Community-based youth tobacco control interventions: cost effectiveness of the Full Court Press project.

PubMed

Ross, Hana; Powell, Lisa M; Bauer, Joseph E; Levy, David T; Peck, Richard M; Lee, Hye-Ryeon

2006-01-01

We evaluated the impact of a community-based tobacco control project that was implemented in the city of Tucson, Arizona, USA, between 1996 and 2001. The project's goal was to reduce the prevalence of youth smoking through change in social norms at schools and in communities and workplaces. As is often the case, these community-based health promotion interventions were implemented in conjunction with other broader programmes, in this case implemented on the state level. Taking into account state level interventions as well as changes in sociodemographic and economic environment over the course of the project (e.g. increases in cigarette prices), we measure the net effect of the intervention in terms of the number of people who quit or did not initiate smoking and by the discounted life-years gained. To establish the value of investing into community-based intervention, we calculated the real discounted cost per quit and per life-year gained of 3789 US dollars and 3942 US dollars, respectively. These compare favourably with the real cost per quit of 4270 US dollars when implementing the 1996 US Clinical Practice Guideline for smoking cessation but exceed the real cost of 2923 US dollars per discounted life-year gained when following the guideline. A sensitivity analysis that assumed 5% programme persistence (i.e. 5% of the programme's impact would last forever in the absence of future funding for the programme), one-third would relapse and that one-third of those who quit may have quit smoking even without the programme, suggested a lower cost per discounted life-year saved of 3476 US dollars. The cost effectiveness of this project compares favourably with other tobacco control interventions. Despite its relatively small target group, this community-based intervention was cost effective.

A hospital-based child protection programme evaluation instrument: a modified Delphi study.

PubMed

Wilson, Denise; Koziol-McLain, Jane; Garrett, Nick; Sharma, Pritika

2010-08-01

Refine instrument for auditing hospital-based child abuse and neglect violence intervention programmes prior to field-testing. A modified Delphi study to identify and rate items and domains indicative of an effective and quality child abuse and neglect intervention programme. Experts participated in four Delphi rounds: two surveys, a one-day workshop and the opportunity to comment on the penultimate instrument. New Zealand. Twenty-four experts in the field of care and protection of children. Items with panel agreement >or=85% and mean importance rating >or=4.0 (scale from 1 (not important) to 5 (very important)). There was high-level consensus on items across Rounds 1 and 2 (89% and 85%, respectively). In Round 3 an additional domain (safety and security) was agreed upon and cultural issues, alert systems for children at risk, and collaboration among primary care, community, non-government and government agencies were discussed. The final instrument included nine domains ('policies and procedures', 'safety and security', 'collaboration', 'cultural environment', 'training of providers', 'intervention services', 'documentation' 'evaluation' and 'physical environment') and 64 items. The refined instrument represents the hallmarks of an ideal child abuse and neglect programme given current knowledge and experience. The instrument enables rigorous evaluations of hospital-based child abuse and neglect intervention programmes for quality improvement and benchmarking with other programmes.

Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study

PubMed Central

2013-01-01

Introduction Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. Methods IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. Results HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother’s diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. Conclusion We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial. PMID:24373301

Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study.

PubMed

Taylor, Natalie J; Sahota, Pinki; Sargent, Judith; Barber, Sally; Loach, Jackie; Louch, Gemma; Wright, John

2013-12-28

Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother's diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.

Mothers' Satisfaction with a Home Based Early Intervention Programme for Children with ASD

ERIC Educational Resources Information Center

Rodger, Sylvia; Keen, Deb; Braithwaite, Michelle; Cook, Shannon

2008-01-01

Background: Early intervention services adopting a family-centred approach are considered important for ensuring parent satisfaction. This study investigated the satisfaction of two mothers with an early intervention programme for young children with autistic spectrum disorder. Materials and Methods: While 16 mother-child dyads participated in a…

Evaluating disease management programme effectiveness: an introduction to the regression discontinuity design.

PubMed

Linden, Ariel; Adams, John L; Roberts, Nancy

2006-04-01

Although disease management (DM) has been in existence for over a decade, there is still much uncertainty as to its effectiveness in improving health status and reducing medical cost. The main reason is that most programme evaluations typically follow weak observational study designs that are subject to bias, most notably selection bias and regression to the mean. The regression discontinuity (RD) design may be the best alternative to randomized studies for evaluating DM programme effectiveness. The most crucial element of the RD design is its use of a 'cut-off' score on a pre-test measure to determine assignment to intervention or control. A valuable feature of this technique is that the pre-test measure does not have to be the same as the outcome measure, thus maximizing the programme's ability to use research-based practice guidelines, survey instruments and other tools to identify those individuals in greatest need of the programme intervention. Similarly, the cut-off score can be based on clinical understanding of the disease process, empirically derived, or resource-based. In the RD design, programme effectiveness is determined by a change in the pre-post relationship at the cut-off point. While the RD design is uniquely suitable for DM programme evaluation, its success will depend, in large part, on fundamental changes being made in the way DM programmes identify and assign individuals to the programme intervention.

A new evidence-based model for weight management in primary care: the Counterweight Programme.

PubMed

Laws, Rachel

2004-06-01

Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care. The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18-75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit. By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m(2) (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months. The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care.

The Neuroscience of Callous-Unemotional Subtype of Conduct Problems: Implications for Intervention and Education

ERIC Educational Resources Information Center

Jones, Alice P.; Viding, Essi

2010-01-01

This paper presents a novel school-based intervention programme for children with chronic and severe emotional and behavioural difficulties. The main aim of the programme is to reduce conduct problems and to increase prosocial behaviours. The ultimate aim of such a programme is to help pupils with severe and chronic conduct problems back on track…

The effect of a sexuality education programme among out- of- school adolescents in Lagos, Nigeria.

PubMed

Odeyemi, K A; Onajole, A T; Ogunowo, B E; Olufunlayo, T; Segun, B

2014-06-01

This study was conducted to assess the effect of a community based sexuality education programme on the sexual health knowledge and practices of out of school female adolescents. This Intervention study was conducted in two markets within Lagos, Nigeria. Representative samples of adolescents were interviewed on their sexual health knowledge and practices. An Education- entertainment programme provided sexuality education to adolescents in Mushin market only (intervention group) followed by post intervention surveys in Mushin market and Sangrouse market (control group). The pre and post intervention surveys were compared 6 months post intervention to detect any changes. Sexual health knowledge and behaviour was similar among respondents in both markets pre intervention. Post intervention, the sexual health knowledge of the respondents in the intervention site improved significantly. (p<0.05) Fewer adolescents initiated sex in the intervention site than in the control site and contraceptive use increased. However among the sexually active, there was no significant change in their condom use and number of sexual partners. Community based health education programmes can be used to provide effective sexuality education for out of school adolescents. Provision should be made by government and non-governmental organisations during adolescent reproductive health programming for sexuality education targeted at out of school adolescents.

The pro children intervention: applying the intervention mapping protocol to develop a school-based fruit and vegetable promotion programme.

PubMed

Pérez-Rodrigo, Carmen; Wind, Marianne; Hildonen, Christina; Bjelland, Mona; Aranceta, Javier; Klepp, Knut-Inge; Brug, Johannes

2005-01-01

The importance of careful theory-based intervention planning is recognized for fruit and vegetable promotion. This paper describes the application of the Intervention Mapping (IM) protocol to develop the Pro Children intervention to promote consumption of fruit and vegetable among 10- to 13-year-old schoolchildren. Based on a needs assessment, promotion of intake of fruit and vegetable was split into performance objectives and related personal, social and environmental determinants. Crossing the performance objectives with related important and changeable determinants resulted in a matrix of learning and change objectives for which appropriate educational strategies were identified. Theoretically similar but culturally relevant interventions were designed, implemented and evaluated in Norway, the Netherlands and Spain during 2 school years. Programme activities included provision of fruits and vegetables in the schools, guided classroom activities, computer-tailored feedback and advice for children, and activities to be completed at home with the family. Additionally, optional intervention components for community reinforcement included incorporation of mass media, school health services or grocery stores. School project committees were supported. The Pro Children intervention was carefully developed based on the IM protocol that resulted in a comprehensive school-based fruit and vegetable promotion programme, but culturally sensible and locally relevant. (c) 2005 S. Karger AG, Basel

Using intervention mapping to develop a home-based parental-supervised toothbrushing intervention for young children.

PubMed

Gray-Burrows, K A; Day, P F; Marshman, Z; Aliakbari, E; Prady, S L; McEachan, R R C

2016-05-06

Dental caries in young children is a major public health problem impacting on the child and their family in terms of pain, infection and substantial financial burden on healthcare funders. In the UK, national guidance on the prevention of dental caries advises parents to supervise their child's brushing with fluoride toothpaste until age 7. However, there is a dearth of evidence-based interventions to encourage this practice in parents. The current study used intervention mapping (IM) to develop a home-based parental-supervised toothbrushing intervention to reduce dental caries in young children. The intervention was developed using the six key stages of the IM protocol: (1) needs assessment, including a systematic review, qualitative interviews, and meetings with a multi-disciplinary intervention development group; (2) identification of outcomes and change objectives following identification of the barriers to parental-supervised toothbrushing (PSB), mapped alongside psychological determinants outlined in the Theoretical Domains Framework (TDF); (3) selection of methods and practical strategies; (4) production of a programme plan; (5) adoption and implementation and (6) Evaluation. The comprehensive needs assessment highlighted key barriers to PSB, such as knowledge, skills, self-efficacy, routine setting and behaviour regulation and underlined the importance of individual, social and structural influences. Parenting skills (routine setting and the ability to manage the behaviour of a reluctant child) were emphasised as critical to the success of PSB. The multi-disciplinary intervention development group highlighted the need for both universal and targeted programmes, which could be implemented within current provision. Two intervention pathways were developed: a lower cost universal pathway utilising an existing national programme and an intensive targeted programme delivered via existing parenting programmes. A training manual was created to accompany each intervention to ensure knowledge and standardise implementation procedures. PSB is a complex behaviour and requires intervention across individual, social and structural levels. IM, although a time-consuming process, allowed us to capture this complexity and allowed us to develop two community-based intervention pathways covering both universal and targeted approaches, which can be integrated into current provision. Further research is needed to evaluate the acceptability and sustainability of these interventions.

Applied Behaviour Analysis: Does Intervention Intensity Relate to Family Stressors and Maternal Well-Being?

ERIC Educational Resources Information Center

Schwichtenberg, A.; Poehlmann, J.

2007-01-01

Background: Interventions based on applied behaviour analysis (ABA) are commonly recommended for children with an autism spectrum disorder (ASD); however, few studies address how this intervention model impacts families. The intense requirements that ABA programmes place on children and families are often cited as a critique of the programme,…

The Continued Effects of Home Intervention on Child Development Outcomes in the Kingdom of Bahrain

ERIC Educational Resources Information Center

Hadeed, Julie

2011-01-01

This article presents the continued effects of a home-based intervention programme on child development outcomes and parenting practices in Bahrain. The intervention is the "Mother-Child Home Education Programme" (MOCEP) which was implemented in Arabic in the Kingdom of Bahrain beginning in 2001. One hundred and sixty-seven poor,…

Outreach Programmes to Attract Girls into Computing: How the Best Laid Plans Can Sometimes Fail

ERIC Educational Resources Information Center

Lang, Catherine; Fisher, Julie; Craig, Annemieke; Forgasz, Helen

2015-01-01

This article presents a reflective analysis of an outreach programme called the Digital Divas Club. This curriculum-based programme was delivered in Australian schools with the aim of stimulating junior and middle school girls' interest in computing courses and careers. We believed that we had developed a strong intervention programme based on…

Maintaining evaluation designs in long term community based health promotion programmes: Heartbeat Wales case study.

PubMed Central

Nutbeam, D; Smith, C; Murphy, S; Catford, J

1993-01-01

STUDY OBJECTIVE--To examine the difficulties of developing and maintaining outcome evaluation designs in long term, community based health promotion programmes. DESIGN--Semistructured interviews of health promotion managers. SETTING--Wales and two reference health regions in England. PARTICIPANTS--Nine health promotion managers in Wales and 18 in England. MEASUREMENTS AND MAIN RESULTS--Information on selected heart health promotion activity undertaken or coordinated by health authorities from 1985-90 was collected. The Heartbeat Wales coronary heart disease prevention programme was set up in 1985, and a research and evaluation strategy was established to complement the intervention. A substantial increase in the budget occurred over the period. In the reference health regions in England this initiative was noted and rapidly taken up, thus compromising their use as control areas. CONCLUSION--Information on large scale, community based health promotion programmes can disseminate quickly and interfere with classic intervention/evaluation control designs through contamination. Alternative experimental designs for assessing the effectiveness of long term intervention programmes need to be considered. These should not rely solely on the use of reference populations, but should balance the measurement of outcome with an assessment of the process of change in communities. The development and use of intervention exposure measures together with well structured and comprehensive process evaluation in both the intervention and reference areas is recommended. PMID:8326270

Behavioural Effects of a Short School-Based Fruit and Vegetable Promotion Programme

ERIC Educational Resources Information Center

Mittmann, Silke; Austel, Anja; Ellrott, Thomas

2016-01-01

Purpose: The purpose of this paper is to investigate the effects of the Cancer Society of Lower Saxony's school-based nutrition education programme "5-a-day for kids", designed to increase children's fruit and vegetable consumption. Intervention: the programme included three parts (each 45 minutes): education-based classroom session;…

An Intervention Programme for Promoting More Effective Learning among Foundation Phase Learners in South Africa

ERIC Educational Resources Information Center

van Rensburg, Ona Janse

2015-01-01

The author defends the claim, based on her experience as a teacher in the Foundation Phase as well as on her experience as the educator of student teachers in this Phase, that a specially constructed intervention programme will improve Grade 1's learning in several key areas. She firstly show that such a programme is required, given the current…

Bottom-up implementation of disease-management programmes: results of a multisite comparison.

PubMed

Lemmens, K M M; Nieboer, A P; Rutten-Van Mölken, M P M H; van Schayck, C P; Spreeuwenberg, C; Asin, J D; Huijsman, R

2011-01-01

To evaluate the implementation of three regional disease-management programmes on chronic obstructive pulmonary disease (COPD) based on bottlenecks experienced in professional practice. The authors performed a multisite comparison of three Dutch regional disease-management programmes combining patient-related, professional-directed and organisational interventions. Process (Assessing Chronic Illness Care survey) and outcome (disease specific quality of life (clinical COPD questionnaire (CCQ); chronic respiratory questionnaire (CRQ)), Medical Research Council dyspnoea and patients' experiences) data were collected for 370 COPD patients and their care providers. Bottlenecks in region A were mostly related to patient involvement, in region B to organisational issues and in region C to both. Selected interventions related to identified bottlenecks were implemented in all programmes, except for patient-related interventions in programme A. Within programmes, significant improvements were found on dyspnoea and patients' experiences with practice nurses. Outcomes on quality of life differed between programmes: programme A did not show any significant improvements; programme B did show any significant improvements on CCQ total (p<0.001), functional (p=0.011) and symptom (p<0.001), CRQ fatigue (p<0.001) and emotional scales (p<0.001); in programme C, CCQ symptom (p<0.001) improved significantly, whereas CCQ mental score (p<0.001) deteriorated significantly. Regression analyses showed that programmes with better implementation of selected interventions resulted in relatively larger improvements in quality of life (CCQ). Bottom-up implementation of COPD disease-management programmes is a feasible approach, which in multiple settings leads to significant improvements in outcomes of care. Programmes with a better fit between implemented interventions and bottlenecks showed more positive changes in outcomes.

Revealing the Community Within: Valuing the Role of Local Community Structures within Evidence-Based School Intervention Programmes

ERIC Educational Resources Information Center

McIntyre, Joanna; Knight, Rupert

2016-01-01

Schools and the families they serve are sometimes perceived as deficient and in need of fixing. One response has been the implementation of evidence-based family intervention programmes, which may be highly regulated and prescriptive as a condition of their (often philanthropic) funding. This article seeks to explore and bring to the foreground…

"The One That Got Away": How Angling as a Culture of Practice Manifests in the Teaching and Learning Relationship within Angling-Based Intervention Programmes

ERIC Educational Resources Information Center

Djohari, Natalie; Brown, Adam; Stolk, Paul

2016-01-01

In recent years a professional sector has emerged within the UK delivering angling-based intervention programmes targeted at young people "disengaged" with education. These coaches bring with them an angling cultural background, which influences their interactions with young people as "novices", emerging in "angler…

Parental Concerns Regarding a Centre-Based Early Intervention Programme for Down Syndrome in Malaysia: A Case Study

ERIC Educational Resources Information Center

Kunagaratnam, Nagasangari; Loh, Sau Cheong

2010-01-01

This qualitative study provides information on the concerns faced by parents having children with Down syndrome in a centre-based Early Intervention Programme in Malaysia and how they coped with these concerns. Semi-structured interviews were conducted with a total of five parents and two special educators. The interview and observation findings…

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

PubMed

Nakamura, Saki; Inayama, Takayo; Arao, Takashi

2017-01-13

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. 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. The fact that this study is an RCT with an established control group is a strong advantage. Information and communications technology is not limited by time or place. If we could show this web-based nutrition education programmes has a positive effect, it may be an appropriate tool for reaching individuals in lower socio-economic state. Current Controlled Trials UMIN-ICDR UMIN 000019376 (Registered October 16, 2015).

Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren.

PubMed

Mariño, R; Fajardo, J; Morgan, M

2012-12-01

This study aims to estimate the cost-effectiveness from a societal perspective of seven dental caries prevention programmes among schoolchildren in Chile: three community-based programmes: water-fluoridation, salt-fluoridation and dental sealants; and four school-based programmes: milk-fluoridation; fluoridated mouthrinses (FMR); APF-Gel, and supervised toothbrushing with fluoride toothpaste. Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating each programme, using a societal perspective, were identified and estimated. The comparator was non-intervention. Health outcomes were measured as dental caries averted over a 6-year period. Costs were estimated as direct treatment costs, programmes costs and costs of productivity losses as a result of each dental caries prevention programme. Incremental cost-effectiveness ratios were calculated for each programme. Sensitivity analyses were conducted over key parameters. Primary cost-effectiveness analysis (discounted) indicated that four programmes showed net social savings by the DMFT averted. These savings encompassed a range of values per diseased tooth averted; US$16.21 (salt-fluoridation), US$14.89 (community water fluoridation); US$14.78 (milk fluoridation); and US$8.63 (FMR). Individual programmes using an APF-Gel application, dental sealants, and supervised tooth brushing using fluoridated toothpaste, represent costs for the society per diseased tooth averted of US$21.30, US$11.56 and US$8.55, respectively. Based on cost required to prevent one carious tooth among schoolchildren, salt fluoridation was the most cost-effective, with APF-Gel ranking as least cost-effective. Findings confirm that most community/school-based dental caries interventions are cost-effective uses of society's financial resources. The models used are conservative and likely to underestimate the real benefits of each intervention.

Optimising text messaging to improve adherence to web-based smoking cessation treatment: a randomised control trial protocol

PubMed Central

Graham, Amanda L; Jacobs, Megan A; Cohn, Amy M; Cha, Sarah; Abroms, Lorien C; Papandonatos, George D; Whittaker, Robyn

2016-01-01

Introduction Millions of smokers use the Internet for smoking cessation assistance each year; however, most smokers engage minimally with even the best designed websites. The ubiquity of mobile devices and their effectiveness in promoting adherence in other areas of health behaviour change make them a promising tool to address adherence in Internet smoking cessation interventions. Text messaging is used by most adults, and messages can proactively encourage use of a web-based intervention. Text messaging can also be integrated with an Internet intervention to facilitate the use of core Internet intervention components. Methods and analysis We identified four aspects of a text message intervention that may enhance its effectiveness in promoting adherence to a web-based smoking cessation programme: personalisation, integration, dynamic tailoring and message intensity. Phase I will use a two-level full factorial design to test the impact of these four experimental features on adherence to a web-based intervention. The primary outcome is a composite metric of adherence that incorporates general utilisation metrics (eg, logins, page views) and specific feature utilisation shown to predict abstinence. Participants will be N=860 adult smokers who register on an established Internet cessation programme and enrol in its text message programme. Phase II will be a two-arm randomised trial to compare the efficacy of the web-based cessation programme alone and in conjunction with the optimised text messaging intervention on 30-day point prevalence abstinence at 9 months. Phase II participants will be N=600 adult smokers who register to use an established Internet cessation programme and enrol in text messaging. Secondary analyses will explore whether adherence mediates the effect of treatment condition on outcome. Ethics and dissemination This protocol was approved by Chesapeake IRB. We will disseminate study results through peer-reviewed manuscripts and conference presentations related to the methods and design, outcomes and exploratory analyses. Trial registration number NCT02585206. PMID:27029775

A pilot study of an online universal school-based intervention to prevent alcohol and cannabis use in the UK

PubMed Central

Newton, Nicola C; Conrod, Patricia J; Rodriguez, Daniel M; Teesson, Maree

2014-01-01

Objectives The online universal Climate Schools intervention has been found to be effective in reducing the use of alcohol and cannabis among Australian adolescents. The aim of the current study was to examine the feasibility of implementing this prevention programme in the UK. Design A pilot study examining the feasibility of the Climate Schools programme in the UK was conducted with teachers and students from Year 9 classes at two secondary schools in southeast London. Teachers were asked to implement the evidence-based Climate Schools programme over the school year with their students. The intervention consisted of two modules (each with six lessons) delivered approximately 6 months apart. Following completion of the intervention, students and teachers were asked to evaluate the programme. Results 11 teachers and 222 students from two secondary schools evaluated the programme. Overall, the evaluations were extremely positive. Specifically, 85% of students said the information on alcohol and cannabis and how to stay safe was easy to understand, 84% said it was easy to learn and 80% said the online cartoon-based format was an enjoyable way to learn health theory topics. All teachers said the students were able to recall the information taught, 82% said the computer component was easy to implement and all teachers said the teacher's manual was easy to use to prepare class activities. Importantly, 82% of teachers said it was likely that they would use the programme in the future and recommend it to others. Conclusions The Internet-based universal Climate Schools prevention programme to be both feasible and acceptable to students and teachers in the UK. A full evaluation trial of the intervention is now required to examine its effectiveness in reducing alcohol and cannabis use among adolescents in the UK before implementation in the UK school system. PMID:24840248

Evaluation of a family intervention programme for the treatment of overweight and obese children (Nereu Programme): a randomized clinical trial study protocol.

PubMed

Serra-Paya, Noemi; Ensenyat, Assumpta; Real, Jordi; Castro-Viñuales, Iván; Zapata, Amalia; Galindo, Gisela; Solé-Mir, Eduard; Bosch-Muñoz, Jordi; Mur, Jose Maria; Teixidó, Concepció

2013-10-23

Obesity is mainly attributed to environmental factors. In developed countries, the time spent on physical activity tasks is decreasing, whereas sedentary behaviour patterns are increasing.The purpose of the intervention is to evaluate the effectiveness of an intensive family-based behavioural multi-component intervention (Nereu programme) and compared it to counselling intervention such as a health centre intervention programme for the management of children's obesity. The study design is a randomized controlled multicenter clinical trial using two types of interventions: Nereu and Counselling. The Nereu programme is an 8-month intensive family-based multi-component behavioural intervention. This programme is based on a multidisciplinary intervention consisting of 4 components: physical activity sessions for children, family theoretical and practical sessions for parents, behaviour strategy sessions involving both, parents and children, and lastly, weekend extra activities for all. Counselling is offered to the family in the form of a monthly physical health and eating habits session. Participants will be recruited according the following criteria: 6 to 12 year-old-children, referred from their paediatricians due to overweight or obesity according the International Obesity Task Force criteria and with a sedentary profile (less than 2 hours per week of physical activity), they must live in or near the municipality of Lleida (Spain) and their healthcare paediatric unit must have previously accepted to cooperate with this study. The following variables will be evaluated: a) cardiovascular risk factors (anthropometric parameters, blood test and blood pressure), b) sedentary and physical activity behaviour and dietary intake, c) psychological aspects d) health related quality of life (HRQOL), e) cost-effectiveness of the intervention in relation to HRQOL. These variables will be then be evaluated 4 times longitudinally: at baseline, at the end of the intervention (8 months later), 6 and 12 months after the intervention. We have considered necessary to recruit 100 children and divide them in 2 groups of 50 to detect the differences between the groups. This trial will provide new evidence for the long-term effects of childhood obesity management, as well as help to know the impact of the present intervention as a health intervention tool for healthcare centres. ClinicalTrials.gov, NCT01878994.

Evaluation of a family intervention programme for the treatment of overweight and obese children (Nereu Programme): a randomized clinical trial study protocol

PubMed Central

2013-01-01

Background Obesity is mainly attributed to environmental factors. In developed countries, the time spent on physical activity tasks is decreasing, whereas sedentary behaviour patterns are increasing. The purpose of the intervention is to evaluate the effectiveness of an intensive family-based behavioural multi-component intervention (Nereu programme) and compared it to counselling intervention such as a health centre intervention programme for the management of children’s obesity. Methods/Design The study design is a randomized controlled multicenter clinical trial using two types of interventions: Nereu and Counselling. The Nereu programme is an 8-month intensive family-based multi-component behavioural intervention. This programme is based on a multidisciplinary intervention consisting of 4 components: physical activity sessions for children, family theoretical and practical sessions for parents, behaviour strategy sessions involving both, parents and children, and lastly, weekend extra activities for all. Counselling is offered to the family in the form of a monthly physical health and eating habits session. Participants will be recruited according the following criteria: 6 to 12 year-old-children, referred from their paediatricians due to overweight or obesity according the International Obesity Task Force criteria and with a sedentary profile (less than 2 hours per week of physical activity), they must live in or near the municipality of Lleida (Spain) and their healthcare paediatric unit must have previously accepted to cooperate with this study. The following variables will be evaluated: a) cardiovascular risk factors (anthropometric parameters, blood test and blood pressure), b) sedentary and physical activity behaviour and dietary intake, c) psychological aspects d) health related quality of life (HRQOL), e) cost-effectiveness of the intervention in relation to HRQOL. These variables will be then be evaluated 4 times longitudinally: at baseline, at the end of the intervention (8 months later), 6 and 12 months after the intervention. We have considered necessary to recruit 100 children and divide them in 2 groups of 50 to detect the differences between the groups. Discussion This trial will provide new evidence for the long-term effects of childhood obesity management, as well as help to know the impact of the present intervention as a health intervention tool for healthcare centres. Trial registration ClinicalTrials.gov, NCT01878994 PMID:24153001

Applying Intervention Mapping to develop a community-based intervention aimed at improved psychological and social well-being of unmarried teenage mothers in Uganda.

PubMed

Leerlooijer, Joanne N; Kok, Gerjo; Weyusya, Joseph; Bos, Arjan E R; Ruiter, Robert A C; Rijsdijk, Liesbeth E; Nshakira, Nathan; Bartholomew, Leona K

2014-08-01

Out-of-wedlock pregnancy among adolescents in sub-Saharan Africa is a major concern, because of its association with health, social, psychological, economic and demographic factors. This article describes the development of the Teenage Mothers Project, a community-based intervention to improve psychological and social well-being of unmarried teenage mothers in rural Uganda. We used Intervention Mapping (IM) for systematically developing a theory and evidence-based comprehensive health promotion programme. A planning group consisting of community leaders, teenage mothers, staff of a community-based organization and a health promotion professional was involved in the six steps of IM: needs assessment, programme objectives, methods and applications, intervention design, planning for adoption and implementation and planning for evaluation. The programme includes five intervention components: community awareness raising, teenage mother support groups, formal education and income generation, counselling, and advocacy. The intervention components are based on a variety of theoretical methods, including entertainment education, persuasive communication, mobilization of social networks and social action. In conclusion, IM facilitated the planning group to structure the iterative, bottom-up, participatory design of the project in a real-life setting and to use evidence and theory. The article provides suggestions for the planning of support interventions for unmarried teenage mothers. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE)--a realist synthesis.

PubMed

Maidment, Ian; Booth, Andrew; Mullan, Judy; McKeown, Jane; Bailey, Sylvia; Wong, Geoffrey

2017-07-03

Medication-related adverse events have been estimated to be responsible for 5700 deaths and cost the UK £750 million annually. This burden falls disproportionately on older people. Outcomes from interventions to optimise medication management are caused by multiple context-sensitive mechanisms. The MEdication Management in Older people: REalist Approaches BAsed on Literature and Evaluation (MEMORABLE) project uses realist synthesis to understand how, why, for whom and in what context interventions, to improve medication management in older people on complex medication regimes residing in the community, work. This realist synthesis uses secondary data and primary data from interviews to develop the programme theory. A realist logic of analysis will synthesise data both within and across the two data sources to inform the design of a complex intervention(s) to help improve medication management in older people. 1. Literature review The review (using realist synthesis) contains five stages to develop an initial programme theory to understand why processes are more or less successful and under which situations: focussing of the research question; developing the initial programme theory; developing the search strategy; selection and appraisal based on relevance and rigour; and data analysis/synthesis to develop and refine the programme theory and context, intervention and mechanism configurations. 2. Realist interviews Realist interviews will explore and refine our understanding of the programme theory developed from the realist synthesis. Up to 30 older people and their informal carers (15 older people with multi-morbidity, 10 informal carers and 5 older people with dementia), and 20 care staff will be interviewed. 3. Developing framework for the intervention(s) Data from the realist synthesis and interviews will be used to refine the programme theory for the intervention(s) to identify: the mechanisms that need to be 'triggered', and the contexts related to these mechanisms. Intervention strategies that change the contexts so the mechanisms are triggered to produce desired outcomes will be developed. Feedback on these strategies will be obtained. This realist synthesis aims to develop a framework (underpinned by our programme theory) for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens. PROSPERO CRD42016043506.

TRAVELLERS: a school-based early intervention programme helping young people manage and process change, loss and transition. Pilot phase findings.

PubMed

Dickinson, Pauline; Coggan, Carolyn; Bennett, Sara

2003-06-01

This paper outlines the conceptual background and findings from the pilot phase of TRAVELLERS--an early intervention programme designed to enhance protective factors for young people experiencing change, loss and transition events and early signs of emotional distress. The pilot study aimed to determine whether TRAVELLERS was a feasible, acceptable and promising intervention for young people within secondary schools in Aotearoa/New Zealand. The conceptual origins of the TRAVELLERS programme are described in terms of: adolescent mental health concerns; emerging mental health promotion theory and practice; and prevention and early intervention models. The key elements of the TRAVELLERS programme are described. The programme was piloted in two secondary schools, one rural and one urban with 34 participants (females n = 24, males n = 10). Evaluation methods included: review of programme materials; identification of potential selection tools appropriate to Year 9 students; analysis of selection questionnaire; and conduct of feedback from participants, facilitators and parents/caregivers. The TRAVELLERS programme provides a means of identifying and selecting young people who may benefit from participating in an early intervention programme. The programme has achieved a statistically significant reduction in participants' distress (p < 0.01). Young people were overwhelmingly enthusiastic about most aspects of TRAVELLERS. School personnel reported that TRAVELLERS was an appropriate and acceptable programme to the school. Targeted interventions provided within a supportive school environment can contribute to enhancing protective factors such as personal and interpersonal coping strategies, increased help-seeking behaviour, and young people feeling more positive about themselves and their lives. The pilot programme has been amended and prepared for a two year trial phase in 10 secondary schools during 2002-2003.

Impact of a Six-Month Empowerment-Based Exercise Intervention Programme in Non-Physically Active Adolescent Swedish Girls

ERIC Educational Resources Information Center

Lindgren, Eva-Carin; Baigi, Amir; Apitzsch, Erwin; Bergh, Hakan

2011-01-01

Objective: This study evaluated changes in self-efficacy in non-physically active adolescent girls (13-19 years old) who participated in a six-month, empowerment-based exercise intervention programme (EIP). Design: The study used a pre- and post-test randomized group design and included one pre- and one post-test (at six months) and non-physically…

The Incredible Years Parent-Toddler Programme and parental language: a randomised controlled trial.

PubMed

Gridley, N; Hutchings, J; Baker-Henningham, H

2015-01-01

Parental language is associated with children's later language development. Parenting programmes, based on social learning theory, enhance a range of parenting behaviours, yet there is limited evidence for their effect on parental language. To assess the benefits of a behavioural-based parenting programme, which features components of language and communication, to enhance parental language. Parents of toddlers, aged 12 to 36 months, were recruited from eight Flying Start early intervention centres across Wales. Participants were randomised 2:1 either to a parenting programme (n = 60) or to a wait-list control group (n = 29). Researchers were blind to participant allocation throughout the trial. Fifteen-minute video-recorded observations of parents and children interacting during free-play, both at a pre-intervention and at 6-month follow-up, provided the data for the study. Five observed measures of parental language were assessed; quantity and variety, encouraging, critical, child-led and parent led interactions. The Incredible Years Parent-Toddler Programme (IYPTP) is a 12-week group-based behavioural intervention that teaches effective relationship and behavioural management skills including social, emotional and persistence coaching to enable parents to better support their children's development. Of 89 dyads that completed pre-intervention assessments 81 (54 intervention and 27 control) met the criteria for the current study. Intention to treat analysis indicated that child-led language interactions significantly benefited from the intervention [regression coefficient (B) = -1.44, 95% confidence intervals (CI) = -2.59 to -0.29, P = 0.015, effect size (ES) = 0.47] and a positive trend for encouraging language in favour of the intervention sample was evident. Per-protocol sample analysis replicated these findings with encouraging language reaching statistical significance (B = 1.07, 95% CI = 0.11 to 2.03, P = 0.03, ES = 0.52). No further benefits were evident. The IYPTP has limited evidence as an effective programme for enhancing some aspects of parental language. © 2014 John Wiley & Sons Ltd.

Process evaluation of the implementation of scorecard-based antenatal risk assessment, care pathways and interdisciplinary consultation: the Healthy Pregnancy 4 All study.

PubMed

Vos, A A; van Voorst, S F; Posthumus, A G; Waelput, A J M; Denktaş, S; Steegers, E A P

2017-09-01

To evaluate the implementation of a complex intervention in the antenatal healthcare field in 14 Dutch municipalities. The intervention consisted of the implementation of a systematic scorecard-based risk assessment in pregnancy, subsequent patient-tailored care pathways, and consultations of professionals from different medical and social disciplines. Saunders's seven-step method was used for the development of a programme implementation monitoring plan, with specific attention to the setting and context of the programme. Data were triangulated from multiple sources, and prespecified criteria were applied to examine the evidence for implementation. Six out of 11 municipalities (54%) met the implementation criteria for the entire risk assessment programme, whereas three municipalities (27%) met the criteria if the three components of implementation were analysed separately. A process evaluation of implementation of a complex intervention is possible. The results can be used to improve understanding of the associations between specific programme elements and programme outcomes on effectiveness of the intervention. Additionally, the results are important for formative purposes to assess how future implementation of antenatal risk assessment can be improved in comparable contexts. Copyright © 2017. Published by Elsevier Ltd.

Recent trends in working with the private sector to improve basic healthcare: a review of evidence and interventions.

PubMed

Montagu, Dominic; Goodman, Catherine; Berman, Peter; Penn, Amy; Visconti, Adam

2016-10-01

The private sector provides the majority of health care in Africa and Asia. A number of interventions have, for many years, applied different models of subsidy, support and engagement to address social and efficiency failures in private health care markets. We have conducted a review of these models, and the evidence in support of them, to better understand what interventions are currently common, and to what extent practice is based on evidence. Using established typologies, we examined five models of intervention with private markets for care: commodity social marketing, social franchising, contracting, accreditation and vouchers. We conducted a systematic review of both published and grey literature, identifying programmes large enough to be cited in publications, and studies of the listed intervention types. 343 studies were included in the review, including both published and grey literature. Three hundred and eighty programmes were identified, the earliest having begun operation in 1955. Commodity social marketing programmes were the most common intervention type, with 110 documented programmes operating for condoms alone at the highest period. Existing evidence shows that these models can improve access and utilization, and possibly quality, but for all programme types, the overall evidence base remains weak, with practice in private sector engagement consistently moving in advance of evidence. Future research should address key questions concerning the impact of interventions on the market as a whole, the distribution of benefits by socio-economic status, the potential for scale up and sustainability, cost-effectiveness compared to relevant alternatives and the risk of unintended consequences. Alongside better data, a stronger conceptual basis linking programme design and outcomes to context is also required. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

NGO facilitation of a government community-based maternal and neonatal health programme in rural India: improvements in equity.

PubMed

Baqui, Abdullah H; Rosecrans, Amanda M; Williams, Emma K; Agrawal, Praween K; Ahmed, Saifuddin; Darmstadt, Gary L; Kumar, Vishwajeet; Kiran, Usha; Panwar, Dharmendra; Ahuja, Ramesh C; Srivastava, Vinod K; Black, Robert E; Santosham, Mathuram

2008-07-01

Socio-economic disparities in health have been well documented around the world. This study examines whether NGO facilitation of the government's community-based health programme improved the equity of maternal and newborn health in rural Uttar Pradesh, India. A quasi-experimental study design included one intervention district and one comparison district of rural Uttar Pradesh. A household survey conducted between January and June 2003 established baseline rates of programme coverage, maternal and newborn care practices, and health care utilization during 2001-02. An endline household survey was conducted after 30 months of programme implementation between January and March 2006 to measure the same indicators during 2004-05. The changes in the indicators from baseline to endline in the intervention and comparison districts were calculated by socio-economic quintiles, and concentration indices were constructed to measure the equity of programme indicators. The equity of programme coverage and antenatal and newborn care practices improved from baseline to endline in the intervention district while showing little change in the comparison district. Equity in health care utilization for mothers and newborns also showed some improvements in the intervention district, but notable socio-economic differentials remained, with the poor demonstrating less ability to access health services. NGO facilitation of government programmes is a feasible strategy to improve equity of maternal and neonatal health programmes. Improvements in equity were most pronounced for household practices, and inequities were still apparent in health care utilization. Furthermore, overall programme coverage remained low, limiting the ability to address equity. Programmes need to identify and address barriers to universal coverage and care utilization, particularly in the poorest segments of the population.

Developing a structured education reminiscence-based programme for staff in long-stay care facilities in Ireland.

PubMed

Cooney, Adeline; O'Shea, Eamon; Casey, Dympna; Murphy, Kathy; Dempsey, Laura; Smyth, Siobhan; Hunter, Andrew; Murphy, Edel; Devane, Declan; Jordan, Fionnuala

2013-07-01

This paper describes the steps used in developing and piloting a structured education programme - the Structured Education Reminiscence-based Programme for Staff (SERPS). The programme aimed to prepare nurses and care assistants to use reminiscence when caring for people with dementia living in long-term care. Reminiscence involves facilitating people to talk or think about their past. Structured education programmes are used widely as interventions in randomised controlled trials. However, the process of developing a structured education programme has received little attention relative to that given to evaluating the effectiveness of such programmes. This paper makes explicit the steps followed to develop the SERPS, thereby making a contribution to the methodology of designing and implementing effective structured education programmes. The approach to designing the SERPS was informed by the Van Meijel et al. (2004) model (Journal of Advanced Nursing 48, 84): (1) problem definition, (2) accumulation of building blocks for intervention design, (3) intervention design and (4) intervention validation. Grounded theory was used (1) to generate data to shape the 'building blocks' for the SERPS and (2) to explore residents, family and staff's experience of using/receiving reminiscence. Analysis of the pilot data indicated that the programme met its objective of preparing staff to use reminiscence with residents with dementia. Staff were positive both about the SERPS and the use of reminiscence with residents with dementia. This paper outlines a systematic approach to developing and validating a structured education programme. Participation in a structured education programme is more positive for staff if they are expected to actively implement what they have learnt. Ongoing support during the delivery of the programme is important for successful implementation. The incorporation of client and professional experience in the design phase is a key strength of this approach to programme design. © 2012 Blackwell Publishing Ltd.

Preliminary evaluation of STRIDE programme in primary schools of Malaysia.

PubMed

Hanjeet, K; Wan Rozita, W M; How, T B; Santhana Raj, L; Baharudin, Omar

2007-12-01

The Students' Resilience and Interpersonal Skills Development Education (STRIDE) is a preventive drug education programme. The rational of this programme is that preventive drug education has to begin early in age, before the development of social attitudes and behaviour of students. A pre and a post intervention surveys were performed to evaluate the impact of this programme. Nine schools from three states were identified to participate in the intervention. These schools were selected based on their locations in high-drug-use areas (where the prevalence of drug use exceeds 0.5% of the student population). The new intervention curriculum was put into practice for three months in the nine schools. The overall scores obtained by each respondent to assess their knowledge on drugs and its implications were analysed. The results showed that the programme made a positive impact from the pre to post intervention programme by using the Wilcoxon Signed Rank Test (p < 0.05). A high percentage of the questions showed significant evidence through the McNemar matched pair Chi-Squared test with Bonferonni correction that there were positive shifts in the answers by comparing the pre and post intervention results (p < 0.05). Recommendations have been discussed with the Ministry of Education to integrate this programme into the national primary school curriculum.

Cost effectiveness of brief interventions for reducing alcohol consumption.

PubMed

Wutzke, S E; Shiell, A; Gomel, M K; Conigrave, K M

2001-03-01

The direct costs and health effects of a primary-care-based brief intervention for hazardous alcohol consumption were examined. The total cost of the intervention was calculated from costs associated with: marketing the intervention programme; providing training and support in the use of the intervention materials; physician time required for providing brief advice for 'at-risk' drinkers. The effect of the intervention on health outcomes was expressed in terms of number of life years saved by preventing alcohol-related deaths. This was derived by combining estimates of the impact of the programme if it were implemented nationally with available evidence on the health effects of excess alcohol consumption. Results are based on international trial evidence showing the physical resources required by the intervention and its effectiveness combined with Australian price data. The costs associated with screening and brief advice using the current intervention programme range from Aus$19.14 to Aus$21.50. The marginal costs per additional life year saved were below Aus$1873. The robustness of the model used is supported by an extensive sensitivity analysis. In comparison with existing health promotion strategies the costs and effects of the current intervention are highly encouraging.

A nutritional intervention programme at a worksite canteen to promote a healthful lifestyle inspired by the traditional Mediterranean diet.

PubMed

Vitale, Marilena; Bianchi, Marta A; Rapetti, Valeria; Pepe, Josè M; Giacco, Angela; Giacco, Rosalba; Riccardi, Gabriele

2018-02-01

This study investigates the effectiveness and long-term impact on the composition of the habitual diet of a nutritional intervention programme - undertaken through panels, totems, and table mats or handout leaflets - based on the promotion at a worksite canteen of healthy food-choices resembling the traditional Mediterranean diet. A significantly higher choice of dishes based on wholegrain cereals, legumes, white meat and fish, and a lower choice of dishes based on refined cereals, red and processed meat, eggs and cheese was observed at the end of the intervention and after six months and three years of follow-ups. A significantly better adherence to the nutritional recommendations for saturated-fat, cholesterol, sugars and fibre was observed. This study reveals that a nutritional intervention programme promoting the traditional Mediterranean diet and utilising a minimally intensive approach is feasible and effective to modify in a beneficial way the dietary habits of a working population and keep these changes in the long-term.

Visuospatial training improves elementary students' mathematics performance.

PubMed

Lowrie, Tom; Logan, Tracy; Ramful, Ajay

2017-06-01

Although spatial ability and mathematics performance are highly correlated, there is scant research on the extent to which spatial ability training can improve mathematics performance. This study evaluated the efficacy of a visuospatial intervention programme within classrooms to determine the effect on students' (1) spatial reasoning and (2) mathematics performance as a result of the intervention. The study involved grade six students (ages 10-12) in eight classes. There were five intervention classes (n = 120) and three non-intervention control classes (n = 66). A specifically designed 10-week spatial reasoning programme was developed collaboratively with the participating teachers, with the intervention replacing the standard mathematics curriculum. The five classroom teachers in the intervention programme presented 20 hr of activities aimed at enhancing students' spatial visualization, mental rotation, and spatial orientation skills. The spatial reasoning programme led to improvements in both spatial ability and mathematics performance relative to the control group who received standard mathematics instruction. Our study is the first to show that a classroom-based spatial reasoning intervention improves elementary school students' mathematics performance. © 2017 The British Psychological Society.

Aggressive behaviour in adolescent psychiatric settings: what are risk factors, possible interventions and implications for nursing practice? A literature review.

PubMed

Hage, S; Van Meijel, B; Fluttert, F; Berden, G F M G

2009-09-01

This study was aimed to identify the risk factors of aggressive behaviour in adolescents (1318 years), and to describe available intervention strategies. The findings are evaluated on the basis of their implications for nursing practice. Aggressive behaviour in adolescent psychiatric settings is a neglected research area. The consequences of aggressive behaviour on nurses, other patients and the therapeutic environment can be profound. For the development and implementation of innovative intervention strategies aimed at preventing aggressive behaviour in adolescent psychiatric patients, knowledge of risk factors and evidence-based interventions for aggressive behaviour are of the utmost importance. A systematic search of PubMed, Cinahl, PsychINFO and Cochrane Systematic Reviews (19912007) was employed. The risk factors for aggressive behaviour comprise personal and environmental risk factors. Some risk factors can be influenced by nursing intervention strategies. Available intervention programmes range from interpersonal skills training to massage therapy, parent management training, functional family therapy and multi-systemic therapy. The most effective programmes combine interpersonal skills training with parent management training. No specific nursing intervention programmes were found for dealing with aggressive behaviour in adolescent patients. Nursing staff can assist in achieving a systematic improvement in the treatment outcomes of existing intervention programmes for the prevention of aggression. There is a need for specific nursing intervention programmes to deal with aggressive behaviour in adolescent psychiatric settings.

Experiences of a commercial weight-loss programme after primary care referral: a qualitative study.

PubMed

Allen, Jodie T; Cohn, Simon R; Ahern, Amy L

2015-04-01

Referral to a commercial weight-loss programme is a cost-effective intervention that is already used within the NHS. Qualitative research suggests this community-based, non-medical intervention accords with participants' view of weight management as a lifestyle issue. To examine the ways in which participants' attitudes and beliefs about accessing a commercial weight management programme via their doctor relate to their weight-loss experience, and to understand how these contextual factors influence motivation and adherence to the intervention. A qualitative study embedded in a randomised controlled trial evaluating primary care referral to a commercial weight-loss programme in adults who are overweight or obese in England. The study took place from June-September 2013. Twenty-nine participants (body mass index [BMI] ≥28 kg/m(2); age ≥18 years), who took part in the WRAP (Weight Loss Referrals for Adults in Primary Care) trial, were recruited at their 3-month assessment appointment to participate in a semi-structured interview about their experience of the intervention and weight management more generally. Interviews were audiorecorded, transcribed verbatim, and analysed inductively using a narrative approach. Although participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management, the referral from the GP and subsequent clinical assessments frame their experience of the intervention as medically pertinent with clear health benefits. Referral by the GP and follow-up assessment appointments were integral to participant experiences of the intervention, and could be adapted for use in general practice potentially to augment treatment effects. © British Journal of General Practice 2015.

‘Football for Health’—a football-based health-promotion programme for children in South Africa: a parallel cohort study

PubMed Central

Fuller, Colin W; Junge, Astrid; DeCelles, Jeff; Donald, James; Jankelowitz, Ryan; Dvorak, Jiri

2010-01-01

Objectives To develop, implement and assess an interactive, football-based health education programme for children in South Africa. Design Prospective cohort study with control group. Setting Two schools in Khayelitsha township, South Africa. Participants 370 children making up two intervention groups (Grade 6: 125; Grade 7: 131) and one control group (Grade 7: 114). Intervention Eleven 90 min sessions, each divided into two 45 min halves of Play Football (football skills) and Play Fair (health issues), each session focused on one specific health risk factor. Main outcome measures Health knowledge using a 20-item questionnaire; coaches' attitudes towards their training programme using a 10-item questionnaire and children's attitudes towards the health education programme using a six-item questionnaire. Results Children in the Grade 7 intervention group showed significant (p<0.05) increases in the proportion of correct responses for nine of the 20 health knowledge questions postintervention, and these increases were maintained at 3 months postintervention. The Grade 6 intervention group showed significant increases in the proportion of correct responses for 15 of the 20 health knowledge questions postintervention. The Grade 7 control group showed a significant increase in the proportion of correct responses to one of the 20 health knowledge questions post-Play Football sessions and nine of 20 questions post-Play Fair sessions. Over 90% of the children provided positive attitude responses to the health-education programme. Conclusions The programme demonstrated that it was possible to implement a football-based health-education programme for children in Africa that achieved significant increases in health knowledge and that was also well received by participants. PMID:20547667

The development of an adolescent smoking cessation intervention--an Intervention Mapping approach to planning.

PubMed

Dalum, Peter; Schaalma, Herman; Kok, Gerjo

2012-02-01

The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally operationalized change methods into practical intervention strategies. We found that guided practice, modelling, self-monitoring, coping planning, consciousness raising, dramatic relief and decisional balance were suitable methods for adolescent smoking cessation. We selected behavioural journalism, guided practice and Motivational Interviewing as strategies in our intervention. Intervention Mapping helped us to develop as systematic adolescent smoking cessation intervention with a clear link between behavioural goals, theoretical methods, practical strategies and materials and with a strong focus on implementation and recruitment. This paper does not present evaluation data.

Psychosocial behaviour management programme for home-dwelling people with dementia: A cluster-randomized controlled trial.

PubMed

Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi

2018-03-01

Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo. Each provider recruited persons with dementia aged 65 years or older to receive home care in the BASE programme in August 2016. An online monitoring and assessment system was introduced to the intervention group for repeated measures of challenging behaviour with a total score of the Neuropsychiatric Inventory. Care professionals in both the intervention and control groups evaluated challenging behaviour of persons with dementia at baseline (September 2016) and follow-up (February 2017). A majority of persons with dementia had Alzheimer disease (59.3%). One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. Multilevel modelling revealed a significant reduction in challenging behaviour in the intervention group after 6 months (mean score, 18.3 to 11.2) compared with that of the control group (11.6 to 10.8; P < .05). The implementation of the BASE programme resulted in a reduction of challenging behaviour of home-dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia. Copyright © 2017 John Wiley & Sons, Ltd.

Can a school-based sleep education programme improve sleep knowledge, hygiene and behaviours using a randomised controlled trial.

PubMed

Rigney, Gabrielle; Blunden, Sarah; Maher, Carol; Dollman, James; Parvazian, Somayeh; Matricciani, Lisa; Olds, Timothy

2015-06-01

The present study investigated the effectiveness of a school-based sleep education programme in improving key sleep behaviours, sleep knowledge, and sleep hygiene. A cross-sectional cluster-randomised controlled trial with two groups (Intervention and Control) and three assessment time points [baseline, immediately post intervention (6 weeks post baseline) and follow-up (18 weeks post baseline)] was employed. A total of 296 students (mean age = 12.2 ± 0.6 years; 59% female) from 12 schools in Adelaide, South Australia, were recruited, with 149 participants in the Intervention group and 147 in the Control group. The intervention consisted of four classroom lessons delivered at weekly intervals, followed by a group project on sleep topics, which students presented at a parental information evening. Sleep patterns were assessed objectively (actigraphy, n = 175) and subjectively (time-use recall, n = 251) at three time points. Sleep knowledge and sleep hygiene (n = 296) were also measured. Generalised estimating equations were used to compare changes in the Intervention and Control groups. The programme increased time in bed by 10 min (p = 0.03) for the Intervention group relative to the Control group, due to a 10-min delay in wake time (p = 0.00). These changes were not sustained at follow-up. There was no impact on sleep knowledge or sleep hygiene. Investment in the sleep health of youth through sleep education is important but changes to sleep patterns are difficult to achieve. More intensive programmes, programmes with a different focus or programmes targeting different age groups may be more effective. Copyright © 2015 Elsevier B.V. All rights reserved.

Preventing type 2 diabetes: systematic review of studies of cost-effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes

PubMed Central

Roberts, Samantha; Barry, Eleanor; Craig, Dawn; Airoldi, Mara; Bevan, Gwyn; Greenhalgh, Trisha

2017-01-01

Objective Explore the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes, both alone and in combination with a screening programme to identify high-risk individuals. Design Systematic review of economic evaluations. Data sources and eligibility criteria Database searches (Embase, Medline, PreMedline, NHS EED) and citation tracking identified economic evaluations of lifestyle interventions or metformin alone or in combination with screening programmes in people at high risk of developing diabetes. The International Society for Pharmaco-economics and Outcomes Research’s Questionnaire to Assess Relevance and Credibility of Modelling Studies for Informing Healthcare Decision Making was used to assess study quality. Results 27 studies were included; all had evaluated lifestyle interventions and 12 also evaluated metformin. Primary studies exhibited considerable heterogeneity in definitions of pre-diabetes and intensity and duration of lifestyle programmes. Lifestyle programmes and metformin appeared to be cost effective in preventing diabetes in high-risk individuals (median incremental cost-effectiveness ratios of £7490/quality-adjusted life-year (QALY) and £8428/QALY, respectively) but economic estimates varied widely between studies. Intervention-only programmes were in general more cost effective than programmes that also included a screening component. The longer the period evaluated, the more cost-effective interventions appeared. In the few studies that evaluated other economic considerations, budget impact of prevention programmes was moderate (0.13%–0.2% of total healthcare budget), financial payoffs were delayed (by 9–14 years) and impact on incident cases of diabetes was limited (0.1%–1.6% reduction). There was insufficient evidence to answer the question of (1) whether lifestyle programmes are more cost effective than metformin or (2) whether low-intensity lifestyle interventions are more cost effective than the more intensive lifestyle programmes that were tested in trials. Conclusions The economics of preventing diabetes are complex. There is some evidence that diabetes prevention programmes are cost effective, but the evidence base to date provides few clear answers regarding design of prevention programmes because of differences in denominator populations, definitions, interventions and modelling assumptions. PMID:29146638

The potential of smoking cessation programmes and a smoking ban in public places: comparing gain in life expectancy and cost effectiveness.

PubMed

Højgaard, Betina; Olsen, Kim Rose; Pisinger, Charlotta; Tønnesen, Hanne; Gyrd-Hansen, Dorte

2011-12-01

Interventions aimed at reducing the number of smokers are generally believed to be cost effective. However as the cost of the interventions should be paid up front whereas the gains in life years only appear in the future--the budgetary consequences might be a barrier to implementing such interventions. The aim of the present paper was to assess the long-term cost effectiveness as well as the short-term (10 years) budget consequences of cessation programmes and a smoking ban in enclosed public places. We develop a population-based Markov model capable of analyzing both interventions and assess long-term costs effectiveness as well as short-term budgetary consequences and outcome gains. The smoking cessation programme model was based on data from the Danish National Smoking Cessation Database (SCDB), while the model of the smoking ban was based on effect estimates found in the literature. On a population level the effect of a smoking ban has the largest potential compared with the effect of smoking cessation programmes. Our results suggest that smoking cessation programmes are cost saving and generate life-years, whereas the costs per life-year gained by a smoking ban are 40,645 to 64,462 DKK (100 DKK = €13.4). These results are conservative as they do not include the healthcare cost saving related to reduced passive smoking. Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are cost-effective strategies compared with the status quo.

Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK)

PubMed Central

2012-01-01

Background School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems. Methods/design A realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK). The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting). Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a ‘reality check’ on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health. PMID:23083508

The development of peer educator-based harm reduction programmes in Northern Vietnam.

PubMed

Walsh, Nick; Gibbie, Tania M; Higgs, Peter

2008-03-01

Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

Community-based programmes to promote use of bicycle helmets in children aged 0-14 years: a systematic review.

PubMed

Spinks, Anneliese; Turner, Cathy; McClure, Rod; Acton, Caroline; Nixon, Jim

2005-09-01

Hospital-based research has shown that wearing a helmet reduces the risk of head injury in bicycle riders. These studies have provided the impetus for community-wide interventions to increase the numbers of cyclists who wear helmets; however, the effectiveness of such programmes is undetermined. This study employs extensive search strategies to review the scientific literature to establish the effectiveness of community-wide programmes to increase helmet use among cyclists. Thirteen community-wide intervention studies using substantive methodologies were located in 16 published papers. The community-wide interventions include mandating helmet wearing, education campaigns, distribution of free or subsidized helmets or, more frequently, combinations of all of these methods of influence. All studies reported success in influencing helmet wearing across communities. However, none of the studies reveals enough detail of the mix or techniques employed in the interventions to replicate the interventions. While it is encouraging that all of the studies showed positive results, the way forward for further implementation of helmet wearing is for adequate documentation of successful interventions.

Development of the SALdável programme to reduce salt intake among hypertensive Brazilian women: an intervention mapping approach.

PubMed

Cornélio, Marilia Estevam; Godin, Gaston; Rodrigues, Roberta; Agondi, Rúbia; Spana, Thaís; Gallani, Maria-Cecilia

2013-08-01

Despite strong evidence for a relationship between high salt intake and hypertension, plus the widespread recommendations for dietary salt restriction among hypertensive subjects, there are no nursing studies describing effective theory-based interventions. To describe a systematic process for development of a theory-based nursing intervention that is aimed at reducing salt intake among hypertensive women, by applying the 'intervention mapping' protocol. We developed our intervention following the six steps of the 'intervention mapping' protocol: assessing needs, creating a matrix of change objectives, selecting theoretical methods and practical applications, defining the intervention programme, organizing the adoption and implementation plan, and defining the evaluation plan. Addition of salt during cooking is identified as the main source for salt consumption, plus women are identified as the people responsible for cooking meals at home. In our study, the motivational predictors of this behaviour were self-efficacy and habit. Guided practice, verbal persuasion, coping barriers, consciousness-raising and counter-conditioning were the theoretical methods we selected for enhancing self-efficacy and promoting habit change, respectively. Brainstorming, role-playing, cookbook use, measuring spoon use, label reading, hands-on skill-building activities and reinforcement phone calls were the chosen practical applications. We designed our intervention programme, and then organized the adoption and implementation plans. Finally, we generated a plan to evaluate our intervention. 'Intervention mapping' was a feasible methodological framework to guide the development of a theory-based nursing intervention for dietary salt reduction among hypertensive women.

A community-based Falls Management Exercise Programme (FaME) improves balance, walking speed and reduced fear of falling.

PubMed

Yeung, Pui Yee; Chan, Wayne; Woo, Jean

2015-04-01

Although effective community falls prevention programmes for the older persons have been described, challenges remain in translating proven interventions into daily practice. To evaluate the efficacy, feasibility and acceptability of a falls prevention programme that can be integrated into daily activities in a group of community-dwelling older adults with risk of falling. A cohort study with intervention and comparison groups was designed to evaluate a 36-week group-based falls prevention exercise programme (FaME) in the community setting. Participants were aged 60 years or older, had fallen in the past 12 months, had fear of falling with avoidance of activities or had deficits in balance control. Primary outcome measures included assessment of balance control and mobility; secondary outcome measures included level of physical activity, assessment of fear of falling and health-related quality of life. There were 48 and 51 participants in the intervention and comparison groups, respectively. There were improvements in measurements of balance, walking speed and self-efficacy. The drop out rate was low (14.6% and 3.9% from the intervention and comparison groups, respectively). Overall compliance in the intervention group was 79%. Factors that motivated continued participation include the regular and long-term nature of the programme helping to reinforce their exercise habits, the simplicity of movements and friendliness of the group. The FaME programme improves balance, walking speed and reduces fear of falling. It could be widely promoted and integrated into regular health and social activities in community settings.

Optimising text messaging to improve adherence to web-based smoking cessation treatment: a randomised control trial protocol.

PubMed

Graham, Amanda L; Jacobs, Megan A; Cohn, Amy M; Cha, Sarah; Abroms, Lorien C; Papandonatos, George D; Whittaker, Robyn

2016-03-30

Millions of smokers use the Internet for smoking cessation assistance each year; however, most smokers engage minimally with even the best designed websites. The ubiquity of mobile devices and their effectiveness in promoting adherence in other areas of health behaviour change make them a promising tool to address adherence in Internet smoking cessation interventions. Text messaging is used by most adults, and messages can proactively encourage use of a web-based intervention. Text messaging can also be integrated with an Internet intervention to facilitate the use of core Internet intervention components. We identified four aspects of a text message intervention that may enhance its effectiveness in promoting adherence to a web-based smoking cessation programme: personalisation, integration, dynamic tailoring and message intensity. Phase I will use a two-level full factorial design to test the impact of these four experimental features on adherence to a web-based intervention. The primary outcome is a composite metric of adherence that incorporates general utilisation metrics (eg, logins, page views) and specific feature utilisation shown to predict abstinence. Participants will be N=860 adult smokers who register on an established Internet cessation programme and enrol in its text message programme. Phase II will be a two-arm randomised trial to compare the efficacy of the web-based cessation programme alone and in conjunction with the optimised text messaging intervention on 30-day point prevalence abstinence at 9 months. Phase II participants will be N=600 adult smokers who register to use an established Internet cessation programme and enrol in text messaging. Secondary analyses will explore whether adherence mediates the effect of treatment condition on outcome. This protocol was approved by Chesapeake IRB. We will disseminate study results through peer-reviewed manuscripts and conference presentations related to the methods and design, outcomes and exploratory analyses. NCT02585206. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Economic evaluation of type 2 diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia.

PubMed

Roberts, Samantha; Craig, Dawn; Adler, Amanda; McPherson, Klim; Greenhalgh, Trisha

2018-01-30

National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years. This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently.

An Evaluation of a Community Health Intervention Programme Aimed at Improving Health and Wellbeing

ERIC Educational Resources Information Center

Strachan, G.; Wright, G. D.; Hancock, E.

2007-01-01

Objective: The objective of this evaluation was to examine the extent to which participants in the Tailor Made Leisure Package programme experienced any improvement in their health and wellbeing. Design: A quantitative survey. Setting: The Healthy Living Centre initiative is an example of a community-based intervention which was formalized as part…

A critical review of adolescent mindfulness-based programmes.

PubMed

Tan, Lucy B G

2016-04-01

Previous research has demonstrated that mindfulness-based programmes improve psychological functioning in a myriad of adult domains. These include health care, marketing and sports industries. The efficacy of mindfulness-based programmes in the adult population is well established. Indeed, compared to adult empirical literature, mindfulness programmes for adolescents are relatively developmental and less articulated until now. It may be argued that mindfulness-based programmes could and should begin early and be applicable to young people at a time that is critical in their development. Hence, this article analyses the characteristics, objectives and outcomes of mindfulness interventions for adolescents, focusing on the mindfulness programme adjustments and adaptations made to the content for this target group. A critique of the literature that included published articles of mindfulness-based interventions (both clinical and universal programmes) for adolescents were sourced and reviewed. Conference papers and unpublished dissertations were excluded. The review indicated that a majority of these were longitudinal and feasibility studies, with only one clinical randomised controlled trial study. Preliminary evidence for the use of mindfulness-based with adolescents continues to be nascent, with many of the studies using inappropriate or no mindfulness process measures at all. In addition, a majority of the studies did not provide specific details of the mindfulness programmes for adolescents, nor discuss what modifications were undertaken--all of which makes comparison difficult. However, with the availability of recent and age-appropriate mindfulness measures for adolescents, more rigorous and robust research looks promising. © The Author(s) 2015.

Video-based training to improve perceptual-cognitive decision-making performance of Australian football umpires.

PubMed

Larkin, Paul; Mesagno, Christopher; Berry, Jason; Spittle, Michael; Harvey, Jack

2018-02-01

Decision-making is a central component of the in-game performance of Australian football umpires; however, current umpire training focuses largely on physiological development with decision-making skills development conducted via explicit lecture-style meetings with limited practice devoted to making actual decisions. Therefore, this study investigated the efficacy of a video-based training programme, aimed to provide a greater amount of contextualised visual experiences without explicit instruction, to improve decision-making skills of umpires. Australian football umpires (n = 52) were recruited from metropolitan and regional Division 1 competitions. Participants were randomly assigned to an intervention or control group and classified according to previous umpire game experience (i.e., experienced; less experienced). The intervention group completed a 12-week video-based decision-making training programme, with decision-making performance assessed at pre-training, and 1-week retention and 3-week retention periods. The control group did not complete any video-based training. Results indicated a significant Group (intervention; Control) × Test interaction (F(1, 100) = 3.98; P = 0.02, partial ῆ 2  = 0.074), with follow-up pairwise comparisons indicating significant within-group differences over time for the intervention group. In addition, decision-making performance of the less experienced umpires in the intervention group significantly improved (F(2, 40) = 5.03, P = 0.01, partial ῆ 2  = 0.201). Thus, video-based training programmes may be a viable adjunct to current training programmes to hasten decision-making development, especially for less experienced umpires.

Criminal thinking shifts among male prisoners participating in a cognitive-based education programme.

PubMed

Warner, Cody; Conley, Timothy; Murphy, Riley

2018-04-01

Many prisoners rationalise criminal behaviour, and this type of thinking has been linked to recidivism. Correctional programmes for modifying criminal thinking can reshape how offenders view themselves and their circumstances. Our aim was to test whether participation in a cognitive-based curriculum called Steps to Economic and Personal Success (STEPS) was associated with changes in criminal thinking. The STEPS curriculum is delivered in 15 video-based facilitated classes. A pre-intervention/post-intervention survey design was applied to 128 adult male prisoners who completed the programme. Criminal thinking was measured by the Texas Christian University Criminal Thinking Scale, a self-report instrument with the six domains: entitlement, justification, power orientation, cold heartedness, criminal rationalisation and personal irresponsibility. Participants had lower scores in most of the criminal thinking domains after the intervention than before, with largest reductions in justification and power orientation. Findings provide evidence that attitudes to crime can be changed in a correctional setting, and the programme under study shows promise as an effective intervention for changing these attitudes among prisoners. Future research should build on these findings to examine whether and how such changes are related to desistance from offending behaviours. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

The cost-effectiveness of the RSI QuickScan intervention programme for computer workers: Results of an economic evaluation alongside a randomised controlled trial.

PubMed

Speklé, Erwin M; Heinrich, Judith; Hoozemans, Marco J M; Blatter, Birgitte M; van der Beek, Allard J; van Dieën, Jaap H; van Tulder, Maurits W

2010-11-11

The costs of arm, shoulder and neck symptoms are high. In order to decrease these costs employers implement interventions aimed at reducing these symptoms. One frequently used intervention is the RSI QuickScan intervention programme. It establishes a risk profile of the target population and subsequently advises interventions following a decision tree based on that risk profile. The purpose of this study was to perform an economic evaluation, from both the societal and companies' perspective, of the RSI QuickScan intervention programme for computer workers. In this study, effectiveness was defined at three levels: exposure to risk factors, prevalence of arm, shoulder and neck symptoms, and days of sick leave. The economic evaluation was conducted alongside a randomised controlled trial (RCT). Participating computer workers from 7 companies (N = 638) were assigned to either the intervention group (N = 320) or the usual care group (N = 318) by means of cluster randomisation (N = 50). The intervention consisted of a tailor-made programme, based on a previously established risk profile. At baseline, 6 and 12 month follow-up, the participants completed the RSI QuickScan questionnaire. Analyses to estimate the effect of the intervention were done according to the intention-to-treat principle. To compare costs between groups, confidence intervals for cost differences were computed by bias-corrected and accelerated bootstrapping. The mean intervention costs, paid by the employer, were 59 euro per participant in the intervention and 28 euro in the usual care group. Mean total health care and non-health care costs per participant were 108 euro in both groups. As to the cost-effectiveness, improvement in received information on healthy computer use as well as in their work posture and movement was observed at higher costs. With regard to the other risk factors, symptoms and sick leave, only small and non-significant effects were found. In this study, the RSI QuickScan intervention programme did not prove to be cost-effective from the both the societal and companies' perspective and, therefore, this study does not provide a financial reason for implementing this intervention. However, with a relatively small investment, the programme did increase the number of workers who received information on healthy computer use and improved their work posture and movement. NTR1117.

Effectiveness of an implementation optimisation intervention aimed at increasing parent engagement in HENRY, a childhood obesity prevention programme - the Optimising Family Engagement in HENRY (OFTEN) trial: study protocol for a randomised controlled trial.

PubMed

Bryant, Maria; Burton, Wendy; Cundill, Bonnie; Farrin, Amanda J; Nixon, Jane; Stevens, June; Roberts, Kim; Foy, Robbie; Rutter, Harry; Hartley, Suzanne; Tubeuf, Sandy; Collinson, Michelle; Brown, Julia

2017-01-24

Family-based interventions to prevent childhood obesity depend upon parents' taking action to improve diet and other lifestyle behaviours in their families. Programmes that attract and retain high numbers of parents provide an enhanced opportunity to improve public health and are also likely to be more cost-effective than those that do not. We have developed a theory-informed optimisation intervention to promote parent engagement within an existing childhood obesity prevention group programme, HENRY (Health Exercise Nutrition for the Really Young). Here, we describe a proposal to evaluate the effectiveness of this optimisation intervention in regard to the engagement of parents and cost-effectiveness. The Optimising Family Engagement in HENRY (OFTEN) trial is a cluster randomised controlled trial being conducted across 24 local authorities (approximately 144 children's centres) which currently deliver HENRY programmes. The primary outcome will be parental enrolment and attendance at the HENRY programme, assessed using routinely collected process data. Cost-effectiveness will be presented in terms of primary outcomes using acceptability curves and through eliciting the willingness to pay for the optimisation from HENRY commissioners. Secondary outcomes include the longitudinal impact of the optimisation, parent-reported infant intake of fruits and vegetables (as a proxy to compliance) and other parent-reported family habits and lifestyle. This innovative trial will provide evidence on the implementation of a theory-informed optimisation intervention to promote parent engagement in HENRY, a community-based childhood obesity prevention programme. The findings will be generalisable to other interventions delivered to parents in other community-based environments. This research meets the expressed needs of commissioners, children's centres and parents to optimise the potential impact that HENRY has on obesity prevention. A subsequent cluster randomised controlled pilot trial is planned to determine the practicality of undertaking a definitive trial to robustly evaluate the effectiveness and cost-effectiveness of the optimised intervention on childhood obesity prevention. ClinicalTrials.gov identifier: NCT02675699 . Registered on 4 February 2016.

Internet-based learning programme to increase nurses' knowledge level about venous leg ulcer care in home health care.

PubMed

Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

2017-11-01

To test the effectiveness of an Internet-based education programme about venous leg ulcer nursing care on perceived and theoretical knowledge levels and attitudes among nurses working in home health care. Nurses have been shown to have knowledge gaps in venous leg ulcer nursing care. Internet-based learning could offer a means for flexible continuing education for home healthcare environment. Quasi-experimental study with pre- and postmeasurements and nonequivalent intervention and comparison groups. Nurses (n = 946) in home health care in two Finnish municipalities were invited to participate in the study and divided into intervention and comparison groups. The intervention group received education programme about venous leg ulcer nursing care, while the comparison group did not. Data were collected at baseline, at six weeks and at 10 weeks to test the hypotheses: nurses using education programme about venous leg ulcer nursing care will have higher level of knowledge and more positive attitudes than those not using education programme about venous leg ulcer nursing care. An analysis of variance and mixed models with repeated measures were used to test differences in knowledge and attitudes between and within the groups. There were statistically significant increases in knowledge levels in the intervention group from baseline to the first and second follow-up measurements. In the comparison group, the knowledge levels remained unchanged during the study. Attitude levels remained unchanged in both groups. Nurses' perceived and theoretical knowledge levels of venous leg ulcer nursing care can be increased with Internet-based education. However, this increase in knowledge levels is short-lived, which emphasises the need for continuous education. Internet-based education about venous leg ulcer nursing care is recommended for home healthcare nurses. Education programme about venous leg ulcer nursing care provides flexible method for nurses' learning with feasible and cost-effective access to evidence-based education. Education programme about venous leg ulcer nursing care material can be used in all nursing environments where Internet is available. © 2017 John Wiley & Sons Ltd.

Outcomes and process evaluation of a programme integrating physical activity into the primary school mathematics curriculum: The EASY Minds pilot randomised controlled trial.

PubMed

Riley, Nicholas; Lubans, David R; Morgan, Philip J; Young, Myles

2015-11-01

This study evaluated the feasibility of the 'Encouraging Activity to Stimulate Young (EASY) Minds' programme, a school-based intervention for integrating physical activity (PA) into mathematics lessons. Randomised controlled trial. Two classes from a single school (n = 54) were randomised to receive either the 6-week EASY Minds intervention (n = 27) or follow their usual school programme (n = 27). The intervention involved the embedding of PA across the pre-existing mathematics programme for 3 × 60 min sessions per week. Changes in PA were measured using accelerometers and 'on task' behaviour was measured using momentary time sampling observation. Using intention-to-treat analysis, significant intervention effects were found for MVPA (9.7%, 95%CI = 7.6, 11.8, p ≤ 0.001) and sedentary time (-22.4%, CI = -24.9, -12.2, p ≤ 0.001) for the intervention group during Mathematics lessons (9.30 am-10.30 am). Significant intervention effects were also shown for MVPA 8.7% (95% CI = 5.8, 11.6, p ≤ 0.001 and sedentary time -18.6% (95% CI = -24.9, -12.2, p ≤ 0.001) across the whole school day. Furthermore, children displayed significantly greater 'on-task' behaviour across the intervention period with a 19.9% (95%CI = 2.4, 37.4, p ≤ 0.03) mean difference between groups. The EASY Minds programme demonstrated that integrating movement across the primary mathematics syllabus is feasible and efficacious in enhancing school based-PA and improving on-task behaviour in mathematics lessons. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The cost-effectiveness of three interventions for providing preventive services to low-income children.

PubMed

Johnson, Ben; Serban, Nicoleta; Griffin, Paul M; Tomar, Scott L

2017-12-01

We evaluated the impact of loan repayment programmes, revising Medicaid fee-for-service rates, and changing dental hygienist supervision requirements on access to preventive dental care for children in Georgia. We estimated cost savings from the three interventions of preventive care for young children after netting out the intervention cost. We used a regression model to evaluate the impact of changing the Medicaid reimbursement rates. The impact of supervision was evaluated by comparing general and direct supervision in school-based dental sealant programmes. Federal loan repayments to dentists and school-based sealant programmes (SBSPs) had lower intervention costs (with higher potential cost savings) than raising the Medicaid reimbursement rate. General supervision had costs 56% lower than direct supervision of dental hygienists for implementing a SBSP. Raising the Medicaid reimbursement rate by 10 percentage points would improve utilization by <1% and cost over $38 million. Given one parameter set, SBSPs could serve over 27 000 children with an intervention cost between $500 000 and $1.3 million with a potential cost saving of $1.1 million. Loan repayment could serve almost 13 000 children for a cost of $400 000 and a potential cost saving of $176 000. The three interventions all improved met need for preventive dental care. Raising the reimbursement rate alone would marginally affect utilization of Medicaid services but would not substantially increase acceptance of Medicaid by providers. Both loan repayment programmes and amending supervision requirements are potentially cost-saving interventions. Loan repayment programmes provide complete care to targeted areas, while amending supervision requirements of dental hygienists could provide preventive care across the state. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Development of an intervention programme to encourage high school students to stay in school for lunch instead of eating at nearby fast-food restaurants.

PubMed

Beaulieu, Dominique; Godin, Gaston

2012-08-01

Many schools have recently adopted food policies and replaced unhealthy products by healthy foods. Consequently, adolescents are more likely to consume a healthy meal if they stay in school for lunch to eat a meal either prepared at home or purchased in school cafeterias. However, many continue to eat in nearby fast-food restaurants. The present paper describes the development of a theory-based intervention programme aimed at encouraging high school students to stay in school for lunch. Intervention Mapping and the Theory of Planned Behaviour served as theoretical frameworks to guide the development of a 12-week intervention programme of activities addressing intention, descriptive norm, perceived behavioural control and attitude. It was offered to students and their parents with several practical applications, such as structural environmental changes, and educational activities, such as audio and electronic messages, posters, cooking sessions, pamphlets, improvisation play theatre, quiz, and conferences. The programme considers theoretical and empirical data, taking into account specific beliefs and contexts of the target population. This paper should help programme planners in the development of appropriate interventions addressing the problem. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour.

PubMed

Rodríguez-Díaz, Luciano; Ruiz-Frutos, Carlos; Vázquez-Lara, Juana María; Ramírez-Rodrigo, Jesús; Villaverde-Gutiérrez, Carmen; Torres-Luque, Gema

To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population. A sample consisting of a total of 105 pregnant women was divided into two groups: intervention group (n=50) (32.87±4.46 years old) and control group (n=55) (31.52±4.95 years old). The intervention group followed a physical activity programme based on the Pilates method, for 2 weekly sessions, whereas the control group did not follow the program. Significant improvements (p<0.05) in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention. A physical activity programme of 8 weeks based on the Pilates method improves functional parameters in pregnant women and benefits delivery. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Environmental risks in the developing world: exposure indicators for evaluating interventions, programmes, and policies.

PubMed

Ezzati, Majid; Utzinger, Jürg; Cairncross, Sandy; Cohen, Aaron J; Singer, Burton H

2005-01-01

Monitoring and empirical evaluation are essential components of evidence based public health policies and programmes. Consequently, there is a growing interest in monitoring of, and indicators for, major environmental health risks, particularly in the developing world. Current large scale data collection efforts are generally disconnected from micro-scale studies in health sciences, which in turn have insufficiently investigated the behavioural and socioeconomic factors that influence exposure. A basic framework is proposed for development of indicators of exposure to environmental health risks that would facilitate the (a) assessment of the health effects of risk factors, (b) design and evaluation of interventions and programmes to deliver the interventions, and (c) appraisal and quantification of inequalities in health effects of risk factors, and benefits of intervention programmes and policies. Specific emphasis is put on the features of environmental risks that should guide the choice of indicators, in particular the interactions of technology, the environment, and human behaviour in determining exposure. The indicators are divided into four categories: (a) access and infrastructure, (b) technology, (c) agents and vectors, and (d) behaviour. The study used water and sanitation, indoor air pollution from solid fuels, urban ambient air pollution, and malaria as illustrative examples for this framework. Organised and systematic indicator selection and monitoring can provide an evidence base for design and implementation of more effective and equitable technological interventions, delivery programmes, and policies for environmental health risks in resource poor settings.

Early interventions and lessons from Harvard Business Review.

PubMed

Chong, Siow-Ann

2007-11-01

To describe the establishment and development of an Early Psychosis Intervention Programme in Singapore that is based on a business model and with concepts drawn from the corporate world. The author who directed this programme describes the circumstances that led to this initiative, the ideas borrowed and adapted from the corporate world, and the lessons learnt in setting up this intervention programme. The modus operandi of the programme is based on the Balanced Scorecard - a model which stresses four equally important components: customers, internal processes, financial health and learning and innovation. Other complementary actions like creating a sense of urgency, forging a vision with a core ideology, empowerment of team members, creating short-term wins, anchoring the changes and finding meaning in the work are vital for the programme to thrive. This model also emphasizes the importance of accountability through the measurability of indicators. These indicators included a significant reduction in the duration of untreated psychosis, a positive change in the referral patterns with better engagement of the primary health-care sector and an improvement in the quality of care for the patients. Much can be learnt from the business world in building and maintaining a public mental health programme. Effective change also requires effective leadership, and the successful implementation of certain strategic steps.

A Knowledge Translation Programme to Increase the Utilization of Thoracic Spine Mobilization and Manipulation for Patients with Neck Pain.

PubMed

Karas, Steve; Westerheide, Angela; Daniel, Laura

2016-06-01

There is extensive evidence that mobilization and manipulation of the thoracic spine is associated with improved outcomes in patients with neck pain. However, these evidence-based techniques are not always utilized. Successful knowledge translation programmes are needed to move the best available evidence to clinical practice. The purpose of the present research was to evaluate the effects of a structured knowledge translation programme on the frequency of manual therapy techniques performed by physical therapists on patients with neck pain. Prior to our intervention, we assessed physical therapists' use of thoracic spine intervention for the treatment of neck pain and their knowledge of the evidence. We delivered a multimodal knowledge translation programme and then reassessed their use and knowledge of the interventions. The majority of our physical therapists increased the use of thoracic spine techniques for their patients with neck pain. The increase was greater in those who used the techniques infrequently. Overall knowledge of the evidence appeared unchanged. Knowledge translation programmes are essential in ensuring clinical use of evidence-based practice. Our programme results, although on a small scale and not statistically significant, showed a positive trend toward increased thoracic spine manual therapy use for neck pain. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Effect of Sex Education Programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria.

PubMed

Esere, Mary Ogechi

2008-06-01

Adolescents display sexual behaviours and developmental characteristics that place them at risk for Sexually Transmitted Diseases (STDs). Because young people experiment sexually and because of the consequences of indiscriminate sexual activities on the youth, there is the need to mount sex education programmes that are geared towards enlightenment and appropriate education about sex and sexuality. To determine whether Sex Education Intervention Programme would reduce at-risk sexual behaviours of school-going adolescents. Pre-test, post-test control group quasi-experimental design. A randomly selected co-educational school in Ilorin Metropolis, Nigeria. 24 school-going adolescents aged 13-19 years. Sex Education Programme (treatment group) versus Control programme (placebo). Self-reported exposure to sexually transmitted diseases, multiple sex partners, anal sex, oral sex, non use of condom. When the treatment (intervention) group was compared with the control group in an intention to treat analysis, there were significant differences in at-risk sexual behaviours of the two groups. Those in the intervention group reported less at-risk sexual behaviours than their counterparts in the control group. The treatment group evaluated the intervention programme positively and their knowledge of sexual health improved. Lack of behavioural effect on the control group could be linked to differential quality of delivery of intervention. Compared with the control group, this specially designed intervention sex education programme reduced at-risk sexual behaviour in adolescents. Based on this finding, it was recommended that sex education be introduced into the curriculum of secondary school education in Nigeria.

Effectiveness of a School-Based Early Intervention CBT Group Programme for Children with Anxiety Aged 5-7 Years

ERIC Educational Resources Information Center

Ruocco, Sylvia; Gordon, Jocelynne; McLean, Louise A.

2016-01-01

Early manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the "Get Lost Mr. Scary" programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5-7 years. Participants were 134 children (65 males and 69 females) drawn…

"Abazali Abazamayo" (Parents Who Keep on Trying): Mothers' Responses to the Ububele Mother-Baby Home Visiting Programme

ERIC Educational Resources Information Center

Bain, Katherine; Dawson, Nicola; Esterhuizen, Melanie; Frost, Katharine; Pininski, Darren

2017-01-01

Early parent-infant home visiting interventions have been found to be effective in both developed and developing countries. However, there is a need to build an evidence base for these interventions in the South African context, to inform local early childhood development policy. The Ububele Mother-Baby Home Visiting Programme in Alexandra,…

Development of "Long Live Love+," a School-Based Online Sexual Health Programme for Young Adults. An Intervention Mapping Approach

ERIC Educational Resources Information Center

Mevissen, Fraukje E. F.; van Empelen, Pepijn; Watzeels, Anita; van Duin, Gee; Meijer, Suzanne; van Lieshout, Sanne; Kok, Gerjo

2018-01-01

This paper describes the development of a Dutch online programme called "Long Live Love+" focusing on positive, coercion-free relationships, contraception use, and the prevention of STIs, using the Intervention Mapping (IM) approach. All six steps of the approach were followed. Step 1 confirmed the need for a sexual health programme…

A qualitative evidence synthesis of employees’ views of workplace smoking reduction or cessation interventions

PubMed Central

2013-01-01

Background The need to reduce smoking rates is a recognised public health policy issue in many countries. The workplace offers a potential context for offering smokers’ programmes and interventions to assist smoking cessation or reduction. A qualitative evidence synthesis of employees’ views about such programmes might explain why some interventions appear effective and others not, and can be used to develop evidence-based interventions for this population and setting. Methods A qualitative evidence synthesis of primary research exploring employees’ views about workplace interventions to encourage smoking cessation, including both voluntary programmes and passive interventions, such as restrictions or bans. The method used was theory-based “best fit” framework synthesis. Results Five relevant theories on workplace smoking cessation were identified and used as the basis for an a priori framework. A comprehensive literature search, including interrogation of eight databases, retrieved 747 unique citations for the review. Fifteen primary research studies of qualitative evidence were found to satisfy the inclusion criteria. The synthesis produced an evidence-based conceptual model explaining employees’ experiences of, and preferences regarding, workplace smoking interventions. Conclusion The synthesis suggests that workplace interventions should employ a range of different elements if they are to prove effective in reducing smoking among employees. This is because an employee who feels ready and able to change their behaviour has different needs and preferences from an employee who is not at that stage. Only a multi-faceted intervention can satisfy the requirements of all employees. PMID:24274158

Qualitative evaluation of the Safety and Improvement in Primary Care (SIPC) pilot collaborative in Scotland: perceptions and experiences of participating care teams.

PubMed

Bowie, Paul; Halley, Lyn; Blamey, Avril; Gillies, Jill; Houston, Neil

2016-01-29

To explore general practitioner (GP) team perceptions and experiences of participating in a large-scale safety and improvement pilot programme to develop and test a range of interventions that were largely new to this setting. Qualitative study using semistructured interviews. Data were analysed thematically. Purposive sample of multiprofessional study participants from 11 GP teams based in 3 Scottish National Health Service (NHS) Boards. 27 participants were interviewed. 3 themes were generated: (1) programme experiences and benefits, for example, a majority of participants referred to gaining new theoretical and experiential safety knowledge (such as how unreliable evidence-based care can be) and skills (such as how to search electronic records for undetected risks) related to the programme interventions; (2) improvements to patient care systems, for example, improvements in care systems reliability using care bundles were reported by many, but this was an evolving process strongly dependent on closer working arrangements between clinical and administrative staff; (3) the utility of the programme improvement interventions, for example, mixed views and experiences of participating in the safety climate survey and meeting to reflect on the feedback report provided were apparent. Initial theories on the utilisation and potential impact of some interventions were refined based on evidence. The pilot was positively received with many practices reporting improvements in safety systems, team working and communications with colleagues and patients. Barriers and facilitators were identified related to how interventions were used as the programme evolved, while other challenges around spreading implementation beyond this pilot were highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Qualitative evaluation of the Safety and Improvement in Primary Care (SIPC) pilot collaborative in Scotland: perceptions and experiences of participating care teams

PubMed Central

Bowie, Paul; Halley, Lyn; Blamey, Avril; Gillies, Jill; Houston, Neil

2016-01-01

Objectives To explore general practitioner (GP) team perceptions and experiences of participating in a large-scale safety and improvement pilot programme to develop and test a range of interventions that were largely new to this setting. Design Qualitative study using semistructured interviews. Data were analysed thematically. Subjects and setting Purposive sample of multiprofessional study participants from 11 GP teams based in 3 Scottish National Health Service (NHS) Boards. Results 27 participants were interviewed. 3 themes were generated: (1) programme experiences and benefits, for example, a majority of participants referred to gaining new theoretical and experiential safety knowledge (such as how unreliable evidence-based care can be) and skills (such as how to search electronic records for undetected risks) related to the programme interventions; (2) improvements to patient care systems, for example, improvements in care systems reliability using care bundles were reported by many, but this was an evolving process strongly dependent on closer working arrangements between clinical and administrative staff; (3) the utility of the programme improvement interventions, for example, mixed views and experiences of participating in the safety climate survey and meeting to reflect on the feedback report provided were apparent. Initial theories on the utilisation and potential impact of some interventions were refined based on evidence. Conclusions The pilot was positively received with many practices reporting improvements in safety systems, team working and communications with colleagues and patients. Barriers and facilitators were identified related to how interventions were used as the programme evolved, while other challenges around spreading implementation beyond this pilot were highlighted. PMID:26826149

[Tools to assess the impact on health of public health programmes and community interventions from an equity perspective].

PubMed

Suárez Álvarez, Óscar; Fernández-Feito, Ana; Vallina Crespo, Henar; Aldasoro Unamuno, Elena; Cofiño, Rafael

2018-05-11

It is essential to develop a comprehensive approach to institutionally promoted interventions to assess their impact on health from the perspective of the social determinants of health and equity. Simple, adapted tools must be developed to carry out these assessments. The aim of this paper is to present two tools to assess the impact of programmes and community-based interventions on the social determinants of health. The first tool is intended to assess health programmes through interviews and analysis of information provided by the assessment team. The second tool, by means of online assessments of community-based interventions, also enables a report on inequality issues that includes recommendations for improvement. In addition to reducing health-related social inequities, the implementation of these tools can also help to improve the efficiency of public health interventions. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

'Football for Health'--a football-based health-promotion programme for children in South Africa: a parallel cohort study.

PubMed

Fuller, Colin W; Junge, Astrid; DeCelles, Jeff; Donald, James; Jankelowitz, Ryan; Dvorak, Jiri

2010-06-01

To develop, implement and assess an interactive, football-based health education programme for children in South Africa. Prospective cohort study with control group. Two schools in Khayelitsha township, South Africa. 370 children making up two intervention groups (Grade 6: 125; Grade 7: 131) and one control group (Grade 7: 114). Eleven 90 min sessions, each divided into two 45 min halves of Play Football (football skills) and Play Fair (health issues), each session focused on one specific health risk factor. Health knowledge using a 20-item questionnaire; coaches' attitudes towards their training programme using a 10-item questionnaire and children's attitudes towards the health education programme using a six-item questionnaire. Children in the Grade 7 intervention group showed significant (p<0.05) increases in the proportion of correct responses for nine of the 20 health knowledge questions postintervention, and these increases were maintained at 3 months postintervention. The Grade 6 intervention group showed significant increases in the proportion of correct responses for 15 of the 20 health knowledge questions postintervention. The Grade 7 control group showed a significant increase in the proportion of correct responses to one of the 20 health knowledge questions post-Play Football sessions and nine of 20 questions post-Play Fair sessions. Over 90% of the children provided positive attitude responses to the health-education programme. The programme demonstrated that it was possible to implement a football-based health-education programme for children in Africa that achieved significant increases in health knowledge and that was also well received by participants.

Community-based physical activity intervention using principles of social marketing: a demonstration project in Southern India.

PubMed

Subitha, L; Soudarssanane, M Bala; Murugesan, R

2013-01-01

We aimed to study the development and implementation of promotion of physical activity in a rural community by applying the principles of social marketing and to determine participation behaviour in a physical activity programme in a community setting. The intervention targeted 485 people, 20-49 years of age, residents of Periakattupalayam and Rangareddipalayam villages, Tamil Nadu. This community-based participatory research was based on the principles of 'social marketing'. Health education by one-to-one counselling, written materials and community events were used to popularize moderate intensity physical activity (brisk walking for 30 minutes on 4 days/week). We formed 30 walking groups under four coordinators, in a home-based setting with professional supervision and guidance. A log of physical activity sessions for the 10-week intervention period was maintained in the form of group attendance record. Village leaders, self-help groups and youth clubs were involved in promoting physical activity. Of the 485 subjects, 265 people (54.6%) engaged in brisk walking >4 days a week, while 156 subjects (32.2%) performed walking on 1-4 days per week during the intervention. The drop-out rate was 13.2% (64 subjects). Age, occupation and educational status were important determinants of participation and adherence to the physical activity programme. Application of social marketing techniques in an intervention to promote physical activity was successful in a rural Indian community. Studying the determinants of adoption of a physical activity programme and addressing the barriers to behaviour change are essential for designing relevant policies and effective programmes. Copyright 2012, NMJI.

A Self-Management Programme of Activity Coping and Education - SPACE for COPD(C) - in primary care: The protocol for a pragmatic trial.

PubMed

Bourne, Claire LA; Kanabar, Pratiksha; Mitchell, Katy; Schreder, Sally; Houchen-Wolloff, Linzy; Bankart, M John G; Apps, Lindsay; Hewitt, Stacey; Harvey-Dunstan, Theresa; Singh, Sally J

2017-07-10

National guidance for chronic obstructive pulmonary disease (COPD) suggests that self-management support be provided for patients. Our institution has developed a standardised, manual-based, supported self-management programme: Self-Management Programme of Activity Coping and Education (SPACE for COPD(C)). SPACE was previously piloted on a 1-2-1 basis, delivered by researchers, to individuals with COPD. Discussions with stakeholders highlighted considerable interest in delivering the SPACE for COPD(C) intervention as a group-based self-management programme facilitated by healthcare professionals (HCPs) in primary care settings. The study aims are to explore the feasibility, acceptability and efficacy for the intervention to be delivered and supported by HCPs and to examine whether group-based delivery of SPACE for COPD(C), with sustained support, improves patient outcomes following the SPACE for COPD(C) intervention. A prospective, multi-site, single-blinded randomised controlled trial (RCT) will be conducted, with follow-up at 6 and 9 months. Participants will be randomly assigned to either the control group (usual care) or intervention group (a six-session, group-based SPACE for COPD(C)self-management programme delivered over 5 months). The primary outcome is change in COPD assessment test at 6 months.A discussion session will be conducted with HCPs who deliver the intervention to discuss and gain insight into any potential facilitators/barriers to implementing the intervention in practice. Furthermore, we will conduct semi-structured focus groups with intervention participants to understand feasibility and acceptability. All qualitative data will be analysed thematically. The project has received a favourable opinion from South Hampshire B Research Ethics Committee, REC reference: 14/SC/1169 and full R&D approval from the University Hospitals of Leicester NHS Trust: 152408.Study results will be disseminated through appropriate peer-reviewed journals, national and international respiratory/physiotherapy conferences, via the Collaboration and Leadership in Applied Health Research and Care and through social media. ISRCTN17942821; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Virtual rehabilitation in a school setting: is it feasible for children with cerebral palsy?

PubMed

Rosie, Juliet A; Ruhen, Shelley; Hing, Wayne A; Lewis, Gwyn N

2015-01-01

To determine the feasibility of a school-based virtual rehabilitation intervention for children with cerebral palsy. A feasibility study was conducted using a mixed method approach. Participants were five children with cerebral palsy who were currently attending a rural school. Each child received an 8-week rehabilitation programme involving an Interactive Virtual Reality Exercise (IREX) system. The IREX was placed in the child's school for the duration of the intervention. Each child's programme was designed by a physiotherapist but supervised by a teacher aide at the school. Feasibility of the intervention was assessed through a questionnaire completed by the child and an interview conducted with the teacher supervisor. The children all rated the IREX intervention as fun, easy to use, and beneficial for their arm. Categories from the supervisor interviews centred on resolving technical issues, the enjoyment of taking part due to the child's progress, and the central role of interacting with the child. Input from the research physiotherapist was critical to the success of the intervention. The IREX is feasible to implement in a school-based setting supervised by teachers. This provides an option for delivering physiotherapy to children in isolated areas who do not receive on-going therapy. Implication for Rehabilitation Virtual rehabilitation programmes using the IREX are feasible in a school-based setting. The negative impact of technical difficulties is likely to be overcome by the user's enjoyment and rehabilitation benefits gained. Input from a therapist in designing and monitoring the programme is critical.

Mobile phone-based interventions for smoking cessation.

PubMed

Whittaker, Robyn; Borland, Ron; Bullen, Chris; Lin, Ruey B; McRobbie, Hayden; Rodgers, Anthony

2009-10-07

Innovative effective smoking cessation interventions are required to appeal to those who are not accessing traditional cessation services. Mobile phones are widely used and are now well integrated into the daily lives of many, particularly young adults. Mobile phones are a potential medium for the delivery of health programmes such as smoking cessation. To determine whether mobile phone-based interventions are effective at helping people who smoke, to quit. We searched MEDLINE, EMBASE, Cinahl, PsycINFO, The Cochrane Library, the National Research Register and the ClinicalTrials register, with no restrictions placed on language or publication date. We included randomized or quasi-randomized trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone. Information on the specified quality criteria and methodological details was extracted using a standardised form. Participants who dropped out of the trials or were lost to follow up were considered to be smoking. Meta-analysis of the included studies was undertaken using the Mantel-Haenszel Risk Ratio fixed-effect method provided that there was no evidence of substantial statistical heterogeneity as assessed by the I(2) statistic. Where meta-analysis was not possible, summary and descriptive statistics are presented. Four studies were excluded as they were small non-randomized feasibility studies, and two studies were excluded because follow up was less than six months. Four trials (reported in five papers) are included: a text message programme in New Zealand; a text message programme in the UK; and an Internet and mobile phone programme involving two different groups in Norway. The different types of interventions are analysed separately. When combined by meta-analysis the text message programme trials showed a significant increase in short-term self-reported quitting (RR 2.18, 95% CI 1.80 to 2.65). However, there was considerable heterogeneity in long-term outcomes, with the much larger trial having problems with misclassification of outcomes; therefore these data were not combined. When the data from the Internet and mobile phone programmes were pooled we found statistically significant increases in both short and long-term self-reported quitting (RR 2.03, 95% CI 1.40 to 2.94). The current evidence shows no effect of mobile phone-based smoking cessation interventions on long-term outcome. While short-term results are positive, more rigorous studies of the long-term effects of mobile phone-based smoking cessation interventions are needed.

e-TC: Development and pilot testing of a web-based intervention to reduce anxiety and depression in survivors of testicular cancer.

PubMed

Heiniger, L E; Smith, A B; Olver, I; Grimison, P; Klein, B; Wootten, A; Abbott, J-A M; Price, M A; McJannett, M; Tran, B; Stockler, M R; Gurney, H; Butow, P N

2017-11-01

e-TC is an online intervention designed to address common psychosocial concerns of testicular cancer survivors. It aims to reduce anxiety, depression and fear of cancer recurrence by providing evidence-based information and psychological intervention. This paper details the development and pilot testing of e-TC. During pilot testing, 25 men (with varying psychological profiles) who had completed treatment for testicular cancer, 6 months to 5 years ago (which had not recurred), used e-TC over a 10-week period and provided quantitative and qualitative feedback on the feasibility and acceptability of the programme. Six men also completed a qualitative interview to provide detailed feedback on their experiences using e-TC. Fourteen men (56%) completed at least 80% of the programme. Participants reported a high level of satisfaction with the programme. Men's limited time was a barrier to programme use and completion, and participants suggested that men with a more recent diagnosis and a higher level of distress may be more likely to engage with the programme. e-TC appears to be a feasible and acceptable online intervention for survivors of testicular cancer. Findings from this study are currently being used to refine e-TC and guide the design of a larger efficacy study. © 2017 John Wiley & Sons Ltd.

Overcoming Barriers to Using Precision Teaching with a Web-Based Programme

ERIC Educational Resources Information Center

Hayes, Ben; Heather, Andrew; Jones, Daniel; Clarke, Christopher

2018-01-01

Precision Teaching (PT) is an evidence-based intervention, which research indicates is frequently not implemented following training, with few teachers using it in schools after training events. The web-based programme in this research focuses on word-level reading skills and targets blending and segmenting skills rather than whole word reading.…

Evaluation of a group based cognitive behavioural therapy programme for menstrual pain management in young women with intellectual disabilities: protocol for a mixed methods controlled clinical trial

PubMed Central

2014-01-01

Background Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities. The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. Methods/Design The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12 – 30 years who have a Mild - Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. Discussion Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. Trial registration Current Controlled Trials ISRCTN75567759 PMID:25201648

The 'European Alliance Against Depression (EAAD)': a multifaceted, community-based action programme against depression and suicidality.

PubMed

Hegerl, Ulrich; Wittmann, Meike; Arensman, Ella; Van Audenhove, Chantal; Bouleau, Jean-Hervé; Van Der Feltz-Cornelis, Christina; Gusmao, Ricardo; Kopp, Maria; Löhr, Cordula; Maxwell, Margaret; Meise, Ulrich; Mirjanic, Milan; Oskarsson, Högni; Sola, Victor Perez; Pull, Charles; Pycha, Roger; Ricka, Regula; Tuulari, Jyrki; Värnik, Airi; Pfeiffer-Gerschel, Tim

2008-01-01

Action programmes fostering partnerships and bringing together regional and national authorities to promote the care of depressed patients are urgently needed. In 2001 the 'Nuremberg Alliance Against Depression' was initiated as a community-based model project within the large-scale 'German Research Network on Depression and Suicidality' (Kompetenznetz 'Depression, Suizidalität'). The 'Nuremberg Alliance Against Depression' was an action programme, conducted in the city of Nuremberg (500,000 inhabitants) in 2001/2002, addressing four intervention levels (Hegerl et al. Psychol Med 2006;36:1225). Based on the positive results of the Nuremberg project (a significant reduction of suicidal behaviour by more than 20%) 18 international partners representing 16 different European countries established the 'European Alliance Against Depression' (EAAD) in 2004. Based on the four-level approach of the Nuremberg project, all regional partners initiated respective regional intervention programmes addressing depression and suicidality. Evaluation of the activities takes place on regional and international levels. This paper gives a brief overview of the background for and experiences with the EAAD. It describes the components of the programme, provides the rationale for the intervention and outlines the current status of the project. The aim of the paper is to disseminate information about the programme's potential to reduce suicidal behaviour and to provide examples of how European community-based 'best practice' models for improving the care of depressed patients and suicidal persons can be implemented using a bottom-up approach. EAAD is mentioned by the European commission as a best practice example within the Green Paper 'Improving the mental health of the population: Towards a strategy on mental health for the European Union' (European Commission 2005).

Dimensions of lay health worker programmes: results of a scoping study and production of a descriptive framework.

PubMed

South, Jane; Meah, Angela; Bagnall, Anne-Marie; Jones, Rebecca

2013-03-01

Approaches that engage and support lay health workers in the delivery of health improvement activities have been widely applied across different health issues and populations. The lack of a common terminology, inconsistency in the use of role descriptors and poor indexing of lay health worker roles are all barriers to the development of a shared evidence base for lay health worker interventions. The aim of the paper is to report results from a scoping study of approaches to involve lay people in public health roles and to present a framework for categorisation of the different dimensions of lay health worker programmes. Our scoping study comprised a systematic scoping review to map the literature on lay health worker interventions and to identify role dimensions and common models. The review, which was limited to interventions relevant to UK public health priorities, covered a total of 224 publications. The scoping study also drew on experiential evidence from UK practice. Research-based and practice-based evidence confirmed the variety of role descriptors in use and the complexity of role dimensions. Five common models that define the primary role of the lay health worker were identified from the literature. A framework was later developed that grouped features of lay health worker programmes into four dimensions: intervention, role, professional support/service and the community. More account needs to be taken of the variations that occur between lay health worker programmes. This framework, with the mapping of key categories of difference, may enable better description of lay health worker programmes, which will in turn assist in building a shared evidence base. More research is needed to examine the transferability of the framework within different contexts.

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

PubMed Central

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 protocol describes the purpose, intervention design and study protocol of ‘Fun without Smokes’. Expectations are that pupils receiving tailored advice will be less likely to smoke after 24 months in contrast to pupils in the control condition. Furthermore, tailored feedback letters and prompting is expected to be more effective than providing tailored feedback letters only. Trial registration Dutch Trial Register NTR3116 PMID:22490110

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

PubMed

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

2014-10-27

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

The Effectiveness and Sustainability of a Universal School-Based Programme for Preventing Depression in Chinese Adolescents: A Follow-Up Study Using Quasi-Experimental Design

PubMed Central

Lai, Eliza S. Y.; Kwok, Chi-Leung; Wong, Paul W. C.; Fu, King-Wa; Law, Yik-Wa; Yip, Paul S. F.

2016-01-01

Background A pilot study about the effectiveness of a universal school-based programme, “The Little Prince is Depressed”, for preventing depression in Chinese adolescents in Hong Kong was conducted and reported previously. This study used a larger sample to examine the effectiveness and sustainability of the programme. Methods This study used quasi-experimental design. Twelve schools enrolled in “The Little Prince is Depressed” programme either as an intervention or a control condition. The intervention schools carried out the 12-session programme in two phases: the professional-led first phase and the teacher-led second phase. All participants were required to complete a questionnaire at three time points measuring their (1) depressive, anxiety, and stress levels; (2) knowledge of mental health; (3) attitudes towards mental illness; (4) perceived social support; and (5) help-seeking behaviours. Results A total of 3,391 students participated in the study. The level of depressive symptoms did not reduce significantly at post-intervention; however, a delayed effect was observed at follow-up assessment for the participants of the teacher-led group in reducing anxiety and stress levels. Also, the knowledge of mental health and attitudes towards mental illness of the intervention-group participants significantly improved at post-test, and the outcomes were maintained at 4 to 5 months after the intervention in both the professional-led and the teacher-led conditions (p<.05). A preference among schoolchildren for whom to seek help from was identified. Conclusions The universal depression prevention programme was effective in enhancing knowledge of mental health and promoting a more positive attitude towards mental illness among adolescents in Hong Kong. In particular, the teacher-led group showed better outcomes than the professional-led group in reducing students’ anxiety and stress at follow-up period. The programme can achieve sustainability in schools if teachers are provided with adequate support. PMID:26921275

The Effectiveness and Sustainability of a Universal School-Based Programme for Preventing Depression in Chinese Adolescents: A Follow-Up Study Using Quasi-Experimental Design.

PubMed

Lai, Eliza S Y; Kwok, Chi-Leung; Wong, Paul W C; Fu, King-Wa; Law, Yik-Wa; Yip, Paul S F

2016-01-01

A pilot study about the effectiveness of a universal school-based programme, "The Little Prince is Depressed", for preventing depression in Chinese adolescents in Hong Kong was conducted and reported previously. This study used a larger sample to examine the effectiveness and sustainability of the programme. This study used quasi-experimental design. Twelve schools enrolled in "The Little Prince is Depressed" programme either as an intervention or a control condition. The intervention schools carried out the 12-session programme in two phases: the professional-led first phase and the teacher-led second phase. All participants were required to complete a questionnaire at three time points measuring their (1) depressive, anxiety, and stress levels; (2) knowledge of mental health; (3) attitudes towards mental illness; (4) perceived social support; and (5) help-seeking behaviours. A total of 3,391 students participated in the study. The level of depressive symptoms did not reduce significantly at post-intervention; however, a delayed effect was observed at follow-up assessment for the participants of the teacher-led group in reducing anxiety and stress levels. Also, the knowledge of mental health and attitudes towards mental illness of the intervention-group participants significantly improved at post-test, and the outcomes were maintained at 4 to 5 months after the intervention in both the professional-led and the teacher-led conditions (p<.05). A preference among schoolchildren for whom to seek help from was identified. The universal depression prevention programme was effective in enhancing knowledge of mental health and promoting a more positive attitude towards mental illness among adolescents in Hong Kong. In particular, the teacher-led group showed better outcomes than the professional-led group in reducing students' anxiety and stress at follow-up period. The programme can achieve sustainability in schools if teachers are provided with adequate support.

User value and usability of a web-based mindfulness intervention for families living with mental health problems.

PubMed

Stjernswärd, Sigrid; Hansson, Lars

2017-03-01

Mental health problems affect the patients and their families, who may also need therapeutic interventions. Mindfulness interventions have shown beneficial health effects for clinical and healthy populations. A web-based mindfulness intervention was tailored to address families' needs of support and tested in a pilot intervention study. The aim of this study was to explore the participants' experiences of using an 8-week web-based mindfulness programme in terms of user value and usability. Qualitative semi-structured interviews were carried out over the phone (Spring 2015, Sweden) with 15 randomly selected participants after the 3-month follow-up as part of the pilot study. Data were also collected through usability surveys online post intervention and at the 3-month follow-up. Qualitative data were analysed with content analysis and quantitative data with descriptive statistics. The analysis of the interviews resulted in four categories describing the participants' experiences of the programme's usability and value: A valuable and flexible tool that requires time and discipline, New perspective and coping strategies for an enhanced well-being, I'm important too - my limits, my responsibility, and Taming the inner critic. The programme's usability was satisfactory and largely corroborated by the surveys. The programme was experienced as a valuable tool to cope with stress in both private and professional contexts, making it a viable option to support families living with mental health problems. Time for self-care, a widened perspective, a less judgmental and more accepting attitude, deterring automatic reactions and setting limits helped the participants to deal with their situation and health. The programme's ease and flexibility of use were major advantages, although the training requires discipline. Motivators and barriers to use were illuminated, which should be considered in the development of further online services and study designs. © 2016 John Wiley & Sons Ltd.

Implementation Process and Acceptance of a Setting Based Prevention Programme to Promote Healthy Lifestyle in Preschool Children

ERIC Educational Resources Information Center

Herbert, Birgit; Strauss, Angelika; Mayer, Andrea; Duvinage, Kristin; Mitschek, Christine; Koletzko, Berthold

2013-01-01

Objective: Evaluation of the implementation process of a kindergarten-based intervention ("TigerKids") to promote a healthy lifestyle. Design: Questionnaire survey among kindergarten teachers about programme implementation and acceptance. Setting: Kindergartens in Bavaria, Germany. Methods: Two hundred and fifteen kindergartens were…

Using Community Radio in a Rural Women's Post-Literacy Programme in Nepal

ERIC Educational Resources Information Center

Nagaoka, Chizuko; Karki, Manohar

2014-01-01

This paper examines the literacy and post-literacy needs of rural women in Nepal, describes a pilot study in using community radio to supplement a classroom-based post-literacy programme for these women, analyses the findings of this intervention and considers the implications for similar programmes in other settings.

Using Epidemiological Survey Data to Examine Factors Influencing Participation in Parent-Training Programmes

ERIC Educational Resources Information Center

Morawska, Alina; Dyah Ramadewi, Mikha; Sanders, Matthew R.

2014-01-01

Evidence-based parent-training programmes aim to reduce child behaviour problems; however, the effects of these programmes are often limited by poor participation rates. This study proposes a model of parent, child and family factors related to parental participation in parenting interventions. A computer-assisted telephone interview was used to…

WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial.

PubMed

Hamdani, S U; Akhtar, P; Zill-E-Huma; Nazir, H; Minhas, F A; Sikander, S; Wang, D; Servilli, C; Rahman, A

2017-01-01

Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan. The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by 'family volunteers' to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule - child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894). This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings. Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.

Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review

PubMed Central

Lussiana, Cristina

2016-01-01

The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. PMID:25862732

Costing Human Rights and Community Support Interventions as a Part of Universal Access to HIV Treatment and Care in a Southern African Setting

PubMed Central

Jones, Louisa; Akugizibwe, Paula; Clayton, Michaela; Amon, Joseph J; Sabin, Miriam Lewis; Bennett, Rod; Stegling, Christine; Baggaley, Rachel; Kahn, James G; Holmes, Charles B; Garg, Navneet; Obermeyer, Carla Makhlouf; Mack, Christina DeFilippo; Williams, Phoebe; Smyth, Caoimhe; Vitoria, Marco; Crowley, Siobhan; Williams, Brian; McClure, Craig; Granich, Reuben; Hirnschall, Gottfried

2011-01-01

Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, ‘Know Your Rights’ information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall programmes costs. ART programs should consider measuring the cost and impact of human rights and community support interventions as key aspects of successful programme expansion. PMID:21999777

Costing human rights and community support interventions as a part of universal access to HIV treatment and care in a Southern African setting.

PubMed

Jones, Louisa; Akugizibwe, Paula; Clayton, Michaela; Amon, Joseph J; Sabin, Miriam Lewis; Bennett, Rod; Stegling, Christine; Baggaley, Rachel; Kahn, James G; Holmes, Charles B; Garg, Navneet; Obermeyer, Carla Makhlouf; Mack, Christina DeFilippo; Williams, Phoebe; Smyth, Caoimhe; Vitoria, Marco; Crowley, Siobhan; Williams, Brian; McClure, Craig; Granich, Reuben; Hirnschall, Gottfried

2011-09-01

Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, 'Know Your Rights' information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall programmes costs. ART programs should consider measuring the cost and impact of human rights and community support interventions as key aspects of successful programme expansion.

Community interventions for preventing smoking in young people.

PubMed

Sowden, A; Arblaster, L

2000-01-01

Decisions to smoke are made within a broad social context. Community interventions use co-ordinated, widespread, multi-component programmes to try and influence behaviour. To determine the effectiveness of community interventions in preventing the uptake of smoking in young people. The Tobacco Addiction group specialised register, Medline and 21 other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and contact was made with content area specialists. Randomised and non randomised controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years. Information relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined using qualitative narrative synthesis. Thirteen studies were included in the review, 44 studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with four using random allocation of schools or communities. Of nine studies which compared community interventions to no intervention controls, two, which were part of cardiovascular disease prevention programmes, reported lower smoking prevalence. Of three studies comparing community interventions to school-based programmes only, one found differences in reported smoking prevalence. One study reported a lower rate of increase in prevalence in a community receiving a multi-component intervention compared to a community exposed to a mass media campaign alone. One study reported a significant difference in smoking prevalence between a group receiving a media, school and homework intervention compared to a group receiving the media component only There is some limited support for the effectiveness of community interventions in helping prevent the uptake of smoking in young people.

Community interventions for preventing smoking in young people.

PubMed

Sowden, A; Arblaster, L; Stead, L

2003-01-01

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

Preschoolers with Autism Spectrum Disorders: Evaluating the Impact of a Home-Based Intervention to Promote Their Communication

ERIC Educational Resources Information Center

McConkey, Roy; Truesdale-Kennedy, Maria; Crawford, Heather; McGreevy, Elaine; Reavey, Michaela; Cassidy, Arlene

2010-01-01

The complexities that practitioners face in evaluating interventions are illustrated in this article. An early intervention programme (known as Keyhole), based mainly around Treatment and Education of Autistic and related Communications handicapped CHildren (TEACCH), Picture Exchange Communication System (PECS) and Hanen approaches, was delivered…

An ecological approach to hearing-health promotion in workplaces.

PubMed

Reddy, Ravi; Welch, David; Ameratunga, Shanthi; Thorne, Peter

2017-05-01

To develop and assess use, acceptability and feasibility of an ecological hearing conservation programme for workplaces. A school-based public health hearing preservation education programme (Dangerous Decibels®) was adapted for workplaces using the Multi-level Approach to Community Health (MATCH) Model. The programme was delivered in small manufacturing companies and evaluated using a questionnaire before the training and at one week and two-months after training. Workers (n = 56) from five small manufacturing companies were recruited. There was a significant improvement in knowledge, attitudes and behaviour of workers at the intrapersonal level; in behaviour motivation and safety culture at the interpersonal and organisational levels; and an overall improvement in hearing-health behaviour after two months post-intervention. The developed programme offers a simple, interactive and theory-based intervention that is well accepted and effective in promoting positive hearing-health behaviour in workplaces.

The development of an intervention programme to reduce whole-body vibration exposure at work induced by a change in behaviour: a study protocol

PubMed Central

Tiemessen, Ivo JH; Hulshof, Carel TJ; Frings-Dresen, Monique HW

2007-01-01

Background Whole body vibration (WBV) exposure at work is common and studies found evidence that this exposure might cause low back pain (LBP). A recent review concluded there is a lack of evidence of effective strategies to reduce WBV exposure. Most research in this field is focussed on the technical implications, although changing behaviour towards WBV exposure might be promising as well. Therefore, we developed an intervention programme to reduce WBV exposure in a population of drivers with the emphasis on a change in behaviour of driver and employer. The hypothesis is that an effective reduction in WBV exposure, in time, will lead to a reduction in LBP as WBV exposure is a proxy for an increased risk of LBP. Methods/Design The intervention programme was developed specifically for the drivers of vibrating vehicles and their employers. The intervention programme will be based on the most important determinants of WBV exposure as track conditions, driving speed, quality of the seat, etc. By increasing knowledge and skills towards changing these determinants, the attitude, social influence and self-efficacy (ASE) of both drivers and employers will be affected having an effect on the level of exposure. We used the well-known ASE model to develop an intervention programme aiming at a change or the intention to change behaviour towards WBV exposure. The developed programme consists of: individual health surveillance, an information brochure, an informative presentation and a report of the performed field measurements. Discussion The study protocol described is advantageous as the intervention program actively tries to change behaviour towards WBV exposure. The near future will show if this intervention program is effective by showing a decrease in WBV exposure. PMID:18005400

[Evaluation of the Family-based Familien stärken-Program for Preventing Substance Abuse and Behavior Problems in Youth].

PubMed

Stappenbeck, J; Wendell, A; Thomasius, R

2015-09-01

The Strengthening Families Program was developed in the USA and is regarded as an effective family-based prevention programme for youth. The evaluation of an adapted German version was carried out as a randomised-controlled multicentre trial. 292 families were recruited, 150 followed the intervention, and 142 received a minimal intervention. Acceptance from families and programme facilitators was high. Results about the effectiveness will be reported as soon as follow-up assessments are completed. © Georg Thieme Verlag KG Stuttgart · New York.

Hip and pelvic fracture patients with fear of falling: development and description of the "Step by Step" treatment protocol.

PubMed

Kampe, Karin; Kohler, Michaela; Albrecht, Diana; Becker, Clemens; Hautzinger, Martin; Lindemann, Ulrich; Pfeiffer, Klaus

2017-05-01

Based on a theoretical framework and sound evidence, this article describes a rehabilitation programme for patients with fear of falling after hip and pelvic fracture. Based on exercise science principles, current knowledge from fall prevention, emotion regulation, and the Health Action Process Approach we developed a theoretical framework, from which the components of the intervention were derived. Description of the intervention: The intervention consists of 6 components: (1) relaxation, (2) meaningful activities and mobility-based goals, (3) falls related cognitions and emotions, coping with high risk tasks and situations, (4) individual exercise programme, (5) planning and implementing exercises and activities, and (6) fall risks and hazards. The intervention comprises of 8 individual sessions during 3 to 5 weeks of inpatient rehabilitation and 4 telephone calls and 1 home visit over a 2-month post-discharge period. Each session or telephone call takes about 30-60 minutes. It is provided to geriatric hip and pelvic fracture patients with concerns about falling and no cognitive impairment. To ensure completeness of reporting, the Template for Intervention Description and Replication (TIDierR) is used. Fifty-seven patients were assigned to the intervention group. All 46 completers met all pre-defined criteria for an intervention per protocol. The programme is feasible to administer. We have completed a randomised controlled trial, which will be submitted in due time (for trial protocol: www.isrctn.org ; ISRCTN79191813).

The effect of a Web-based education programme (WBEP) on disease severity, quality of life and mothers' self-efficacy in children with atopic dermatitis.

PubMed

Son, Hae Kyoung; Lim, Jiyoung

2014-10-01

To develop and evaluate the effects of a web-based education programme in early childhood for children with atopic dermatitis. The prevalence rate of atopic dermatitis is highest in early childhood. A holistic approach is urgently needed for young children with respect to disease severity, quality of life and management, particularly parental knowledge about atopic dermatitis and adherence to treatment. A quasi-experimental study design was used. A total of 40 mother-child dyads participated in the study from 1 July-30 November 2011 in Korea. All children were under 3 years of age. The programme was based on the Network-Based Instructional System Design model, which consists of five phases: analysis, design, development, implementation and evaluation. The experimental group participated in the programme for 2 weeks. Participants took part in a learning session during the first week and then conducted the practice session at home during the second week. Participant knowledge and compliance were evaluated through online quizzes and self-checklists. Statistical analyses (chi-square test and t-test) were performed using the Statistical Analysis System, Version 9.13. There was a significant improvement in disease severity, quality of life and mothers' self-efficacy in the experimental group; thus, the web-based education programme was effective. The web-based education programme as an advanced intervention may be useful in providing basic data for future atopic dermatitis-related studies. Moreover, the programme may serve as a nursing educational intervention tool for clinical nursing practices. © 2014 John Wiley & Sons Ltd.

Increasing engagement with, and effectiveness of, an online CBT-based stress management intervention for employees through the use of an online facilitated bulletin board: study protocol for a pilot randomised controlled trial.

PubMed

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

2016-12-15

The evidence for the benefits of online cognitive behaviour therapy (CBT)-based programmes delivered in a clinical context is clear, but this evidence does not translate to online CBT-based stress management programmes delivered within a workplace context. One of the challenges to the delivery of online interventions is programme engagement; this challenge is even more acute for interventions delivered in real-world settings such as the workplace. The purpose of this pilot study is to explore the effect of an online facilitated discussion group on engagement, and to estimate the potential effectiveness of an online CBT-based stress management programme. This study is a three-arm randomised controlled trial (RCT) comparing a minimally guided, online, CBT-based stress management intervention delivered with and without an online facilitated bulletin board, and a wait list control group. Up to 90 employees from six UK-based organisations will be recruited to the study. Inclusion criteria will include age 18 years or over, elevated levels of stress (as measured on the PSS-10 scale), access to a computer or a tablet and the Internet. The primary outcome measure will be engagement, as defined by the number of logins to the site; secondary outcome measures will include further measures of engagement (the number of pages visited, the number of modules completed and self-report engagement) and measures of effectiveness (psychological distress and subjective wellbeing). Possible moderators will include measures of intervention quality (satisfaction, acceptability, credibility, system usability), time pressure, goal conflict, levels of distress at baseline and job autonomy. Measures will be taken at baseline, 2 weeks (credibility and expectancy measures only), 8 weeks (completion of intervention) and 16 weeks (follow-up). Primary analysis will be conducted on intention-to-treat principles. To our knowledge this is the first study to explore the effect of an online discussion group on the engagement and effectiveness of an online CBT-based stress management intervention. This study could provide a solution to the growing problem of poor employee psychological health and begin to address the challenge of increasing engagement with Internet-delivered health interventions. ClinicalTrials.gov Identifier: NCT02729987 . Registered on 18 Mar 2016.

Implementation of a school-based social and emotional learning intervention: understanding diffusion processes within complex systems.

PubMed

Evans, Rhiannon; Murphy, Simon; Scourfield, Jonathan

2015-07-01

Sporadic and inconsistent implementation remains a significant challenge for social and emotional learning (SEL) interventions. This may be partly explained by the dearth of flexible, causative models that capture the multifarious determinants of implementation practices within complex systems. This paper draws upon Rogers (2003) Diffusion of Innovations Theory to explain the adoption, implementation and discontinuance of a SEL intervention. A pragmatic, formative process evaluation was conducted in alignment with phase 1 of the UK Medical Research Council's framework for Developing and Evaluating Complex Interventions. Employing case-study methodology, qualitative data were generated with four socio-economically and academically contrasting secondary schools in Wales implementing the Student Assistance Programme. Semi-structured interviews were conducted with 15 programme stakeholders. Data suggested that variation in implementation activity could be largely attributed to four key intervention reinvention points, which contributed to the transformation of the programme as it interacted with contextual features and individual needs. These reinvention points comprise the following: intervention training, which captures the process through which adopters acquire knowledge about a programme and delivery expertise; intervention assessment, which reflects adopters' evaluation of an intervention in relation to contextual needs; intervention clarification, which comprises the cascading of knowledge through an organisation in order to secure support in delivery; and intervention responsibility, which refers to the process of assigning accountability for sustainable delivery. Taken together, these points identify opportunities to predict and intervene with potential implementation problems. Further research would benefit from exploring additional reinvention activity.

Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial

PubMed Central

Hislop, Michael D; Stokes, Keith A; Williams, Sean; McKay, Carly D; England, Mike E; Kemp, Simon P T; Trewartha, Grant

2017-01-01

Background Injury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies. Aim To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures. Methods In a cluster-randomised controlled trial, 40 independent schools (118 teams, 3188 players aged 14–18 years) were allocated to receive either the intervention or a reference programme, both of which were to be delivered by school coaches. The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting manoeuvres. Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff. Results 441 time-loss match injuries (intervention, 233; control, 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR=0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR=0.28, 0.14 to 0.51) and concussion incidence (RR=0.41, 0.17 to 0.99) were noted in the intervention group. Conclusion A preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week. PMID:28515056

Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial.

PubMed

Hislop, Michael D; Stokes, Keith A; Williams, Sean; McKay, Carly D; England, Mike E; Kemp, Simon P T; Trewartha, Grant

2017-08-01

Injury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies. To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures. In a cluster-randomised controlled trial, 40 independent schools (118 teams, 3188 players aged 14-18 years) were allocated to receive either the intervention or a reference programme, both of which were to be delivered by school coaches. The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting manoeuvres. Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff. 441 time-loss match injuries (intervention, 233; control, 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR=0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR=0.28, 0.14 to 0.51) and concussion incidence (RR=0.41, 0.17 to 0.99) were noted in the intervention group. A preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

`Discover, Understand, Implement, and Transfer': Effectiveness of an intervention programme to motivate students for science

NASA Astrophysics Data System (ADS)

Schütte, Kerstin; Köller, Olaf

2015-09-01

Considerable research has focused on how best to satisfy modern societies' needs for skilled labour in the field of science. The present study evaluated an intervention programme designed to increase secondary school students' motivation to pursue a science career. Students from 3 schools of the highest educational track participated for up to 2 years in the intervention programme, which was implemented as an elective in the school curriculum. Our longitudinal study design for evaluating the effectiveness of the intervention programme included all students at the grade levels involved in the programme with students who did not participate serving as a control group. Mixed-model analyses of variance showed none of the intended effects of the intervention programme on science motivation; latent growth models corroborated these results. When the programme began, students who enrolled in the science elective (n = 92) were already substantially more motivated than their classmates (n = 228). Offering such an intervention programme as an elective did not further increase the participating students' science motivation. It seems worthwhile to carry out intervention programmes with talented students who show (comparatively) little interest in science at the outset rather than with highly motivated students who self-select into the programme.

Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia.

PubMed

Brinkman, Sally A; Johnson, Sarah E; Codde, James P; Hart, Michael B; Straton, Judith A; Mittinty, Murthy N; Silburn, Sven R

2016-11-05

Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia. In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13-15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. This study is registered as an international randomised controlled trial, number ISRCTN24952438. 57 (86%) of 66 eligible schools were enrolled into the trial and randomly assigned 1:1 to the intervention (28 schools) or the control group (29 schools). Then, between Feb 1, 2003, and May 31, 2006, 1267 girls in the intervention schools received the VIP programme while 1567 girls in the control schools received the standard health education curriculum. Compared with girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (97 [8%] of 1267 in the intervention group vs 67 [4%] of 1567 in the control group) or at least one abortion as the first pregnancy event (113 [9%] vs 101 [6%]). After adjustment for potential confounders, the intervention group had a higher overall pregnancy risk than the control group (relative risk 1·36 [95% CI 1·10-1·67], p=0·003). Similar results were obtained with the use of proportional hazard models (hazard ratio 1·35 [95% CI 1·10-1·67], p=0·016). The infant simulator-based VIP programme did not achieve its aim of reducing teenage pregnancy. Girls in the intervention group were more likely to experience a birth or an induced abortion than those in the control group before they reached 20 years of age. Western Australian Health Promotion Foundation (Healthway), Lotteries WA, the Western Australian Department of Education and Training, and the Western Australian Department of Health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Feasibility of a school reintegration programme for children with acute lymphoblastic leukaemia.

PubMed

Annett, R D; Erickson, S J

2009-07-01

Despite children with acute lymphoblastic leukaemia missing a significant amount of school, little empirical literature guides the optimal content, setting and timing of a school reintegration programme. We examined the feasibility of a 4-month school reintegration intervention by: (1) developing collaboration with a community-based advocacy organisation; (2) developing intervention modules and observable end points; and (3) determining how the study achieved recruitment expectations. Eight families with children aged 6-12 years diagnosed with acute lymphoblastic leukaemia and parents were enrolled in the study. An experienced advocate implemented a series of eight modules over a 4-month period (twice per month) with the families. Participants completed pre-post measures. Successful collaboration with the advocacy organisation and the development of an intervention module series were achieved. Recruitment aims proved more difficult: enrolment was extended when recruitment for the original 1- to 6-month post-diagnosis window proved difficult. The advocate was able to complete between three and seven of the modules (mean = 5.2, standard deviation = 1.5). Families preferred clinic-based intervention. Challenges faced and lessons learned include: (1) advocacy organisations may be useful resources for school reintegration interventions; (2) school reintegration interventions must be flexibly applied; and (3) measurement end points constructed to gauge programme effectiveness.

Variation in community intervention programmes and consequences for children and families: the example of Sure Start Local Programmes.

PubMed

Melhuish, Edward; Belsky, Jay; Anning, Angela; Ball, Mog; Barnes, Jacqueline; Romaniuk, Helena; Leyland, Alastair

2007-06-01

An area-based initiative, Sure Start Local Programmes (SSLPs), was established by the UK government to reduce social exclusion through improving the well-being of children aged 0-3 years and their families in disadvantaged communities; a true community intervention in that all children under four and their families in specified areas served as targets of universal services. A national evaluation examined the links between variation in programme implementation and effectiveness. Data gathered from multiple sources produced measures of implementation in terms of proficiency, services and staffing. Measures of programme impact on child/parenting outcomes derived from multilevel models, controlling for child, family and area characteristics, were identified to demonstrate programme effectiveness. Some modest linkage between programme implementation (e.g., proficiency, empowerment of parents and staff, identification of users) and effectiveness for child and parenting outcomes. Overall proficiency and specific aspects of implementation may influence effectiveness, which should guide the design of other child, family and community services.

Exploring the theoretical foundations of visual art programmes for people living with dementia.

PubMed

Windle, Gill; Gregory, Samantha; Howson-Griffiths, Teri; Newman, Andrew; O'Brien, Dave; Goulding, Anna

2017-01-01

Despite the growing international innovations for visual arts interventions in dementia care, limited attention has been paid to their theoretical basis. In response, this paper explores how and why visual art interventions in dementia care influence changes in outcomes. The theory building process consists of a realist review of primary research on visual art programmes. This aims to uncover what works, for whom, how, why and in what circumstances. We undertook a qualitative exploration of stakeholder perspectives of art programmes, and then synthesised these two pieces of work alongside broader theory to produce a conceptual framework for intervention development, further research and practice. This suggests effective programmes are realised through essential attributes of two key conditions (provocative and stimulating aesthetic experience; dynamic and responsive artistic practice). These conditions are important for cognitive, social and individual responses, leading to benefits for people with early to more advanced dementia. This work represents a starting point at identifying theories of change for arts interventions, and for further research to critically examine, refine and strengthen the evidence base for the arts in dementia care. Understanding the theoretical basis of interventions is important for service development, evaluation and implementation.

The NIHR Public Health Research Programme: responding to local authority research needs in the United Kingdom.

PubMed

Dorling, Hannah; Cook, Andrew; Ollerhead, Liz; Westmore, Matt

2015-12-11

The remit of the National Institute for Health Research Public Health Research (PHR) Programme is to evaluate public health interventions, providing new knowledge on the benefits, costs, acceptability and wider impacts of interventions, set outside of the National Health Service, intended to improve the health of the public and reduce inequalities. This paper illustrates how the PHR Programme is providing new knowledge for public health decision makers, based on the nine key areas for local authority public health action, described by the King's Fund. Many funded PHR projects are evaluating interventions, applied in a range of settings, across the identified key areas for local authority influence. For example, research has been funded on children and young people, and for some of the wider determinants of health, such as housing and travel. Other factors, such as spatial planning, or open and green spaces and leisure, are less represented in the PHR Programme. Further opportunities in research include interventions to improve the health of adolescents, adults in workplaces, and communities. Building evidence for public health interventions at local authority level is important to prioritise and implement effective changes to improve population health.

A community-based multilevel intervention for smoking, physical activity and diet: short-term findings from the Community Interventions for Health programme in Hangzhou, China.

PubMed

Lv, Jun; Liu, Qing-Min; Ren, Yan-Jun; He, Ping-Ping; Wang, Sheng-Feng; Gao, Fang; Li, Li-Ming

2014-04-01

To assess the short-term impact of a comprehensive, community-based multilevel intervention on knowledge, beliefs and practices with respect to smoking, physical activity and diet in Hangzhou, China. A non-randomised, controlled, before-after quasi-experimental trial was conducted in two intervention areas and one comparison area. The intervention built on a socioecological framework and took place across four settings: neighbourhoods, schools, workplaces and community health centres. Two independent cross-sectional surveys of adults aged 18-64 years at baseline and a subsequent follow-up were conducted in 2008/2009 and 2011 in the intervention and comparison areas. A 2-year intervention programme was begun in mid-2009 and continued until mid-2011. A total of 2016 adults at baseline and 2016 adults at follow-up completed the survey. Over the 2-year intervention period, the intervention areas showed a statistically significant decline (25.2% vs 18.7%, p<0.001) in the prevalence of smoking compared with the comparison area (18.0% vs 16.4%, p=0.343). The proportion of individuals who had noticed anyone smoking in any of nine locations in the previous 30 days demonstrated a statistically significant decline in the intervention (78.9% vs 66.5%, p<0.001) and comparison (76.3% vs 66.5%, p<0.001) areas. The fruit and vegetable consumption score increased in a statistically significant manner in the intervention (24.84 vs 25.97, p=0.036) and comparison (24.25 vs 26.67, p<0.001) areas. The metabolic equivalent of physical activity increased from 1204 to 1386 (p=0.023) in the intervention areas compared with 918 to 924 in the comparison area (p=0.201). After a 2-year intervention, beneficial changes were noted in the intervention areas with respect to smoking and physical activity but not diet. A community-based multilevel intervention programme is feasible in urban China.

Mechanisms of change of a novel weight loss programme provided by a third sector organisation: a qualitative interview study.

PubMed

McMahon, Naoimh E; Visram, Shelina; Connell, Louise A

2016-05-10

There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session). Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme), alumni support (face-to-face and online) and family attendance at exercise sessions. Data were collected through interviews with programme providers (n = 2) and focus groups with participants (n = 12). Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Clients' interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. There is an urgent need to establish robust interventions that can support people who are overweight and obese to achieve a healthy weight and maintain this change. Third sector organisations may be a feasible alternative to private and public sector weight loss programmes. We have presented findings from one example of a novel community-based weight loss programme and identified how the programme components resulted in change amongst the participants. Further research is needed to robustly test the effectiveness, and cost-effectiveness, of this programme.

Health belief model based evaluation of school health education programme for injury prevention among high school students in the community context.

PubMed

Cao, Zhi-Juan; Chen, Yue; Wang, Shu-Mei

2014-01-10

Although multifaceted community-based programmes have been widely developed, there remains a paucity of evaluation of the effectiveness of multifaceted injury prevention programmes implemented in different settings in the community context. This study was to provide information for the evaluation of community-based health education programmes of injury prevention among high school students. The pre-intervention survey was conducted in November 2009. Health belief model (HBM) based health education for injury prevention started in January 2010 and stopped in the end of 2011 among high school students in the community context in Shanghai, China. A post-intervention survey was conducted six weeks after the completion of intervention. Injury-related health belief indicators were captured by a short questionnaire before and after the intervention. Health belief scores were calculated and compared using the simple sum score (SSS) method and the confirmatory factor analysis weighted score (CFAWS) method, respectively. The average reliability coefficient for the questionnaire was 0.89. The factor structure of HBM was given and the data fit HBM in the confirmatory factor analysis (CFA) very well. The result of CFA showed that Perceived Benefits of Taking Action (BEN) and Perceived Seriousness (SER) had the greatest impact on the health belief, Perceived Susceptibility (SUS) and Cues to Action (CTA) were the second and third most important components of HBM respectively. Barriers to Taking Action (BAR) had no notable impact on HBM. The standardized path coefficient was only 0.35, with only a small impact on CTA. The health belief score was significantly higher after intervention (p < 0.001), which was similar in the CFAWS method and in the SSS method. However, the 95% confidential interval in the CFAWS method was narrower than that in the SSS method. The results of CFA provide further empirical support for the HBM in injury intervention. The CFAWS method can be used to calculate the health belief scores and evaluate the injury related intervention. The community-based school health education might improve injury-related health belief among high school students; however, this preliminary observation needs to be confirmed in further research.

An extensive literature review of the evaluation of HIV prevention programmes.

PubMed

Coleman, L M; Ford, N J

1996-09-01

This paper draws out and distils three key themes that have emerged from a substantial bibliographical review of a range of HIV intervention programmes, implemented throughout the world between years 1987 and 1995. Specifically, the paper assesses (1) to what extent intervention programmes have been tailored to meet the requirements and needs of specific target groups; (2) to what extent intervention programmes are supported by social and psychological theory of attitudinal and behavioural change, and also to what extent the results and findings from the interventions have amended existing theory; and, finally, (3) the range of methodologies employed in evaluating intervention programmes and also to what extent behavioural measures have been used in examining a programme's effectiveness. In light of these themes, the paper presents and discusses the principal factors thought to contribute towards the effectiveness of HIV intervention programmes.

"If it's issues to do with nutrition…I can decide…": gendered decision-making in joining community-based child nutrition interventions within rural coastal Kenya.

PubMed

Muraya, Kelly W; Jones, Caroline; Berkley, James A; Molyneux, Sassy

2017-12-01

Gender roles and relations play an important role in child health and nutritional status. While there is increasing recognition of the need to incorporate gender analysis in health planning and programme development, there has been relatively little attention paid to the gendered nature of child nutrition interventions. This qualitative study undertaken in rural Coastal Kenya aimed to explore the interaction between household gender relations and a community-based child nutrition programme, with a focus on household decision-making dynamics related to joining the intervention. Fifteen households whose children were enrolled in the programme were followed up over a period of 12 months. Over a total of 60 household visits, group and individual in-depth interviews were conducted with a range of respondents, supplemented by non-participant observations. Data were analysed using a framework analysis approach. Engagement with the intervention was highly gendered with women being the primary decision-makers and engagers. Women were responsible for managing child feeding and minor child illnesses in households. As such, involvement in community-based nutrition interventions and particularly one that targeted a condition perceived as non-serious, fell within women's domain. Despite this, the nutrition programme of interest could be categorized as gender-blind. Gender was not explicitly considered in the design and implementation of the intervention, and the gender roles and norms in the community with regards to child nutrition were not critically examined or challenged. In fact, the intervention might have inadvertently reinforced existing gender divisions and practices in relation to child nutrition, by (unintentionally) excluding men from the nutrition discussions and activities, and thereby supporting the notion of child feeding and nutrition as "women's business". To improve outcomes, community-based nutrition interventions need to understand and take into account gendered household dynamics, and incorporate strategies that promote behaviour change and attitude shifts in relation to gendered norms and child nutrition. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Are family-oriented interventions in Portuguese genetics services a remote possibility? Professionals' views on a multifamily intervention for cancer susceptibility families.

PubMed

Mendes, Alvaro; Paneque, Milena; Sousa, Liliana

2012-10-01

This article examines genetics healthcare professionals' opinions about a multifamily psychoeducational programme for hereditary cancer susceptibility families, implemented at a Portuguese genetics service. Their views on how a family-oriented approach is envisioned to be incorporated in Portuguese genetic counselling services are also reported. Six focus groups and three individual interviews were undertaken comprising 30 professionals working in the provision of genetic counselling and genetic counsellor trainees. Participants were given a page-summary describing the intervention and asked to comment the strengths and limitations of the multifamily intervention. All interviews were fully transcribed and analysed using the constant comparison method. The qualitative analysis generated data comprising four thematic categories in relation to the professionals' views: (a) usefulness of the programme; (b) programme's methodological and practical obstacles; (c) genetics services constraints; and (d) suggestions for improving the programme and further family-oriented interventions. We reflect on the reported views examining the intervention, and on how current constraints of genetic services limit the provision of psychosocial support for cancer susceptibility families. The implications of these findings regarding the purpose of genetic counselling are discussed. Results may sensitise stakeholders and policy makers for the need to deliver family-based services in cancer genetic counselling, with adequate planning and collaborative involvement of different professionals.

The cost-effectiveness of a child nutrition education programme in Peru.

PubMed

Waters, Hugh R; Penny, Mary E; Creed-Kanashiro, Hilary M; Robert, Rebecca C; Narro, Rocío; Willis, Jeff; Caulfield, Laura E; Black, Robert E

2006-07-01

This article reports impact and cost results from a health facility-based nutrition education programme targeting children less than 2 years of age in Trujillo, Peru. Key elements of the programme included participative complementary feeding demonstrations, growth monitoring sessions and an accreditation process. Data were collected from six intervention and six control health facilities to measure utilization and costs associated with the intervention. To calculate the unit costs of services, these costs are allocated using activity-based costing. To measure the effects of the intervention, 338 children were followed through household surveys at regular intervals from birth until the age of 18 months. The intervention had a clear positive impact both on the use of nutrition-related services and on children's growth outcomes. Children in the intervention areas made 17.6 visits to health facilities in the first 18 months of life, compared with 14.1 visits for children in the control areas (P < 0.001). This pattern holds true for all socioeconomic groups. The intervention prevented 11.1 cases of stunting per 100 children. In multivariate logistic regression analysis, children in the intervention were 0.33 times as likely to be stunted as the controls (P = 0.002). The marginal cost of the intervention - including external costs, training, health education materials and extra travel and equipment - is 6.12 US dollars per child reached and 55.16 US dollars per case of stunting prevented. The estimated marginal cost of the intervention per death averted is 1952 US dollars.

Long-term effectiveness of a back education programme in elementary schoolchildren: an 8-year follow-up study.

PubMed

Dolphens, Mieke; Cagnie, Barbara; Danneels, Lieven; De Clercq, Dirk; De Bourdeaudhuij, Ilse; Cardon, Greet

2011-12-01

The purpose of this study was to investigate the long-term effectiveness of a spine care education programme conducted in 9- to 11-year-old schoolchildren. The study sample included 96 intervention subjects and 98 controls (9- to 11-year-olds at baseline). Intervention consisted of a 6-week school-based back education programme (predominantly biomechanically oriented) and was implemented by a physical therapist. Self-reported outcomes on back care knowledge, spinal care behaviour, self-efficacy towards favourable back care behaviour, prevalence of back and neck pain during the week and fear-avoidance beliefs were evaluated by the use of questionnaires. Post-tests were performed within 1 week after programme completion, after 1 year and after 8 years. Whereas the educational back care programme resulted in increased back care knowledge up to adulthood (P < 0.001), intervention did not change spinal care behaviour or self-efficacy. Pain prevalence figures increased less in the experimental group compared to the controls over the 8-year time span, yet statistical significance was not reached. Dropout analysis revealed spinal pain prevalence rates to be different in both groups throughout the study, including at baseline. Back education at young age did not reinforce fear-avoidance beliefs up to adulthood. Predominantly biomechanical oriented back education in elementary schoolchildren is effective in improving the cognitive aspect of back care up to adulthood, yet not in changing actual behaviour or self-efficacy. The current study does not provide evidence that educational back care programmes have any impact on spinal pain in adulthood. The true long-term impact of school-based spinal health interventions on clinically relevant outcome measures merits further attention.

The implementation and effectiveness of school-based nutrition promotion programmes using a health-promoting schools approach: a systematic review.

PubMed

Wang, Dongxu; Stewart, Donald

2013-06-01

To evaluate implementation and effectiveness of nutrition promotion programmes using the health-promoting schools (HPS) approach, to indicate areas where further research is needed and to make recommendations for practice in this field. The searched electronic databases included: CINAHL, Cochrane Library, Health Reference Center, Informit Search, MEDLINE, ProQuest, PsycINFO, PubMed, ScienceDirect, Scopus, Social Services Abstracts and Web of Science. Inclusion criteria were: (i) controlled or before-and-after studies evaluating a nutrition intervention and involving the HPS approach, either fully or in part; (ii) provision of information about components and delivery of the intervention; and (iii) report on all evaluated outcomes. Schools. Students, parents and school staff. All included studies described intervention delivery and six reported on process evaluation. In intervention schools school environment and ethos were more supportive, appropriate curriculum was delivered and parents and/or the community were more engaged and involved. Students participated in interventions at differing levels, but the majority was satisfied with the intervention. The evidence indicates that nutrition promotion programmes using the HPS approach can increase participants' consumption of high-fibre foods, healthier snacks, water, milk, fruit and vegetables. It can also reduce participants' 'breakfast skipping', as well as reduce intakes of red food, low-nutrient dense foods, fatty and cream foods, sweet drinks consumption and eating disorders. It can help to develop hygienic habits and improved food safety behaviours. More professional training for teachers in the HPS approach, further qualitative studies, longer intervention periods, improved follow-up evaluations and adequate funding are required for future school-based nutrition promotion programmes.

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS)

PubMed Central

Griffiths, Chris; Bremner, Stephen; Islam, Kamrul; Sohanpal, Ratna; Vidal, Debi-Lee; Dawson, Carolyn; Foster, Gillian; Ramsay, Jean; Feder, Gene; Taylor, Stephanie; Barnes, Neil; Choudhury, Aklak; Packe, Geoff; Bayliss, Elizabeth; Trathen, Duncan; Moss, Philip; Cook, Viv; Livingstone, Anna Eleri; Eldridge, Sandra

2016-01-01

Background People with asthma from ethnic minority groups experience significant morbidity. Culturally-specific interventions to reduce asthma morbidity are rare. We tested the hypothesis that a culturally-specific education programme, adapted from promising theory-based interventions developed in the USA, would reduce unscheduled care for South Asians with asthma in the UK. Methods A cluster randomised controlled trial, set in two east London boroughs. 105 of 107 eligible general practices were randomised to usual care or the education programme. Participants were south Asians with asthma aged 3 years and older with recent unscheduled care. The programme had two components: the Physician Asthma Care Education (PACE) programme and the Chronic Disease Self Management Programme (CDSMP), targeted at clinicians and patients with asthma respectively. Both were culturally adapted for south Asians with asthma. Specialist nurses, and primary care teams from intervention practices were trained using the PACE programme. South Asian participants attended an outpatient appointment; those registered with intervention practices received self-management training from PACE-trained specialist nurses, a follow-up appointment with PACE-trained primary care practices, and an invitation to attend the CDSMP. Patients from control practices received usual care. Primary outcome was unscheduled care. Findings 375 south Asians with asthma from 84 general practices took part, 183 registered with intervention practices and 192 with control practices. Primary outcome data were available for 358/375 (95.5%) of participants. The intervention had no effect on time to first unscheduled attendance for asthma (Adjusted Hazard Ratio AHR = 1.19 95% CI 0.92 to 1.53). Time to first review in primary care was reduced (AHR = 2.22, (1.67 to 2.95). Asthma-related quality of life and self-efficacy were improved at 3 months (adjusted mean difference -2.56, (-3.89 to -1.24); 0.44, (0.05 to 0.82) respectively. Conclusions A multi-component education programme adapted for south Asians with asthma did not reduce unscheduled care but did improve follow-up in primary care, self-efficacy and quality of life. More effective interventions are needed for south Asians with asthma. PMID:28030569

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review

PubMed Central

de Colombani, Pierpaolo

2015-01-01

Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public health Best practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the frequent branding of interventions as best practices or good practices, there is no consensus on the definition and desirable characteristics of such best practices. Hence, this is likely to be the first systematic review on the topic of best practices in public health. Having a single widely accepted framework for selecting best practices will ensure that the selection processes by different agencies are fair and comparable, as well as enable public health workers to better appreciate and adopt best practices in different settings. Ultimately, standardisation will improve the credibility and usefulness of practice-based evidence to that of research-based evidence. PMID:26753159

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review.

PubMed

Ng, Eileen; de Colombani, Pierpaolo

2015-11-17

Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public healthBest practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the frequent branding of interventions as best practices or good practices, there is no consensus on the definition and desirable characteristics of such best practices. Hence, this is likely to be the first systematic review on the topic of best practices in public health. Having a single widely accepted framework for selecting best practices will ensure that the selection processes by different agencies are fair and comparable, as well as enable public health workers to better appreciate and adopt best practices in different settings. Ultimately, standardisation will improve the credibility and usefulness of practice-based evidence to that of research-based evidence.

Effect of a hospital outreach intervention programme on decreasing hospitalisations and medical costs in patients with chronic obstructive pulmonary disease in China: protocol of a randomised controlled trial.

PubMed

Yan, Jin; Wang, Lianhong; Liu, Chun; Yuan, Hong; Wang, Xiaowan; Yu, Baorong; Luo, Qian

2016-06-15

Patients with chronic obstructive pulmonary disease (COPD) often have multiple hospitalisations because of exacerbation. Evidence shows disease management programmes are one of the most cost-effective measures to prevent re-hospitalisation for COPD exacerbation, but lack implementation and economic appraisal in China. The aims of the proposed study are to determine whether a hospital outreach invention programme for disease management can decrease hospitalisations and medical costs in patients with COPD in China. Economic appraisal of the programme will also be carried out. A randomised single-blinded controlled trial will be conducted. 220 COPD patients with exacerbations will be recruited from the Third Xiangya Hospital, Central South University, China. After hospital discharge they will be randomly allocated into an intervention or a control group. Participants in the intervention group will attend a 3-month hospital-based pulmonary rehabilitation intervention and then receive a home-based programme. Both groups will receive identical usual discharge care before discharge from hospital. The primary outcomes will include rate of hospitalisation and medical cost, while secondary outcomes will include mortality, self-efficacy, self-management, health status, quality of life, exercise tolerance and pulmonary function, which will be evaluated at baseline and at 3, 12 and 24 months after the intervention. Cost-effectiveness analysis will be employed for economic appraisal. The study has been approved by the institutional review board (IRB) of the Third Xiangya Hospital, Central South University (IRB2014-S159). Findings will be shared widely through conference presentations and peer-reviewed publications. Furthermore, the results of the programme will be submitted to health authorities and policy reform will be recommended. Chi CTR-TRC-14005108; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Educational interventions to enhance competencies for interprofessional collaboration among nurse and physician managers: An integrative review.

PubMed

Clausen, Christina; Cummins, Kelly; Dionne, Kelley

2017-11-01

Collaborative leadership and management structures are critical to transforming care delivery. Both nurse and physician managers are uniquely positioned to co-lead. However, little is known on how to prepare and support individuals for these co-leader arrangements. The re-design of healthcare professional education focuses on interprofessional collaboration, mutual learning, and a competency-based approach. While competencies for interprofessional collaboration have been delineated, competencies for collaborative management practice have yet to be addressed. An integrative review of empirical studies on existing educational interventions was conducted to critically appraise and synthesise the results regarding collaborative competence among nurse and physician leaders. We reviewed how these interventions have been designed, implemented, and evaluated within workplace settings in order to inform our understanding of what components are effective or ineffective for the future development of an educational programme. This review reports on key characteristics of nine empirical studies and emphasises that: a uniprofessional approach to leadership development is predominant within educational programmes and that the assessment of shared learning experiences are not addressed; there are inconsistency in terms used to describe competencies by individual researchers and limitations within the competency frameworks used in the studies reviewed; and there is a lack of suitable instruments available to assess whether competencies have been achieved through the educational programmes. None of the studies discussed the process of how individuals learned specific competencies or whether learning outcome were achieved. Educational programmes were developed based on a perceived lack of leadership preparation and orientation programmes for leaders in formal management positions and used multiple interventions. Only two of the programmes involved organisational or systems level competencies. Interprofessional co-leading requires enhanced capabilities and capacity for managers. There is a need for developing an in-action education intervention that addresses the unique learning needs of co-leader arrangements particularly among nurses and physicians who are new to their role.

Effect of a hospital outreach intervention programme on decreasing hospitalisations and medical costs in patients with chronic obstructive pulmonary disease in China: protocol of a randomised controlled trial

PubMed Central

Yan, Jin; Wang, Lianhong; Liu, Chun; Yuan, Hong; Wang, Xiaowan; Yu, Baorong; Luo, Qian

2016-01-01

Introduction Patients with chronic obstructive pulmonary disease (COPD) often have multiple hospitalisations because of exacerbation. Evidence shows disease management programmes are one of the most cost-effective measures to prevent re-hospitalisation for COPD exacerbation, but lack implementation and economic appraisal in China. The aims of the proposed study are to determine whether a hospital outreach invention programme for disease management can decrease hospitalisations and medical costs in patients with COPD in China. Economic appraisal of the programme will also be carried out. Methods and analysis A randomised single-blinded controlled trial will be conducted. 220 COPD patients with exacerbations will be recruited from the Third Xiangya Hospital, Central South University, China. After hospital discharge they will be randomly allocated into an intervention or a control group. Participants in the intervention group will attend a 3-month hospital-based pulmonary rehabilitation intervention and then receive a home-based programme. Both groups will receive identical usual discharge care before discharge from hospital. The primary outcomes will include rate of hospitalisation and medical cost, while secondary outcomes will include mortality, self-efficacy, self-management, health status, quality of life, exercise tolerance and pulmonary function, which will be evaluated at baseline and at 3, 12 and 24 months after the intervention. Cost-effectiveness analysis will be employed for economic appraisal. Ethics and dissemination The study has been approved by the institutional review board (IRB) of the Third Xiangya Hospital, Central South University (IRB2014-S159). Findings will be shared widely through conference presentations and peer-reviewed publications. Furthermore, the results of the programme will be submitted to health authorities and policy reform will be recommended. Trial registration number Chi CTR-TRC-14005108; Pre-results. PMID:27311900

School-based secondary prevention programmes for preventing violence.

PubMed

Mytton, J; DiGuiseppi, C; Gough, D; Taylor, R; Logan, S

2006-07-19

Early aggressive behaviour is a risk factor for later violence and criminal behaviour. Despite over 20 years of violence prevention interventions being delivered in the school setting, questions remain regarding the effectiveness of different interventions for children exhibiting aggressive behaviour. To examine the effect of school based violence prevention programmes for children identified as aggressive or at risk of being aggressive. We searched CENTRAL, Cochrane Injuries Group specialised register, MEDLINE, EMBASE, other specialised databases and reference lists of articles. We also contacted authors and organisations to identify any further studies. We included trials meeting the following criteria; 1) participants were randomly assigned to intervention and control groups; 2) outcome data were collected concurrently; 3) participants comprised children in mandatory education identified as exhibiting, or at risk of, aggressive behaviour; 4) interventions designed to reduce aggression, violence, bullying, conflict or anger; 5) school based interventions; 6) outcomes included aggressive behaviour, school and agency responses to acts of aggression, or violent injuries. Data were collected on design, participants, interventions, outcomes and indicators of study quality. Results of any intervention to no intervention were compared immediately post-intervention and at 12 months using meta-analysis where appropriate. Of 56 trials identified, none reported data on violent injuries. Aggressive behaviour was significantly reduced in intervention groups compared to no intervention groups immediately post intervention in 34 trials with data, (Standardised Mean Difference (SMD) = -0.41; 95% confidence interval (CI) -0.56 to -0.26). This effect was maintained in the seven studies reporting 12 month follow-up (SMD = -0.40, (95% CI -0.73 to -0.06)). School or agency disciplinary actions in response to aggressive behaviour were reduced in intervention groups for nine trials with data, SMD = -0.48; 95% CI -1.16 to 0.19, although this difference may have been due to chance and was not maintained, based on two studies reporting follow-up to two to four months (SMD = 0.03; 95% CI -0.42 to 0.47). Subgroup analyses suggested that interventions designed to improve relationship or social skills may be more effective than interventions designed to teach skills of non-response to provocative situations, but that benefits were similar when delivered to children in primary versus secondary school, and to groups of mixed sex versus boys alone. School-based secondary prevention programmes to reduce aggressive behaviour appear to produce improvements in behaviour greater than would have been expected by chance. Benefits can be achieved in both primary and secondary school age groups and in both mixed sex groups and boys-only groups. Further research is required to establish whether such programmes reduce the incidence of violent injuries or if the benefits identified can be maintained beyond 12 months.

A pilot study to evaluate the efficacy of adding a structured home visiting intervention to improve outcomes for high-risk families attending the Incredible Years Parent Programme: study protocol for a randomised controlled trial.

PubMed

Lees, Dianne G; Fergusson, David M; Frampton, Christopher M; Merry, Sally N

2014-02-25

Antisocial behaviour and adult criminality often have their origins in childhood and are best addressed early in the child's life using evidence-based treatments such as the 'Incredible Years Parent Programme'. However, families with additional risk factors who are at highest risk for poor outcomes do not always make sufficient change while attending such programmes. Additional support to address barriers and improve implementation of positive parenting strategies while these families attend the Incredible Years Programme may improve overall outcomes.The study aims to evaluate the efficacy of adding a structured home visiting intervention (Home Parent Support) to improve outcomes in families most at risk of poor treatment response from the Incredible Years intervention. This study will inform the design of a larger prospective randomised controlled trial. A pilot single-blind, parallel, superiority, randomised controlled trial. Randomisation will be undertaken using a computer-generated sequence in a 1:1 ratio to the two treatments arranged in permuted blocks with stratification by age, sex, and ethnicity. One hundred and twenty six participants enrolled in the Incredible Years Parent Programme who meet the high-risk criteria will be randomly allocated to receive either Incredible Years Parent Programme and Home Parent Support, or the Incredible Years Parent Programme alone. The Home Parent Support is a 10-session structured home visiting intervention provided by a trained therapist, alongside the usual Incredible Years Parent Programme, to enhance the adoption of key parenting skills. The primary outcome is the change in child behaviour from baseline to post-intervention in parent reported Eyberg Child Behavior Inventory Problem Scale. This is the first formal evaluation of adding Home Parent Support alongside Incredible Years Parent Programme for families with risk factors who typically have poorer treatment outcomes. We anticipate that the intervention will help vulnerable families stay engaged, strengthen the adoption of effective parenting strategies, and improve outcomes for both the children and families. Australian New Zealand Clinical Trials Registry ACTRN12612000878875.

Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial.

PubMed

Emmerson, Kellie B; Harding, Katherine E; Taylor, Nicholas F

2017-08-01

To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. A community rehabilitation programme within a large metropolitan health service. Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. A total of 62 participants were allocated to the intervention ( n = 30) and control groups ( n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI -12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI -0.1 to 0.1). There were no between-group differences in how participants found instructions ( p = 0.452), whether they remembered to do their exercises ( p = 0.485), or whether they enjoyed doing their exercises ( p = 0.864). The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx.

Home-based smoking prevention program Smoke-free Kids on smoking-related cognitions: Secondary outcomes from a cluster randomized controlled trial.

PubMed

Hiemstra, Marieke; Engels, Rutger C M E; van Schayck, Onno C P; Otten, Roy

2016-01-01

The home-based smoking prevention programme 'Smoke-free Kids' did not have an effect on primary outcome smoking initiation. A possible explanation may be that the programme has a delayed effect. The aim of this study was to evaluate the effects on the development of important precursors of smoking: smoking-related cognitions. We used a cluster randomised controlled trial in 9- to 11-year-old children and their mothers. The intervention condition received five activity modules, including a communication sheet for mothers, by mail at four-week intervals. The control condition received a fact-based programme. Secondary outcomes were attitudes, self-efficacy and social norms. Latent growth curves analyses were used to calculate the development of cognitions over time. Subsequently, path modelling was used to estimate the programme effects on the initial level and growth of each cognition. Analyses were performed on 1398 never-smoking children at baseline. Results showed that for children in the intervention condition, perceived maternal norms increased less strongly as compared to the control condition (β = -.10, p = .03). No effects were found for the other cognitions. Based on the limited effects, we do not assume that the programme will have a delayed effect on smoking behaviour later during adolescence.

THAO-CHILD HEALTH PROGRAMME: COMMUNITY BASED INTERVENTION FOR HEALTHY LIFESTYLES PROMOTION TO CHILDREN AND FAMILIES: RESULTS OF A COHORT STUDY.

PubMed

Gómez Santos, Santiago Felipe; Estévez Santiago, Rocío; Palacios Gil-Antuñano, Nieves; Leis Trabazo, Maria Rosaura; Tojo Sierra, Rafael; Cuadrado Vives, Carmen; Beltrán de Miguel, Beatriz; Ávila Torres, José Manuel; Varela Moreiras, Gregorio; Casas Esteve, Rafael

2015-12-01

childhood obesity is one of the main public health concerns. The multifactorial and multilevel causes require complex interventions such the community based interventions (CBI). Thao-Child Health Programme is a CBI implemented in Spain since 2007. show the Thao methodology and the latest cross-sectional and longitudinal results. longitudinal cohort study (4 years of follow- up) and cross sectional study. the longitudinal study found an increase of 1% in the overweight prevalence after a follow-up of 4 years of Thao-Programme implementation in 10 municipalities with 6 697 children involved. The cross-sectional study carried out with 20 636 children from 22 municipalities found a childhood overweight prevalence of 26.6%. currently a brake in the increase of childhood overweight prevalence is considered a success due to the high prevalence worldwide. More studies well methodologically performed are needed to know the efficacy of the CBI's in this field. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

The Effects of Cluster-Based Mentoring Programme on Classroom Teaching Practices: Lessons from Pakistan

ERIC Educational Resources Information Center

Rizvi, Meher; Nagy, Philip

2016-01-01

This paper presents and evaluates a teacher training approach called the cluster-based mentoring programme (CBMP) for the professional development of government primary school teachers in Pakistan. The study sought to find differences in the teaching practices between districts where the CBMP was used (intervention) and control districts where it…

Cultural Adaptations of the "Strengthening Families Programme 10-14" in the US Pacific Northwest: A Qualitative Evaluation

ERIC Educational Resources Information Center

Roulette, Jennifer W; Hill, Laura G; Diversi, Marcelo; Overath, Renee

2017-01-01

Objective: Most reports of adaptations to evidence-based prevention programmes for delivery to specific cultural groups describe formal adaptation procedures. In this paper, we report on how practitioners identify and manage issues of perceived cultural mismatch when delivering a scripted, evidence-based intervention. Design: We used grounded…

The effect of a healthy lifestyle programme on 8-9 year olds from social disadvantage.

PubMed

Breslin, Gavin; Brennan, Deirdre; Rafferty, Ruth; Gallagher, Alison M; Hanna, Donncha

2012-07-01

This study assessed the efficacy of a school-based healthy lifestyle intervention (Sport for LIFE) for increasing physical activity, decreasing sedentary behaviour, reducing screen time behaviour, encouraging healthy attitudes and behaviour to nutrition, and reducing body mass index (BMI) in 8-9-year-old primary school children from lower socioeconomic backgrounds in Northern Ireland. A non-randomised controlled trial of 416 children from 24 schools took part. Schools were randomly assigned to one of two groups, an intervention or control group with 12 schools in each group. The intervention group received a 12-week school-based programme based on social cognitive theory. At baseline and follow-up, groups completed questionnaires assessing physical activity, screen time behaviour and dietary patterns. On each occasion anthropometric assessments of height and weight were taken. Physical activity and sedentary behaviour were measured by accelerometry. Significant effects were observed for vigorous, moderate and light activity for the intervention group at follow-up. Sedentary behaviour was significantly reduced for the intervention group but not for the control group. No significant effects of the intervention on BMI, screen time behaviour or attitudes to nutrition, with the exception of non-core foods, were shown. The programme was effective in increasing physical activity and reducing sedentary behaviour, however no significant changes in screen time behaviour and attitude to nutrition, with the exception of non-core foods, were observed. Future research ideas are offered for tackling low levels of physical activity in children.

Community-based interventions to promote increased physical activity: a primer.

PubMed

Bopp, Melissa; Fallon, Elizabeth

2008-01-01

Current recommendations, based on an abundance of empirical data documenting the impact of physical activity (PA) on preventing morbidity and mortality associated with common chronic diseases, indicate that adults should accumulate 30 minutes of moderate-intensity PA > or =5 days per week. However, worldwide rates of PA remain low, indicating a great need for large-scale implementation of evidence-based PA interventions. We briefly present practical aspects of intervention planning, implementation and evaluation within common community settings. The first stage of intervention planning is formative research, which allows for a better understanding of the elements needed for a successful intervention. Partnering with community settings (schools, worksites, faith-based organizations and healthcare organizations) offers many benefits and the opportunity to reach specific populations. Setting-based approaches allow for multilevel strategies, ranging from individual-based programmes and educational initiatives to physical and social environmental changes. Various settings such as healthcare, worksite, and school- and community-based settings are discussed. Intervention delivery methods and strategies can range, depending on the population and setting targeted, from small-group approaches to mediated methods (e.g. print, telephone, electronic). The final phase of intervention planning and implementation is evaluation. Several objective and subjective methods of PA assessment are available to determine the effectiveness of the intervention. We have highlighted the need for process evaluation of intervention implementation to provide valuable information for the dissemination and sustainability of successful interventions. Although there are numerous considerations for the design, implementation, assessment and evaluation of PA interventions, the potential for positive impact on the overall health of the public indicates the necessity for programmes designed to increase PA.

Starting Strong: Feasibility of an Indicated Prevention Programme during the Transition to Kindergarten

ERIC Educational Resources Information Center

Eisenhower, Abbey; Baker, Bruce L.; Taylor, Heather

2016-01-01

School-based mental health services are a promising context for evidence-based interventions to promote early socio-emotional development, yet implementation presents significant challenges. This paper describes the rationale, content and format of a school-based intervention, Starting Strong in Kindergarten (Starting Strong). Starting Strong is a…

Oral language skills intervention in pre-school-a cautionary tale.

PubMed

Haley, Allyson; Hulme, Charles; Bowyer-Crane, Claudine; Snowling, Margaret J; Fricke, Silke

2017-01-01

While practitioners are increasingly asked to be mindful of the evidence base of intervention programmes, evidence from rigorous trials for the effectiveness of interventions that promote oral language abilities in the early years is sparse. To evaluate the effectiveness of a language intervention programme for children identified as having poor oral language skills in preschool classes. A randomized controlled trial was carried out in 13 UK nursery schools. In each nursery, eight children (N = 104, mean age = 3 years 11 months) with the poorest performance on standardized language measures were selected to take part. All but one child were randomly allocated to either an intervention (N = 52) or a waiting control group (N = 51). The intervention group received a 15-week oral language programme in addition to their standard nursery curriculum. The programme was delivered by trained teaching assistants and aimed to foster vocabulary knowledge, narrative and listening skills. Initial results revealed significant differences between the intervention and control group on measures of taught vocabulary. No group differences were found on any standardized language measure; however, there were gains of moderate effect size in listening comprehension. The study suggests that an intervention, of moderate duration and intensity, for small groups of preschool children successfully builds vocabulary knowledge, but does not generalize to non-taught areas of language. The findings strike a note of caution about implementing language interventions of moderate duration in preschool settings. The findings also highlight the importance of including a control group in intervention studies. © 2016 Royal College of Speech and Language Therapists.

Impact of education on interdental cleaning behaviour based on the transtheoretical model.

PubMed

Hashemian, Masomeh; Fallahi, Arezoo; Tavakoli, Golaleh; Zarezadeh, Yadolah; Babaki, B Nemat; Rahaei, Zohreh

2012-01-01

To determine the impact of education on stages of change of behaviour in Iranian senior high school students for interdental cleaning based on the transtheoretical model. This experimental study took place from April to November 2010. 306 students were selected by multistage cluster sampling and placed into two groups: control (153 students) and intervention (153 students). Appropriate instruments and the intervention programme were designed with the purpose of improving stages of interdental cleaning behaviour, perceived benefits and self-efficacy, as well as reducing perceived barriers and gingival index (GI). The impact of the intervention programme was assessed after 24 weeks and the GI of each student was recorded for both groups before and after intervention. The data were analysed using SPSS software and the chi-square, t test, ANOVA, paired t test, Mann-Whitney U-test and sign test. The intervention had a significant, positive impact on improvement of the stages of interdental cleaning behaviour, increase in self-efficacy, perceived benefits, decrease in perceived barriers and improvement of GI (P < 0.001). After the intervention, the average grades of self-efficacy, perceived barriers and perceived benefits in the control group vs the intervention group were significantly different (P < 0.001 to 0.01). The programme was found to positively influence the stages of change and potential indicators of interdental cleaning behaviour and GI. It is suggested that this model be used for interventions in the other population groups.

Community-Based Early Intervention for Children with Behavioural, Emotional and Social Problems: Evaluation of the Scallywags Scheme

ERIC Educational Resources Information Center

Lovering, Kathryn; Frampton, Ian; Crowe, Ben; Moseley, Alice; Broadhead, Moira

2006-01-01

Scallywags is a community-based, early intervention programme for young children (aged 3-7) with behavioural, emotional and social problems, which integrates work in the home and school with a parenting curriculum and direct work with children. A pre-post intervention study across multi-sites of 340 participants is reported. Using standardised…

Can a Targeted, Group-Based CBT Intervention Reduce Depression and Anxiety and Improve Self-Concept in Primary-Age Children?

ERIC Educational Resources Information Center

O'Callaghan, Paul; Cunningham, Enda

2015-01-01

This pilot study examined the impact of a 10 session, group-based, early-intervention cognitive behavioural therapy (CBT) programme (Cool Connections) on anxiety, depression and self-concept in nine 8-11 year old pupils in Northern Ireland. The intervention was facilitated by a teacher, education welfare officer and two classroom assistants, with…

Application of eco-friendly tools and eco-bio-social strategies to control dengue vectors in urban and peri-urban settings in Thailand

PubMed Central

Kittayapong, Pattamaporn; Thongyuan, Suporn; Olanratmanee, Phanthip; Aumchareoun, Worawit; Koyadun, Surachart; Kittayapong, Rungrith; Butraporn, Piyarat

2012-01-01

Background Dengue is considered one of the most important vector-borne diseases in Thailand. Its incidence is increasing despite routine implementation of national dengue control programmes. This study, conducted during 2010, aimed to demonstrate an application of integrated, community-based, eco-bio-social strategies in combination with locally-produced eco-friendly vector control tools in the dengue control programme, emphasizing urban and peri-urban settings in eastern Thailand. Methodology Three different community settings were selected and were randomly assigned to intervention and control clusters. Key community leaders and relevant governmental authorities were approached to participate in this intervention programme. Ecohealth volunteers were identified and trained in each study community. They were selected among active community health volunteers and were trained by public health experts to conduct vector control activities in their own communities using environmental management in combination with eco-friendly vector control tools. These trained ecohealth volunteers carried out outreach health education and vector control during household visits. Management of public spaces and public properties, especially solid waste management, was efficiently carried out by local municipalities. Significant reduction in the pupae per person index in the intervention clusters when compared to the control ones was used as a proxy to determine the impact of this programme. Results Our community-based dengue vector control programme demonstrated a significant reduction in the pupae per person index during entomological surveys which were conducted at two-month intervals from May 2010 for the total of six months in the intervention and control clusters. The programme also raised awareness in applying eco-friendly vector control approaches and increased intersectoral and household participation in dengue control activities. Conclusion An eco-friendly dengue vector control programme was successfully implemented in urban and peri-urban settings in Thailand, through intersectoral collaboration and practical action at household level, with a significant reduction in vector densities. PMID:23318236

Application of eco-friendly tools and eco-bio-social strategies to control dengue vectors in urban and peri-urban settings in Thailand.

PubMed

Kittayapong, Pattamaporn; Thongyuan, Suporn; Olanratmanee, Phanthip; Aumchareoun, Worawit; Koyadun, Surachart; Kittayapong, Rungrith; Butraporn, Piyarat

2012-12-01

Dengue is considered one of the most important vector-borne diseases in Thailand. Its incidence is increasing despite routine implementation of national dengue control programmes. This study, conducted during 2010, aimed to demonstrate an application of integrated, community-based, eco-bio-social strategies in combination with locally-produced eco-friendly vector control tools in the dengue control programme, emphasizing urban and peri-urban settings in eastern Thailand. Three different community settings were selected and were randomly assigned to intervention and control clusters. Key community leaders and relevant governmental authorities were approached to participate in this intervention programme. Ecohealth volunteers were identified and trained in each study community. They were selected among active community health volunteers and were trained by public health experts to conduct vector control activities in their own communities using environmental management in combination with eco-friendly vector control tools. These trained ecohealth volunteers carried out outreach health education and vector control during household visits. Management of public spaces and public properties, especially solid waste management, was efficiently carried out by local municipalities. Significant reduction in the pupae per person index in the intervention clusters when compared to the control ones was used as a proxy to determine the impact of this programme. Our community-based dengue vector control programme demonstrated a significant reduction in the pupae per person index during entomological surveys which were conducted at two-month intervals from May 2010 for the total of six months in the intervention and control clusters. The programme also raised awareness in applying eco-friendly vector control approaches and increased intersectoral and household participation in dengue control activities. An eco-friendly dengue vector control programme was successfully implemented in urban and peri-urban settings in Thailand, through intersectoral collaboration and practical action at household level, with a significant reduction in vector densities.

Trauma rehabilitation for war-affected persons in northern Uganda: a pilot evaluation of the EMPOWER programme.

PubMed

Sonderegger, Robi; Rombouts, Sacha; Ocen, Benson; McKeever, Reyelle Sarah

2011-09-01

OBJECTIVES. This study evaluated the impact of a culturally sensitive cognitive behaviour therapy (CBT)-based intervention (the EMPOWER programme) for war-affected persons in northern Uganda. DESIGN. The study conducted a pilot evaluation with a convenience sample of participants from internally displaced persons (IDPs) camps (i.e., a treatment camp and waitlist control camp). This was done to avoid treatment effects spreading from the intervention to control conditions. METHODS. A total of 202 participants (N= 90 treatment participants and N= 112 control participants) were included as a convenience sample. The Acholi Psychosocial Assessment Instrument (APAI), a culturally appropriate measure of psychosocial functioning, was administered to participants residing in two IDP camps at pre-treatment, post-treatment, and at 3-month follow-up. Participants in the treatment camp received the EMPOWER programme--a culturally sensitive CBT-based intervention teaching emotional resiliency and promoting forgiveness. RESULTS. Participants in the treatment condition reported (a) significantly lower scores on the depression-like syndromes and the anxiety-like syndrome and (b) significantly more prosocial behaviours, than participants in the control condition. CONCLUSIONS. The results of this study provide initial support for the application of structured CBT interventions in war-affected areas, illustrating that the EMPOWER programme could be utilized by humanitarian agencies to address the psychosocial needs of war-affected displaced persons. ©2010 The British Psychological Society.

Evaluation of Talking Parents, Healthy Teens, a new worksite based parenting programme to promote parent-adolescent communication about sexual health: randomised controlled trial

PubMed Central

Corona, Rosalie; Elliott, Marc N; Kanouse, David E; Eastman, Karen L; Zhou, Annie J; Klein, David J

2008-01-01

Objective To evaluate a worksite based parenting programme—Talking Parents, Healthy Teens—designed to help parents learn to address sexual health with their adolescent children. Design Randomised controlled trial (April 2002-December 2005). Setting 13 worksites in southern California. Participants 569 parents completed baseline surveys at work, gave permission for confidential surveys to be posted to their adolescent children, and were randomised to intervention or control groups. Parents and adolescents completed follow-up surveys at one week, three months, and nine months after the programme. Intervention Talking Parents, Healthy Teens consists of eight weekly one hour sessions at worksites for parents of adolescent children in 6th-10th grade (about ages 11-16 years). Main outcome measures Parent-adolescent communication about a list of sexual topics; whether parent taught adolescent how to use a condom; ability to communicate with parent/adolescent about sex; openness of parent-adolescent communication about sex. Results Differences between intervention and control groups were significant for the mean number of new sexual topics that parents and adolescents reported discussing between baseline and each follow-up (P<0.001 for each); intervention parents were less likely than controls to discuss no new topics (8% v 29%, 95% confidence interval for difference 16% to 24%) and more likely to discuss seven or more new topics (38% v 8%, 19% to 41%) at nine months. Some differences increased after completion of the programme: at one week after the programme, 18% of adolescents in the intervention group and 3% in the control group (6% to 30%) said that their parents had reviewed how to use a condom since baseline (P<0.001); this grew to 29% v 5% (13% to 36%) at nine months (P<0.001). Compared with controls at nine months, parents and adolescents in the intervention group reported greater ability to communicate with each other about sex (P<0.001) and more openness in communication about sex (P<0.001). Conclusions A worksite based programme can have substantial effects on communication between parents and adolescents about sexual health. Trial registration Clinical Trials NCT00465010. PMID:18617492

The application of Intervention Mapping in developing and implementing school-based sexuality and HIV/AIDS education in a developing country context: the case of Tanzania.

PubMed

Mkumbo, Kitila; Schaalma, Herman; Kaaya, Sylvia; Leerlooijer, Joanne; Mbwambo, Jessie; Kilonzo, Gad

2009-06-01

Effective sexuality and HIV/AIDS education programmes are needed to protect young people against HIV/AIDS and teenage pregnancy in Tanzania and other Sub-Saharan African countries. Using a theory- and evidence-based approach and adapting the programmes to local contexts, increases the effectiveness of these programmes. This paper describes and discusses the challenges and opportunities concerning the application of Intervention Mapping (IM) in the development and implementation of a sexuality and HIV/AIDS education programme targeting young people aged 12-14 in Tanzania. The sexuality and HIV/AIDS programme was designed in a participatory manner, involving researchers, curriculum developers and teachers' and students' panels. The programme comprised five lessons, organized around 23 sessions with the aim of delaying the onset of sexual intercourse and increase correct and consistent condom use among young people. The programme was delivered by trained teachers as an extracurricular lesson. The IM protocol facilitated the development of a comprehensive sexuality and HIV/AIDS education programme relevant and appropriate to the social cultural context and the needs of learners in Tanzania. The paper has demonstrated that, although the IM was developed in the Western context, it can be used in a flexible manner to adapt to local contexts such as those in Sub-Saharan Africa.

School Area Road Safety Assessment and Improvements (SARSAI) programme reduces road traffic injuries among children in Tanzania.

PubMed

Poswayo, Ayikai; Kalolo, Simon; Rabonovitz, Katheryn; Witte, Jeffrey; Guerrero, Alejandro

2018-05-19

To determine the impact of a paediatric road traffic injury (RTI) prevention programme in urban Sub-Saharan Africa. Dares Salaam, Republic of Tanzania. Household surveys were conducted in catchment areas around 18 primary schools in Dar es Salaam, Republic of Tanzania; the catchment areas were divided into control and intervention groups. Collected data included basic demographic information on all school-aged household members and whether or not they had been involved in an RTI in the previous 12 months, and, if so, what the characteristics of that RTI were. Based on these findings, a separate road safety engineering site analysis and consultation with the communities and other stakeholders, an injury-prevention programme was developed and implemented, consisting of infrastructure enhancements and a site-specific educational programme. The programme was initially implemented at the intervention schools. After 1 year, data were collected in the same manner. The control group received the same intervention after follow-up data were collected. Data were collected on 12 957 school-aged children in the baseline period and 13 555 school-aged children in the post-intervention period, in both the control and intervention communities. There was a statistically significant reduction in RTIs in the intervention group and a non-significant increase in RTI in the control group. The greatest reduction was in motorcycle-pedestrian RTI, private vehicle-pedestrian RTI and morning RTI. The programme demonstrated a significant reduction in paediatric RTI after its implementation, in very specific ways. This study demonstrates that for a reasonable investment, scientifically driven injury-prevention programmes are feasible in resource-limited settings with high paediatric RTI rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exercise intervention and cardiovascular risk factors in obese children. Comparison between obese youngsters taking part in a physical activity school-based programme with and without individualised diet counselling: the ACORDA project.

PubMed

Aires, Luísa; Silva, Gustavo; Martins, Clarice; Marques, Elisa; Lagoa, Maria João; Ribeiro, José Carlos; Rêgo, Carla; Nascimento, Henrique; Pereira, Petronila Rocha; Santos-Silva, Alice; Belo, Luís; Mota, Jorge

2016-05-01

To determine the effects of a school-based exercise intervention programme on cardiovascular risk factors, including body fat (BF), metabolic profile and physical activity (PA) in children with and without individualised dietary counselling approach (IDC and WIDC). Forty-six overweight children from 6-16 years old (25 girls, 54.3%; age = 10.3 ± 2.8) of six schools took part in an 8-month interdisciplinary, school-based intervention programme. All children were engaged in PA classes, but only one group was exposed to individualised counselling. Blood pressure (BP), lipids and lipoproteins, accelerometer-based PA, percentage of body fat (%BF) and trunk fat (%TF) measures were taken before and after intervention. General Linear Model (Repeated Measures ANOVA) adjusted for age, maturation and height change was used to analyse the longitudinal effect of individualised counselling between two evaluations in each group. Favourable changes were observed for %BF, %TF, systolic BP and total cholesterol in the IDC group. Subjects WIDC only increased light and moderate-vigorous PA. In IDC, significant effects for time * group interactions were found for systolic BP, total cholesterol and LDL-cholesterol, indicating that counselling might add favourable changes in these markers, beyond those explained by PA and growth. School-based interventions can contribute to counteracting obesity in youth, particularly when individualised dietary counselling is provided. Therefore, the link between schools and professional counselling should be strengthened to ensure consolidated changes towards healthy behaviours.

An evidence-based shared decision making programme on the prevention of myocardial infarction in type 2 diabetes: protocol of a randomised-controlled trial.

PubMed

Buhse, Susanne; Heller, Tabitha; Kasper, Jürgen; Mühlhauser, Ingrid; Müller, Ulrich Alfons; Lehmann, Thomas; Lenz, Matthias

2013-10-19

Lack of patient involvement in decision making has been suggested as one reason for limited treatment success. Concepts such as shared decision making may contribute to high quality healthcare by supporting patients to make informed decisions together with their physicians.A multi-component shared decision making programme on the prevention of heart attack in type 2 diabetes has been developed. It aims at improving the quality of decision-making by providing evidence-based patient information, enhancing patients' knowledge, and supporting them to actively participate in decision-making. In this study the efficacy of the programme is evaluated in the setting of a diabetes clinic. A single blinded randomised-controlled trial is conducted to compare the shared decision making programme with a control-intervention. The intervention consists of an evidence-based patient decision aid on the prevention of myocardial infarction and a corresponding counselling module provided by diabetes educators. Similar in duration and structure, the control-intervention targets nutrition, sports, and stress coping. A total of 154 patients between 40 and 69 years of age with type 2 diabetes and no previous diagnosis of ischaemic heart disease or stroke are enrolled and allocated either to the intervention or the control-intervention. Primary outcome measure is the patients' knowledge on benefits and harms of heart attack prevention captured by a standardised knowledge test. Key secondary outcome measure is the achievement of treatment goals prioritised by the individual patient. Treatment goals refer to statin taking, HbA1c-, blood pressure levels and smoking status. Outcomes are assessed directly after the counselling and at 6 months follow-up. Analyses will be carried out on intention-to-treat basis. Concurrent qualitative methods are used to explore intervention fidelity and to gain insight into implementation processes. Interventions to facilitate evidence-based shared decision making represent an innovative approach in diabetes care. The results of this study will provide information on the efficacy of such a concept in the setting of a diabetes clinic in Germany. ISRCTN84636255.

Health behaviour change theories: contributions to an ICF-based behavioural exercise therapy for individuals with chronic diseases.

PubMed

Geidl, Wolfgang; Semrau, Jana; Pfeifer, Klaus

2014-01-01

The purpose of this perspective is (1) to incorporate recent psychological health behaviour change (HBC) theories into exercise therapeutic programmes, and (2) to introduce the International Classification of Functioning (ICF)-based concept of a behavioural exercise therapy (BET). Relevant personal modifiable factors of physical activity (PA) were identified based on three recent psychological HBC theories. Following the principles of intervention mapping, a matrix of proximal programme objectives specifies desirable parameter values for each personal factor. As a result of analysing reviews on behavioural techniques and intervention programmes of the German rehabilitation setting, we identified exercise-related techniques that impact the personal determinants. Finally, the techniques were integrated into an ICF-based BET concept. Individuals' attitudes, skills, emotions, beliefs and knowledge are important personal factors of PA behaviour. BET systematically addresses these personal factors by a systematic combination of adequate exercise contents with related behavioural techniques. The presented 28 intervention techniques serve as a theory-driven "tool box" for designing complex BET programmes to promote PA. The current paper highlights the usefulness of theory-based integrative research in the field of exercise therapy, offers explicit methods and contents for physical therapists to promote PA behaviour, and introduces the ICF-based conceptual idea of a BET. Implications for Rehabilitation Irrespective of the clients' indication, therapeutic exercise programmes should incorporate effective, theory-based approaches to promote physical activity. Central determinants of physical activity behaviour are a number of personal factors: individuals' attitudes, skills, emotions, beliefs and knowledge. Clinicians implementing exercise therapy should set it within a wider theoretical framework including the personal factors that influence physical activity. To increase exercise-adherence and promote long-term physical activity behaviour change, the concept of a behavioural exercise therapy (BET) offers a theory-based approach to systematically address relevant personal factors with a combination of adequate contents of exercise with exercise-related techniques of behaviour change.

The effect of group-based exercise on cognitive performance and mood in seniors residing in intermediate care and self-care retirement facilities: a randomised controlled trial.

PubMed

Brown, A K; Liu-Ambrose, T; Tate, R; Lord, S R

2009-08-01

To determine the effect of a general group-based exercise programme on cognitive performance and mood among seniors without dementia living in retirement villages. Randomised controlled trial. Four intermediate care and four self-care retirement village sites in Sydney, Australia. 154 seniors (19 men, 135 women; age range 62 to 95 years), who were residents of intermediate care and self-care retirement facilities. Participants were randomised to one of three experimental groups: (1) a general group-based exercise (GE) programme composed of resistance training and balance training exercises; (2) a flexibility exercise and relaxation technique (FR) programme; or (3) no-exercise control (NEC). The intervention groups (GE and FR) participated in 1-hour exercise classes twice a week for a total period of 6 months. Using standard neuropsychological tests, we assessed cognitive performance at baseline and at 6-month re-test in three domains: (1) fluid intelligence; (2) visual, verbal and working memory; and (3) executive functioning. We also assessed mood using the Geriatric Depression Scale (GDS) and the Positive and Negative Affect Schedule (PANAS). The GE programme significantly improved cognitive performance of fluid intelligence compared with FR or NEC. There were also significant improvements in the positive PANAS scale within both the GE and FR groups and an indication that the two exercise programmes reduced depression in those with initially high GDS scores. Our GE programme significantly improved cognitive performance of fluid intelligence in seniors residing in retirement villages compared with our FR programme and the NEC group. Furthermore, both group-based exercise programmes were beneficial for certain aspects of mood within the 6-month intervention period.

Cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya.

PubMed

McPake, Barbara; Edoka, Ijeoma; Witter, Sophie; Kielmann, Karina; Taegtmeyer, Miriam; Dieleman, Marjolein; Vaughan, Kelsey; Gama, Elvis; Kok, Maryse; Datiko, Daniel; Otiso, Lillian; Ahmed, Rukhsana; Squires, Neil; Suraratdecha, Chutima; Cometto, Giorgio

2015-09-01

To assess the cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Incremental cost-effectiveness ratios for the three programmes were estimated from a government perspective. Cost data were collected for 2012. Life years gained were estimated based on coverage of reproductive, maternal, neonatal and child health services. For Ethiopia and Kenya, estimates of coverage before and after the implementation of the programme were obtained from empirical studies. For Indonesia, coverage of health service interventions was estimated from routine data. We used the Lives Saved Tool to estimate the number of lives saved from changes in reproductive, maternal, neonatal and child health-service coverage. Gross domestic product per capita was used as the reference willingness-to-pay threshold value. The estimated incremental cost per life year gained was 82 international dollars ($)in Kenya, $999 in Ethiopia and $3396 in Indonesia. The results were most sensitive to uncertainty in the estimates of life-years gained. Based on the results of probabilistic sensitivity analysis, there was greater than 80% certainty that each programme was cost-effective. Community-based approaches are likely to be cost-effective for delivery of some essential health interventions where community-based practitioners operate within an integrated team supported by the health system. Community-based practitioners may be most appropriate in rural poor communities that have limited access to more qualified health professionals. Further research is required to understand which programmatic design features are critical to effectiveness.

Unpacking the ‘structural’ in a structural approach for HIV prevention among female sex workers: A case study from China

PubMed Central

Huang, Yingying; Muessig, Kathryn E.; Zhang, Ning; Maman, Suzanne

2015-01-01

Interventions for HIV prevention among female sex workers (FSWs) in China focus on HIV/sexually transmitted infection (STI) and individual behaviour change. An occupational health framework facilitates intervention across an array of health issues FSWs face including HIV/STI, violence, reproductive health, stigma and substance use. Through a case study of a community-based Jiaozhou (JZ) FSW programme, we developed a conceptual framework incorporating global discussions of structural approaches to HIV prevention with the specific social and structural contexts identified among FSWs in China. Based on ethnographic fieldwork between August 2010 and May 2013, we describe the evolution of this programme to its current occupational health focus and unpack the intervention strategies. We describe the critical features of the programme that have fostered success among FSWs including high-quality clinical services provided within a welcoming setting, responsive outreach work through staff and trained FSW peers, interpersonal and community-level engagement aimed at changing the local social and structural environments of sex work and tailored health education materials. This intervention differs from other projects in China by adopting a more holistic approach to FSW health that incorporates social issues. It also demonstrates the feasibility of structural interventions among FSWs even within an environment that has strong anti-prostitution policies. PMID:25742611

The impact of active stakeholder involvement on recruitment, retention and engagement of schools, children and their families in the cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP): a school-based intervention to prevent obesity.

PubMed

Lloyd, J; McHugh, C; Minton, J; Eke, H; Wyatt, K

2017-08-14

Recruitment and retention of participants is crucial for statistical power and internal and external validity and participant engagement is essential for behaviour change. However, many school-based interventions focus on programme content rather than the building of supportive relationships with all participants and tend to employ specific standalone strategies, such as incentives, to improve retention. We believe that actively involving stakeholders in both intervention and trial design improves recruitment and retention and increases the chances of creating an effective intervention. The Healthy Lifestyles Programme, HeLP (an obesity prevention programme for children 9-10 years old) was developed using intervention mapping and involved extensive stakeholder involvement in both the design of the trial and the intervention to ensure that: (i) delivery methods were suitably engaging, (ii) deliverers had the necessary skills and qualities to build relationships and (iii) the intervention dovetailed with the National Curriculum. HeLP was a year-long intervention consisting of 4 multi-component phases using a range of delivery methods. We recruited 1324 children from 32 schools from the South West of England to a cluster-randomised controlled trial to determine the effectiveness of HeLP in preventing obesity. The primary outcome was change in body mass index standard deviation score (BMI SDS) at 24 months post randomisation. Secondary outcomes included additional anthropometric and behavioural (physical activity and diet) measures at 18 and 24 months. Anthropometric and behavioural measures were taken in 99%, 96% and 94% of children at baseline, 18 and 24 months, respectively, with no differential follow up between the control and intervention groups at each time point. All children participated in the programme and 92% of children and 77% of parents across the socio-economic spectrum were considered to have actively engaged with HeLP. We attribute our excellent retention and engagement results to the high level of stakeholder involvement in both trial and intervention design, the building of relationships using appropriate personnel and creative delivery methods that are accessible to children and their families across the social spectrum. International Standard Randomised Controlled Trials Register, ISRCTN15811706 . Registered on 1 May 2012.

School-based programmes for preventing smoking.

PubMed

Thomas, R

2002-01-01

Smoking rates in adolescents are rising. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated. To review all randomised controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking. We searched The Cochrane Controlled Trials and Tobacco Review group registers, MEDLINE, EMBASE, Psyclnfo, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomised controlled trials in this area. Types of studies: those in which individual students, classes, schools, or school districts were randomised to the intervention or control groups and followed for at least six months. Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow-up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion. We assessed whether identified citations were randomised controlled trials. We assessed the quality of design and execution, and abstracted outcome data. Because of the marked heterogeneity of design and outcomes, we did not perform a meta-analysis. We synthesised the data using narrative systematic review. We grouped studies by intervention method (information; social competence; social influences; combined social influences/social competence and multi-modal programmes). Within each category, we placed them into three groups according to validity using quality criteria for reported study design. Of the 76 randomised controlled trials identified, we classified 16 as category one (most valid). There were no category one studies of information giving alone. There were fifteen category one studies of social influences interventions. Of these, eight showed some positive effect of intervention on smoking prevalence, and seven failed to detect an effect on smoking prevalence. The largest and most rigorous study, the Hutchinson Smoking Prevention Project, found no long-term effect of an intensive 8-year programme on smoking behaviour. There was a lack of high quality evidence about the effectiveness of combinations of social influences and social competence approaches. There was limited evidence about the effectiveness of multi-modal approaches including community initiatives. There is no rigorous test of the effects of information giving about smoking. There are well-conducted randomised controlled trials to test the effects of social influences interventions: in half of the group of best quality studies those in the intervention group smoke less than those in the control, but many studies showed no effect of the intervention. There is a lack of high-quality evidence about the effectiveness of combinations of social influences and social competence interventions, and of multi-modal programmes that include community interventions.

Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial.

PubMed

Mikó, Ibolya; Szerb, Imre; Szerb, Anna; Poor, Gyula

2017-02-01

To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.

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?

ERIC Educational Resources Information Center

Sanders, Matthew; Calam, Rachel; Durand, Marianne; Liversidge, Tom; Carmont, Sue Ann

2008-01-01

Background: 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. Method: Parents with a child aged 2 to 9 (N=454) were randomly assigned to either a standard or enhanced intervention condition. In…

A dual-task home-based rehabilitation programme for improving balance control in patients with acquired brain injury: a single-blind, randomized controlled pilot study.

PubMed

Peirone, Eliana; Goria, Paolo Filiberto; Anselmino, Arianna

2014-04-01

To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury. Single-blind, randomized controlled pilot study. Single rehabilitation centre. Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score <10 seconds on the One-Leg Stance Test (eyes open). All participants received 50-minutes individualised traditional physiotherapy sessions three times a week for seven weeks. In addition, the intervention group (N = 8) performed an individualised dual-task home-based programme six days a week for seven weeks. The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling. At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63). This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.

Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes in Hong Kong.

PubMed

Lam, Winsome; Dawson, Angela; Fowler, Cathrine

2015-04-01

To identify factors affecting the delivery of health promotion interventions to prevent early childhood human influenza at the household level. Yearly, influenza epidemics seriously affect all age groups, particularly those with weakened immune systems, including children. Influenza is transmitted easily from person to person through droplet and direct contact. Maintaining personal hygiene, avoiding close contact with the infected person and proper hand washing are recommended as the most effective means of preventing the transmission of influenza. However, it is not clear what programme-related mechanisms and contexts are crucial to the successful delivery of interventions in the home. This study systematically reviewed published research studies to identify factors influencing the effective delivery of health promotion programmes targeting influenza in a household. Realist review. A realist review methodology was selected to examine what interventions are effective in preventing and managing influenza at the household level and in what circumstances. A structured search of the peer-reviewed primary research literature was undertaken using a defined search protocol. Eight studies were retrieved for the analysis. Mechanisms impacting on intervention delivery were identified, including timing of implementation, programme reach, organisational and healthcare worker involvement, mode and place of delivery, contact with infected person, health practice compliance and sustainability at home. These findings suggest contextual factors that could be identified through ecological approaches to health promotion that are crucial for policymakers to consider when designing interventions. The active involvement of community nurses through an integrated household visiting programme may help to better deliver family-based health promotion interventions to prevent illnesses such as influenza in children. © 2014 John Wiley & Sons Ltd.

The "Som la Pera" intervention: sustainability capacity evaluation of a peer-led social-marketing intervention to encourage healthy lifestyles among adolescents.

PubMed

Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Prades-Tena, Jordi; Kettner, Helle; Arola, Lluis; Giralt, Montse; Solà, Rosa

2018-02-10

Sustainability capacity, always considered a challenge, is the ability to maintain effective long-term intervention in a community. The aim of the study was to improve the sustainability capacity of effective "Som la Pera," a school-based, peer-led, social-marketing intervention that encourages healthy diet and physical activity, in low socioeconomic adolescents from Spain. The sustainability capacity was analyzed by a "programme sustainability assessment tool (PSAT)" comprising eight domains: political support, funding stability, partnerships, organizational capacity, programme evaluation, programme adaptation, communications, and strategic planning. Each domain was evaluated from 1 (no or to a small extent) to 7 points (to a great extent). The final score for sustainability capacity was the mean of the eight domain scores. The PSAT was assessed by nine professionals (researchers, staff members, and stakeholders) at two periods during intervention implementation: end of the first year (January 2015) and end of the second year (September 2015). At the end of the first year, strategic planning (4.43 ± 1.98) and funding stability (4.38 ± 1) were considered deficient domains, and at the end of the second year, these domains had improved by 1.67 points (p =.043) and 0.59 points (p = .159), respectively. The funding stability increase was not significant because only one of the five specific items, "policies implemented to ensure sustained funding," improved by 1.08 points (p = .036). The sustainability capacity final score was 5.93 ± 1.13. The sustainability capacity assessment during the intervention allows its improvement before the programme expires, ensuring the long-term implementation of the "Som la Pera" intervention programme to encourage healthy lifestyles in adolescents. © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study.

PubMed

Hsu, Ming Hung; Flowerdew, Rosamund; Parker, Michael; Fachner, Jörg; Odell-Miller, Helen

2015-07-18

Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients' care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes. 17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents' symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers' feedback through semi-structured interviews, programme evaluations and track records of the study. The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (-0.74, 95 % CI: [-1.15 to -0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme. The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size. Clinicaltrials.gov, number NCT01744600.

Establishing psychiatric registrars' competence in psychotherapy: a portfolio based model.

PubMed

Naidu, T; Ramlall, S

2008-11-01

During most of the latter part of the last century, South Africa has followed international trends in the training of psychiatrists. Training programmes have become increasingly focused on the neurobiological aspects of psychiatric disorders with less attention being paid to psychotherapy. This is consistent with developments in psychiatric research. In the clinical arena this manifests as a focus on pharmacological and medically based interventions and a resulting relative inattention to non-pharmacological interventions, most especially psychotherapy. In an effort to address this imbalance there has been an international initiative, over the past two decades, to establish an acceptable level of competence in psychotherapy in the training of psychiatrists. A South African programme is needed that can take account of international trends and adapt them for the local context. In order to produce a programme for establishing competence in psychotherapy for psychiatric registrars at the Nelson R. Mandela School of Medicine, the authors examine directives for the development of psychotherapy skills from international regulatory bodies for graduate medical training and their application. Defining and setting preliminary standards for competence is emphasized. A programme based on five core psychotherapy components using a portfolio based model to facilitate learning and assessment of competence in psychotherapy, is proposed.

Evaluation of a school-based intervention programme for South African children of divorce.

PubMed

Botha, Cornelius J; Wild, Lauren G

2013-01-01

Parental divorce affects approximately 30 000 South African children annually. This pilot study aimed to evaluate the effectiveness of the Children of Divorce Intervention Programme (CODIP) at two South African schools. CODIP is a preventively oriented group programme which was developed to foster resilience by helping children cope more effectively with possible academic, behavioural, and emotional problems brought about by their parents' divorce. Twenty-five 10- to 14-year-old boys from two primary schools were randomly assigned to 2 experimental groups and 1 delayed intervention control group. The experimental groups attended 12 one-hour weekly sessions; the control group received no intervention until after the study was completed. Children's understanding of divorce related events and social, emotional and behavioural adjustment was assessed one week before the intervention and three months thereafter using a battery of self-rated, teacher-rated and parent-rated questionnaires. One-way ANOVAs indicated no statistically significant decline in children's self-reported problematic beliefs about divorce or total difficulties. However, teachers' and parents' ratings indicated that compared to the control group, the combined experimental groups showed significant improvement in their general behavioural, emotional and social adjustment after programme participation. The results suggest that South African children who experience parental divorce may benefit from participation in CODIP.

Quality and safety in the transitional care of the elderly (phase 2): the study protocol of a quasi-experimental intervention study for a cross-level educational programme

PubMed Central

Storm, Marianne; Groene, Oliver; Testad, Ingelin; Dyrstad, Dagrunn N; Heskestad, Randi N; Aase, Karina

2014-01-01

Introduction Transitional care and patient handover are important areas to ensure quality and safety in elderly healthcare services. Previous studies showed that healthcare professionals have little knowledge of the setting they are transferring patients to and a limited understanding of roles and functions; these constitute barriers to effective communication and shared care responsibilities across levels of care. Aim The main objective is to implement a cross-level education-based intervention programme with healthcare professionals aimed at (1) increasing professionals’ awareness and competencies about quality and safety in the transitional care of the elderly; (2) creating a discussion platform for knowledge exchange and learning across levels and units of care and (3) improving patient safety culture, in particular, in transitional care. Methods and analysis A quasi-experimental control group study design with an intervention group and a control group; this includes a pretest, post-test and 1-year follow-up test assessment of patient safety culture. Qualitative data will be collected during the intervention programme and between the measurements. The study design will be beneficial for addressing the effects of the cross-level educational intervention programme on reports of patient safety culture and for addressing the feasibility of the intervention measures. Ethics and dissemination The study has been approved by the Regional Committees for Medical and Health Research Ethics in Norway, Ref. No. 2011/1978. The study is based on informed written consent; informants can withdraw from the study at any point in time. The results will be disseminated at research conferences, in peer review journals and through public presentations outside the scientific community. PMID:25082425

Comparing the effectiveness of a multi-component weight loss intervention in adults with and without intellectual disabilities.

PubMed

Spanos, D; Hankey, C; Boyle, S; Melville, C

2014-02-01

The prevalence of obesity in adults with intellectual disabilities (ID) is rising, although the evidence base for its treatment in this population group is minimal. Weight management interventions that are accessible to adults with ID will reduce the inequalities that they frequently experience in health services. This short report compared the effectiveness of weight management in those with and without ID who completed nine sessions of a multi-component weight management programme. TAKE 5 is a 16-week multi-component weight management intervention for adults with ID and obesity [body mass index (BMI) ≥30 kg m(-2) ]. This intervention is an adaption of the weight management programme provided by the Glasgow & Clyde Weight Management Service (GCWMS) for adults without ID and obesity (National Health Service based). Fifty-two participants of the TAKE 5 programme were individually matched by baseline characteristics (sex, age and BMI) with two participants without ID of the GCWMS programme. Comparisons in terms of weight and BMI change and rate of weight loss were made for those who attended all nine sessions. There were no significant differences between the groups in the amount of weight loss (median: -3.6 versus -3.8 kg, respectively, P = 0.4), change in BMI (median: -1.5 versus -1.4 kg m(-2) , P = 0.9), success of achieving 5% weight loss (41.3% versus 36.8%, P = 0.9) and rate of weight loss across the 16-week intervention. A multi-component weight loss intervention can be equally effective for adults with and without ID and obesity. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Addressing sexual health behaviour during emerging adulthood: a critical review of the literature

PubMed Central

Alexander, Kamila A; Jemmott1, Loretta S; Teitelman, Anne M; D’Antonio, Patricia

2016-01-01

Aims and objectives In this critical literature review, we examine evidence-based interventions that target sexual behaviours of 18- to 25-year-old emerging adult women. Background Nurses and clinicians implement theory-driven research programmes for young women with increased risk of HIV/AIDS and sexually transmitted infections. Strategies to decrease transmission of HIV and sexually transmitted infections are rigorously evaluated and promoted by public health agencies such as the United States Centers for Disease Control and Prevention. While many interventions demonstrate episodic reductions in sexual risk behaviours and infection transmission, there is little evidence they build sustainable skills and behaviours. Programmes may not attend to contextual and affective influences on sexual behaviour change. Design Discursive paper. Methods We conducted a conceptually based literature review and critical analysis of the Centers for Disease Control and Prevention’s best-evidence and good-evidence HIV behavioural interventions. In this review, we examined three contextual and affective influences on the sexual health of emerging adult women: (1) developmental age, (2) reproduction and pregnancy desires and (3) sexual security or emotional responses accompanying relationship experiences. Results Our analyses revealed intervention programmes paid little attention to ways age, desires for pregnancy or emotional factors influence sexual decisions. Some programmes included 18- to 25-year-olds, but they made up small percentages of the sample and did not attend to unique emerging adult experiences. Second, primary focus on infection prevention overshadowed participant desires for pregnancy. Third, few interventions considered emotional mechanisms derived from relationship experiences involved in sexual decision-making. Conclusions Growing evidence demonstrates sexual health interventions may be more effective if augmented to attend to contextual and affective influences on relationship risks and decision-making. Modifying currently accepted strategies may enhance sustainability of sexual health-promoting behaviours. PMID:24988875

Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Programme for providing innovative mental health care in rural communities in India.

PubMed

Maulik, P K; Devarapalli, S; Kallakuri, S; Praveen, D; Jha, V; Patel, A

2015-01-01

India has few mental health professionals to treat the large number of people suffering from mental disorders. Rural areas are particularly disadvantaged due to lack of trained health workers. Ways to improve care could be by training village health workers in basic mental health care, and by using innovative methods of service delivery. The ongoing Systematic Medical Appraisal, Referral and Treatment Mental Health Programme will assess the acceptability, feasibility and preliminary effectiveness of a task-shifting mobile-based intervention using mixed methods, in rural Andhra Pradesh, India. The key components of the study are an anti-stigma campaign followed by a mobile-based mental health services intervention. The study will be done across two sites in rural areas, with intervention periods of 1 year and 3 months, respectively. The programme uses a mobile-based clinical decision support tool to be used by non-physician health workers and primary care physicians to screen, diagnose and manage individuals suffering from depression, suicidal risk and emotional stress. The key aim of the study will be to assess any changes in mental health services use among those screened positive following the intervention. A number of other outcomes will also be assessed using mixed methods, specifically focussed on reduction of stigma, increase in mental health awareness and other process indicators. This project addresses a number of objectives as outlined in the Mental Health Action Plan of World Health Organization and India's National Mental Health Programme and Policy. If successful, the next phase will involve design and conduct of a cluster randomised controlled trial.

Cost-effectiveness of a community-based physical activity programme for adults (Be Active) in the UK: an economic analysis within a natural experiment.

PubMed

Frew, Emma J; Bhatti, Mobeen; Win, Khine; Sitch, Alice; Lyon, Anna; Pallan, Miranda; Adab, Peymane

2014-02-01

To determine the cost-effectiveness of a physical activity programme (Be Active) aimed at city-dwelling adults living in Birmingham, UK. Very little is known about the cost-effectiveness of public health programmes to improve city-wide physical activity rates. This paper presents a cost-effectiveness analysis that compares a physical activity intervention (Be Active) with no intervention (usual care) using an economic model to quantify the reduction in disease risk over a lifetime. Metabolic equivalent minutes achieved per week, quality-adjusted life years (QALYs) gained and healthcare costs were all included as the main outcome measures in the model. A cost-benefit analysis was also conducted using 'willingness-to-pay' as a measure of value. Under base-case assumptions-that is, assuming that the benefits of increased physical activity are sustained over 5 years, participation in the Be Active programme increased quality-adjusted life expectancy by 0.06 years, at an expected discounted cost of £3552, and thus the cost-effectiveness of Be Active is £400 per QALY. When the start-up costs of the programme are removed from the economic model, the cost-effectiveness is further improved to £16 per QALY. The societal value placed on the Be Active programme was greater than the operation cost therefore the Be Active physical activity intervention results in a net benefit to society. Participation in Be Active appeared to be cost-effective and cost-beneficial. These results support the use of Be Active as part of a public health programme to improve physical activity levels within the Birmingham-wide population.

Mentoring, coaching and action learning: interventions in a national clinical leadership development programme.

PubMed

McNamara, Martin S; Fealy, Gerard M; Casey, Mary; O'Connor, Tom; Patton, Declan; Doyle, Louise; Quinlan, Christina

2014-09-01

To evaluate mentoring, coaching and action learning interventions used to develop nurses' and midwives' clinical leadership competencies and to describe the programme participants' experiences of the interventions. Mentoring, coaching and action learning are effective interventions in clinical leadership development and were used in a new national clinical leadership development programme, introduced in Ireland in 2011. An evaluation of the programme focused on how participants experienced the interventions. A qualitative design, using multiple data sources and multiple data collection methods. Methods used to generate data on participant experiences of individual interventions included focus groups, individual interviews and nonparticipant observation. Seventy participants, including 50 programme participants and those providing the interventions, contributed to the data collection. Mentoring, coaching and action learning were positively experienced by participants and contributed to the development of clinical leadership competencies, as attested to by the programme participants and intervention facilitators. The use of interventions that are action-oriented and focused on service development, such as mentoring, coaching and action learning, should be supported in clinical leadership development programmes. Being quite different to short attendance courses, these interventions require longer-term commitment on the part of both individuals and their organisations. In using mentoring, coaching and action learning interventions, the focus should be on each participant's current role and everyday practice and on helping the participant to develop and demonstrate clinical leadership skills in these contexts. © 2014 John Wiley & Sons Ltd.

Talk for Literacy: Evaluation Report and Executive Summary

ERIC Educational Resources Information Center

Styles, Ben; Bradshaw, Sally

2015-01-01

This NFER report has been produced for the Education Endowment Foundation and its evaluation of a speaking and listening intervention combining two programmes: the Vocabulary Enrichment Intervention Programme (VEIP) and the narrative Intervention Programme (NIP). The intervention was used with pupils who needed extra support to improve their…

What childhood obesity prevention programmes work? A systematic review and meta-analysis

PubMed Central

Wang, Y.; Cai, L.; Wu, Y.; Wilson, R. F.; Weston, C.; Fawole, O.; Bleich, S. N.; Cheskin, L. J.; Showell, N. N.; Lau, B. D.; Chiu, D. T.; Zhang, A.; Segal, J.

2015-01-01

Summary Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2–18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet–physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school-based interventions for preventing childhood obesity. More research is needed to evaluate programmes in other settings or of other design types, especially environmental, policy and consumer health informatics-oriented interventions. PMID:25893796

Cost-effectiveness of a day hospital falls prevention programme for screened community-dwelling older people at high risk of falls.

PubMed

Irvine, Lisa; Conroy, Simon P; Sach, Tracey; Gladman, John R F; Harwood, Rowan H; Kendrick, Denise; Coupland, Carol; Drummond, Avril; Barton, Garry; Masud, Tahir

2010-11-01

multifactorial falls prevention programmes for older people have been proved to reduce falls. However, evidence of their cost-effectiveness is mixed. economic evaluation alongside pragmatic randomised controlled trial. randomised trial of 364 people aged ≥70, living in the community, recruited via GP and identified as high risk of falling. Both arms received a falls prevention information leaflet. The intervention arm were also offered a (day hospital) multidisciplinary falls prevention programme, including physiotherapy, occupational therapy, nurse, medical review and referral to other specialists. self-reported falls, as collected in 12 monthly diaries. Levels of health resource use associated with the falls prevention programme, screening (both attributed to intervention arm only) and other health-care contacts were monitored. Mean NHS costs and falls per person per year were estimated for both arms, along with the incremental cost-effectiveness ratio (ICER) and cost effectiveness acceptability curve. in the base-case analysis, the mean falls programme cost was £349 per person. This, coupled with higher screening and other health-care costs, resulted in a mean incremental cost of £578 for the intervention arm. The mean falls rate was lower in the intervention arm (2.07 per person/year), compared with the control arm (2.24). The estimated ICER was £3,320 per fall averted. the estimated ICER was £3,320 per fall averted. Future research should focus on adherence to the intervention and an assessment of impact on quality of life.

Processes of change in a school-based mindfulness programme: cognitive reactivity and self-coldness as mediators.

PubMed

Van der Gucht, Katleen; Takano, Keisuke; Raes, Filip; Kuppens, Peter

2018-05-01

The underlying mechanisms of the effectiveness of mindfulness-based interventions for emotional well-being remain poorly understood. Here, we examined the potential mediating effects of cognitive reactivity and self-compassion on symptoms of depression, anxiety and stress using data from an earlier randomised controlled school trial. A moderated time-lagged mediation model based on multilevel modelling was used to analyse the data. The findings showed that post-treatment changes in cognitive reactivity and self-coldness, an aspect of self-compassion, mediated subsequent changes in symptoms of depression, anxiety and stress. These results suggest that cognitive reactivity and self-coldness may be considered as transdiagnostic mechanisms of change of a mindfulness-based intervention programme for youth.

Two-year effects of a school-based prevention programme on adolescent cigarette smoking in Guangzhou, China: a cluster randomized trial

PubMed Central

Wen, Xiaozhong; Chen, Weiqing; Gans, Kim M; Colby, Suzanne M; Lu, Ciyong; Liang, Caihua; Ling, Wenhua

2010-01-01

Background The prevalence of adolescent smoking has been increasing rapidly in China. Theory-based smoking prevention programmes in schools may be an effective approach in preventing smoking among Chinese adolescents. Methods A school-level cluster randomized controlled trial was conducted among 7th and 8th grade students (N = 2343) in four junior high schools in southern China during 2004–06. The theory-based, multi-level intervention was compared with the standard health curriculum. Outcome measures comprised changes in students’ smoking-related knowledge, attitudes and behaviour. Results The mean knowledge scores from baseline to the 1- and 2-year follow-ups increased more in the intervention group than in the control group, whereas there was little change in attitude scores. At the 1-year follow-up (the total sample), the interventions reduced the probability of baseline experimental smokers’ escalating to regular smoker [7.9 vs 18.3%; adjusted odds ratio (OR) 0.34, 95% confidence interval (CI) 0.12–0.97, P = 0.043], but did not reduce the probability of baseline non-smokers’ initiating smoking (7.9 vs 10.6%; adjusted OR 0.86, 95% CI 0.54–1.38, P = 0.538). At the 2-year follow-up (only 7th grade students), similar proportions of baseline non-smokers initiated smoking in the intervention group and the control group (13.5 vs 13.1%), while a possibly lower proportion of baseline experimental smokers escalated to regular smoking in the intervention group than the control group (22.6 vs 40.0%; adjusted OR 0.43, 95% CI 0.12–1.57, P = 0.199). Conclusions This multi-level intervention programme had a moderate effect on inhibiting the escalation from experimental to regular smoking among Chinese adolescents, but had little effect on the initiation of smoking. The programme improved adolescents’ smoking-related knowledge, but did not change their attitudes towards smoking. PMID:20236984

Effectiveness of a cognitive behavioural therapy-based anxiety prevention programme at an elementary school in Japan: a quasi-experimental study.

PubMed

Urao, Yuko; Yoshida, Michiko; Koshiba, Takako; Sato, Yasunori; Ishikawa, Shin-Ichi; Shimizu, Eiji

2018-01-01

The efficacy of cognitive behavioural therapy (CBT) for anxiety related problems in children is empirically supported. In addition, universal anxiety prevention programmes based on CBT have been demonstrated in recent years. The purpose of this study was to verify the effectiveness of a CBT based original programme 'Journey of the Brave,' aiming to prevent anxiety disorders and anxiety-related problems for Japanese children aged 10-12 years old. Intervention groups from two classes of 5th grade elementary students ( n  = 41) received ten 45-min programme sessions. The control group was drawn from one class of 5th grade children ( n  = 31) from a nearby school. All participants completed the Spence Children's Anxiety Scale (SCAS) at pre, post, and 3 months follow-up. Mixed-effects model for repeated measures analysis was conducted. The mean anxiety score on the SCAS for the intervention group was significantly reduced at both post intervention and 3 months follow-up compared with the control group. The group differences on the SCAS from baseline to post-test were - 5.321 (95% CI - 10.12 to - 0.523, p  = 0.030), and at the 3-month follow-up were - 7.104 (95% CI - 11.90 to - 2.306, p  = 0.004). The effectiveness of the anxiety prevention programme 'Journey of the Brave' was verified though this study using a quasi-experimental design on a small sample. Trial registration : UMIN000009021.

A partnership model of early intervention in psychosis programme--a Canadian experience.

PubMed

Oyewumi, Lamidi Kola; Savage, Troy

2009-08-01

To describe how a new partnership model of early intervention in psychosis, early intervention in psychosis (EIP) programme delivery in Canada attracted the interest of the community and acquired government funding. The process by which a few individuals used a conceptual framework of integrated, collaborative, flexible and recovery focused principles to engage community partners and attract government funding is described. The establishment of a small EIP programme and its expansion to a regional programme serving an area of 20,000 square kilometers and a population of approximately 500,000 people were achieved. A programme specific logic prototype was developed. A synergy of public, private and academic services emerged with an infrastructure for ongoing cohesiveness and productivity. Annual clinic visits increased from 641 in 2002 to 1904 in 2007 and annual new patients enrollments grew from 46 to 128 within the same period. Staffing grew from an interdisciplinary staff of 1.5 full-time equivalent (FTE) to the current 10.0 FTE. A carefully orchestrated programme organization that is inclusive rather than exclusive can produce a balance of evidence-based best practices in client focused service, community mental health integration and academic productivity. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

Experiences of parenting and clinical intervention for mothers affected by personality disorder: a pilot qualitative study combining parent and clinician perspectives.

PubMed

Wilson, Ruth; Weaver, Tim; Michelson, Daniel; Day, Crispin

2018-05-25

Evidence-based parenting programmes are recommended for the treatment of child mental health difficulties. Families with complex psychosocial needs show poorer retention and outcomes when participating in standard parenting programmes. The Helping Families Programme (HFP) is a 16-week community-based parenting intervention designed to meet the needs of these families, including families with parental personality disorder. This study aimed to explore the help seeking and participatory experiences of parents with a diagnosis of personality disorder. It further aimed to examine the acceptability of referral and intervention processes for the HFP from the perspectives of (i) clinicians referring into the programme; and (ii) referred parents. Semi-structured interviews were conducted with parents recruited to receive HFP (n = 5) as part of a research case series and the referring NHS child and adolescent mental health service (CAMHS) clinicians (n = 5). Transcripts were analysed using Interpretive Phenomenological Analysis. Four themes were identified for parents: (i) the experience of parenthood, (ii) being a parent affected by personality disorder, (iii) experience of the intervention, and (iv) qualities of helping. Three themes emerged for clinicians: (i) challenges of addressing parental need, (ii) experience of engaging parents with personality disorders and (iii) limited involvement during HFP. Comparison of parent and clinician themes led to the identification of two key interlinked themes: (i) concerns prior to receiving the intervention, and (ii) the challenges of working together without a mutual understanding. This pilot study identifies potentially significant challenges of working with parents affected by personality disorder and engaging them in HFP and other similar interventions. Results have important wider clinical implications by highlighting potential barriers to engagement and participation and providing insights on how these barriers might be overcome. Findings have been used to inform the referral and intervention processes of a pilot RCT and further intervention development.

Internet-based intervention programme for obese adolescents and their families (Next.Step): research protocol of a controlled trial.

PubMed

Sousa, Pedro; Fonseca, Helena; Gaspar, Pedro; Gaspar, Filomena

2014-04-01

This paper describes the design and rationale of a controlled trial that aims to determine the effectiveness of an intervention programme in which the internet is used. Adolescent obesity is a major health problem, there being urgency to find effective interventions that induce behavioural change. The inclusion of the internet in the intervention may improve adolescents' adherence to the weight management programme and lead to adoption of healthier lifestyles. A clinical trial with a control group (non-randomized). Participants are adolescents with appointments at a paediatric obesity clinic (Portugal). Sample size was calculated according to the power analysis. The experimental group will follow the standard treatment protocol and receive free access to the e-therapeutic platform. The control group will follow the standard treatment protocol and join a waiting list. Intervention length will be 36 weeks (24 weeks of direct intervention with a follow-up for 12 weeks). This study was approved by the Ethical Committee for Health (Lisbon, Portugal) in January 2012 and funded by the Foundation for Science and Technology (Portugal) in December 2012. The results of this research will promote reflection on new approaches directed to treat adolescent obesity and on the promotion of healthy behaviours. We expect to gather empirical evidence of the intervention programme effectiveness. The expectations lie on the population health gains, empowerment in decision-making and adoption of healthier lifestyles. © 2013 John Wiley & Sons Ltd.

A systematic review of randomised controlled trials examining the effectiveness of breast and cervical cancer screening interventions for ethnic minority women.

PubMed

Chan, Dorothy N S; So, Winnie K W

2015-10-01

To examine the effect that breast and/or cervical cancer screening programmes for ethnic minority women have on their knowledge of and beliefs about breast or cervical cancer and screening, and on their screening intentions and uptake rates. Recommendations are also made for the format and content of such programmes, based on existing evidence. A comprehensive literature search was carried out both manually and by means of five electronic databases. The findings are summarised and synthesised in narrative fashion. The ten RCTs included here were conducted among ethnic minority women in the United States or Canada, where breast or cervical cancer screening programmes have led to improvements in screening intentions, knowledge of cervical cancer and pap test uptake. The Breast Cancer Screening Belief Scale and self-reporting were the methods commonly used to measure outcomes. The shared characteristics of both countries' programmes were that they were theory- and language-based, the instruction took place in a community setting, the materials were culturally relevant, the content highlighted key messages about breast or cervical cancer and screening measures, and there were multiple intervention strategies. Breast or cervical cancer screening programmes in Western countries have demonstrated improvements in knowledge of the disease, screening intentions and pap test uptake, although evidence on the effectiveness of the interventions has been limited. The common characteristics of programmes are identified, but a comprehensive model is still needed to link these characteristics with other factors and mediators influencing outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Museums and art galleries as partners for public health interventions.

PubMed

Camic, Paul M; Chatterjee, Helen J

2013-01-01

The majority of public health programmes are based in schools, places of employment and in community settings. Likewise, nearly all health-care interventions occur in clinics and hospitals. An underdeveloped area for public health-related planning that carries international implications is the cultural heritage sector, and specifically museums and art galleries. This paper presents a rationale for the use of museums and art galleries as sites for public health interventions and health promotion programmes through discussing the social role of these organisations in the health and well-being of the communities they serve. Recent research from several countries is reviewed and integrated into a proposed framework for future collaboration between cultural heritage, health-care and university sectors to further advance research, policy development and evidence-based practice.

The Diabetes Manual trial protocol – a cluster randomized controlled trial of a self-management intervention for type 2 diabetes [ISRCTN06315411

PubMed Central

Sturt, Jackie; Hearnshaw, Hilary; Farmer, Andrew; Dale, Jeremy; Eldridge, Sandra

2006-01-01

Background The Diabetes Manual is a type 2 diabetes self-management programme based upon the clinically effective 'Heart Manual'. The 12 week programme is a complex intervention theoretically underpinned by self-efficacy theory. It is a one to one intervention meeting United Kingdom requirements for structured diabetes-education and is delivered within routine primary care. Methods/design In a two-group cluster randomized controlled trial, GP practices are allocated by computer minimisation to an intervention group or a six-month deferred intervention group. We aim to recruit 250 participants from 50 practices across central England. Eligibility criteria are adults able to undertake the programme with type 2 diabetes, not taking insulin, with HbA1c over 8% (first 12 months) and following an agreed protocol change over 7% (months 13 to 18). Following randomisation, intervention nurses receive two-day training and delivered the Diabetes Manual programme to participants. Deferred intervention nurses receive the training following six-month follow-up. Primary outcome is HbA1c with total and HDL cholesterol; blood pressure, body mass index; self-efficacy and quality of life as additional outcomes. Primary analysis is between-group HbA1c differences at 6 months powered to give 80% power to detect a difference in HbA1c of 0.6%. A 12 month cohort analysis will assess maintenance of effect and assess relationship between self-efficacy and outcomes, and a qualitative study is running alongside. Discussion This trial incorporates educational and psychological diabetes interventions into a single programme and assesses both clinical and psychosocial outcomes. The trial will increase our understanding of intervention transferability between conditions, those diabetes related health behaviours that are more or less susceptible to change through efficacy enhancing mechanisms and how this impacts on clinical outcomes. PMID:16846517

The Diabetes Manual trial protocol - a cluster randomized controlled trial of a self-management intervention for type 2 diabetes [ISRCTN06315411].

PubMed

Sturt, Jackie; Hearnshaw, Hilary; Farmer, Andrew; Dale, Jeremy; Eldridge, Sandra

2006-07-17

The Diabetes Manual is a type 2 diabetes self-management programme based upon the clinically effective 'Heart Manual'. The 12 week programme is a complex intervention theoretically underpinned by self-efficacy theory. It is a one to one intervention meeting United Kingdom requirements for structured diabetes-education and is delivered within routine primary care. In a two-group cluster randomized controlled trial, GP practices are allocated by computer minimisation to an intervention group or a six-month deferred intervention group. We aim to recruit 250 participants from 50 practices across central England. Eligibility criteria are adults able to undertake the programme with type 2 diabetes, not taking insulin, with HbA1c over 8% (first 12 months) and following an agreed protocol change over 7% (months 13 to 18). Following randomisation, intervention nurses receive two-day training and delivered the Diabetes Manual programme to participants. Deferred intervention nurses receive the training following six-month follow-up. Primary outcome is HbA1c with total and HDL cholesterol; blood pressure, body mass index; self-efficacy and quality of life as additional outcomes. Primary analysis is between-group HbA1c differences at 6 months powered to give 80% power to detect a difference in HbA1c of 0.6%. A 12 month cohort analysis will assess maintenance of effect and assess relationship between self-efficacy and outcomes, and a qualitative study is running alongside. This trial incorporates educational and psychological diabetes interventions into a single programme and assesses both clinical and psychosocial outcomes. The trial will increase our understanding of intervention transferability between conditions, those diabetes related health behaviours that are more or less susceptible to change through efficacy enhancing mechanisms and how this impacts on clinical outcomes.

A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward.

PubMed

Lee, Seul; Oh, HyunSoo; Suh, YeonOk; Seo, WhaSook

2017-03-01

To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress management and make meaningful contribution to the relief of family relocation stress, promote patient recovery and enhance the well-being of patients and family caregivers. © 2016 John Wiley & Sons Ltd.

Humans, 'things' and space: costing hospital infection control interventions.

PubMed

Page, K; Graves, N; Halton, K; Barnett, A G

2013-07-01

Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Community involvement in dengue vector control: cluster randomised trial.

PubMed

Vanlerberghe, V; Toledo, M E; Rodríguez, M; Gómez, D; Baly, A; Benítez, J R; Van der Stuyft, P

2010-01-01

To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Design Cluster randomised trial. Setting Guantanamo, Cuba. Participants 32 circumscriptions (around 2000 inhabitants each). Interventions The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach. The primary outcome was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of Ae aegypti per 100 inspected houses), Breteau index (number of containers positive for immature stages of Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of Ae aegypti pupae per inhabitant). All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the Aedes infestation levels were comparable between intervention and control clusters: house index 0.25% v 0.20%, pupae per inhabitant 0.44 x 10(-3) v 0.29 x 10(-3). At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76). A community based environmental management embedded in a routine control programme was effective at reducing levels of Aedes infestation. Trial Registration Current Controlled Trials ISRCTN88405796.

Home-based exercise and support programme for people with dementia and their caregivers: study protocol of a randomised controlled trial

PubMed Central

2011-01-01

Background Dementia affects the mood of people with dementia but also of their caregivers. In the coming years, the number of people with dementia will increase worldwide and most of them will continue to live in the community as long as possible. Home-based psychosocial interventions reducing the depressive symptoms of both people with dementia and their caregivers in their own home are highly needed. Methods/Design This manuscript describes the design of a Randomised Controlled Trial (RCT) of the effects of a home-based exercise and support programme for people with dementia and their caregivers. The aim is to randomly assign 156 dyads (caregiver and dementia diagnosed person) to an intervention group or a comparison group. The experimental group receives a home programme in which exercise and support for the people with dementia and their caregivers are combined and integrated. The comparison group receives a minimal intervention. Primary outcomes are physical health (people with dementia) and mood (people with dementia and caregivers). In addition, to get more insight in the working components of the intervention and the impact of the intervention on the relationship of the dyads a qualitative sub-study is carried out. Discussion This study aims to contribute to an evidence-based treatment to reduce depressive symptoms among people with dementia and their caregivers independently living in the community. Trial Registration The study has been registered at the Netherlands National Trial Register (NTR), which is connected to the International Clinical Trials Registry Platform of the WHO. Trial number: NTR1802. PMID:22117691

Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review.

PubMed

Lussiana, Cristina

2016-09-01

The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Mapping multiple components of malaria risk for improved targeting of elimination interventions.

PubMed

Cohen, Justin M; Le Menach, Arnaud; Pothin, Emilie; Eisele, Thomas P; Gething, Peter W; Eckhoff, Philip A; Moonen, Bruno; Schapira, Allan; Smith, David L

2017-11-13

There is a long history of considering the constituent components of malaria risk and the malaria transmission cycle via the use of mathematical models, yet strategic planning in endemic countries tends not to take full advantage of available disease intelligence to tailor interventions. National malaria programmes typically make operational decisions about where to implement vector control and surveillance activities based upon simple categorizations of annual parasite incidence. With technological advances, an enormous opportunity exists to better target specific malaria interventions to the places where they will have greatest impact by mapping and evaluating metrics related to a variety of risk components, each of which describes a different facet of the transmission cycle. Here, these components and their implications for operational decision-making are reviewed. For each component, related mappable malaria metrics are also described which may be measured and evaluated by malaria programmes seeking to better understand the determinants of malaria risk. Implementing tailored programmes based on knowledge of the heterogeneous distribution of the drivers of malaria transmission rather than only consideration of traditional metrics such as case incidence has the potential to result in substantial improvements in decision-making. As programmes improve their ability to prioritize their available tools to the places where evidence suggests they will be most effective, elimination aspirations may become increasingly feasible.

Teaching Handwriting Skills to Children with Intellectual Disabilities Using an Adapted Handwriting Programme

ERIC Educational Resources Information Center

Grindle, Corinna F.; Cianfaglione, Rina; Corbel, Liz; Wormald, Emily V.; Brown, Freddy Jackson; Hastings, Richard P.; Hughes, J. Carl

2017-01-01

Children with intellectual disabilities often struggle with handwriting, but there is very little research to inform intervention approaches. In this study, we developed a teaching manual based on Handwriting Without Tears®, a comprehensive handwriting programme designed for typically developing children. Three children with intellectual…

Development of a Human Papillomavirus Vaccination Intervention for Australian Adolescents

ERIC Educational Resources Information Center

Cooper, Spring C.; Davies, Cristyn; McBride, Kate; Blades, Joanna; Stoney, Tanya; Marshall, Helen; Skinner, S. Rachel

2016-01-01

Objective: Australia has implemented a nation-wide programme providing a human papillomavirus (HPV) vaccine to girls and boys through school-based programmes. Previous research has identified three distinct areas for attention: (1) lack of understanding about HPV and HPV vaccination, (2) young people's desire for involvement in decision-making…

Evaluating the implementation of a school-based emotional well-being programme: a cluster randomized controlled trial of Zippy's Friends for children in disadvantaged primary schools.

PubMed

Clarke, Aleisha M; Bunting, Brendan; Barry, Margaret M

2014-10-01

Schools are recognized as one of the most important settings for promoting social and emotional well-being among children and adolescents. This clustered randomized controlled trial evaluated Zippy's Friends, an international school-based emotional well-being programme, with 766 children from designated disadvantaged schools. The purpose of this study was to evaluate the immediate and long term impact of the programme and to determine the impact of implementation fidelity on programme outcomes. Teachers reported emotional literacy outcomes using the Emotional Literacy Checklist, and emotional and behavioural outcomes using the Strengths and Difficulties Questionnaire. Controlling for the hierarchical structure of the data, path analysis using structural equation modelling revealed that the programme had a significant positive impact on the children's emotional literacy scores including significant improvements in the subscale scores of self-awareness (P < 0.001), self-regulation (P < 0.01), motivation (P < 0.001) and social skills (P < 0.001) at post-intervention. These results were maintained at 12-month follow-up (P < 0.01). The programme, however, did not have a significant impact on children's emotional and behavioural problems. Analysis of programme fidelity indicated that high fidelity was directly related to improved emotional literacy scores at post-intervention. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Falls Assessment Clinical Trial (FACT): design, interventions, recruitment strategies and participant characteristics.

PubMed

Elley, C Raina; Robertson, M Clare; Kerse, Ngaire M; Garrett, Sue; McKinlay, Eileen; Lawton, Beverley; Moriarty, Helen; Campbell, A John

2007-07-29

Guidelines recommend multifactorial intervention programmes to prevent falls in older adults but there are few randomised controlled trials in a real life health care setting. We describe the rationale, intervention, study design, recruitment strategies and baseline characteristics of participants in a randomised controlled trial of a multifactorial falls prevention programme in primary health care. Participants are patients from 19 primary care practices in Hutt Valley, New Zealand aged 75 years and over who have fallen in the past year and live independently. Two recruitment strategies were used - waiting room screening and practice mail-out. Intervention participants receive a community based nurse assessment of falls and fracture risk factors, home hazards, referral to appropriate community interventions, and strength and balance exercise programme. Control participants receive usual care and social visits. Outcome measures include number of falls and injuries over 12 months, balance, strength, falls efficacy, activities of daily living, quality of life, and physical activity levels. 312 participants were recruited (69% women). Of those who had fallen, 58% of people screened in the practice waiting rooms and 40% when screened by practice letter were willing to participate. Characteristics of participants recruited using the two methods are similar (p > 0.05). Mean age of all participants was 81 years (SD 5). On average participants have 7 medical conditions, take 5.5 medications (29% on psychotropics) with a median of 2 falls (interquartile range 1, 3) in the previous year. The two recruitment strategies and the community based intervention delivery were feasible and successful, identifying a high risk group with multiple falls. Recruitment in the waiting room gave higher response rates but was less efficient than practice mail-out. Testing the effectiveness of an evidence based intervention in a 'real life' setting is important.

Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial.

PubMed

O'Dea, Angela; Tierney, Marie; McGuire, Brian E; Newell, John; Glynn, Liam G; Gibson, Irene; Noctor, Eoin; Danyliv, Andrii; Connolly, Susan B; Dunne, Fidelma P

2015-01-01

To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM). A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n = 24) or wait control (n = 26) and postintervention qualitative interviews with participants. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

'I learned to accept every part of myself': the transformative impact of a theatre-based sexual health and HIV prevention programme.

PubMed

Grewe, Mary E; Taboada, Arianna; Dennis, Alexis; Chen, Elizabeth; Stein, Kathryn; Watson, Sable; Barrington, Clare; Lightfoot, Alexandra F

Theatre-based interventions have been used in health promotion activities among young people to address HIV and sexual health. In this study, we explored the experience of undergraduate student performers participating in a theatre-based HIV prevention and sexual health education intervention for high school students in the USA. Undergraduate students enrolled in a credit-bearing course to learn about HIV and sexual health, participatory theatre and health education techniques. We analysed students' reflective essays written throughout the semester to identify any changes and the intervention processes that promoted these changes. Students experienced five interrelated forms of transformation: (1) increased knowledge about HIV and sexual health; (2) changes in attitude and communication about sex; (3) artistic growth; (4) emotional growth; and (5) clarification of career goals and future plans. Intervention processes that contributed to these transformations included improvisation, guided writing exercises, the creation of a close-knit cohesive group, and interactions with a group of HIV-positive speakers. Theatre-based, peer-led sexual health programmes can provide a transformative experience for undergraduate student performers. The transformative effects are linked to specific activities and processes of the intervention and require examination in future research.

Facilitators and barriers to the delivery of school-based smoking prevention interventions for children and young people: a protocol for a systematic review of qualitative studies.

PubMed

Dobbie, Fiona; Angus, Kathryn; Littlecott, Hannah; Allum, Karen; Wells, Valerie; Amos, Amanda; Haw, Sally; Bauld, Linda

2018-04-06

Despite a decline in child and adult smoking prevalence, young people who smoke (even occasionally) can rapidly become addicted to nicotine, with most adult smokers initiating smoking before they are 18. Schools have long been a popular setting to deliver youth smoking prevention interventions, but evidence of the effectiveness of school-based prevention programmes is mixed, and outcomes vary by the type of programme delivered. Existing systematic reviews that explore the factors contributing to the success or failure of school-based smoking prevention programmes often exclude qualitative studies, due to a focus on intervention effectiveness which qualitative research cannot answer. Instead, qualitative research is focussed on the experiences and perceptions of those involved in the programmes. This systematic review will address this gap by updating a 2009 review to examine qualitative studies. The aim is to generate deeper insight to help target resources which have the potential to save lives by preventing smoking initiation among children and young people. This systematic review will be searching the following databases: the Cochrane Library, MEDLINE, EMBASE, PsycINFO, HMIC, ERIC, ASSIA, Web of Science and CINAHL. In order to identify additional references, we will consult the reference lists of a sample of systematic reviews and search relevant organizational websites in order to identify appropriate grey literature. The search strategy will include key words and database-specific subject headings relating to smoking, children and young people, health promotion and school. Authors will independently screen, assess data quality and extract data for synthesis. Study findings will be synthesised thematically using 'best-fit framework syntheses'. This allows for an existing set of themes to be used as a starting point to map or code included studies. These themes are then adapted as coding takes place to accommodate new emerging themes. This review will focus on qualitative studies that seek to examine the barriers and facilitators to the delivery of school-based smoking prevention programmes in order to inform the design of future theory-based interventions in schools to prevent children and young people from smoking. PROSPERO CRD42014015483.

Raising Literacy Levels Using Digital Learning: A Design-Based Approach in New Zealand

ERIC Educational Resources Information Center

Jesson, Rebecca; McNaughton, Stuart; Wilson, Aaron

2015-01-01

This paper reports on a design-based intervention in urban primary and secondary schools serving culturally diverse students from low socio-economic status (SES) communities. The intervention capitalises on a partially implemented programme in seven schools which use digital devices (netbooks) and applications to raise literacy levels. Learning…

School Psychology and School-Based Child and Family Interventions in Singapore

ERIC Educational Resources Information Center

Chong, Wan Har; Lee, Boon Ooi; Tan, Soo Yin; Wong, Shyh Shin; Yeo, Lay See

2013-01-01

This article presents an overview of the range of primary, secondary, and tertiary interventions based on the Singapore Education Ministry-developed whole-school framework for pupil management and support. At the preventive level, a range of school-wide programmes are implemented to provide learning, emotional, and behavioural support for…

Moving against the Grain? Investigating the Efficacy of a Touch-Based Intervention in a Climate of Suspicion

ERIC Educational Resources Information Center

MacIntyre, Helen; Colwell, Jennifer; Ota, Cathy

2010-01-01

This article considers the implications of a small-scale research project, undertaken by the authors, which used the example of the Massage in Schools Programme (a simple peer massage programme) to ascertain whether the planned use of touch-based activity can support the growth of social and emotional skills in the primary classroom. Such claims…

The Constraints of Ghanaian Polytechnics in Adopting Competency Based Training (CBT): The Case of a Pilot-Tested Programme

ERIC Educational Resources Information Center

Alhassan, Munkaila; Habib, Abdallah Mohammed

2016-01-01

Polytechnics in Ghana view Competency Based Training (CBT) as a major intervention to the perennial constraints confronting its education and training. On the basis of this, and by government policy, a pilot programme of CBT was instituted in all the 10 polytechnics of Ghana, and was pilot tested in, at least, one department. Agricultural…

Considering the Contextual Fit of an Intervention for Families Headed by Parents with an Intellectual Disability: An Exploratory Study

ERIC Educational Resources Information Center

Mildon, Robyn; Wade, Catherine; Matthews, Jan

2008-01-01

Background: The purpose of this paper was to report on the results of an exploratory trial of an intensive home-based parenting programme for parents with an intellectual disability. The aim of the programme was to combine the delivery of evidence-based parent education technology for parents with an intellectual disability with two strategies…

How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa.

PubMed

Van Belle, Sara B; Marchal, Bruno; Dubourg, Dominique; Kegels, Guy

2010-11-30

This paper presents the development of a study design built on the principles of theory-driven evaluation. The theory-driven evaluation approach was used to evaluate an adolescent sexual and reproductive health intervention in Mali, Burkina Faso and Cameroon to improve continuity of care through the creation of networks of social and health care providers. Based on our experience and the existing literature, we developed a six-step framework for the design of theory-driven evaluations, which we applied in the ex-post evaluation of the networking component of the intervention. The protocol was drafted with the input of the intervention designer. The programme theory, the central element of theory-driven evaluation, was constructed on the basis of semi-structured interviews with designers, implementers and beneficiaries and an analysis of the intervention's logical framework. The six-step framework proved useful as it allowed for a systematic development of the protocol. We describe the challenges at each step. We found that there is little practical guidance in the existing literature, and also a mix up of terminology of theory-driven evaluation approaches. There is a need for empirical methodological development in order to refine the tools to be used in theory driven evaluation. We conclude that ex-post evaluations of programmes can be based on such an approach if the required information on context and mechanisms is collected during the programme.

How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa

PubMed Central

2010-01-01

Background This paper presents the development of a study design built on the principles of theory-driven evaluation. The theory-driven evaluation approach was used to evaluate an adolescent sexual and reproductive health intervention in Mali, Burkina Faso and Cameroon to improve continuity of care through the creation of networks of social and health care providers. Methods/design Based on our experience and the existing literature, we developed a six-step framework for the design of theory-driven evaluations, which we applied in the ex-post evaluation of the networking component of the intervention. The protocol was drafted with the input of the intervention designer. The programme theory, the central element of theory-driven evaluation, was constructed on the basis of semi-structured interviews with designers, implementers and beneficiaries and an analysis of the intervention's logical framework. Discussion The six-step framework proved useful as it allowed for a systematic development of the protocol. We describe the challenges at each step. We found that there is little practical guidance in the existing literature, and also a mix up of terminology of theory-driven evaluation approaches. There is a need for empirical methodological development in order to refine the tools to be used in theory driven evaluation. We conclude that ex-post evaluations of programmes can be based on such an approach if the required information on context and mechanisms is collected during the programme. PMID:21118510

Destigmatizing psychosis: Investigating the effectiveness of a school-based programme in Hong Kong secondary school students.

PubMed

Hui, Christy L M; Leung, Whitty W T; Wong, Andreas K H; Loong, Ka Yan; Kok, Joy; Hwang, Amanda; Lee, Edwin H M; Chan, Sherry K W; Chang, Wing Chung; Chen, Eric Y H

2018-06-11

Although the reasons behind the stigmatization of psychosis are manifold, poor mental health literacy among the general public is likely to be a major factor. In Hong Kong, the Early Psychosis Foundation (EPISO) was established in 2007 to tackle this issue by providing educational and mental health promotional activities, among other aims and services. The current study evaluated the effectiveness of a school-based interventional programme, the School Tour, developed by EPISO. The School Tour differentiates itself from other interventional programmes by supplementing a traditional psychoeducational talk with 2 additional elements: an engaging drama performance and exercise demonstrations. Twelve secondary schools, with a total of 4520 students, participated in the study. Knowledge and attitudes towards psychosis were evaluated before and after the school programme. The School Tour was found to improve both students' knowledge of psychosis (P < .001) and their attitude (P < .001) towards the illness. Its effectiveness in reducing the stigma towards psychosis validates the use of novel strategies like drama performances to engage adolescent students, and urges the government to support increased student participation in the programme by providing funding to the relevant organizations. © 2018 John Wiley & Sons Australia, Ltd.

Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial

PubMed Central

James, Janet; Thomas, Peter; Cavan, David; Kerr, David

2004-01-01

Objective To determine if a school based educational programme aimed at reducing consumption of carbonated drinks can prevent excessive weight gain in children. Design Cluster randomised controlled trial. Setting Six primary schools in southwest England. Participants 644 children aged 7-11 years. Intervention Focused educational programme on nutrition over one school year. Main outcome measures Drink consumption and number of overweight and obese children. Results Consumption of carbonated drinks over three days decreased by 0.6 glasses (average glass size 250 ml) in the intervention group but increased by 0.2 glasses in the control group (mean difference 0.7, 95% confidence interval 0.1 to 1.3). At 12 months the percentage of overweight and obese children increased in the control group by 7.5%, compared with a decrease in the intervention group of 0.2% (mean difference 7.7%, 2.2% to 13.1%). Conclusion A targeted, school based education programme produced a modest reduction in the number of carbonated drinks consumed, which was associated with a reduction in the number of overweight and obese children. PMID:15107313

Raising the Reading Skills of Secondary-Age Students with Severe and Persistent Reading Difficulties: Evaluation of the Efficacy and Implementation of a Phonics-Based Intervention Programme

ERIC Educational Resources Information Center

Jeffes, Ben

2016-01-01

The importance of reading skills to academic achievement, job acquisition and future success is well documented. Most of the research on reading interventions focuses on children in primary schools but many children start secondary school with very poor reading skills and schools require evidence-based interventions to support these children. The…

Parents' Experiences of Applied Behaviour Analysis (ABA)-Based Interventions for Children Diagnosed with Autistic Spectrum Disorder

ERIC Educational Resources Information Center

McPhilemy, Catherine; Dillenburger, Karola

2013-01-01

Applied behaviour analysis (ABA)-based programmes are endorsed as the gold standard for treatment of children with autistic spectrum disorder (ASD) in most of North America. This is not the case in most of Europe, where instead a non-specified "eclectic" approach is adopted. We explored the social validity of ABA-based interventions with…

"I Learned to Accept Every Part of Myself": The Transformative Impact of a Theatre-Based Sexual Health and HIV Prevention Programme

ERIC Educational Resources Information Center

Grewe, Mary E.; Taboada, Arianna; Dennis, Alexis; Chen, Elizabeth; Stein, Kathryn; Watson, Sable; Barrington, Clare; Lightfoot, Alexandra F.

2015-01-01

Theatre-based interventions have been used in health promotion with young people to address HIV and sexual health. In this study, we explored the experience of undergraduate student performers participating in a theatre-based HIV prevention and sexual health education intervention for high school students in the USA. Undergraduate students…

Understanding the theoretical underpinning of the exercise component in a fall prevention programme for older adults with mild dementia: a realist review protocol.

PubMed

Booth, Vicky; Harwood, Rowan; Hood, Victoria; Masud, Tahir; Logan, Philippa

2016-07-19

Older adults with mild dementia are at an increased risk of falls. Preventing those at risk from falling requires complex interventions involving patient-tailored strength- and balance-challenging exercises, home hazard assessment, visual impairment correction, medical assessment and multifactorial combinations. Evidence for these interventions in older adults with mild cognitive problems is sparse and not as conclusive as the evidence for the general community-dwelling older population. The objectives of this realist review are (i) to identify the underlying programme theory of strength and balance exercise interventions targeted at those individuals that have been identified as falling and who have a mild dementia and (ii) to explore how and why that intervention reduces falls in that population, particularly in the context of a community setting. This protocol will explain the rationale for using a realist review approach and outline the method. A realist review is a methodology that extends the scope of a traditional narrative or systematic evidence review. Increasingly used in the evaluation of complex interventions, a realist enquiry can look at the wider context of the intervention, seeking more to explain than judge if the intervention is effective by investigating why, what the underlying mechanism is and the necessary conditions for success. In this review, key rough programme theories were articulated and defined through discussion with a stakeholder group. The six rough programme theories outlined within this protocol will be tested against the literature found using the described comprehensive search strategy. The process of data extraction, appraisal and synthesis is outlined and will lead to the production of an explanatory programme theory. As far as the authors are aware, this is the first realist literature review within fall prevention research and adds to the growing use of this methodology within healthcare. This synthesis of evidence will provide a valuable addition to the evidence base surrounding the exercise component of a fall intervention programme for older adults with mild dementia and will ultimately provide clinically relevant recommendations for improving the care of people with dementia. PROSPERO CRD42015030169.

Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews.

PubMed

Foxcroft, David R; Tsertsvadze, Alexander

2012-05-01

Alcohol misuse by young people causes significant health and social harm, including death and disability. Therefore, prevention of youth alcohol misuse is a policy aim in many countries. Our aim was to examine the effectiveness of (1) school-based, (2) family-based and (3) multi-component universal alcohol misuse prevention programmes in children and adolescents. Three Cochrane systematic reviews were performed: searches in MEDLINE, EMBASE, PsycINFO, Project CORK and the Cochrane Register of Controlled Trials up to July 2010, including randomised trials evaluating universal alcohol misuse prevention programmes in school, family or multiple settings in youths aged 18 years or younger. Two independent reviewers identified eligible studies and any discrepancies were resolved via discussion. A total of 85 trials were included in the reviews of school (n = 53), family (n = 12) and multi-component (n = 20) programmes. Meta-analysis was not performed due to study heterogeneity. Most studies were conducted in North America. Risk of bias assessment revealed problems related to inappropriate unit of analysis, moderate to high attrition, selective outcome reporting and potential confounding. Certain generic psychosocial and life skills school-based programmes were effective in reducing alcohol use in youth. Most family-based programmes were effective. There was insufficient evidence to conclude that multiple interventions provided additional benefit over single interventions. In these Cochrane reviews, some school, family or multi-component prevention programmes were shown to be effective in reducing alcohol misuse in youths. However, these results warrant a cautious interpretation, since bias and/or contextual factors may have affected the trial results. Further research should replicate the most promising studies identified in these reviews and pay particular attention to content and context factors through rigorous evaluation.

Stepped-care to prevent depression and anxiety in visually impaired older adults--design of a randomised controlled trial.

PubMed

van der Aa, Hilde P A; van Rens, Ger H M B; Comijs, Hannie C; Bosmans, Judith E; Margrain, Tom H; van Nispen, Ruth M A

2013-08-09

Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in The Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Identifier: NTR3296.

A home-based rehabilitation intervention for people living with HIV and disability in a resource-poor community, KwaZulu-Natal: study protocol for a randomised controlled trial.

PubMed

Cobbing, Saul; Hanass-Hancock, Jill; Myezwa, Hellen

2015-11-02

In the era of highly active antiretroviral therapy HIV is now viewed as a chronic disease. Although people living with HIV are living longer lives, they are prone to a number of disabilities. Home-based rehabilitation has been shown to be an effective means of improving quality of life and function for people with a wide range of chronic diseases. There is a dearth of evidence, however, related to home-based rehabilitation interventions for people living with HIV, particularly in sub-Saharan Africa - the region with the highest global prevalence of HIV. A randomised controlled trial design will be employed. Adults living with HIV who have been on antiretroviral therapy for at least six months and with defined limited mobility will be randomly allocated to either an intervention group or the control group. Pre and post-intervention testing will be conducted at a public hospital in KwaZulu-Natal, South Africa in order to assess the participants' quality of life, perceived level of disability, functional ability and endurance. Individuals randomly allocated to the intervention group will participate in a four-month home-based rehabilitation programme, conducted once a week in their homes. This programme will be implemented by community workers who will be trained and supervised by a qualified physiotherapist. The participants in the control group will continue with the standard clinic management offered to them. On completion of the intervention, all participants will be re-assessed using the same outcome measures. Analysis of results will be carried out on intention-to-treat basis in order to identify any changes between intervention and control groups. The researchers aim to employ a novel task shifting approach to implement a needs-based home-based rehabilitation programme for people living with HIV in order to improve their quality of life and functional ability. It is hoped that this study will provide rehabilitation professionals and researchers with evidence that can be utilised to improve existing rehabilitation interventions for people living with HIV. South African National Clinical Trials Register: NHREC#4094 (Date of registration: 21 July 2015).

Can Developmental Cognitive Neuroscience Inform Intervention for Social, Emotional and Behavioural Difficulties (SEBD)?

ERIC Educational Resources Information Center

Frederickson, Norah; Jones, Alice P.; Warren, Laura; Deakes, Tara; Allen, Geoff

2013-01-01

An initial evaluation of the utility of designing an intervention to address neuroscience-based subtyping of children who have conduct problems was undertaken in this pilot study. Drawing on the literature on callous-unemotional traits, a novel intervention programme, "Let's Get Smart", was implemented in a school for children with…

Effects of an exercise programme for chronically ill and mobility-restricted elderly with structured support by the general practitioner's practice (HOMEfit) - study protocol of a randomised controlled trial

PubMed Central

2011-01-01

Background Exercise programmes can be administered successfully as therapeutic agents to patients with a number of chronic diseases and help to improve physical functioning in older adults. Usually, such programmes target either healthy and mobile community-dwelling seniors or elderly individuals living in nursing institutions or special residences. Chronically ill or mobility-restricted individuals, however, are difficult to reach when they live in their own homes. A pilot study has shown good feasibility of a home-based exercise programme that is delivered to this target group through cooperation between general practitioners and exercise therapists. A logical next step involves evaluation of the effects of the programme. Methods/design The study is designed as a randomised controlled trial. We plan to recruit 210 patients (≥ 70 years) in about 15 general practices. The experimental intervention (duration 12 weeks)-a multidimensional home-based exercise programme-is delivered to the participant by an exercise therapist in counselling sessions at the general practitioner's practice and on the telephone. It is based on methods and strategies for facilitating behaviour change according to the Health Action Process Approach (HAPA). The control intervention-baseline physical activities-differs from the experimental intervention with regard to content of the counselling sessions as well as to content and frequency of the promoted activities. Primary outcome is functional lower body strength measured by the "chair-rise" test. Secondary outcomes are: physical function (battery of motor tests), physical activity (step count), health-related quality of life (SF-8), fall-related self-efficacy (FES-I), and exercise self-efficacy (SSA-Scale). The hypothesis that there will be differences between the two groups (experimental/control) with respect to post-interventional chair-rise time will be tested using an ANCOVA with chair-rise time at baseline, treatment group, and study centre effects as explanatory variables. Analysis of the data will be undertaken using the principle of intention-to-treat. Trial registration Current Controlled Trials ISRCTN17727272. PMID:22188781

Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations.

PubMed

Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

2016-09-13

Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention.

Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations

PubMed Central

Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

2016-01-01

Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention. PMID:27649218

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

PubMed

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

2014-07-24

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

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

PubMed Central

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

2014-01-01

Introduction A survey conducted by the German Federal Centre for Health Education in 2012 showed that 35.2% of all young adults (18–25 years) and 12.0% of all adolescents (12–17 years) in Germany are regular cigarette smokers. Most smoked their first cigarette in early adolescence. We recently reported a significantly positive short-term effect of a physician-delivered school-based smoking prevention programme on the smoking behaviour of schoolchildren in Germany. However, physician-based programmes are usually very expensive. Therefore, we will evaluate and optimise Education against Tobacco (EAT), a widespread, low-cost programme delivered by about 400 medical students from 16 universities in Germany. Methods and analysis A prospective quasi-experimental study design with two measurements at baseline (t1) and 6 months post-intervention (t2) to investigate an intervention in 10–15-year-olds in grades 6–8 at German secondary schools. The intervention programme consists of two 60-min school-based medical-student-delivered modules with (module 1) and without the involvement of patients with tobacco-related diseases and control groups (no intervention). The study questionnaire measuring smoking status (water pipe and cigarette smoking), smoking-related cognitions, and gender, social and cultural aspects was designed and pre-tested in advance. The primary end point is the prevalence of smokers and non-smokers in the two study arms at 6 months after the intervention. The percentage of former smokers and new smokers in the two groups and the measures of smoking behaviour will be studied as secondary outcome measures. Ethics and dissemination In accordance with Good Epidemiologic Practice (GEP) guidelines, the study protocol was submitted for approval by the responsible ethics committee, which decided that the study does not need ethical approval (Goethe University, Frankfurt-Main, Germany). Findings will be disseminated in peer-reviewed journals, at conferences, within our scientific advisory board and through medical students within the EAT project. PMID:25059969

Informing the design of a randomised controlled trial of an exercise-based programme for long term stroke survivors: lessons from a before-and-after case series study

PubMed Central

2013-01-01

Background To inform the design of a randomised controlled trial (RCT) of an exercise-based programme for long term stroke survivors, we conducted a mixed methods before-and-after case series with assessment at three time points. We evaluated Action for Rehabilitation from Neurological Injury (ARNI), a personalised, functionally-focussed programme. It was delivered through 24 hours of one-to-one training by an Exercise Professional (EP), plus at least 2 hours weekly unsupervised exercise, over 12- 14 weeks. Assessment was by patient-rated questionnaires addressing function, physical activity, confidence, fatigue and health-related quality of life; objective assessment of gait quality and speed; qualitative individual interviews conducted with participants. Data were collected at baseline, 3 months and 6 months. Fidelity and acceptability was assessed by participant interviews, audit of participant and EP records, and observation of training. Findings Four of six enrolled participants completed the exercise programme. Quantitative data demonstrated little change across the sample, but marked changes on some measures for some individuals. Qualitative interviews suggested that small benefits in physical outcomes could be of great psychological significance to participants. Participant-reported fatigue levels commonly increased, and non-completers said they found the programme too demanding. Most key components of the intervention were delivered, but there were several potentially important departures from intervention fidelity. Discussion The study provided data and experience that are helping to inform the design of an RCT of this intervention. It suggested the need for a broader recruitment strategy; indicated areas that could be explored in more depth in the qualitative component of the trial; and highlighted issues that should be addressed to enhance and evaluate fidelity, particularly in the preparation and monitoring of intervention providers. The experience illustrates the value of even small sample before-and-after studies in the development of trials of complex interventions. PMID:23941470

Early interventions for youths at high risk for bipolar disorder: a developmental approach.

PubMed

Benarous, Xavier; Consoli, Angèle; Milhiet, Vanessa; Cohen, David

2016-03-01

In recent decades, ongoing research programmes on primary prevention and early identification of bipolar disorder (BD) have been developed. The aim of this article is to review the principal forms of evidence that support preventive interventions for BD in children and adolescents and the main challenges associated with these programmes. We performed a literature review of the main computerised databases (MEDLINE, PUBMED) and a manual search of the literature relevant to prospective and retrospective studies of prodromal symptoms, premorbid stages, risk factors, and early intervention programmes for BD. Genetic and environmental risk factors of BD were identified. Most of the algorithms used to measure the risk of developing BD and the early interventions programmes focused on the familial risk. The prodromal signs varied greatly and were age dependent. During adolescence, depressive episodes associated with genetic or environmental risk factors predicted the onset of hypomanic/manic episodes over subsequent years. In prepubertal children, the lack of specificity of clinical markers and difficulties in mood assessment were seen as impeding preventive interventions at these ages. Despite encouraging results, biomarkers have not thus far been sufficiently validated in youth samples to serve as screening tools for prevention. Additional longitudinal studies in youths at high risk of developing BD should include repeated measures of putative biomarkers. Staging models have been developed as an integrative approach to specify the individual level of risk based on clinical (e.g. prodromal symptoms and familial history of BD) and non-clinical (e.g. biomarkers and neuroimaging) data. However, there is still a lack of empirically validated studies that measure the benefits of using these models to design preventive intervention programmes.

Development and evaluation of a dietary self-management programme for older adults with low literacy and heart disease: pilot study of feasibility and acceptability.

PubMed

Shao, Jung-Hua; Chen, Su-Hui

2016-12-01

To develop a dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours for older adults with low literacy and heart disease and evaluate the feasibility and acceptability of the programme. Eating behaviours such as fluid, salt, fat and cholesterol intake are an important factor related to heart disease outcomes. People with low literacy have difficulty following recommended health behaviours, but limited research has investigated intervention programmes for this population. Programme development and pilot testing its feasibility and acceptability. Recommendations were also collected from participants and the research assistant for future large-scale interventions. The study had two phases. Phase I consisted of programme development based on previous qualitative findings, a systematic review of the literature, clinical practice experience and expert opinion. In Phase II, we pilot tested the programme from January - June 2014 in a convenience sample of 10 older adults with low literacy, heart disease and recruited from a medical centre in northern Taiwan. Pilot testing showed that our programme was feasible and acceptable to older adults with low literacy and heart disease. Moreover, the final version of the programme was revised based on participants' and the research assistant's recommendations. Our study results suggest that with guidance and assistance, older adults with low literacy and heart disease can be motivated to take action for their health and are empowered by learning how to self-manage their heart-healthy eating behaviours. © 2016 John Wiley & Sons Ltd.

Employment and educational outcomes in early intervention programmes for early psychosis: a systematic review.

PubMed

Bond, G R; Drake, R E; Luciano, A

2015-10-01

Young adults with early psychosis want to pursue normal roles - education and employment. This paper summarises the empirical literature on the effectiveness of early intervention programmes for employment and education outcomes. We conducted a systematic review of employment/education outcomes for early intervention programmes, distinguishing three programme types: (1) those providing supported employment, (2) those providing unspecified vocational services and (3) those without vocational services. We summarised findings for 28 studies. Eleven studies evaluated early intervention programmes providing supported employment. In eight studies that reported employment outcomes separately from education outcomes, the employment rate during follow-up for supported employment patients was 49%, compared with 29% for patients receiving usual services. The two groups did not differ on enrolment in education. In four controlled studies, meta-analysis showed that the employment rate for supported employment participants was significantly higher than for control participants, odds ratio = 3.66 [1.93-6.93], p < 0.0001. Five studies (four descriptive and one quasi-experimental) of early intervention programmes evaluating unspecified vocational services were inconclusive. Twelve studies of early intervention programmes without vocational services were methodologically heterogeneous, using diverse methods for evaluating vocational/educational outcomes and precluding a satisfactory meta-analytic synthesis. Among studies with comparison groups, 7 of 11 (64%) reported significant vocational/education outcomes favouring early intervention over usual services. In early intervention programmes, supported employment moderately increases employment rates but not rates of enrolment in education. These improvements are in addition to the modest effects early programmes alone have on vocational/educational outcomes compared with usual services.

The First-aid Advice and Safety Training (FAST) parents programme for the prevention of unintentional injuries in preschool children: a protocol.

PubMed

Mytton, Julie A; Towner, Elizabeth Ml; Kendrick, Denise; Stewart-Brown, Sarah; Emond, Alan; Ingram, Jenny; Blair, Peter S; Powell, Jane; Mulvaney, Caroline; Thomas, James; Deave, Toity; Potter, Barbara

2014-02-01

Unintentional injury is the leading cause of preventable death in children in the UK, and 0-4-year-olds frequently attend emergency departments following injuries in the home. Parenting programmes designed to support parents, promote behaviour change and enhance parent-child relationships have been shown to improve health outcomes in children. It is not known whether group-based parenting programmes have the potential to prevent unintentional injuries in preschool children. A study to develop a group-based parenting programme to prevent unintentional home injuries in preschool children, and assess the feasibility of evaluation through a cluster-randomised controlled trial. The intervention, designed for parents of children who have sustained a medically attended injury, will be developed with two voluntary sector organisations. The feasibility study will assess ability to recruit parents, deliver the programme and follow-up participants. Participants will complete questionnaires at baseline, 3 months and 6 months, and report injuries in their preschool children using a tool designed and validated for this study. Qualitative methods will assess user and deliverer perceptions of the programme. This study will develop the first group-based parenting programme to prevent injuries in preschool children, and design tools for parent-reported injury outcomes. A key challenge will be to recruit parents to participate in a manner that is non-stigmatising, and does not result in feelings of guilt or belief that they are perceived to be a bad parent. The findings will be used to prepare a trial to assess the effectiveness and cost-effectiveness of the intervention.

Addressing sexual health behaviour during emerging adulthood: a critical review of the literature.

PubMed

Alexander, Kamila A; Jemmott, Loretta S; Teitelman, Anne M; D'Antonio, Patricia

2015-01-01

In this critical literature review, we examine evidence-based interventions that target sexual behaviours of 18- to 25-year-old emerging adult women. Nurses and clinicians implement theory-driven research programmes for young women with increased risk of HIV/AIDS and sexually transmitted infections. Strategies to decrease transmission of HIV and sexually transmitted infections are rigorously evaluated and promoted by public health agencies such as the United States Centers for Disease Control and Prevention. While many interventions demonstrate episodic reductions in sexual risk behaviours and infection transmission, there is little evidence they build sustainable skills and behaviours. Programmes may not attend to contextual and affective influences on sexual behaviour change. Discursive paper. We conducted a conceptually based literature review and critical analysis of the Centers for Disease Control and Prevention's best-evidence and good-evidence HIV behavioural interventions. In this review, we examined three contextual and affective influences on the sexual health of emerging adult women: (1) developmental age, (2) reproduction and pregnancy desires and (3) sexual security or emotional responses accompanying relationship experiences. Our analyses revealed intervention programmes paid little attention to ways age, desires for pregnancy or emotional factors influence sexual decisions. Some programmes included 18- to 25-year-olds, but they made up small percentages of the sample and did not attend to unique emerging adult experiences. Second, primary focus on infection prevention overshadowed participant desires for pregnancy. Third, few interventions considered emotional mechanisms derived from relationship experiences involved in sexual decision-making. Growing evidence demonstrates sexual health interventions may be more effective if augmented to attend to contextual and affective influences on relationship risks and decision-making. Modifying currently accepted strategies may enhance sustainability of sexual health-promoting behaviours. This study provides nurses and public health educators with recommendations for broadening the content of sexual health promotion intervention programming. © 2014 John Wiley & Sons Ltd.

A qualitative evidence synthesis on the management of male obesity

PubMed Central

Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Stewart, Fiona; Robertson, Clare; Boyers, Dwayne; Avenell, Alison

2015-01-01

Objectives To investigate what weight management interventions work for men, with which men, and under what circumstances. Design Realist synthesis of qualitative studies. Data sources Sensitive searches of 11 electronic databases from 1990 to 2012 supplemented by grey literature searches. Study selection Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m2 in all settings. Results 22 studies were identified, including 5 qualitative studies linked to randomised controlled trials of weight maintenance interventions and 8 qualitative studies linked to non-randomised intervention studies, and 9 relevant UK-based qualitative studies not linked to any intervention. Health concerns and the perception that certain programmes had ‘worked’ for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled ‘obese’; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design. Conclusions Men's perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition. PMID:26459486

A qualitative evidence synthesis on the management of male obesity.

PubMed

Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Stewart, Fiona; Robertson, Clare; Boyers, Dwayne; Avenell, Alison

2015-10-12

To investigate what weight management interventions work for men, with which men, and under what circumstances. Realist synthesis of qualitative studies. Sensitive searches of 11 electronic databases from 1990 to 2012 supplemented by grey literature searches. Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m(2) in all settings. 22 studies were identified, including 5 qualitative studies linked to randomised controlled trials of weight maintenance interventions and 8 qualitative studies linked to non-randomised intervention studies, and 9 relevant UK-based qualitative studies not linked to any intervention. Health concerns and the perception that certain programmes had 'worked' for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled 'obese'; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design. Men's perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A systematic review of assessment and intervention strategies for effective clinical communication in culturally and linguistically diverse students.

PubMed

Chan, Annie; Purcell, Alison; Power, Emma

2016-09-01

Culturally and linguistically diverse (CALD) students often experience difficulties with the clinical communication skills that are essential for successful interactions in the workplace. However, there is little evidence on the effectiveness of assessment and intervention strategies for this population. The two aims of this study were: to evaluate the effectiveness of assessment tools in identifying and describing the clinical communication difficulties of CALD health care students; and to determine whether communication programmes improved their clinical communication skills. Systematic review based on the Cochrane protocol. Articles were identified through a search of established databases using MeSH and key search terms. Studies published in English from 1990 to March 2015 were included if they described assessment strategies or a training programme for communication skills of CALD students. Studies were excluded if they did not describe implementation of a specific assessment or intervention programme. Data were extracted independently by the first author and verified by the second author. Quality was measured by the Best Evidence Medical Education guide and the Educational Interventions Critical Appraisal Tool. The Kirkpatrick hierarchy was used to measure impact. Meta-analysis was not conducted because of the heterogeneity of programme design and outcome measures. One hundred and twenty-nine articles met the criteria for full text review. Eighty-six articles were excluded. Thirteen articles addressing assessment and 30 articles reporting on communication training programmes were included in this review. Assessment tools used rubrics and rating scales effectively. Intervention studies focused on speech and language skills (n = 20), interpersonal skills (n = 7) and faculty-level support (n = 5). Although 17 studies reported positive findings on student satisfaction, only eight reported improved skills post-training. The development of effective assessment and intervention programmes should have an integrated design and include specific outcome measures to increase educational impact. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

[Psychopedagogical intervention in attention deficit hyperactivity disorder].

PubMed

Abad-Mas, Luis; Ruiz-Andrés, Rosalía; Moreno-Madrid, Francisca; Herrero, Raquel; Suay, Enrique

2013-09-06

Children with attention deficit hyperactivity disorder (ADHD) present alterations in both their attentional mechanisms and their inhibitory control processes (impulsiveness and hyperactivity), which have different effects on their academic, socio-emotional and behavioural achievement. Therefore it is essential to have access to intervention strategies in the field of psychopedagogics that can have a favourable effect on the developmental course of the patients. To review the psychopedagogical foundations underlying interventions in cases of ADHD, bearing in mind the relation between the functional anatomy and the clinical symptoms and the corresponding programmes of intervention. Three syndromes stand out above the rest: orbitofrontal, dorsolateral and in the cingulate at the medial level. The phases of psychopedagogical intervention should cover both the child and his or her family and school. Neurocognitive training is focused on the child, and is based on programmes for training the executive functions and on interventions involving the academic, behavioural and socio-affective spheres. Behavioural modification programmes are complementary and on many occasions improve the compromised behaviour in children with ADHD. Psychopedagogical guidance at school must be considered necessary for an effective intervention in the academic environment. Psychopedagogical interventions in children with ADHD must include personalised treatment within a multidisciplinary methodology that takes into account all the contexts in which the child is developing, his or her cognitive performance and the appropriate pharmacological intervention in each case.

Levels of cardiovascular disease risk factors in Singapore following a national intervention programme.

PubMed Central

Cutter, J.; Tan, B. Y.; Chew, S. K.

2001-01-01

OBJECTIVE: To evaluate the impact of the National Healthy Lifestyle Programme, a noncommunicable disease intervention programme for major cardiovascular disease risk factors in Singapore, implemented in 1992. METHODS: The evaluation was carried out in 1998 by the Singapore National Health Survey (NHS). The reference population was 2.2 million multiracial Singapore residents, 18-69 years of age. A population-based survey sample (n = 4723) was selected by disproportionate stratified and systematic sampling. Anthropometric and blood pressure measurements were carried out on all subjects and blood samples were taken for biochemical analysis. FINDINGS: The 1998 results suggest that the National Healthy Lifestyle Programme significantly decreased regular smoking and increased regular exercise over 1992 levels and stabilized the prevalence of obesity and diabetes mellitus. However, the prevalence of high total blood cholesterol and hypertension increased. Ethnic differences in the prevalence of diabetes mellitus, hypertension, and smoking; and in lipid profile and exercise levels were also observed. CONCLUSION: The intervention had mixed results after six years. Successful strategies have been continued and strengthened. PMID:11693972

Telerehabilitation - a new model for community-based stroke rehabilitation.

PubMed

Lai, Jerry C K; Woo, Jean; Hui, Elsie; Chan, W M

2004-01-01

Community resources for stroke clients are underdeveloped in Hong Kong and stroke survivors often face difficulties in community reintegration. We have examined the feasibility of using videoconferencing for community-based stroke rehabilitation. The sample comprised 21 stroke patients living at home. All the subjects participated in an eight-week intervention programme at a community centre for seniors. The intervention, which comprised educational talks, exercise and psychosocial support, was conducted by a physiotherapist via a videoconference link. The Berg Balance Scale (BBS), State Self-Esteem Scale (SSES), Medical Outcomes Study 36-item Short Form (SF-36) and a stroke knowledge test were administered at the start and end of the programme. In addition, at the start of the study the Geriatric Depression Scale 15-item Short Form, the Elderly Mobility Scale and the Lawton Instrumental Activities of Daily Living Scale were used to assess subjects' baseline status, and a focus group was also held at the end of the programme to gather qualitative findings. Nineteen subjects completed the eight-week intervention. The baseline functional status was high, although 52% had symptoms of depression. After the intervention, there were significant improvements in BBS, SSES and knowledge test scores and scores on all subscales of the SF-36. All the subjects accepted the use of videoconferencing for delivery of the intervention. The pilot study demonstrated the feasibility, efficacy and high level of acceptance of telerehabilitation for community-dwelling stroke clients.

Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach.

PubMed

Shields-Zeeman, Laura; Pathare, Soumitra; Walters, Bethany Hipple; Kapadia-Kundu, Nandita; Joag, Kaustubh

2017-01-01

There are limited accounts of community-based interventions for reducing distress or providing support for people with common mental disorders (CMDs) in low and middle-income countries. The recently implemented Atmiyata programme is one such community-based mental health intervention focused on promoting wellness and reducing distress through community volunteers in a rural area in the state of Maharashtra, India. This case study describes the content and the process of implementation of Atmiyata and how community volunteers were trained to become Atmiyata champions and mitras ( friends ). The Atmiyata programme trained Atmiyata champions to provide support and basic counselling to community members with common mental health disorders, facilitate access to mental health care and social benefits, improve community awareness of mental health issues, and to promote well-being. Challenges to implementation included logistical challenges (difficult terrain and weather conditions at the implementation site), content-related challenges (securing social welfare benefits for people with CMDs), and partnership challenges (turnover of public health workers involved in referral chain, resistance from public sector mental health specialists). The case study serves as an example for how such a model can be sustained over time at low cost. The next steps of the programme include evaluation of the impact of the Atmiyata intervention through a pre-post study and adapting the intervention for further scale-up in other settings in India.

Outcomes of people with psychotic disorders in a community-based rehabilitation programme in rural India

PubMed Central

Chatterjee, Sudipto; Pillai, Aravind; Jain, Sumeet; Cohen, Alex; Patel, Vikram

2009-01-01

Background There is little evidence of the feasibility, acceptability and impact of services for the care of people with psychotic disorders in low- and middle-income countries. Aims To describe the scaling up and impact of a community-based rehabilitation programme for people with psychotic disorders in a very-low-resource setting. Methods Longitudinal study of people with psychotic disorders who had been ill for an average of 8 years in a rural Indian community. All individuals received a community-based intervention package comprising psychotropic medications, psychoeducation, adherence management, psychosocial rehabilitation and support for livelihoods. The primary outcome was change in disability scores. Results The cohort consisted of 256 people with psychotic disorders (schizophrenia, bipolar affective disorder and other psychosis) of whom 236 people completed the end-point assessments (92%), with a median follow-up of 46 months. There were significant reductions (P<0.05) in the levels of disability for the cohort, the vast majority (83.5%) of whom engaged with the programme. On multivariate analyses, lower baseline disability scores, family engagement with the programme, medication adherence and being a member of a self-help group were independent determinants of good outcomes. Lack of formal education, a diagnosis of schizophrenia and dropping out of the programme were independent determinants of poor outcomes. Conclusions Community-based rehabilitation is a feasible and acceptable intervention with a beneficial impact on disability for the majority of people with psychotic disorders in low-resource settings. The impact on disability is influenced by a combination of clinical, programme and social determinants. PMID:19880934

Evaluation of quality improvement programmes

PubMed Central

Ovretveit, J; Gustafson, D

2002-01-01



 In response to increasing concerns about quality, many countries are carrying out large scale programmes which include national quality strategies, hospital programmes, and quality accreditation, assessment and review processes. Increasing amounts of resources are being devoted to these interventions, but do they ensure or improve quality of care? There is little research evidence as to their effectiveness or the conditions for maximum effectiveness. Reasons for the lack of evaluation research include the methodological challenges of measuring outcomes and attributing causality to these complex, changing, long term social interventions to organisations or health systems, which themselves are complex and changing. However, methods are available which can be used to evaluate these programmes and which can provide decision makers with research based guidance on how to plan and implement them. This paper describes the research challenges, the methods which can be used, and gives examples and guidance for future research. It emphasises the important contribution which such research can make to improving the effectiveness of these programmes and to developing the science of quality improvement. PMID:12486994

Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women

PubMed Central

Ismail, Suriani; Shamsuddin, Khadijah; Latiff, Khalib A.; Saad, Hazizi A.; Majid, Latifah A.; Othman, Fadlan M.

2015-01-01

Objectives: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. Methods: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants’ dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan. Results: Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01). Conclusion: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients. PMID:25685394

A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviour.

PubMed

Lee, Tarryn J; Cameron, Linda D; Wünsche, Burkhard; Stevens, Carey

2011-02-01

Advances in web-based animation technologies provide new opportunities to develop graphic health communications for dissemination throughout communities. We developed imagery and text contents of brief, computer-based programmes about heart disease risk, with both imagery and text contents guided by the common-sense model (CSM) of self-regulation. The imagery depicts a three-dimensional, beating heart tailored to user-specific information. A 2 × 2 × 4 factorial design was used to manipulate concrete imagery (imagery vs. no imagery) and conceptual information (text vs. no text) about heart disease risk in prevention-oriented programmes and assess changes in representations and behavioural motivations from baseline to 2 days, 2 weeks, and 4 weeks post-intervention. Sedentary young adults (N= 80) were randomized to view one of four programmes: imagery plus text, imagery only, text only, or control. Participants completed measures of risk representations, worry, and physical activity and healthy diet intentions and behaviours at baseline, 2 days post-intervention (except behaviours), and 2 weeks (intentions and behaviours only) and 4 weeks later. The imagery contents increased representational beliefs and mental imagery relating to heart disease, worry, and intentions at post-intervention. Increases in sense of coherence (understanding of heart disease) and worry were sustained after 1 month. The imagery contents also increased healthy diet efforts after 2 weeks. The text contents increased beliefs about causal factors, mental images of clogged arteries, and worry at post-intervention, and increased physical activity 2 weeks later and sense of coherence 1 month later. The CSM-based programmes induced short-term changes in risk representations and behaviour motivation. The combination of CSM-based text and imagery appears to be most effective in instilling risk representations that motivate protective behaviour. ©2010 The British Psychological Society.

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care.

PubMed

Guiriguet, Carolina; Muñoz-Ortiz, Laura; Burón, Andrea; Rivero, Irene; Grau, Jaume; Vela-Vallespín, Carmen; Vilarrubí, Mercedes; Torres, Miquel; Hernández, Cristina; Méndez-Boo, Leonardo; Toràn, Pere; Caballeria, Llorenç; Macià, Francesc; Castells, Antoni

2016-07-01

Participation rates in colorectal cancer screening are below recommended European targets. To evaluate the effectiveness of an alert in primary care electronic medical records (EMRs) to increase individuals' participation in an organised, population-based colorectal cancer screening programme when compared with usual care. Cluster randomised controlled trial in primary care centres of Barcelona, Spain. Participants were males and females aged 50-69 years, who were invited to the first round of a screening programme based on the faecal immunochemical test (FIT) (n = 41 042), and their primary care professional. The randomisation unit was the physician cluster (n = 130) and patients were blinded to the study group. The control group followed usual care as per the colorectal cancer screening programme. In the intervention group, as well as usual care, an alert to health professionals (cluster level) to promote screening was introduced in the individual's primary care EMR for 1 year. The main outcome was colorectal cancer screening participation at individual participant level. In total, 67 physicians and 21 619 patients (intervention group) and 63 physicians and 19 423 patients (control group) were randomised. In the intention-to-treat analysis screening participation was 44.1% and 42.2% respectively (odds ratio 1.08, 95% confidence interval [CI] = 0.97 to 1.20, P = 0.146). However, in the per-protocol analysis screening uptake in the intervention group showed a statistically significant increase, after adjusting for potential confounders (OR, 1.11; 95% CI = 1.02 to 1.22; P = 0.018). The use of an alert in an individual's primary care EMR is associated with a statistically significant increased uptake of an organised, FIT-based colorectal cancer screening programme in patients attending primary care centres. © British Journal of General Practice 2016.

Introducing a new monitoring manual for home fortification and strengthening capacity to monitor nutrition interventions.

PubMed

Jefferds, Maria Elena D; Flores-Ayala, Rafael

2015-12-01

Lack of monitoring capacity is a key barrier for nutrition interventions and limits programme management, decision making and programme effectiveness in many low-income and middle-income countries. A 2011 global assessment reported lack of monitoring capacity was the top barrier for home fortification interventions, such as micronutrient powders or lipid-based nutrient supplements. A Manual for Developing and Implementing Monitoring Systems for Home Fortification Interventions was recently disseminated. It is comprehensive and describes monitoring concepts and frameworks and includes monitoring tools and worksheets. The monitoring manual describes the steps of developing and implementing a monitoring system for home fortification interventions, including identifying and engaging stakeholders; developing a programme description including logic model and logical framework; refining the purpose of the monitoring system, identifying users and their monitoring needs; describing the design of the monitoring system; developing indicators; describing the core components of a comprehensive monitoring plan; and considering factors related to stage of programme development, sustainability and scale up. A fictional home fortification example is used throughout the monitoring manual to illustrate these steps. The monitoring manual is a useful tool to support the development and implementation of home fortification intervention monitoring systems. In the context of systematic capacity gaps to design, implement and monitor nutrition interventions in many low-income and middle-income countries, the dissemination of new tools, such as monitoring manuals may have limited impact without additional attention to strengthening other individual, organisational and systems levels capacities. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Evaluation of a School-Based Sex Education Programme Delivered to Grade Nine Students in Canada

ERIC Educational Resources Information Center

Smylie, Lisa; Maticka-Tyndale, Eleanor; Boyd, Dana

2008-01-01

The effectiveness of a multidimensional Canadian sex education programme was evaluated using 240 Grade Nine students. The intervention was offered by representatives from various community groups and involved instructional classes on anatomy/physiology of the reproductive system and sexually transmitted infections, a video and group discussion on…

Striking the Right Note: The Cultural Preparedness Approach to Developing Resonant Career Guidance Programmes

ERIC Educational Resources Information Center

Arulmani, G.

2011-01-01

Cultural preparedness is presented as a conceptual framework that could guide the development of culture-resonant interventions. The "Jiva" careers programme is presented as a case study to illustrate a method of career and livelihood planning based upon Indian epistemology and cultural practices. Social cognitive environments and career beliefs…

Physical activity school intervention: context matters.

PubMed

Guldager, J D; Andersen, P T; von Seelen, J; Leppin, A

2018-06-01

School-based interventions for increasing physical activity among children are widespread, however there is still a lack of knowledge about how school context factors are linked to implementation quality and effectiveness of programmes. The aim of this paper is to examine teacher-perceived effectiveness of a Danish national classroom-based health programme 'Active Around Denmark' and in particular, to investigate whether perceptions vary as a function of school social context factors. After completion of the programme all teachers (N = 5.892) received an electronic questionnaire. 2.097 completed the questionnaire (response rate 36%) and 1.781 datasets could be used for analysis. The teachers were asked about their perceptions of changes in children's attitudes towards and levels of physical activity after the competition. Our results indicated that certain contextual factors, such as schools' prioritization of health promotion, teachers' support by their school principal in implementation as well as teacher's satisfaction with the school' physical environment made a significant difference in teacher-perceived effectiveness. To conclude, teacher-perceived effectiveness of the health programme does vary as a function of school social context factors.

Lessons learned from the AFLY5 RCT process evaluation: implications for the design of physical activity and nutrition interventions in schools.

PubMed

Jago, R; Rawlins, E; Kipping, R R; Wells, S; Chittleborough, C; Peters, T J; Mytton, J; Lawlor, D A; Campbell, R

2015-09-23

Systematic reviews have highlighted that school-based diet and physical activity (PA) interventions have had limited effects. This study used qualitative methods to examine how the effectiveness of future primary (elementary) school diet and PA interventions could be improved. Data are from the Active For Life Year 5 (AFLY5) study, which was a cluster randomised trial conducted in 60 UK primary schools. Year 5 (8-9 years of age) pupils in the 30 intervention schools received a 12-month intervention. At the end of the intervention period, interviews were conducted with: 28 Year 5 teachers (including 8 teachers from control schools); 10 Headteachers (6 control); 31 parents (15 control). Focus groups were conducted with 70 year 5 pupils (34 control). Topics included how the AFLY5 intervention could have been improved and how school-based diet and PA interventions should optimally be delivered. All interviews and focus groups were transcribed and thematically analysed across participant groups. Analysis yielded four themes. Child engagement: Data suggested that programme success is likely to be enhanced if children feel that they have a sense of autonomy over their own behaviour and if the activities are practical. School: Finding a project champion within the school would enhance intervention effectiveness. Embedding diet and physical activity content across the curriculum and encouraging teachers to role model good diet and physical activity behaviours were seen as important. Parents and community: Encouraging parents and community members into the school was deemed likely to enhance the connection between schools, families and communities, and "create a buzz" that was likely to enhance behaviour change. Government/Policy: Data suggested that there was a need to adequately resource health promotion activity in schools and to increase the infrastructure to facilitate diet and physical activity knowledge and practice. Future primary school diet and PA programmes should find ways to increase child engagement in the programme content, identify programme champions, encourage teachers to work as role models, engage parents and embed diet and PA behaviour change across the curriculum. However, this will require adequate funding and cost-effectiveness will need to be established. ISRCTN50133740.

Effectiveness of a community-based nutrition programme to improve child growth in rural Ethiopia: a cluster randomized trial.

PubMed

Kang, Yunhee; Kim, Sungtae; Sinamo, Sisay; Christian, Parul

2017-01-01

Few trials have shown that promoting complementary feeding among young children is effective in improving child linear growth in resource-challenged settings. We designed a community-based participatory nutrition promotion (CPNP) programme adapting a Positive Deviance/Hearth approach that engaged mothers in 2-week nutrition sessions using the principles of 'learning by doing' around child feeding. We aimed to test the effectiveness of the CPNP for improving child growth in rural Ethiopia. A cluster randomized trial was implemented by adding the CPNP to the existing government nutrition programmes (six clusters) vs. government programmes only (six clusters). A total of 1790 children aged 6 to 12 months (876 in the intervention and 914 in the control areas) were enrolled and assessed on anthropometry every 3 months for a year. Multi-level mixed-effect regression analysis of longitudinal outcome data (n = 1475) examined the programme impact on growth, adjusting for clustering and enrollment characteristics. Compared with children 6 to 24 months of age in the control area, those in the intervention area had a greater increase in z scores for length-for-age [difference (diff): 0.021 z score/month, 95% CI: 0.008, 0.034] and weight-for-length (diff: 0.042 z score/month, 95% CI: 0.024, 0.059). At the end of the 12-month follow-up, children in the intervention area showed an 8.1% (P = 0.02) and 6.3% (P = 0.046) lower prevalence of stunting and underweight, respectively, after controlling for differences in the prevalence at enrollment, compared with the control group. A novel CPNP programme was effective in improving child growth and reducing undernutrition in this setting. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

Effects of a community-based nutrition promotion programme on child feeding and hygiene practices among caregivers in rural Eastern Ethiopia.

PubMed

Kang, Yunhee; Suh, Youn Kyoung; Debele, Lemma; Juon, Hee-Soon; Christian, Parul

2017-06-01

To evaluate the effectiveness of a community-based participatory nutrition promotion (CPNP) programme involving a 2-week group nutrition session in improving child feeding and hygiene practices among caregivers. Cluster randomized trial. In the intervention area (six clusters), the CPNP programme was added to the context of government nutrition programmes; the control area (six clusters) received the government programme only. Child feeding practices were assessed every 3 months using a 24 h dietary recall questionnaire, and hand washing with soap was assessed every 6 months, over a period of 12 months. Feeding and hygiene measures at each visit were scored and the scores summed up for the entire follow-up period. Habro and Melka Bello districts, Ethiopia. Randomly selected mothers with a child aged 6-12 months (n 1790). A total of 1199 mothers, 629 in the control and 570 in the intervention areas, were assessed at all visits and included in the analysis. Mothers in the intervention area showed higher scores than those in the control area regarding meal frequency (difference: 1·04, 95 % CI 0·35, 1·73), composite feeding score_1 (difference: 1·25, 95 % CI 0·37, 2·13; a summing score of currently breast-feeding, meal frequency and dietary diversity) and composite feeding score_2 (difference: 1·40, 95 % CI 0·49, 2·32; a summing score of meal frequency and dietary diversity). However, there were no differences in the scores of breast-feeding, dietary diversity and hand washing between the two areas (all P>0·05). The CPNP programme was effective in improving some child feeding behaviours in rural Eastern Ethiopia.

Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomised controlled trial

PubMed Central

Simpson, Sharon A; Dunstan, Frank; Rollnick, Stephen; Cohen, David; Gillespie, David; Evans, Meirion R; health, senior lecturer in epidemiology and public; Alam, M Fasihul; Bekkers, Marie-Jet; Evans, John; Moore, Laurence; Howe, Robin; Hayes, Jamie; Hare, Monika; Hood, Kerenza

2012-01-01

Objective To evaluate the effectiveness and costs of a multifaceted flexible educational programme aimed at reducing antibiotic dispensing at the practice level in primary care. Design Randomised controlled trial with general practices as the unit of randomisation and analysis. Clinicians and researchers were blinded to group allocation until after randomisation. Setting 68 general practices with about 480 000 patients in Wales, United Kingdom. Participants 34 practices were randomised to receive the educational programme and 34 practices to be controls. 139 clinicians from the intervention practices and 124 from control practices had agreed to participate before randomisation. Practice level data covering all the clinicians in the 68 practices were analysed. Interventions Intervention practices followed the Stemming the Tide of Antibiotic Resistance (STAR) educational programme, which included a practice based seminar reflecting on the practices’ own dispensing and resistance data, online educational elements, and practising consulting skills in routine care. Control practices provided usual care. Main outcome measures Total numbers of oral antibiotic items dispensed for all causes per 1000 practice patients in the year after the intervention, adjusted for the previous year’s dispensing. Secondary outcomes included reconsultations, admissions to hospital for selected causes, and costs. Results The rate of oral antibiotic dispensing (items per 1000 registered patients) decreased by 14.1 in the intervention group but increased by 12.1 in the control group, a net difference of 26.1. After adjustment for baseline dispensing rate, this amounted to a 4.2% (95% confidence interval 0.6% to 7.7%) reduction in total oral antibiotic dispensing for the year in the intervention group relative to the control group (P=0.02). Reductions were found for all classes of antibiotics other than penicillinase-resistant penicillins but were largest and significant individually for phenoxymethylpenicillins (penicillin V) (7.3%, 0.4% to 13.7%) and macrolides (7.7%, 1.1% to 13.8%). There were no significant differences between intervention and control practices in the number of admissions to hospital or in reconsultations for a respiratory tract infection within seven days of an index consultation. The mean cost of the programme was £2923 (€3491, $4572) per practice (SD £1187). There was a 5.5% reduction in the cost of dispensed antibiotics in the intervention group compared with the control group (−0.4% to 11.4%), equivalent to a reduction of about £830 a year for an average intervention practice. Conclusion The STAR educational programme led to reductions in all cause oral antibiotic dispensing over the subsequent year with no significant change in admissions to hospital, reconsultations, or costs. Trial registration ISRCT No 63355948. PMID:22302780

Community-Based Interventions for Newborns in Ethiopia (COMBINE): Cost-effectiveness analysis.

PubMed

Mathewos, Bereket; Owen, Helen; Sitrin, Deborah; Cousens, Simon; Degefie, Tedbabe; Wall, Stephen; Bekele, Abeba; Lawn, Joy E; Daviaud, Emmanuelle

2017-10-01

About 87 000 neonates die annually in Ethiopia, with slower progress than for child deaths and 85% of births are at home. As part of a multi-country, standardized economic evaluation, we examine the incremental benefit and costs of providing management of possible serious bacterial infection (PSBI) for newborns at health posts in Ethiopia by Health Extension Workers (HEWs), linked to improved implementation of existing policy for community-based newborn care (Health Extension Programme). The government, with Save the Children/Saving Newborn Lives and John Snow, Inc., undertook a cluster randomized trial. Both trial arms involved improved implementation of the Health Extension Programme. The intervention arm received additional equipment, support and supervision for HEWs to identify and treat PSBI. In 2012, ∼95% of mothers in the study area received at least one pregnancy or postnatal visit in each arm, an average of 5.2 contacts per mother in the intervention arm (4.9 in control). Of all visits, 79% were conducted by volunteer community health workers. HEWs spent around 9% of their time on the programme. The financial cost per mother and newborn was $34 (in 2015 USD) in the intervention arm ($27 in control), economic costs of $37 and $30, respectively. Adding PSBI management at community level was estimated to reduce neonatal mortality after day 1 by 17%, translating to a cost per DALY averted of $223 or 47% of the GDP per capita, a highly cost-effective intervention by WHO thresholds. In a routine situation, the intervention programme cost would represent 0.3% of public health expenditure per capita and 0.5% with additional monthly supervision meetings. A platform wide approach to improved supervision including a dedicated transport budget may be more sustainable than a programme-specific approach. In this context, strengthening the existing HEW package is cost-effective and also avoids costly transfers to health centres/hospitals. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A study protocol of a randomised controlled trial to investigate if a community based strength training programme improves work task performance in young adults with Down syndrome.

PubMed

Shields, Nora; Taylor, Nicholas F; Fernhall, Bo

2010-03-25

Muscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome. A randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry), muscle strength (1 repetition maximum for chest and leg press) and physical activity (frequency, duration, intensity over 7-days) will be assessed at baseline (Week 0), following the intervention (Week 11), and at 3 months post intervention (Week 24) by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates. This paper outlines the study protocol for a randomised controlled trial on the effects of progressive resistance training on work task performance and physical activity for adolescents and young adults with Down syndrome. The intervention addresses the impairment of muscle weakness which may improve work task performance and help to increase physical activity levels. Australian New Zealand Clinical Trials Registry ACTRN12609000938202.

The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation

PubMed Central

2012-01-01

Background Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. Methods The intervention was based on the WHO’s Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Results Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students’ anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the programme, as expressed by principals, parents and students. A minority of teachers complained that there was inadequate information sharing about the programme and mentioned reservations about the capacities of the lay health counsellor. Preliminary evidence of the positive effects of the programme included the correction of vision problems detected in health screening camps, and qualitative evidence of changes in health-related knowledge and behaviour of students. Conclusion A task-shifting approach of delegating school health promotion activities to lay school health counsellors rather than education or health professionals shows promise of effectiveness as a scalable model for promoting the health and well being of school based adolescents in resource constrained settings. PMID:22630607

The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation.

PubMed

Rajaraman, Divya; Travasso, Sandra; Chatterjee, Achira; Bhat, Bhargav; Andrew, Gracy; Parab, Suraj; Patel, Vikram

2012-05-25

Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. The intervention was based on the WHO's Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students' anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the programme, as expressed by principals, parents and students. A minority of teachers complained that there was inadequate information sharing about the programme and mentioned reservations about the capacities of the lay health counsellor. Preliminary evidence of the positive effects of the programme included the correction of vision problems detected in health screening camps, and qualitative evidence of changes in health-related knowledge and behaviour of students. A task-shifting approach of delegating school health promotion activities to lay school health counsellors rather than education or health professionals shows promise of effectiveness as a scalable model for promoting the health and well being of school based adolescents in resource constrained settings.

Community involvement in dengue vector control: cluster randomised trial

PubMed Central

Toledo, M E; Rodríguez, M; Gomez, D; Baly, A; Benitez, J R; Van der Stuyft, P

2009-01-01

Objective To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Design Cluster randomised trial. Setting Guantanamo, Cuba. Participants 32 circumscriptions (around 2000 inhabitants each). Interventions The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach. Main outcome measures The primary outcome was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of Ae aegypti per 100 inspected houses), Breteau index (number of containers positive for immature stages of Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of Ae aegypti pupae per inhabitant). Results All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the Aedes infestation levels were comparable between intervention and control clusters: house index 0.25% v 0.20%, pupae per inhabitant 0.44×10−3 v 0.29×10−3. At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76). Conclusion A community based environmental management embedded in a routine control programme was effective at reducing levels of Aedes infestation. Trial registration Current Controlled Trials ISRCTN88405796. PMID:19509031

Unintentional injury mortality among indigenous communities of Taiwan: trends from 2002 to 2013 and evaluation of a community-based intervention.

PubMed

Pan, Stephen W; Chong, Hiu Ha; Kao, Hui-Chuan

2017-11-27

Indigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan's indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates. Standardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention. Between 2002 and 2013, unintentional injury mortality rates among Taiwan's indigenous population significantly declined by about 4.5 deaths per 100 000 each year (p<0.0001). During that time, the unintentional injury mortality rate ratio between indigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the 'Healthy and Safe Tribe' programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81). Taiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the 'Healthy and Safe Tribe' indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Using the Intervention Mapping Protocol to develop an online video intervention for parents to prevent childhood obesity: Movie Models.

PubMed

De Lepeleere, Sara; Verloigne, Maïté; Brown, Helen Elizabeth; Cardon, Greet; De Bourdeaudhuij, Ilse

2016-08-08

The increasing prevalence of childhood overweight/obesity caused by an unhealthy diet, insufficient physical activity (PA) and high levels of sedentary behaviour (SB) is a prominent public health concern. Parenting practices may contribute to healthy behaviour change in children, but well-researched examples are limited. The aim of this study is to describe the systematic development of an intervention for parents to prevent childhood overweight/obesity through the improvement of parenting practices. The six steps of the Intervention Mapping Protocol (IMP), a theory- and evidence-based tool to develop health-related interventions, were used as a framework to develop the 'Movie Models' programme. In Step 1, a needs assessment was performed to better understand the health problem of overweight/obesity in children and its association with diet, PA and SB. In Step 2, the programme goal (increasing the adoption of effective parenting practices) was sub-divided into performance objectives. Change objectives, which specify explicit actions required to accomplish the performance objectives, were also identified. Step 3 included the selection of theoretical methods (e.g. 'modelling' and 'images'), which were then translated into the practical strategy of online parenting videos. Step 4 comprised the development of a final intervention framework, and Step 5 included the planning of programme adoption and implementation. The final phase, Step 6, included the development of an effect- and process-evaluation plan. The IMP was used to structure the development of 'Movie Models', an intervention targeting specific parenting practices related to children's healthy diet, PA, SB, and parental self-efficacy. A clear framework for process analyses is offered, which aims to increase the potential effectiveness of an intervention and can be useful for those developing health promotion programmes. © The Author(s) 2016.

Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits

PubMed Central

2013-01-01

Background The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the development and optimization of the Football Fans in Training (FFIT) programme, which aims to help overweight men (many of them football supporters) lose weight through becoming more active and adopting healthier eating habits. Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases. In Phase 1, a multidisciplinary working group developed the pilot programme (p-FFIT) and used a scoping review to summarize previous research and identify the target population. Phase 2 involved a process evaluation of p-FFIT in 11 Scottish Premier League (SPL) clubs. Participant and coach feedback, focus group discussions and interviews explored the utility/acceptability of programme components and suggestions for changes. Programme session observations identified examples of good practice and problems/issues with delivery. Together, these findings informed redevelopment of the optimized programme (FFIT), whose components were mapped onto specific behaviour change techniques using an evidence-based taxonomy. Results p-FFIT comprised 12, weekly, gender-sensitised, group-based weight management classroom and ‘pitch-side’ physical activity sessions. These in-stadia sessions were complemented by an incremental, pedometer-based walking programme. p-FFIT was targeted at men aged 35-65 years with body mass index ≥ 27 kg/m2. Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components, and valued the camaraderie and peer-support offered by the programme. Coaches appreciated the simplicity of the key healthy eating and physical activity messages. Suggestions for improvements that were incorporated into the optimized FFIT programme included: more varied in-stadia physical activity with football-related components; post-programme weight management support (emails and a reunion session); and additional training for coaches in SMART goal setting and the pedometer-based walking programme. Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches, and is appropriate for evaluation in a randomised controlled trial. PMID:23496915

Towards Developing an Initial Programme Theory: Programme Designers and Managers Assumptions on the Antiretroviral Treatment Adherence Club Programme in Primary Health Care Facilities in the Metropolitan Area of Western Cape Province, South Africa.

PubMed

Mukumbang, Ferdinand C; van Belle, Sara; Marchal, Bruno; van Wyk, Brian

2016-01-01

The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory-the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa.

A Mathematics Intervention for Low-Performing Finnish Second Graders: Findings from a Pilot Study

ERIC Educational Resources Information Center

Mononen, Riikka; Aunio, Pirjo

2014-01-01

Evidence-based practice is highly appreciated and demanded in the field of education, especially in relation to extra support provided for children struggling with learning. Currently, there is a lack of intervention studies in the area of mathematics. This study aimed to investigate the effects of a short mathematics intervention programme on…

Analysis System for Self-Efficacy Training (ASSET). Assessing treatment fidelity of self-management interventions.

PubMed

Zinken, Katarzyna M; Cradock, Sue; Skinner, T Chas

2008-08-01

The paper presents the development of a coding tool for self-efficacy orientated interventions in diabetes self-management programmes (Analysis System for Self-Efficacy Training, ASSET) and explores its construct validity and clinical utility. Based on four sources of self-efficacy (i.e., mastery experience, role modelling, verbal persuasion and physiological and affective states), published self-efficacy based interventions for diabetes care were analysed in order to identify specific verbal behavioural techniques. Video-recorded facilitating behaviours were evaluated using ASSET. The reliability between four coders was high (K=0.71). ASSET enabled assessment of both self-efficacy based techniques and participants' response to those techniques. Individual patterns of delivery and shifts over time across facilitators were found. In the presented intervention we observed that self-efficacy utterances were followed by longer patient verbal responses than non-self-efficacy utterances. These detailed analyses with ASSET provide rich data and give the researcher an insight into the underlying mechanism of the intervention process. By providing a detailed description of self-efficacy strategies ASSET can be used by health care professionals to guide reflective practice and support training programmes.

Community involvement in dengue vector control: cluster randomised trial.

PubMed

Vanlerberghe, V; Toledo, M E; Rodríguez, M; Gomez, D; Baly, A; Benitez, J R; Van der Stuyft, P

2009-06-09

To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Cluster randomised trial. Guantanamo, Cuba. 32 circumscriptions (around 2000 inhabitants each). The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach. The primary outcome was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of Ae aegypti per 100 inspected houses), Breteau index (number of containers positive for immature stages of Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of Ae aegypti pupae per inhabitant). All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the Aedes infestation levels were comparable between intervention and control clusters: house index 0.25% v 0.20%, pupae per inhabitant 0.44x10(-3) v 0.29x10(-3). At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76). A community based environmental management embedded in a routine control programme was effective at reducing levels of Aedes infestation. Current Controlled Trials ISRCTN88405796.

Understanding the impact of visual arts interventions for people living with dementia: a realist review protocol.

PubMed

Windle, Gill; Gregory, Samantha; Newman, Andrew; Goulding, Anna; O'Brien, Dave; Parkinson, Clive

2014-08-15

Arts-based activities are being increasingly suggested as a valuable activity for people living with dementia in terms of countering the negative aspects of their condition. The potential for such programmes to improve a broad range of psychosocial outcomes is suggested in some studies. However, there is largely an absence of rigorous methodology to demonstrate the benefits, and research results are mixed. Practice variability in terms of the content, contexts and implementation of such interventions raises challenges in terms of identifying an optimal arts programme model that could be adopted by other service providers. Understanding how interventions may have the best chance at broad implementation success and uptake is limited. A realist review will be undertaken. This aims to understand how visual arts interventions influence outcomes in people living with dementia. The review will explore how the context, that is the circumstances which enable or constrain, affect outcomes through the activation of mechanisms. An early scoping search and a stakeholder survey formulated the preliminary programme theory. A systematic literature search across a broad range of disciplines (arts, humanities, social sciences, health) will be undertaken to identify journal articles and grey literature. Data will be extracted in relation to the programme theory, contextual factors, mechanisms and outcomes and their configurations, background information about the study design and participant characteristics, detail about the quantity ('dose') of an intervention, theoretical perspectives proposed by the authors of the paper and further theorising by the reviewer. Thematic connections/patterns will be sought across the extracted data, identifying patterns amongst contextual factors, the mechanisms they trigger and the associated outcomes. Along with stakeholder engagement and validation, this review will help inform the development of an optimal, replicable arts intervention for people with dementia as part of our broader research programme, titled 'Dementia and Imagination' (funded by the Arts and Humanities Research Council). Forthcoming work under this programme of research will test this theoretically informed intervention in three different geographical areas of the UK. The production of freely available practice guidance is a key aspect of dissemination. PROSPERO registration number CRD42014008702.

NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation

PubMed Central

Penn, Linda; Rodrigues, Angela; Haste, Anna; Marques, Marta M; Budig, Kirsten; Sainsbury, Kirby; Bell, Ruth; Araújo-Soares, Vera; White, Martin; Summerbell, Carolyn; Goyder, Elizabeth; Brennan, Alan; Adamson, Ashley J; Sniehotta, Falko F

2018-01-01

Objectives Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on programme quality, improvements and future evaluation. Design We reviewed programme documents, mapping against the NHS DPP specification and National Institute for Health and Care Excellence (NICE) public health guideline: Type 2 diabetes (T2D) prevention in people at high risk (PH38), conducted qualitative research using individual interviews and focus group discussions with stakeholders and examined recruitment, fidelity and data collection procedures. Setting Seven NHS DPP demonstrator sites and, subsequently, 27 first wave areas across England. Interventions Intensive behavioural intervention with weight loss, diet and physical activity goals. The national programme specifies at least 13 sessions over 9 months, delivered face to face to groups of 15–20 adults with non-diabetic hyperglycaemia, mainly recruited from primary care and NHS Health Checks. Participants Participants for qualitative research were purposively sampled to provide a spread of stakeholder experience. Documents for review were provided via the NHS DPP Management Group. Findings The NHS DPP specification reflected current evidence with a clear framework for service provision. Providers, with national capacity to deliver, supplied intervention plans compliant with this framework. Stakeholders highlighted limitations in fidelity assessment and recruitment and retention challenges, especially in reach and equity, that could adversely impact on implementation. Risk assessment for first wave eligibility differed from NICE guidance. Conclusions The NHS DPP provides an evidence-based behavioural intervention for prevention of T2D in adults at high risk, with capacity to deliver nationally. Framework specification allows for balance between consistency and contextual variation in intervention delivery, with session details devolved to providers. Limitations in fidelity assurance, data collection procedures and recruitment issues could adversely impact on intervention effectiveness and restrict evaluation. PMID:29467134

Evaluation of a web-based ECG-interpretation programme for undergraduate medical students.

PubMed

Nilsson, Mikael; Bolinder, Gunilla; Held, Claes; Johansson, Bo-Lennart; Fors, Uno; Ostergren, Jan

2008-04-23

Most clinicians and teachers agree that knowledge about ECG is of importance in the medical curriculum. Students at Karolinska Institute have asked for more training in ECG-interpretation during their undergraduate studies. Clinical tutors, however, have difficulties in meeting these demands due to shortage of time. Thus, alternative ways to learn and practice ECG-interpretation are needed. Education offered via the Internet is readily available, geographically independent and flexible. Furthermore, the quality of education may increase and become more effective through a superior educational approach, improved visualization and interactivity. A Web-based comprehensive ECG-interpretation programme has been evaluated. Medical students from the sixth semester were given an optional opportunity to access the programme from the start of their course. Usage logs and an initial evaluation survey were obtained from each student. A diagnostic test was performed in order to assess the effect on skills in ECG interpretation. Students from the corresponding course, at another teaching hospital and without access to the ECG-programme but with conventional teaching of ECG served as a control group. 20 of the 32 students in the intervention group had tested the programme after 2 months. On a five-graded scale (1- bad to 5 - very good) they ranked the utility of a web-based programme for this purpose as 4.1 and the quality of the programme software as 3.9. At the diagnostic test (maximal points 16) by the end of the 5-month course at the 6th semester the mean result for the students in the intervention group was 9.7 compared with 8.1 for the control group (p = 0.03). Students ranked the Web-based ECG-interpretation programme as a useful instrument to learn ECG. Furthermore, Internet-delivered education may be more effective than traditional teaching methods due to greater immediacy, improved visualisation and interactivity.

Arts-based palliative care training, education and staff development: A scoping review.

PubMed

Turton, Benjamin Mark; Williams, Sion; Burton, Christopher R; Williams, Lynne

2018-02-01

The experience of art offers an emerging field in healthcare staff development, much of which is appropriate to the practice of palliative care. The workings of aesthetic learning interventions such as interactive theatre in relation to palliative and end-of-life care staff development programmes are widely uncharted. To investigate the use of aesthetic learning interventions used in palliative and end-of-life care staff development programmes. Scoping review. Published literature from 1997 to 2015, MEDLINE, CINAHL and Applied Social Sciences Index and Abstracts, key journals and citation tracking. The review included 138 studies containing 60 types of art. Studies explored palliative care scenarios from a safe distance. Learning from art as experience involved the amalgamation of action, emotion and meaning. Art forms were used to transport healthcare professionals into an aesthetic learning experience that could be reflected in the lived experience of healthcare practice. The proposed learning included the development of practical and technical skills; empathy and compassion; awareness of self; awareness of others and the wider narrative of illness; and personal development. Aesthetic learning interventions might be helpful in the delivery of palliative care staff development programmes by offering another dimension to the learning experience. As researchers continue to find solutions to understanding the efficacy of such interventions, we argue that evaluating the contextual factors, including the interplay between the experience of the programme and its impact on the healthcare professional, will help identify how the programmes work and thus how they can contribute to improvements in palliative care.

The Incredible Years Therapeutic Dinosaur Programme to build social and emotional competence in Welsh primary schools: study protocol for a randomised controlled trial.

PubMed

Bywater, Tracey; Hutchings, Judy; Whitaker, Christopher; Evans, Ceri; Parry, Laura

2011-02-11

School interventions such as the Incredible Years Classroom Dinosaur Programme targets pupil behaviour across whole classrooms, yet for some children a more intense approach is needed. The Incredible Years Therapeutic Dinosaur Programme is effective for clinically referred children by enhancing social, problem-solving skills, and peer relationship-building skills when delivered in a clinical setting in small groups. The aim of this trial is to evaluate the effectiveness of the Therapeutic Programme, delivered with small groups of children at high-risk of developing conduct disorder, delivered in schools already implementing the Classroom Programme. This is a pragmatic, parallel, randomised controlled trial.Two hundred and forty children (aged 4-8 years) rated by their teacher as above the 'borderline cut-off' for concern on the Strengths and Difficulties Questionnaire, and their parents, will be recruited. Randomisation is by individual within blocks (schools); 1:1 ratio, intervention to waiting list control. Twenty schools will participate in two phases. Two teachers per school will deliver the programme to six intervention children for 2-hours/week for 18 weeks between baseline and first follow-up. The control children will receive the intervention after first follow up. Phase 1 comprises three data collection points - baseline and two follow-ups eight months apart. Phase 2 includes baseline and first follow-up.The Therapeutic Programme includes elements on; Learning school rules; understanding, identifying, and articulating feelings; problem solving; anger management; how to be friendly; how to do your best in school. Primary outcomes are; change in child social, emotional and behavioural difficulties. Secondary outcomes are; teacher and parent mental wellbeing, child academic attainment, child and teacher school attendance. Intervention delivery will be assessed for fidelity. Intention to treat analyses will be conducted. ANCOVA, effect sizes, mediator and moderator analyses will be applied to establish differences between conditions, and for whom the intervention works best for and why. This trial will provide information on the delivery and effectiveness of a child centred, school-based intervention delivered in small groups of children, at risk of developing more severe conduct problems. The effects on child behaviour in school and home environments, academic attainment, peer interactions, parent and teacher mental health will be assessed. UK Clinical Research Network UKCRNID8615. Current Controlled Trials ISRCTN96803379.

Development and use of the generic WHO/CDC logic model for vitamin and mineral interventions in public health programmes

PubMed Central

De-Regil, Luz Maria; Peña-Rosas, Juan Pablo; Flores-Ayala, Rafael; del Socorro Jefferds, Maria Elena

2015-01-01

Objective Nutrition interventions are critical to achieve the Millennium Development Goals; among them, micronutrient interventions are considered cost-effective and programmatically feasible to scale up, but there are limited tools to communicate the programme components and their relationships. The WHO/CDC (Centers for Disease Control and Prevention) logic model for micronutrient interventions in public health programmes is a useful resource for planning, implementation, monitoring and evaluation of these interventions, which depicts the programme theory and expected relationships between inputs and expected Millennium Development Goals. Design The model was developed by applying principles of programme evaluation, public health nutrition theory and programmatic expertise. The multifaceted and iterative structure validation included feedback from potential users and adaptation by national stakeholders involved in public health programmes' design and implementation. Results In addition to the inputs, main activity domains identified as essential for programme development, implementation and performance include: (i) policy; (ii) products and supply; (iii) delivery systems; (iv) quality control; and (v) behaviour change communication. Outputs encompass the access to and coverage of interventions. Outcomes include knowledge and appropriate use of the intervention, as well as effects on micronutrient intake, nutritional status and health of target populations, for ultimate achievement of the Millennium Development Goals. Conclusions The WHO/CDC logic model simplifies the process of developing a logic model by providing a tool that has identified high-priority areas and concepts that apply to virtually all public health micronutrient interventions. Countries can adapt it to their context in order to support programme design, implementation, monitoring and evaluation for the successful scale-up of nutrition interventions in public health. PMID:23507463

Contribution of social marketing strategies to community-based obesity prevention programmes in children.

PubMed

Gracia-Marco, L; Vicente-Rodríguez, G; Borys, J M; Le Bodo, Y; Pettigrew, S; Moreno, L A

2011-04-01

To review child and adolescent obesity prevention programmes to determine whether they have included the Social Marketing Benchmark Criteria (BC). In addition, we analysed whether there was a relationship between the presence of the criteria and the effectiveness of the programme. Interventions had to be aimed at preventing obesity through behaviour changes relating to diet, physical activity, lifestyle and social support, separately or in combination. A total of 41 interventions were identified in PubMed and Embase that fulfilled the inclusion criteria. The more recent the studies, the greater the number of the BC that seem to have been used. However, regarding behaviour changes, we found the most effective period to be 1997-2002, with 100% of the interventions resulting in behaviour changes (9/9). In addition, almost all interventions resulted in improvements in body composition variables: 5 of 6 for body mass index or overweight/obesity prevalence and 6 of 6 for skin-folds. The presence of a higher number of BC does not assure higher effectiveness. Further research is required in this field. At the moment, studies aimed at preventing obesity in children and adolescents have not included social marketing aspects in their interventions in a comprehensive manner.

A systematic review investigating interventions that can help reduce consumption of sugar-sweetened beverages in children leading to changes in body fatness.

PubMed

Avery, A; Bostock, L; McCullough, F

2015-01-01

Both the prevalence of childhood obesity and the consumption of sugar-sweetened beverages (SSBs) have increased globally. The present review describes interventions that reduce the consumption of SSBs in children and determines whether this leads to subsequent changes in body fatness. Three databases were searched from 2000 to August 2013. Only intervention control trials, ≥6 months in duration, which aimed to reduce the consumption of SSBs in >100 children aged 2-18 years, and reporting changes in body fatness, were included. The quality of selected papers was assessed. Eight studies met inclusion criteria. Six interventions achieved significant (P < 0.05) reductions in SSB intake, although this was not always sustained. In the two interventions providing replacement drinks, significant differences in body mass index (12- or 18-month follow-up) were reported (P = 0.001 and 0.045). The risk of being overweight/obesity was reduced (P < 0.05) in three of the five education programmes but in one programme only for girls who were overweight at baseline and in one programme only for pupils perceived to be at greater risk at baseline. In the one study that included both provision of water and education, the risk of being overweight was reduced by 31% (P = 0.04) in the intervention group. The evidence suggests that school-based education programmes focusing on reducing SSB consumption, but including follow-up modules, offer opportunities for implementing effective, sustainable interventions. Peer support and changing the school environment (e.g. providing water or replacement drinks) to support educational programmes could improve their effectiveness. Home delivery of more suitable drinks has a big impact on reducing SSB consumption, with associated reductions in body weight. © 2014 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

A systematic review investigating interventions that can help reduce consumption of sugar-sweetened beverages in children leading to changes in body fatness

PubMed Central

Avery, A; Bostock, L; McCullough, F

2015-01-01

Background Both the prevalence of childhood obesity and the consumption of sugar-sweetened beverages (SSBs) have increased globally. The present review describes interventions that reduce the consumption of SSBs in children and determines whether this leads to subsequent changes in body fatness. Methods Three databases were searched from 2000 to August 2013. Only intervention control trials, ≥6 months in duration, which aimed to reduce the consumption of SSBs in >100 children aged 2–18 years, and reporting changes in body fatness, were included. The quality of selected papers was assessed. Results Eight studies met inclusion criteria. Six interventions achieved significant (P < 0.05) reductions in SSB intake, although this was not always sustained. In the two interventions providing replacement drinks, significant differences in body mass index (12- or 18-month follow-up) were reported (P = 0.001 and 0.045). The risk of being overweight/obesity was reduced (P < 0.05) in three of the five education programmes but in one programme only for girls who were overweight at baseline and in one programme only for pupils perceived to be at greater risk at baseline. In the one study that included both provision of water and education, the risk of being overweight was reduced by 31% (P = 0.04) in the intervention group. Conclusions The evidence suggests that school-based education programmes focusing on reducing SSB consumption, but including follow-up modules, offer opportunities for implementing effective, sustainable interventions. Peer support and changing the school environment (e.g. providing water or replacement drinks) to support educational programmes could improve their effectiveness. Home delivery of more suitable drinks has a big impact on reducing SSB consumption, with associated reductions in body weight. PMID:25233843

The Role of Theory in Increasing Adherence to Prescribed Practice

PubMed Central

Richardson, Julie; Wishart, Laurie; Hanna, Steven

2009-01-01

ABSTRACT Purpose: The purpose of this article is to apply theoretical frameworks to adherence behaviour and to guide the development of an intervention to increase adherence to prescribed home programmes. Summary of Key Points: Delivering an effective intervention requires establishing one that is evidence based and of adequate dosage. Two-thirds of patients who receive home exercise prescriptions do not adhere to their home programme, which may contribute to their physiotherapy's being ineffective. The mediating concepts of self-efficacy (SE) and outcome expectations (OE) are common to the five relevant theories used to explain adherence to exercise: the health belief model, protection motivation theory, theory of reasoned action, theory of planned behaviour, and social cognitive theory. Conclusion/Recommendations: Few intervention studies with any theoretical underpinning have examined adherence to exercise. Even fewer have been designed to affect and measure change in the theoretical mediators of SE and OE in patient populations. Physiotherapists must consider increasing adherence as a component of effective physiotherapy. Ongoing research is needed to increase our understanding of adherence to prescribed home programmes and to design interventions to affect theoretical mediators for increasing adherence. PMID:20190989

Development of theory-based health messages: three-phase programme of formative research

PubMed Central

Epton, Tracy; Norman, Paul; Harris, Peter; Webb, Thomas; Snowsill, F. Alexandra; Sheeran, Paschal

2015-01-01

Online health behaviour interventions have great potential but their effectiveness may be hindered by a lack of formative and theoretical work. This paper describes the process of formative research to develop theoretically and empirically based health messages that are culturally relevant and can be used in an online intervention to promote healthy lifestyle behaviours among new university students. Drawing on the Theory of Planned Behaviour, a three-phase programme of formative research was conducted with prospective and current undergraduate students to identify (i) modal salient beliefs (the most commonly held beliefs) about fruit and vegetable intake, physical activity, binge drinking and smoking, (ii) which beliefs predicted intentions/behaviour and (iii) reasons underlying each of the beliefs that could be targeted in health messages. Phase 1, conducted with 96 pre-university college students, elicited 56 beliefs about the behaviours. Phase 2, conducted with 3026 incoming university students, identified 32 of these beliefs that predicted intentions/behaviour. Phase 3, conducted with 627 current university students, elicited 102 reasons underlying the 32 beliefs to be used to construct health messages to bolster or challenge these beliefs. The three-phase programme of formative research provides researchers with an example of how to develop health messages with a strong theoretical- and empirical base for use in health behaviour change interventions. PMID:24504361

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

PubMed

Kramer, Jeannet Jam; Willemsen, Marc C; Conijn, Barbara; van Emst, Andrée J; Brunsting, Suzanne; Riper, Heleen

2009-01-22

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. 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. 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. ISRCTN74423766.

Using intervention mapping to develop a theory-driven, group-based complex intervention to support self-management of osteoarthritis and low back pain (SOLAS).

PubMed

Hurley, Deirdre A; Murphy, Laura Currie; Hayes, David; Hall, Amanda M; Toomey, Elaine; McDonough, Suzanne M; Lonsdale, Chris; Walsh, Nicola E; Guerin, Suzanne; Matthews, James

2016-04-26

The Medical Research Council framework provides a useful general approach to designing and evaluating complex interventions, but does not provide detailed guidance on how to do this and there is little evidence of how this framework is applied in practice. This study describes the use of intervention mapping (IM) in the design of a theory-driven, group-based complex intervention to support self-management (SM) of patients with osteoarthritis (OA) and chronic low back pain (CLBP) in Ireland's primary care health system. The six steps of the IM protocol were systematically applied to develop the self-management of osteoarthritis and low back pain through activity and skills (SOLAS) intervention through adaptation of the Facilitating Activity and Self-management in Arthritis (FASA) intervention. A needs assessment including literature reviews, interviews with patients and physiotherapists and resource evaluation was completed to identify the programme goals, determinants of SM behaviour, consolidated definition of SM and required adaptations to FASA to meet health service and patient needs and the evidence. The resultant SOLAS intervention behavioural outcomes, performance and change objectives were specified and practical application methods selected, followed by organised programme, adoption, implementation and evaluation plans underpinned by behaviour change theory. The SOLAS intervention consists of six weekly sessions of 90-min education and exercise designed to increase participants' physical activity level and use of evidence-based SM strategies (i.e. pain self-management, pain coping, healthy eating for weight management and specific exercise) through targeting of individual determinants of SM behaviour (knowledge, skills, self-efficacy, fear, catastrophizing, motivation, behavioural regulation), delivered by a trained physiotherapist to groups of up to eight individuals using a needs supportive interpersonal style based on self-determination theory. Strategies to support SOLAS intervention adoption and implementation included a consensus building workshop with physiotherapy stakeholders, development of a physiotherapist training programme and a pilot trial with physiotherapist and patient feedback. The SOLAS intervention is currently being evaluated in a cluster randomised controlled feasibility trial. IM is a time-intensive collaborative process, but the range of methods and resultant high level of transparency is invaluable and allows replication by future complex intervention and trial developers.

Psychosocial interventions in opiate substitution treatment services: does the evidence provide a case for optimism or nihilism?

PubMed

Day, Ed; Mitcheson, Luke

2017-08-01

Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond 'routine counselling'. We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice. The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions. © 2017 Society for the Study of Addiction.

Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial.

PubMed

Mathews, Catherine; Eggers, Sander M; Townsend, Loraine; Aarø, Leif E; de Vries, Petrus J; Mason-Jones, Amanda J; De Koker, Petra; McClinton Appollis, Tracy; Mtshizana, Yolisa; Koech, Joy; Wubs, Annegreet; De Vries, Hein

2016-09-01

Young South Africans, especially women, are at high risk of HIV. We evaluated the effects of PREPARE, a multi-component, school-based HIV prevention intervention to delay sexual debut, increase condom use and decrease intimate partner violence (IPV) among young adolescents. We conducted a cluster RCT among Grade eights in 42 high schools. The intervention comprised education sessions, a school health service and a school sexual violence prevention programme. Participants completed questionnaires at baseline, 6 and 12 months. Regression was undertaken to provide ORs or coefficients adjusted for clustering. Of 6244 sampled adolescents, 55.3 % participated. At 12 months there were no differences between intervention and control arms in sexual risk behaviours. Participants in the intervention arm were less likely to report IPV victimisation (35.1 vs. 40.9 %; OR 0.77, 95 % CI 0.61-0.99; t(40) = 2.14) suggesting the intervention shaped intimate partnerships into safer ones, potentially lowering the risk for HIV.

‘I learned to accept every part of myself’: the transformative impact of a theatre-based sexual health and HIV prevention programme

PubMed Central

Grewe, Mary E.; Taboada, Arianna; Dennis, Alexis; Chen, Elizabeth; Stein, Kathryn; Watson, Sable; Barrington, Clare; Lightfoot, Alexandra F.

2015-01-01

Theatre-based interventions have been used in health promotion activities among young people to address HIV and sexual health. In this study, we explored the experience of undergraduate student performers participating in a theatre-based HIV prevention and sexual health education intervention for high school students in the USA. Undergraduate students enrolled in a credit-bearing course to learn about HIV and sexual health, participatory theatre and health education techniques. We analysed students’ reflective essays written throughout the semester to identify any changes and the intervention processes that promoted these changes. Students experienced five interrelated forms of transformation: (1) increased knowledge about HIV and sexual health; (2) changes in attitude and communication about sex; (3) artistic growth; (4) emotional growth; and (5) clarification of career goals and future plans. Intervention processes that contributed to these transformations included improvisation, guided writing exercises, the creation of a close-knit cohesive group, and interactions with a group of HIV-positive speakers. Theatre-based, peer-led sexual health programmes can provide a transformative experience for undergraduate student performers. The transformative effects are linked to specific activities and processes of the intervention and require examination in future research. PMID:26085813

Internet-based interventions for smoking cessation.

PubMed

Civljak, Marta; Sheikh, Aziz; Stead, Lindsay F; Car, Josip

2010-09-08

The Internet has become a regular part of daily life for the majority of people in many parts of the world. It now offers an additional means of effecting changes to behaviour such as smoking. To determine the effectiveness of Internet-based interventions for smoking cessation. We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and Google Scholar. There were no restrictions placed on language of publication or publication date. The most recent search was in June 2010. We included randomized and quasi-randomized trials. Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet-based intervention was eligible. The comparison condition could be a no-intervention control or a different Internet site or programme. Methodological and study quality details were extracted using a standardised form. We selected smoking cessation outcomes at short term (one to three months) and long term (6 months or more) follow up, and reported study effects as a risk ratio with 95% confidence intervals. Only limited meta-analysis was performed, as the heterogeneity of the data for populations, interventions and outcomes allowed for very little pooling. Twenty trials met the inclusion criteria. There were more female than male participants. Some Internet programmes were intensive and included multiple outreach contacts with participants, whilst others relied on participants to initiate and maintain use.Ten trials compared an Internet intervention to a non-Internet based smoking cessation intervention or to a no intervention control. Six of these recruited adults, one recruited young adult university students and three recruited adolescents. Two trials of the same intensive automated intervention in populations of adult who smoked showed significantly increased cessation compared to printed self-help materials at 12 months. In one of these, all trial participants were provided with nicotine replacement therapy (NRT). Three other trials in adults did not detect significant long term effects. One of these provided access to a website as an adjunct to counselling and bupropion, one compared web-based counselling, proactive telephone-based counselling or a combination of the two as an adjunct to varenicline. The third only provided a list of Internet resources. One further short-term trial did show a significant increase in quit rates at 3 months. A trial in college students increased point prevalence abstinence after 30 weeks but had no effect on sustained abstinence. Two small trials in adolescents did not detect an effect on cessation compared to control, whilst a third small trial did detect a benefit of a web-based adjunct to a group programme amongst adolescents.Ten trials, all in adult populations, compared different Internet sites or programmes. There was some evidence that sites that were tailored and interactive might be more effective than static sites, but this was not detected in all the trials that explored this factor. One large trial did not detect differences between different Internet sites. One trial of a tailored intervention as an adjunct to NRT use showed a significant benefit but only had a 3-month follow up. One trial detected evidence of a benefit from tailored email letter compared to a non-tailored one. Trials failed to detect a benefit of including a mood management component (three trials), or an asynchronous bulletin board. Higher abstinence rates were typically reported by participants who actively engaged with the programme (as reflected by the number of log-ins). Results suggest that some Internet-based interventions can assist smoking cessation, especially if the information is appropriately tailored to the users and frequent automated contacts with the users are ensured, however trials did not show consistent effects.

How effective are strategies for non-communicable disease prevention and control in a high risk population in a developing country? Isfahan Healthy Heart Programme

PubMed Central

Baghaei, Abdolmehdi; Rabiei, Katayoun; Gharipour, Mojgan; Tavasoli, Ali Akbar; Shirani, Shahin; Bahonar, Ahamad; Davarpanah, Amir Hossein; Ramezani, Mohammad Arash; Kelishadi, Roya

2010-01-01

Introduction The Isfahan Healthy Heart Programme (IHHP) is a community-based programme for non-communicable diseases prevention and control using both a population and high risk approach in Iran. This study demonstrated the efficacy of IHHP interventional strategies to improve lifestyle behaviours in a population at risk for developing cardiovascular diseases. Material and methods Healthy Lifestyle for NCDs High Risk Population is one of ten projects of IHHP. High risk individuals were defined as those who have at least one risk factor for developing coronary artery disease (CAD). Changes of behavioural indicators have been compared between two areas with a survey after 5 years of intervention. Results Among high risk individuals in the intervention and reference areas, 77.8% and 82.5% had at least one major risk factor for CAD. The prevalence of major risk factors for CAD (except cigarette smoking) was decreased in both intervention and reference areas during 5 years of intervention and the pattern of diet and physical activity was improved. Conclusions Interventional activities in IHHP targeting the high risk population seem to be effective in improving lifestyle behaviour, increasing awareness and control of risk factors of the high risk population. PMID:22371716

Effect of diabetic case management intervention on health service utilization in Korea.

PubMed

Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George

2015-12-01

This study is to estimate the effectiveness of a diabetic case management programme on health-care service utilization. The study population included 6007 as the intervention group and 956,766 as the control group. As the indicators of health-care service utilization, numbers of medical ambulatory consultations, days of medication prescribed and medical expenses for one year were used, and we analysed the claim data of the health insurance from 2005 to 2007. The study population was classified into three subgroups based on the number of medical ambulatory consultations per year before this intervention. In the under-serviced subgroup, the intervention group showed a significant increase in the number of consultations (3.2), days of prescribed medication (66.4) and medical expenses (287,900 KRW) compared with the control group. Conversely, in the over-serviced subgroup, the intervention group showed a less decrease days of prescribed medication (1.6) compared with the control group. This showed that the case management programme led the intervention group to optimize their utilization of health-care services by subgroups. It is necessary to evaluate the appropriateness of health-care usage and clinical outcome to show the direct effectiveness of the case management programme by subgroups. © 2014 Wiley Publishing Asia Pty Ltd.

The efficacy of a movement control exercise programme to reduce injuries in youth rugby: a cluster randomised controlled trial

PubMed Central

Hislop, M D; Stokes, K A; Williams, S; McKay, C D; England, M; Kemp, S P T

2016-01-01

Background Injuries to youth rugby players have become an increasingly prominent health concern, highlighting the importance of developing and implementing appropriate preventive strategies. A growing body of evidence from other youth sports has demonstrated the efficacy of targeted exercise regimens to reduce injury risk. However, studies have yet to investigate the effect of such interventions in youth contact sport populations like rugby union. Objective To determine the efficacy of an evidence-based movement control exercise programme compared with a sham exercise programme to reduce injury risk in youth rugby players. Exercise programme compliance between trial arms and the effect of coach attitudes on compliance will also be evaluated. Setting School rugby coaches in England will be the target of the researcher intervention, with the effects of the injury prevention programmes being measured in male youth players aged 14–18 years in school rugby programmes over the 2015–2016 school winter term. Methods A cluster-randomised controlled trial with schools randomly allocated to either a movement control exercise programme or a sham exercise programme, both of which are coach-delivered. Injury measures will derive from field-based injury surveillance, with match and training exposure and compliance recorded. A questionnaire will be used to evaluate coach attitudes, knowledge, beliefs and behaviours both prior to and on the conclusion of the study period. Outcome measures Summary injury measures (incidence, severity and burden) will be compared between trial arms, as will the influence of coach attitudes on compliance and injury burden. Additionally, changes in these outcomes through using the exercise programmes will be evaluated. Trial registration number ISRTCNN13422001. PMID:27900148

A qualitative study of teacher's perceptions of an intervention to prevent conduct problems in Jamaican pre-schools.

PubMed

Baker-Henningham, H; Walker, S

2009-09-01

There is a growing evidence base showing the efficacy of school-based interventions to prevent conduct problems but few evaluations have addressed teachers' perceptions of these programmes. Teachers' views on the acceptability, feasibility and usefulness of an intervention will influence implementation fidelity and programme sustainability and can help further our understanding of how the intervention works and how it may be improved. A pilot study of the Incredible Years Teacher Training Programme supplemented by a curriculum unit on social and emotional skills was conducted in inner-city pre-schools in Kingston, Jamaica. Three pre-schools comprising 15 classrooms participated in the intervention which involved seven monthly teacher workshops and 14 weekly child lessons in each class. At the end of the intervention in-depth individual interviews were conducted with each intervention teacher. Teachers reported benefits to their own teaching skills and professional development, to their relationships with children and to the behaviour, social-emotional competence and school readiness skills of the children in their class. Teachers also reported benefits to teacher-parent relationships and to children's behaviour at home. A hypothesis representing the teachers' perceptions of how the intervention achieved these benefits was developed. The hypothesis suggests that intervention effects were due to teachers' gains in skills and knowledge in three main areas: (1) a deeper understanding of young children's needs and abilities; (2) increased use of positive and proactive strategies; and (3) explicitly teaching social and emotional skills. These changes then led to the variety of benefits reported for teachers, children and parents. Teachers reported few difficulties in implementing the majority of strategies and strongly recommended wider dissemination of the intervention. The intervention was valued by Jamaican pre-school teachers and teachers felt they were able to successfully integrate the strategies learned into their regular practice.

Pilot of "Families for Health": community-based family intervention for obesity.

PubMed

Robertson, W; Friede, T; Blissett, J; Rudolf, M C J; Wallis, M; Stewart-Brown, S

2008-11-01

To develop and evaluate "Families for Health", a new community based family intervention for childhood obesity. Programme development, pilot study and evaluation using intention-to-treat analysis. Coventry, England. 27 overweight or obese children aged 7-13 years (18 girls, 9 boys) and their parents, from 21 families. Families for Health is a 12-week programme with parallel groups for parents and children, addressing parenting, lifestyle change and social and emotional development. Change in baseline BMI z score at the end of the programme (3 months) and 9-month follow-up. Attendance, drop-out, parents' perception of the programme, child's quality of life and self-esteem, parental mental health, parent-child relationships and lifestyle changes were also measured. Attendance rate was 62%, with 18 of the 27 (67%) children completing the programme. For the 22 children with follow-up data (including four who dropped out), BMI z score was reduced by -0.18 (95% CI -0.30 to -0.05) at 3 months and -0.21 (-0.35 to -0.07) at 9 months. Statistically significant improvements were observed in children's quality of life and lifestyle (reduced sedentary behaviour, increased steps and reduced exposure to unhealthy foods), child-parent relationships and parents' mental health. Fruit and vegetable consumption, participation in moderate/vigorous exercise and children's self-esteem did not change significantly. Topics on parenting skills, activity and food were rated as helpful and used with confidence by most parents. Families for Health is a promising new childhood obesity intervention. Definitive evaluation of its clinical effectiveness by randomised controlled trial is now required.

Stepped-care to prevent depression and anxiety in visually impaired older adults – design of a randomised controlled trial

PubMed Central

2013-01-01

Background Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. Method/design A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in the Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Discussion Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Trial registration Identifier: NTR3296 PMID:23937975

Developing professional caregivers’ empathy and emotional competencies through mindfulness-based stress reduction (MBSR): results of two proof-of-concept studies

PubMed Central

Lamothe, Martin; McDuff, Pierre; Pastore, Yves D; Duval, Michel; Sultan, Serge

2018-01-01

Objectives To assess the feasibility and acceptability of a mindfulness-based stress reduction (MBSR)-based intervention and determine if the intervention is associated with a significant signal on empathy and emotional competencies. Design Two pre–post proof-of-concept studies. Setting Participants were recruited at the University of Montreal’s Psychology Department (Study 1) and the CHU Sainte-Justine Department of Hematology-Oncology (Study 2). Participants Study 1: 12 students completed the 8-week programme (mean age 24, range 18–34). Study 2: 25 professionals completed the 8-week programme (mean age 48, range 27–63). Intervention Standard MBSR programme including 8-week mindfulness programme consisting of 8 consecutive weekly 2-hour sessions and a full-day silent retreat. Outcomes measures Mindfulness as measured by the Mindful Attention Awareness Scale; empathy as measured by the Interpersonal Reactivity Index (IRI)’s Perspective Taking and Empathic Concern subscales; identification of one’s own emotions and those of others as measured by the Profile of Emotional Competence (PEC)’s Identify my Emotions and Identify Others’ Emotions subscales; emotional acceptance as measured by the Acceptance and Action Questionnaire-II (AAQ-II) and the Emotion Regulation Scale (ERQ)’s Expressive Suppression subscale; and recognition of emotions in others as measured by the Geneva Emotion Recognition Test (GERT). Results In both studies, retention rates (80%–81%) were acceptable. Participants who completed the programme improved on all measures except the PEC’s Identify Others’ Emotions and the IRI’s Empathic Concern (Cohen’s d median=0.92, range 45–1.72). In Study 2, favourable effects associated with the programme were maintained over 3 months on the PEC’s Identify my Emotions, the AAQ-II, the ERQ’s Expressive Suppression and the GERT. Conclusions The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one’s own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes. PMID:29306887

A qualitative process evaluation of a randomised controlled trial of a parenting intervention in community (school) settings for children at risk of attention deficit hyperactivity disorder (ADHD).

PubMed

Taylor, John A; Valentine, Althea Z; Sellman, Edward; Bransby-Adams, Kate; Daley, David; Sayal, Kapil

2015-11-17

Interventions for parents of children experiencing emotional and/or behavioural difficulties can help to improve their children's health, educational and social outcomes. However, the desirability and acceptability of screening and offering such interventions for attention-deficit hyperactivity disorder (ADHD)-type problems are currently unclear. This article is a qualitative process evaluation of a pragmatic cluster randomised controlled trial (Trial registration: ISRCTN87634685; reported elsewhere) to assess the feasibility and acceptability of a school-based parenting intervention programme for parents and teachers of children with high levels of ADHD symptoms. Parents (n = 22) and teaching staff (n = 29) took part in semi-structured group or individual interviews, either by telephone or face-to-face, following the main trial. Interviews were digitally-recorded, transcribed verbatim and subjected to thematic analysis. The parenting intervention was acceptable to parents and teachers, and they were enthusiastic about the need for parenting groups in the school environment and stressed the importance of parent-school collaboration. Parents generally stated a preference for universal recruitment approaches to such programmes whilst teachers described the need to target specific parents. Most parents who took part in the parenting intervention described it favourably and many saw benefits, at least in the short-term. Parents differed in their preferred group size, with some desiring one-to-one sessions and others favouring a larger group. Non-attending parents reported barriers to attendance such as fear of attending in a group, previous use of the programme, work and other commitments. Suggestions to improve the programme included: clearer communication; offering booster sessions; and greater collaboration with teachers. It is feasible to deliver parenting intervention programmes within or near schools. The intervention was acceptable to the majority of parents, thus retention was high, but recruitment was difficult and reaching the parents with the most need was challenging. The findings of the process evaluation identified greater benefits to families than were apparent in the main trial. Recommendations identified by parents and teaching staff may be used to inform service delivery and future research to enhance recruitment to parenting interventions in the school environment.

A RCT of three training and support strategies to encourage implementation of screening and brief alcohol intervention by general practitioners.

PubMed

Kaner, E F; Lock, C A; McAvoy, B R; Heather, N; Gilvarry, E

1999-09-01

Providing doctors with new research findings or clinical guidelines is rarely sufficient to promote changes in clinical practice. An implementation strategy is required to provide clinicians with the skills and encouragement needed to alter established routines. To evaluate the effectiveness and cost-effectiveness of different training and support strategies in promoting implementation of screening and brief alcohol intervention (SBI) by general practitioners (GPs). Subjects were 128 GPs, one per practice, from the former Northern and Yorkshire Regional Health Authority, who agreed to use the 'Drink-Less' SBI programme in an earlier dissemination trial. GPs were stratified by previous marketing conditions and randomly allocated to three intensities of training and support: controls (n = 43) received the programme with written guidelines only, trained GPs (n = 43) received the programme plus practice-based training in programme usage, trained and supported GPs (n = 42) received the programme plus practice-based training and a support telephone call every two weeks. GPs were requested to use the programme for three months. Outcome measures included proportions of GPs implementing the programme and numbers of patients screened and intervened with. Seventy-three (57%) GPs implemented the programme and screened 11,007 patients for risk drinking. Trained and supported GPs were significantly more likely to implement the programme (71%) than controls (44%) or trained GPs (56%); they also screened, and intervened with, significantly more patients. Costs per patient screened were: trained and supported GPs, 1.05 Pounds; trained GPs, 1.08 Pounds; and controls, 1.47 Pounds. Costs per patient intervened with were: trained and supported GPs, 5.43 Pounds; trained GPs, 6.02 Pounds; and controls, 8.19 Pounds. Practice-based training plus support telephone calls was the most effective and cost-effective strategy to encourage implementation of SBI by GPs.

The Effect of a Basic Home Stimulation Programme on the Development of Young Children Infected with HIV

ERIC Educational Resources Information Center

Potterton, Joanne; Stewart, Aimee; Cooper, Peter; Becker, Pieter

2010-01-01

Aims: The human immunodeficiency virus (HIV) potentially causes a significant encephalopathy and resultant developmental delay in infected children. The aim of this study was to determine whether a home-based intervention programme could have an impact on the neurodevelopmental status of children infected with HIV. Method: A longitudinal,…

The Effectiveness of a Weight Maintenance Intervention for Adults with Intellectual Disabilities and Obesity: A Single Stranded Study

ERIC Educational Resources Information Center

Spanos, Dimitrios; Hankey, Catherine R.; Melville, Craig A.

2016-01-01

Background: The evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5).…

Effects of a Teacher Training Programme on Symptoms of Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Froelich, Jan; Breuer, Dieter; Doepfner, Manfred; Amonn, Frauke

2012-01-01

A substantial lack of effective school based interventions especially in the natural setting exists in the treatment of Attention Deficit Hyperactivity Disorder. We performed a 18-week teacher training programme in a public elementary school with 378 pupils in 16 classes. After completing a screening assessment for symptoms related to ADHD and to…

Increasing Primary School Children's Fruit and Vegetable Consumption: A Review of the Food Dudes Programme

ERIC Educational Resources Information Center

Taylor, Charlotte; Upton, Penney; Upton, Dominic

2015-01-01

Purpose: The purpose of this paper is to evaluate the evidence base of the Food Dudes healthy eating programme, specifically the short- and long-term effectiveness of the intervention for consumption of fruit and vegetables both at school and at home and displacement of unhealthy snack consumption. Design/Methodology/Approach: Articles were…

Theory and Praxis: Reflections and Lessons from a Bilateral Educational Aid Programme in Guinea-Bissau

ERIC Educational Resources Information Center

Santos, Júlio Gonçalves dos; Silva, Rui da

2017-01-01

This article examines Portuguese official aid (POA) in Guinea-Bissau, based on the experience of a bilateral educational aid Programme--PASEG (2000-2012). It explores the theory and praxis (understood as instructed action) of PASEG as a complex and transversal intervention in a context of fragility and political uncertainty. It discusses the…

Randomised Trial Evaluation of the In:tuition Programme

ERIC Educational Resources Information Center

Lynch, Sarah; Styles, Ben; Poet, Helen; White, Richard; Bradshaw, Sally; Rabiasz, Adam

2015-01-01

This summary reports the findings from two cluster-randomised trials of Drinkaware's school-based In:tuition life skills and alcohol education intervention: one trial of the programme for 10-11 year olds in primary schools, and another for 12-13 year olds in secondary schools. The trials have been carried out by the National Foundation for…

Procedures and Claims among US Evidence-Producing Organisations: The Case of the Incredible Years Programme

ERIC Educational Resources Information Center

Karlsson, Patrik; Bergmark, Anders; Lundström, Tommy

2014-01-01

We explore how four evidence-producing organisations in the US go ahead when they rate the evidence base for psychosocial interventions, using the Incredible Years programme as our case study. The findings demonstrate variation in the procedures and resulting evidence claims across the organisations, with some organisations being strict and some…

Contemplative Education: A Systematic, Evidence-Based Review of the Effect of Meditation Interventions in Schools

ERIC Educational Resources Information Center

Waters, Lea; Barsky, Adam; Ridd, Amanda; Allen, Kelly

2015-01-01

Schools need reliable evidence about the outcomes of meditation programs before they consider if and how such programmes can influence learning agendas, curriculum and timetables. This paper reviewed evidence from 15 peer-reviewed studies of school meditation programmes with respect to three student outcomes: well-being, social competence and…

Poor uptake of an online intervention in a cluster randomised controlled trial of online diabetes education for rural general practitioners.

PubMed

Paul, Christine L; Piterman, Leon; Shaw, Jonathan E; Kirby, Catherine; Forshaw, Kristy L; Robinson, Jennifer; Thepwongsa, Isaraporn; Sanson-Fisher, Robert W

2017-03-23

In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control. Trial design: the cluster randomised controlled trial involved towns as the unit of allocation and analysis with outcomes assessed by de-identified pathology data (not reported here). The intervention programme consisted of an online active learning module, direct electronic access to specialist advice and performance feedback. Multiple rounds of invitation were used to engage GPs with the online intervention content. Evidence-based strategies (e.g. pre-notification, rewards, incentives) were incorporated into the invitations to enrol in the programme. Recruitment to the programme was electronically monitored through the hosting software package during the study intervention period. Eleven matched pairs of towns were included in the study. There were 146 GPs in the 11 intervention towns, of whom 34 (23.3%) enrolled in the programme, and 8 (5.5%) completed the online learning module. No town had more than 10% of the resident GPs complete the learning module. There were no contacts made by GPs regarding requests for specialist advice. Consequently, the trial was discontinued. There is an ongoing need to engage primary care physicians in improving diabetes monitoring and management in rural areas. Online training options, while notionally attractive and accessible, are not likely to have high levels of uptake, even when evidence-based recruitment strategies are implemented. Australian New Zealand Clinical Trials Registry, identifier: ACTRN12611000553976 . Retrospectively registered on 31 May 2011.

Strengthening the afferent limb of rapid response systems: an educational intervention using web-based learning for early recognition and responding to deteriorating patients.

PubMed

Liaw, Sok Ying; Wong, Lai Fun; Ang, Sophia Bee Leng; Ho, Jasmine Tze Yin; Siau, Chiang; Ang, Emily Neo Kim

2016-06-01

The timely recognition and response to patients with clinical deteriorations constitute the afferent limb failure of a rapid response system (RRS). This area is a persistent problem in acute healthcare settings worldwide. In this study, we evaluated the effect of an educational programme on improving the nurses' knowledge and performances in recognising and responding to clinical deterioration. The interactive web-based programme addressed three areas: (1) early detection of changes in vital signs; (2) performance of nursing assessment and interventions using airway, breathing, circulation, disability and expose/examine and (3) reporting clinical deterioration using identity, situation, background, assessment and recommendation. Sixty-seven registered nurses participated in the randomised control study. The experimental group underwent a 3 h programme while the control group received no intervention. Pretests and post-tests, a mannequin-based assessment and a multiple-choice knowledge questionnaire were conducted. We evaluated the participants' performances in assessing, managing and reporting the deterioration of a patient using a validated performance tool. A significantly higher number of nurses from the experimental group than the control group monitored respiratory rates (48.2% vs 25%, p<0.05) and pulse rates (74.3% vs 37.5%, p<0.01) in the simulated environment, after the intervention. The post-test mean scores of the experimental group was significantly higher than the control group for knowledge (21.29 vs 18.28, p<0.001), performance in assessing and managing clinical deterioration (25.83 vs 19.50, p<0.001) and reporting clinical deterioration (12.83 vs 10.97, p<0.001). A web-based educational programme developed for hospital nurses to strengthen the afferent limb of the RRS significantly increased their knowledge and performances in assessing, managing and reporting clinical deterioration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Harm reduction programmes in the Asia--Pacific Region.

PubMed

Reid, Gary; Devaney, Madonna L; Baldwin, Simon

2008-01-01

This paper reports on the public health intervention of harm reduction to address drug use issues in the Asia-Pacific region. It is based on the report 'Situational analysis of illicit drug issues and responses in Asia and the Pacific', commissioned by the Australian National Council on Drugs Asia Pacific Drug Issues Committee. A comprehensive desk-based review based on published and unpublished literature and key informant data. Drug use in the Asia--Pacific region is widespread, resulting in serious adverse health consequences. Needle and syringe programmes are found in some parts of Asia, but not in the six Pacific Island countries reviewed. Outreach and peer education programmes are implemented, but overall appear minor in size and scope. Substitution therapy programmes appear to be entering a new era of acceptance in some parts of Asia. Primary health care specifically for drug users overall is limited. Harm reduction programmes in the Asia--Pacific region are either small in scale or do not exist. Most programmes lack the technical capacity, human resources and a limited scope of operations to respond effectively to the needs of drug users. Governments in this region should be encouraged to endorse evidence-based harm reduction programmes.

Design of the Resistance and Endurance exercise After ChemoTherapy (REACT) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of exercise interventions after chemotherapy on physical fitness and fatigue.

PubMed

Kampshoff, Caroline S; Buffart, Laurien M; Schep, Goof; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai J M

2010-11-30

Preliminary studies suggest that physical exercise interventions can improve physical fitness, fatigue and quality of life in cancer patients after completion of chemotherapy. Additional research is needed to rigorously test the effects of exercise programmes among cancer patients and to determine optimal training intensity accordingly. The present paper presents the design of a randomized controlled trial evaluating the effectiveness and cost-effectiveness of a high intensity exercise programme compared to a low-to-moderate intensity exercise programme and a waiting list control group on physical fitness and fatigue as primary outcomes. After baseline measurements, cancer patients who completed chemotherapy are randomly assigned to either a 12-week high intensity exercise programme or a low-to-moderate intensity exercise programme. Next, patients from both groups are randomly assigned to immediate training or a waiting list (i.e. waiting list control group). After 12 weeks, patients of the waiting list control group start with the exercise programme they have been allocated to.Both interventions consist of equal bouts of resistance and endurance interval exercises with the same frequency and duration, but differ in training intensity. Additionally, patients of both exercise programmes are counselled to improve compliance and achieve and maintain an active lifestyle, tailored to their individual preferences and capabilities.Measurements will be performed at baseline (t = 0), 12 weeks after randomization (t = 1), and 64 weeks after randomization (t = 2). The primary outcome measures are cardiorespiratory fitness and muscle strength assessed by means of objective performance indicators, and self-reported fatigue. Secondary outcome measures include health-related quality of life, self-reported physical activity, daily functioning, body composition, mood and sleep disturbances, and return to work. In addition, compliance and satisfaction with the interventions will be evaluated. Potential moderation by pre- and post-illness lifestyle, health and exercise-related attitudes, beliefs and motivation will also be assessed. Finally, the cost-effectiveness of both exercise interventions will be evaluated. This randomized controlled trial will be a rigorous test of effects of exercise programmes for cancer patients after chemotherapy, aiming to contribute to evidence-based practice in cancer rehabilitation programmes. This study is registered at the Netherlands Trial Register (NTR2153).

Evaluation of a manual-based programme for the promotion of social and emotional skills in elementary school children: results from a 4-year study in Portugal.

PubMed

Moreira, Paulo; Crusellas, Lorena; Sá, Isabel; Gomes, Paulo; Matias, Carla

2010-09-01

The promotion of socio-emotional skills in educational contexts is highly beneficial to individuals' global adjustment and development. Evaluation research suggests that interventions for the promotion of socio-emotional skills are effective. However, most of this work has been carried out in the USA and there is now a pressing need to evaluate interventions at the cross-cultural level. This 4-year study evaluated the effectiveness of a teacher manual-based intervention for the promotion of social and emotional skills in Portuguese elementary school children. Using a quasi-experimental design, teachers taught manual-based strategies to children in the experimental group, focusing on specific social and emotional skills. These strategies were integrated as part of the curricular activities. Results showed statistically significant differences between the experimental group and the control group on the evaluated outcomes (self-control, emotional differentiation, emotional regulation, social skills, and self-esteem). For each of the dimensions studied, effect sizes were large (above 0.80). Findings are similar to those reported by international research evaluating the effectiveness of programmes for the promotion of social and emotional skills in school-age children. This study is an important contribution in the establishment of evidence-based socio-emotional skills programmes at the cross-cultural level.

Cost effectiveness of the Oregon quitline "free patch initiative".

PubMed

Fellows, Jeffrey L; Bush, Terry; McAfee, Tim; Dickerson, John

2007-12-01

We estimated the cost effectiveness of the Oregon tobacco quitline's "free patch initiative" compared to the pre-initiative programme. Using quitline utilisation and cost data from the state, intervention providers and patients, we estimated annual programme use and costs for media promotions and intervention services. We also estimated annual quitline registration calls and the number of quitters and life years saved for the pre-initiative and free patch initiative programmes. Service utilisation and 30-day abstinence at six months were obtained from 959 quitline callers. We compared the cost effectiveness of the free patch initiative (media and intervention costs) to the pre-initiative service offered to insured and uninsured callers. We conducted sensitivity analyses on key programme costs and outcomes by estimating a best case and worst case scenario for each intervention strategy. Compared to the pre-intervention programme, the free patch initiative doubled registered calls, increased quitting fourfold and reduced total costs per quit by $2688. We estimated annual paid media costs were $215 per registered tobacco user for the pre-initiative programme and less than $4 per caller during the free patch initiative. Compared to the pre-initiative programme, incremental quitline promotion and intervention costs for the free patch initiative were $86 (range $22-$353) per life year saved. Compared to the pre-initiative programme, the free patch initiative was a highly cost effective strategy for increasing quitting in the population.

Promoting mental wellbeing: developing a theoretically and empirically sound complex intervention.

PubMed

Millar, S L; Donnelly, M

2014-06-01

This paper describes the development of a complex intervention to promote mental wellbeing using the revised framework for developing and evaluating complex interventions produced by the UK Medical Research Council (UKMRC). Application of the first two phases of the framework is described--development and feasibility and piloting. The theoretical case and evidence base were examined analytically to explicate the theoretical and empirical foundations of the intervention. These findings informed the design of a 12-week mental wellbeing promotion programme providing early intervention for people showing signs of mental health difficulties. The programme is based on the theoretical constructs of self-efficacy, self-esteem, purpose in life, resilience and social support and comprises 10 steps. A mixed methods approach was used to conduct a feasibility study with community and voluntary sector service users and in primary care. A significant increase in mental wellbeing was observed following participation in the intervention. Qualitative data corroborated this finding and suggested that the intervention was feasible to deliver and acceptable to participants, facilitators and health professionals. The revised UKMRC framework can be successfully applied to the development of public health interventions. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Early home-based intervention in the Netherlands for children at familial risk of dyslexia.

PubMed

van Otterloo, Sandra G; van der Leij, Aryan; Henrichs, Lotte F

2009-08-01

Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and letter knowledge. A control group (n=25) received a non-specific training in morphology, syntax, and vocabulary. Both interventions were designed to take 10 min a day, 5 days a week for 10 weeks. Most parents were sufficiently able to work with the programme properly. At post-test the experimental group had gained more on phoneme awareness than the control group. The control group gained more on one of the morphology measures. On average, these specific training results did not lead to significant group differences in first-grade reading and spelling measures. However, fewer experimental children scored below 10th percentile on word recognition. (c) 2008 John Wiley & Sons, Ltd.

An exploration of group-based HIV/AIDS treatment and care models in Sub-Saharan Africa using a realist evaluation (Intervention-Context-Actor-Mechanism-Outcome) heuristic tool: a systematic review.

PubMed

Mukumbang, Ferdinand C; Van Belle, Sara; Marchal, Bruno; van Wyk, Brian

2017-08-25

It is increasingly acknowledged that differentiated care models hold potential to manage large volumes of patients on antiretroviral therapy (ART). Various group-based models of ART service delivery aimed at decongesting local health facilities, encouraging patient retention in care, and enhancing adherence to medication have been implemented across sub-Saharan Africa. Evidence from the literature suggests that these models of ART service delivery are more effective than corresponding facility-based care and superior to individual-based models. Nevertheless, there is little understanding of how these care models work to achieve their intended outcomes. The aim of this study was to review the theories explicating how and why group-based ART models work using a realist evaluation framework. A systematic review of the literature on group-based ART support models in sub-Saharan Africa was conducted. We searched the Google Scholar and PubMed databases and supplemented these with a reference chase of the identified articles. We applied a theory-driven approach-narrative synthesis-to synthesise the data. Data were analysed using the thematic content analysis method and synthesised according to aspects of the Intervention-Context-Actor-Mechanism-Outcome heuristic-analytic tool-a realist evaluation theory building tool. Twelve articles reporting primary studies on group-based models of ART service delivery were included in the review. The six studies that employed a quantitative study design failed to identify aspects of the context and mechanisms that work to trigger the outcomes of group-based models. While the other four studies that applied a qualitative and the two using a mixed methods design identified some of the aspects of the context and mechanisms that could trigger the outcomes of group-based ART models, these studies did not explain the relationship(s) between the theory elements and how they interact to produce the outcome(s). Although we could distill various components of the Intervention-Context-Actor-Mechanism-Outcome analytic tool from different studies exploring group-based programmes, we could not, however, identify a salient programme theory based on the Intervention-Context-Actor-Mechanism-Outcome heuristic analysis. The scientific community, policy makers and programme implementers would benefit more if explanatory findings of how, why, for whom and in what circumstances programmes work are presented rather than just reporting on the outcomes of the interventions.

Improved cognitive performance in preadolescent Danish children after the school-based physical activity programme "FIFA 11 for Health" for Europe - A cluster-randomised controlled trial.

PubMed

Lind, Rune Rasmussen; Geertsen, Svend Sparre; Ørntoft, Christina; Madsen, Mads; Larsen, Malte Nejst; Dvorak, Jiri; Ritz, Christian; Krustrup, Peter

2018-02-01

Recent studies have shown promising effects of physical activity on cognitive function, but there is a need to investigate this link in real-life settings such as schools. Hence, the objective of the present pilot study was to investigate whether the school-based physical activity programme "FIFA 11 for Health" for Europe could improve cognitive performance in preadolescent Danish children. The pilot study used an 11-week cluster-randomised intervention study design. School classes were randomly assigned to either a control group (CG) (n = 93 children, age = 11.8, s = 0.2 years), which performed the obligatory daily school-based physical activity (5 × 45 minutes per week); or an intervention group (IG) (n = 838 children, age = 11.9, s = 0.4 years), which substituted 2 × 45 minutes per week of the daily school physical activity with the "FIFA 11 for Health" for Europe programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. The IG improved their cognitive performance compared to the CG for psychomotor function (56, s x -  = 22 ms, p < .001), attention (39, s x -  = 17 ms, p = .012) and working memory (79, s x -  = 35 ms, p = .020). This pilot study provides evidence that the school-based physical activity programme "FIFA 11 for Health" for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt to disentangle the effects of "FIFA 11 for Health" for Europe on cognitive performance by investigating the characteristics of the programme's physical activity.

Brief exposure to a self-paced computer-based reading programme and how it impacts reading ability and behaviour problems.

PubMed

Hughes, J Antony; Phillips, Gordon; Reed, Phil

2013-01-01

Basic literacy skills underlie much future adult functioning, and are targeted in children through a variety of means. Children with reading problems were exposed either to a self-paced computer programme that focused on improving phonetic ability, or underwent a classroom-based reading intervention. Exposure was limited to 3 40-min sessions a week, for six weeks. The children were assessed in terms of their reading, spelling, and mathematics abilities, as well as for their externalising and internalising behaviour problems, before the programme commenced, and immediately after the programme terminated. Relative to the control group, the computer-programme improved reading by about seven months in boys (but not in girls), but had no impact on either spelling or mathematics. Children on the programme also demonstrated fewer externalising and internalising behaviour problems than the control group. The results suggest that brief exposure to a self-paced phonetic computer-teaching programme had some benefits for the sample.

Longitudinal 2-Year Follow-up on the Effect of a Non-Randomised School-Based Physical Activity Intervention on Reducing Overweight and Obesity of Czech Children Aged 10–12 Years

PubMed Central

Sigmund, Erik; Sigmundová, Dagmar

2013-01-01

Background: This study assessed whether the benefits of a 2-year longitudinal non-randomised school-based physical activity (PA) intervention programme to reduce overweight and obesity were still apparent two years after completion of the controlled intervention. Methods: The study involved 84 girls (G) and 92 boys (B) aged 10–12 years who had participated in the PA intervention in 2006–2008 as 6- to 9-year olds and were included in the intervention (I) (43 G and 45 B) and the control (C) groups (41 G and 47 B). Participants’ overweight/obesity was assessed using the percentile graph of Body Mass Index (BMI) from the World Health Organization for girls and boys aged 5–19. Logistic regression (Enter method) determined the overweight/obesity occurrence in a follow-up measurement (2010) two years after completion of the controlled intervention was used. Results: Two years after the controlled PA intervention had finished, the intervention children were less likely to be overweight/obese than the control children (2.3%GI vs. 17.1%GC, 6.7%BI vs. 23.4%BC, odds ratio: 0.25; 95% confidence interval: 0.12; 0.53; p < 0.001). Conclusions: The current study indicates favourable effects of an everyday school-based PA intervention programme on lower overweight/obesity incidence, which was maintained two years after the end of the direct involvement of the researchers. PMID:23959084

Recruiting, Retaining and Engaging Men in Social Interventions: Lessons for Implementation Focusing on a Prison-based Parenting Intervention for Young Incarcerated Fathers

PubMed Central

Buston, Katie

2018-01-01

ABSTRACT Recruiting, retaining and engaging men in social interventions can be challenging. The focus of this paper is the successful implementation of a parenting programme for incarcerated fathers, delivered in a Young Offender Institution (YOI) in Scotland. Reasons for high levels of recruitment, retention and engagement are explored, with barriers identified. A qualitative design was employed using ethnographic approaches including participant observation of the programme, informal interactions, and formal interviews with programme participants, the facilitators and others involved in managing the programme. Framework analysis was conducted on the integrated data set. The prison as the setting for programme delivery was both an opportunity and a challenge. It enabled easy access to participants and required low levels of effort on their part to attend. The creation of a nurturing and safe environment within the prison classroom facilitated engagement: relationships between the facilitators and participants, and between the participants themselves were key to understanding high levels of retention and engagement. The most fundamental challenge to high engagement levels arose from clashes in embedded institutional ways of working, between the host institution and the organisation experienced in delivering such intervention work. This threatened to compromise trust between the participants and the facilitators. Whilst adding specifically to the very sparse literature on reaching incarcerated young fathers and engaging them in parenting work, the findings have transferability to other under-researched areas: the implementation of social interventions generally in the prison setting, and engaging marginalised fathers in parenting/family work in community settings. The paper highlights ways of overcoming some of the challenges faced. PMID:29503596

Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands.

PubMed

Detaille, Sarah I; van der Gulden, Joost W J; Engels, Josephine A; Heerkens, Yvonne F; van Dijk, Frank J H

2010-06-21

Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. The method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed. The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease. Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.

Surveillance and Control of Aedes albopictus in the Swiss-Italian Border Region: Differences in Egg Densities between Intervention and Non-intervention Areas

PubMed Central

Suter, Tobias T.; Flacio, Eleonora; Feijoó Fariña, Begoña; Engeler, Lukas; Tonolla, Mauro; Regis, Lêda N.; de Melo Santos, Maria A. V.; Müller, Pie

2016-01-01

Background Aedes albopictus, the Asian tiger mosquito, originates from the tropical and subtropical regions of Southeast Asia. Over the recent decades it has been passively spread across the globe, primarily through the used tyre trade and passive transportation along major traffic routes. A. albopictus is a proven vector for many arboviruses, most notably chikungunya and dengue, with recent outbreaks also in continental Europe. In southern Switzerland, in the Canton of Ticino A. albopictus was spotted for the first time in 2003. Since then the local authorities have implemented a control programme based on larval source reduction. Despite these efforts, mosquito densities have increased over the last decade, casting doubts on the effectiveness of such larval control programmes. Methodology/Principal Findings The Italian communities just across the Swiss-Italian border lack a control programme. This motivated us to compare the intervention and the non-intervention areas side by side in an attempt to find evidence for, or against, the effectiveness of larval A. albopictus control. Using ovitraps and a randomised sampling scheme, we examined the seasonal and spatial abundance of A. albopictus in sylvatic and urban environments across the Swiss-Italian border in 2012 and 2013. In the urban environments of the non-intervention area, egg densities were 2.26 times higher as compared to the intervention area. In the sylvatic environments, as compared to the urban environments, egg densities were 36% in the intervention area and 18% in the non-intervention area. Conclusions/Significance Though alternative explanations are also valid, the results support the hypothesis that the Ticino intervention programme does have an impact. At the same time the data also suggest that current larval interventions fall short in gaining full control over the mosquito, calling for the evaluation of additional, or alternative, approaches. Ideally, these should also consider inclusion of the neighbouring Italian communities in the surveillance and control efforts. PMID:26734946

Come On! Using intervention mapping to help healthy pregnant women achieve healthy weight gain.

PubMed

Merkx, Astrid; Ausems, Marlein; de Vries, Raymond; Nieuwenhuijze, Marianne J

2017-06-01

Gaining too much or too little weight in pregnancy (according to Institute of Medicine (IOM) guidelines) negatively affects both mother and child, but many women find it difficult to manage their gestational weight gain (GWG). Here we describe the use of the intervention mapping protocol to design 'Come On!', an intervention to promote adequate GWG among healthy pregnant women. We used the six steps of intervention mapping: (i) needs assessment; (ii) formulation of change objectives; (iii) selection of theory-based methods and practical strategies; (iv) development of the intervention programme; (v) development of an adoption and implementation plan; and (vi) development of an evaluation plan. A consortium of users and related professionals guided the process of development. As a result of the needs assessment, two goals for the intervention were formulated: (i) helping healthy pregnant women to stay within the IOM guidelines for GWG; and (ii) getting midwives to adequately support the efforts of healthy pregnant women to gain weight within the IOM guidelines. To reach these goals, change objectives and determinants influencing the change objectives were formulated. Theories used were the Transtheoretical Model, Social Cognitive Theory and the Elaboration Likelihood Model. Practical strategies to use the theories were the foundation for the development of 'Come On!', a comprehensive programme that included a tailored Internet programme for pregnant women, training for midwives, an information card for midwives, and a scheduled discussion between the midwife and the pregnant woman during pregnancy. The programme was pre-tested and evaluated in an effect study.

Using ethnography in implementation research to improve nutrition interventions in populations

PubMed Central

Neufeld, Lynnette M.; Pelto, Gretel H.

2015-01-01

Abstract ‘Implementation research in nutrition’ is an emerging area of study aimed at building evidence‐based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view – the insider's perspective – and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the ‘emic’ (insider's) perspective.Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography.Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the ‘black box’ in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. PMID:26778802

Using ethnography in implementation research to improve nutrition interventions in populations.

PubMed

Tumilowicz, Alison; Neufeld, Lynnette M; Pelto, Gretel H

2015-12-01

'Implementation research in nutrition' is an emerging area of study aimed at building evidence-based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view--the insider's perspective--and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the 'emic' (insider's) perspective. Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography. Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the 'black box' in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. © 2015 John Wiley & Sons Ltd.

Workplace pedometer interventions for increasing physical activity.

PubMed

Freak-Poli, Rosanne L A; Cumpston, Miranda; Peeters, Anna; Clemes, Stacy A

2013-04-30

The World Health Organization and the World Economic Forum have recommended further research to strengthen current knowledge of workplace health programmes, particularly on effectiveness and using simple instruments. A pedometer is one such simple instrument that can be incorporated in workplace interventions. To assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes. Electronic searches of the Cochrane Central Register of Controlled Trials (671 potential papers), MEDLINE (1001), Embase (965), CINAHL (1262), OSH UPDATE databases (75) and Web of Science (1154) from the earliest record to between 30th January and 6th February 2012 yielded 3248 unique records. Reference lists of articles yielded an additional 34 papers. Contact with individuals and organisations did not produce any further records. We included individual and cluster-randomised controlled trials of workplace health promotion interventions with a pedometer component in employed adults. The primary outcome was physical activity and was part of the eligibility criteria. We considered subsequent health outcomes, including adverse effects, as secondary outcomes. Two review authors undertook the screening of titles and abstracts and the full-text papers independently. Two review authors (RFP and MC) independently completed data extraction and risk of bias assessment. We contacted authors to obtain additional data and clarification. We found four relevant studies providing data for 1809 employees, 60% of whom were allocated to the intervention group. All studies assessed outcomes immediately after the intervention had finished and the intervention duration varied between three to six months. All studies had usual treatment control conditions; however one study's usual treatment was an alternative physical activity programme while the other three had minimally active controls. In general, there was high risk of bias mainly due to lack of blinding, self reported outcome measurement, incomplete outcome data due to attrition, and most of the studies had not published protocols, which increases the likelihood of selective reporting.Three studies compared the pedometer programme to a minimally active control group, but the results for physical activity could not be combined because each study used a different measure of activity. One study observed an increase in physical activity under a pedometer programme, but the other two did not find a significant difference. For secondary outcomes we found improvements in body mass index, waist circumference, fasting plasma glucose, the quality of life mental component and worksite injury associated with the pedometer programmes, but these results were based on limited data from one or two small studies. There were no differences between the pedometer programme and the control group for blood pressure, a number of biochemical outcomes and the quality of life physical component. Sedentary behaviour and disease risk scores were not measured by any of the included studies.One study compared a pedometer programme and an alternative physical activity programme, but baseline imbalances made it difficult to distinguish the true improvements associated with either programme.Overall, there was insufficient evidence to assess the effectiveness of pedometer interventions in the workplace.There is a need for more high quality randomised controlled trials to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes. To improve the quality of the evidence available, future studies should be registered in an online trials register, publish a protocol, allocate time and financial support to reducing attrition, and try to blind personnel (especially those who undertake measurement). To better identify the effects of pedometer interventions, future studies should report a core set of outcomes (total physical activity in METs, total time sitting in hours and minutes, objectively measured cardiovascular disease and type II diabetes risk factors, quality of life and injury), assess outcomes in the long term and undertake subgroup analyses based upon demographic subgroups (e.g. age, gender, educational status). Future studies should also compare different types of active intervention to test specific intervention components (eligibility, duration, step goal, step diary, settings), and settings (occupation, intervention provider). There was limited and low quality data providing insufficient evidence to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes.

Application of segmented dental panoramic tomography among children: positive effect of continuing education in radiation protection

PubMed Central

Waltimo-Sirén, Janna; Laatikainen, Tuula; Haukka, Jari; Ekholm, Marja

2016-01-01

Objectives: Dental panoramic tomography is the most frequent examination among 7–12-year olds, according to the Radiation Safety and Nuclear Authority of Finland. At those ages, dental panoramic tomographs (DPTs) are mostly obtained for orthodontic reasons. Children's dose reduction by trimming the field size to the area of interest is important because of their high radiosensitivity. Yet, the majority of DPTs in this age group are still taken by using an adult programme and never by using a segmented programme. The purpose of the present study was to raise the awareness of dental staff with respect to children's radiation safety, to increase the application of segmented and child DPT programmes by further educating the whole dental team and to evaluate the outcome of the educational intervention. Methods: A five-step intervention programme, focusing on DPT field limitation possibilities, was carried out in community-based dental care as a part of mandatory continuing education in radiation protection. Application of segmented and child DPT programmes was thereafter prospectively followed up during a 1-year period and compared with our similar data from 2010 using a logistic regression analysis. Results: Application of the child programme increased by 9% and the segmented programme by 2%, reaching statistical significance (odds ratios 1.68; 95% confidence interval 1.23–2.30; p-value < 0.001). The number of repeated exposures remained at an acceptable level. The segmented DPTs were most frequently taken from the maxillary lateral incisor–canine area. Conclusions: The educational intervention resulted in improvement of radiological practice in respect to radiation safety of children during dental panoramic tomography. Segmented and child DPT programmes can be applied successfully in dental practice for children. PMID:27142159

Application of segmented dental panoramic tomography among children: positive effect of continuing education in radiation protection.

PubMed

Pakbaznejad Esmaeili, Elmira; Waltimo-Sirén, Janna; Laatikainen, Tuula; Haukka, Jari; Ekholm, Marja

2016-05-23

Dental panoramic tomography is the most frequent examination among 7-12-year olds, according to the Radiation Safety and Nuclear Authority of Finland. At those ages, dental panoramic tomographs (DPTs) are mostly obtained for orthodontic reasons. Children's dose reduction by trimming the field size to the area of interest is important because of their high radiosensitivity. Yet, the majority of DPTs in this age group are still taken by using an adult programme and never by using a segmented programme. The purpose of the present study was to raise the awareness of dental staff with respect to children's radiation safety, to increase the application of segmented and child DPT programmes by further educating the whole dental team and to evaluate the outcome of the educational intervention. A five-step intervention programme, focusing on DPT field limitation possibilities, was carried out in community-based dental care as a part of mandatory continuing education in radiation protection. Application of segmented and child DPT programmes was thereafter prospectively followed up during a 1-year period and compared with our similar data from 2010 using a logistic regression analysis. Application of the child programme increased by 9% and the segmented programme by 2%, reaching statistical significance (odds ratios 1.68; 95% confidence interval 1.23-2.30; p-value < 0.001). The number of repeated exposures remained at an acceptable level. The segmented DPTs were most frequently taken from the maxillary lateral incisor-canine area. The educational intervention resulted in improvement of radiological practice in respect to radiation safety of children during dental panoramic tomography. Segmented and child DPT programmes can be applied successfully in dental practice for children.

Recruiting, Retaining and Engaging Men in Social Interventions: Lessons for Implementation Focusing on a Prison-Based Parenting Intervention for Young Incarcerated Fathers

ERIC Educational Resources Information Center

Buston, Katie

2018-01-01

Recruiting, retaining and engaging men in social interventions can be challenging. The focus of this paper is the successful implementation of a parenting programme for incarcerated fathers, delivered in a Young Offender Institution (YOI) in Scotland. Reasons for high levels of recruitment, retention and engagement are explored, with barriers…

Outcome and Process Evaluation of a Norwegian School-Randomized Fruit and Vegetable Intervention: Fruits and Vegetables Make the Marks (FVMM)

ERIC Educational Resources Information Center

Bere, E.; Veierod, M. B.; Bjelland, M.; Klepp, K.-I.

2006-01-01

This study reports the effect of the Fruits and Vegetables Make the Marks intervention, a school-based fruit and vegetable intervention consisting of a home economics classroom component and parental involvement and encouraged participation in the Norwegian School Fruit Programme, all delivered during the school year of 2001-02. Nine randomly…

Perceived access to fruits and vegetables associated with increased consumption.

PubMed

Caldwell, Erin M; Miller Kobayashi, M; DuBow, W M; Wytinck, S M

2009-10-01

To examine the association between fruit and vegetable access in the community and change in fruit and vegetable consumption among participants in community-based health promotion programmes. Fruit and vegetable consumption and perceived access to fresh fruit and vegetables were measured by self-administered questionnaires at programme start, end and 1-year follow-up. Community produce availability was determined by grocery store assessments measuring the display space devoted to fruit and vegetable offerings, as well as price, variety and freshness. A total of nine communities were studied; 130 participants completed the fruit and vegetable portions of the questionnaires and could be linked to grocery store assessments. Participants made modest but significant increases in fruit and vegetable consumption from programme start to end: the average increase was 2.88 (95% CI 1.52, 4.25) servings weekly; the average increase from start to follow-up was 2.52 (95% CI 1.09, 3.95) servings weekly. Greater perceived access to fruits and vegetables was significantly associated with higher increases in fruit and vegetable consumption from programme start to programme end. Greater availability of produce was associated with greater increases in fruit and vegetable servings from programme start to programme end as measured by store assessments. Environmental factors, such as access to fruits and vegetables, can modify the effects of community interventions. Interventions with the goal of increasing fruit and vegetable consumption should consider focusing on increasing access to fresh fruits and vegetables in target communities. Similarly, researchers may want to study access as an intervention, not just a contextual variable.

Local food environment interventions to improve healthy food choice in adults: a systematic review and realist synthesis protocol.

PubMed

Penney, Tarra L; Brown, Helen Elizabeth; Maguire, Eva R; Kuhn, Isla; Monsivais, Pablo

2015-05-03

Local food environments have been linked with dietary intake and obesity in adults. However, overall evidence remains mixed with calls for increased theoretical and conceptual clarity related to how availability of neighbourhood food outlets, and within-outlet food options, influence food purchasing and consumption. The purpose of this work is to develop a programme theory of food availability, supported by empirical evidence from a range of local food environment interventions. A systematic search of the literature will be followed by duplicate screening and quality assessment (using the Effective Public Health Practice Project tool). Realist synthesis will then be conducted according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standards, including transparent appraisal, synthesis and drawing conclusions via consensus. The final synthesis will propose an evidence-based programme theory of food availability, including evidence mapping to demonstrate contextual factors, pathways of influence and potential mechanisms. With the paucity of empirically supported programme theories used in current local food environment interventions to improve food availability, this synthesis may be used to understand how and why interventions work, and thus inform the development of theory-driven, evidence-based interventions to improve healthy food choice and future empirical work. PROSPERO CRD42014009808. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

To be seen, confirmed and involved - a ten year follow-up of perceived health and cardiovascular risk factors in a Swedish community intervention programme

PubMed Central

Emmelin, Maria; Weinehall, Lars; Stenlund, Hans; Wall, Stig; Dahlgren, Lars

2007-01-01

Background Public health interventions are directed towards social systems and it is difficult to foresee all consequences. While targeted outcomes may be positively influenced, interventions may at worst be counterproductive. To include self-reported health in an evaluation is one way of addressing possible side-effects. This study is based on a 10 year follow-up of a cardiovascular community intervention programme in northern Sweden. Methods Both quantitative and qualitative approaches were used to address the interaction between changes in self-rated health and risk factor load. Qualitative interviews contributed to an analysis of how the outcome was influenced by health related norms and attitudes. Results Most people maintained a low risk factor load and a positive perception of health. However, more people improved than deteriorated their situation regarding both perceived health and risk factor load. "Ideal types" of attitude sets towards the programme, generated from the interviews, helped to interpret an observed polarisation for men and the lower educated. Conclusion Our observation of a socially and gender differentiated intervention effect suggests a need to test new intervention strategies. Future community interventions may benefit from targeting more directly those who in combination with high risk factor load perceive their health as bad and to make all participants feel seen, confirmed and involved. PMID:17672911

Reading Comprehension: A Computerized Intervention with Primary-age Poor Readers.

PubMed

Horne, Joanna Kathryn

2017-05-01

The current study investigates the effectiveness of a computerized reading comprehension programme on the reading accuracy, reading comprehension and reading rate of primary-age poor readers. There is little published literature relating to computerized reading interventions in UK primary schools, and no previous studies have investigated the Comprehension Booster programme. Thirty-eight children (26 boys and 12 girls; aged 6:7 to 11:0) from two schools in East Yorkshire, UK, took part. Half of the participants (the intervention group) undertook the Comprehension Booster programme for a 6-week period, whilst the other half (the control group) continued with their usual teaching. Significant effects of the intervention were found, with increases in reading accuracy and reading comprehension for the intervention group. It is concluded that computerized reading programmes can be effective in improving reading skills, and these are particularly useful for pupils with reading difficulties in disadvantaged areas, where resources are limited and family support in reading is lower. However, such programmes are not a replacement for good teaching, and regular monitoring of children with reading difficulties is required. Further research is necessary to compare the programme used here to other conventional and computerized intervention programmes, using a larger sample. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

"Four legs instead of two"--perspectives on a Nordic walking-based walking programme among people with arthritis.

PubMed

O'Donovan, Rhona; Kennedy, Norelee

2015-01-01

Nordic Walking (NW) is growing in popularity among people with arthritis. The aim of this study was to explore the perspectives of participants with arthritis on a NW-based walking programme including factors contributing to sustained participation in the programme. Three semi-structured focus groups were conducted with a total of 27 participants with various types of arthritis. The groups consisted of participants who completed a NW-based walking programme in the previous 4 years. Only participants who had sustained involvement in the walking group were included. Groups were audio-recorded, transcribed verbatim and thematic analysis was performed. Participants reported that the walking programme offered numerous benefits. Two distinct themes emerged: (1) "four legs instead of two legs" and (2) "a support group". Theme 1 incorporates the physical, psychological and educational benefits that stem from involvement in a walking group while Theme 2 incorporates the benefits of social support in group-based activity. Several benefits of a NW-based walking programme from the perspectives of individuals with arthritis who engage in group-based walking programmes were identified. The benefits may encourage sustained participation and justify the promotion of NW as an intervention for people with arthritis. Considering how to sustain exercise participation is important to ensure continued benefits from physical activity participation. A community-based Nordic walking-based walking programme for people with arthritis improved exercise knowledge and confidence to exercise. Group exercise is valuable in providing support and motivation to continue exercising.

Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial.

PubMed

Beentjes, Titus A A; van Gaal, Betsie G I; Goossens, Peter J J; Schoonhoven, Lisette

2016-01-19

E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. The trial is registered in the Dutch Trial Register: NTR4772 .

Responding to excessive alcohol consumption in third-level (REACT): a study protocol.

PubMed

Davoren, Martin P; Calnan, Susan; Mulcahy, Judith; Lynch, Emily; Perry, Ivan J; Byrne, Michael

2018-05-11

Problem alcohol use is an ongoing, worldwide phenomenon of considerable concern. Throughout the past 20 years, national policies have noted the importance of students when tackling alcohol consumption. Considering alcohol is a multifaceted issue, a multi-component response is required to combat its excessive use. This protocol sets out the approach used for developing, implementing and evaluating the REACT (Responding to Excessive Alcohol Consumption in Third-level) Programme. This evaluation will provide the evidence base for programme development, implementation and improvement. Stage one involved defining the multi-component intervention. This was developed following a systematic review of existing literature and a Delphi-consensus workshop involving university students, staff and relevant stakeholders. Following this, the programme is being implemented across the Higher Education sector in Ireland. A number of Higher Education Institutes have declined the invitation to participate in the programme. These institutions will act as control sites. Each intervention site will have a steering committee whose membership will include a mix of students and academic and student service staff. This steering committee will report to the REACT research team on the implementation of mandatory and optional action points at local sites. An online cross-sectional study at baseline and two-years post intervention will be utilised to determine the impact of the REACT programme. The impact assessment will focus on (1) whether the intervention has reduced alcohol consumption among third-level students (2); whether the programme altered students attitudes toward alcohol and (3) whether the programme has decreased the second-hand effects associated with excessive consumption. Finally, qualitative research will focus on factors influencing the take-up and implementation of this programme as well as students' views on the initiative. Alcohol consumption has remained on the policy agenda at both national and international level over recent decades. Students are regularly among the highest alcohol consumers, yet university management and public policymakers struggle to tackle this burgeoning issue. The REACT Programme provides a structure to translate policy into practice for those seeking to reduce hazardous alcohol consumption and related harms among third-level students.

MAKINGtheLINK: A school-based intervention to improve help-seeking for substance use problems.

PubMed

Lubman, Dan I; Cheetham, Ali; Berridge, Bonita J; McKay-Brown, Lisa

2017-05-18

Many young people are reluctant to seek professional help for alcohol and other substance use problems, preferring to rely on family and friends. MAKINGtheLINK is a school-based intervention that teaches adolescents how to help their peers overcome barriers to engaging with professional help. The current study examined the effect of the MAKINGtheLINK programme in a sample of 12- to 15-year-old students. Participants included 247 Grade 8 students (49% male, 51% female) recruited from 3 schools in Victoria, Australia. Participants completed questionnaires measuring barriers to professional help-seeking, help-seeking intentions and confidence to seek help at 3 time points (pre-intervention, post-intervention and 6-week follow-up). A non-controlled repeated measures design was used to assess the effect of the programme on help-seeking across time points. The programme decreased barriers, increased intentions to seek help from formal sources, decreased intentions to seek help from family and increased confidence to seek help for a peer. The decrease in barriers was maintained at the 6-week follow-up, as were decreased intentions to seek help from family members, and increased intentions to seek help from school counsellors and alcohol and drug workers. The effects of the intervention did not differ substantially between males and females. The MAKINGtheLINK is the first intervention to focus on overcoming barriers to help-seeking for substance use problems by helping adolescents develop skills to support their peers. The intervention has promise as a means of facilitating help-seeking during adolescence, although further research is needed to test its effectiveness in a more rigorous design. © 2017 John Wiley & Sons Australia, Ltd.

An internet-based self-administered intervention for promoting healthy habits and weight loss in hypertensive people who are overweight or obese: a randomized controlled trial.

PubMed

Banos, Rosa M; Mensorio, Marinna S; Cebolla, Ausias; Rodilla, Enrique; Palomar, Gonzalo; Lisón, JuanFrancisco; Botella, Cristina

2015-08-04

The prevalence of overweight and obesity is on the rise worldwide with severe physical and psychosocial consequences. One of the most dangerous is hypertension. Lifestyle changes related to eating behaviour and physical activity are the critical components in the prevention and treatment of hypertension and obesity. Data indicates that the usual procedures to promote these healthy habits in health services are either insufficient or not efficient enough. Internet has been shown to be an effective tool for the implementation of lifestyle interventions based on this type of problem. This study aims to assess the efficacy of a totally self-administered online intervention programme versus the usual medical care for obese and overweight participants with hypertension (from the Spanish public health care system) to promote healthy lifestyles (eating behaviour and physical activity). A randomized controlled trial will be conducted with 100 patients recruited from the hypertension unit of a public hospital. Participants will be randomly assigned to one of two conditions: a) SII: a self-administered Internet-based intervention protocol; and b) MUC-medical usual care. The online intervention is an Internet-delivered, multimedia, interactive, self-administered programme, composed of nine modules designed to promote healthy eating habits and increase physical activity. The first five modules will be activated at a rate of one per week, and access for modules 5 to 9 will open every two weeks. Patients will be assessed at four points: before the intervention, after the intervention (3 months), and at 6 and 12 months (follow-up). The outcome variables will include blood pressure, and Body Mass Index, as primary outcome measures, and quality of life and other lifestyle and anthropometrical variables as secondary outcome measures. The literature highlights the need for more studies on the benefits of using the Internet to promote lifestyle interventions. This study aims to investigate the efficiency of a totally self-administered Internet - +based programme for promoting healthy habits and improving the medical indicators of a hypertensive and overweight population. NCT02445833.

Changing attitudes and beliefs towards a woman's right to protect against HIV risk in Malawi.

PubMed

Fedor, Theresa M; Kohler, Hans-Peter; McMahon, James M

2016-01-01

Female empowerment and positive attitudes towards women's rights in sexual relationships have been found to be key elements of successful behaviour-based HIV prevention programmes. However, HIV prevention programmes that do not specifically engage with gender issues may also affect attitudes and beliefs towards women's rights within sexual relationships. Using data from the Malawi Longitudinal Study of Families and Health we compare measures of female empowerment and changing gender norms between intervention participants and non-participants. Results suggest that female intervention participants were more likely than non-participants to believe that: (1) women have more rights within sexual relationships in general and (2) women have the right to protect themselves against HIV risk (indicating possible increases in female self-efficacy in making HIV prevention decisions). Male intervention participants showed no substantial positive change in attitudes towards women's rights. These results highlight an important positive effect of HIV prevention programmes on women's attitudes towards their own rights.

Changing attitudes and beliefs towards a woman’s right to protect against HIV risk in Malawi

PubMed Central

Fedor, Theresa Marie; Kohler, Hans-Peter; McMahon, James M.

2016-01-01

Female empowerment and positive attitudes towards women’s rights in sexual relationships have been found to be key elements of successful behaviour-based HIV prevention programmes. However, HIV prevention programmes that do not specifically engage with gender issues may also affect attitudes and beliefs towards women’s rights within sexual relationships. Using data from the Malawi Longitudinal Study of Families and Health (MLSFH) we compare measures of female empowerment and changing gender norms between intervention participants and non-participants. Results suggest that female intervention participants were more likely than non-participants to believe that (1) women have more rights within sexual relationships in general, and (2) women have the right to protect themselves against HIV risk (indicating possible increases in female self-efficacy in making HIV prevention decisions). Male intervention participants showed no substantial positive change in attitudes towards women’s rights. These results highlight an important positive effect of HIV prevention programmes on women’s attitudes towards their own rights. PMID:26503918

Peer-led versus teacher-led AIDS education for female high-school students in Yazd, Islamic Republic of Iran.

PubMed

Baghianimoghadam, M H; Forghani, H; Zolghadr, R; Rahaei, Z; Khani, P

2012-04-01

Peer-led programmes on AIDS prevention have shown a good level of effectiveness when tested among high-risk populations. This study compared peer-led and teacher-led methods of education about HIV/AIDS among female high-school students in Yazd city, Islamic Republic of Iran. In 2009 students in 3 high schools were trained by their classmates (peer-led), by the research team (teacher-led) or had no education (controls); 180 students completed a specially designed questionnaire based on the health belief model, before and after the intervention. Post-intervention mean knowledge scores increased 2-fold in the peer-led group, and this was significantly higher than the increase in the teacher-led group scores (1.5-fold). Control group scores were unchanged. In the peer-led programme all of the components of the model were significantly improved whereas in the teacher-led programme, only perceived severity and perceived barriers scored significantly higher after the intervention.

Preventing alcohol misuse in young people aged 9-11 years through promoting family communication: an exploratory evaluation of the Kids, Adults Together (KAT) Programme

PubMed Central

2011-01-01

Background Alcohol misuse by young people is an important public health issue, and has led to the development of a range of prevention interventions. Evidence concerning the most effective approaches to intervention design and implementation is limited. Parental involvement in school-based interventions is important, but many programmes fail to recruit large numbers of parents. This paper reports findings from an exploratory evaluation of a new alcohol misuse prevention programme - Kids, Adults Together (KAT), which comprised a classroom component, engagement with parents through a fun evening for families with children aged 9-11 years, and a DVD. The evaluation aimed to establish the programme's theoretical basis, explore implementation processes and acceptability, and identify plausible precursors of the intended long-term outcomes. Methods Documentary analysis and interviews with key personnel examined the programme's development. Classroom preparation and KAT family events in two schools were observed. Focus groups with children, and interviews with parents who attended KAT family events were held immediately after programme delivery, and again after three months. Interviews with head teachers and with teachers who delivered the classroom preparation were conducted. Follow-up interviews with programme personnel were undertaken. Questionnaires were sent to parents of all children involved in classroom preparation. Results KAT achieved high levels of acceptability and involvement among both children and parents. Main perceived impacts of the programme were increased pro-social communication within families (including discussions about harmful parental alcohol consumption), heightened knowledge and awareness of the effects of alcohol consumption and key legal and health issues, and changes in parental drinking behaviours. Conclusions KAT demonstrated promise as a prevention intervention, primarily through its impact on knowledge and communication processes within families, and its ability to engage with large numbers of parents. A key programme mechanism was the classroom preparation's facilitation of parental involvement in the family fun evening. The programme also incorporated features identified in the literature as likely to increase effectiveness, including a focus on harm reduction, interactive delivery, and targeting primary-school-age children. Further research is needed to test and develop programme theory through implementation in different school contexts, and to examine potential longer-term impacts, and the feasibility of large scale delivery. PMID:22004185

Exercise training characteristics in cardiac rehabilitation programmes: a cross-sectional survey of Australian practice.

PubMed

Abell, Bridget; Glasziou, Paul; Briffa, Tom; Hoffmann, Tammy

2016-01-01

Exercise training is a core component of cardiac rehabilitation (CR), however, little information exists regarding the specific exercise interventions currently provided for coronary heart disease in Australian practice. We aimed to analyse the current status of exercise-based CR services across Australia. Cross-sectional survey. Australian sites offering exercise-based CR were identified from publically available directories. All sites were invited by email to participate in an online Survey Monkey questionnaire between October 2014 and March 2015, with reminders via email and phone follow-up. Questions investigated the demographics and format of individual programmes, as well as specific exercise training characteristics. 297 eligible programmes were identified, with an 82% response rate. Most sites (82%) were based at hospital or outpatient centres, with home (15%), community (18%) or gym-based options (5%) less common. While CR was most often offered in a comprehensive format (72% of sites), the level of exercise intervention varied greatly among programmes. Most frequently, exercise was prescribed 1-2 times per week for 60 min over 7 weeks. Almost one-quarter (24%) had a sole practitioner supervising exercise, although the majority used a nurse/physiotherapist combination. Low to moderate exercise intensities were used in 60% of programmes, however, higher intensity prescriptions were not uncommon. Few sites (<6%) made use of technology, such as mobile phones or the internet, to deliver or support exercise training. While advances have been made towards providing flexible and accessible exercise-based CR, much of Australia's service remains within traditional models of care. A continuing focus on service improvement and evidence-based care should, therefore, be considered a core aim of those providing exercise for CR in order to improve health service delivery and optimise outcomes for patients.

Feasibility and effect of home-based therapy programmes for children with cerebral palsy: a protocol for a systematic review.

PubMed

Beckers, L W M E; Schnackers, M L A P; Janssen-Potten, Y J; Kleijnen, J; Steenbergen, B

2017-02-24

Given the promising advantages of upper extremity home-based programmes in children with cerebral palsy (CP), a systematic review of the available literature on this topic is warranted. The purpose of the systematic review described in this protocol is to investigate currently available home-based occupational therapy and physiotherapy programmes regarding both their feasibility and effect. This protocol describes a systematic review, developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015. Studies will be included in which primary data are collected, participants are children aged <18 years with any type of CP and the intervention of interest is a home-based occupational therapy or physiotherapy intervention. Comparators of interest are: no therapy, care as usual, centre-based occupational therapy or physiotherapy, an alternative home-based programme and a medical intervention. Studies will be included that report either on feasibility (ie, acceptability, demand, implementation, practicality, adaptation, expansion or integration) or on efficacy/effectiveness (ie, child-related upper extremity outcomes within all International Classification of Functioning, Disability and Health levels or parent-related/caregiver-related outcomes on the psychological and social domain). Relevant studies will be identified by searching the databases MEDLINE, EMBASE, CINAHL, PsycINFO, PEDro, OTSeeker and CPCI-S as well as the trial registers ICTRP and CENTRAL, the reference lists of included records and by circulating a bibliography of the included records to authors of included studies. There will be no restrictions on language or year of publication. The search strategy consists of terms related to the population and intervention. Data will be extracted in duplicate using a digital data extraction form. The proposed study does not involve collection of primary data. Accordingly, no ethical approval is required. The authors will disseminate the findings of this systematic review through publication in a peer-reviewed journal and conference presentation(s). CRD42016043743; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Dissemination and use of a participatory ergonomics guide for workplaces.

PubMed

Van Eerd, Dwayne; King, Trevor; Keown, Kiera; Slack, Tesha; Cole, Donald C; Irvin, Emma; Amick, Benjamin C; Bigelow, Philip

2016-06-01

Musculoskeletal disorders (MSDs) result in lost-time injury claims and lost productivity worldwide, placing a substantial burden on workers and workplaces. Participatory ergonomics (PE) is a popular approach to reducing MSDs; however, there are challenges to implementing PE programmes. Using evidence to overcome challenges may be helpful but the impacts of doing so are unknown. We sought to disseminate an evidence-based PE tool and to describe its use. An easy-to-use, evidence-based PE Guide was disseminated to workplace parties, who were surveyed about using the tool. The greatest barrier to using the tool was a lack of time. Reported tool use included for training purposes, sharing and integrating the tool into existing programmes. New actions related to tool use included training, defining team responsibilities and suggesting programme implementation steps. Evidence-based tools could help ergonomists overcome some challenges involved in implementing injury reduction programmes such as PE. Practitioner Summary Practitioners experience challenges implementing programmes to reduce the burden of MSDs in workplaces. Implementing participatory interventions requires multiple workplace parties to be 'on-board'. Disseminating and using evidence-based guides may help to overcome these challenges. Using evidence-based tools may help ergonomics practitioners implement PE programmes.

Exploring synergistic interactions and catalysts in complex interventions: longitudinal, mixed methods case studies of an optimised multi-level suicide prevention intervention in four european countries (Ospi-Europe).

PubMed

Harris, Fiona M; Maxwell, Margaret; O'Connor, Rory; Coyne, James C; Arensman, Ella; Coffey, Claire; Koburger, Nicole; Gusmão, Ricardo; Costa, Susana; Székely, András; Cserhati, Zoltan; McDaid, David; van Audenhove, Chantal; Hegerl, Ulrich

2016-03-15

The Medical Research Council (MRC) Framework for complex interventions highlights the need to explore interactions between components of complex interventions, but this has not yet been fully explored within complex, non-pharmacological interventions. This paper draws on the process evaluation data of a suicide prevention programme implemented in four European countries to illustrate the synergistic interactions between intervention levels in a complex programme, and to present our method for exploring these. A realist evaluation approach informed the process evaluation, which drew on mixed methods, longitudinal case studies. Data collection consisted of 47 semi-structured interviews, 12 focus groups, one workshop, fieldnoted observations of six programme meetings and 20 questionnaires (delivered at six month intervals to each of the four intervention sites). Analysis drew on the framework approach, facilitated by the use of QSR NVivo (v10). Our qualitative approach to exploring synergistic interactions (QuaSIC) also developed a matrix of hypothesised synergies that were explored within one workshop and two waves of data collection. All four implementation countries provided examples of synergistic interactions that added value beyond the sum of individual intervention levels or components in isolation. For instance, the launch ceremony of the public health campaign (a level 3 intervention) in Ireland had an impact on the community-based professional training, increasing uptake and visibility of training for journalists in particular. In turn, this led to increased media reporting of OSPI activities (monitored as part of the public health campaign) and also led to wider dissemination of editorial guidelines for responsible reporting of suicidal acts. Analysis of the total process evaluation dataset also revealed the new phenomenon of the OSPI programme acting as a catalyst for externally generated (and funded) activity that shared the goals of suicide prevention. The QuaSIC approach enabled us to develop and refine our definition of synergistic interactions and add the innovative concept of catalytic effects. This represents a novel approach to the evaluation of complex interventions. By exploring synergies and catalytic interactions related to a complex intervention or programme, we reveal the added value to planned activities and how they might be maximised.

Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men.

PubMed

Robertson, Clare; Archibald, Daryll; Avenell, Alison; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne; Stewart, Fiona; Boachie, Charles; Fioratou, Evie; Wilkins, David; Street, Tim; Carroll, Paula; Fowler, Colin

2014-05-01

Obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. More men than women are overweight or obese in the UK but men are less likely to perceive their weight as a problem and less likely to engage with weight-loss services. The aim of this study was to systematically review evidence-based management strategies for treating obesity in men and investigate how to engage men in obesity services by integrating the quantitative, qualitative and health economic evidence base. Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database were searched from inception to January 2012, with a limited update search in July 2012. Subject-specific websites, reference lists and professional health-care and commercial organisations were also consulted. Six systematic reviews were conducted to consider the clinical effectiveness, cost-effectiveness and qualitative evidence on interventions for treating obesity in men, and men in contrast to women, and the effectiveness of interventions to engage men in their weight reduction. Randomised controlled trials (RCTs) with follow-up data of at least 1 year, or any study design and length of follow-up for UK studies, were included. Qualitative and mixed-method studies linked to RCTs and non-randomised intervention studies, and UK-based, men-only qualitative studies not linked to interventions were included. One reviewer extracted data from the included studies and a second reviewer checked data for omissions or inaccuracies. Two reviewers carried out quality assessment. We undertook meta-analysis of quantitative data and a realist approach to integrating the qualitative and quantitative evidence synthesis. From a total of 12,764 titles reviewed, 33 RCTs with 12 linked reports, 24 non-randomised reports, five economic evaluations with two linked reports, and 22 qualitative studies were included. Men were more likely than women to benefit if physical activity was part of a weight-loss programme. Reducing diets tended to produce more favourable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise programme -3.2 kg, 95% CI -4.8 kg to -1.6 kg). The type of reducing diet did not affect long-term weight loss. A reducing diet plus physical activity and behaviour change gave the most effective results. Low-fat reducing diets, some with meal replacements, combined with physical activity and behaviour change training gave the most effective long-term weight change in men [-5.2 kg (standard error 0.2 kg) after 4 years]. Such trials may prevent type 2 diabetes in men and improve erectile dysfunction. Although fewer men joined weight-loss programmes, once recruited they were less likely to drop out than women (difference 11%, 95% CI 8% to 14%). The perception of having a health problem (e.g. being defined as obese by a health professional), the impact of weight loss on health problems and desire to improve personal appearance without looking too thin were motivators for weight loss amongst men. The key components differ from those found for women, with men preferring more factual information on how to lose weight and more emphasis on physical activity programmes. Interventions delivered in social settings were preferred to those delivered in health-care settings. Group-based programmes showed benefits by facilitating support for men with similar health problems, and some individual tailoring of advice assisted weight loss in some studies. Generally, men preferred interventions that were individualised, fact-based and flexible, which used business-like language and which included simple to understand information. Preferences for men-only versus mixed-sex weight-loss group programmes were divided. In terms of context, programmes which were cited in a sporting context where participants have a strong sense of affiliation showed low drop out rates and high satisfaction. Although some men preferred weight-loss programmes delivered in an NHS context, the evidence comparing NHS and commercial programmes for men was unclear. The effect of family and friends on participants in weight-loss programmes was inconsistent in the evidence reviewed - benefits were shown in some cases, but the social role of food in maintaining relationships may also act as a barrier to weight loss. Evidence on the economics of managing obesity in men was limited and heterogeneous. The main limitations were the limited quantity and quality of the evidence base and narrow outcome reporting, particularly for men from disadvantaged and minority groups. Few of the studies were undertaken in the UK. Weight reduction for men is best achieved and maintained with the combination of a reducing diet, physical activity advice or a physical activity programme, and behaviour change techniques. Tailoring interventions and settings for men may enhance effectiveness, though further research is needed to better understand the influence of context and content. Future studies should include cost-effectiveness analyses in the UK setting. This project was funded by the NIHR Health Technology Assessment programme.

Community-based pilot intervention to tackle childhood obesity: a whole-system approach.

PubMed

Vamos, E P; Lewis, E; Junghans, C; Hrobonova, E; Dunsford, E; Millett, C

2016-11-01

Go-Golborne is a pilot intervention to prevent childhood obesity in the Royal Borough of Kensington and Chelsea between 2014 and 2018. It is a multistrategy approach targeting children aged 0-16 years and their families in all settings where children live, learn and play. This paper describes the methodology and the practical steps in the development of Go-Golborne. The programme uses a quasi-experimental design for the evaluation of changes in weight status using data from the extended National Child Measurement Programme across local schools. For specific behavioural change objectives, baseline self-reported lifestyle measures will be compared against annual follow-up data over the 3-year study period. Qualitative methods will be used to explore the perceptions of stakeholders and participants and organizational change. Go-Golborne aims to mobilize everyone in the community who has a role or interest in shaping the local environment, norms and behaviours across a range of sectors. A community network of local organizations has been established to codesign all programme activities. The Steering Group of Council officers support programme implementation and environmental changes. The programme has identified six specific behaviour change objectives representing the key areas of need in Golborne and all activities in the council and the community target these objectives during specific programme phases. Key components include community capacity building, community-wide social marketing, environment and policy change and evaluation. The programme is currently at the beginning of its implementation phase with activities in the community and council targeting the first behaviour change objective. The pilot aims to test the effectiveness of this approach to support behaviour change and prevent unhealthy weight gain in children using multiple strategies. This programme will inform the development of an intervention model that defines essential programme components, accountability of partner organizations delivering obesity prevention programmes and the effective use of existing assets. Copyright © 2016 The Royal Society for Public Health. All rights reserved.

Supply-Side Interventions and Student Learning in Guatemala

ERIC Educational Resources Information Center

Vasquez, William F.

2012-01-01

This paper presents estimates of production functions of reading and mathematics test scores to assess the effects of supply-side interventions, such as the provision of a community-based school management programme, bilingual education and multigrade teaching, on student learning in Guatemala. The efficiency and consistency of the estimates is…

Mindfulness as a complementary intervention in the treatment of overweight and obesity in primary health care: study protocol for a randomised controlled trial.

PubMed

Salvo, Vera; Kristeller, Jean; Marin, Jesus Montero; Sanudo, Adriana; Lourenço, Bárbara Hatzlhoffer; Schveitzer, Mariana Cabral; D'Almeida, Vania; Morillo, Héctor; Gimeno, Suely Godoy Agostinho; Garcia-Campayo, Javier; Demarzo, Marcelo

2018-05-11

Mindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes-partly responsible for weight regain for a large number of people-and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training. A randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme's impact on the participants' lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods. This clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of this study confirm the effectiveness of mindfulness programmes in this population, it will be possible to improve quality of life and health while optimising public resources and reaching a greater number of people. In addition, on the basis of the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy. ClinicalTrials.gov, NCT02893150 . Registered retrospectively on 30 March 2017.

Efficacy of a smoking prevention programme in Catalan secondary schools: a cluster-randomized controlled trial in Spain.

PubMed

Valdivieso López, Empar; Rey-Reñones, Cristina; Rodriguez-Blanco, Teresa; Ferre Grau, Carmen; Arija, Victoria; Barrera Uriarte, Maria Luisa; Granado-Font, Esther; Flores-Mateo, Gemma

2015-05-01

To evaluate the efficacy of a school-based educational programme in reducing the incidence and prevalence of smoking in secondary school students (compulsory secondary education: CSE) in Catalonia (Spain). Cluster-randomized controlled trial. Schools in the Tarragona Health Care Region of Spain. All students enrolled in the first year of CSE during the 2007-08 school year in the 29 participating schools (n = 2245); 1583 students completed the follow-up over the 4-year study period (804 and 779 in the control and intervention groups, respectively). Self-reported questionnaires were administered during the first quarter of the 2007, 2008, 2009 and 2010 school years. A smoker was defined as 'smoking cigarettes daily or occasionally within the past 30 days'. Multi-level logistic regression analysis was conducted to analyse the prevalence and incidence of smoking between the intervention and control groups. A school-based educational programme comprising seven modules, each with a different approach to smoking habits. Each module included activities, work-shops and/or class sessions. The initial prevalence of smokers in the control and intervention groups who completed the follow-up was 3.9% and 4.2%, respectively. At the end of the study, the prevalence of smokers was 24.4% in the control group and 19.9% in the intervention group. The accumulated incidence of new smokers was 230.57/1000 in the control group and 183.65/1000 in the intervention group. The adjusted odds ratio (OR) comparing the intervention group with the control group was 0.75 [95% confidence interval (CI) = 0.49, 1.15] for smoking prevalence, and 0.74 (95% CI = 0.48, 1.14) for smoking incidence. A school-based educational intervention for secondary school students in Catalonia, Spain was not found to lead to a statistically significant reduction of smoking prevalence and incidence. © 2015 Society for the Study of Addiction.

Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence.

PubMed

Schenk, Katie D

2009-07-01

Children affected by HIV in their families and communities face multiple risks to their health, education and psychosocial wellbeing. Community interventions for children who have been orphaned or rendered vulnerable take many forms, including educational assistance, home-based care, legal protection and psychosocial support. Despite a recent influx of funding for programme implementation, there exists little evidence to inform policymakers about whether their investments are improving the lives of vulnerable children and meeting key benchmarks including the Millennium Development Goals. This paper reviews the current evidence base on evaluations of community interventions for orphans and vulnerable children (OVC) in high HIV-prevalence African settings, focusing on studies' methodologies. Sources reviewed include published research studies and evidence from the unpublished programmatic "grey literature" located through database and internet searches. A total of 21 studies, varying in scope and generalisability, were identified. Interventions reviewed address children's wellbeing through various strategies within their communities. Evaluation methodologies reflect quantitative and qualitative approaches, including surveys (with and without baseline or comparison data), costing studies, focus groups, interviews, case studies, and participatory review techniques. Varied study methodologies reflect diverse research questions, various intervention types, and the challenges associated with evaluating complex interventions; highlighting the need to broaden the research paradigm in order to build the evidence base by including quasi-experimental and process evaluation approaches, and seeking further insights through participatory qualitative methodologies and costing studies. Although findings overall indicate the value of community interventions in effecting measurable improvements in child and family wellbeing, the quality and rigour of evidence is varied. A strategic research agenda is urgently needed to inform resource allocation and programme management decisions. Immediate imperatives include building local technical capacity to conduct quantitative and qualitative evaluation research, and strengthening monitoring and evaluation systems to collect process and outcome data (including costing) on key support models. Donors and implementers must support the collection of sound empirical evidence to inform the development and scale-up of OVC programmes.

Towards Developing an Initial Programme Theory: Programme Designers and Managers Assumptions on the Antiretroviral Treatment Adherence Club Programme in Primary Health Care Facilities in the Metropolitan Area of Western Cape Province, South Africa

PubMed Central

Mukumbang, Ferdinand C.; van Belle, Sara; Marchal, Bruno; van Wyk, Brian

2016-01-01

Background The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory—the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). Methods We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. Results We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. Conclusion The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa. PMID:27560352

Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

PubMed Central

Liu, Nancy H.; Daumit, Gail L.; Dua, Tarun; Aquila, Ralph; Charlson, Fiona; Cuijpers, Pim; Druss, Benjamin; Dudek, Kenn; Freeman, Melvyn; Fujii, Chiyo; Gaebel, Wolfgang; Hegerl, Ulrich; Levav, Itzhak; Munk Laursen, Thomas; Ma, Hong; Maj, Mario; Elena Medina‐Mora, Maria; Nordentoft, Merete; Prabhakaran, Dorairaj; Pratt, Karen; Prince, Martin; Rangaswamy, Thara; Shiers, David; Susser, Ezra; Thornicroft, Graham; Wahlbeck, Kristian; Fekadu Wassie, Abe; Whiteford, Harvey; Saxena, Shekhar

2017-01-01

Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain limited, and strategies for implementation and scaling up of programmes with a strong evidence base are scarce. Furthermore, the majority of available interventions focus on a single or an otherwise limited number of risk factors. Here we present a multilevel model highlighting risk factors for excess mortality in persons with SMD at the individual, health system and socio‐environmental levels. Informed by that model, we describe a comprehensive framework that may be useful for designing, implementing and evaluating interventions and programmes to reduce excess mortality in persons with SMD. This framework includes individual‐focused, health system‐focused, and community level and policy‐focused interventions. Incorporating lessons learned from the multilevel model of risk and the comprehensive intervention framework, we identify priorities for clinical practice, policy and research agendas. PMID:28127922

Shaping the Social: design of a settings-based intervention study to improve well-being and reduce smoking and dropout in Danish vocational schools.

PubMed

Andersen, Susan; Tolstrup, Janne Schurmann; Rod, Morten Hulvej; Ersbøll, Annette Kjær; Sørensen, Betina Bang; Holmberg, Teresa; Johansen, Christoffer; Stock, Christiane; Laursen, Bjarne; Zinckernagel, Line; Øllgaard, Anne Louise; Ingholt, Liselotte

2015-06-20

The social environment at schools is an important setting to promote educational attainment, and health and well-being of young people. However, within upper secondary education there is a need for evidence-based school intervention programmes. The Shaping the Social intervention is a comprehensive programme integrating social and educational activities to promote student well-being and reduce smoking and dropout in upper secondary vocational education. The evaluation design is reported here. The evaluation employed a non-randomised cluster controlled design, and schools were selected to either implement the intervention or continue with normal practice for comparison. In the baseline survey conducted 2011-2012, 2,329 students from four intervention schools and 3,371 students from six comparison schools answered a computer-based questionnaire during class, representing 73% and 81% of eligible students, and 22% of all technical/agricultural vocational schools in Denmark. Follow-up assessment was conducted 10 weeks after baseline and at the same time teachers of the intervention classes answered a questionnaire about implementation. School dropout rates will be tracked via national education registers through a 2-year follow-up period. Shaping the Social was designed to address that students at Danish vocational schools constitute a high risk population concerning health behaviour as well as school dropout by modifying the school environment, alongside developing appropriate evaluation strategies. To address difficulties in implementing settings-based interventions, as highlighted in prior research, the strategy was to involve intervention schools in the development of the intervention. Baseline differences will be included in the effectiveness analysis, so will the impact of likely mediators and moderators of the intervention. ISRCTN57822968. Date of registration: 16/01/2013.

Intervention fidelity in a school-based diet and physical activity intervention in the UK: Active for Life Year 5.

PubMed

Campbell, Rona; Rawlins, Emma; Wells, Sian; Kipping, Ruth R; Chittleborough, Catherine R; Peters, Tim J; Lawlor, Debbie A; Jago, Russell

2015-11-11

Active for Life Year 5 (AFLY5) is an educational programme for Year 5 children (aged 9-10) designed to increase children's physical activity, decrease sedentary behaviour and increase fruit and vegetable intake. This paper reports findings from a process evaluation embedded within a randomised controlled trial evaluating the programme's effectiveness. It considers the fidelity of implementation of AFLY5 with a focus on three research questions: 1. To what extent was the intervention delivered as planned? 2. In what ways, if any, did the teachers amend the programme? and 3. What were the reasons for any amendments? Mixed methods were used including data collection via observation of the intervention delivery, questionnaire, teacher's intervention delivery log and semi-structured interviews with teachers and parents. Qualitative data were analysed thematically and quantitative data were summarised using descriptive statistics. Following training, 42 of the 43 intervention school teachers/teaching staff (98%) were confident they could deliver the nutrition and physical activity lessons according to plan. The mean number of lessons taught was 12.3 (s.d. 3.7), equating to 77% of the intervention. Reach was high with 95% of children in intervention schools receiving lessons. A mean of 6.2 (s.d. 2.6) out of 10 homeworks were delivered. Median lesson preparation time was 10 min (IQR 10-20) and 28% of lessons were reported as having been amended. Qualitative findings revealed that those who amended the lessons did so to differentiate for student ability, update them for use with new technologies and to enhance teacher and student engagement. Teachers endorsed the aims of the intervention, but some were frustrated with having to adapt the lesson materials. Teachers also a reported tendency to delegate the physical activity lessons to other staff not trained in the intervention. Fidelity of intervention implementation was good but teachers' enthusiasm for the AFLY5 programme was mixed despite them believing that the messages behind the lessons were important. This may have meant that the intervention messages were not delivered as anticipated and explain why the intervention was found not to be effective. ISRCTN50133740.

Cost-effectiveness of an internet-based perioperative care programme to enhance postoperative recovery in gynaecological patients: economic evaluation alongside a stepped-wedge cluster-randomised trial

PubMed Central

Bosmans, Judith E; van Dongen, Johanna M; Brölmann, Hans A M; Anema, Johannes R; Huirne, Judith A F

2018-01-01

Objectives To evaluate the cost-effectiveness and cost-utility of an internet-based perioperative care programme compared with usual care for gynaecological patients. Design Economic evaluation from a societal perspective alongside a stepped-wedge cluster-randomised controlled trial with 12 months of follow-up. Setting Secondary care, nine hospitals in the Netherlands, 2011–2014. Participants 433 employed women aged 18–65 years scheduled for a hysterectomy and/or laparoscopic adnexal surgery. Intervention The intervention comprised an internet-based care programme aimed at improving convalescence and preventing delayed return to work (RTW) following gynaecological surgery and was sequentially rolled out. Depending on the implementation phase of their hospital, patients were allocated to usual care (n=206) or to the intervention (n=227). Main outcome measures The primary outcome was duration until full sustainable RTW. Secondary outcomes were quality-adjusted life years (QALYs), health-related quality of life and recovery. Results At 12 months, there were no statistically significant differences in total societal costs (€−647; 95% CI €−2116 to €753) and duration until RTW (−4.1; 95% CI −10.8 to 2.6) between groups. The incremental cost-effectiveness ratio (ICER) for RTW was 56; each day earlier RTW in the intervention group was associated with cost savings of €56 compared with usual care. The probability of the intervention being cost-effective was 0.79 at a willingness-to-pay (WTP) of €0 per day earlier RTW, which increased to 0.97 at a WTP of €76 per day earlier RTW. The difference in QALYs gained over 12 months between the groups was clinically irrelevant resulting in a low probability of cost-effectiveness for QALYs. Conclusions Considering that on average the costs of a day of sickness absence are €230, the care programme is considered cost-effective in comparison with usual care for duration until sustainable RTW after gynaecological surgery for benign disease. Future research should indicate whether widespread implementation of this care programme has the potential to reduce societal costs associated with gynaecological surgery. Trial registration number NTR2933; Results. PMID:29358423

Effectiveness and implementation of a community-based prevention programme targeting anabolic androgenic steroid use in gyms: study protocol of a quasi-experimental control group study.

PubMed

Molero, Yasmina; Gripenberg, Johanna; Bakshi, Ann-Sofie

2016-01-01

During the past decades, concerns about increased anabolic androgenic steroid (AAS) use among recreational sportspeople have been raised, yet there is a paucity of AAS prevention efforts targeting this group. Accordingly, doping prevention efforts aimed at gyms have been recommended. The overall objective of the present project is to examine a prevention programme named 100% Pure Hard Training (100% PHT), which targets AAS use among recreational sportspeople training in gyms. Specifically, the project aims to: 1) assess the prevalence of AAS, and its associations with alcohol, illicit drugs, and nutritional supplements use; 2) examine whether 100% PHT can decrease AAS use in gyms, and 3) provide insights into which factors facilitate and/or impede implementation of the programme. The intervention group consists of 27 gyms, and 27 gyms serve as controls. Intervention gyms take part in 100% PHT, a community-based programme involving several components: (a) training of key stakeholders (i.e., gym staff, gym owners, local police, and municipal prevention coordinators) regarding AAS use; (b) developing an action plan for AAS prevention for each gym; (c) certification of gyms that follow 100% PHT; (d) cooperative relationship between stakeholders; (e) annual follow-up of gyms. The project consists of two studies: Study A will examine the prevalence of AAS use and the effectiveness of 100% PHT (aims 1 and 2), and data for Study A will be collected using questionnaires distributed to gym attendees at two assessment points: baseline (pre-intervention) and follow-up (post-intervention). Study B will evaluate the implementation of 100% PHT (aim 3), and semi-structured interviews with participating stakeholders will be carried out post-intervention. Knowledge gained from the present project can be used to develop community-based doping prevention efforts aimed at recreational sportspeople training in gyms. Furthermore, it can provide insights into which factors are important for successful implementation of AAS prevention programmes that target gyms. Results are also expected to yield information on the prevalence of AAS use as well as associations between the use of AAS and other licit and illicit substances, including nutritional supplements, among recreational sportspeople. The study was registered retrospectively at isrctn.com (Identifier: ISRCTN11655041; Registration date: 3 November 2016;).

Religion-based tobacco control interventions: how should WHO proceed?

PubMed Central

Jabbour, Samer; Fouad, Fouad Mohammad

2004-01-01

Using religion to improve health is an age-old practice. However, using religion and enlisting religious authorities in public health campaigns, as exemplified by tobacco control interventions and other activities undertaken by WHO's Eastern Mediterranean Regional Office, is a relatively recent phenomenon. Although all possible opportunities within society should be exploited to control tobacco use and promote health, religion-based interventions should not be exempted from the evidence-based scrutiny to which other interventions are subjected before being adopted. In the absence of data and debate on whether this approach works, how it should be applied, and what the potential downsides and alternatives are, international organizations such as WHO should think carefully about using religion-based public health interventions in their regional programmes. PMID:15654406

Active Play in After-school Programmes: development of an intervention and description of a matched-pair cluster-randomised trial assessing physical activity play in after-school programmes.

PubMed

Riiser, Kirsti; Helseth, Sølvi; Ellingsen, Hanna; Fallang, Bjørg; Løndal, Knut

2017-08-04

Interventions delivered in after-school programmes (ASPs) have the potential to become a means of ensuring adequate physical activity among schoolchildren. This requires a motivational climate, allowing for self-determined play. If trained, ASP staff may represent a valuable resource for supporting such play. Increasing knowledge and supportive skills among ASP staff may also potentially increase their motivation for work. The purpose of this article is to describe the development of the 'Active Play in ASP' intervention, which aims to promote physical activity among first graders attending ASP, and to present a protocol for a matched-pair cluster-randomised trial to evaluate the intervention. Informed by experiences from practice, evidence-based knowledge and theory, the intervention was developed in a stepwise process including focus group meetings and a small-scale pilot test. The intervention contains a course programme for ASP staff to increase their skills in how to support physical activity through play. In a cluster randomised controlled trial, the ASPs will be matched and randomly allocated to receive the 7-month intervention or to a control group. Outcomes will be assessed at baseline, after 7 and 19 months. First graders attending the ASPs included are eligible. The primary outcome will be accelerometer-determined minutes in moderate to vigorous physical activity in the ASP. The study uses a mixed methods approach including observations and interviews to provide rich descriptions of the concept of children's physical activity in ASP. Moreover, the trial will assess whether the ASP staff benefits from participation in the intervention in terms of increased work motivation. Lastly, process evaluations of programme fidelity, satisfaction and suggestions on improvement will be performed. The study is approved by the Data Protection Official for Research (reference no 46008). Results will be presented in conferences and peer-reviewed journals. Clinical Trials (NCT02954614), pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effectiveness of a universal parental support programme to promote healthy dietary habits and physical activity and to prevent overweight and obesity in 6-year-old children: the Healthy School Start Study, a cluster-randomised controlled trial.

PubMed

Nyberg, Gisela; Sundblom, Elinor; Norman, Åsa; Bohman, Benjamin; Hagberg, Jan; Elinder, Liselotte Schäfer

2015-01-01

To develop and evaluate the effectiveness of a parental support programme to promote healthy dietary and physical activity habits and to prevent overweight and obesity in Swedish children. A cluster-randomised controlled trial was carried out in areas with low to medium socio-economic status. Participants were six-year-old children (n = 243) and their parents. Fourteen pre-school classes were randomly assigned to intervention (n = 7) and control groups (n = 7). The intervention lasted for 6 months and included: 1) Health information for parents, 2) Motivational Interviewing with parents and 3) Teacher-led classroom activities with children. Physical activity was measured by accelerometry, dietary and physical activity habits and parental self-efficacy through a questionnaire. Body weight and height were measured and BMI standard deviation score was calculated. Measurements were conducted at baseline, post-intervention and at 6-months follow-up. Group differences were examined using analysis of covariance and Poisson regression, adjusted for gender and baseline values. There was no significant intervention effect in the primary outcome physical activity. Sub-group analyses showed a significant gender-group interaction in total physical activity (TPA), with girls in the intervention group demonstrating higher TPA during weekends (p = 0.04), as well as in sedentary time, with boys showing more sedentary time in the intervention group (p = 0.03). There was a significantly higher vegetable intake (0.26 servings) in the intervention group compared to the control group (p = 0.003). At follow-up, sub-group analyses showed a sustained effect for boys. The intervention did not affect the prevalence of overweight or obesity. It is possible to influence vegetable intake in children and girls' physical activity through a parental support programme. The programme needs to be intensified in order to increase effectiveness and sustain the effects long-term. These findings are an important contribution to the further development of evidence-based parental support programmes to prevent overweight and obesity in children. Controlled-trials.com ISRCTN32750699.

A 6-week warm-up injury prevention programme results in minimal biomechanical changes during jump landings: a randomized controlled trial.

PubMed

Taylor, Jeffrey B; Ford, Kevin R; Schmitz, Randy J; Ross, Scott E; Ackerman, Terry A; Shultz, Sandra J

2018-01-16

To examine the extent to which an ACL injury prevention programme modifies lower extremity biomechanics during single- and double-leg landing tasks in both the sagittal and frontal plane. It was hypothesized that the training programme would elicit improvements in lower extremity biomechanics, but that these improvements would be greater during a double-leg sagittal plane landing task than tasks performed on a single leg or in the frontal plane. Ninety-seven competitive multi-directional sport athletes that competed at the middle- or high-school level were cluster randomized into intervention (n = 48, age = 15.4 ± 1.0 years, height = 1.7 ± 0.07 m, mass = 59.9 ± 11.0 kg) and control (n = 49, age = 15.7 ± 1.6 years, height = 1.7 ± 0.06 m, mass = 60.4 ± 7.7 kg) groups. The intervention group participated in an established 6-week warm-up-based ACL injury prevention programme. Three-dimensional biomechanical analyses of a double- (SAG-DL) and single-leg (SAG-SL) sagittal, and double- (FRONT-DL) and single-leg (FRONT-SL) frontal plane jump landing tasks were tested before and after the intervention. Peak angles, excursions, and external joint moments were analysed for group differences using 2 (group) × 4 (task) repeated measures MANOVA models of delta scores (post-pre-test value) (α < 0.05). Relative to the control group, no significant biomechanical changes were identified in the intervention group for any of the tasks (n.s.). However, a group by task interaction was identified for knee abduction (λ = 0.80, p = 0.02), such that participants in the intervention group showed relative decreases in knee abduction moments during the SAG-DL compared to the SAG-SL (p = 0.005; d = 0.45, CI = 0.04-0.85) task. A 6-week warm-up-based ACL injury prevention programme resulted in no significant biomechanical changes during a variety of multi-directional jump landings. Clinically, future prevention programmes should provide a greater training stimulus (intensity, volume), more specificity to tasks associated with the mechanism of ACL injury (single-leg, non-sagittal plane jump landings), and longer programme duration (> 6 weeks) to elicit meaningful biomechanical changes. I.

Tailoring of the Tell-us Card communication tool for nurses to increase patient participation using Intervention Mapping.

PubMed

van Belle, Elise; Zwakhalen, Sandra M G; Caris, Josien; Van Hecke, Ann; Huisman-de Waal, Getty; Heinen, Maud

2018-02-01

To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. Even though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences into account. The Tell-us Card intervention seems promising, but needs to be tailored and tested before implementation in a different setting or on large scale. Description of the Intervention Mapping framework to systematically tailor the Tell-us Card intervention to the Dutch hospital setting. Intervention Mapping consists of: (i) identification of the problem through needs assessment and determination of fit, based on patients and nurses interviews and focus group interviews; (ii) developing a logic model of change and matrices, based on literature and interviews; (iii) selection of theory-based methods and practical applications; (iv) producing programme components and piloting; (v) planning for adoption, implementation and sustainability; and (vi) preparing for programme evaluation. Knowledge, attitude, outcome expectations, self-efficacy and skills were identified as the main determinants influencing the use of the Tell-us Card. Linking identified determinants and performance objectives with behaviour change techniques from the literature resulted in a well-defined and tailored intervention and evaluation plan. The Tell-us Card intervention was adapted to fit the Dutch hospital setting and prepared for evaluation. The Medical Research Council framework was followed, and the Intervention Mapping approach was used to prepare a pilot study to confirm feasibility and relevant outcomes. This article shows how Intervention Mapping is applied within the Medical Research Council framework to adapt the Tell-us Card intervention, which could serve as a guide for the tailoring of similar interventions. © 2017 John Wiley & Sons Ltd.

Effect of Two Educational Interventions on Pharmacy Students' Confidence and Skills in Dealing with Adolescents with Asthma

ERIC Educational Resources Information Center

Donnelly, Amy; Shah, Smita; Bosnic-Anticevich, Sinthia

2013-01-01

Objectives: The aim of this study was: (1) to investigate the feasibility of incorporating the Triple A programme into the undergraduate pharmacy curriculum; (2) to compare the effect of the Triple A programme versus problem-based learning methods on the asthma knowledge of final-year pharmacy students and their perceived confidence in dealing…

Accelerated Reader as a Literacy Catch-Up Intervention during Primary to Secondary School Transition Phase

ERIC Educational Resources Information Center

Siddiqui, Nadia; Gorard, Stephen; See, Beng Huat

2016-01-01

This paper describes an evaluation of an internet-based reading programme called Accelerated Reader (AR), which is widely used in UK schools and worldwide. AR is a whole-group reading management and monitoring programme that aims to stimulate the habit of independent reading among primary and secondary age pupils. The evaluation involved 349…

The Contribution of Group Work Programmes to Early Intervention and Improving Children's Emotional Well-Being

ERIC Educational Resources Information Center

Parton, Christine; Manby, Martin

2009-01-01

Recent government policy has emphasised links between the acquisition of social skills by children and young people and their educational attainment. This study aims to fill a gap in the literature about the contribution of school-based group work programmes to developing children's social skills. National Society for the Prevention of Cruelty to…

Efficacy of the Lexicon Pirate Strategy Therapy for Improving Lexical Learning in School-Age Children: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Motsch, Hans-Joachim; Marks, Dana-Kristin

2015-01-01

Lexicon Pirate was originally developed as a strategy intervention programme to treat lexical disorders of pre-school children. To evaluate the therapy's effectiveness for school-age students, a randomized controlled trial (RCT, N = 157) was conducted. Based on a pre--post-test design, the programme's impacts were compared with a control group…

Lifestyle Knowledge and Preferences in Preschool Children: Evaluation of the "Get up and Grow" Healthy Lifestyle Education Programme

ERIC Educational Resources Information Center

Wiseman, Nicola; Harris, Neil; Lee, Patricia

2016-01-01

Objective: Early childhood is considered a window of opportunity for lifestyle interventions, as this is a critical life-stage at which children accumulate knowledge and skills around behaviours such as eating and physical activity. This study examined how exposure to a settings-based healthy lifestyle programme influences knowledge and preference…

Embedding Weight-Related Messages within a General Parenting Programme: Development and Feasibility Evaluation of Parents and Tots Together

ERIC Educational Resources Information Center

Haines, Jess; Mayorga, Angela M.; McDonald, Julia; O'Brien, Ashley; Gross, Deborah; Taveras, Elsie M.; Epee-Bounya, Alexandra; Gillman, Matthew W.

2012-01-01

In this article, we describe the development and feasibility evaluation of Parents and Tots Together (PTT), a family-based obesity prevention intervention that embeds weight-related messages within a general parenting programme. To inform the development of PTT, we conducted 5 focus groups with 19 racially/ethnically diverse parents to examine…

Empowering older people with early dementia and family caregivers: a participatory action research study.

PubMed

Nomura, Michie; Makimoto, Kiyoko; Kato, Motoko; Shiba, Tamami; Matsuura, Chieko; Shigenobu, Kazue; Ishikawa, Tomohisa; Matsumoto, Naomi; Ikeda, Manabu

2009-04-01

The increase in the number of people suffering from dementia is of increasing global concern. A survey on the living conditions of the elderly in a Japanese rural community revealed a high prevalence of early dementia and the necessity for interventions not only for the elderly with early dementia but also for their families. To describe the implementation and process evaluation of a programme based on cognitive rehabilitation aimed at empowering the elderly with early dementia and education and counselling programmes aimed at likewise empowering their family caregivers. This study used a community health action research model. Participatory action research (PAR) was conducted through a cycle of planning, action, and reflection to identify effective interventions to empower participants with dementia (PsWD) and their caregivers. A rural town in Japan. This project involved 37 community-dwelling elderly with early or mild dementia and 31 family caregivers. A focus group interview was used for assessment. A monthly activity-based programme based on cognitive rehabilitation was developed to improve cognitive function. Three types of data were collected: observational data collected during the activities, written comments from the caregivers, the record of phone interviews and counsellings with caregivers. These data were compiled in chronological order into a portfolio for analysis. To empower family caregivers, educational and counselling programmes were offered. The PAR lasted for 5 years and evolved over three cycles: individual, group and community. In the first cycle, the major focus of the intervention was to regain procedural skills for each PWD through a cooking programme. In the second cycle, to increase interactions with family members and with other PsWD, group activities that promoted communication among family members as well as among PsWD were implemented. The collective values and the beliefs of the PsWD's generation were validated by a series of trips to temples and shrines. In the third cycle, community participation was planned and implemented through culturally relevant sequential activities. PsWD demonstrated their expert skills and regained confidence. For family caregivers, the educational programme provided knowledge about dementia and utilization of social resources. Face-to-face and phone counsellings were offered as needed to coach problem-focused coping. These programmes helped to interpret the symptoms of dementia and to reduce the behavioural problems. Cognitive rehabilitation theory was useful to restore lost procedural skills and regain confidence for PsWD. This PAR illustrated the importance of interventions for both community dwelling elderly with early dementia and their family caregivers.

NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation.

PubMed

Penn, Linda; Rodrigues, Angela; Haste, Anna; Marques, Marta M; Budig, Kirsten; Sainsbury, Kirby; Bell, Ruth; Araújo-Soares, Vera; White, Martin; Summerbell, Carolyn; Goyder, Elizabeth; Brennan, Alan; Adamson, Ashley J; Sniehotta, Falko F

2018-02-21

Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on programme quality, improvements and future evaluation. We reviewed programme documents, mapping against the NHS DPP specification and National Institute for Health and Care Excellence (NICE) public health guideline: Type 2 diabetes (T2D) prevention in people at high risk (PH38), conducted qualitative research using individual interviews and focus group discussions with stakeholders and examined recruitment, fidelity and data collection procedures. Seven NHS DPP demonstrator sites and, subsequently, 27 first wave areas across England. Intensive behavioural intervention with weight loss, diet and physical activity goals. The national programme specifies at least 13 sessions over 9 months, delivered face to face to groups of 15-20 adults with non-diabetic hyperglycaemia, mainly recruited from primary care and NHS Health Checks. Participants for qualitative research were purposively sampled to provide a spread of stakeholder experience. Documents for review were provided via the NHS DPP Management Group. The NHS DPP specification reflected current evidence with a clear framework for service provision. Providers, with national capacity to deliver, supplied intervention plans compliant with this framework. Stakeholders highlighted limitations in fidelity assessment and recruitment and retention challenges, especially in reach and equity, that could adversely impact on implementation. Risk assessment for first wave eligibility differed from NICE guidance. The NHS DPP provides an evidence-based behavioural intervention for prevention of T2D in adults at high risk, with capacity to deliver nationally. Framework specification allows for balance between consistency and contextual variation in intervention delivery, with session details devolved to providers. Limitations in fidelity assurance, data collection procedures and recruitment issues could adversely impact on intervention effectiveness and restrict evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exercise interventions for smoking cessation.

PubMed

Ussher, Michael H; Taylor, Adrian; Faulkner, Guy

2008-10-08

Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. To determine whether exercise-based interventions alone or combined with a smoking cessation programme are more effective than a smoking cessation intervention alone. In July 2008, we searched the Cochrane Tobacco Addiction Group Specialized Register for studies including the terms 'exercise' or 'physical activity'. We also searched MEDLINE, EMBASE, PsycINFO, Dissertation Abstracts and CINAHL. We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme, recruiting smokers or recent quitters, and with a follow up of six months or more. We extracted data on study characteristics and smoking outcomes. Because of differences in studies we summarized the results narratively, making no attempt at meta-analysis. We identified 13 trials, six of which had fewer than 25 people in each treatment arm. They varied in the timing and intensity of the smoking cessation and exercise programmes. Three studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow up and a benefit for exercise of borderline significance (P = 0.05) at the 12-month follow up. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow up but not at the end of treatment or 12-month follow up. The other studies showed no significant effect for exercise on abstinence. Only one of the 13 trials offered evidence for exercise aiding smoking cessation at a 12-month follow up. All the other trials were too small to exclude reliably an effect of intervention, or included an exercise intervention which was insufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions, equal contact control conditions, measures of exercise adherence and change in physical activity in both exercise and comparison groups.

Exercise interventions for smoking cessation.

PubMed

Ussher, Michael H; Taylor, Adrian; Faulkner, Guy

2012-01-18

Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. In July 2011, we searched the Cochrane Tobacco Addiction Group Specialized Register for studies including the terms 'exercise' or 'physical activity'. We also searched MEDLINE, EMBASE, PsycINFO, Dissertation Abstracts and CINAHL using the terms 'exercise' or 'physical activity' and 'smoking cessation'. We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme, recruiting smokers or recent quitters, and with a follow up of six months or more. We extracted data on study characteristics and smoking outcomes. Because of differences in studies we summarized the results narratively, making no attempt at meta-analysis. We identified 15 trials, seven of which had fewer than 25 people in each treatment arm. They varied in the timing and intensity of the smoking cessation and exercise programmes. Three studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow up and a benefit for exercise of borderline significance (p = 0.05) at the 12-month follow up. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow up but not at the end of treatment or 12-month follow up. The other studies showed no significant effect for exercise on abstinence. Only one of the 15 trials offered evidence for exercise aiding smoking cessation at a 12-month follow up. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which was insufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.

A school-based intervention incorporating smartphone technology to improve health-related fitness among adolescents: rationale and study protocol for the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study

PubMed Central

Lubans, David R; Smith, Jordan J; Peralta, Louisa R; Plotnikoff, Ronald C; Okely, Anthony D; Salmon, Jo; Eather, Narelle; Dewar, Deborah L; Kennedy, Sarah; Lonsdale, Chris; Hilland, Toni A; Estabrooks, Paul; Finn, Tara L; Pollock, Emma; Morgan, Philip J

2016-01-01

Introduction Physical inactivity has been described as a global pandemic. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be ‘scaled-up’ and disseminated. This study aims to: (1) assess the effectiveness of two physical activity promotion programmes (ie, NEAT and ATLAS) that have been modified for scalability; and (2) evaluate the dissemination of these programmes throughout government funded secondary schools. Methods and analysis The study will be conducted in two phases. In the first phase (cluster randomised controlled trial), 16 schools will be randomly allocated to the intervention or a usual care control condition. In the second phase, the Reach, Effectiveness, Adoption, Implementation and Maintenance (Re-AIM) framework will be used to guide the design and evaluation of programme dissemination throughout New South Wales (NSW), Australia. In both phases, teachers will be trained to deliver the NEAT and ATLAS programmes, which will include: (1) interactive student seminars; (2) structured physical activity programmes; (3) lunch-time fitness sessions; and (4) web-based smartphone apps. In the cluster RCT, study outcomes will be assessed at baseline, 6 months (primary end point) and 12-months. Muscular fitness will be the primary outcome and secondary outcomes will include: objectively measured body composition, cardiorespiratory fitness, flexibility, resistance training skill competency, physical activity, self-reported recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem and well-being. Ethics and dissemination This study has received approval from the University of Newcastle (H-2014-0312) and the NSW Department of Education (SERAP: 2012121) human research ethics committees. This study is funded by the Australian Research Council (FT140100399) and the NSW Department of Education. Trial registration number ACTRN12615000360516; Pre-results. PMID:27354070

A school-based intervention incorporating smartphone technology to improve health-related fitness among adolescents: rationale and study protocol for the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study.

PubMed

Lubans, David R; Smith, Jordan J; Peralta, Louisa R; Plotnikoff, Ronald C; Okely, Anthony D; Salmon, Jo; Eather, Narelle; Dewar, Deborah L; Kennedy, Sarah; Lonsdale, Chris; Hilland, Toni A; Estabrooks, Paul; Finn, Tara L; Pollock, Emma; Morgan, Philip J

2016-06-27

Physical inactivity has been described as a global pandemic. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be 'scaled-up' and disseminated. This study aims to: (1) assess the effectiveness of two physical activity promotion programmes (ie, NEAT and ATLAS) that have been modified for scalability; and (2) evaluate the dissemination of these programmes throughout government funded secondary schools. The study will be conducted in two phases. In the first phase (cluster randomised controlled trial), 16 schools will be randomly allocated to the intervention or a usual care control condition. In the second phase, the Reach, Effectiveness, Adoption, Implementation and Maintenance (Re-AIM) framework will be used to guide the design and evaluation of programme dissemination throughout New South Wales (NSW), Australia. In both phases, teachers will be trained to deliver the NEAT and ATLAS programmes, which will include: (1) interactive student seminars; (2) structured physical activity programmes; (3) lunch-time fitness sessions; and (4) web-based smartphone apps. In the cluster RCT, study outcomes will be assessed at baseline, 6 months (primary end point) and 12-months. Muscular fitness will be the primary outcome and secondary outcomes will include: objectively measured body composition, cardiorespiratory fitness, flexibility, resistance training skill competency, physical activity, self-reported recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem and well-being. This study has received approval from the University of Newcastle (H-2014-0312) and the NSW Department of Education (SERAP: 2012121) human research ethics committees. This study is funded by the Australian Research Council (FT140100399) and the NSW Department of Education. ACTRN12615000360516; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

School-Based Intervention for Nutrition Promotion in Mi Yun County, Beijing, China: Does a Health-Promoting School Approach Improve Parents' Knowledge, Attitudes and Behaviour?

ERIC Educational Resources Information Center

Wang, Dongxu; Stewart, Donald; Chang, Chun

2016-01-01

Purpose: The purpose of this paper is to assess whether the school-based nutrition programme using the health-promoting school (HPS) framework was effective to improve parents' knowledge, attitudes and behaviour (KAB) in relation to nutrition in rural Mi Yun County, Beijing. Design/methodology/approach: A cluster-randomised intervention trial…

Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India

PubMed Central

2010-01-01

Background Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. Methods Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY) saved as a measure of cost-effectiveness of each type of HIV prevention intervention. Results The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. Conclusions The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India. PMID:20459755

Improvement in nutrition-related knowledge and behaviour of urban Asian Indian school children: findings from the 'Medical education for children/Adolescents for Realistic prevention of obesity and diabetes and for healthy aGeing' ( MARG) intervention study.

PubMed

Shah, Priyali; Misra, Anoop; Gupta, Nidhi; Hazra, Daya Kishore; Gupta, Rajeev; Seth, Payal; Agarwal, Anand; Gupta, Arun Kumar; Jain, Arvind; Kulshreshta, Atul; Hazra, Nandita; Khanna, Padmamalika; Gangwar, Prasann Kumar; Bansal, Sunil; Tallikoti, Pooja; Mohan, Indu; Bhargava, Rooma; Sharma, Rekha; Gulati, Seema; Bharadwaj, Swati; Pandey, Ravindra Mohan; Goel, Kashish

2010-08-01

Increasing prevalence of childhood obesity calls for comprehensive and cost-effective educative measures in developing countries such as India. School-based educative programmes greatly influence children's behaviour towards healthy living. We aimed to evaluate the impact of a school-based health and nutritional education programme on knowledge and behaviour of urban Asian Indian school children. Benchmark assessment of parents and teachers was also done. We educated 40 196 children (aged 8-18 years), 25 000 parents and 1500 teachers about health, nutrition, physical activity, non-communicable diseases and healthy cooking practices in three cities of North India. A pre-tested questionnaire was used to assess randomly selected 3128 children, 2241 parents and 841 teachers before intervention and 2329 children after intervention. Low baseline knowledge and behaviour scores were reported in 75-94 % government and 48-78 % private school children, across all age groups. A small proportion of government school children gave correct answers about protein (14-17 %), carbohydrates (25-27 %) and saturated fats (18-32 %). Private school children, parents and teachers performed significantly better than government school subjects (P < 0.05). Following the intervention, scores improved in all children irrespective of the type of school (P < 0.001). A significantly higher improvement was observed in younger children (aged 8-11 years) as compared with those aged 12-18 years, in females compared with males and in government schools compared with private schools (P < 0.05 for all). Major gaps exist in health and nutrition-related knowledge and behaviour of urban Asian Indian children, parents and teachers. This successful and comprehensive educative intervention could be incorporated in future school-based health and nutritional education programmes.

Individualised mindfulness-based stress reduction for head and neck cancer patients undergoing radiotherapy of curative intent: a descriptive pilot study.

PubMed

Pollard, A; Burchell, J L; Castle, D; Neilson, K; Ftanou, M; Corry, J; Rischin, D; Kissane, D W; Krishnasamy, M; Carlson, L E; Couper, J

2017-03-01

People with head and neck cancer (HNC) experience elevated symptom toxicity and co-morbidity as a result of treatment, which is associated with poorer psychosocial and quality-of-life (QoL) outcomes. This Phase I study examined whether an individualised mindfulness-based stress reduction (IMBSR) programme could be successfully used with HNC patients undergoing curative treatment. Primary aims were to explore feasibility, compliance, acceptability and fidelity. Secondary aims were to determine whether (1) participation in the intervention was associated with changes in post-intervention mindfulness and (2) post-intervention mindfulness was associated with post-intervention distress and QoL. Nineteen HNC patients participated in a seven-session IMBSR programme with pre- and post-test outcome measures of psychological distress, depression, anxiety and QoL. Primary aims were assessed by therapists or participants. Mindfulness, distress and QoL were assessed using self-report questionnaires at pre- and post-intervention. Longer time spent meditating daily was associated with higher post-intervention mindfulness. After controlling for pre-intervention mindfulness, there was an association between higher post-intervention mindfulness and lower psychological distress and higher total, social and emotional QoL. This study offers important preliminary evidence than an IMBSR intervention can be administered to HNC patients during active cancer treatment. A randomised controlled trial is warranted to confirm these findings. © 2016 John Wiley & Sons Ltd.

Evaluation of the national roll-out of parenting programmes across England: the parenting early intervention programme (PEIP)

PubMed Central

2013-01-01

Background Evidence based parenting programmes can improve parenting skills and the behaviour of children exhibiting, or at risk of developing, antisocial behaviour. In order to develop a public policy for delivering these programmes it is necessary not only to demonstrate their efficacy through rigorous trials but also to determine that they can be rolled out on a large scale. The aim of the present study was to evaluate the UK government funded national implementation of its Parenting Early Intervention Programme, a national roll-out of parenting programmes for parents of children 8–13 years in all 152 local authorities (LAs) across England. Building upon our study of the Pathfinder (2006–08) implemented in 18 LAs. To the best of our knowledge this is the first comparative study of a national roll-out of parenting programmes and the first study of parents of children 8–13 years. Methods The UK government funded English LAs to implement one or more of five evidence based programmes (later increased to eight): Triple P, Incredible Years, Strengthening Families Strengthening Communities, Families and Schools Together (FAST), and the Strengthening Families Programme (10–14). Parents completed measures of parenting style (laxness and over-reactivity), and mental well-being, and also child behaviour at three time points: pre- and post-course and again one year later. Results 6143 parents from 43 LAs were included in the study of whom 3325 provided post-test data and 1035 parents provided data at one-year follow up. There were significant improvements for each programme, with effect sizes (Cohen’s d) for the combined sample of 0.72 parenting laxness, 0.85 parenting over-reactivity, 0.79 parent mental well-being, and 0.45 for child conduct problems. These improvements were largely maintained one year later. All four programmes for which we had sufficient data for comparison were effective. There were generally larger effects on both parent and child measures for Triple P, but not all between programme comparisons were significant. Results for the targeted group of parents of children 8–13 years were very similar. Conclusions Evidence-based parenting programmes can be rolled out effectively in community settings on a national scale. This study also demonstrates the impact of research on shaping government policy. PMID:24138747

Cluster randomised controlled trial of 'whole school' child maltreatment prevention programme in primary schools in Northern Ireland: study protocol for Keeping Safe.

PubMed

McElearney, Aisling; Brennan-Wilson, Aoibheann; Murphy, Christina; Stephenson, Phyllis; Bunting, Brendan

2018-05-03

Child maltreatment has a pervasive, detrimental impact on children's wellbeing. Despite a growing focus on prevention through school based education, few programmes adopt a whole- school approach, are multi-component, seek to address all forms of maltreatment, or indeed have been robustly evaluated. This paper describes a cluster randomised controlled trial designed to evaluate a school based child maltreatment prevention programme: 'Keeping Safe' in primary schools in Northern Ireland. The intervention has been designed by a non-profit agency. Programme resources include 63 lessons taught incrementally to children between four and 11 years old, and is premised on three core themes: healthy relationships, my body, and being safe. There are programme resources to engage parents and to build the capacity and skills of school staff. A cluster Randomised Controlled Trial (RCT) will be conducted with children in 80 schools over a two-year period. The unit of randomisation is the school. Schools will be allocated to intervention or wait-list control groups using a computer-generated list. Data will be collected at three time points: baseline, end of year one, and end of year two of programme implementation. Primary outcomes will include: children's understanding of key programme concepts, self-efficacy to keep safe in situations of maltreatment, anxiety arising from programme participation, and disclosure of maltreatment. Secondary outcomes include teachers' comfort and confidence in teaching the programme and parents' confidence in talking to their children about programme concepts. This RCT will address gaps in current practice and evidence regarding school based child maltreatment prevention programmes. This includes the use of a whole- school approach and multi-component programme that addresses all maltreatment concepts, a two-year period of programme implementation, and the tracking of outcomes for children, parents, and teachers. Methodologically, it will extend our understanding and learning in: capturing sensitive outcome data from young children, adapting and using standardised measures with children of different ages, the use of school level administrative data on staff reports/children's disclosure of maltreatment as behavioural outcomes, and the conduct of complex trials within the busy school environment. ClinicalTrials.gov: NCT02961010 (Retrospectively registered 8 November 2016).

Evaluation of the national roll-out of parenting programmes across England: the parenting early intervention programme (PEIP).

PubMed

Lindsay, Geoff; Strand, Steve

2013-10-19

Evidence based parenting programmes can improve parenting skills and the behaviour of children exhibiting, or at risk of developing, antisocial behaviour. In order to develop a public policy for delivering these programmes it is necessary not only to demonstrate their efficacy through rigorous trials but also to determine that they can be rolled out on a large scale. The aim of the present study was to evaluate the UK government funded national implementation of its Parenting Early Intervention Programme, a national roll-out of parenting programmes for parents of children 8-13 years in all 152 local authorities (LAs) across England. Building upon our study of the Pathfinder (2006-08) implemented in 18 LAs. To the best of our knowledge this is the first comparative study of a national roll-out of parenting programmes and the first study of parents of children 8-13 years. The UK government funded English LAs to implement one or more of five evidence based programmes (later increased to eight): Triple P, Incredible Years, Strengthening Families Strengthening Communities, Families and Schools Together (FAST), and the Strengthening Families Programme (10-14). Parents completed measures of parenting style (laxness and over-reactivity), and mental well-being, and also child behaviour at three time points: pre- and post-course and again one year later. 6143 parents from 43 LAs were included in the study of whom 3325 provided post-test data and 1035 parents provided data at one-year follow up. There were significant improvements for each programme, with effect sizes (Cohen's d) for the combined sample of 0.72 parenting laxness, 0.85 parenting over-reactivity, 0.79 parent mental well-being, and 0.45 for child conduct problems. These improvements were largely maintained one year later. All four programmes for which we had sufficient data for comparison were effective. There were generally larger effects on both parent and child measures for Triple P, but not all between programme comparisons were significant. Results for the targeted group of parents of children 8-13 years were very similar. Evidence-based parenting programmes can be rolled out effectively in community settings on a national scale. This study also demonstrates the impact of research on shaping government policy.

Targeting children of substance-using parents with the community-based group intervention TRAMPOLINE: A randomised controlled trial - design, evaluation, recruitment issues

PubMed Central

2012-01-01

Background Children of substance-abusing parents are at risk for developing psychosocial development problems. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated programme for children from substance-affected families exists in Germany. The study described in this protocol is designed to test the effectiveness of the group programme TRAMPOLINE for children aged 8-12 years with at least one substance-abusing or -dependent caregiver. The intervention is specifically geared to issues and needs of children from substance-affected families. Methods/Design The effectiveness of the manualised nine-session group programme TRAMPOLINE is tested among N = 218 children from substance-affected families in a multicentre randomised controlled trial. Outpatient counselling facilities across the nation from different settings (rural/urban, Northern/Southern/Eastern/Western regions of the country) will deliver the interventions, as they hold the primary access to the target group in Germany. The control condition is a group programme with the same duration that is not addiction-specific. We expect that participants in the intervention condition will show a significant improvement in the use of adaptive coping strategies (in general and within the family) compared to the control condition as a direct result of the intervention. Data is collected shortly before and after as well as six months after the intervention. Discussion In Germany, the study presented here is the first to develop and evaluate a programme for children of substance-abusing parents. Limitations and strengths are discussed with a special focus on recruitment challenges as they appear to be the most potent threat to feasibility in the difficult-to-access target group at hand (Trial registration: ISRCTN81470784). PMID:22439919

Evaluating the impact of a school-based health intervention using a randomized field experiment.

PubMed

Greve, Jane; Heinesen, Eskil

2015-07-01

We conduct an econometric evaluation of a health-promoting programme in primary and lower secondary schools in Denmark. The programme includes health-related measurements of the students, communication of knowledge about health, and support of health-promoting projects for students. Half of the schools in the fourth largest municipality in Denmark were randomly selected into a treatment group implementing the programme, while the remainder served as a control group. We estimate both OLS models using only post-intervention observations and difference in differences (DID) models using also pre-intervention observations. We estimate effects of the initiative on BMI, waist/height ratio, overweight and obesity for the entire sample and by gender and grade. We find no consistent effect of the programme. When we use the entire sample, no estimates are statistically significant at conventional levels, although the point estimates for the effect on BMI, indicating an average reduction in the range of 0.10-0.15 kg/m(2), are consistent with the results in a recent Cochrane review evaluating 55 studies of diet and exercise interventions targeting children; and DID estimates which are marginally significant (at the 10% level) indicate that the intervention reduces the risk of obesity by 1% point. Running separate estimations by gender and grade we find a few statistically significant estimates: OLS estimates indicate that the intervention reduces BMI in females in grade 5 by 0.39 kg/m(2) and reduces the risk of obesity in females in grade 9 by 2.6% points; DID estimates indicate an increase in waist for females in preschool class by 1.2 cm and an increase in the risk of obesity in grade 9 males by 4% points. However, if we corrected for multiple hypotheses testing these estimates would be insignificant. There is no statistically significant correlation between participation in the programme and the number of other health-promoting projects at the schools. Copyright © 2015 Elsevier B.V. All rights reserved.

Targeting children of substance-using parents with the community-based group intervention TRAMPOLINE: a randomised controlled trial--design, evaluation, recruitment issues.

PubMed

Bröning, Sonja; Wiedow, Annika; Wartberg, Lutz; Ruths, Sylvia; Haevelmann, Andrea; Kindermann, Sally-Sophie; Moesgen, Diana; Schaunig-Busch, Ines; Klein, Michael; Thomasius, Rainer

2012-03-22

Children of substance-abusing parents are at risk for developing psychosocial development problems. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated programme for children from substance-affected families exists in Germany. The study described in this protocol is designed to test the effectiveness of the group programme TRAMPOLINE for children aged 8-12 years with at least one substance-abusing or -dependent caregiver. The intervention is specifically geared to issues and needs of children from substance-affected families. The effectiveness of the manualised nine-session group programme TRAMPOLINE is tested among N = 218 children from substance-affected families in a multicentre randomised controlled trial. Outpatient counselling facilities across the nation from different settings (rural/urban, Northern/Southern/Eastern/Western regions of the country) will deliver the interventions, as they hold the primary access to the target group in Germany. The control condition is a group programme with the same duration that is not addiction-specific. We expect that participants in the intervention condition will show a significant improvement in the use of adaptive coping strategies (in general and within the family) compared to the control condition as a direct result of the intervention. Data is collected shortly before and after as well as six months after the intervention. In Germany, the study presented here is the first to develop and evaluate a programme for children of substance-abusing parents. Limitations and strengths are discussed with a special focus on recruitment challenges as they appear to be the most potent threat to feasibility in the difficult-to-access target group at hand (Trial registration: ISRCTN81470784).

Parents' Training: Effects of the Self-Help Skills Programme with Down's Syndrome Babies

ERIC Educational Resources Information Center

Sanz, Maria Teresa; Menendez, Javier

2010-01-01

This article reviews studies evaluating the effectiveness of two types of early intervention programmes for babies with Down's syndrome (DS). Evaluation of self-help early intervention programmes was done with two types of training with the parents: in the first the parents learned the training programme from observing the clinician, and in the…

Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme.

PubMed

Hetzel, Manuel W; Iteba, Nelly; Makemba, Ahmed; Mshana, Christopher; Lengeler, Christian; Obrist, Brigit; Schulze, Alexander; Nathan, Rose; Dillip, Angel; Alba, Sandra; Mayumana, Iddy; Khatib, Rashid A; Njau, Joseph D; Mshinda, Hassan

2007-06-29

Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.

We have the programme, what next? Planning the implementation of an injury prevention programme

PubMed Central

Donaldson, Alex; Lloyd, David G; Gabbe, Belinda J; Cook, Jill

2017-01-01

Background and aim The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. Methods An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. Results An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. Conclusions A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context. PMID:26787739

Train the trainer? A randomized controlled trial of a multi-tiered oral health education programme in community-based residential services for adults with intellectual disability.

PubMed

Mac Giolla Phadraig, Caoimhin; Guerin, Suzanne; Nunn, June

2013-04-01

To assess the impact of a multi-tiered oral health education programme on care staff caring for people with intellectual disability (ID). Postal questionnaires were sent to all care staff of a community-based residential care service for adults, randomly assigned to control and intervention groups. A specifically developed training programme was delivered to residential staff nominees, who then trained all staff within the intervention group. The control group received no training. Post-test questionnaires were sent to both groups. Paired-samples t-test was used to compare oral health-related knowledge (K) and behaviour, attitude and self-efficacy (BAS) scores. Of the initial 219 respondents, 154 (response rate between 40% and 35.8%, with attrition rate of 29.7% from baseline to repeat) returned completed questionnaires at post-test (M=8.5 months, range=6.5-11 months). Control and intervention groups were comparable for general training, employment and demographic variables. In the intervention group, mean Knowledge Index score rose from K=7.2 to K=7.9 (P<0.001) and mean BAS scale score rose from BAS=4.7 to BAS=5.4 (P<0.001). There was no statistically significant increase in mean scores from test (K=7.0, BAS=4.7) to post-test (K=7.2, BAS=4.9) for the control group. Mean scores regarding knowledge, attitude, self-efficacy and reported behaviour increased significantly at 8.5 months in staff where training was provided. The results indicate that a multi-tiered training programme improved knowledge, attitude, self-efficacy and reported behaviour amongst staff caring for people with ID. © 2012 John Wiley & Sons A/S.

School-based programmes for preventing smoking.

PubMed

Thomas, R; Perera, R

2006-07-19

Smoking rates in adolescents are rising in some countries. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated. To review all randomized controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Tobacco Addiction Group's Specialized Register, MEDLINE, EMBASE, PsyclNFO, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomized controlled trials in this area. Types of studies: those in which individual students, classes, schools, or school districts were randomized to the intervention or control groups and followed for at least six months. Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion. We assessed whether identified citations were randomized controlled trials. We assessed the quality of design and execution, and abstracted outcome data. Because of the marked heterogeneity of design and outcomes, we computed pooled estimates only for those trials that could be analyzed together and for which statistical data were available. We predominantly synthesized the data using narrative systematic review. We grouped studies by intervention method (information; social competence; social influences; combined social influences/social competence; multi-modal programmes). Within each group, we placed them into three categories (low, medium and high risk of bias) according to validity using quality criteria for reported study design. Of the 94 randomized controlled trials identified, we classified 23 as category one (most valid). There was one category one study of information-giving and two of teaching social comeptence. There were thirteen category one studies of social influences interventions. Of these, nine found some positive effect of intervention on smoking prevalence, and four failed to detect an effect on smoking prevalence. The largest and most rigorous study, the Hutchinson Smoking Prevention Project, found no long-term effect of an intensive eight-year programme on smoking behaviour. There were three category one RCTs of combined social influences and social competence interventions: one provided significant results and one only for instruction by health educators compared to self-instruction. There was a lack of high quality evidence about the effectiveness of combinations of social influences and social competence approaches. There was one category one study providing data on social influences compared with information giving. There were four category one studies of multi-modal approaches but they provided limited evidence about the effectiveness of multi-modal approaches including community initiatives. There is one rigorous test of the effects of information-giving about smoking. There are well-conducted randomized controlled trials to test the effects of social influences interventions: in half of the group of best quality studies those in the intervention group smoke less than those in the control, but many studies failed to detect an effect of the intervention. There are only three high quality RCTs which test the effectiveness of combinations of social influences and social competence interventions, and four which test multi-modal interventions; half showed significant positive results.

Feasibility and cost-effectiveness of a multidisciplinary home-telehealth intervention programme to reduce falls among elderly discharged from hospital: study protocol for a randomized controlled trial.

PubMed

Giordano, Alessandro; Bonometti, Gian Pietro; Vanoglio, Fabio; Paneroni, Mara; Bernocchi, Palmira; Comini, Laura; Giordano, Amerigo

2016-12-07

Fall incidents are the third cause of chronic disablement in elderly according to the World Health Organization (WHO). Recent meta-analyses shows that a multifactorial falls risk assessment and management programmes are effective in all older population studied. However, the application of these programmes may not be the same in all National health care setting and, consequently, needs to be evaluated by cost-effectiveness studies before to plan this intervention in regular care. In Italy structured collaboration between hospital staff and primary care is generally lacking and the role of Information and Communication Technologies (ICT) in a fall prevention programme at home has never been explored. This will be a two-group randomised controlled trial aiming to evaluate the effects of a home-based intervention programme delivered by a multidisciplinary health team. The home tele-management programme, previously adopted in our Institute for chronic patients, will be proposed to elderly people affected by chronic diseases at high risk of falling at hospital discharge. The programme will involve the hospital staff and will be managed thanks to the collaboration between hospital and primary care setting. Patients will be followed for 6 months after hospital discharge. A nurse-tutor telephone support and tele-exercise will characterize the intervention programme. People in the control group will receive usual care. The main outcome measure of the study will be the percentage of patients sustaining a fall during the 6-months follow-up period. An economic evaluation will be performed from a societal perspective and will involve calculating cost-effectiveness and cost utility ratios. To date, no adequately powered studies have investigated the effect of the Information and Communication Technologies (ICT) in a home fall prevention program. We aim the program will be feasible in terms of intensity and characteristics, but particularly in terms of patient and provider compliance. The results of the economic evaluation could provide information about the cost-effectiveness of the intervention and the effects on quality of life. In case of shown effectiveness and cost effectiveness, the program could be implemented into health services settings. ClinicalTrials.gov ( NCT02487589 ).

Testing a Dutch web-based tailored lifestyle programme among adults: a study protocol.

PubMed

Schulz, Daniela N; Kremers, Stef Pj; van Osch, Liesbeth Adm; Schneider, Francine; van Adrichem, Mathieu Jg; de Vries, Hein

2011-02-16

Smoking, high alcohol consumption, unhealthy eating habits and physical inactivity often lead to (chronic) diseases, such as cardiovascular diseases and cancer. Tailored online interventions have been proven to be effective in changing health behaviours. The aim of this study is to test and compare the effectiveness of two different tailoring strategies for changing lifestyle compared to a control group using a multiple health behaviour web-based approach. In our Internet-based tailored programme, the five lifestyle behaviours of smoking, alcohol intake, fruit consumption, vegetable consumption, and physical activity are addressed. This randomized controlled trial, conducted among Dutch adults, includes two experimental groups (i.e., a sequential behaviour tailoring condition and a simultaneous behaviour tailoring condition) and a control group. People in the sequential behaviour tailoring condition obtain feedback on whether their lifestyle behaviours meet the Dutch recommendations. Using a step-by-step approach, they are stimulated to continue with a computer tailored module to change only one unhealthy behaviour first. In the course of the study, they can proceed to change a second behaviour. People in the simultaneous behaviour tailoring condition receive computer tailored feedback about all their unhealthy behaviours during their first visit as a stimulation to change all unhealthy behaviours. The experimental groups can re-visit the website and can then receive ipsative feedback (i.e., current scores are compared to previous scores in order to give feedback about potential changes). The (difference in) effectiveness of the different versions of the programme will be tested and compared to a control group, in which respondents only receive a short health risk appraisal. Programme evaluations will assess satisfaction with and appreciation and personal relevance of the intervention among the respondents. Finally, potential subgroup differences pertaining to gender, age and socioeconomic status regarding the behaviour effects and programme evaluation will be assessed. Research regarding multiple behaviour change is in its infancy. We study how to offer multiple behaviour change interventions optimally. Using these results could strengthen the effectiveness of web-based computer-tailoring lifestyle programmes. This study will yield new results about the need for differential lifestyle approaches using Internet-based expert systems and potential differences in subgroups concerning the effectiveness and appreciation. Dutch Trial Register NTR2168.

Effects of self reflection on engagement in a 12-step addiction treatment programme: a linguistic analysis of diary entries.

PubMed

Stephenson, Geoffrey M; Zygouris, Nikolaos

2007-02-01

Thirty clients receiving Twelve-Step Facilitation Therapy in a rehabilitation setting formed the intervention group. They were asked to complete in third person a weekly evaluation of progress based on reading personal "Feelings" diaries they had written on a daily basis over a period of one week, starting 3weeks previously. The diaries of the clients and of a further 60 clients in two matched control groups were compared. One control group consisted of clients receiving treatment before the intervention was introduced, and clients in the second control group received treatment after the intervention was terminated. Clients in the control groups were matched to the intervention group according to presenting disorder (alcohol, drugs or food), gender and age. Analysis of the number of words written and diaries produced suggested that the experimental group's productivity was enhanced. Linguistic and cluster analyses indicated that the clients in the Intervention group referred more frequently to key elements of the programme (steps and spirituality) and responded in a more integrated way to the major aspects of their treatment regime. The study supported the expectation that by promoting self-reflection on progress in therapeutic settings, an increase in programme engagement can be expected.

Prevention of violence against women and girls: what does the evidence say?

PubMed

Ellsberg, Mary; Arango, Diana J; Morton, Matthew; Gennari, Floriza; Kiplesund, Sveinung; Contreras, Manuel; Watts, Charlotte

2015-04-18

In this Series paper, we review evidence for interventions to reduce the prevalence and incidence of violence against women and girls. Our reviewed studies cover a broad range of intervention models, and many forms of violence--ie, intimate partner violence, non-partner sexual assault, female genital mutilation, and child marriage. Evidence is highly skewed towards that from studies from high-income countries, with these evaluations mainly focusing on responses to violence. This evidence suggests that women-centred, advocacy, and home-visitation programmes can reduce a woman's risk of further victimisation, with less conclusive evidence for the preventive effect of programmes for perpetrators. In low-income and middle-income countries, there is a greater research focus on violence prevention, with promising evidence on the effect of group training for women and men, community mobilisation interventions, and combined livelihood and training interventions for women. Despite shortcomings in the evidence base, several studies show large effects in programmatic timeframes. Across different forms of violence, effective programmes are commonly participatory, engage multiple stakeholders, support critical discussion about gender relationships and the acceptability of violence, and support greater communication and shared decision making among family members, as well as non-violent behaviour. Further investment in intervention design and assessment is needed to address evidence gaps. Copyright © 2015 Elsevier Ltd. All rights reserved.

A pilot effectiveness study of the Enhancing Parenting Skills (EPaS) 2014 programme for parents of children with behaviour problems: study protocol for a randomised controlled trial.

PubMed

Williams, Margiad Elen; Hutchings, Judy

2015-05-20

The Enhancing Parenting Skills (EPaS) 2014 programme is a home-based, health visitor-delivered parenting support programme for parents of children with identified behaviour problems. This trial aims to evaluate the effectiveness of the EPaS 2014 programme compared to a waiting-list treatment as usual control group. This is a pragmatic, multicentre randomised controlled trial. Sixty health visitors will each be asked to identify two families that have a child scoring above the clinical cut-off for behaviour problems using the Eyberg Child Behaviour Inventory (ECBI). Families recruited to the trial will be randomised in a 1:1 ratio into an intervention or waiting-list control group. Randomisation will occur within health visitor to ensure that each health visitor has one intervention family and one control family. The primary outcome is change in child behaviour problems as measured by the parent-reported ECBI. Secondary outcomes include other measures of child behaviour, parent behaviour, and parental depression as measured by parent-reports and an independent observation of parent and child behaviour. Follow-up measures will be collected 6-months after the collection of baseline measures. This is the first rigorous evaluation of the EPaS 2014 programme. The trial will provide important information on the effectiveness of a one-to-one home-based intervention, delivered by health visitors, for pre-school children with behaviour problems. It will also examine potential mediating (improved parent behaviour and/or improved parental depression) and moderating (single parent, teenage parent, poverty, low education level) factors. Current Controlled Trials ISRCTN06867279 (18 June 2014).

Promoting sexual and reproductive health among adolescents in southern and eastern Africa (PREPARE): project design and conceptual framework.

PubMed

Aarø, Leif Edvard; Mathews, Catherine; Kaaya, Sylvia; Katahoire, Anne Ruhweza; Onya, Hans; Abraham, Charles; Klepp, Knut-Inge; Wubs, Annegreet; Eggers, Sander Matthijs; de Vries, Hein

2014-01-18

Young people in sub-Saharan Africa are affected by the HIV pandemic to a greater extent than young people elsewhere and effective HIV-preventive intervention programmes are urgently needed. The present article presents the rationale behind an EU-funded research project (PREPARE) examining effects of community-based (school delivered) interventions conducted in four sites in sub-Saharan Africa. One intervention focuses on changing beliefs and cognitions related to sexual practices (Mankweng, Limpopo, South Africa). Another promotes improved parent-offspring communication on sexuality (Kampala, Uganda). Two further interventions are more comprehensive aiming to promote healthy sexual practices. One of these (Western Cape, South Africa) also aims to reduce intimate partner violence while the other (Dar es Salaam, Tanzania) utilises school-based peer education. A modified Intervention Mapping approach is used to develop all programmes. Cluster randomised controlled trials of programmes delivered to school students aged 12-14 will be conducted in each study site. Schools will be randomly allocated (after matching or stratification) to intervention and delayed intervention arms. Baseline surveys at each site are followed by interventions and then by one (Kampala and Limpopo) or two (Western Cape and Dar es Salaam) post-intervention data collections. Questionnaires include questions common for all sites and are partly based on a set of social cognition models previously applied to the study of HIV-preventive behaviours. Data from all sites will be merged in order to compare prevalence and associations across sites on core variables. Power is set to .80 or higher and significance level to .05 or lower in order to detect intervention effects. Intraclass correlations will be estimated from previous surveys carried out at each site. We expect PREPARE interventions to have an impact on hypothesized determinants of risky sexual behaviour and in Western Cape and Dar es Salaam to change sexual practices. Results from PREPARE will (i) identify modifiable cognitions and social processes related to risky sexual behaviour and (ii) identify promising intervention approaches among young adolescents in sub-Saharan cultures and contexts. Controlled Trials ISRCTN56270821 (Cape Town); Controlled Trials ISRCTN10386599 (Limpopo); Clinical Trials NCT01772628 (Kampala); Australian New Zealand Clinical Trials Registry ACTRN12613000900718 (Dar es Salaam).

Promoting sexual and reproductive health among adolescents in southern and eastern Africa (PREPARE): project design and conceptual framework

PubMed Central

2014-01-01

Background Young people in sub-Saharan Africa are affected by the HIV pandemic to a greater extent than young people elsewhere and effective HIV-preventive intervention programmes are urgently needed. The present article presents the rationale behind an EU-funded research project (PREPARE) examining effects of community-based (school delivered) interventions conducted in four sites in sub-Saharan Africa. One intervention focuses on changing beliefs and cognitions related to sexual practices (Mankweng, Limpopo, South Africa). Another promotes improved parent-offspring communication on sexuality (Kampala, Uganda). Two further interventions are more comprehensive aiming to promote healthy sexual practices. One of these (Western Cape, South Africa) also aims to reduce intimate partner violence while the other (Dar es Salaam, Tanzania) utilises school-based peer education. Methods/design A modified Intervention Mapping approach is used to develop all programmes. Cluster randomised controlled trials of programmes delivered to school students aged 12–14 will be conducted in each study site. Schools will be randomly allocated (after matching or stratification) to intervention and delayed intervention arms. Baseline surveys at each site are followed by interventions and then by one (Kampala and Limpopo) or two (Western Cape and Dar es Salaam) post-intervention data collections. Questionnaires include questions common for all sites and are partly based on a set of social cognition models previously applied to the study of HIV-preventive behaviours. Data from all sites will be merged in order to compare prevalence and associations across sites on core variables. Power is set to .80 or higher and significance level to .05 or lower in order to detect intervention effects. Intraclass correlations will be estimated from previous surveys carried out at each site. Discussion We expect PREPARE interventions to have an impact on hypothesized determinants of risky sexual behaviour and in Western Cape and Dar es Salaam to change sexual practices. Results from PREPARE will (i) identify modifiable cognitions and social processes related to risky sexual behaviour and (ii) identify promising intervention approaches among young adolescents in sub-Saharan cultures and contexts. Trial registrations Controlled Trials ISRCTN56270821 (Cape Town); Controlled Trials ISRCTN10386599 (Limpopo); Clinical Trials NCT01772628 (Kampala); Australian New Zealand Clinical Trials Registry ACTRN12613000900718 (Dar es Salaam). PMID:24438582

Living with diabetes: a group-based self-management support programme for T2DM patients in the early phases of illness and their partners, study protocol of a randomised controlled trial.

PubMed

van Puffelen, Anne L; Rijken, Mieke; Heijmans, Monique J W M; Nijpels, Giel; Rutten, Guy E H M; Schellevis, François G

2014-04-01

The present article presents the protocol for a randomised controlled trial to test the effectiveness of a group-based self-management support programme for recently diagnosed type 2 diabetes mellitus (T2DM) patients (one to three years post-diagnosis) and their partners. The course aims to support T2DM patients and their partners in successfully integrating diabetes care into their daily lives and hereby enhance self-management and diabetes-specific health-related quality of life. The content of the course is based on the Common-Sense Model of Self-Regulation (CSM). Furthermore, principles from the Social Cognitive Theory (SCT) and social support theories are integrated. We aim to recruit 160 recently diagnosed T2DM patients and their partners from general practices in six different regions in the Netherlands. Patients need to be diagnosed with T2DM for one to three years and have to experience some degree of diabetes-related difficulties, as measured with a three-item screener. Participating patients and their partners are randomly allocated to the intervention or control condition. Participants in the intervention condition receive three monthly group sessions and a booster session three months later. Participants in the control condition receive a single information meeting. Data will be collected at baseline (T0), directly after the programme (T1) and six months post-programme (T2), including: self-management, diabetes-specific health-related quality of life, illness perceptions, attitudes, social support and empowerment. A three-level multilevel model will be used to compare change-scores between the conditions (intervention/control) on each outcome. Our study will be the first to determine whether a group-based support programme based on the CSM is effective in enhancing self-management and diabetes-specific health-related quality of life in recently diagnosed T2DM patients. The important role of patients' partners in effective diabetes care is also acknowledged in the study. Netherlands National Trial Register (NTR) NTR3302.

Effect of a universal anxiety prevention programme (FRIENDS) on children's academic performance: results from a randomised controlled trial.

PubMed

Skryabina, Elena; Taylor, Gordon; Stallard, Paul

2016-11-01

Evaluations of school-based anxiety prevention programmes have reported improvements in psychological functioning although little is known about their effect upon educational outcomes. One thousand three hundred and sixty-two children from 40 primary schools in England took part in the randomised controlled trial, Preventing Anxiety in Children through Education in Schools. The trial investigated the effectiveness of a universal school-based cognitive behaviour therapy prevention programme, FRIENDS, delivered by health care staff or school staff compared with usual personal, social, health and education (PSHE) lessons. Self-report psychological outcomes and educational attainment on national standardised attainment tests in reading, writing and maths were collected 12 months postintervention. Analysis was performed at individual level using multivariable mixed effect models controlling for gender, type of intervention and school effect. Registered trial: ISRCTN: 23563048. At 12 months, anxiety reduced in the health-led FRIENDS group compared to school-led FRIENDS and PSHE. There were no between-group differences in academic performance regardless of gender, deprivation, ethnicity and additional educational needs. School-based mental health interventions should assess psychological and educational outcomes. Further research should directly compare the effects of interventions led by health and school staff. © 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

A Nurse-Led School-Based Sun Protection Programme in Turkey.

PubMed

Erkin, Özüm; Temel, Ayla Bayık

2017-12-01

The aim of this study was to determine the effects of a nurse-led school-based sun protection programme in Turkey. A randomized controlled trial was performed at two public schools between February and October 2014. Children with written consent from their parents were screened by nurses for skin type, and 80 children at moderate to high risk for skin cancer were included in the study. The sample was randomized by age, gender and skin type. Stratified and block randomizations were used. The participants were separated into an intervention group (n=40) and control group (n=40). Data were collected using a personal information form and two scales for sun protection behaviour and self-efficacy. In the intervention group, the pretest mean score for sun protection behaviour was 19.25±5.44 and increased significantly in the posttest assessment (33.05±4.23, p<0.001). Self-efficacy scores also increased significantly after the intervention (pretest 20.50±6.68, post-test 35.85±4.70, p<0.001). However, there were no significant increases in mean sun protection behaviour or self-efficacy scores in the control group (p>0.05). A nurse-led school-based sun protection programme effectively promoted children's self-efficacy and sun protection behaviour. Copyright© by the National Institute of Public Health, Prague 2017

Parenting for Autism, Language, And Communication Evaluation Study (PALACES): protocol for a pilot randomised controlled trial.

PubMed

Williams, Margiad Elen; Hastings, Richard; Charles, Joanna Mary; Evans, Sue; Hutchings, Judy

2017-02-16

Children with autistic spectrum disorder (ASD) often have associated behavioural difficulties that can present a challenge for parents and parenting. There are several effective social learning theory-based parenting programmes for dealing with behavioural difficulties, including the Incredible Years (IY) parent programmes. However, these programmes typically do not specifically target parents of children with ASD. Recently, a new addition to the IY suite of programmes known as the IY Autistic Spectrum and Language Delays (IY-ASLD) parent programme was developed. The main aims of the present study are to examine the feasibility of delivering this programme within child health services and to provide initial evidence for effectiveness and economic costs. The Parenting for Autism, Language, And Communication Evaluation Study (PALACES) trial is a pragmatic, multicentre, pilot randomised controlled trial comparing the IY-ASLD programme with a wait-list control condition. 72 parents of children with ASD (aged 3-8 years) will be randomly allocated to either the intervention or control condition. Data will be collected prior to randomisation and 6 months postrandomisation for all families. Families in the intervention condition only will also be followed up at 12 and 18 months postrandomisation. This study will provide initial evidence of effectiveness for the newly developed IY-ASLD parenting programme. It will also add to the limited economic evidence for an intervention targeting parents of children with ASD and provide longer term data, an important component for evaluations of parenting programmes. Approval for the study was granted by the Research Ethics Committee at the School of Psychology, Bangor University (reference number: 2016-15768) and the North Wales Research Ethics Committee, UK (reference number: 16/WA/0224). The findings will be disseminated through research conferences and peer-reviewed journals. ISRCTN57070414; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Parenting for Autism, Language, And Communication Evaluation Study (PALACES): protocol for a pilot randomised controlled trial

PubMed Central

Williams, Margiad Elen; Hastings, Richard; Charles, Joanna Mary; Evans, Sue; Hutchings, Judy

2017-01-01

Introduction Children with autistic spectrum disorder (ASD) often have associated behavioural difficulties that can present a challenge for parents and parenting. There are several effective social learning theory-based parenting programmes for dealing with behavioural difficulties, including the Incredible Years (IY) parent programmes. However, these programmes typically do not specifically target parents of children with ASD. Recently, a new addition to the IY suite of programmes known as the IY Autistic Spectrum and Language Delays (IY-ASLD) parent programme was developed. The main aims of the present study are to examine the feasibility of delivering this programme within child health services and to provide initial evidence for effectiveness and economic costs. Methods and analysis The Parenting for Autism, Language, And Communication Evaluation Study (PALACES) trial is a pragmatic, multicentre, pilot randomised controlled trial comparing the IY-ASLD programme with a wait-list control condition. 72 parents of children with ASD (aged 3–8 years) will be randomly allocated to either the intervention or control condition. Data will be collected prior to randomisation and 6 months postrandomisation for all families. Families in the intervention condition only will also be followed up at 12 and 18 months postrandomisation. This study will provide initial evidence of effectiveness for the newly developed IY-ASLD parenting programme. It will also add to the limited economic evidence for an intervention targeting parents of children with ASD and provide longer term data, an important component for evaluations of parenting programmes. Ethics and dissemination Approval for the study was granted by the Research Ethics Committee at the School of Psychology, Bangor University (reference number: 2016–15768) and the North Wales Research Ethics Committee, UK (reference number: 16/WA/0224). The findings will be disseminated through research conferences and peer-reviewed journals. Trial registration number ISRCTN57070414; Pre-results. PMID:28209607

Improving quality of care for depression: the German Action Programme for the implementation of evidence-based guidelines.

PubMed

Härter, Martin; Bermejo, Isaac; Ollenschläger, Günter; Schneider, Frank; Gaebel, Wolfgang; Hegerl, Ulrich; Niebling, Wilhelm; Berger, Mathias

2006-04-01

Depressive disorders are of great medical and political significance. The potential inherent in achieving better guideline orientation and a better collaboration between different types of care is clear. Throughout the 1990s, educational initiatives were started for implementing guidelines. Evidence-based guidelines on depression have been formulated in many countries. This article presents an action programme for structural, educational, and research-related measures to implement evidence-based care of depressive disorders in the German health system. The starting points of the programme are the 'Guidelines Critical Appraisal Reports' of the 'Guideline Clearing House' and measures from the 'Competence Network on Depression and Suicidality' (CNDS) funded by the Federal Ministry of Education and Research. The article gives an overview of the steps achieved as recommended by the Guidelines Critical Appraisal Reports and the ongoing transfer process into the German health care system. The action programme shows that comprehensive interventions to develop and introduce evidence-based guidelines for depression can achieve benefits in the care of depression, e.g. in recognition, management, and clinical outcome. It was possible to implement the German Action Programme in selected care settings, and initial evaluation results suggest some improvements. The action programme provides preliminary work, materials, and results for developing a future 'Disease Management Programme' (DMP) for depression.

Early Detection and Intervention of ASD: A European Overview

PubMed Central

Narzisi, Antonio; García-Primo, Patricia; Kawa, Rafal

2017-01-01

Over the last several years there has been an increasing focus on early detection of Autism Spectrum Disorder (ASD), not only from the scientific field but also from professional associations and public health systems all across Europe. Not surprisingly, in order to offer better services and quality of life for both children with ASD and their families, different screening procedures and tools have been developed for early assessment and intervention. However, current evidence is needed for healthcare providers and policy makers to be able to implement specific measures and increase autism awareness in European communities. The general aim of this review is to address the latest and most relevant issues related to early detection and treatments. The specific objectives are (1) analyse the impact, describing advantages and drawbacks, of screening procedures based on standardized tests, surveillance programmes, or other observational measures; and (2) provide a European framework of early intervention programmes and practices and what has been learnt from implementing them in public or private settings. This analysis is then discussed and best practices are suggested to help professionals, health systems and policy makers to improve their local procedures or to develop new proposals for early detection and intervention programmes. PMID:29194420

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization - a cluster-randomised controlled trial

PubMed Central

2013-01-01

Background The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. Methods The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. Results The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Conclusions Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Trial registration Clinicaltrials.gov identifier: NCT01228708. PMID:24090189

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization--a cluster-randomised controlled trial.

PubMed

Smidth, Margrethe; Christensen, Morten Bondo; Fenger-Grøn, Morten; Olesen, Frede; Vedsted, Peter

2013-10-03

The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Clinicaltrials.gov identifier: NCT01228708.

Mainstreaming nutrition into maternal and child health programmes: scaling up of exclusive breastfeeding.

PubMed

Bhandari, Nita; Kabir, A K M Iqbal; Salam, Mohammed Abdus

2008-04-01

Interventions to promote exclusive breastfeeding have been estimated to have the potential to prevent 13% of all under-5 deaths in developing countries and are the single most important preventive intervention against child mortality. According to World Health Organization and United Nations Children Funds (UNICEF), only 39% infants are exclusively breastfed for less than 4 months. This review examines programme efforts to scale up exclusive breastfeeding in different countries and draws lesson for successful scale-up. Opportunities and challenges in scaling up of exclusive breastfeeding into Maternal and Child Health programmes are identified. The key processes required for exclusive breastfeeding scale-up are: (1) an evidence-based policy and science-driven technical guidelines; and (2) an implementation strategy and plan for achieving high exclusive breastfeeding rates in all strata of society, on a sustainable basis. Factors related to success include political will, strong advocacy, enabling policies, well-defined short- and long-term programme strategy, sustained financial support, clear definition of roles of multiple stakeholders and emphasis on delivery at the community level. Effective use of antenatal, birth and post-natal contacts at homes and through community mobilization efforts is emphasized. Formative research to ensure appropriate intervention design and delivery is critical particularly in areas with high HIV prevalence. Strong communication strategy and support, quality trainers and training contributed significantly to programme success. Monitoring and evaluation with feedback systems that allow for periodic programme corrections and continued innovation are central to very high coverage. Legal framework must make it possible for mothers to exclusively breastfeed for at least 4 months. Sustained programme efforts are critical to achieve high coverage and this requires strong national- and state-level leadership.

The Eczema Education Programme: intervention development and model feasibility.

PubMed

Jackson, K; Ersser, S J; Dennis, H; Farasat, H; More, A

2014-07-01

The systematic support of parents of children with eczema is essential to their effective management; however, we have few models of support. This study examines the rationale, evidence base and development of a large-scale, structured, theory-based, nurse-led intervention, the 'Eczema Education Programme' (EEP), for parents of children with eczema. To outline development of the EEP, model of delivery, determine its feasibility and evaluate this based on service access and parental satisfaction data. Parent-child dyads meeting EEP referral criteria were recruited and demographic information recorded. A questionnaire survey of parental satisfaction was conducted 4 weeks post EEP; parental focus groups at 6 weeks provided comparative qualitative data. Descriptive statistics were derived from the questionnaire data using Predictive Analytics Software (PASW); content analysis was applied to focus group data. A total of 356 parents attended the EEP during the evaluation period. Service access was achieved for those in a challenging population. Both survey data (n = 146 parents, 57%) and focus group data (n = 21) revealed a significant level of parental satisfaction with the programme. It was feasible to provide the EEP as an adjunct to normal clinical care on a large scale, achieving a high level of patient/parent satisfaction and access within an urban area of multiple deprivation and high mobility. The intervention is transferable and the results are generalizable to other ethnically diverse child eczema populations within metropolitan areas in Britain. A multicentre RCT is required to test the effectiveness of this intervention on a larger scale. © 2013 European Academy of Dermatology and Venereology.

The iNEAR programme: an existential positive psychology intervention for resilience and emotional wellbeing.

PubMed

Tunariu, Aneta D; Tribe, Rachel; Frings, Dan; Albery, Ian P

2017-08-01

The aim of this study was to evaluate the effectiveness of a new psychological intervention, the iNEAR, which is a resilience and wellbeing programme consisting of a classroom based set of activities designed to facilitate the formation of positive identities through the acquisition of skills for growth and personal flourishing. Three hundred and fifty-four young people aged 11 and 12, matched for age and gender, were randomly allocated to the intervention (84 girls; 80 boys) and control conditions (93 girls; 96 boys). Following the intervention, boys, compared to girls, showed higher levels of wellbeing and environmental mastery, and higher levels of tolerance to uncertainty. The intervention was effective in increasing appreciation of positive relationships with others, for girls, and, although not statistically significant, it generated change in the desired direction for boys. In contrast to boys, girls' scores on openness to diversity also increased between baseline and post-intervention. Ways in which positive psychology interventions can resource individuals to better respond to adversity, coercion, and personal uncertainty, and so contribute to safeguarding against the adoption of extreme belief systems are also discussed.

"FearNot!": A Computer-Based Anti-Bullying-Programme Designed to Foster Peer Intervention

ERIC Educational Resources Information Center

Vannini, Natalie; Enz, Sibylle; Sapouna, Maria; Wolke, Dieter; Watson, Scott; Woods, Sarah; Dautenhahn, Kerstin; Hall, Lynne; Paiva, Ana; Andre, Elizabeth; Aylett, Ruth; Schneider, Wolfgang

2011-01-01

Bullying is widespread in European schools, despite multiple intervention strategies having been proposed over the years. The present study investigates the effects of a novel virtual learning strategy ("FearNot!") to tackle bullying in both UK and German samples. The approach is intended primarily for victims to increase their coping…

Effectiveness of Special Nursery Provision for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Reed, Phil; Osborne, Lisa A.; Corness, Mark

2010-01-01

The effectiveness of three local authority early teaching interventions for children with autism spectrum disorders (ASDs) was studied. Thirty-three children (2:6 to 4:0 years old) received one of three early teaching interventions: a 1:1 home-based programme, and two different forms of special nursery placement. Measures from the…

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

The importance of promoting gender equality and human rights in sexual and reproductive health (SRH) programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994–2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader set of SRH topics and populations. PMID:28002440

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care

PubMed Central

Guiriguet, Carolina; Muñoz-Ortiz, Laura; Burón, Andrea; Rivero, Irene; Grau, Jaume; Vela-Vallespín, Carmen; Vilarrubí, Mercedes; Torres, Miquel; Hernández, Cristina; Méndez-Boo, Leonardo; Toràn, Pere; Caballeria, Llorenç; Macià, Francesc; Castells, Antoni

2016-01-01

Background Participation rates in colorectal cancer screening are below recommended European targets. Aim To evaluate the effectiveness of an alert in primary care electronic medical records (EMRs) to increase individuals’ participation in an organised, population-based colorectal cancer screening programme when compared with usual care. Design and setting Cluster randomised controlled trial in primary care centres of Barcelona, Spain. Method Participants were males and females aged 50–69 years, who were invited to the first round of a screening programme based on the faecal immunochemical test (FIT) (n = 41 042), and their primary care professional. The randomisation unit was the physician cluster (n = 130) and patients were blinded to the study group. The control group followed usual care as per the colorectal cancer screening programme. In the intervention group, as well as usual care, an alert to health professionals (cluster level) to promote screening was introduced in the individual’s primary care EMR for 1 year. The main outcome was colorectal cancer screening participation at individual participant level. Results In total, 67 physicians and 21 619 patients (intervention group) and 63 physicians and 19 423 patients (control group) were randomised. In the intention-to-treat analysis screening participation was 44.1% and 42.2% respectively (odds ratio 1.08, 95% confidence interval [CI] = 0.97 to 1.20, P = 0.146). However, in the per-protocol analysis screening uptake in the intervention group showed a statistically significant increase, after adjusting for potential confounders (OR, 1.11; 95% CI = 1.02 to 1.22; P = 0.018). Conclusion The use of an alert in an individual’s primary care EMR is associated with a statistically significant increased uptake of an organised, FIT-based colorectal cancer screening programme in patients attending primary care centres. PMID:27266861

Improving child nutrition and development through community-based childcare centres in Malawi - The NEEP-IE study: study protocol for a randomised controlled trial.

PubMed

Gelli, Aulo; Margolies, Amy; Santacroce, Marco; Sproule, Katie; Theis, Sophie; Roschnik, Natalie; Twalibu, Aisha; Chidalengwa, George; Cooper, Amrik; Moorhead, Tyler; Gladstone, Melissa; Kariger, Patricia; Kutundu, Mangani

2017-06-19

The Nutrition Embedded Evaluation Programme Impact Evaluation (NEEP-IE) study is a cluster randomised controlled trial designed to evaluate the impact of a childcare centre-based integrated nutritional and agricultural intervention on the diets, nutrition and development of young children in Malawi. The intervention includes activities to improve nutritious food production and training/behaviour-change communication to improve food intake, care and hygiene practices. This paper presents the rationale and study design for this randomised control trial. Sixty community-based childcare centres (CBCCs) in rural communities around Zomba district, Malawi, were randomised to either (1) a control group where children were attending CBCCs supported by Save the Children's Early Childhood Health and Development (ECD) programme, or (2) an intervention group where nutritional and agricultural support activities were provided alongside the routine provision of the Save the Children's ECD programme. Primary outcomes at child level include dietary intake (measured through 24-h recall), whilst secondary outcomes include child development (Malawi Development Assessment Tool (MDAT)) and nutritional status (anthropometric measurements). At household level, primary outcomes include smallholder farmer production output and crop-mix (recall of last production season). Intermediate outcomes along theorised agricultural and nutritional pathways were measured. During this trial, we will follow a mixed-methods approach and undertake child-, household-, CBCC- and market-level surveys and assessments as well as in-depth interviews and focus group discussions with project stakeholders. Assessing the simultaneous impact of preschool meals on diets, nutrition, child development and agriculture is a complex undertaking. This study is the first to explicitly examine, from a food systems perspective, the impact of a preschool meals programme on dietary choices, alongside outcomes in the nutritional, child development and agricultural domains. The findings of this evaluation will provide evidence to support policymakers in the scale-up of national programmes. ISRCTN registry, ID: ISRCTN96497560 . Registered on 21 September 2016.

Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention

PubMed Central

Wartha, Olivia; Dreyhaupt, Jens; Lämmle, Christine; Friedemann, Eva-Maria; Kelso, Anne; Kutzner, Claire; Hermeling, Lina

2017-01-01

Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew's Intervention Mapping approach considering Bandura's social-cognitive theory and Bronfenbrenner's ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089. PMID:28303253

Enhancing the Intercultural Effectiveness of Exchange Programmes: Formal and Non-Formal Educational Interventions

ERIC Educational Resources Information Center

Almeida, Joana; Fantini, Alvino E.; Simões, Ana Raquel; Costa, Nilza

2016-01-01

This paper examines how the addition of intercultural interventions carried out throughout European credit-bearing exchange programmes can enhance sojourners' development of intercultural competencies, and it explores how both formal and non-formal pedagogical interventions may be designed and implemented. Such interventions were conducted at a…

Roles as a Route to Being "Other": Drama-Based Interventions with At-Risk Students

ERIC Educational Resources Information Center

Elliott, Victoria; Dingwall, Nicole

2017-01-01

Four drama programmes for at-risk youth run by a community theatre formed the basis for a 9-month participant observation and interview study. This paper focuses on the concept of roles, using this as a lens to explore participants' experiences, and to suggest ways in which taking part in the programmes enabled young people to "be Other"…

The Effectiveness of a Universal School-Based Programme on Coping and Mental Health: A Randomised, Controlled Study of Zippy' Friends

ERIC Educational Resources Information Center

Holen, Solveig; Waaktaar, Trine; Lervag, Arne; Ystgaard, Mette

2012-01-01

The purpose of this study was to evaluate Zippy's Friends, a universal school programme that aims at strengthening children's coping skills. The sample consisted of 1483 children (aged 7-8 years) from 91 second-grade classes in 35 schools. The schools were matched and randomly assigned to intervention or control conditions. Coping was assessed by…

VIP in construction: systematic development and evaluation of a multifaceted health programme aiming to improve physical activity levels and dietary patterns among construction workers

PubMed Central

2012-01-01

Background The prevalence of both overweight and musculoskeletal disorders (MSD) in the construction industry is high. Many interventions in the occupational setting aim at the prevention and reduction of these health problems, but it is still unclear how these programmes should be designed. To determine the effectiveness of interventions on these health outcomes randomised controlled trials (RCTs) are needed. The aim of this study is to systematically develop a tailored intervention for prevention and reduction of overweight and MSD among construction workers and to describe the evaluation study regarding its (cost-)effectiveness. Methods/Design The Intervention Mapping (IM) protocol was applied to develop and implement a tailored programme aimed at the prevention and reduction of overweight and MSD. The (cost-) effectiveness of the intervention programme will be evaluated using an RCT. Furthermore, a process evaluation will be conducted. The research population will consist of blue collar workers of a large construction company in the Netherlands. Intervention The intervention programme will be aimed at improving (vigorous) physical activity levels and healthy dietary behaviour and will consist of tailored information, face-to-face and telephone counselling, training instruction (a fitness "card" to be used for exercises), and materials designed for the intervention (overview of the company health promoting facilities, waist circumference measuring tape, pedometer, BMI card, calorie guide, recipes, and knowledge test). Main study parameters/endpoints The intervention effect on body weight and waist circumference (primary outcome measures), as well as on lifestyle behaviour, MSD, fitness, CVD risk indicators, and work-related outcomes (i.e. productivity, sick leave) (secondary outcome measures) will be assessed. Discussion The development of the VIP in construction intervention led to a health programme tailored to the needs of construction workers. This programme, if proven effective, can be directly implemented. Trial registration Netherlands Trial Register (NTR): NTR2095 PMID:22289212

Effect of a group intervention in the primary healthcare setting on continuing adherence to physical exercise routines in obese women.

PubMed

del Rey-Moya, Luz Maria; Castilla-Álvarez, Carmen; Pichiule-Castañeda, Myrian; Rico-Blázquez, Milagros; Escortell-Mayor, Esperanza; Gómez-Quevedo, Rosa

2013-08-01

To determine the effect of a seven-week-long, group-delivered, nurse-monitored, exercise training programme on the adherence of obese women to physical exercise routines at 12 months. The worldwide obesity epidemic is posing huge public health challenges. The main cause of obesity in Europe is very possibly a sedentary lifestyle. Uncertainty exists regarding whether people will continue to exercise once a structured intervention programme of physical activity ends. No-control-group (before-after) intervention study. One Hundred Seventy-Four women from the Madrid region (Spain) aged ≥ 45 years with a body mass index of ≥30 undertook a maximum of 21 × 1 hour exercise training programme sessions (three per week) over seven weeks starting in February 2009. The number of women making use of exercise training programme before the intervention, and at 6 and 12 months postintervention, was recorded using the Nursing Outcome Classification. Information was collected by interviewing the study subjects. Bivariate (McNemar and Student's t-tests) and multivariate (binary logistic regression) analyses were then performed. The Nursing Outcome Classification Indicator 'Does the subject follow an exercise training programme?' showed that at the end of one year, the percentage of women who remained adhered to exercise training programme increased in those who completed the study (from 11-41%). As the number of programmed exercise training programme sessions completed increased beyond 14, so too did the likelihood of adhering to an exercise training programme regime at one year. The results show that an exercise training programme intervention can encourage obese women to continue exercising after exercise interventions end. This type of intervention could provide a valuable means of helping women lose weight and improve their health. It may also have important economic benefits for health systems. Clinical trials with longer follow-up times and in other populations are needed to confirm the present results. © 2013 John Wiley & Sons Ltd.

Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE). Early evaluation of a complex intervention

PubMed Central

Shaw, Martin; Iwashyna, Theodore J.; Daniel, Malcolm; Devine, Helen; Jarvie, Lyndsey; Kinsella, John; MacTavish, Pamela; Quasim, Tara

2017-01-01

Background Many patients suffer significant physical, social and psychological problems in the months and years following critical care discharge. At present, there is minimal evidence of any effective interventions to support this patient group following hospital discharge. The aim of this project was to understand the impact of a complex intervention for ICU survivors. Methods Quality improvement project conducted between September 2014 and June 2016, enrolling 49 selected patients from one ICU in Scotland. To evaluate the impact of this programme outcomes were compared to an existing cohort of patients from the same ICU from 2008–2009. Patients attended a five week peer supported rehabilitation programme. This multidisciplinary programme included pharmacy, physiotherapy, nursing, medical, and psychology input. The primary outcome in this evaluation was the EQ-5D, a validated measure of health-related quality of life. The minimally clinically important difference (MCID) in the EQ-5D is 0.08. We also measured change in self-efficacy over the programme duration. Based on previous research, this study utilised a 2.4 (6%) point change in self-efficacy scores as a MCID. Results 40 patients (82%) completed follow-up surveys at 12 months. After regression adjustment for those factors known to impact recovery from critical care, there was a 0.07–0.16 point improvement in quality of life for those patients who took part in the intervention compared to historical controls from the same institution, depending on specific regression strategy used. Self-efficacy scores increased by 2.5 points (6.25%) over the duration of the five week programme (p = 0.003), and was sustained at one year post intervention. In the year following ICU, 15 InS:PIRE patients returned to employment or volunteering roles (88%) compared with 11 (46%) in the historical control group (p = 0.15). Conclusions and relevance This historical control study suggests that a complex intervention may improve quality of life and self-efficacy in survivors of ICU. A larger, multi-centre study is needed to investigate this intervention further. PMID:29186177

Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE). Early evaluation of a complex intervention.

PubMed

McPeake, Joanne; Shaw, Martin; Iwashyna, Theodore J; Daniel, Malcolm; Devine, Helen; Jarvie, Lyndsey; Kinsella, John; MacTavish, Pamela; Quasim, Tara

2017-01-01

Many patients suffer significant physical, social and psychological problems in the months and years following critical care discharge. At present, there is minimal evidence of any effective interventions to support this patient group following hospital discharge. The aim of this project was to understand the impact of a complex intervention for ICU survivors. Quality improvement project conducted between September 2014 and June 2016, enrolling 49 selected patients from one ICU in Scotland. To evaluate the impact of this programme outcomes were compared to an existing cohort of patients from the same ICU from 2008-2009. Patients attended a five week peer supported rehabilitation programme. This multidisciplinary programme included pharmacy, physiotherapy, nursing, medical, and psychology input. The primary outcome in this evaluation was the EQ-5D, a validated measure of health-related quality of life. The minimally clinically important difference (MCID) in the EQ-5D is 0.08. We also measured change in self-efficacy over the programme duration. Based on previous research, this study utilised a 2.4 (6%) point change in self-efficacy scores as a MCID. 40 patients (82%) completed follow-up surveys at 12 months. After regression adjustment for those factors known to impact recovery from critical care, there was a 0.07-0.16 point improvement in quality of life for those patients who took part in the intervention compared to historical controls from the same institution, depending on specific regression strategy used. Self-efficacy scores increased by 2.5 points (6.25%) over the duration of the five week programme (p = 0.003), and was sustained at one year post intervention. In the year following ICU, 15 InS:PIRE patients returned to employment or volunteering roles (88%) compared with 11 (46%) in the historical control group (p = 0.15). This historical control study suggests that a complex intervention may improve quality of life and self-efficacy in survivors of ICU. A larger, multi-centre study is needed to investigate this intervention further.

Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school-based and community-based cluster randomised controlled trial

PubMed Central

McKay, Michael; Agus, Ashley; Cole, Jonathan; Doherty, Paul; Foxcroft, David; Harvey, Séamus; Murphy, Lynn; Percy, Andrew; Sumnall, Harry

2018-01-01

Objectives To assess the effectiveness of a combined classroom curriculum and parental intervention (the Steps Towards Alcohol Misuse Prevention Programme (STAMPP)), compared with alcohol education as normal (EAN), in reducing self-reported heavy episodic drinking (HED) and alcohol-related harms (ARHs) in adolescents. Setting 105 high schools in Northern Ireland (NI) and in Scotland. Participants Schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational). Eligible students were in school year 8/S1 (aged 11–12 years) at baseline (June 2012). Intervention A classroom-based alcohol education intervention, coupled with a brief alcohol intervention for parents/carers. Primary outcomes (1) The prevalence of self-reported HED in the previous 30 days and (2) the number of self-reported ARHs in the previous 6 months. Outcomes were assessed using two-level random intercepts models (logistic regression for HED and negative binomial for number of ARHs). Results At 33 months, data were available for 5160 intervention and 5073 control students (HED outcome), and 5234 and 5146 students (ARH outcome), respectively. Of those who completed a questionnaire at either baseline or 12 months (n=12 738), 10 405 also completed the questionnaire at 33 months (81.7%). Fewer students in the intervention group reported HED compared with EAN (17%vs26%; OR=0.60, 95% CI 0.49 to 0.73), with no significant difference in the number of self-reported ARHs (incident rate ratio=0.92, 95% CI 0.78 to 1.05). Although the classroom component was largely delivered as intended, there was low uptake of the parental component. There were no reported adverse effects. Conclusions Results suggest that STAMPP could be an effective programme to reduce HED prevalence. While there was no significant reduction in ARH, it is plausible that effects on harms would manifest later. Trial registration number ISRCTN47028486; Post-results. PMID:29525770

The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh

PubMed Central

Haque, Syed Emdadul; Rahman, Mosiur; Itsuko, Kawashima; Mutahara, Mahmuda; Sakisaka, Kayako

2014-01-01

Objectives To assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents. Design Intervention study. Setting Araihazar area, Bangladesh. Participants 416 adolescent female students aged 11–16 years, in grade 6–8, and living with their parents. Interventions A school-based health education study conducted from April 2012 to April 2013. Primary and secondary outcome measures We randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments. Results After health education, participants reported a significant improvement (p<0.001) in ‘high knowledge and beliefs’ scores compared to baseline (51% vs 82.4%). Significant improvement was also observed in overall good menstrual practices (28.8% vs 88.9%), including improvements in using sanitary pads (22.4% change after the intervention), frequency of changing pads/cloths per day (68.8%), drying the used absorbent (77.6%), methods of disposing of the used absorbent (25.5%), and cleaning of genitalia (19.2%). During the follow-up, the participants reported significant improvements in the regularity of their menstrual cycle (94.5% vs 99.5%) and fewer complications during menstruation (78.6% vs 59.6%). Conclusions The programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh. PMID:24993753

The development and implementation of the Chronic Care Management Programme in Counties Manukau.

PubMed

Wellingham, John; Tracey, Jocelyn; Rea, Harold; Gribben, Barry

2003-02-21

To develop an effective and efficient process for the seamless delivery of care for targeted patients with specific chronic diseases. To reduce inexplicable variation and maximise use of available resources by implementing evidence-based care processes. To develop a programme that is acceptable and applicable to the Counties Manukau region. A model for the management of people with chronic diseases was developed. Model components and potential interventions were piloted. For each disease project, a return on investment was calculated and external evaluation was undertaken. The initial model was subsequently modified and individual disease projects aligned to it. The final Chronic Care Management model, agreed in September 2001, described a single common process. Key components were the targeting of high risk patients, organisation of cost effective interventions into a system of care, and an integrated care server acting as a data warehouse with a rules engine, providing flags and reminders. Return on investment analysis suggested potential savings for each disease component from $277 to $980 per person per annum. For selected chronic diseases, introduction of an integrated chronic care management programme, based on internationally accepted best practice processes and interventions can make significant savings, reducing morbidity and improving the efficiency of health delivery in the Counties Manukau region.

The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches

PubMed Central

Brown, Katherine; Barrett, Hazel

2013-01-01

With increased migration, female genital mutilation (FGM) also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. To date, however, little progress has been made in adopting a behaviour change approach in strategies aimed at ending FGM. Based on research undertaken as part of the EU's Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE), this paper argues that behaviour change has not been implemented due to a lack of understanding relating to the application of the two broad categories of behaviour change approach: individualistic decision-theoretic and community-change game-theoretic approaches, and how they may be integrated to aid our understanding and the development of future intervention strategies. We therefore discuss how these can be integrated and implemented using community-based participatory action research methods with affected communities. PMID:23983698

Improving Newborn Survival in Southern Tanzania (INSIST) trial; community-based maternal and newborn care economic analysis

PubMed Central

Manzi, Fatuma; Daviaud, Emmanuelle; Schellenberg, Joanna; Lawn, Joy E; John, Theopista; Msemo, Georgina; Owen, Helen; Barger, Diana; Hanson, Claudia; Borghi, Josephine

2017-01-01

Abstract Despite health systems improvements in Tanzania, gaps in the continuum of care for maternal, newborn and child health persist. Recent improvements have largely benefited those over one month of age, leading to a greater proportion of under-five mortality in newborns. Community health workers providing home-based counselling have been championed as uniquely qualified to reach the poorest. We provide financial and economic costs of a volunteer home-based counselling programme in southern Tanzania. Financial costs of the programme were extracted from project accounts. Ministry of Health and Social Welfare costs associated with programme implementation were collected based on staff and project monthly activity plans. Household costs associated with facility-based delivery were also estimated based on exit interviews with post-natal women. Time spent on the programme by implementers was assessed by interviews conducted with volunteers and health staff. The programme involved substantial design and set-up costs. The main drivers of set-up costs were activities related to volunteer training. Total annualized costs (design, set-up and implementation) amounted to nearly US$300 000 for financial costs and just over US$400 000 for economic costs. Volunteers (n = 842) spent just under 14 hours per month on programme-related activities. When volunteer time was valued under economic costs, this input amounted to just under half of the costs of implementation. The economic consequences of increased service use to households were estimated at US$36 985. The intervention cost per mother–newborn pair visited was between US$12.60 and US$19.50, and the incremental cost per additional facility-based delivery ranged from US$85.50 to US$137.20 for financial and economic costs (with household costs). Three scale-up scenarios were considered, with the financial cost per home visit respectively varying from $1.44 to $3.21 across scenarios. Cost-effectiveness compares well with supply-side initiatives to increase coverage of facility-based deliveries, and the intervention would benefit from substantial economies of scale. PMID:27335165

Improving Newborn Survival in Southern Tanzania (INSIST) trial; community-based maternal and newborn care economic analysis.

PubMed

Manzi, Fatuma; Daviaud, Emmanuelle; Schellenberg, Joanna; Lawn, Joy E; John, Theopista; Msemo, Georgina; Owen, Helen; Barger, Diana; Hanson, Claudia; Borghi, Josephine

2017-10-01

Despite health systems improvements in Tanzania, gaps in the continuum of care for maternal, newborn and child health persist. Recent improvements have largely benefited those over one month of age, leading to a greater proportion of under-five mortality in newborns. Community health workers providing home-based counselling have been championed as uniquely qualified to reach the poorest. We provide financial and economic costs of a volunteer home-based counselling programme in southern Tanzania. Financial costs of the programme were extracted from project accounts. Ministry of Health and Social Welfare costs associated with programme implementation were collected based on staff and project monthly activity plans. Household costs associated with facility-based delivery were also estimated based on exit interviews with post-natal women. Time spent on the programme by implementers was assessed by interviews conducted with volunteers and health staff. The programme involved substantial design and set-up costs. The main drivers of set-up costs were activities related to volunteer training. Total annualized costs (design, set-up and implementation) amounted to nearly US$300 000 for financial costs and just over US$400 000 for economic costs. Volunteers (n = 842) spent just under 14 hours per month on programme-related activities. When volunteer time was valued under economic costs, this input amounted to just under half of the costs of implementation. The economic consequences of increased service use to households were estimated at US$36 985. The intervention cost per mother-newborn pair visited was between US$12.60 and US$19.50, and the incremental cost per additional facility-based delivery ranged from US$85.50 to US$137.20 for financial and economic costs (with household costs). Three scale-up scenarios were considered, with the financial cost per home visit respectively varying from $1.44 to $3.21 across scenarios. Cost-effectiveness compares well with supply-side initiatives to increase coverage of facility-based deliveries, and the intervention would benefit from substantial economies of scale. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

What do we know about preventing school violence? A systematic review of systematic reviews.

PubMed

Lester, Soraya; Lawrence, Cayleigh; Ward, Catherine L

2017-03-01

Many children across the world are exposed to school violence, which undermines their right to education and adversely affects their development. Studies of interventions for school violence suggest that it can be prevented. However, this evidence base is challenging to navigate. We completed a systematic review of interventions to reduce four types of school violence: (a) peer violence; (b) corporal punishment; (c) student-on-teacher violence and (d) teacher-on-student violence. Reviewers independently searched databases and journals. Included studies were published between 2005 and 2015; in English; considered school-based interventions for children and measured violence as an outcome. Many systematic reviews were found, thus we completed a systematic review of systematic reviews. Only systematic reviews on interventions for intimate partner violence (IPV) and peer aggression were found. These reviews were generally of moderate quality. Research on both types of violence was largely completed in North America. Only a handful of programmes demonstrate promise in preventing IPV. Cognitive behavioral, social-emotional and peer mentoring/mediation programmes showed promise in reducing the levels of perpetration of peer aggression. Further research needs to determine the long-term effects of interventions, potential moderators and mediators of program effects, program effects across different contexts and key intervention components.

Support group programme for siblings of children with special needs: predictors of improved emotional and behavioural functioning.

PubMed

Roberts, Rachel M; Ejova, Anastasia; Giallo, Rebecca; Strohm, Kate; Lillie, Meredith E

2016-10-01

A pilot study to identify the predictors of improvement in emotional and behavioural functioning of siblings of children with special needs following participation in SibworkS, a six-week manual-based, cognitive-behavioural group programme. Data from 36 participants from a recent evaluation of the SibworkS programme was used. Measures were administered pre-intervention, immediately post-intervention and three months post-intervention. Treatment effects were measured using change scores for siblings on the Strengths and Difficulties Questionnaire - Parent Version (SDQ). Seven predictors were analysed: symptom severity of the child with special needs, participant age and gender, sibling birth order, family socio-economic status, participant baseline SDQ score and participant use of additional support services. The overall model significantly predicted change in SDQ scores at post-intervention and follow-up (adjusted R(2) = 0.41 and 0.40). At both evaluation points, SDQ change scores were significantly predicted by baseline SDQ score. Furthermore, symptom severity of the child with special needs was a significant predictor at three months post-intervention. Poorer emotional and behavioural functioning among participants and symptom severity of the child with special needs were associated with greater intervention effects. These results indicate that SibworkS is likely to be beneficial for siblings who have difficulties adjusting, and siblings of children with more severe special needs. Implications for Rehabilitation Siblings of children with disability are at increased risk of emotional and behavioural difficulties. Sibworks is a manualised group-based intervention for the siblings of children with a disability. Poorer emotional and behavioural functioning among participants and symptom severity of the child with special needs were associated with greater intervention effects. SibworkS is likely to be beneficial for siblings who have difficulties adjusting and siblings of children with more severe disabilities.

Evidence, theory and context - using intervention mapping to develop a school-based intervention to prevent obesity in children

PubMed Central

2011-01-01

Background Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. Methods This paper describes the development of the Healthy Lifestyles Programme (HeLP), a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM). The intervention focuses on the following health behaviours, i) reduction of the consumption of sweetened fizzy drinks, ii) increase in the proportion of healthy snacks consumed and iii) reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Results Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives - establish motivation, take action and stay motivated - in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. Conclusion The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their eating and activity behaviours. Although the process was time consuming, this systematic approach ensures that the behaviour change techniques and delivery methods link directly to the Programme's performance objectives and their associated determinants. This in turn provides a clear framework for process analysis and increases the potential of the intervention to realise the desired outcome of preventing and reducing obesity in children. PMID:21752261

Evidence, theory and context--using intervention mapping to develop a school-based intervention to prevent obesity in children.

PubMed

Lloyd, Jennifer J; Logan, Stuart; Greaves, Colin J; Wyatt, Katrina M

2011-07-13

Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. This paper describes the development of the Healthy Lifestyles Programme (HeLP), a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM). The intervention focuses on the following health behaviours, i) reduction of the consumption of sweetened fizzy drinks, ii) increase in the proportion of healthy snacks consumed and iii) reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives--establish motivation, take action and stay motivated--in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their eating and activity behaviours. Although the process was time consuming, this systematic approach ensures that the behaviour change techniques and delivery methods link directly to the Programme's performance objectives and their associated determinants. This in turn provides a clear framework for process analysis and increases the potential of the intervention to realise the desired outcome of preventing and reducing obesity in children.

Review: interventions to increase influenza vaccination among healthcare workers in hospitals

PubMed Central

Hollmeyer, Helge; Hayden, Frederick; Mounts, Anthony; Buchholz, Udo

2012-01-01

Please cite this paper as: Hollmeyer et al. (2012) Review: interventions to increase influenza vaccination among healthcare workers in hospitals. Influenza and Other Respiratory Viruses 7(4), 604–621. Annual influenza vaccination rates among hospital healthcare workers (HCW) are almost universally low despite recommendations from WHO and public health authorities in many countries. To assist in the development of successful vaccination programmes, we reviewed studies where interventions aimed to increase the uptake of influenza vaccination among hospital HCW. We searched PUBMED from 1990 up to December 2011 for publications with predetermined search strategies and of pre‐defined criteria for inclusion or exclusion. We evaluated a large number of ‘intervention programmes’ each employing one or more ‘intervention components’ or strategies, such as easy access to vaccine or educational activities, with the goal to raise influenza vaccine uptake rates in hospital HCW during one influenza season. Included studies reported results of intervention programmes and compared the uptake with the season prior to the intervention (historical control) or to another intervention programme within the same season that started from the same set of baseline activities. Twenty‐five studies performed in eight countries met our selection criteria and described 45 distinct intervention programmes. Most studies used their own facility as historical control and evaluated only one season. The following elements were used in intervention programmes that increased vaccine uptake: provision of free vaccine, easy access to the vaccine (e.g. through mobile carts or on‐site vaccination), knowledge and behaviour modification through educational activities and/or reminders and/or incentives, management or organizational changes, such as the assignment of personnel dedicated to the intervention programme, long‐term implementation of the strategy, requiring active declination and mandatory immunization policies. The number of these components applied appeared to be proportional to the increase in uptake. If influenza uptake in hospital HCW is to be increased on sustained basis, hospital managers need to be committed to conduct a well‐designed long‐term intervention programme that includes a variety of co‐ordinated managerial and organizational elements. PMID:22984794

Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study.

PubMed

Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

2015-05-01

Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study describes preliminary data from a group format manual-based intervention, the Interpersonal Problem-Solving for Workplace Adaptation Programme, aimed at improving the cognitive and metacognitive process of social problem-solving skills focusing on typical social situations in the workplace based on mediation as the main strategy. A total of 50 adults with Asperger syndrome received the programme and were compared with a control group of typical development. The feasibility and effectiveness of the treatment were explored. Participants were assessed at pre-treatment and post-treatment on a task of social problem-solving skills and two secondary measures of socialisation and work profile using self- and caregiver-report. Using a variety of methods, the results showed that scores were significantly higher at post-treatment in the social problem-solving task and socialisation skills based on reports by parents. Differences in comparison to the control group had decreased after treatment. The treatment was acceptable to families and subject adherence was high. The Interpersonal Problem-Solving for Workplace Adaptation Programme appears to be a feasible training programme. © The Author(s) 2014.

Exploring the use of positive psychology interventions in brain injury survivors with challenging behaviour.

PubMed

Andrewes, H E; Walker, V; O'Neill, B

2014-01-01

To investigate the feasibility and effectiveness of conducting two positive psychology interventions to improve mood and self-concept with survivors of traumatic brain injury (TBI), within a neuro-rehabilitation hospital. Ten patients with brain injury were randomly allocated to an intervention and control group. The efficacy of the first intervention, 'three positive things in life' was measured via Seligman's Authentic Happiness Index (AHI), at base-line, directly following the intervention and at the end of the 12-week group programme. The second intervention, the 'Value in Action (VIA) signature strengths intervention' was measured by the Head Injury Semantic Differential Scale (HISDS) at baseline and at the end of the group. Compared to baseline and control group scores, the AHI index showed an increase in the intervention group's happiness following the intervention and at the end of the 12-week programme, albeit the latter increase was non-significant. The HISDS showed non-significant improvement in self-concept and reduction in polarization of the self in the present, future and past in the second intervention. Anecdotal evidence revealed a clear improved mood following the interventions. This study shows promising results for the effectiveness of Positive Psychology interventions and methods to improve feasibility when applying this treatment within a hospital setting.

School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial.

PubMed

Wasserman, Danuta; Hoven, Christina W; Wasserman, Camilla; Wall, Melanie; Eisenberg, Ruth; Hadlaczky, Gergö; Kelleher, Ian; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Guillemin, Francis; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean-Pierre; Keeley, Helen; Musa, George J; Nemes, Bogdan; Postuvan, Vita; Saiz, Pilar; Reiter-Theil, Stella; Varnik, Airi; Varnik, Peeter; Carli, Vladimir

2015-04-18

Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025), compared with the control group. 14 pupils (0·70%) reported incident suicide attempts at the 12 month follow-up in the YAM versus 34 (1·51%) in the control group, and 15 pupils (0·75%) reported incident severe suicidal ideation in the YAM group versus 31 (1·37%) in the control group. No participants completed suicide during the study period. YAM was effective in reducing the number of suicide attempts and severe suicidal ideation in school-based adolescents. These findings underline the benefit of this universal suicide preventive intervention in schools. Coordination Theme 1 (Health) of the European Union Seventh Framework Programme. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial.

PubMed

Sayal, K; Taylor, J A; Valentine, A; Guo, B; Sampson, C J; Sellman, E; James, M; Hollis, C; Daley, D

2016-07-01

National Institute for Health and Care Excellence guidelines recommend a stepped care approach for the identification and management of children with, or at risk of, attention-deficit/hyperactivity disorder (ADHD). We investigated the effectiveness, cost-effectiveness and acceptability of a group parenting intervention programme (+/- a teacher session) for children at risk of ADHD. In a three-arm cluster randomised controlled trial, 12 primary schools were randomly assigned to control, parent-only and combined (parent + teacher) intervention arms. Eligible children had high levels of parent-rated hyperactivity/inattention (n = 199). At 6 month follow-up, the primary outcome measure was the parent-completed Conners' Rating Scale - Revised (ADHD index). Secondary outcomes included the Conners' sub-scales (hyperactivity, cognitive problems/inattention and oppositional behaviour), the teacher-completed Conners' Rating Scale - Revised, child health-related quality of life, parental burden and parental mental health. The cost-effectiveness analyses reflected a health and personal social services perspective. ISRCTN87634685. Follow-up data were obtained from 76 parents and 169 teachers. There was no effect of the parent-only (mean difference = -1.1, 95% CI -5.1,2.9; p = 0.57) or combined interventions (mean difference = -2.1, 95% CI -6.4,2.1; p = 0.31) on the ADHD index. The combined intervention was associated with reduced parent-reported hyperactivity symptoms (mean difference = -5.3; 95% CI -10.5,-0.01; p = 0.05) and the parent-only intervention with improved parental mental health (mean difference = -1.9; 95% CI -3.2,-0.5; p = 0.009). The incremental costs of the parent-only and the combined interventions were £73 and £123, respectively. Above a willingness-to-pay of £31 per one-point improvement in the ADHD index, the parent-only programme had the highest probability of cost-effectiveness. Participants found the interventions acceptable. For children at risk of ADHD, this school-based parenting programme was not associated with improvement in core ADHD symptoms. Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems. Future research should compare targeted interventions against watchful waiting and specialist referral. © 2016 John Wiley & Sons Ltd.

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial

PubMed Central

El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline

2015-01-01

Objective To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Design Pragmatic multicentre, two arm, parallel group, randomised controlled trial. Setting 20 study sites in 16 medium to large cities throughout France. Participants 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Intervention Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. Outcome measures A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a “shared frailty” model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. Results There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls related to the intervention were recorded. Conclusion A two year progressive balance retraining programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged 75-85 at risk of falling. Trial registration ClinicalTrials.gov (NCT00545350). PMID:26201510

Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study.

PubMed

Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier

2017-01-01

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. Clinical Trials.gov Registration ID: NCT02643927.

Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial

PubMed Central

2014-01-01

Background Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population’s reasons for refusing to take part in the screening programme and to find out the health professionals’ opinion about the official programme implementation and on the new computerised tool. Methods/Design This is a parallel randomised trial with a cross-sectional second stage. Participants: all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50–69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient’s electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach. Discussion We expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by physicians and nurse practitioners to perform colorectal cancer screening will mean an increase in participation of the target population. The introduction of this new software tool will have good acceptance and increase compliance with recommendations from health professionals. Trial registration Clinical Trials.gov identifier NCT01877018 PMID:24685117

Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study

PubMed Central

Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier

2017-01-01

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. Clinical Trials.gov Registration ID: NCT02643927 PMID:28848465

Impact of parental weight status on a school-based weight management programme designed for Mexican-American children.

PubMed

Moreno, J P; Johnston, C A; Hernandez, D C; LeNoble, J; Papaioannou, M A; Foreyt, J P

2016-10-01

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P < .001) or one obese (F = 4.99, P < .05) parent. Between-group comparisons indicated that children with zero and one obese parents demonstrated greater decreases in zBMI compared to children with two obese parents at every time point. The school-based weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts. © 2015 World Obesity.

Use of programme theory to understand the differential effects of interventions across socio-economic groups in systematic reviews-a systematic methodology review.

PubMed

Maden, Michelle; Cunliffe, Alex; McMahon, Naoimh; Booth, Andrew; Carey, Gina Michelle; Paisley, Suzy; Dickson, Rumona; Gabbay, Mark

2017-12-29

Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice. A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health. Multiple databases were searched from January 2013 to May 2016. Studies were included if they were systematic reviews assessing the effectiveness of an intervention and included data on SES. Two reviewers independently screened all studies, undertook quality assessment and extracted data. A narrative approach to synthesis was adopted. A total of 37 systematic reviews were included, 10 of which were explicit in the use of terminology for 'programme theory'. Twenty-nine studies used programme theory to inform both their a priori assumptions and explain their review findings. Of these, 22 incorporated considerations of both what and how interventions do/do not work in SES groups to both predict and explain their review findings. Thirteen studies acknowledged 24 unique theoretical references to support their assumptions of what or how interventions may have different effects in SES groups. Most reviewers used supplementary evidence to support their considerations of differential effectiveness. The majority of authors outlined a programme theory in the "Introduction" and "Discussion" sections of the review to inform their assumptions or provide explanations of what or how interventions may result in differential effects within or across SES groups. About a third of reviews used programme theory to inform the review analysis and/or synthesis. Few authors used programme theory to inform their inclusion criteria, data extraction or quality assessment. Twenty-one studies tested their a priori programme theory. The use of programme theory to inform considerations of if, what and how interventions lead to differential effects on health in different SES groups in the systematic review process is not yet widely adopted, is used implicitly, is often fragmented and is not implemented in a systematic way.

Effects of the X:IT smoking intervention: a school-based cluster randomized trial.

PubMed

Andersen, Anette; Krølner, Rikker; Bast, Lotus Sofie; Thygesen, Lau Caspar; Due, Pernille

2015-12-01

Uptake of smoking in adolescence is still of major public health concern. Evaluations of school-based programmes for smoking prevention show mixed results. The aim of this study was to examine the effect of X:IT, a multi-component school-based programme to prevent adolescent smoking. Data from a Danish cluster randomized trial included 4041 year-7 students (mean age: 12.5) from 51 intervention and 43 control schools. Outcome measure 'current smoking' was dichotomized into smoking daily, weekly, monthly or more seldom vs do not smoke. Analyses were adjusted for baseline covariates: sex, family socioeconomic position (SEP), best friend's smoking and parental smoking. We performed multilevel, logistic regression analyses of available cases and intention-to-treat (ITT) analyses, replacing missing outcome values by multiple imputation. At baseline, 4.7% and 6.8% of the students at the intervention and the control schools smoked, respectively. After 1 year of the intervention, the prevalence was 7.9% and 10.7%, respectively. At follow-up, 553 students (13.7%) did not answer the question on smoking. Available case analyses: crude odds ratios (OR) for smoking at intervention schools compared with control schools: 0.65 (0.48-0.88) and adjusted: 0.70 (0.47-1.04). ITT analyses: crude OR for smoking at intervention schools compared with control schools: 0.67 (0.50-0.89) and adjusted: 0.61 (0.45-0.82). Students at intervention schools had a lower risk of smoking after a year of intervention in year 7. This multi-component intervention involving educational, parental and context-related intervention components seems to be efficient in lowering or postponing smoking uptake in Danish adolescents. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

STEPWISE - STructured lifestyle Education for People WIth SchizophrEnia: a study protocol for a randomised controlled trial.

PubMed

Gossage-Worrall, Rebecca; Holt, Richard I G; Barnard, Katharine; E Carey, Marian; J Davies, Melanie; Dickens, Chris; Doherty, Yvonne; Edwardson, Charlotte; French, Paul; Gaughran, Fiona; Greenwood, Kathryn; Kalidindi, Sridevi; Hind, Daniel; Khunti, Kamlesh; McCrone, Paul; Mitchell, Jonathan; Pendlebury, John; Rathod, Shanaya; Shiers, David; Siddiqi, Najma; Swaby, Lizzie; Wright, Stephen

2016-09-29

People with schizophrenia are two to three times more likely to be overweight than the general population. The UK National Institute of Health and Care Excellence (NICE) recommends an annual physical health review with signposting to, or provision of, a lifestyle programme to address weight concerns and obesity. The purpose of this randomised controlled trial is to assess whether a group-based structured education programme can help people with schizophrenia to lose weight. Design: a randomised controlled trial of a group-based structured education programme. 10 UK community mental health trusts. 396 adults with schizophrenia, schizoaffective, or first-episode psychosis who are prescribed antipsychotic medication will be recruited. Participants will be overweight, obese or be concerned about their weight. participants will be randomised to either the intervention or treatment as usual (TAU). The intervention arm will receive TAU plus four 2.5-h weekly sessions of theory-based lifestyle structured group education, with maintenance contact every 2 weeks and 'booster' sessions every 3 months. All participants will receive standardised written information about healthy eating, physical activity, alcohol and smoking. the primary outcome is weight (kg) change at 1 year post randomisation. Secondary outcomes, which will be assessed at 3 and 12 months, include: the proportion of participants who maintained or reduced their weight; waist circumference; body mass index; objectively measured physical activity (wrist accelerometer); self-reported diet; blood pressure; fasting plasma glucose, lipid profile and HbA 1c (baseline and 1 year only); health-related quality of life (EQ-5D-5L and RAND SF-36); (adapted) brief illness perception questionnaire; the Brief Psychiatric Rating Scale; the Client Service Receipt Inventory; medication use; smoking status; adverse events; depression symptoms (Patient Health Questionnaire-9); use of weight-loss programmes; and session feedback (intervention only). Outcome assessors will be blind to trial group allocation. Qualitative interviews with a subsample of facilitators and invention-arm participants will provide data on intervention feasibility and acceptability. Assessment of intervention fidelity will also be performed. The STEPWISE trial will provide evidence for the clinical and cost-effectiveness of a tailored intervention, which, if successful, could be implemented rapidly in the NHS. ISRCTN19447796 , registered on 20 March 2014.

A factorial-design cluster randomised controlled trial investigating the cost-effectiveness of a nutrition supplement and an exercise programme on pneumonia incidence, walking capacity and body mass index in older people living in Santiago, Chile: the CENEX study protocol

PubMed Central

Dangour, Alan D; Albala, Cecilia; Aedo, Cristian; Elbourne, Diana; Grundy, Emily; Walker, Damian; Uauy, Ricardo

2007-01-01

Background Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. In an effort to promote healthy ageing and preserve function, the government of Chile has formulated a package of actions into the Programme of Complementary Feeding for the Older Population (PACAM) which has been providing a nutritional supplement to older people since 1998. PACAM distributes micronutrient fortified foods to individuals aged 70 years and over registered at Primary Health Centres and enrolled in the programme. The recommended serving size (50 g/day) of these supplements provides 50% of daily micronutrient requirements and 20% of daily energy requirements of older people. No information is currently available on the cost-effectiveness of the supplementation programme. Aim The aim of the CENEX cluster randomised controlled trial is to evaluate the cost-effectiveness of an ongoing nutrition supplementation programme, and a specially designed physical exercise intervention for older people of low to medium socio-economic status living in Santiago, Chile. Methods The study has been conceptualised as a public health programme effectiveness study and has been designed as a 24-month factorial cluster-randomised controlled trial conducted among 2800 individuals aged 65.0–67.9 years at baseline attending 28 health centres in Santiago. The main outcomes are incidence of pneumonia, walking capacity and change in body mass index over 24 months of intervention. Costing data (user and provider), collected at all levels, will enable the determination of the cost-effectiveness of the two interventions individually and in combination. The study is supported by the Ministry of Health in Chile, which is keen to expand and improve its national programme of nutrition for older people based on sound science-base and evidence for cost-effectiveness. Trial registration ISRCTN48153354 PMID:17615064

Effectiveness and cost-effectiveness of the Salut Programme: a universal health promotion intervention for parents and children-protocol of a register-based retrospective observational study.

PubMed

Feldman, Inna; Eurenius, Eva; Häggström, Jenny; Sampaio, Filipa; Lindkvist, Marie; Pulkki-Brännström, Anni-Maria; Ivarsson, Anneli

2016-08-04

There is inadequate evidence for the effectiveness and cost-effectiveness of health promotion interventions. The Salut Programme aims to reach all parents and children in the Västerbotten County of Sweden with a combination of health promotion interventions initiated during pregnancy and continued over the childhood period. This study protocol describes an effectiveness study and an economic evaluation study, where the ongoing Salut Programme is compared to care-as-usual over the periods of pregnancy, delivery and the child's first 2 years of life. A register-based retrospective observational study design will be used with existing data sources with respect to exposures and outcomes. Outcomes of interest are clustered at 3 points: around the child's birth, 1 month after the child's birth and 2 years after the child's birth. We will simulate an experiment by retrospectively identifying and comparing children and their parents in the geographical areas where the Salut Programme was implemented since 2006 and onwards, and the areas where the Programme was not implemented before 2009. Outcomes will be analysed and compared for the premeasure period, and the postmeasure period for both groups. Our analysis combines difference-in-difference estimation with matching. A complementary analysis will be carried out on the longitudinal subsample of mothers who gave birth at least once during each of the time periods. The economic evaluation aims to capture the wider societal costs and benefits of the Salut Programme for the first 2 years of the children's lives. Incremental costs will be compared with incremental health gains and the results will be presented as a cost-consequence analysis. The Regional Ethical Review Board in Umeå has given clearance for the Salut Programme research (2010-63-31M). No individual's identity will be revealed when presenting results. This study will provide information that can guide decision-makers to allocate resources optimally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The impact of a home-based walking programme on falls in older people: the Easy Steps randomised controlled trial.

PubMed

Voukelatos, Alexander; Merom, Dafna; Sherrington, Catherine; Rissel, Chris; Cumming, Robert G; Lord, Stephen R

2015-05-01

walking is the most popular form of exercise in older people but the impact of walking on falls is unclear. This study investigated the impact of a 48-week walking programme on falls in older people. three hundred and eighty-six physically inactive people aged 65+ years living in the community were randomised into an intervention or control group. The intervention group received a self-paced, 48-week walking programme that involved three mailed printed manuals and telephone coaching. Coinciding with the walking programme manual control group participants received health information unrelated to falls. Monthly falls calendars were used to monitor falls (primary outcome) over 48 weeks. Secondary outcomes were self-reported quality of life, falls efficacy, exercise and walking levels. Mobility, leg strength and choice stepping reaction time were measured in a sub-sample (n = 178) of participants. there was no difference in fall rates between the intervention and control groups in the follow-up period (IRR = 0.88, 95% CI: 0.60-1.29). By the end of the study, intervention group participants spent significantly more time exercising in general, and specifically walking for exercise (median 1.69 versus 0.75 h/week, P < 0.001). our finding that a walking programme is ineffective in preventing falls supports previous research and questions the suitability of recommending walking as a fall prevention strategy for older people. Walking, however, increases physical activity levels in previously inactive older people. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[How to assess and reduce social inequalities in cancer screening programmes].

PubMed

Binefa, Gemma; García, Montse; Peiró, Rosana; Molina-Barceló, Ana; Ibáñez, Raquel

2016-01-01

This field note presents the conclusions and recommendations made at the meeting 'How to reduce social inequalities in cancer screening programmes?' held at the XXVI School of Public Health of Mahon (Menorca, Spain). Participants developed recommendations based on experiences of population-based screening programmes (breast and colorectal) and opportunistic screening (cervical). The conclusions and recommendations focused on four main areas (information systems, evaluation and quality, research, and interventions): the inclusion of social variables at an individual level in health information systems; the establishment of minimum standards for gathering information regarding inequalities in access to preventive services; the performance of actions in vulnerable populations; and the promotion of the exchange of experiences and best practices through the Cancer Screening Programmes Network and working groups of the scientific societies. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: background, design and conceptual model of FINALE.

PubMed

Holtermann, Andreas; Jørgensen, Marie B; Gram, Bibi; Christensen, Jeanette R; Faber, Anne; Overgaard, Kristian; Ektor-Andersen, John; Mortensen, Ole S; Sjøgaard, Gisela; Søgaard, Karen

2010-03-09

A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr). Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and cognitive and behavioral skills) and physical work demands, and thereby reduce the physical deterioration in a long term perspective by interventions tailored for each respective job-group. The FINALE programme has the potential to provide evidence-based knowledge of significant importance for public health policy and health promotion strategies for employees at high risk for physical deterioration. ISRCTN96241850, NCT01015716 and NCT01007669.

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: Background, design and conceptual model of FINALE

PubMed Central

2010-01-01

Background A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. Methods/Design A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr). Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and cognitive and behavioral skills) and physical work demands, and thereby reduce the physical deterioration in a long term perspective by interventions tailored for each respective job-group. Discussion The FINALE programme has the potential to provide evidence-based knowledge of significant importance for public health policy and health promotion strategies for employees at high risk for physical deterioration. Trial registrations ISRCTN96241850, NCT01015716 and NCT01007669 PMID:20214807

The effectiveness of exercise programmes in patients with multiple myeloma: A literature review.

PubMed

Gan, J H; Sim, C Y L; Santorelli, L A

2016-02-01

A limited number of clinical studies have investigated the effectiveness of participation in exercise training programmes for patients with multiple myeloma (MM), exploring the different biomedical, physical, psychological and quality of life. The aim of this literature review is to evaluate current quantitative and qualitative evidence concerning the effectiveness of participation in exercise programmes for patients with MM in improving physiological and/or psychological status. A literature search encompassing studies published between January 1998 and July 2013 was conducted through ten electronic databases. This search was further expanded through citation chaining, manual grey literature searches, and peer review consultation. In total, seven interventional studies were identified and appraised using Critical Appraisal Skill Programme (CASP) or Centre for Evidence-Based Management of Amsterdam (CEBMa). Though the majority of the studies presented encouraging data, however, three studies that implemented individualized exercise interventions for patients at different stages of MM and myeloablative treatment showed mixed results. In conclusion, the effectiveness of participation in exercise programmes remains unclear for patients with MM, as the studies reviewed were flawed by relatively weak methodological approaches. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

Effectiveness of a structured education reminiscence-based programme for staff on the quality of life of residents with dementia in long-stay units: a study protocol for a cluster randomised trial.

PubMed

O'Shea, Eamon; Devane, Declan; Murphy, Kathy; Cooney, Adeline; Casey, Dympna; Jordan, Fionnuala; Hunter, Andrew; Murphy, Edel

2011-02-14

Current projections indicate that there will be a significant increase in the number of people with dementia in Ireland, from approximately 40,000 at present to 100,000 by 2036. Psychosocial interventions, such as reminiscence, have the potential to improve the quality of life of people with dementia. However, while reminiscence is used widely in dementia care, its impact on the quality of life of people with dementia remains largely undocumented and there is a need for a robust and fair assessment of its overall effectiveness. The DementiA education programme incorporating REminiscence for Staff study will evaluate the effectiveness of a structured reminiscence-based education programme for care staff on the quality of life of residents with dementia in long-stay units. The study is a two-group, single-blind cluster randomised trial conducted in public and private long-stay residential settings in Ireland. Randomisation to control and intervention is at the level of the long-stay residential unit. Sample size calculations suggest that 18 residential units each containing 17 people with dementia are required for randomisation to control and intervention groups to achieve power of at least 80% with alpha levels of 0.05. Each resident in the intervention group is linked with a nurse and care assistant who have taken the structured reminiscence-based education programme. Participants in the control group will receive usual care. The primary outcome is quality of life of residents as measured by the Quality of Life-AD instrument. Secondary outcomes include agitation, depression and carer burden. Blinded outcome assessment is undertaken at baseline and at 18-22 weeks post-randomisation. Trials on reminiscence-based interventions for people with dementia have been scarce and the quality of the information arising from those that have been done has been undermined by methodological problems, particularly in relation to scale and scope. This trial is powered to deliver more credible and durable results. The trial may also convey process utility to a long-stay system in Ireland that has not been geared for education and training, especially in relation to dementia. The results of this trial are applicable to long-stay residential units in Ireland and internationally. Current Controlled Trials ISRCTN99651465.

School-based diagnosis and treatment of malaria by teachers using rapid diagnostic tests and artemisinin-based combination therapy: experiences and perceptions of users and implementers of the Learner Treatment Kit, southern Malawi.

PubMed

Mphwatiwa, Treza; Witek-McManus, Stefan; Mtali, Austin; Okello, George; Nguluwe, Paul; Chatsika, Hard; Roschnik, Natalie; Halliday, Katherine E; Brooker, Simon J; Mathanga, Don P

2017-08-07

Training teachers to diagnose uncomplicated malaria using malaria rapid diagnostic tests and treat with artemisinin-based combination therapy has the potential to improve the access of primary school children (6-14 years) to prompt and efficient treatment for malaria, but little is known about the acceptability of such an intervention. This qualitative study explored experiences and perceptions of users and implementers of a programme of school-based malaria case management via a first-aid kit-the Learner Treatment Kit (LTK)-implemented as part of a cluster-randomized controlled trial in Zomba district, Malawi. From 29 primary schools where teachers were trained to test and treat school children for malaria using the LTK, six schools were purposively selected on the basis of relative intervention usage (low, medium or high); school size and geographical location. In total eight focus group discussions were held with school children, parents and guardians, and teachers; and 20 in-depth interviews were conducted with key stakeholders at the school, district and national levels. Interviews were recorded, transcribed, and analysed using a thematic analysis approach. The LTK was widely perceived by respondents to be a worthwhile intervention, with the opinion that trained teachers were trusted providers of malaria testing and treatment to school children. Benefits of the programme included a perception of improved access to malaria treatment for school children; decreased school absenteeism; and that the programme supported broader national health and education policies. Potential barriers to successful implementation expressed included increased teacher workloads, a feeling of inadequate supervision from health workers, lack of incentives and concerns for the sustainability of the programme regarding the supply of drugs and commodities. Training teachers to test for and treat uncomplicated malaria in schools was well received by both users and implementers alike, and was perceived by the majority of stakeholders to be a valuable programme. Factors raised as critical to the success of such a programme included ensuring an effective supervisory system, a reliable supply chain, and the training of greater numbers of teachers per school to manage high consultation numbers, especially during the peak malaria transmission season.

Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol.

PubMed

Gould, Natalie J; Lorencatto, Fabiana; Stanworth, Simon J; Michie, Susan; Prior, Maria E; Glidewell, Liz; Grimshaw, Jeremy M; Francis, Jill J

2014-07-29

Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention. This study is part of a larger programme of work to promote the uptake of evidence-based transfusion practice. The objectives of this study are to design two theoretically enhanced audit and feedback interventions; one focused on content and one on delivery, and investigate the feasibility and acceptability. Study A (Content): A coding framework based on current evidence regarding audit and feedback, and behaviour change theory and frameworks will be developed and applied as part of a structured content analysis to specify the key components of existing feedback documents. Prototype feedback documents with enhanced content and also a protocol, describing principles for enhancing feedback content, will be developed. Study B (Delivery): Individual semi-structured interviews with healthcare professionals and observations of team meetings in four hospitals will be used to specify, and identify views about, current audit and feedback practice. Interviews will be based on a topic guide developed using the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. Analysis of transcripts based on these frameworks will form the evidence base for developing a protocol describing an enhanced intervention that focuses on feedback delivery. Study C (Feasibility and Acceptability): Enhanced interventions will be piloted in four hospitals. Semi-structured interviews, questionnaires and observations will be used to assess feasibility and acceptability. This intervention development work reflects the UK Medical Research Council's guidance on development of complex interventions, which emphasises the importance of a robust theoretical basis for intervention design and recommends systematic assessment of feasibility and acceptability prior to taking interventions to evaluation in a full-scale randomised study. The work-up includes specification of current practice so that, in the trials to be conducted later in this programme, there will be a clear distinction between the control (usual practice) conditions and the interventions to be evaluated.

Costs of the 'Hartslag Limburg' community heart health intervention

PubMed Central

Ronckers, Emma T; Groot, Wim; Steenbakkers, Mieke; Ruland, Erik; Ament, Andre

2006-01-01

Background Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. Methods Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000). Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. Results The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000) were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. Conclusion The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very large. Cost sharing was facilitated by the unique approach used in the Hartslag Limburg programme. PMID:16512909

Costs and outcomes of an intervention programme for offenders with personality disorders.

PubMed

Barrett, Barbara; Byford, Sarah

2012-04-01

The dangerous severe personality disorder programme was developed in high secure prisons and hospitals at great expense to identify and treat the most dangerous offenders with personality disorders. To evaluate whether the long-term costs of the programme are greater or less than the long-term outcomes. We used a Markov decision model with a cost-effectiveness analysis to determine the incremental cost of the programme per serious offence prevented and a cost-offset analysis to consider whether monetary benefits were greater than costs. Costs were consistently higher for the intervention programme and the cost per serious offence prevented was over £2 million, although there was some evidence that adjustments to the programme could lead to similar interventions becoming cost-effective. Little evidence was found to support the cost-effectiveness of the intervention programme for offenders with personality disorders, although delivery of the programme in a lower-cost prison would probably yield greater benefits than costs. There are frequent calls for mentally disordered offenders to be detained in secure hospitals rather than prisons; however, if reoffending remains the outcome of interest for policy makers, it is likely that the costs of detention in hospital will remain greater than the benefits for dangerous offenders with a personality disorder.

The effectiveness of manual-guided, problem-solving-based self-learning programme for family caregivers of people with recent-onset psychosis: A randomised controlled trial with 6-month follow-up.

PubMed

Chien, Wai Tong; Yip, Annie L K; Liu, Justina Y W; McMaster, Terry W

2016-07-01

Family intervention for psychotic disorders is an integral part of psychiatric treatment with positive effects on patients' mental state and relapse rate. However, the effect of such family-based intervention on caregivers' psychological distress and well-being, especially in non-Western countries, has received comparatively much less attention. To test the effects of guided problem-solving-based manual-guided self-learning programme for family caregivers of adults with recent-onset psychosis over a 6-month period of follow-up, when compared with those in usual family support service. A single-centre randomised controlled trial, which was registered at ClinicalTrials.gov (NCT02391649), with a repeated-measures, two-arm (parallel-group) design. One main psychiatric outpatient clinic in the New Territories of Hong Kong. A random sample of 116 family caregiverss of adult outpatients with recent-onset psychosis. Following pre-test measurement, caregivers were assigned randomly to one of two study groups: a 5-month self-help, problem-solving-based manual-guided self-learning (or bibliotherapy) programme (in addition to usual care), or usual family support service only. Varieties of patient and caregiver health outcomes were assessed and compared at baseline and at 1-week and 6-month post-intervention. One hundred and eleven (96%) caregivers completed the 6-month follow-up (two post-tests); 55 of them (95%) completed ≥4 modules and attended ≥2 review sessions (i.e., 75% of the intervention). The family participants' mean age was about 38 years and over 64% of them were female and patient's parent or spouse. Multivariate analyses of variance indicated that the manual-guided self-learning group reported significantly greater improvements than the usual care group in family burden [F(1,110)=6.21, p=0.006] and caregiving experience [F(1,110)=6.88, p=0.0004], and patients' psychotic symptoms [F(1,110)=6.25, p=0.0003], functioning [F(1,110)=7.01, p=0.0005] and number of hospitalisations [F(1,110)=5.71, p=0.005] over 6-month follow-up. Problem-solving-based, manual-guided self-learning programme for family caregivers of adults with recent-onset psychosis can be an effective self-help programme and provide medium-term benefits to patients' and caregivers' mental health and duration of patients' re-hospitalisations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Teacher Training Intervention for Early Identification of Common Child Mental Health Problems in Pakistan

ERIC Educational Resources Information Center

Hussein, S. A.; Vostanis, P.

2013-01-01

School-based interventions involving teacher training programmes have been shown to benefit teachers' ability to identify and manage child mental health problems in developed countries. However, very few studies have been conducted in low-income countries with limited specialist services. The aim of the study was to evaluate the impact of the…

Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

PubMed Central

Hetzel, Manuel W; Iteba, Nelly; Makemba, Ahmed; Mshana, Christopher; Lengeler, Christian; Obrist, Brigit; Schulze, Alexander; Nathan, Rose; Dillip, Angel; Alba, Sandra; Mayumana, Iddy; Khatib, Rashid A; Njau, Joseph D; Mshinda, Hassan

2007-01-01

Background Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. Project The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. Conclusion The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services. PMID:17603898

The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students.

PubMed

Sundgot-Borgen, Christine; Bratland-Sanda, Solfrid; Engen, Kethe M E; Pettersen, Gunn; Friborg, Oddgeir; Torstveit, Monica Klungland; Kolle, Elin; Piran, Niva; Sundgot-Borgen, Jorunn; Rosenvinge, Jan H

2018-03-06

Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating. Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme. The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services. The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.

Effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of older adults living alone.

PubMed

Ahn, Jeong-Ah; Park, JeeWon; Kim, Chun-Ja

2017-09-07

The effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of 71 older adults living alone were examined. Although a regular dietary meal plan is recommended for improving nutritional status of older adults living alone, little research is done in this field in Korea. A pre- and post-test controlled quasi-experimental design was used at public health centres. The intervention group participated in an intensive nutritional education and support programme once a week for 8 weeks with dietary menus provided by home visiting nurses/dieticians; control group received usual care. Dietary habits and nutritional knowledge were assessed using structured questionnaires; nutritional intake status was analysed using Computer Aided Nutritional Analysis Program 5.0. The mean age of participants was 77.6 years, and 81.7% of the participants were women. At 8 weeks, there were significant interactions of group by time for dietary habits, nutritional knowledge and selected nutritional status of protein, iron and vitamins of B 2 and C. Changes over time in the mean score of dietary habits and nutritional knowledge were significantly improved in the intervention group compared to the control group. The percentages of normal nutrition intake of protein, iron and vitamins A and C in the intervention group were significantly higher than the control group at 8 weeks. Nutritional education and support programme positively impacted dietary habits, nutritional knowledge and selected nutritional status in older adults living alone, and we highlight the need for community-based nutritional education and counselling programmes. Older adults living alone in a community have relatively poor nutritional status and thus require tailored nutritional intervention according to objective nutritional analysis. It is necessary to link visiting nurses with dieticians in the community to manage effective nutritional programme continuously. © 2017 John Wiley & Sons Ltd.

Tailoring a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) to Tunisia: process and relevant adaptations.

PubMed

Spagnolo, Jessica; Champagne, François; Leduc, Nicole; Melki, Wahid; Guesmi, Imen; Bram, Nesrine; Guisset, Ann-Lise; Piat, Myra; Laporta, Marc; Charfi, Fatma

2018-01-01

In order to make mental health services more accessible, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Montreal, the World Health Organization office in Tunisia and the Montreal World Health Organization-Pan American Health Organization Collaborating Center for Research and Training in Mental Health, implemented a training programme based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) (version 1.0) , developed by the World Health Organization. This article describes the phase prior to the implementation of the training, which was offered to general practitioners working in primary care settings in the Greater Tunis area of Tunisia. The phase prior to implementation consisted of adapting the standard mhGAP-IG (version 1.0) to the local primary healthcare context. This adaptation process, an essential step before piloting the training, involved discussions with stakeholder groups, as well as field observations. Through the adaptation process, we were able to make changes to the standard training format and material. In addition, the process helped uncover systemic barriers to effective mental health care. Targeting these barriers in addition to implementing a training programme may help reduce the mental health treatment gap, and promote implementation that is successful and sustainable.

Age-shifting in malaria incidence as a result of induced immunological deficit: a simulation study.

PubMed

Pemberton-Ross, Peter; Smith, Thomas A; Hodel, Eva Maria; Kay, Katherine; Penny, Melissa A

2015-07-25

Effective population-level interventions against Plasmodium falciparum malaria lead to age-shifts, delayed morbidity or rebounds in morbidity and mortality whenever they are deployed in ways that do not permanently interrupt transmission. When long-term intervention programmes target specific age-groups of human hosts, the age-specific morbidity rates ultimately adjust to new steady-states, but it is very difficult to study these rates and the temporal dynamics leading up to them empirically because the changes occur over very long time periods. This study investigates the age and magnitude of age- and time- shifting of incidence induced by either pre-erythrocytic vaccination (PEV) programmes or seasonal malaria chemo-prevention (SMC), using an ensemble of individual-based stochastic simulation models of P. falciparum dynamics. The models made various assumptions about immunity decay, transmission heterogeneity and were parameterized with data on both age-specific infection and disease incidence at different levels of exposure, on the durations of different stages of the parasite life-cycle and on human demography. Effects of transmission intensity, and of levels of access to malaria treatment were considered. While both PEV and SMC programmes are predicted to have overall strongly positive health effects, a shift of morbidity into older children is predicted to be induced by either programme if transmission levels remain static and not reduced by other interventions. Predicted shifting of burden continue into the second decade of the programme. Even if long-term surveillance is maintained it will be difficult to avoid mis-attribution of such long-term changes in age-specific morbidity patterns to other factors. Conversely, short-lived transient changes in incidence measured soon after introduction of a new intervention may give over-positive views of future impacts. Complementary intervention strategies could be designed to specifically protect those age-groups at risk from burden shift.

Preventing domestic abuse for children and young people: A review of school-based interventions.

PubMed

Stanley, Nicky; Ellis, Jane; Farrelly, Nicola; Hollinghurst, Sandra; Downe, Soo

2015-12-01

Schools provide the setting in which interventions aimed at preventing intimate partner violence and abuse (IPVA) are delivered to young people in the general population and a range of programmes have been designed and evaluated. To date, most rigorous studies have been undertaken in North America and the extent to which programmes are transferable to other settings and cultures is uncertain. This paper reports on a mixed methods review, aimed at informing UK practise and policy, which included a systematic review of the international literature, a review of the UK grey literature and consultation with young people as well as experts to address the question of what works for whom in what circumstances. The context in which an intervention was delivered was found to be crucial. Context included: the wider policy setting; the national or regional level, where the local culture shaped understandings of IPVA, and the readiness of an individual school. The programmes included in the systematic review provided stronger evidence for changing knowledge and attitudes than for behavioural change and those young people who were at higher risk at baseline may have exerted a strong influence on study outcomes. Shifting social norms in the peer group emerged as a key mechanism of change and the young people consulted emphasised the importance of authenticity which could be achieved through the use of drama and which required those delivering programmes to have relevant expertise. While the consultation identified increasing interest in targeting interventions on boys, there was an identified lack of materials designed for minority groups of young people, especially Lesbian, Gay, Bisexual and Transgender young people. Increased responsivity to the local context can be achieved by involving those who will deliver and receive these preventive programmes in their development. Schools need to be better prepared and supported in the task of delivering these interventions and this is particularly relevant for the management of disclosures of IPVA. Outcomes measured by evaluations should include those relevant to education.

Preventing domestic abuse for children and young people: A review of school-based interventions

PubMed Central

Stanley, Nicky; Ellis, Jane; Farrelly, Nicola; Hollinghurst, Sandra; Downe, Soo

2015-01-01

Schools provide the setting in which interventions aimed at preventing intimate partner violence and abuse (IPVA) are delivered to young people in the general population and a range of programmes have been designed and evaluated. To date, most rigorous studies have been undertaken in North America and the extent to which programmes are transferable to other settings and cultures is uncertain. This paper reports on a mixed methods review, aimed at informing UK practise and policy, which included a systematic review of the international literature, a review of the UK grey literature and consultation with young people as well as experts to address the question of what works for whom in what circumstances. The context in which an intervention was delivered was found to be crucial. Context included: the wider policy setting; the national or regional level, where the local culture shaped understandings of IPVA, and the readiness of an individual school. The programmes included in the systematic review provided stronger evidence for changing knowledge and attitudes than for behavioural change and those young people who were at higher risk at baseline may have exerted a strong influence on study outcomes. Shifting social norms in the peer group emerged as a key mechanism of change and the young people consulted emphasised the importance of authenticity which could be achieved through the use of drama and which required those delivering programmes to have relevant expertise. While the consultation identified increasing interest in targeting interventions on boys, there was an identified lack of materials designed for minority groups of young people, especially Lesbian, Gay, Bisexual and Transgender young people. Increased responsivity to the local context can be achieved by involving those who will deliver and receive these preventive programmes in their development. Schools need to be better prepared and supported in the task of delivering these interventions and this is particularly relevant for the management of disclosures of IPVA. Outcomes measured by evaluations should include those relevant to education. PMID:26740731

Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme.

PubMed

Charles, Joanna M; Bywater, Tracey J; Edwards, Rhiannon Tudor; Hutchings, Judy; Zou, Lu

2013-12-18

There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children's health and social care service use, but little is known about the programme's impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme. This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents' service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group. Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only. Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents' service use and the cost implications for publically funded health and social care services is needed.

Family-based HIV prevention and intervention services for youth living in poverty-affected contexts: the CHAMP model of collaborative, evidence-informed programme development

PubMed Central

2010-01-01

Family-based interventions with children who are affected by HIV and AIDS are not well established. The Collaborative HIV Prevention and Adolescent Mental Health Program (CHAMP) represents one of the few evidence-based interventions tested in low-income contexts in the US, Caribbean and South Africa. This paper provides a description of the theoretical and empirical bases of the development and implementation of CHAMP in two of these countries, the US and South Africa. In addition, with the advent of increasing numbers of children infected with HIV surviving into adolescence and young adulthood, a CHAMP+ family-based intervention, using the founding principles of CHAMP, has been developed to mitigate the risk influences associated with being HIV positive. PMID:20573290

Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community-dwelling older persons?

PubMed

Tang, Shuk Kwan; Tse, M Y Mimi

2014-01-01

To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (P<0.05). The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

If it works there, will it work here? The effect of a multi-component responsible beverage service (RBS) programme on violence in Oslo.

PubMed

Skardhamar, Torbjørn; Fekjær, Silje Bringsrud; Pedersen, Willy

2016-12-01

The Stockholm Prevents Alcohol and Drug Problems (STAD) programme has been regarded as one of the most successful programmes to date, in reducing alcohol-related violence. This multi-component Responsible Beverage Service (RBS) programme was implemented in Stockholm, Sweden, and has been documented to be extremely effective in reducing alcohol-related nightlife violence. The SALUTT programme in Oslo, Norway was carefully modelled on the STAD project. We investigate whether the results from STAD were replicated in the SALUTT intervention. Using geocoded data, the level of violence in the intervention area was compared with different control areas before and after the intervention. Autoregressive moving average models (ARIMA). The SALUTT programme had no statistically significant effect on violence. However, the level of violence in the different potential control areas of Oslo fluctuated without a clear common trend. Hence, it was difficult to establish proper control areas. The results from the Swedish STAD-intervention were not replicated in Oslo. Successful interventions are not necessarily replicated in other contexts, and the current literature does not shed sufficient light on the conditions under which such interventions actually work. Moreover, more attention should be devoted to the identification of adequate control areas in future research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The effect of skill mix in non-nursing assistants on work engagements among home visiting nurses in Japan.

PubMed

Naruse, Takashi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Sakai, Mahiro; Watai, Izumi; Murashima, Sachiyo

2015-05-01

This study evaluated the effect of a skill-mix programme intervention on work engagement in home visiting nurses. A skill-mix programme in which home visiting nurses are assisted by non-nursing workers is assumed to foster home visiting nurses' work engagement. Pre- and post-intervention evaluations of work engagement were conducted using self-administered questionnaires. A skill-mix programme was introduced in the intervention group of home visiting nurses. After 6 months, their pre- and post-intervention work engagement ratings were compared with those of a control group. Baseline questionnaires were returned by 174 home visiting nurses (44 in the intervention group, 130 in the control group). Post-intervention questionnaires were returned by 38 and 97 home visiting nurses from each group. The intervention group's average work engagement scores were 2.2 at baseline and 2.3 at post-intervention; the control group's were 3.3 and 2.6. Generalised linear regression showed significant between-group differences in score changes. The skill-mix programme might foster home visiting nurses' work engagement by improving the quality of care for each client. Future research is needed to explain the exact mechanisms that underlie its effectiveness. In order to improve the efficiency of services provided by home visiting nurses and foster their work engagement, skill-mix programmes might be beneficial. © 2014 John Wiley & Sons Ltd.

A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial

PubMed Central

Hunt, Kate; Wyke, Sally; Gray, Cindy M; Anderson, Annie S; Brady, Adrian; Bunn, Christopher; Donnan, Peter T; Fenwick, Elisabeth; Grieve, Eleanor; Leishman, Jim; Miller, Euan; Mutrie, Nanette; Rauchhaus, Petra; White, Alan; Treweek, Shaun

2015-01-01

Summary Background The prevalence of male obesity is increasing but few men take part in weight loss programmes. We assessed the effect of a weight loss and healthy living programme on weight loss in football (soccer) fans. Methods We did a two-group, pragmatic, randomised controlled trial of 747 male football fans aged 35–65 years with a body-mass index (BMI) of 28 kg/m2 or higher from 13 Scottish professional football clubs. Participants were randomly assigned with SAS (version 9·2, block size 2–9) in a 1:1 ratio, stratified by club, to a weight loss programme delivered by community coaching staff in 12 sessions held every week. The intervention group started a weight loss programme within 3 weeks, and the comparison group were put on a 12 month waiting list. All participants received a weight management booklet. Primary outcome was mean difference in weight loss between groups at 12 months, expressed as absolute weight and a percentage of their baseline weight. Primary outcome assessment was masked. Analyses were based on intention to treat. The trial is registered with Current Controlled Trials, number ISRCTN32677491. Findings 374 men were allocated to the intervention group and 374 to the comparison group. 333 (89%) of the intervention group and 355 (95%) of the comparison group completed 12 month assessments. At 12 months the mean difference in weight loss between groups, adjusted for baseline weight and club, was 4·94 kg (95% CI 3·95–5·94) and percentage weight loss, similarly adjusted, was 4·36% (3·64–5·08), both in favour of the intervention (p<0·0001). Eight serious adverse events were reported, five in the intervention group (lost consciousness due to drugs for pre-existing angina, gallbladder removal, hospital admission with suspected heart attack, ruptured gut, and ruptured Achilles tendon) and three in the comparison group (transient ischaemic attack, and two deaths). Of these, two adverse events were reported as related to participation in the programme (gallbladder removal and ruptured Achilles tendon). Interpretation The FFIT programme can help a large proportion of men to lose a clinically important amount of weight; it offers one effective strategy to challenge male obesity. PMID:24457205

Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial

PubMed Central

Llewellyn-Jones, Robert H; Baikie, Karen A; Smithers, Heather; Cohen, Jasmine; Snowdon, John; Tennant, Chris C

1999-01-01

Objective To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Design Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Setting Population of residential facility in Sydney living in self care units and hostels. Participants 220 depressed residents aged ⩾65 without severe cognitive impairment. Intervention The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Main outcome measure Geriatric depression scale. Results Intention to treat analysis was used. There was significantly more movement to “less depressed” levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). Conclusions The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents. Key messagesLarge numbers of depressed elderly people live in residential care but few receive appropriate managementA population based, multifaceted shared care intervention for late life depression was more effective than routine care in improving depression outcomeThe outcome of late life depression can be improved by enhancing the clinical skills of general practitioners and care staff and by providing depression related health education and activity programmes for residentsThe intervention needs further refining and evaluation to improve its effectiveness and to determine how best to implement it in other residential care settings PMID:10480824

[A communication intervention in autism spectrum disorder by means of the programme 'More than Words'. A case study].

PubMed

Baixauli-Fortea, I; Gascon-Herranz, N; de Carlos-Isla, M; Colomer-Diago, C

2018-03-01

The 'More than Words' programme aims to enable parents to take advantage of day-to-day situations as communication learning settings, through the use of instruction in responsive-type interaction strategies. To describe the effects of this programme on the communication skills of a child with autism spectrum disorder and on the language the parents use to address him. A three-phase design (pre-intervention, intervention and post-intervention) was employed, in which the responsive interactions of the parents and the child's communicative acts were measured. The intervention can modify the parents' communicative style, especially when the family receives guidance from a speech therapist. Nevertheless, the responsive nature of the parents' communication tends to diminish when the intervention finishes. Conversely, the child's communicative acts increase, with a medium-sized effect of the treatment. The 'More than Words' programme can be a good starting point for parents to become familiar with strategies that foster communication with their children who have autism spectrum disorder.

School-based interventions for preventing Hiv, sexually transmitted infections, and pregnancy in adolescents

PubMed Central

Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl

2016-01-01

Background School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). Objectives To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. Search methods We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. Selection criteria We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Data collection and analysis Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. Main results We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in sub-Saharan Africa (Malawi, South Africa, Tanzania, Zimbabwe, and Kenya), one in Latin America (Chile), and two in Europe (England and Scotland). Sexual and reproductive health educational programmes Six trials evaluated school-based educational interventions. In these trials, the educational programmes evaluated had no demonstrable effect on the prevalence of HIV (RR 1.03, 95% CI 0.80 to 1.32, three trials; 14,163 participants; low certainty evidence), or other STIs (herpes simplex virus prevalence: RR 1.04, 95% CI 0.94 to 1.15; three trials, 17,445 participants; moderate certainty evidence; syphilis prevalence: RR 0.81, 95% CI 0.47 to 1.39; one trial, 6977 participants; low certainty evidence). There was also no apparent effect on the number of young women who were pregnant at the end of the trial (RR 0.99, 95% CI 0.84 to 1.16; three trials, 8280 participants; moderate certainty evidence). Material or monetary incentive-based programmes to promote school attendance Two trials evaluated incentive-based programmes to promote school attendance. In these two trials, the incentives used had no demonstrable effect on HIV prevalence (RR 1.23, 95% CI 0.51 to 2.96; two trials, 3805 participants; low certainty evidence). Compared to controls, the prevalence of herpes simplex virus infection was lower in young women receiving a monthly cash incentive to stay in school (RR 0.30, 95% CI 0.11 to 0.85), but not in young people given free school uniforms (Data not pooled, two trials, 7229 participants; very low certainty evidence). One trial evaluated the effects on syphilis and the prevalence was too low to detect or exclude effects confidently (RR 0.41, 95% CI 0.05 to 3.27; one trial, 1291 participants; very low certainty evidence). However, the number of young women who were pregnant at the end of the trial was lower among those who received incentives (RR 0.76, 95% CI 0.58 to 0.99; two trials, 4200 participants; low certainty evidence). Combined educational and incentive-based programmes The single trial that evaluated free school uniforms also included a trial arm in which participants received both uniforms and a programme of sexual and reproductive education. In this trial arm herpes simplex virus infection was reduced (RR 0.82, 95% CI 0.68 to 0.99; one trial, 5899 participants; low certainty evidence), predominantly in young women, but no effect was detected for HIV or pregnancy (low certainty evidence). Authors' conclusions There is a continued need to provide health services to adolescents that include contraceptive choices and condoms and that involve them in the design of services. Schools may be a good place in which to provide these services. There is little evidence that educational curriculum-based programmes alone are effective in improving sexual and reproductive health outcomes for adolescents. Incentive-based interventions that focus on keeping young people in secondary school may reduce adolescent pregnancy but further trials are needed to confirm this. School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents Cochrane researchers conducted a review of the effects of school-based interventions for reducing HIV, sexually transmitted infections (STIs), and pregnancy in adolescents. After searching for relevant trials up to 7 April 2016, they included eight trials that had enrolled 55,157 adolescents. Why is this important and how might school-based programmes work? Sexually active adolescents, particularly young women, are at high risk in many countries of contracting HIV and other STIs. Early unintended pregnancy can also have a detrimental impact on young people's lives. The school environment plays an important role in the development of children and young people, and curriculum-based sexuality education programmes have become popular in many regions of the world. While there is some evidence that these programmes improve knowledge and reduce self-reported risk taking, this review evaluated whether they have any impact on the number of young people that contracted STIs or on the number of adolescent pregnancies. What the research says Sexual and reproductive health education programmes As they are currently configured, educational programmes alone probably have no effect on the number of young people infected with HIV during adolescence (low certainty evidence). They also probably have no effect on the number of young people infected with other STIs (herpes simplex virus: moderate certainty evidence; syphilis: low certainty evidence), or the number of adolescent pregnancies (moderate certainty evidence). Material or monetary incentive-based programmes to promote school attendance Giving monthly cash, or free school uniforms, to encourage students to stay in school may have no effect on the number of young people infected with HIV during adolescence (low certainty evidence). We do not currently know whether monthly cash or free school uniforms will reduce the number of young people infected with other STIs (very low certainty evidence). However, incentives to promote school attendance may reduce the number of adolescent pregnancies (low certainty evidence). Combined educational and incentive-based programmes Based on a single included trial, giving an incentive such as a free school uniform combined with a programme of sexual and reproductive health education may reduce STIs (herpes simplex virus; low certainty evidence) in young women, but no effect was detected for HIV or pregnancy (low certainty evidence). Authors' conclusions There is currently little evidence that educational programmes alone are effective at reducing STIs or adolescent pregnancy. Incentive-based interventions that focus on keeping young people, especially girls, in secondary school may reduce adolescent pregnancy but further high quality trials are needed to confirm this. PMID:27824221

Life Skills in Educational Contexts: Testing the Effects of an Intervention Programme

ERIC Educational Resources Information Center

Gomes, A. Rui; Marques, Brazelina

2013-01-01

This study examined the effects of a training programme on students' acquisition of life skills, life satisfaction, life orientation and expectations about academic achievement. Participants were allocated to either an intervention group ("n"?=?41) that took part in a life skills programme, or a control group ("n"?=?43).…

Study of an Inclusive Intervention Programme in Pictorial Perception with Blind and Sighted Students

ERIC Educational Resources Information Center

Carpio, Carmen; Amérigo, María; Durán, Manuel

2017-01-01

This study evaluates the effectiveness of an intervention programme administered to blind and sighted school students. The students were given information concerning style, author and technique of three paintings from three different artistic periods, as well as guidelines to assess the overall aesthetics of each image. This programme was…

The effect of a short anti-smoking awareness programme on the knowledge, attitude and practice of cigarette smoking among secondary school students in Lagos state, Nigeria.

PubMed

Odukoya, O O; Odeyemi, K A; Oyeyemi, A S; Upadhyay, R P

2014-06-01

This study aimed to assess the effect of a short school-based anti-smoking program on the knowledge, attitude and practice of cigarette smoking among students in secondary schools in Lagos State. A non-randomized, controlled intervention study was done among respondents selected using multi-stage sampling. Baseline data was collected using self-administered questionnaires. An anti-smoking awareness programme was carried out among students in the intervention group using health talks, information leaflets and posters. Post-intervention data collection took place three months later. There were significant increments in the mean knowledge and attitude scores after the intervention. There was however no statistically significant change in the current smoking habits of respondents (4% vs. 3%; p=0.41)in the intervention group. Nevertheless, in the intervention group, the number of never- smokers who reported that they were likely to initiate cigarette smoking within the next year significantly reduced. There was also a significant increase in the proportion of current smokers who desired to quit smoking. Even brief anti-smoking programs of this nature are effective at improving the knowledge and modifying the attitude of the respondents but do not improve smoking habits. It however motivated the desire to quit among current smokers. Health education sessions and periodic anti-smoking programmes should be introduced into the secondary school curriculum. More intensive approaches may be needed to influence the smoking behaviour of adolescent smokers.

An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial.

PubMed

Gouveia, Bruna Raquel; Gonçalves Jardim, Helena; Martins, Maria Manuela; Gouveia, Élvio Rúbio; de Freitas, Duarte Luís; Maia, José António; Rose, Debra J

2016-04-01

This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. Single-blind, randomised controlled trial. University laboratory. Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25). A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, p<0.001, Partial Eta Squared=0.57) and a main effect for time (F (2, 43)=3.76, p=0.03, Partial Eta Squared=0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F (1, 43)=21.90, p<0.001, Partial Eta Squared=0.34) confirmed a clear positive effect of the intervention when compared to the control. This study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. ACTRN12612000301864. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strengthening environmental and educational nutrition programmes in worksite cafeterias and supermarkets in The Netherlands.

PubMed

Steenhuis, I H; Van Assema, P; Glanz, K

2001-03-01

The purpose of this study was to assess conditions for the adoption and continued implementation of different healthy nutrition programmes in worksite cafeterias and supermarkets, i.e. an educational programme and two environmental programmes (a food labelling programme and a food supply programme). Twenty semi-structured interviews were conducted with representatives of worksite cafeterias and supermarkets. Concepts of theories of diffusion were used as a framework for the study. Questions were formulated about the attributes of the innovation, and organizational and personal characteristics that might influence programme adoption and implementation. Results indicated that educational and environmental programmes in both worksite cafeterias and supermarkets should meet specific requirements regarding programme design, methods and materials in order to be adopted and implemented. Besides, some important implementation strategies of the educational and environmental programmes were identified. It is concluded that it seems feasible to conduct educational and environmental intervention programmes in worksite cafeterias and supermarkets, but that certain conditions for adoption and continued implementation have to be met. Based on the implications of this study, the development of an educational programme, a labelling programme and a food supply programme was completed.

Community-based assessment and intervention for early childhood caries in rural El Salvador.

PubMed

Dabiri, Darya; Fontana, Margherita; Kapila, Yvonne; Eckert, George; Sokal-Gutierrez, Karen

2016-08-01

The objectives were to assess early childhood caries (ECC) in rural areas of El Salvador and to investigate the changes in caries and mouth pain in the presence of community-based interventions. This study was a retrospective analysis of de-identified and anonymous data obtained from baseline and four annual follow-up visits that focused on the preventive oral health intervention and nutrition in a convenience sample of children 0-6 years of age. The decayed, missing and filled teeth (dmft) index for primary teeth was used as the survey tool. Caries was defined as a cavitated lesion. Descriptive statistics were used to describe the prevalence of ECC in the sample in relation to age and dmft score. Linear mixed model analysis of variance (ANOVA) and generalised linear mixed effects models were used to compare the pre-intervention and post-intervention outcomes. The prevalence of caries was 58%. Incorporation of a community oral health education and fluoride supplementation programme contributed to significant reductions in caries experience (from 74% to 61%) and mouth pain (from 58% to 39%), in children 3-6 years of age. ECC is a common public health problem in rural El Salvador. In an established community-based maternal-child health programme in El Salvador, there appears to be an association between the incorporation of preventive oral health intervention and improvement in children's oral health and quality of life over time. © 2016 FDI World Dental Federation.

Effectiveness of a 12-week school-based educational preventive programme on weight and fasting blood glucose in "at-risk" adolescents of type 2 diabetes mellitus: Randomized controlled trial.

PubMed

Bani Salameh, Ayman; Al-Sheyab, Nihaya; El-Hneiti, Mamdouh; Shaheen, Abeer; Williams, Leonie M; Gallagher, Robyn

2017-06-01

To assess the effectiveness of a 12-week school-based educational preventive programme for type 2 diabetes by change in weight and fasting blood glucose level in Jordanian adolescents. Sixteen percent of Jordanian adults have obesity-related type 2 diabetes and 5.6% of obese adolescents examined, however one-third unexamined. Rates in Arabic countries will double in 20 years, but this can be prevented and reversed by controlling obesity. A single-blinded randomized controlled trial was conducted in 2 unisex high schools in Irbid, Jordan, in 2012. Intervention and control participants, aged 12 to 18 years, were visibly overweight/obese. They were randomly allocated to the intervention (n = 205) or control (n = 196) groups. At-risk students were assessed before and after the 12-week intervention, for change in weight and fasting blood glucose level following preventive instruction and parent-supported changes. Mean age of participants was 15.3 years with equal percentages of both males (49.4%) and females. Post intervention, the intervention group, demonstrated statistically significant reductions: mean difference of 3.3 kg in weight (P < .000) and 1.36 mg/dL (0.075 mmol/L) in fasting blood glucose (P < .000). School-based early prevention intervention effectively reduced weight and fasting blood glucose in Jordanian at-risk adolescents. © 2017 John Wiley & Sons Australia, Ltd.

Improving maternal and child healthcare programme using community-participatory interventions in Ebonyi State Nigeria.

PubMed

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Urochukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

2014-10-01

In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government's FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers' groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities' health.

Improving maternal and child healthcare programme using community-participatory interventions in Ebonyi State Nigeria

PubMed Central

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Urochukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

2014-01-01

In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government’s FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers’ groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities’ health. PMID:25337602

Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery.

PubMed

Valkenet, K; Trappenburg, J C A; Hulzebos, E H; van Meeteren, N L U; Backx, F J G

2017-09-01

Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Complementary analyses of a published randomised controlled trial. The initial trial included patients awaiting CABG surgery at a Dutch university hospital. The secondary analyses used data from the initial trial for patients who had completed at least one quality-of-life questionnaire. Participants were allocated at random to the intervention group or the usual care group. The intervention group followed a home-based pre-operative inspiratory muscle training programme. Quality of life was measured at five time points. Between-group differences in quality-of-life scores were analysed using mixed linear modelling. The secondary analyses used data for 235 patients. In line with the initial trial, pneumonia and length of hospital stay were decreased significantly in the intervention group. The time courses for all patients showed significant improvements in quality of life after surgery compared with baseline. No significant differences in quality of life were observed over time between the two groups. Despite decreased incidence of pneumonia and length of hospital stay in the intervention group, this study did not find any improvements in quality of life due to the pre-operative home-based inspiratory muscle training programme. Clinical trial registration number ISRCTN17691887. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Effect of comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, medical costs and quality of life: A cost-effectiveness analysis.

PubMed

Frederix, Ines; Hansen, Dominique; Coninx, Karin; Vandervoort, Pieter; Vandijck, Dominique; Hens, Niel; Van Craenenbroeck, Emeline; Van Driessche, Niels; Dendale, Paul

2016-05-01

Notwithstanding the cardiovascular disease epidemic, current budgetary constraints do not allow for budget expansion of conventional cardiac rehabilitation programmes. Consequently, there is an increasing need for cost-effectiveness studies of alternative strategies such as telerehabilitation. The present study evaluated the cost-effectiveness of a comprehensive cardiac telerehabilitation programme. This multi-centre randomized controlled trial comprised 140 cardiac rehabilitation patients, randomized (1:1) to a 24-week telerehabilitation programme in addition to conventional cardiac rehabilitation (intervention group) or to conventional cardiac rehabilitation alone (control group). The incremental cost-effectiveness ratio was calculated based on intervention and health care costs (incremental cost), and the differential incremental quality adjusted life years (QALYs) gained. The total average cost per patient was significantly lower in the intervention group (€2156 ± €126) than in the control group (€2720 ± €276) (p = 0.01) with an overall incremental cost of €-564.40. Dividing this incremental cost by the baseline adjusted differential incremental QALYs (0.026 QALYs) yielded an incremental cost-effectiveness ratio of €-21,707/QALY. The number of days lost due to cardiovascular rehospitalizations in the intervention group (0.33 ± 0.15) was significantly lower than in the control group (0.79 ± 0.20) (p = 0.037). This paper shows the addition of cardiac telerehabilitation to conventional centre-based cardiac rehabilitation to be more effective and efficient than centre-based cardiac rehabilitation alone. These results are useful for policy makers charged with deciding how limited health care resources should best be allocated in the era of exploding need. © The European Society of Cardiology 2015.

Hear here: children with hearing loss learn words by listening.

PubMed

Lew, Joyce; Purcell, Alison A; Doble, Maree; Lim, Lynne H

2014-10-01

Early use of hearing devices and family participation in auditory-verbal therapy has been associated with age-appropriate verbal communication outcomes for children with hearing loss. However, there continues to be great variability in outcomes across different oral intervention programmes and little consensus on how therapists should prioritise goals at each therapy session for positive clinical outcomes. This pilot intervention study aimed to determine whether therapy goals that concentrate on teaching preschool children with hearing loss how to distinguish between words in a structured listening programme is effective, and whether gains in speech perception skills impact on vocabulary and speech development without them having to be worked on directly in therapy. A multiple baseline across subjects design was used in this within-subject controlled study. 3 children aged between 2:6 and 3:1 with moderate-severe to severe-profound hearing loss were recruited for a 6-week intervention programme. Each participant commenced at different stages of the 10-staged listening programme depending on their individual listening skills at recruitment. Speech development and vocabulary assessments were conducted before and after the training programme in addition to speech perception assessments and probes conducted throughout the intervention programme. All participants made gains in speech perception skills as well as vocabulary and speech development. Speech perception skills acquired were noted to be maintained a week after intervention. In addition, all participants were able to generalise speech perception skills learnt to words that had not been used in the intervention programme. This pilot study found that therapy directed at listening alone is promising and that it may have positive impact on speech and vocabulary development without these goals having to be incorporated into a therapy programme. Although a larger study is necessary for more conclusive findings, the results from this preliminary study are promising in support of emphasise on listening skills within auditory-verbal therapy programmes. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

Impact of a child stimulation intervention on early child development in rural Peru: a cluster randomised trial using a reciprocal control design

PubMed Central

Hartinger, Stella Maria; Lanata, Claudio Franco; Hattendorf, Jan; Wolf, Jennyfer; Gil, Ana Isabel; Obando, Mariela Ortiz; Noblega, Magaly; Verastegui, Hector; Mäusezahl, Daniel

2017-01-01

Objective Stimulation in early childhood can alleviate adverse effects of poverty. In a community-randomised trial, we implemented 2 home-based interventions, each serving as an attention control for the other. One group received an integrated household intervention package (IHIP), whereas the other group received an early child development (ECD) intervention. The primary objective of the study was to evaluate the effect of IHIP on diarrhoea and respiratory infections, the details of which are described elsewhere. Here, we present the impact of the ECD intervention on early childhood development indicators. Methods In this non-blinded community-randomised trial, an ECD intervention, adapted from the Peruvian government's National Wawa Wasi ECD programme, was implemented in 25 rural Peruvian Andean communities. We enrolled 534 children aged 6–35 months, from 50 communities randomised 1:1 into ECD and IHIP communities. In ECD communities, trained fieldworkers instructed mothers every 3 weeks over the 12 months study, to stimulate and interact with their children and to use standard programme toys. IHIP communities received an improved stove and hygiene promotion. Using a nationally validated ECD evaluation instrument, all children were assessed at baseline and 12 months later for overall performance on age-specific developmental milestones which fall into 7 developmental domains. Findings At baseline, ECD-group and IHIP-group children performed similarly in all domains. After 12 months, data from 258 ECD-group and 251 IHIP-group children could be analysed. The proportion of children scoring above the mean in their specific age group was significantly higher in the ECD group in all domains (range: 12–23%-points higher than IHIP group). We observed the biggest difference in fine motor skills (62% vs 39% scores above the mean, OR: 2.6, 95% CI 1.7 to 3.9). Conclusions The home-based ECD intervention effectively improved child development overall across domains and separately by investigated domain. Home-based strategies could be a promising component of poverty alleviation programmes seeking to improve developmental outcomes among rural Peruvian children. Trial registration number ISRCTN28191222; results. PMID:27612978

Systematic review of the economic evidence on home visitation programmes for vulnerable pregnant women.

PubMed

Stamuli, Eugena; Richardson, Gerry; Duffy, Steven; Robling, Michael; Hood, Kerry

2015-09-01

A systematic review of the economic evidence on home visitation programmes for young or vulnerable pregnant women was undertaken to provide a summary of the existing literature of these interventions. Relevant studies were identified from a number of sources including large databases, free text search on Google Scholar as well as hand-searching of the obtained references. The search yielded a large number of papers, of which 12 were considered appropriate to be included in the review. These were either full or partial economic evaluations: four studies were cost-benefit analyses, three were cost-effectiveness analyses and the remaining were costing studies. The review highlighted the paucity of good quality economic evaluations in the area of home visiting programmes for young or vulnerable pregnant women. Methods varied substantially between the studies spanning from differing data sources (e.g. single randomized trials or meta-analyses) to different perspectives taken, cost items and outcomes included in the analysis. It is difficult to establish a coherent body of economic evidence for these interventions and draw a firm conclusion on their value for money. Home visiting programmes are complex interventions, with impact on the lives of mothers and their children. The funding of such interventions should be based on rigorous effectiveness and economic evidence. There is a need for well-designed economic evaluations which will follow the appropriate methodological guidelines and also take into account the complexity of such interventions. These analyses should preferably consider multiple perspectives and allow for the fact that the majority of the benefits accrue in the long-term future. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A controlled clinical evaluation of the Parents Plus Children's Programme for parents of children aged 6-12 with mild intellectual disability in a school setting.

PubMed

Hand, Ailish; Raghallaigh, Ciara Ní; Cuppage, Jennifer; Coyle, Sadhbh; Sharry, John

2013-10-01

The aim of this study was to evaluate the effectiveness of the parent training, Parents Plus Children's Programme (PPCP) as an intervention for parents of children with mild intellectual disabilities. Participants were parents of children, aged six to 12, attending a special school for children with mild general learning disability (n = 29). Minor programme adaptations were made. Pre and post-assessment included the Strengths and Difficulties Questionnaire, the Parenting Stress Index, the Kansas Parent Satisfaction Scale and parent identified personal and child-related goals. A significant reduction in clinical range scores for treatment group participants (n = 16) was observed. Conversely, clinical range scores for control group participants (n = 13) increased, or remained elevated. These preliminary results suggest that PPCP may be successfully delivered as a routine community-based intervention and aid to prevent and reduce behavioural problems, reduce parent stress and increase parent confidence and satisfaction. Further investigation of programme effectiveness for parents of children with developmental disability is warranted.