and increased F&V by about 1.5 serving/day. There was evidence that the least physically active, those who were obese, and those with poorest nutrition made greater long-term improvements. Given similar outcomes

  5. Online self-help forums on cannabis: A content assessment.

    Science.gov (United States)

    Greiner, Christian; Chatton, Anne; Khazaal, Yasser

    2017-10-01

    To investigate online self-help forums related to cannabis users who were searching for help on the Internet. We analyzed the content of 717 postings by 328 users in three online forums in terms of fields of interest and self-help mechanisms. Only English-language forums that were free of charge and without registration were investigated. The main self-help mechanisms were disclosure and symptoms, with relatively few posts concerning legal issues and social perceptions. The forums differed significantly in all fields of interest and self-help mechanisms except for social network and financial and vocational issues. Highly involved users more commonly posted on topics related to diagnosis, etiology/research, and provision of information and less commonly on those related to gratitude. Correlation analysis showed a moderate negative correlation between emotional support and illness-related aspects and between emotional support and exchange of information. Cannabis forums share similarities with other mental health forums. Posts differ according to user involvement and the specific orientation of the forum. The Internet offers a viable source of self-help and social support for cannabis users, which has potential clinical implications in terms of referring clients to specific forums. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Role of Self-help Group in Substance Addiction Recovery

    Science.gov (United States)

    Das, Prangya Paramita Priyadarshini

    2012-11-01

    Background: The Narcotics Anonymous (NA)/Alcoholic Anonymous(AA) is based on the philosophy of self-help, where the former addicts and recovering addicts share experiences, provide emotional support and do active monitoring through mentoring. In mentoring, a former addict with longer duration of drug-free life acts as a guide to the newly recovering addict. Objective: The objective was to study the effect of involvement in self help group upon addictís level of depression, functional social support, and anxiety. Method: The size of the sample was 60. 30 addicts were taken from rehabilitation centre and 30 were taken from self-help groups. ANOVA was used to analyze the result. Result: In all the criteria it was found that there exists a significant impact of Self-help group. Conclusion: Self-help group provide clients with a social network of individuals with similar problems and experiences, since most of these individuals may be isolated from society due to the social stigma attached to their addictions. The transition from being help recipients to being helpers enables recovering addicts to build their self-confidence and feelings of being wanted and desired in society, which facilitates their self-confidence and positive self-esteem.

  7. Web Based ATM PVC Management

    NARCIS (Netherlands)

    van der Waaij, B.D.; Sprenkels, Ron; van Beijnum, Bernhard J.F.; Pras, Aiko

    1998-01-01

    This paper discusses the design of a public domain web based ATM PVC Management tool for the Dutch SURFnet research ATM network. The aim of this tool is to assists in the creation and deletion of PVCs through local and remote ATM network domains. The tool includes security mechanisms to restrict the

  8. Behavior change through automated e-mails: mediation analysis of self-help strategy use for depressive symptoms.

    Science.gov (United States)

    Morgan, Amy J; Mackinnon, Andrew J; Jorm, Anthony F

    2013-02-01

    To evaluate whether automated e-mails promoting effective self-help strategies for depressive symptoms were effective in changing self-help behavior, and whether this improved depression outcomes. 568 adults with sub-threshold depression participated in a randomized controlled trial and provided complete data. A series of 12 e-mails promoting the use of evidence-based self-help strategies was compared with e-mails providing non-directive depression information. Depression symptoms were assessed with the Patient Health Questionnaire depression scale (PHQ-9) and use of self-help strategies was assessed at baseline and post-intervention. We hypothesized that those receiving the self-help e-mails would increase their use of evidence-based self-help and this would be associated with improvements in depression. Mediation analyses were conducted using a non-parametric bootstrapping procedure. Total use of the self-help strategies promoted in the e-mails significantly mediated the effect of the intervention on depressive symptoms (B = -0.75, SE = 0.16, 95% CI: -1.06 to -0.48). The direct effect of the intervention on depressive symptoms was much smaller and not significant when the mediation path was included. The majority of the individual strategies also had a significant indirect effect on depressive symptoms. In adults with sub-threshold depression, automated e-mails based on behavior change principles can successfully increase use of self-help strategies, leading to a reduction in depressive symptoms. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Development of a Web-Based Intervention for Addressing Distress in Caregivers of Patients Receiving Stem Cell Transplants: Formative Evaluation With Qualitative Interviews and Focus Groups

    Science.gov (United States)

    Pensak, Nicole Amoyal; Joshi, Tanisha; Simoneau, Teresa; Kilbourn, Kristin; Carr, Alaina; Kutner, Jean; Laudenslager, Mark L

    2017-06-22

    Caregivers of cancer patients experience significant burden and distress including depression and anxiety. We previously demonstrated the efficacy of an eight session, in-person, one-on-one stress management intervention to reduce distress in caregivers of patients receiving allogeneic hematopoietic stem cell transplants (allo-HSCT). The objective of this study was to adapt and enhance the in-person caregiver stress management intervention to a mobilized website (eg, tablet, smartphone, or computer-based) for self-delivery in order to enhance dissemination to caregiver populations most in need. We used an established approach for development of a mhealth intervention, completing the first two research and evaluation steps: Step One: Formative Research (eg, expert and stakeholder review from patients, caregivers, and palliative care experts) and Step Two: Pretesting (eg, Focus Groups and Individual Interviews with caregivers of patients with autologous HSCT (auto-HSCT). Step one included feedback elicited for a mock-up version of Pep-Pal session one from caregiver, patients and clinician stakeholders from a multidisciplinary palliative care team (N=9 caregivers and patient stakeholders and N=20 palliative care experts). Step two included two focus groups (N=6 caregivers) and individual interviews (N=9 caregivers) regarding Pep-Pal's look and feel, content, acceptability, and potential usability/feasibility. Focus groups and individual interviews were audio-recorded. In addition, individual interviews were transcribed, and applied thematic analysis was conducted in order to gain an in-depth understanding to inform the development and refinement of the mobilized caregiver stress management intervention, Pep-Pal (PsychoEducation and skills for Patient caregivers). Overall, results were favorable. Pep-Pal was deemed acceptable for caregivers of patients receiving an auto-HSCT. The refined Pep-Pal program consisted of 9 sessions (Introduction to Stress, Stress and the

  10. Can adding web-based support to UK primary care exercise referral schemes improve patients’ physical activity levels? Intervention development for the e-coachER study.

    Directory of Open Access Journals (Sweden)

    Adrian Taylor

    2015-10-01

    Aims: This presentation will provide details on the intervention development and data to be captured to inform a process evaluation. Methods: An initial version of e-coachER was produced, building on experiences from obesity and diabetes self-management interventions using the Lifeguide platform, and beta tested over 7 months. Co-applicants and researchers then provided feedback on a time-truncated version, and ERS patients on a real-time version, for 5 months before it was locked for the RCT. Within the trial, after participants are screened, provide consent and complete baseline assessments, they are randomised to receive usual ERS at each site or usual ERS plus a mailed Welcome Pack (including a user friendly guide to register for e-coachER access in-line, a free pedometer and a fridge magnet with daily recording strips for step counts or minutes of MVPA. Contact details for an e-coachER facilitator are provided for additional technical support. Results: At the core of the intervention are ‘7 Steps to Health’ aimed to last 5-10 mins each, to encourage patients to think about the benefits of PA, seek support from an ERS practitioner (and friends/family, and the web, to self-monitor PA with a pedometer and upload steps or minutes of MVPA, set progressive goals, build confidence, autonomy and relatedness (from Self-Determination Theory, find ways to increase sustainable PA more broadly, and deal with setbacks. An avatar (to avoid having to represent a range of individual characteristics such as age, gender, and ethnicity and brief narratives are used throughout to normalise and support behaviour change and encourage e-coachER use. Automatic or patient chosen e-mails from the Lifeguide system promote on-going use of functions such as recording weekly PA and goal setting. For each site, participants are able to access links to reputable generic websites for further information about chronic conditions and lifestyle, links to other sites and apps for self

  11. Effects of web-based stress and depression literacy intervention on improving work engagement among workers with low work engagement: An analysis of secondary outcome of a randomized controlled trial.

    Science.gov (United States)

    Imamura, Kotaro; Kawakami, Norito; Tsuno, Kanami; Tsuchiya, Masao; Shimada, Kyoko; Namba, Katsuyuki; Shimazu, Akihito

    2017-01-24

    The purpose of this randomized, controlled trial was to examine the effects of a psychoeducational information website on improving work engagement among individual workers with low work engagement, where work engagement was measured as a secondary outcome. Participants were recruited from registered members of a web survey site in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to intervention or control groups. Immediately after the baseline survey, the intervention group was invited to study a psychoeducational website called the "UTSMed," which provided general mental health literacy and cognitive behavioral skills. Work engagement was assessed by using the Utrecht Work Engagement Scale at baseline, 1-, and 4-month follow-ups for both intervention and control groups. An exploratory analysis was conducted for a subgroup with low (lower than the median scores) work engagement scores at baseline. A total of 1,236 workers completed the baseline survey. In the low work engagement subgroup, a total of 313 and 300 participants were allocated to an intervention and control group, respectively. In the high work engagement subgroup, 305 and 318 participants were allocated to an intervention and control group, respectively. The program showed a significant effect on work engagement (t = 1.98, P = 0.048) at the 4-month follow-up in the low work engagement subgroup, with a small effect size (d = 0.17). A web-based psychoeducation resource of mental health literacy and cognitive behavioral skills may be effective for improving work engagement among individual workers with low work engagement.

  12. Use and Appreciation of a Web-Based, Tailored Intervention (E-health4Uth) Combined With Counseling to Promote Adolescents' Health in Preventive Youth Health Care: Survey and Log-File Analysis.

    Science.gov (United States)

    Bannink, Rienke; Broeren, Suzanne; Joosten-van Zwanenburg, Evelien; van As, Els; van de Looij-Jansen, Petra; Raat, Hein

    2014-01-06

    Health promotion for adolescents is important in the prevention of mental health problems and health-risk behaviors. We implemented two interventions in a preventive youth health care setting. Adolescents in the E-health4Uth group received Web-based, tailored messages on their health behavior and well-being. Adolescents in the E-health4Uth and counseling group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems. This study evaluated the use and appreciation of these Web-based, tailored messages and additional consultation with a school nurse. Differences in use and appreciation according to demographics (ie, gender, level of education, and ethnicity) of the adolescents were also assessed. Two youth health care organizations participated in this study and conducted the interventions in 12 secondary schools. In total, 1702 adolescents participated; 533 in the E-health4Uth group, 554 in the E-health4Uth and counseling group, and 615 in the control group (ie, care as usual). Adolescents completed an evaluation questionnaire assessing the use and appreciation of the tailored messages immediately after receiving these messages and at a 4-month follow-up. After the consultation, adolescents and nurses completed an evaluation questionnaire on the use and appreciation of the consultation. The majority of the adolescents (845/1034, 81.72%) indicated they had read the tailored messages. Most items on the use and appreciation of the tailored messages and the program were scored positive (overall satisfaction on a scale from 1, most-negative, to 10, most-positive: mean 6.70, SD 1.60). In general, adolescents in vocational training, girls, and adolescents of non-Dutch ethnicity, indicated they used the tailored messages more often and appreciated the content of the messages better than adolescents receiving preuniversity education, boys, and adolescents of Dutch ethnicity

  13. Use and Appreciation of a Web-Based, Tailored Intervention (E-health4Uth) Combined With Counseling to Promote Adolescents’ Health in Preventive Youth Health Care: Survey and Log-File Analysis

    Science.gov (United States)

    Bannink, Rienke; Broeren, Suzanne; Joosten-van Zwanenburg, Evelien; van As, Els; van de Looij-Jansen, Petra

    2014-01-01

    Background Health promotion for adolescents is important in the prevention of mental health problems and health-risk behaviors. We implemented two interventions in a preventive youth health care setting. Adolescents in the E-health4Uth group received Web-based, tailored messages on their health behavior and well-being. Adolescents in the E-health4Uth and counseling group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems. Objective This study evaluated the use and appreciation of these Web-based, tailored messages and additional consultation with a school nurse. Differences in use and appreciation according to demographics (ie, gender, level of education, and ethnicity) of the adolescents were also assessed. Methods Two youth health care organizations participated in this study and conducted the interventions in 12 secondary schools. In total, 1702 adolescents participated; 533 in the E-health4Uth group, 554 in the E-health4Uth and counseling group, and 615 in the control group (ie, care as usual). Adolescents completed an evaluation questionnaire assessing the use and appreciation of the tailored messages immediately after receiving these messages and at a 4-month follow-up. After the consultation, adolescents and nurses completed an evaluation questionnaire on the use and appreciation of the consultation. Results The majority of the adolescents (845/1034, 81.72%) indicated they had read the tailored messages. Most items on the use and appreciation of the tailored messages and the program were scored positive (overall satisfaction on a scale from 1, most-negative, to 10, most-positive: mean 6.70, SD 1.60). In general, adolescents in vocational training, girls, and adolescents of non-Dutch ethnicity, indicated they used the tailored messages more often and appreciated the content of the messages better than adolescents receiving preuniversity education, boys, and

  14. Self-Help for Depression via E-mail: A Randomised Controlled Trial of Effects on Depression and Self-Help Behaviour.

    Directory of Open Access Journals (Sweden)

    Amy J Morgan

    Full Text Available Self-help or self-management strategies are commonly used to deal with depression, but not all are thought to be helpful. A previous study found that sub-threshold depression symptoms were improved by an e-mail intervention that encouraged the use of evidence-based self-help strategies.To investigate whether these e-mails were effective for adults with a range of depression symptomatology including major depression.The study was a parallel-group randomised controlled trial. Adult participants with any level of depressive symptoms were recruited over the internet from the United Kingdom, Australia, Canada, Ireland, New Zealand and the United States. Participants were randomised to receive a series of e-mails either promoting the use of evidence-based self-help strategies or containing depression information as a control. E-mails were sent automatically twice a week for six weeks. Depression symptoms were assessed with the self-rated Patient Health Questionnaire depression scale (PHQ-9.1736 participants with a wide range of symptom severity were recruited and assigned to active (n = 862 and control (n = 874 groups. However, there was a significant attrition rate, with 66.9% lost to follow-up at post-intervention. Both groups showed large improvements in depression symptoms overall, with no significant difference in improvement at the end of the study (mean difference in improvement 0.35 points, 95% CI: -0.57 to 1.28, d = 0.11, 95% CI: -0.06 to 0.27, although there was a small effect at the study mid-point. Results were similar for the sub-group of participants with major depression. The active group showed small to moderate improvements in self-help behaviour (d = 0.40, 95% CI: 0.23 to 0.56.These results suggest that the e-mails were able to increase participants' use of evidence-based self-help, but that this did not improve depression more than an attention control.NCT01399502.

  15. Guided self-help for mental health disorders in children and young people with chronic neurological conditions: A qualitative evaluation.

    Science.gov (United States)

    Bennett, Sophie D; Coughtrey, Anna E; Heyman, Isobel; Greally, Suzanna; Clarkson, Harriet; Bhattacharyya, Tuhina; Lewis, Corah; Varadkar, Sophia; Shafran, Roz

    2018-03-09

    Children with neurological conditions such as epilepsy are at high risk of developing mental health disorders. Guided self-help can be used to increase access to psychological therapies. When developing and evaluating interventions, it is important to obtain the views of service-users about their acceptability. A telephone-guided self-help intervention was used to treat common mental health difficulties in children and young people with neurological conditions. The intervention was not adapted in content to account for chronic illness. This study therefore reports on qualitative interviews with participants to determine the acceptability of the intervention. Semi-structured interviews were conducted with 27 participants (25 parents and 2 young people) who had undertaken a telephone-delivered guided self-help intervention for common mental health difficulties in the context of a paediatric neurological condition. Transcripts were analysed thematically using the framework approach. Thirteen themes were extracted, organised into three main domains, which covered: the practicalities of telephone guided self-help treatment; the outcomes of the intervention; and the extent to which adaptation was needed for chronic illness. Most families found the intervention helpful in working towards their specific goals and noticed changes for the child and/or parents and family. Participants had a positive experience of the intervention and the majority of parents found the standard intervention with individualised goals sufficient to meet the young person's mental health needs. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  16. The Feasibility of Using Facebook, Craigslist, and Other Online Strategies to Recruit Young African American Women for a Web-Based Healthy Lifestyle Behavior Change Intervention.

    Science.gov (United States)

    Staffileno, Beth A; Zschunke, Jessica; Weber, Mallery; Gross, Lauren E; Fogg, Louis; Tangney, Christy C

    Reports describing successful recruiting of minority participants are available; however, they focus largely on traditional strategies. Internet and mobile devices are widely used, providing alternative approaches, yet less information is available describing the success of these approaches. This article (1) evaluates the feasibility of using online advertising as a recruiting modality for a healthy lifestyle behavior change intervention targeting young African American women and (2) describes lessons learned to better inform researchers for future directions. African American women, aged 18 to 45 years, with untreated prehypertension and Internet access were eligible for a 12-week randomized study providing physical activity or nutrition behavior change education delivered via online modules. Traditional strategies included flyers, tabletop cards, blood pressure screenings, health fairs, and clinics. Online-related strategies included posting ads on Facebook, Craigslist, and on the university Web site, intranet, and "on-hold" telephone line. Descriptive statistics were used to identify frequency of recruitment strategies. χ Analysis was used to assess differences between enrolled and nonenrolled inquiries. Among all 176 inquiries, the most frequented strategies were the university Web site (44%), blood pressure screenings (15%), Facebook/Craigslist (13%), and clinics (12%). Enrollment rates differed across recruitment strategies (χ P = .046). The 3 highest enrollment rates were (1) employee in-services (100%), (2) flyers/tabletop cards (31.6%), and (3) word of mouth/physician referral (25%). Online-related strategies are convenient and have great potential for reaching large numbers of people. However, the actual rate of participants successfully enrolled online was proportionally smaller when compared with traditional recruiting strategies.

  17. Conducting Web-based Surveys.

    OpenAIRE

    David J. Solomon

    2001-01-01

    Web-based surveying is becoming widely used in social science and educational research. The Web offers significant advantages over more traditional survey techniques however there are still serious methodological challenges with using this approach. Currently coverage bias or the fact significant numbers of people do not have access, or choose not to use the Internet is of most concern to researchers. Survey researchers also have much to learn concerning the most effective ways to conduct s...

  18. 50 WOMEN SELF HELP INITIATIVES: A PARADIGMATIC SHIFT IN ...

    African Journals Online (AJOL)

    of significant positive relationship between women self help projects and rural ... portable water, light, good health, basic education, clean environment as well as ... These concerned ... endowed with natural resources like: granite, gmelina, lime stone, rubber, .... conducted in Central Senatorial District of Cross River State.

  19. International Journal of Web Based Communities

    DEFF Research Database (Denmark)

    2006-01-01

    Special Issue on Knowledge Communication, culture and communities of practice in web based communities. ......Special Issue on Knowledge Communication, culture and communities of practice in web based communities. ...

  20. Delivering Acceptance and Commitment Therapy for Weight Self-Stigma through Guided Self-Help: Results from an Open Pilot Trial

    OpenAIRE

    Levin, Michael E.; Potts, Sarah; Haeger, Jack; Lillis, Jason

    2017-01-01

    Weight self-stigma is a promising target for innovative interventions seeking to improve outcomes among overweight/obese individuals. Preliminary research suggests acceptance and commitment therapy (ACT) may be an effective approach for reducing weight self-stigma, but a guided self-help version of this intervention may improve broad dissemination. This pilot open trial sought to evaluate the potential acceptability and efficacy of a guided self-help ACT intervention, included coaching and a ...

  1. Does self-directed and web-based support for parents enhance the effects of viewing a reality television series based on the Triple P-Positive Parenting Programme?

    Science.gov (United States)

    Sanders, Matthew; Calam, Rachel; Durand, Marianne; Liversidge, Tom; Carmont, Sue Ann

    2008-09-01

    This study investigated whether providing self-directed and web-based support for parents enhanced the effects of viewing a reality television series based on the Triple P - Positive Parenting Programme. Parents with a child aged 2 to 9 (N = 454) were randomly assigned to either a standard or enhanced intervention condition. In the standard television alone viewing condition, parents watched the six-episode weekly television series, 'Driving Mum and Dad Mad'. Parents in the enhanced television viewing condition received a self-help workbook, extra web support involving downloadable parenting tip sheets, audio and video streaming of positive parenting messages and email support, in addition to viewing the television series. Parents in both conditions reported significant improvements in their child's disruptive behaviour and improvements in dysfunctional parenting practices. Effects were greater for the enhanced condition as seen on the ECBI, two of the three parenting indicators and overall programme satisfaction. However, no significant differences were seen on other measures, including parent affect indicators. The level of improvement was related to number of episodes watched, with greatest changes occurring in families who watched each episode. Improvements achieved at post-intervention by parents in both groups were maintained at six-month follow-up. Online tip sheets were frequently accessed; uptake of web-based resources was highest early in the series. The value of combining self-help approaches, technology and media as part of a comprehensive public health approach to providing parenting support is discussed.

  2. Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

    Science.gov (United States)

    Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C

    2015-11-01

    Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Exploring individual cognitions, self-regulation skills, and environmental-level factors as mediating variables of two versions of a Web-based computer-tailored nutrition education intervention aimed at adults: A randomized controlled trial.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; Candel, Math J J M; de Vries, Hein; Oenema, Anke

    2016-03-01

    This study explored whether the determinants that were targeted in two versions of a Web-based computer-tailored nutrition education intervention mediated the effects on fruit, high-energy snack, and saturated fat intake among adults who did not comply with dietary guidelines. A RCT was conducted with a basic (tailored intervention targeting individual cognitions and self-regulation), plus (additionally targeting environmental-level factors), and control group (generic nutrition information). Participants were recruited from the general Dutch adult population and randomly assigned to one of the study groups. Online self-reported questionnaires assessed dietary intake and potential mediating variables (behavior-specific cognitions, action- and coping planning, environmental-level factors) at baseline and one (T1) and four (T2) months post-intervention (i.e. four and seven months after baseline). The joint-significance test was used to establish mediating variables at different time points (T1-mediating variables - T2-intake; T1-mediating variables - T1-intake; T2-mediating variables - T2-intake). Educational differences were examined by testing interaction terms. The effect of the plus version on fruit intake was mediated (T2-T2) by intention and fruit availability at home and for high-educated participants also by attitude. Among low/moderate-educated participants, high-energy snack availability at home mediated (T1-T1) the effect of the basic version on high-energy snack intake. Subjective norm mediated (T1-T1) the effect of the basic version on fat intake among high-educated participants. Only some of the targeted determinants mediated the effects of both intervention versions on fruit, high-energy snack, and saturated fat intake. A possible reason for not finding a more pronounced pattern of mediating variables is that the educational content was tailored to individual characteristics and that participants only received feedback for relevant and not for all

  4. Web based emergency room PACS

    International Nuclear Information System (INIS)

    Cha, Soon Joo; Cheon, Yong Kyung; Choi, Sung Woo Kim

    2005-01-01

    We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web Paces by using a system independent from PACS in the hospital and minimizing the information patients

  5. Web based emergency room PACS

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Soon Joo; Cheon, Yong Kyung; Choi, Sung Woo Kim [Ilsan Paik Hospital, Inje University, Seoul (Korea, Republic of)] (and others)

    2005-07-15

    We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web Paces by using a system independent from PACS in the hospital and minimizing the information patients.

  6. Web-Based Patient Education in Orthopedics: Systematic Review.

    Science.gov (United States)

    Dekkers, Tessa; Melles, Marijke; Groeneveld, Bob Sander; de Ridder, Huib

    2018-04-23

    Patients with orthopedic conditions frequently use the internet to find health information. Patient education that is distributed online may form an easily accessible, time- and cost-effective alternative to education delivered through traditional channels such as one-on-one consultations or booklets. However, no systematic evidence for the comparative effectiveness of Web-based educational interventions exists. The objective of this systematic review was to examine the effects of Web-based patient education interventions for adult orthopedic patients and to compare its effectiveness with generic health information websites and traditional forms of patient education. CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, PUBMED, ScienceDirect, Scopus, and Web of Science were searched covering the period from 1995 to 2016. Peer-reviewed English and Dutch studies were included if they delivered patient education via the internet to the adult orthopedic population and assessed its effects in a controlled or observational trial. A total of 10 trials reported in 14 studies involving 4172 patients were identified. Nine trials provided evidence for increased patients' knowledge after Web-based patient education. Seven trials reported increased satisfaction and good evaluations of Web-based patient education. No compelling evidence exists for an effect of Web-based patient education on anxiety, health attitudes and behavior, or clinical outcomes. Web-based patient education may be offered as a time- and cost-effective alternative to current educational interventions when the objective is to improve patients' knowledge and satisfaction. However, these findings may not be representative for the whole orthopedic patient population as most trials included considerably younger, higher-educated, and internet-savvy participants only. ©Tessa Dekkers, Marijke Melles, Bob Sander Groeneveld, Huib de Ridder. Originally published in the Journal of Medical Internet Research (http

  7. Web-Based Patient Education in Orthopedics: Systematic Review

    Science.gov (United States)

    Melles, Marijke; Groeneveld, Bob Sander; de Ridder, Huib

    2018-01-01

    Background Patients with orthopedic conditions frequently use the internet to find health information. Patient education that is distributed online may form an easily accessible, time- and cost-effective alternative to education delivered through traditional channels such as one-on-one consultations or booklets. However, no systematic evidence for the comparative effectiveness of Web-based educational interventions exists. Objective The objective of this systematic review was to examine the effects of Web-based patient education interventions for adult orthopedic patients and to compare its effectiveness with generic health information websites and traditional forms of patient education. Methods CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, PUBMED, ScienceDirect, Scopus, and Web of Science were searched covering the period from 1995 to 2016. Peer-reviewed English and Dutch studies were included if they delivered patient education via the internet to the adult orthopedic population and assessed its effects in a controlled or observational trial. Results A total of 10 trials reported in 14 studies involving 4172 patients were identified. Nine trials provided evidence for increased patients’ knowledge after Web-based patient education. Seven trials reported increased satisfaction and good evaluations of Web-based patient education. No compelling evidence exists for an effect of Web-based patient education on anxiety, health attitudes and behavior, or clinical outcomes. Conclusions Web-based patient education may be offered as a time- and cost-effective alternative to current educational interventions when the objective is to improve patients’ knowledge and satisfaction. However, these findings may not be representative for the whole orthopedic patient population as most trials included considerably younger, higher-educated, and internet-savvy participants only. PMID:29685869

  8. Cyber-support: an analysis of online self-help forums (online self-help forums in bipolar disorder).

    Science.gov (United States)

    Bauer, Rita; Bauer, Michael; Spiessl, Hermann; Kagerbauer, Tanja

    2013-06-01

    The Internet is becoming increasingly important in psychiatry and psychotherapy. The objective of this study was to evaluate if and how online self-help forums are used by patients with bipolar disorders, their relatives and treating professionals. A total of 2400 postings in two online forums were analysed qualitatively and quantitatively. "Disclosure", "friendship" and "online-group cohesion" were the main self-help mechanisms. The topics most discussed were "social network", "symptoms of the illness" and "medication". Factor analyses revealed three factors concerning self-help mechanisms: "group cohesion", "emotional support" and "exchange of information", as well as three factors concerning fields of interest: "illness-related aspects", "social aspects" and "financial and legal issues". We infer that the main interest in participating in online forums for patients with bipolar disorders and their relatives is to share emotions and to discuss their daily struggles with the illness. Our study also reveals that social networking is very important for patients coping with bipolar disorders. Psycho-educative programmes should focus on those aspects.

  9. Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial.

    Science.gov (United States)

    Lewis, Catrin E; Farewell, Daniel; Groves, Vicky; Kitchiner, Neil J; Roberts, Neil P; Vick, Tracey; Bisson, Jonathan I

    2017-06-01

    There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h. Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy. © 2017 Wiley Periodicals, Inc.

  10. Web-Based Distress Management for Implantable Cardioverter Defibrillator Patients

    DEFF Research Database (Denmark)

    Habibović, Mirela; Denollet, Johan; Cuijpers, Pim

    2017-01-01

    distress post-ICD implantation. The WEB-based distress management program for ICD patients (WEBCARE) was developed to mitigate anxiety and depression and enhance health-related quality of life in ICD patients. This study investigates the 6- and 12-months outcomes. METHOD: A total of 289 consecutive ICD...... care as usual. RESULTS: Current findings show no significant difference on anxiety, depression or quality of life between the WEBCARE and Usual Care group at 6- and 12-months postimplantation. CONCLUSIONS: In this clinical trial of a Web-based behavioral intervention for ICD patients, the Web...

  11. CMS Web-Based Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Badgett, William [Fermilab; Lopez-Perez, Juan Antonio [Fermilab; Maeshima, Kaori [Fermilab; Soha, Aron [Fermilab; Sulmanas, Balys [Fermilab; Wan, Zongru [Kansas State U.

    2010-01-01

    With the growth in size and complexity of High Energy Physics experiments, and the accompanying increase in the number of collaborators spread across the globe, the importance of widely relaying timely monitoring and status information has grown. To this end, we present online Web Based Monitoring solutions from the CMS experiment at CERN. The web tools developed present data to the user from many underlying heterogeneous sources, from real time messaging system to relational databases. We provide the power to combine and correlate data in both graphical and tabular formats of interest to the experimentalist, with data such as beam conditions, luminosity, trigger rates, detector conditions and many others, allowing for flexibility on the user side. We also present some examples of how this system has been used during CMS commissioning and early beam collision running at the Large Hadron Collider.

  12. Internet based self-help therapy versus waitlist control group for persons with anxiety disorders: A randomised feasibility study

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Lindschou, Jane; Gluud, Christian

    ) FearFighter or B) waitlist control group. Participants are persons with a diagnosis of social phobia, agora phobia, phobia or panic disorder. The intervention with FearFighter is a nine step cognitive behavioural self-help therapy program delivered over the internet over nine weeks. Participants...

  13. The Evolution of Hmong Self-Help Organizations in Minnesota

    Directory of Open Access Journals (Sweden)

    Shoua Yang

    2012-01-01

    Full Text Available The Hmong have several types of self-help organizations, classified accordingly to their purposes, to assist the Hmong to adapt to life in American culture. The central research question of this modest exploratory study relates to how these organizations haveevolved over the years in terms of their programming focus and funding strategies. To answer this question, a qualitative approach is used to guide the collection and analysis of data. The study was conducted in the St. Paul/Minneapolis region from 2007 to 2012,where a large population of Hmong refugees has settled since the mid-1970s and where these organizations were founded.

  14. An organizational typology for self-help groups.

    Science.gov (United States)

    Schubert, M A; Borkman, T J

    1991-10-01

    Those investigating the nature and functioning of self-help groups have been handicapped by the lack of a conceptual framework to bridge the diversity among such groups as well as to clarify the boundaries between consumer-owned and professionally owned groups. This paper describes a typology that classifies local units of these groups in terms of differences and similarities in their organizational structures. Rooted in organizational theory, it has two dimensions: external dependence upon resources and internal extent of experiential authority. Using it, the authors identified five types of groups, referred to as Unaffiliated, Federated, Affiliated, Hybrid, and Managed. The typology was validated with actual groups.

  15. Web Based Seismological Monitoring (wbsm)

    Science.gov (United States)

    Giudicepietro, F.; Meglio, V.; Romano, S. P.; de Cesare, W.; Ventre, G.; Martini, M.

    Over the last few decades the seismological monitoring systems have dramatically improved tanks to the technological advancements and to the scientific progresses of the seismological studies. The most modern processing systems use the network tech- nologies to realize high quality performances in data transmission and remote controls. Their architecture is designed to favor the real-time signals analysis. This is, usually, realized by adopting a modular structure that allow to easy integrate any new cal- culation algorithm, without affecting the other system functionalities. A further step in the seismic processing systems evolution is the large use of the web based appli- cations. The web technologies can be an useful support for the monitoring activities allowing to automatically publishing the results of signals processing and favoring the remote access to data, software systems and instrumentation. An application of the web technologies to the seismological monitoring has been developed at the "Os- servatorio Vesuviano" monitoring center (INGV) in collaboration with the "Diparti- mento di Informatica e Sistemistica" of the Naples University. A system named Web Based Seismological Monitoring (WBSM) has been developed. Its main objective is to automatically publish the seismic events processing results and to allow displaying, analyzing and downloading seismic data via Internet. WBSM uses the XML tech- nology for hypocentral and picking parameters representation and creates a seismic events data base containing parametric data and wave-forms. In order to give tools for the evaluation of the quality and reliability of the published locations, WBSM also supplies all the quality parameters calculated by the locating program and allow to interactively display the wave-forms and the related parameters. WBSM is a modular system in which the interface function to the data sources is performed by two spe- cific modules so that to make it working in conjunction with a

  16. Stomacare nurses and their share in the work with self-help groups of patiens.

    OpenAIRE

    ŠŤASTNÁ, Olga

    2010-01-01

    Stoma nurses and their contribution to work with self-help groups of patients. The diploma thesis dealt with the cooperation of stoma nurses with self-help groups of stoma patients in ten regions of the Czech Republic. The aim was to find out if stoma nurses recognize the importance of self-help groups for stoma patients, how their work contributes to self-help groups, if stoma nurses cooperate with self-help groups and if they inform stoma patients about the existence of self-help groups. An...

  17. A Revision of Preventive Web-based Psychotherapies in Subjects at Risk of Mental Disorders

    Directory of Open Access Journals (Sweden)

    Teresa Sánchez-Gutiérrez

    2017-08-01

    Full Text Available For the last years, the impulse of new technologies has overcome the traditional pathways of face-to-face clinical intervention and web-based psychological methodologies for intervention have started to gain success. This study aims to review the state-of-art about the effectiveness studies on preventive web- based interventions accomplished in samples of subjects at high risk for depressive, anxiety, eating behavior, problematic substance use symptoms and promotion of psychological well-being. Results showed that web-based psychological interventions for the prevention of mental disorders seemed to be effective for at risk individuals. Online health promotion in the general population was also effective to avoid the onset of clinical psychological circumstances. Future research should focus on personalized online intervention and on the evaluation of web-based engagement.

  18. Web-Based Distributed XML Query Processing

    NARCIS (Netherlands)

    Smiljanic, M.; Feng, L.; Jonker, Willem; Blanken, Henk; Grabs, T.; Schek, H-J.; Schenkel, R.; Weikum, G.

    2003-01-01

    Web-based distributed XML query processing has gained in importance in recent years due to the widespread popularity of XML on the Web. Unlike centralized and tightly coupled distributed systems, Web-based distributed database systems are highly unpredictable and uncontrollable, with a rather

  19. Interest in web-based treatments for postpartum anxiety: an exploratory survey.

    Science.gov (United States)

    Ashford, Miriam T; Ayers, Susan; Olander, Ellinor K

    2017-09-01

    This study aimed to explore women's interest in web-based treatments for postpartum anxiety and determine the feasibility of reaching women with postpartum anxiety online. Anxiety in the postpartum period is common and often untreated. One innovative approach of offering treatment during this period is through web-based self-help. Assessing women's interest in new treatments, such as a web-based self-help, is an important step prior to development efforts. A cross-sectional online survey was created and promoted for 4 months via unpaid social media posts (Facebook and Twitter). To be eligible, women had to be over the age of 18, live in England, fluent in English, be within 12 months postpartum and self-report at least mild levels of anxiety. A sample of 114 eligible women were recruited. The majority were Caucasian, well-educated, middle-class women. Seventy percent reported moderate or severe anxiety. Sixty-one percent of women expressed interest in web-based postpartum anxiety treatments. Women preferred treatment in a smartphone/tablet application format, presented in brief modules and supported by a therapist via email or chat/instant messaging. Based on the stated preferences of participating women it is recommended that postpartum anxiety web-based treatments include different forms of therapist support and use a flexibly accessible smartphone/tablet application format with content split into short sections. The findings also suggest that unpaid social media can be feasible in reaching women with postpartum anxiety, but additional efforts are needed to reach a more diverse population.

  20. Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective

    NARCIS (Netherlands)

    Trompetter, H.R.; Bohlmeijer, Ernst Thomas; Lamers, S.M.A.; Schreurs, Karlein Maria Gertrudis

    2016-01-01

    The web-based delivery of psychosocial interventions is a promising treatment modality for people suffering from chronic pain, and other forms of physical and mental illness. Despite the promising findings of first studies, patients may vary in the benefits they draw from self-managing a full-blown

  1. Online self-help for suicidal thoughts: 3-month follow-up results and participant evaluation

    Directory of Open Access Journals (Sweden)

    Bregje A.J. van Spijker

    2015-09-01

    Conclusions: Effects of online self-help for suicidal thoughts can be maintained for up to three months. Participant evaluation indicated that online self-help for suicidal thoughts is acceptable, but there is also room for improvement.

  2. An Integrated Web-Based Mental Health Intervention of Assessment-Referral-Care to Reduce Stress, Anxiety, and Depression in Hospitalized Pregnant Women With Medically High-Risk Pregnancies: A Feasibility Study Protocol of Hospital-Based Implementation

    OpenAIRE

    Kingston, Dawn; Janes-Kelley, Selikke; Tyrrell, Janie; Clark, Lorna; Hamza, Deena; Holmes, Penny; Parkes, Cheryl; Moyo, Nomagugu; McDonald, Sheila; Austin, Marie-Paule

    2015-01-01

    Background At prevalence rates of up to 40%, rates of depression and anxiety among women with medically complex pregnancies are 3 times greater than those in community-based samples of pregnant women. However, mental health care is not a component of routine hospital-based antenatal care for medically high-risk pregnant women. Objective The purpose of this study is to evaluate the effectiveness and feasibility of the hospital-based implementation of a Web-based integrated mental health interv...

  3. Up from Dependency: A New National Public Assistance Strategy. Supplement 3: A Self-Help Catalog.

    Science.gov (United States)

    Kotler, Martin; And Others

    Self-help among low-income people is vitally important. In no area is self-help more important than in overcoming poverty's burdens and energizing the escape from poverty. This document comprises an inventory of self-help and mutual-help programs that feature active involvement of members of the low-income population. The programs in this…

  4. How and for whom does web-based acceptance and commitment therapy work? Mediation and moderation analyses of web-based ACT for depressive symptoms.

    Science.gov (United States)

    Pots, Wendy T M; Trompetter, Hester R; Schreurs, Karlein M G; Bohlmeijer, Ernst T

    2016-05-23

    Acceptance and Commitment Therapy (ACT) has been demonstrated to be effective in reducing depressive symptoms. However, little is known how and for whom therapeutic change occurs, specifically in web-based interventions. This study focuses on the mediators, moderators and predictors of change during a web-based ACT intervention. Data from 236 adults from the general population with mild to moderate depressive symptoms, randomized to either web-based ACT (n = 82) or one of two control conditions (web-based Expressive Writing (EW; n = 67) and a waiting list (n = 87)), were analysed. Single and multiple mediation analyses, and exploratory linear regression analyses were performed using PROCESS and linear regression analyses, to examine mediators, moderators and predictors on pre- to post- and follow-up treatment change of depressive symptoms. The treatment effect of ACT versus the waiting list was mediated by psychological flexibility and two mindfulness facets. The treatment effect of ACT versus EW was not significantly mediated. The moderator analyses demonstrated that the effects of web-based ACT did not vary according to baseline patient characteristics when compared to both control groups. However, higher baseline depressive symptoms and positive mental health and lower baseline anxiety were identified as predictors of outcome across all conditions. Similar results are found for follow-up. The findings of this study corroborate the evidence that psychological flexibility and mindfulness are distinct process mechanisms that mediate the effects of web-based ACT intervention. The results indicate that there are no restrictions to the allocation of web-based ACT intervention and that web-based ACT can work for different subpopulations. Netherlands Trial Register NTR2736 . Registered 6 February 2011.

  5. Evaluation of a Web-based social network electronic game in enhancing mental health literacy for young people.

    Science.gov (United States)

    Li, Tim M H; Chau, Michael; Wong, Paul W C; Lai, Eliza S Y; Yip, Paul S F

    2013-05-15

    Internet-based learning programs provide people with massive health care information and self-help guidelines on improving their health. The advent of Web 2.0 and social networks renders significant flexibility to embedding highly interactive components, such as games, to foster learning processes. The effectiveness of game-based learning on social networks has not yet been fully evaluated. The aim of this study was to assess the effectiveness of a fully automated, Web-based, social network electronic game on enhancing mental health knowledge and problem-solving skills of young people. We investigated potential motivational constructs directly affecting the learning outcome. Gender differences in learning outcome and motivation were also examined. A pre/posttest design was used to evaluate the fully automated Web-based intervention. Participants, recruited from a closed online user group, self-assessed their mental health literacy and motivational constructs before and after completing the game within a 3-week period. The electronic game was designed according to cognitive-behavioral approaches. Completers and intent-to-treat analyses, using multiple imputation for missing data, were performed. Regression analysis with backward selection was employed when examining the relationship between knowledge enhancement and motivational constructs. The sample included 73 undergraduates (42 females) for completers analysis. The gaming approach was effective in enhancing young people's mental health literacy (d=0.65). The finding was also consistent with the intent-to-treat analysis, which included 127 undergraduates (75 females). No gender differences were found in learning outcome (P=.97). Intrinsic goal orientation was the primary factor in learning motivation, whereas test anxiety was successfully alleviated in the game setting. No gender differences were found on any learning motivation subscales (P>.10). We also found that participants' self-efficacy for learning and

  6. Responding to local needs. Self-help groups.

    Science.gov (United States)

    Jayaseelan, J

    1993-01-01

    Pink Triangle, the only community-based group in Malaysia which works with men who have sex with men, took initial steps in August 1992 to establish a self-help project for people who are HIV-seropositive. Supporting people who are HIV-positive and fighting for their rights is new in Malaysia. The group has thus far been publicized through its public education events, hospitals, and other nongovernmental organizations. For the first time, information is being published specifically by and for people living with HIV/AIDS. The project also has a phone line to allow people to speak anonymously with someone who shares their experience. Many callers are men who have sex with men in the social context of intense prejudice and discrimination. Afraid to openly acknowledge their sexuality with strangers, the callers have yet to accede to meeting each other face-to-face in a group setting. The author notes in closing that Pink Triangle must be realistic about what can be achieved in Malaysia and allow the group to develop according to people's needs and not on the basis of a model imported from outside of the country.

  7. SELF HELP GROUPS (SHGS: MICRO FINANCE IN INDIA

    Directory of Open Access Journals (Sweden)

    Shivam SAKSHI

    2018-05-01

    Full Text Available Micro finance in India has developed in decades from an idea to implementation to many success stories to an overall success. The early dawn of the idea of micro financing was to provide the capital to the population which was considered the bottom of socio economic pyramid so as to carry out the small household business and this idea has gradually grown up to become the way to help improve the socio standards of the poor people. India is the country of villages, more than 70% of the nation’s population resides in the rural areas of the country and 60% of this rural population depends on agriculture for living. In such situation the micro financing can play a vital role in making the rural people’s life easy. In a developing country like India with a lot of people residing in rural areas, micro finance is undoubtedly the best implementation. Self Help Groups of India has emerged as the world’s largest and most successful network of Community Based Organisations. The main goal of an SHG is to elevate the living conditions of the rural poor with a maximum emphasize on women. The present paper’s objective is to explain the situation of micro finance in India and to explain the main channel of micro finance in India which is SHGs and the details of the SHGs.

  8. The web based user interface of RODOS

    International Nuclear Information System (INIS)

    Raskob, W.; Mueller, A.; Munz, E.; Rafat, M.

    2003-01-01

    and platform independent web technology. This enables accessing the RODOS systems by remote users from all kinds of computer platforms with Internet browser. The layout and content structure of this web interface have been designed and developed with a unique standardized interface layout and information structure under due consideration of the needs of the RODOS users. Two types of web-based interfaces have been realized: category B: active user with access to the RODOS system via web browser. The interaction with RODOS is limited to the level (2) and (3) mentioned above: category B users can only define interactive runs via input forms and select results from predefined information. They have no access to data bases and cannot operate RODOS in its automatic mode. Category C: passive user with access via web browser and - if desired - via X-desktop only to RODOS results produced by users of category A or B. The category B users define their requests to the RODOS system via an interactive Web-based interface. The corresponding HTML file is sent to the RODOS Web server. lt transforms the information into RODOS compatible input data, initiates the corresponding RODOS runs, produces an HTML results file and returns it to the web browser. The web browser receives the HTML file, it interprets the page content and displays the page. The layout, content and functions of the new web based interface for category B and category C users will be demonstrated. Example interactive runs will show the interaction with the RODOS system. fig. 1 (author)

  9. Web-based Project Reporting System

    Data.gov (United States)

    US Agency for International Development — Web-PRS is a web-based system that captures financial information and project status information that is sortable by geographical location, pillar, project type and...

  10. Guided self-help for the treatment of pediatric obesity.

    Science.gov (United States)

    Boutelle, Kerri N; Norman, Gregory J; Rock, Cheryl L; Rhee, Kyung E; Crow, Scott J

    2013-05-01

    Clinic-based programs for childhood obesity are not available to a large proportion of the population. The purpose of this study was to evaluate the efficacy of a guided self-help treatment of pediatric obesity (GSH-PO) compared with a delayed treatment control and to evaluate the impact of GSH-PO 6-months posttreatment. Fifty overweight or obese 8- to 12-year-old children and their parents were randomly assigned to immediate treatment or to delayed treatment. The GSH-PO includes 12 visits over 5 months and addresses key components included in more intensive clinic-based programs. Children and parents in the immediate treatment arm were assessed at time 1 (T1), participated in GSH-PO between T1 and T2, and completed their 6-month posttreatment assessment at T3. Children and parents in the delayed treatment arm were assessed at T1, participated in GSH-PO between T2 and T3, and completed their 6-month posttreatment assessment at T4. The main outcome measures were BMI, BMI z score, and percentage overweight (%OW). Children in the immediate treatment GSH-PO arm decreased their BMI significantly more than did the delayed treatment arm (BMI group × time = -1.39; P < .001). Similar results were found for BMI z score and %OW. At the 6-month posttreatment assessment, changes resulting from GSH-PO were maintained for BMI z score and %OW but not BMI (BMI time effect = -0.06, not significant; BMI z score time effect = -0.10, P < .001; %OW time effect = -4.86, P < .05). The GSH-PO showed initial efficacy in decreasing BMI for children in this study. Additional efficacy and translational studies are needed to additionally evaluate GSH-PO.

  11. Efficacy of a self-help manual in increasing resilience in carers of adults with depression in Thailand.

    Science.gov (United States)

    McCann, Terence V; Songprakun, Wallapa; Stephenson, John

    2016-02-01

    Caring for a person with a mental illness can have adverse effects on caregivers; however, little is known about how best to help such caregivers. The aim of the present study was to examine the efficacy of a cognitive behaviour therapy-guided self-help manual in increasing resilience in caregivers of individuals with depression, in comparison to caregivers who receive routine support only. A randomized, controlled trial was conducted, following CONSORT guidelines, with 54 caregivers allocated to parallel intervention (self-help manual) (n = 27) or control (standard support) (n = 27) groups. Resilience was assessed at baseline, post-test (week 8), and follow up (week 12). Intention-to-treat analyses were undertaken. Repeated-measures ANOVA indicated a significant difference in resilience scores between the three time points, showing a large effect. Pairwise comparisons between intervention and control groups indicated resilience to be significantly different between baseline and post-test, and between baseline and follow up, but not between post-test and follow up. Overall, the intervention group showed a slightly greater increase in resilience over time than the control group; however, the time-group interaction was not significant. Guided self-help is helpful in improving caregivers' resilience and could be used as an adjunct to the limited support provided to carers by mental health nurses and other clinicians. © 2016 Australian College of Mental Health Nurses Inc.

  12. Health education in self-help groups to promote healthy lifestyles

    Directory of Open Access Journals (Sweden)

    Bruno López de la Vega

    2012-12-01

    Full Text Available In this review we discuss the formation of self-help groups (GAM in order to help to counteract diseases, illnesses or conditions assertively, effective and above all positive, this in order to integrate health education in its multidisciplinary approach to create GAM that provide viable alternatives to modify unhealthy lifestyles or unhealthy. It is important the introduction of health education in the creation and sustenance of the same, as it provides a different perspective on the implementation of plans, programs and projects open to meet learning needs and changes in lifestyle with the help of support networks and psycho-emotional aspects intervention, which aims to achieve stability at individual and collective level.

  13. Preliminary evaluation of a "formulation-driven cognitive behavioral guided self-help (fCBT-GSH)" for crisis and transitional case management clients.

    Science.gov (United States)

    Naeem, Farooq; Johal, Rupinder K; Mckenna, Claire; Calancie, Olivia; Munshi, Tariq; Hassan, Tariq; Nasar, Amina; Ayub, Muhammad

    2017-01-01

    Cognitive behavioral therapy (CBT) is found to be effective for common mental disorders and has been delivered in self-help and guided self-help formats. Crisis and transitional case management (TCM) services play a vital role in managing clients in acute mental health crises. It is, therefore, an appropriate setting to try CBT in guided self-help format. This was a preliminary evaluation of a formulation-driven cognitive behavioral guided self-help. Thirty-six (36) consenting participants with a diagnosis of nonpsychotic illness, attending crisis and the TCM services in Kingston, Canada, were recruited in this study. They were randomly assigned to the guided self-help plus treatment as usual (TAU) (treatment group) or to TAU alone (control group). The intervention was delivered over 8-12 weeks. Assessments were completed at baseline and 3 months after baseline. The primary outcome was a reduction in general psychopathology, and this was done using Clinical Outcomes in Routine Evaluation - Outcome Measure. The secondary outcomes included a reduction in depression, measured using the Hospital Anxiety and Depression Scale, and reduction in disability, measured using the World Health Organization Disability Assessment Schedule 2.0. Participants in the treatment group showed statistically significant improvement in overall psychopathology ( P crisis and TCM clients and can be effective in improving mental health, when compared with TAU. This is the first report of a trial of guided self-help for clients attending crisis and TCM services.

  14. Self-help groups and mental health/substance use agencies: the benefits of organizational exchange.

    Science.gov (United States)

    Powell, Thomas; Perron, Brian Edward

    2010-02-01

    Self-help groups benefit clients by linking them to people who have "been there" and are successfully coping with their situations. Mental health/substance use agencies can increase access to evidence-based benefits of self-help groups by engaging them in organizational exchanges. Organizational theories are used to frame beneficial exchanges with self-help groups. Adaptational theory is used to frame exchanges with self-help groups and various service agency subunits, e.g., board, practitioner, and client units. Institutional theory is used to frame joint agency/self-help initiatives to promote community acceptance of self-help groups, which in turn may enhance the credibility of the professional agency.

  15. Rationale and design of the Baptist Employee Healthy Heart Study: a randomized trial assessing the efficacy of the addition of an interactive, personalized, web-based, lifestyle intervention tool to an existing health information web platform in a high-risk employee population.

    Science.gov (United States)

    Post, Janisse M; Ali, Shozab S; Roberson, Lara L; Aneni, Ehimen C; Shaharyar, Sameer; Younus, Adnan; Jamal, Omar; Ahmad, Rameez; Aziz, Muhammad A; Malik, Rehan; Spatz, Erica S; Feldman, Theodore; Fialkow, Jonathan; Veledar, Emir; Cury, Ricardo C; Agatston, Arthur S; Nasir, Khurram

    2016-07-01

    Metabolic syndrome (MetS) and diabetes confer a high risk for developing subsequent cardiovascular disease (CVD). Persons with MetS constitute 24-34 % of the employee population at Baptist Health South Florida (BHSF), a self-insured healthcare organization. The Baptist Employee Healthy Heart Study (BEHHS) aims to assess the addition of a personalized, interactive, web-based, nutrition-management and lifestyle-management program to the existing health-expertise web platform available to BHSF employees in reducing and/or stabilizing CVD and lifestyle risk factors and markers of subclinical CVD. Subjects with MetS or Type II Diabetes will be recruited from an employee population at BHSF and randomized to either an intervention or a control arm. The intervention arm will be given access to a web-based personalized diet-modification and weight-modification program. The control arm will be reminded to use the standard informational health website available and accessible to all BHSF employees. Subjects will undergo coronary calcium testing, carotid intima-media thickness scans, peripheral arterial tonometry, and advanced lipid panel testing at visit 1, in addition to lifestyle and medical history questionnaires. All tests will be repeated at visits 2 and 4 with the exception of the coronary calcium test, which will only be performed at baseline and visit 4. Visit 3 will capture vitals, anthropometrics, and responses to the questionnaires only. Results of this study will provide information on the effectiveness of personalized, web-based, lifestyle-management tools in reducing healthcare costs, promoting healthy choices, and reducing cardiovascular risk in an employee population. It will also provide information about the natural history of carotid atherosclerosis and endothelial dysfunction in asymptomatic but high-risk populations. ClinicalTrials.gov registry, NCT01912209 . Registered on 3 July 2013.

  16. Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Christopher Williams

    Full Text Available BACKGROUND: Access to Cognitive behavioural t