Developing leadership capacity for guideline use: a pilot cluster randomized control trial.

PubMed

Gifford, Wendy A; Davies, Barbara L; Graham, Ian D; Tourangeau, Ann; Woodend, A Kirsten; Lefebre, Nancy

2013-02-01

The importance of leadership to influence nurses' use of clinical guidelines has been well documented. However, little is known about how to develop and evaluate leadership interventions for guideline use. The purpose of this study was to pilot a leadership intervention designed to influence nurses' use of guideline recommendations when caring for patients with diabetic foot ulcers in home care nursing. This paper reports on the feasibility of implementing the study protocol, the trial findings related to nursing process outcomes, and leadership behaviors. A mixed methods pilot study was conducted with a post-only cluster randomized controlled trial and descriptive qualitative interviews. Four units were randomized to control or experimental groups. Clinical and management leadership teams participated in a 12-week leadership intervention (workshop, teleconferences). Participants received summarized chart audit data, identified goals for change, and created a team leadership action. Criteria to assess feasibility of the protocol included: design, intervention, measures, and data collection procedures. For the trial, chart audits compared differences in nursing process outcomes. 8-item nursing assessments score. Secondary outcome: 5-item score of nursing care based on goals for change identified by intervention participants. Qualitative interviews described leadership behaviors that influenced guideline use. Conducting this pilot showed some aspects of the study protocol were feasible, while others require further development. Trial findings observed no significant difference in the primary outcome. A significant increase was observed in the 5-item score chosen by intervention participants (p = 0.02). In the experimental group more relations-oriented leadership behaviors, audit and feedback and reminders were described as leadership strategies. Findings suggest that a leadership intervention has the potential to influence nurses' use of guideline recommendations, but further work is required to refine the intervention and outcome measures. A taxonomy of leadership behaviors is proposed to inform future research. © 2012 The authors. World Views on Evidence-Based Nursing © Sigma Theta Tau International.

Gender-Focused HIV and Pregnancy Prevention for School-Going Adolescents: The Mpondombili Pilot Intervention in KwaZulu-Natal, South Africa

PubMed Central

Harrison, Abigail; Hoffman, Susie; Mantell, Joanne E.; Smit, Jennifer A.; Leu, Cheng-Shiun; Exner, Theresa M.; Stein, Zena A.

2016-01-01

This pilot study evaluated a 15 session classroom intervention for HIV and pregnancy prevention among grade 8–10 boys and girls (ages 14–17) in rural South Africa, guided by gender-empowerment theory and implemented by teachers, nurses, and youth peer educators. Pre- and post-intervention surveys included 933 male and female students in two intervention and two comparison schools. Main outcome: condom use at last sex; secondary outcomes: partner communication; gender beliefs and values; perceived peer behaviors; self-efficacy for safer sex. At five months post-intervention, change in condom use did not differ between intervention and comparison schools. Intervention school youth had greater increases in self-efficacy for unsafe sex refusal [OR=1.61; 95% CI=1.01, 2.57] and condom use [OR=1.76; 95% CI=1.07, 2.89], partner communication [OR=2.42; 95% CI=1.27, 4.23], and knowledge of HIV testing opportunities [OR=1.76; 95% CI=1.08, 2.87]. This gender-focused pilot intervention increased adolescents’ self-efficacy and partner communication, and has potential to improve preventive behaviors. PMID:27642267

Behavioral Activation for Depressed Teens: A Pilot Study

ERIC Educational Resources Information Center

Ritschel, Lorie A.; Ramirez, Cynthia L.; Jones, Meredith; Craighead, W. Edward

2011-01-01

Behavioral activation (BA) is a psychosocial intervention that has shown promising treatment outcome results with depressed adults. The current pilot study evaluated a version of BA adapted for depressed adolescents. Six teens (3 male, 3 female, ages 14-17) who met criteria for major depressive disorder participated in the study. Participants were…

The Treatment of Maladaptive Shame in Borderline Personality Disorder: A Pilot Study of "Opposite Action"

ERIC Educational Resources Information Center

Rizvi, Shireen L.; Linehan, Marsha M.

2005-01-01

This study sought to pilot test a short-term intervention for maladaptive shame in borderline personality disorder (BPD) based on the skill of "opposite action" from dialectical behavior therapy. Five women with BPD were treated with the intervention using a single-subject, multiple-baseline design. Results indicate that, although state ratings of…

Using Multi-Component Consultation to Increase the Integrity with Which Teachers Implement Behavioral Classroom Interventions: A Pilot Study

ERIC Educational Resources Information Center

Owens, Julie Sarno; Coles, Erika K.; Evans, Steven W.; Himawan, Lina K.; Girio-Herrera, Erin; Holdaway, Alex S.; Zoromski, Allison K.; Schamberg, Terah; Schulte, Ann

2017-01-01

The goal of this pilot study was to evaluate the effectiveness of a multi-component consultation package in improving teachers' classroom management skills, particularly among teachers with lower baseline levels of knowledge, skills, and intervention-supportive beliefs. Participants were 58 elementary school teachers (93% female; 50% Non-Hispanic…

A Tailored Wellness Intervention for College Students Using Internet-Based Technology: A Pilot Study

ERIC Educational Resources Information Center

Quartiroli, Alessandro; Zizzi, Sam

2012-01-01

The purpose of this study was to develop and pilot a theory-based, computer-tailored feedback system for healthy behaviors for college students at a large, public university, aiming to enhance student wellness. A total of 1300 college students were contacted. Sixty-two students completed the eight week intervention. The participants were randomly…

Efficacy of a behavioral intervention for reducing sedentary behavior in persons with multiple sclerosis: a pilot examination.

PubMed

Klaren, Rachel E; Hubbard, Elizabeth A; Motl, Robert W

2014-11-01

Sitting time (ST), a form of sedentary behavior, has been identified as a highly prevalent risk factor for multiple sclerosis (MS)-related morbidity. There is limited information on the efficacy of behavioral interventions for reducing ST in persons with MS. To examine the efficacy of a behavioral intervention for reducing ST in persons with MS in a pilot RCT. Seventy MS patients were randomly assigned to intervention and waitlist control conditions. The behavioral intervention was delivered April-September 2012 via the Internet and consisted of a dedicated website and one-on-one Skype video chats that taught participants the skills, techniques, and strategies for reducing sedentary behavior based on social cognitive theory. ST was measured by questions on the abbreviated International Physical Activity Questionnaire (IPAQ) before and after the 6-month RCT. Data were analyzed in SPSS, version 21.0 in March 2014. ANCOVA was performed on post-intervention scores controlling for pre-intervention values using an intent-to-treat analysis. The group main effect was statistically significant (F[1, 67]=4.03, p<0.05, η²=0.06) and yielded a parameter estimate of 98.9 (SE=49.3, t=2.01, p<0.05). The adjusted mean scores for intervention and control groups were 429.2 (201.2) and 528.2 (200.7) minutes of ST, respectively (d=0.49). We provide the first data on the efficacy of a behavioral intervention for reducing ST in MS patients. This highlights the importance of designing and testing the effect of behavioral interventions that reduce ST on secondary outcomes such as function, symptoms, quality of life, and health status in persons with MS. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Using Family-Focused Garden, Nutrition, and Physical Activity Programs To Reduce Childhood Obesity: The Texas! Go! Eat! Grow! Pilot Study.

PubMed

Spears-Lanoix, Erica C; McKyer, E Lisako J; Evans, Alexandra; McIntosh, William Alex; Ory, Marcia; Whittlesey, Lisa; Kirk, Alice; Hoelscher, Deanna M; Warren, Judith L

2015-12-01

The TEXAS! GROW! EAT! GO! (TGEG) randomized, control trial is a 5-year study to measure the impact of a nutrition and gardening intervention and/or physical activity (PA) intervention on the weight status of third-grade students. This article describes the results of the pilot study to test the feasibility of two interventions and test the measures to be used in the main trial. The pilot study was conducted in one school with third-grade students and their parents or guardians. The Junior Master Gardner (JMG) and Walk Across Texas (WAT) interventions were implemented over a 5-month period in three third-grade classrooms during spring 2012. The respective interventions focused on improving healthy eating and PA behaviors of children and their families. Baseline and immediate post-test data were collected from students and parents/guardians to measure four child, four parent, and four parent-child interaction behaviors. Process data regarding implementation were also collected from teachers and school administration. Forty-four students and 34 parents or guardians provided both pre- and post-test data. Paired-sample t-tests showed statistically significant changes in student knowledge, vegetable preferences, vegetable consumption, and home food availability (all p < 0.05). At baseline, participants' weight status categories included 57% obese, 10% overweight, and 31% normal weight. Postintervention, weight status categories included 39% obese, 16% overweight, and normal 45%. Data collected from teachers indicated high levels of implementation fidelity. Implementation of both interventions occurred at a very high fidelity level, which led to positive changes in BMI status, and several dietary and PA behaviors. Although the pilot study indicated feasibility of the two interventions for school implementation, results guided revisions to the TGEG program and its survey instruments.

Healthy Choices: Motivational Enhancement Therapy for Health Risk Behaviors in HIV-Positive Youth

ERIC Educational Resources Information Center

Naar-King, Sylvie; Wright, Kathryn; Parsons, Jeffrey T.; Frey, Maureen; Templin, Thomas; Lam, Phebe; Murphy, Debra

2006-01-01

This study piloted a brief individual motivational intervention targeting multiple health risk behaviors in HIV-positive youth aged 16-25. Interviews about sexual behavior and substance use and viral load testing were obtained from 51 HIV-positive youth at baseline and post intervention. Youth were randomized to receive a four-session motivational…

Pilot trial of a parenting and self-care intervention for HIV-positive mothers: the IMAGE program.

PubMed

Murphy, Debra A; Armistead, Lisa; Payne, Diana L; Marelich, William D; Herbeck, Diane M

2017-01-01

A pilot study was conducted to assess the effects of the IMAGE pilot intervention (Improving Mothers' parenting Abilities, Growth, and Effectiveness) on mothers living with HIV (MLH). Based on Fisher and Fisher's IMB model [1992. Changing AIDS risk behavior. Psychological Bulletin, 111, 455-474], the intervention focused on self-care and parenting behavior skills of MLH that affect maternal, child, and family outcomes. A randomized pre-test-post-test two-group design with repeated assessments was used. MLH (n = 62) and their children aged 6-14 (n = 62; total N = 124) were recruited for the trial and randomized to the theory-based skills training condition or a standard care control condition. Assessments were conducted at baseline with follow-ups at 3, 6, and 12 months. Maternal, child, and family outcomes were assessed. Results show significant effects of the intervention for improving parenting practices for mothers. The intervention also improved family outcomes, and showed improvements in the parent-child relationship. IMAGE had a positive impact on parenting behaviors, and on maternal, child, and family outcomes. Given MLH can be challenged by their illness and also live in under-resourced environments, IMAGE may be viewed as a viable way to improve quality of life and family outcomes.

Pilot Testing of the EIT-4-BPSD Intervention.

PubMed

Resnick, Barbara; Kolanowski, Ann; Van Haitsma, Kimberly; Boltz, Marie; Galik, Elizabeth; Bonner, Alice; Vigne, Erin; Holtzman, Lauren; Mulhall, Paula M

2016-11-01

Behavioral and psychological symptoms of dementia are common in nursing home residents, and the Centers for Medicare and Medicaid Services now require that nonpharmacological interventions be used as a first-line treatment. Few staff know how to implement these interventions. The purpose of this study was to pilot test an implementation strategy, Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD), which was developed to help staff integrate behavioral interventions into routine care. The EIT-4-BPSD was implemented in 2 nursing homes, and 21 residents were recruited. A research nurse facilitator worked with facility champions and a stakeholder team to implement the 4 steps of EIT-4-BPSD. There was evidence of reach to all staff; effectiveness with improvement in residents' quality of life and a decrease in agitation; adoption based on the environment, policy, and care plan changes; and implementation and plans for maintenance beyond the 6-month intervention period. © The Author(s) 2016.

Impact of a pilot walking school bus intervention on children's pedestrian safety behaviors: a pilot study

USDA-ARS?s Scientific Manuscript database

Walking school buses (WSB) increased children's physical activity, but impact on pedestrian safety behaviors (PSB) is unknown. We tested the feasibility of a protocol evaluating changes to PSB during a WSB program. Outcomes were school-level street crossing PSB prior to (Time 1) and during weeks 4–5...

Promoting Positive Learning in Australian Students Aged 10- to 12-Years-Old Using Attribution Retraining and Cognitive Behavioral Therapy: A Pilot Study

ERIC Educational Resources Information Center

Chodkiewicz, Alicia R; Boyle, Christopher

2016-01-01

This study piloted an intervention using attribution retraining and cognitive behavioral therapy techniques to promote positive learning experiences and outcomes for students. This research is an important step to revitalise the dwindling field of attribution retraining research by assessing whether these techniques effectively improve student…

Evaluation of a Theory-Based Farm to School Pilot Intervention

ERIC Educational Resources Information Center

Landry, Alicia S.; Butz, Rebecca; Connell, Carol L.; Yadrick, Kathy

2017-01-01

Purpose/Objectives: The purpose of this study was to evaluate behaviors related to fruit and vegetable intake before and after implementation of a theory-based Farm to School pilot intervention in a rural school. Methods: Students in fifth grade at a rural elementary school were asked to complete pre- and post-test measures based on the Theory of…

Physical Activity Intervention for Older Adults with Intellectual Disability: Report on a Pilot Project

ERIC Educational Resources Information Center

Podgorski, Carol Ann; Kessler, Karen; Cacia, Barbara; Peterson, Derick R.; Henderson, C. Michael

2004-01-01

A 12-week pilot project on physical activity was introduced in a day habilitation setting to a group of 12 older adults with intellectual disability and a variety of physical and behavioral conditions. Our purpose was to determine whether (a) this intervention would positively impact physical function in this population, (b) consumers would choose…

Worksite Health Program Promoting Changes in Eating Behavior and Health Attitudes.

PubMed

Mache, Stefanie; Jensen, Sarah; Jahn, Reimo; Steudtner, Mirko; Ochsmann, Elke; Preuß, Geraldine

2015-11-01

The aim of the present study was to evaluate the effectiveness of a worksite multicomponent health promotion intervention on eating behavior and attitudes, changes in body weight, and readiness to make eating behavior changes among workers over a 12-month intervention period. A total of 3,095 workers of a logistic company participated in a quasi-experimental comparison group study design. The intervention group received a multicomponent health training. Two of the main elements of the multicomponent intervention were physical exercise training and nutrition counseling/training. During the pilot year, participants completed a survey at baseline and again after 12 months to assess physical activity-, health-, and diet-related factors. Results showed that participants' body weight did not significantly decrease in the intervention group. Mean weight loss in the intervention groups was 0.5 kg (body mass index = 0.1 kg/m(2)). Eating behaviors in the intervention group improved more than in the comparison group. Some positive intervention effects were observed for the cognitive factors (e.g., changes in eating attitudes). Baseline readiness to change eating behavior was significantly improved over time. We demonstrated initial results of a long-term multicomponent worksite health promotion program with regard to changes in body weight, eating behavior, and attitudes. This evaluation of a 12-month pilot study suggests that a worksite health promotion program may lead to improvements in nutritional health behaviors for a number of workers. An investigation of long-term effects of this multicomponent intervention is strongly recommended. © 2015 Society for Public Health Education.

Developing the Moti-4 intervention, assessing its feasibility and pilot testing its effectiveness.

PubMed

Dupont, Hans B; Lemmens, Paul; Adriana, Gerald; van de Mheen, Dike; de Vries, Nanne K

2015-05-21

The Moti-4 intervention was developed to prevent addiction and other health problems among vulnerable adolescent cannabis users. The aims of Moti-4 are to reduce the use of cannabis among adolescents and to encourage their motivation to change their behavior. Intervention Mapping, a systematic approach to developing theory- and evidence-based interventions, was used to develop a protocol for the intervention. The process of developing the intervention also used the method of responsive evaluation to explore the opinions of the immediate target group and intermediaries (N = 31). Feasibility was assessed in 9 interviews and analyzed in grids. A quantitative pilot analysis involving a pre- and post-assessment in 31 subjects assessed whether the intervention was able to reduce drug use and would change intentions to change drug use behavior. Using Intervention Mapping resulted in the development of a substantial four-session intervention with a clear manual and training for prevention workers. The choice of 12 consecutive steps was based on the Trans Theoretical Model of Behavior Change, Motivational Interviewing, Theory of Planned Behavior and the Self Determination Theory. Positive aspects of working with Moti-4 were assessed in a feasibility study. Criticism by users has led to improvements to the manual. In the pilot study, the average weekly amount spent on cannabis decreased significantly from an average € 17.77 to € 11,95 in the period after the intervention, with a medium effect size (d = 0.36). Likewise, a significant decrease was found in the frequency of use during the past week, from 4.3 to 2.4 (d = .52). As to motivation to change, a statistically significant increase was found in planning (d = .44) and a large increase in the desire to stop (d = .76). The change in the motivation to smoke less cannabis was small. Intervention Mapping proved to be a useful approach for the development of the intervention, using a productive combination of theory and community knowledge. The pre- and post-test pilot study showed that the intervention generally brought about a considerable positive change in the two principle targets, cannabis use and motivation. There is a need for further (controlled) research into its effectiveness and implementation as a standard method in addiction prevention services.

Pilot Test of an Integrated Sexual Risk Reduction Intervention for Women with a History of Childhood Sexual Abuse.

PubMed

Senn, Theresa E; Braksmajer, Amy; Urban, Marguerite A; Coury-Doniger, Patricia; Carey, Michael P

2017-11-01

HIV and childhood sexual abuse (CSA) are intersecting public health problems for women. We pilot tested an integrated sexual risk reduction intervention for women with a history of CSA that addressed both the consequences of CSA [based on the Traumagenic Dynamics (TD) framework] and the antecedents of sexual risk behavior (based on the Information-Motivation-Behavioral Skills [IMB] model). Women with a history of CSA who were attending a public STI clinic (n = 84) were randomly assigned to a five-session integrated TD/IMB (experimental) group intervention or to a time-matched IMB-guided sexual risk reduction (control) group intervention. Preliminary findings indicated that women in the integrated TD/IMB intervention reduced their average number of episodes of unprotected sex with a primary partner, their alcohol use, and their likelihood of being in a violent relationship, relative to women in the IMB-only group. Our findings suggest that sexual risk reduction interventions that address both the consequences of CSA and the antecedents of sexual risk behavior may be efficacious in reducing sexual risk behavior among women who were sexually abused.

The art and science of patient storytelling-harnessing narrative communication for behavioral interventions: the ACCE project.

PubMed

Houston, Thomas K; Cherrington, Andrea; Coley, Heather L; Robinson, Kimberly M; Trobaugh, John A; Williams, Jessica H; Foster, Pamela H; Ford, Daniel E; Gerber, Ben S; Shewchuk, Richard M; Allison, Jeroan J

2011-08-01

Narrative communication is an emerging form of persuasive communication used in health education to solicit actual patient stories. Eliciting a narrative is an open-ended process and may or may not map to desired intervention objectives or underlying behavioral constructs. In addition, incorporating actual, unscripted narratives into multimedia interventions is challenging. The authors evaluated a protocol of editing narratives for a multimedia intervention to promote smoking cessation in the African American community that maintains fidelity to the original message and was related to behavioral constructs from social cognitive theory. The authors used four steps: (a) narrative collection (videotaping), (b) narrative review (rating of content), (c) narrative editing (documentary style), and (d) pilot testing (usability and assessment of transportation). The authors videotaped 50 personal smoking cessation narratives. After coding for presence of theoretical constructs, perceived risks of smoking (present in 53% of narratives) was the most common related behavioral construct. Four narratives were chosen for inclusion in the DVD. Pilot testing showed viewers reported high level of transportation into the narrative. The authors found that some behavioral constructs were rare and difficult to solicit in this population but that the final product was engaging to the viewers. Lessons learned may be useful for other video-based behavioral interventions that incorporate personal narratives.

Building youths' resilience within a psychiatric outpatient setting: results from a pilot clinical intervention project.

PubMed

Waaktaar, Trine; Christie, Helen J; Borge, Anne Inger Helmen; Torgersen, Svenn

2004-02-01

The relevance of resilience research for clinical practice has not yet been established. In this intervention pilot study, the aim was to explore how group work based on enhancing the participants' creativity, self-efficacy, active coping, and sense of continuity could be utilized within a clinical context for adolescents with stressful background experiences. 31 participants and 24 parents completed pre-, post-, and 1-yr. follow-up assessments of the youths' behavior difficulties, as well as depression, positive life attitude, coping, and prosocial behavior. Apart from a drop in self-rated prosocial behavior, no significant treatment effects were found. Implications for clinical practice and research are indicated.

Development of a tobacco cessation intervention for Alaska Native youth

PubMed Central

Patten, Christi A.; Fadahunsi, Oluwole; Hanza, Marcelo; Smith, Christina M.; Hughes, Christine A.; Brockman, Tabetha A.; Boyer, Rahnia; Decker, Paul A.; Luger, Elizabeth; Sinicrope, Pamela S.; Offord, Kenneth P.

2013-01-01

Tobacco cessation treatments have not been evaluated among Alaska Native (AN) adolescents. This pilot study evaluated the feasibility and acceptability of a targeted cessation intervention developed for AN youth. Intervention components were informed by prior focus groups assessing treatment preferences among AN youth, a social cognitive theoretical framework and feedback obtained from a teen advisory group. The intervention consisted of a weekend program where youth traveled by small airplane from their villages to stay overnight with other adolescents who quit tobacco use together. The program included recreational activities, talking circles, personal stories from elders and teen advisors, and cognitive behavioral counseling. Two intervention pilots were conducted from October 2010 to January 2011 using a non-randomized, uncontrolled study design with assessments at baseline and six-week follow-up. One village in Western Alaska was selected for each pilot with a targeted enrollment of 10 adolescents each. Participants were recruited for each pilot within five days, but recruitment challenges and ‘‘lessons learned’’ are described. The first pilot enrolled nine adolescents (all female) aged 13–16 years; all nine attended the intervention program and 78% (7/9) completed follow-up. The second pilot enrolled 12 adolescents (eight females, four males) aged 12–17 years, of which seven attended the intervention program. Six of these seven participants (86%) completed follow-up. In both pilots, participants rated the intervention as highly acceptable. A targeted cessation intervention was feasible and acceptable to AN youth. The intervention will be tested for efficacy in a subsequent randomized controlled trial. PMID:24058327

Positive Effects of Promoting Prosocial Behavior in Early Adolescence: Evidence from a School-Based Intervention

ERIC Educational Resources Information Center

Caprara, Gian Vittorio; Kanacri, Bernadette Paula Luengo; Gerbino, Maria; Zuffianò, Antonio; Alessandri, Guido; Vecchio, Giovanni; Caprara, Eva; Pastorelli, Concetta; Bridglall, Beatrice

2014-01-01

The purpose of this study was to evaluate the effects of a pilot school-based intervention called CEPIDEA, designed to promote prosocial behavior in early adolescence. The study took place in a middle school located in a small city near Rome. The intervention group included 151 students (52.3% males; M[subscript age] = 12.4), and the control group…

Better exercise adherence after treatment for cancer (BEAT Cancer) study: Rationale, design, and methods

PubMed Central

Rogers, Laura Q.; McAuley, Edward; Anton, Philip M.; Courneya, Kerry S.; Vicari, Sandra; Hopkins-Price, Patricia; Verhulst, Steven; Mocharnuk, Robert; Hoelzer, Karen

2011-01-01

Most breast cancer survivors do not engage in regular physical activity. Our physical activity behavior change intervention for breast cancer survivors significantly improved physical activity and health outcomes post-intervention during a pilot, feasibility study. Testing in additional sites with a larger sample and longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in physical activity and social cognitive theory constructs, enhancing our potential for testing mechanisms mediating physical activity behavior change. Here, we report the rationale, design, and methods for a two-site, randomized controlled trial comparing the effects of the BEAT Cancer physical activity behavior change intervention to usual care on short and longer term physical activity adherence among breast cancer survivors. Secondary aims include examining social cognitive theory mechanisms of physical activity behavior change and health benefits of the intervention. Study recruitment goal is 256 breast cancer survivors with a history of ductal carcinoma in situ or Stage I, II, or IIIA disease who have completed primary cancer treatment. Outcome measures are obtained at baseline, 3 months (i.e., immediately post-intervention), 6 months, and 12 months and include physical activity, psychosocial factors, fatigue, sleep quality, lower extremity joint dysfunction, cardiorespiratory fitness, muscle strength, and waist-to-hip ratio. Confirming behavior change effectiveness, health effects, and underlying mechanisms of physical activity behavior change interventions will facilitate translation to community settings for improving the health and well-being of breast cancer survivors. PMID:21983625

Training Community Mental Health Therapists to Deliver a Package of Evidence-Based Practice Strategies for School-Age Children with Autism Spectrum Disorders: A Pilot Study

PubMed Central

Drahota, Amy; Stadnick, Nicole

2012-01-01

Research on moving evidence-based practice (EBP) intervention strategies to community service settings for children with autism spectrum disorders (ASD) is urgently needed. The current pilot study addresses this need by examining the feasibility, acceptability and preliminary outcomes of training therapists practicing in community mental health (CMH) clinics to deliver a package of EBP strategies aimed to reduce challenging behaviors in school-age children with ASD. Results indicate that CMH therapists participated in both initial and ongoing training, were able to deliver the intervention with fidelity, and perceived the intervention strategies as useful. Parents participated in almost all sessions with their children and remained in therapy when therapists delivered the intervention. Meaningful reductions in child problem behaviors occurred over 5 months providing promising support for the intervention. PMID:22102293

Implementation of a Self-Monitoring Application to Improve On-Task Behavior: A High-School Pilot Study

ERIC Educational Resources Information Center

Wills, Howard P.; Mason, Benjamin A.

2014-01-01

Technological innovations offer promise for improving intervention implementation in secondary, inclusive classrooms. A withdrawal design was employed with two high-school students in order to assess the effectiveness of a technologically delivered, self-monitoring intervention in improving on-task behavior in a science classroom. Two students…

Using Randomized Controlled Trials to Evaluate Interventions for Releasing Prisoners

ERIC Educational Resources Information Center

Pettus-Davis, Carrie; Howard, Matthew Owen; Dunnigan, Allison; Scheyett, Anna M.; Roberts-Lewis, Amelia

2016-01-01

Randomized controlled trials (RCTs) are rarely used to evaluate social and behavioral interventions designed for releasing prisoners. Objective: We use a pilot RCT of a social support intervention (Support Matters) as a case example to discuss obstacles and strategies for conducting RCT intervention evaluations that span prison and community…

The Impact of Life Skills Training on Behavior Problems in Left-Behind Children in Rural China: A Pilot Study

ERIC Educational Resources Information Center

Liu, Jia; Liu, Shan; Yan, Jin; Lee, Elizabeth; Mayes, Linda

2016-01-01

A randomized controlled experimental pilot study was conducted in order to investigate the effect of life skills training on behavior problems in left-behind children (LBC) in rural China. Sixty-eight LBC were recruited from a middle school in rural China. The intervention group took a ten-week-long life skills training course. The Child Behavior…

A Pilot Study to Examine the Effects of a Nutrition Intervention on Nutrition Knowledge, Behaviors, and Efficacy Expectations in Middle School Children

ERIC Educational Resources Information Center

Fahlman, Mariane M.; Dake, Joseph A.; McCaughtry, Nate; Martin, Jeffrey

2008-01-01

Background: This was a pilot study to determine the impact of the Michigan Model (MM) Nutrition Curriculum on nutrition knowledge, efficacy expectations, and eating behaviors in middle school students. Methods: The study was conducted in a large metropolitan setting and approved by the Institutional Review Board. The participants for this study…

Pilot Trial of a Parenting and Self-Care Intervention for HIV-Positive Mothers: The IMAGE Program

PubMed Central

Murphy, Debra A.; Armistead, Lisa; Payne, Diana L.; Marelich, William D.; Herbeck, Diane M.

2016-01-01

A pilot study was conducted to assess the effects of the IMAGE pilot intervention (Improving Mothers’ parenting Abilities, Growth, and Effectiveness) on mothers living with HIV (MLH). Based on Fisher and Fisher's IMB model (1992), the intervention focused on self-care and parenting behavior skills of MLH that affect maternal, child, and family outcomes. A randomized pretest-posttest two-group design with repeated assessments was used. MLH (n = 62) and their children ages 6 - 14 (n = 62; total N = 124) were recruited for the trial and randomized to the theory-based skills training condition or a standard care control condition. Assessments were conducted at baseline with follow-ups at 3, 6, and 12 months. Maternal, child, and family outcomes were assessed. Results show significant effects of the intervention for improving parenting practices for mothers. The intervention also improved family outcomes, and showed improvements in the parent-child relationship. IMAGE had a positive impact on parenting behaviors, and on maternal, child, and family outcomes. Given MLH can be challenged by their illness and also live in under-resourced environments, IMAGE may be viewed as a viable way to improve quality of life and family outcomes. PMID:27377577

Translating basic behavioral and social science research to clinical application: the EVOLVE mixed methods approach.

PubMed

Peterson, Janey C; Czajkowski, Susan; Charlson, Mary E; Link, Alissa R; Wells, Martin T; Isen, Alice M; Mancuso, Carol A; Allegrante, John P; Boutin-Foster, Carla; Ogedegbe, Gbenga; Jobe, Jared B

2013-04-01

To describe a mixed-methods approach to develop and test a basic behavioral science-informed intervention to motivate behavior change in 3 high-risk clinical populations. Our theoretically derived intervention comprised a combination of positive affect and self-affirmation (PA/SA), which we applied to 3 clinical chronic disease populations. We employed a sequential mixed methods model (EVOLVE) to design and test the PA/SA intervention in order to increase physical activity in people with coronary artery disease (post-percutaneous coronary intervention [PCI]) or asthma (ASM) and to improve medication adherence in African Americans with hypertension (HTN). In an initial qualitative phase, we explored participant values and beliefs. We next pilot tested and refined the intervention and then conducted 3 randomized controlled trials with parallel study design. Participants were randomized to combined PA/SA versus an informational control and were followed bimonthly for 12 months, assessing for health behaviors and interval medical events. Over 4.5 years, we enrolled 1,056 participants. Changes were sequentially made to the intervention during the qualitative and pilot phases. The 3 randomized controlled trials enrolled 242 participants who had undergone PCI, 258 with ASM, and 256 with HTN (n = 756). Overall, 45.1% of PA/SA participants versus 33.6% of informational control participants achieved successful behavior change (p = .001). In multivariate analysis, PA/SA intervention remained a significant predictor of achieving behavior change (p < .002, odds ratio = 1.66), 95% CI [1.22, 2.27], controlling for baseline negative affect, comorbidity, gender, race/ethnicity, medical events, smoking, and age. The EVOLVE method is a means by which basic behavioral science research can be translated into efficacious interventions for chronic disease populations.

Translating Basic Behavioral and Social Science Research to Clinical Application: The EVOLVE Mixed Methods Approach

PubMed Central

Peterson, Janey C.; Czajkowski, Susan; Charlson, Mary E.; Link, Alissa R.; Wells, Martin T.; Isen, Alice M.; Mancuso, Carol A.; Allegrante, John P.; Boutin-Foster, Carla; Ogedegbe, Gbenga; Jobe, Jared B.

2012-01-01

Objective To describe a mixed-methods approach to develop and test a basic behavioral science-informed intervention to motivate behavior change in three high-risk clinical populations. Our theoretically-derived intervention comprised a combination of positive affect and self-affirmation (PA/SA) which we applied to three clinical chronic disease populations. Methods We employed a sequential mixed methods model (EVOLVE) to design and test the PA/SA intervention in order to increase physical activity in people with coronary artery disease (post-percutaneous coronary intervention [PCI]) or asthma (ASM), and to improve medication adherence in African Americans with hypertension (HTN). In an initial qualitative phase, we explored participant values and beliefs. We next pilot tested and refined the intervention, and then conducted three randomized controlled trials (RCTs) with parallel study design. Participants were randomized to combined PA/SA vs. an informational control (IC) and followed bimonthly for 12 months, assessing for health behaviors and interval medical events. Results Over 4.5 years, we enrolled 1,056 participants. Changes were sequentially made to the intervention during the qualitative and pilot phases. The three RCTs enrolled 242 PCI, 258 ASM and 256 HTN participants (n=756). Overall, 45.1% of PA/SA participants versus 33.6% of IC participants achieved successful behavior change (p=0.001). In multivariate analysis PA/SA intervention remained a significant predictor of achieving behavior change (p<0.002, OR=1.66, 95% CI 1.22–2.27), controlling for baseline negative affect, comorbidity, gender, race/ethnicity, medical events, smoking and age. Conclusions The EVOLVE method is a means by which basic behavioral science research can be translated into efficacious interventions for chronic disease populations. PMID:22963594

Outcomes of a Family-Based HIV Prevention Intervention for Substance Using Juvenile Offenders

PubMed Central

Tolou-Shams, Marina; Dauria, Emily; Conrad, Selby M.; Kemp, Kathleen; Johnson, Sarah; Brown, Larry K.

2017-01-01

Approximately 80% of all arrested youth are diverted from detention and supervised in the community through probation, specialty courts and other community-based diversion efforts. Justice-involved youth have greater psychiatric impairment, substance use and sexual risk behaviors than their non-justice-involved peers. Family-based interventions to address mental health, substance use and recidivism have been successful in improving these youth outcomes; but the lack of integration of HIV/STI prevention is notable given the co-occurrence of substance use, delinquency and sexual risk-taking behaviors among justice-involved youth. Moreover, emotion dysregulation may be an important and understudied underlying construct of these co-occurring risk behaviors for justice-involved youth. Study participants were 47 caregiver-youth dyads enrolled in a juvenile drug court program. As part of a pilot efficacy trial, dyads were randomized to a 5-session family-based integrated substance use and HIV/STI prevention intervention that relied on affect management strategies for risk reduction or an adolescent-only psychoeducation condition matched for time and attention. Data collected at baseline and 3 months post-intervention suggest that a family-based integrated affect management substance use and HIV prevention pilot intervention may lead to justice-involved youths’ enhanced motivation to change their marijuana use, decreased marijuana use and decreased risky sexual behavior over time. Future research is required to replicate these pilot trial findings and should also examine family-level mediators and moderators of treatment response, particularly with respect to HIV prevention efforts for these youth. PMID:28476263

Efficacy of a School-Based Treatment Program for Middle School Youth With ADHD: Pilot Data

ERIC Educational Resources Information Center

Evans, Steven W.; Axelrod, Jennifer; Langberg, Joshua M.

2004-01-01

The effects of a set of behavioral and educational interventions provided in a middle-school-based mental health program on the behavior and academic performance of 7 students diagnosed with attention-deficit/hyperactivity disorder (ADHD) were studied. The treatments included educational, social skills and family interventions designed to target…

A Pilot Randomized Controlled Trial to Promote Immunosuppressant Adherence in Adult Kidney Transplant Recipients.

PubMed

Cukor, Daniel; Ver Halen, Nisha; Pencille, Melissa; Tedla, Fasika; Salifu, Moro

2017-01-01

Nonadherence to immunosuppressant medication is a prevalent practice among kidney transplant recipients and has been associated with increased risk for graft failure and economic burden. The aim of this pilot study was to test whether a culturally sensitive cognitive-behavioral adherence promotion program could significantly improve medication adherence to tacrolimus prescription as measured by telephone pill counts among kidney transplant recipients. Thirty-three adult transplant recipients were less than 98% adherent to tacrolimus prescription based on 3 telephone pill counts and were randomized either to the 2-session cognitive-behavioral adherence promotion program or to standard care. The curriculum was developed from an iterative process with transplant recipients into a 2-session group program that provided psychoeducation, addressed barriers to adherence, fostered motivation to improve adherence behavior, and discussed cultural messages on adherence behavior. The intervention group displayed significantly higher levels of adherence when compared to the control group (t = 2.2, p = 0.04) and. similarly, when the amount of change was compared between the groups, the intervention group showed more change than the control condition (F (22,1) = 12.005, p = 0.003). Tacrolimus trough concentration levels were used as a secondary measure of adherence and, while there were no significant between-group differences for mean trough concentration levels, the variability in the trough levels did significantly decrease over time indicating more consistent pill-taking behavior in the intervention group. There is preliminary support for the pilot program as a successful intervention in helping patients with their immunosuppressant medication. © 2016 S. Karger AG, Basel.

Cognitive behavioral therapy for compulsive buying disorder.

PubMed

Mitchell, James E; Burgard, Melissa; Faber, Ron; Crosby, Ross D; de Zwaan, Martina

2006-12-01

To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale-Brown Obsessive Compulsive Scale--Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.

Mind magic: a pilot study of preventive mind-body-based stress reduction in behaviorally inhibited and activated children.

PubMed

Jellesma, Francine C; Cornelis, Janine

2012-03-01

The aim of this pilot study was to examine a mind-body-based preventive intervention program and to determine relationships between children's behavioral inhibition system (BIS) and behavioral activation system, stress, and stress reduction after the program. Children participated in the program (n=30) or in a control condition (n=24). They filled out questionnaires before and after the program and reported their levels of stress before and after each of the five sessions. The program consisted of weekly sessions. Each session incorporated yoga postures, visualization, and social exercises. Breathing techniques were integrated. Stress reductions were only seen in the intervention group and mainly in children with high BIS--irrespective of their behavioral activation system. The results demonstrate that children with high BIS may benefit from a mind-body-based stress reduction program.

Development and pilot evaluation of an Internet-facilitated cognitive-behavioral intervention for maternal depression.

PubMed

Sheeber, Lisa B; Seeley, John R; Feil, Edward G; Davis, Betsy; Sorensen, Erik; Kosty, Derek B; Lewinsohn, Peter M

2012-10-01

Develop and pilot an Internet-facilitated cognitive-behavioral treatment intervention for depression, tailored to economically disadvantaged mothers of young children. Mothers (N = 70) of children enrolled in Head Start, who reported elevated levels of depressive symptoms, were randomized to either the 8-session, Internet-facilitated intervention (Mom-Net) or delayed intervention/facilitated treatment-as-usual (DI/TAU). Outcomes were measured using the Beck Depression Inventory (BDI-II; Beck, Steer, & Brown, 1996); the Patient Health Questionnaire 9 (PHQ-9; Spitzer et al., 1999), Behavioral Observations of Parent-Child Interactions using the Living in Family Environments coding system (LIFE; Hops, Davis, & Longoria, 1995); the Dyadic Parent-Child Interaction Coding Systems (DPICS; Eyberg, Nelson, Duke, & Boggs, 2005); the Parent Behavior Inventory (PBI; Lovejoy, Weis, O'Hare, & Rubin, 1999); and the Parenting Sense of Competence scale (PSOC; Gibaud-Wallston & Wandersman, 1978). Mom-Net demonstrated high levels of feasibility as indicated by low attrition and high program usage and satisfaction ratings. Participants in the Mom-Net condition demonstrated significantly greater reduction in depression, the primary outcome, at the level of both symptoms and estimates of criteria-based diagnoses over the course of the intervention. They also demonstrated significantly greater improvement on a questionnaire measure of parent satisfaction and efficacy as well as on both questionnaire and observational indices of harsh parenting behavior. Initial results suggest that the Mom-Net intervention is feasible and efficacious as a remotely delivered intervention for economically disadvantaged mothers. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

The Effects of an Early Motor Skill Intervention on Motor Skills, Levels of Physical Activity, and Socialization in Young Children with Autism Spectrum Disorder: A Pilot Study

ERIC Educational Resources Information Center

Ketcheson, Leah; Hauck, Janet; Ulrich, Dale

2017-01-01

Despite evidence suggesting one of the earliest indicators of an eventual autism spectrum disorder diagnoses is an early motor delay, there remain very few interventions targeting motor behavior as the primary outcome for young children with autism spectrum disorder. The aim of this pilot study was to measure the efficacy of an intensive motor…

Behavioral Weight Loss for the Management of Menopausal Hot Flashes: A Pilot Study

PubMed Central

Thurston, Rebecca C.; Ewing, Linda J.; Low, Carissa A.; Christie, Aimee J.; Levine, Michele D.

2014-01-01

Objective Although adiposity has been considered protective against hot flashes, newer data suggest positive relations between flashes and adiposity. No studies have been specifically designed to test whether weight loss reduces hot flashes. This pilot study aimed to evaluate the feasibility, acceptability, and initial efficacy of behavioral weight loss to reduce hot flashes. Methods Forty overweight/obese women with hot flashes (≥4/day) were randomized to a behavioral weight loss intervention or to wait list control. Hot flashes were assessed pre- and post-intervention via physiologic monitor, diary, and questionnaire. Comparisons of changes in hot flashes and anthropometrics between conditions were tested via Wilcoxon tests. Results Study retention (83%) and intervention satisfaction (93.8%) were high. Most women (74.1%) reported that hot flash reduction was a main motivator to lose weight. Women randomized to the weight loss intervention lost more weight (-8.86 kg) than did women randomized to control (+0.23 kg, p<.0001). Women randomized to weight loss also showed greater reductions in questionnaire-reported hot flashes (2-week hot flashes: −63.0) than did women in the control (−28.0, p=.03), a difference not demonstrated in other hot flash measures. Reductions in weight and hot flashes were significantly correlated (e.g., r=.47, p=.006). Conclusions This pilot study showed a behavioral weight loss program to be feasible, acceptable, and effective in producing weight loss among overweight/obese women with hot flashes. Findings indicate the importance of a larger study designed to test behavioral weight loss for hot flash reduction. Hot flash management could motivate women to engage in this health-promoting behavior. PMID:24977456

Behavioral weight loss for the management of menopausal hot flashes: a pilot study.

PubMed

Thurston, Rebecca C; Ewing, Linda J; Low, Carissa A; Christie, Aimee J; Levine, Michele D

2015-01-01

Although adiposity has been considered to be protective against hot flashes, newer data suggest positive relationships between hot flashes and adiposity. No studies have been specifically designed to test whether weight loss reduces hot flashes. This pilot study aimed to evaluate the feasibility, acceptability, and initial efficacy of behavioral weight loss in reducing hot flashes. Forty overweight or obese women with hot flashes (≥ 4 hot flashes/d) were randomized to either behavioral weight loss intervention or wait-list control. Hot flashes were assessed before and after intervention via physiologic monitoring, diary, and questionnaire. Comparisons of changes in hot flashes and anthropometrics between conditions were performed via Wilcoxon tests. Study retention (83%) and intervention satisfaction (93.8%) were high. Most women (74.1%) reported that hot flash reduction was a major motivator for losing weight. Women randomized to the weight loss intervention lost more weight (-8.86 kg) than did women randomized to control (+0.23 kg; P < 0.0001). Women randomized to weight loss also showed greater reductions in questionnaire-reported hot flashes (2-wk hot flashes, -63.0) than did women in the control group (-28.0; P = 0.03)-a difference not demonstrated in other hot flash measures. Reductions in weight and hot flashes were significantly correlated (eg, r = 0.47, P = 0.006). This pilot study shows a behavioral weight loss program that is feasible, acceptable, and effective in producing weight loss among overweight or obese women with hot flashes. Findings indicate the importance of a larger study designed to test behavioral weight loss for hot flash reduction. Hot flash management could motivate women to engage in this health-promoting behavior.

Imagine HEALTH: results from a randomized pilot lifestyle intervention for obese Latino adolescents using Interactive Guided ImagerySM

PubMed Central

2014-01-01

Background There is an urgent need for innovative and developmentally appropriate lifestyle interventions to promote healthy lifestyle behaviors and to prevent the early onset of type 2 diabetes and cardiovascular disease risk in obese Latino adolescents. Guided imagery offers promise to reduce stress and promote lifestyle behavior change to reduce disease risk in obese adolescents. Our objectives were: 1) To pilot test a new 12-wk lifestyle intervention using a randomized trial design in obese Latino adolescents, in order to determine the effects of the mind-body modality of Interactive Guided ImagerySM (IGI), over and above those of a didactic lifestyle education, on insulin resistance, eating and physical activity behaviors, stress and stress biomarkers; and 2) To explore the role of intervention-related changes in stress and stress biomarkers on changes in metabolic outcomes, particularly insulin resistance. Methods Obese (BMI > 95th percentile), Latino adolescents (n = 35, age 14-17) were randomized to receive either 12 weekly sessions of a lifestyle education plus guided imagery program (GI), or lifestyle education plus a digital storytelling computer program (DS). Between-group differences in behavioral, biological, and psychological outcomes were assessed using unpaired T-tests and ANCOVA in the 29 subjects who completed the intervention. Results The GI group demonstrated significant reductions in leisure sedentary behavior (p < .05) and increases in moderate physical activity (p < .05) compared to DS group, and a trend toward reduced caloric intake in GI vs DS (p = .09). Salivary cortisol was acutely reduced by stress-reduction guided imagery (p < .01). There were no group differences in adiposity, insulin resistance, perceived stress, or stress biomarkers across the 12-week intervention, though decrease in serum cortisol over the course of the intervention was associated with improved insulin sensitivity (p = .03) independent of intervention group and other relevant co-variates. Conclusions The improvements in physical activity and stress biomarkers following this pilot intervention support the role of guided imagery in promoting healthy lifestyle behavior change and reducing metabolic disease risk in obese Latino adolescent populations. Future investigations will be needed to determine the full effects of the Imagine HEALTH intervention on insulin resistance, stress, and stress biomarkers. Trial registration Clinicaltrials.gov Registry #: NCT01895595 PMID:24433565

Projets Pilotes Quebecois Portant sur L'Integration Scolaire aux Niveaux Pre-Scolaire et Primaire (Quebec Pilot Projects on Mainstreaming of Preschool and Primary-Level Schoolchildren).

ERIC Educational Resources Information Center

Saint-Laurent, Lise; And Others

1992-01-01

This article synthesizes 55 Quebec (Canada) pilot projects on mainstreaming of pupils with learning disabilities, behavior disorders, physical or sensorial handicaps, or mental handicaps, at preschool and elementary levels. It focuses on extent of integration, interventions, training and support for teachers, and evaluation methodology used.…

Development and Piloting of a Home-Based Couples Intervention During Pregnancy and Postpartum in Southwestern Kenya.

PubMed

Turan, Janet M; Darbes, Lynae A; Musoke, Pamela L; Kwena, Zachary; Rogers, Anna Joy; Hatcher, Abigail M; Anderson, Jami L; Owino, George; Helova, Anna; Weke, Elly; Oyaro, Patrick; Bukusi, Elizabeth A

2018-03-01

Engaging both partners of a pregnant couple can enhance prevention of mother-to-child transmission of HIV and promote family health. We developed and piloted an intervention to promote couple collaboration in health during pregnancy and postpartum in southwestern Kenya. We utilized formative data and stakeholder input to inform development of a home-based couples intervention. Next, we randomized pregnant women to intervention (n = 64) or standard care (n = 63) arms, subsequently contacting their male partners for enrollment. In the intervention arm, lay health workers conducted couple home visits, including health education, couple relationship and communication skills, and offers of couple HIV testing and counseling (CHTC) services. Follow-up questionnaires were conducted 3 months postpartum (n = 114 women, 86 men). Baseline characteristics and health behaviors were examined by study arm using t-tests, chi-square tests, and regression analyses. Of the 127 women randomized, 96 of their partners participated in the study. Of 52 enrolled couples in the intervention arm, 94% completed at least one couple home visit. Over 93% of participants receiving couple home visits were satisfied and no adverse social consequences were reported. At follow-up, intervention couples had a 2.78 relative risk of having participated in CHTC during the study period compared with standard care couples (95% confidence interval: 1.63-4.75), and significant associations were observed in other key perinatal health behaviors. This pilot study revealed that a home-based couples intervention for pregnant women and male partners is acceptable, feasible, and has the potential to enhance CHTC and perinatal health behaviors, leading to improved health outcomes.

Substance Use Recovery Outcomes among a Cohort of Youth Participating in a Mobile-Based Texting Aftercare Pilot Program

PubMed Central

Gonzales, Rachel; Ang, Alfonso; Murphy, Debra A.; Glik, Deborah C.; Anglin, M. Douglas

2014-01-01

Project ESQYIR (Educating & Supporting inquisitive Youth in Recovery) is a pilot study examining the feasibility of a 12-week mobile-based aftercare intervention for youth (ages 12 to 24) transitioning out of community-based substance abuse treatment programs. From January 2012 through July 2013, a total of 80 youth were recruited from outpatient and residential treatment programs, geographically dispersed throughout Los Angeles County, California. Results revealed that youth who participated in the texting mobile pilot intervention were significantly less likely to relapse to their primary compared to the aftercare as usual control condition (OR = 0.52, p = 0.002) over time (from baseline throughout the 12-week aftercare pilot program to a 90-day follow-up). Participants in the texting aftercare pilot program also reported significantly less substance use problem severity (β = −0.46, p = .03) and were more likely to participate in extracurricular recovery behaviors (β = 1.63, p = .03) compared to participants in the standard aftercare group. Collectively, findings from this pilot aftercare study suggest that mobile texting could provide a feasible way to engage youth in recovery after substance abuse treatment to aid with reducing relapse and promoting lifestyle behavior change. PMID:24629885

Scale-out of a community-based behavioral intervention for childhood obesity: pilot implementation evaluation.

PubMed

Heerman, William J; Schludnt, David; Harris, Dawn; Teeters, Leah; Apple, Rachel; Barkin, Shari L

2018-04-13

Expanding the use of evidence-based behavioral interventions in community settings has met with limited success in various health outcomes as fidelity and dose of clinical interventions are often diluted when translated to communities. We conducted a pilot implementation study to examine adoption of the rigorously evaluated Healthier Families Program by Parks and Recreation centers in 3 cities across the country (MI, GA, NV) with diverse socio-cultural environments. Using the RE-AIM framework, we evaluated the program both quantitatively (pre/post surveys of health behavior change; attendance & fidelity) and qualitatively (interviews with Parks and Recreation staff and participants following the program). The 3 partner sites recruited a total of 26 parent-child pairs. Among the 24 participants who completed pre/post surveys, 62.5% were 25-34 years old, and average child age was 3.6 (SD 0.7) years. The distribution of self-reported race/ethnicity was 54% non-Hispanic White, 38% non-Hispanic Black, and 8% Latino. Qualitative interviews with participants demonstrated increased use of the built environment for physical activity and continued use of key strategies for health behavior change. Three of five (60%) collaborating sites proceeded with implementation of the program. The average attendance for the 12-week program was 7.6 (SD 3.9) sessions, with 71% attending > 50% of sessions. Average fidelity for the 12 weekly sessions was 25.2 (SD 1.2; possible range 9-27). All 3 partner sites continued offering the program after grant funding was complete. This pilot is among the first attempts to scale-out an evidence-based childhood obesity intervention in community Parks and Recreation centers. While this pilot was not intended to confirm the efficacy of the original trial on Body Mass Index (BMI) reduction, the effective and sustained behavior change among a geographically and ethnically diverse population with high attendance and fidelity demonstrates an effective approach on which to base future large-scale implementation efforts to reduce childhood obesity in community settings.

Findings from the Families on Track Intervention Pilot Trial for Children with Fetal Alcohol Spectrum Disorders and Their Families.

PubMed

Petrenko, Christie L M; Pandolfino, Mary E; Robinson, Luther K

2017-07-01

Individuals with fetal alcohol spectrum disorders (FASD) are at high risk for costly, debilitating mental health problems and secondary conditions, such as school disruption, trouble with the law, and substance use. The study objective was to pilot a multicomponent intervention designed to prevent secondary conditions in children with FASD and improve family adaptation. Thirty children with FASD or prenatal alcohol exposure (PAE) (ages 4 to 8) and their primary caregivers were enrolled. Families were randomized to either the Families on Track Integrated Preventive Intervention or an active control of neuropsychological assessment and personalized community referrals. The 30-week intervention integrates scientifically validated bimonthly, in-home parent behavioral consultation, and weekly child skills groups. Outcomes measured at baseline and follow-up postintervention included intervention satisfaction, child emotional and behavioral functioning, child self-esteem, caregiver knowledge of FASD and advocacy, caregiver attitudes, use of targeted parenting practices, perceived family needs met, social support, and self-care. Data analysis emphasized calculation of effect sizes and was supplemented with analysis of variance techniques. Analyses indicated that families participating in the intervention reported high program satisfaction. Relative to comparison group outcomes, the intervention was associated with medium-to-large effects for child emotion regulation, self-esteem, and anxiety. Medium-sized improvements in disruptive behavior were observed for both groups. Medium and large effects were seen for important caregiver outcomes: knowledge of FASD and advocacy, attributions of behavior, use of antecedent strategies, parenting efficacy, family needs met, social support, and self-care. This pilot study yielded promising findings from the multicomponent Families on Track Integrated Preventive Intervention for child and caregiver outcomes. An important next step is to complete a randomized control trial of the Families on Track Program with a larger sample fully representative of this underserved clinical population with built-in study of implementation parameters. Copyright © 2017 by the Research Society on Alcoholism.

LifeSkills for Men (LS4M): Pilot Evaluation of a Gender-Affirmative HIV and STI Prevention Intervention for Young Adult Transgender Men Who Have Sex with Men.

PubMed

Reisner, Sari L; Hughto, Jaclyn M White; Pardee, Dana J; Kuhns, Lisa; Garofalo, Rob; Mimiaga, Matthew J

2016-02-01

Young adult transgender men who have sex with men (TMSM) engage in sexual behaviors that place them at risk of sexually transmitted infections (STIs) including HIV. To date, no HIV and STI prevention interventions have been developed specifically for young adult TMSM. To address this gap, the current study aimed to (1) adapt a small group-based behavioral HIV prevention intervention designed for young transgender women ("LifeSkills") to address the unique HIV and STI prevention needs of young TMSM ages 18-29 years and (2) conduct a pilot evaluation of the intervention ("LifeSkills for Men"; LS4M). LS4M was carried out in an iterative approach with community input along the way, which allowed for refinement of the intervention manual and enhanced participant acceptability. A LS4M Task Force was convened to guide intervention development/adaptation and study implementation. Initially, focus groups were conducted to examine the sexual health needs, concerns, and stressors facing young TMSM (n = 12; mean age = 23.8 years; 16.7% people of color). Next, LS4M was pilot tested (n = 17; mean age = 24.3 years; 23.5% people of color) to assess acceptability with the study population and feasibility of all study procedures. Overall attendance, participation rates, and positive feedback from participants demonstrate that LS4M is highly acceptable and feasible to carry out with young TMSM. Trends in outcome measures across 4 months of follow-up suggest that participation in the intervention may improve mental health, reduce internalized stigma, and reduce HIV- and STI-related risk behaviors. Further testing of the intervention enrolling young TMSM with recent sexual risk behavior at baseline and with a control group is warranted. Lessons learned for future work with young TMSM are discussed.

Challenges of Using the Internet for Behavioral Research

PubMed Central

Loescher, Lois J.; Hibler, Elizabeth; Hiscox, Heather; Hla, Htay; Harris, Robin B.

2016-01-01

Using the Internet in behavioral research remains a challenge. We developed a video intervention and conducted a pilot study that was designed to deliver and test the intervention via the Internet. One aim of this study was to evaluate the feasibility of using the Internet to both deliver the intervention and collect data from participants. This article summarizes procedures for delivering the intervention and survey via the Internet, obstacles encountered during delivery of the intervention and data collection, and lessons learned that can be applied to future research involving the Internet. PMID:21084974

Changes in brain-behavior relationships following a 3-month pilot cognitive intervention program for adults with traumatic brain injury.

PubMed

Porter, S; Torres, I J; Panenka, W; Rajwani, Z; Fawcett, D; Hyder, A; Virji-Babul, N

2017-08-01

Facilitating functional recovery following brain injury is a key goal of neurorehabilitation. Direct, objective measures of changes in the brain are critical to understanding how and when meaningful changes occur, however, assessing neuroplasticity using brain based results remains a significant challenge. Little is known about the underlying changes in functional brain networks that correlate with cognitive outcomes in traumatic brain injury (TBI). The purpose of this pilot study was to assess the feasibility of an intensive three month cognitive intervention program in individuals with chronic TBI and to evaluate the effects of this intervention on brain-behavioral relationships. We used tools from graph theory to evaluate changes in global and local brain network features prior to and following cognitive intervention. Network metrics were calculated from resting state electroencephalographic (EEG) recordings from 10 adult participants with mild to severe brain injury and 11 age and gender matched healthy controls. Local graph metrics showed hyper-connectivity in the right inferior frontal gyrus and hypo-connectivity in the left inferior frontal gyrus in the TBI group at baseline in comparison with the control group. Following the intervention, there was a statistically significant increase in the composite cognitive score in the TBI participants and a statistically significant decrease in functional connectivity in the right inferior frontal gyrus. In addition, there was evidence of changes in the brain-behavior relationships following intervention. The results from this pilot study provide preliminary evidence for functional network reorganization that parallels cognitive improvements after cognitive rehabilitation in individuals with chronic TBI.

Virtual Sprouts: A Virtual Gardening Pilot Intervention Increases Self-Efficacy to Cook and Eat Fruits and Vegetables in Minority Youth.

PubMed

Bell, Brooke M; Martinez, Lauren; Gotsis, Marientina; Lane, H Chad; Davis, Jaimie N; Antunez-Castillo, Luz; Ragusa, Gisele; Spruijt-Metz, Donna

2018-04-01

To examine the effect of the Virtual Sprouts intervention, an interactive multiplatform mobile gardening game, on dietary intake and psychosocial determinants of dietary behavior in minority youth. In this quasi-experimental pilot intervention, 180 third-, fourth-, and fifth-grade students in Los Angeles Unified School District participated in a 3-week program that included three Virtual Sprouts gaming sessions, three in-school lessons, and three in-home activities, using a nutrition- and gardening-focused curriculum. Pre- and postintervention questionnaires were used to assess psychosocial determinants of dietary behavior, including knowledge about and self-efficacy to eat fruits and vegetables (FV). Data were collected on FV, whole grains, fiber, total sugar, added sugar, and energy from sugary beverages through the Block Kids Food Screener ("last week" version) for Ages 2-17. Repeated measures analysis of covariance models was used for continuous outcomes, controlling for age, sex, ethnicity, school, and free school lunch. After the intervention, the intervention group (n = 116) compared with the control group (n = 64) had a significantly improved self-efficacy to eat FV score (+1.6% vs. -10.3%, P = 0.01), and an improved self-efficacy to cook FV score (+2.9% vs. -5.0%, P = 0.05). There were no significant differences in dietary intake or self-efficacy to garden scores between intervention and control groups. The results from this 3-week pilot study suggest that an interactive mobile game with a nutrition- and gardening-focused curriculum can improve psychosocial determinants of dietary behavior in minority youth.

Storytelling for promoting colorectal cancer screening among underserved Latina women: a randomized pilot study.

PubMed

Larkey, Linda K; Lopez, Ana Maria; Minnal, Archana; Gonzalez, Julie

2009-01-01

In a low socioeconomic-status population of Latina women, we evaluated the potential of storytelling (ST) as a culturally aligned narrative method to promote colorectal cancer (CRC) prevention and screening, compared to a risk tool (RT)-based intervention. Seventy-eight women were randomized in this pilot study to one of two brief interventions to communicate CRC risk reduction options: ST or an RT. Measures of behavioral intentions relative to CRC prevention and screening were obtained following the intervention. Mean scores for intent to obtain and recommend endoscopy to others were significantly better for participants receiving ST than RT (P = .038 and P = .011, respectively). All participants expressed intent to increase fruit and vegetable consumption and physical activity in response to interventions. Post-intervention perceptions of cancer risk and fear of CRC were not significantly different for participants receiving ST compared with RT. Pre- to post-intervention perceptions of risk increased in ST and decreased in RT, while decreases in fear were similar across both intervention groups. Storytelling may be an effective approach for changing CRC risk-related behavioral intentions among Latinas. Mediating factors (such as perceived risk or fear) often used to predict behavior change may not adequately explain the potential persuasive mechanisms of storytelling.

AN INTERVENTION TO ASSIST MEN WHO HAVE SEX WITH MEN DISCLOSE THEIR SEROSTATUS TO CASUAL SEX PARTNERS

PubMed Central

Serovich, Julianne M.; Reed, Sandra; Grafsky, Erika L.; Andrist, David

2009-01-01

This article reports pilot data from a newly developed disclosure intervention and associated measures specifically tailored for disclosure to casual sexual partners. Treatment consisted of a four-session, theoretically driven intervention focusing on the costs and benefits of disclosure. Using a randomized control, crossover design 77 men were randomized into one of three conditions (wait-list control, facilitator only, and computer and facilitator). Results of the study suggest that facilitated administration of the pilot intervention was effective in reducing mean scores on the HIV disclosure behavior and attitude scales and that these reductions were both statistically and practically significant. PMID:19519236

A Qualitative Approach: Evaluating the Childhood Health and Obesity Initiative Communities Empowered for Success (CHOICES) Pilot Study.

PubMed

Brown, Cynthia Williams; Alexander, Dayna S; Warren, Claudia A; Anderson-Booker, Marian

2017-08-01

Low-income and minority children are susceptible to obesity due to the social and environmental barriers that influence their health behaviors. Many programs and interventions fail to account for these aforementioned barriers among this population. Given what we know about the complexity of childhood obesity, low-income and minority children require innovative prevention strategies from those used in traditional childhood obesity interventions. The purpose of this study was to describe the evaluation of a 6-week summer childhood obesity pilot intervention designed for low-income and minority children. Focus groups and interviews (N = 29) were conducted among caregivers. Overall, caregivers indicated that the experience was mostly positive for their children who obtained small amounts of knowledge and behavioral changes. Caregivers also noted several perceived barriers for intervention completion. The CHOICES intervention is a promising approach that warrants attention in future childhood obesity intervention design. Interventions involving low-income and minority children should aim to help participants make healthier choices given the environmental and social barriers that cannot be overlooked or changed.

Physiological and Emotional Responses of Disabled Children to Therapeutic Clowns: A Pilot Study

PubMed Central

Kingsnorth, Shauna; Blain, Stefanie; McKeever, Patricia

2011-01-01

This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions—television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS) signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood) and behavior (facial expressions and vocalizations). Semistructured interviews were completed with verbally expressive children (n = 7) and nurses of participating children (n = 13). Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self) and nurses' (observed) reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings. PMID:21799690

Results of a Pilot Study to Ameliorate Psychological and Behavioral Outcomes of Minority Stress Among Young Gay and Bisexual Men.

PubMed

Smith, Nathan Grant; Hart, Trevor A; Kidwai, Ammaar; Vernon, Julia R G; Blais, Martin; Adam, Barry

2017-09-01

Project PRIDE (Promoting Resilience In Discriminatory Environments) is an 8-session small group intervention aimed at reducing negative mental and behavioral health outcomes resulting from minority stress. This study reports the results of a one-armed pilot test of Project PRIDE, which aimed to examine the feasibility and potential for efficacy of the intervention in a sample of 33 gay and bisexual men aged 18 to 25. The intervention appeared feasible to administer in two different sites and all participants who completed posttreatment (n = 22) or follow-up (n = 19) assessments reported high satisfaction with the intervention. Small to large effect sizes were observed for increases in self-esteem; small effect sizes were found for decreases in loneliness and decreases in minority stress variables; and small and medium effect sizes were found for reductions in alcohol use and number of sex partners, respectively. Overall, Project PRIDE appears to be a feasible intervention with promise of efficacy. Copyright © 2017. Published by Elsevier Ltd.

Intervention mapping protocol for developing a theory-based diabetes self-management education program.

PubMed

Song, Misoon; Choi, Suyoung; Kim, Se-An; Seo, Kyoungsan; Lee, Soo Jin

2015-01-01

Development of behavior theory-based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping (IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome-focused health education programs.

Preliminary Evaluation of a Family Treatment Component to Augment a School-Based Intervention Serving Low-Income Families

ERIC Educational Resources Information Center

Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Hu-Cordova, Maria; Alvarado-Goldberg, Karla; Maher, Lauren M.; Escudero, Pia

2015-01-01

This pilot feasibility study provided a preliminary test of a community-partnered intervention that targeted engaging parents and improving parent functioning. This intervention was combined with the Cognitive-Behavioral Intervention for Trauma in Schools (CBITS), allowing for a comparison of the CBITS-as-usual (CBITS) with the CBITS-plus-family…

Joint marketing as a framework for targeting men who have sex with men in China: a pilot intervention study.

PubMed

Tan, Jingguang; Cai, Rui; Lu, Zuxun; Cheng, Jinquan; de Vlas, Sake J; Richardus, Jan Hendrik

2013-04-01

To apply the joint marketing principle as a new intervention approach for targeting men who have sex with men (MSM) who are often difficult to reach in societies with discrimination towards homosexuality and HIV/AIDS. A pilot intervention according to the principles of joint marketing was carried out by the CDC in Shenzhen, China, in MSM social venues. A self-designed questionnaire of HIV knowledge, condom use, and access to HIV-related services was used before and after the pilot intervention to evaluate its effectiveness. The CDC supported gatekeepers of MSM social venues in running their business and thereby increasing their respectability and income. In return, the gatekeepers cooperated with the CDC in reaching the MSM at the venues with health promotion messages and materials. Thus a win-win situation was created, bringing together two noncompetitive parties in reaching out to a shared customer, the MSM. The pilot intervention succeeded in demonstrating acceptability and feasibility of the joint marketing approach targeting MSM. HIV knowledge, the rate of condom use, and access to HIV-related services of participants in the pilot intervention increased significantly. The joint marketing intervention is an innovative way to create synergies between the gatekeepers of MSM social venues and public health officials for reaching and potentially changing HIV high-risk behaviors among MSM.

Condom Use Following a Pilot Test of the Popular Opinion Leader Intervention in the Barbados Defence Force

DTIC Science & Technology

2013-01-01

and if it exhibited effects on condom use in the BDF population. The POL intervention was originally designed to reduce sexual risk behavior in...increase condom use in the BDF. We adapted the POL intervention as an improvement to the peer educator model in the context of the BDF’s ongoing prevention...measuring respondent demographics, detailed questions regarding specific sexual behaviors and condom use, alcohol abuse, and psychoso- cial measurements

Iterative development of Vegethon: a theory-based mobile app intervention to increase vegetable consumption.

PubMed

Mummah, Sarah A; King, Abby C; Gardner, Christopher D; Sutton, Stephen

2016-08-08

Mobile technology may serve as a cost-effective and scalable tool for delivering behavioral nutrition interventions. This research sought to iteratively develop a theory-driven mobile app, Vegethon, to increase vegetable consumption. Development of Vegethon followed phases outlined by the IDEAS framework: 1) empathize with users (qualitative interviews, n = 18); 2) specify target behavior; 3) ground in behavioral theory; 4) ideate implementation strategies; 5) prototype potential products; 6) gather user feedback (qualitative interviews, n = 14; questionnaire, n = 41); 7) build minimum viable product; and 8) pilot potential efficacy and usability (pilot RCT, n = 17). Findings from each phase informed subsequent phases. The target population that informed intervention development was 18-50 years of age, had BMIs of 28-40 kg/m(2), and lived in the geographical area surrounding Stanford University. A full description of the final version of Vegethon is included in the paper. Qualitative findings that shaped initial intervention conception were: participants' interests in accountability without judgment; their desire for simple and efficient dietary self-monitoring; and the importance of planning meals in advance. Qualitative findings identified during intervention refinement were the need for a focus on vegetable self-monitoring; inclusion of vegetable challenges; simplification of features; advice and inspiration for eating vegetables; reminder notifications; and peer comparison. Pilot RCT findings suggested the initial efficacy, acceptance, and feasibility of the intervention. The final version of Vegethon enabled easy self-monitoring of vegetable consumption and included a range of features designed to engage the user (e.g., surprise challenges; leaderboard; weekly reports). Vegethon was coded for its inclusion of 18 behavior change techniques (BCTs) (e.g., goal setting; feedback; social comparison; prompts/cues; framing/reframing; identity). Vegethon is a theory-based, user-informed mobile intervention that was systematically developed using the IDEAS framework. Vegethon targets increased vegetable consumption among overweight adults and is currently being evaluated in a randomized controlled efficacy trial. Clinical Trials.gov: NCT01826591.

Telephone-administered motivational interviewing to reduce risky sexual behavior in HIV-infected rural persons: a pilot randomized clinical trial.

PubMed

Cosio, David; Heckman, Timothy G; Anderson, Timothy; Heckman, Bernadette D; Garske, John; McCarthy, John

2010-03-01

Although several studies have characterized patterns and predictors of continued risky sexual behavior in HIV-infected rural persons, far less research has evaluated interventions to reduce risky sex in this group. This pilot randomized clinical trial compared 2 brief telephone-administered interventions designed to reduce continued risky sexual behaviors in HIV-infected rural persons. Participants were 79 HIV-infected rural persons who reported 1 or more occasions of unprotected anal, vaginal, or oral sex in the past 2 months. Participants were recruited through AIDS service organizations in rural areas of 27 states and assigned randomly to either a 2-session, motivational interviewing plus skills-building intervention (i.e., integrated intervention; n = 48) or a 2-session, skills-building only comparison intervention (n = 31). Participants completed self-report measures of sexual behaviors and factors related to risky sex at preintervention and 2-month follow-up. Before enrolling into the intervention, 37% of participants had 2 or more sexual partners in the past 2 months, 29% had sex with 1 or more partners without knowing their partners' HIV serostatus, and almost one-third of participants located sex partners in high-risk environments (e.g., public parks, roadside rest areas). A 2 x 2 repeated measures multivariate analyses of variance found that integrated intervention participants reported greater increases in risk-reduction motivation and greater increases in condom-protected vaginal and oral intercourse occasions at follow-up compared to skills-building only participants. Brief telephone-administered interventions that integrate motivational interviewing with skills-building show potential to reduce risky sexual behaviors in HIV-infected rural persons. Additional and large-scale evaluations of this intervention approach appear warranted.

Tailored activities to manage neuropsychiatric behaviors in persons with dementia and reduce caregiver burden: a randomized pilot study.

PubMed

Gitlin, Laura N; Winter, Laraine; Burke, Janice; Chernett, Nancy; Dennis, Marie P; Hauck, Walter W

2008-03-01

To test whether the Tailored Activity Program (TAP) reduces dementia-related neuropsychiatric behaviors, promotes activity engagement, and enhances caregiver well-being. Prospective, two-group (treatment, wait-list control), randomized, controlled pilot study with 4 months as main trial endpoint. At 4 months, controls received the TAP intervention and were reassessed 4 months later. Patients' homes. Sixty dementia patients and family caregivers. The eight-session occupational therapy intervention involved neuropsychological and functional testing, selection, and customization of activities to match capabilities identified in testing, and instruction to caregivers in use of activities. Behavioral occurrences, activity engagement, and quality of life in dementia patients; objective and subjective burden and skill enhancement in caregivers. At 4 months, compared with controls, intervention caregivers reported reduced frequency of problem behaviors, and specifically for shadowing and repetitive questioning, and greater activity engagement including the ability to keep busy. Fewer intervention caregivers reported agitation or argumentation. Caregiver benefits included fewer hours doing things and being on duty, greater mastery, self-efficacy, and skill enhancement. Wait-list control participants following intervention showed similar benefits for reductions in behavioral frequency and caregiver hours doing things for the patient and mastery. Caregivers with depressed symptoms derived treatment benefits similar to nondepressed caregivers. Tailoring activities to the capabilities of dementia patients and training families in activity use resulted in clinically relevant benefits for patients and caregivers. Treatment minimized trigger behaviors for nursing home placement and reduced objective caregiver burden. Noteworthy is that depressed caregivers effectively engaged in and benefited from the intervention.

Parent cognitive-behavioral intervention for the treatment of childhood anxiety disorders: a pilot study.

PubMed

Smith, Allison M; Flannery-Schroeder, Ellen C; Gorman, Kathleen S; Cook, Nathan

2014-10-01

Strong evidence supports cognitive-behavioral therapy (CBT) for the treatment of childhood anxiety. Many studies suggest that parents play an etiological role in the development and maintenance of child anxiety. This pilot study examined the efficacy of a cognitive-behavioral intervention delivered to the parents of 31 anxious children (ages 7-13). Parents were randomly assigned to an individual parent-only CBT intervention (PCBT, n = 18) or wait-list control (WL, n = 13). PCBT demonstrated significant reductions in children's number of anxiety disorder diagnoses, parent-rated interference and clinician-rated severity of anxiety, and maternal protective behaviors at post-treatment, which were maintained at 3-months. WL did not demonstrate significant changes. There were no significant differences between conditions in child self-reported or parent-report of child anxiety symptoms. Findings were replicated in a combined sample of treated participants, as well as in an intent-to-treat sample. Parent-only CBT may be an effective treatment modality for child anxiety, though future research is warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

Engaging Upstanders: Class-Wide Approach to Promoting Positive Bystander Behavior

ERIC Educational Resources Information Center

Wood, Laura; Smith, Jennifer; Varjas, Kris; Meyers, Joel

2016-01-01

Positive and supportive bystander behaviors have been associated with decreases in the frequency and negative impact of bullying. This article addresses the design, implementation, evaluation, and continuation of a classroom-based intervention that promotes positive bystander behaviors. The Engaging Upstanders curriculum was piloted with two…

Feasibility and Effectiveness of Nutritional Telemonitoring for Home Care Clients: A Pilot Study.

PubMed

van Doorn-van Atten, Marije N; Haveman-Nies, Annemien; Heery, Daniel; de Vries, Jeanne H M; de Groot, Lisette C P G M

2018-06-01

Undernutrition has unfavorable consequences for health and quality of life. This pilot study aimed to evaluate the feasibility of a telemonitoring intervention to improve the nutritional status of community-dwelling older adults. The study involved a one-group pretest post-test design, complemented by a qualitative study. The 3-month intervention included 20 Dutch home care clients aged >65 years and consisted of nutritional telemonitoring, television messages, and dietary advice. A process evaluation provided insight into intervention delivery and acceptability. Changes in behavioral determinants, diet quality, appetite, nutritional status, physical functioning, and quality of life were assessed. Researchers and health care professionals implemented the intervention as intended and health care professionals accepted the intervention well. However, 9 participants dropped out, and participants' acceptance was low, mainly due to the low usability of the telemonitoring television channel. Adherence to the telemonitoring measurements was good, although participants needed more help from nurses than anticipated. Participants increased compliance to several Dutch dietary guidelines and no effects on nutritional status, physical functioning, and quality of life were found. Successful telemonitoring of nutritional parameters in community-dwelling older adults starts with optimal usability and acceptability by older adults and their health care professionals. This pilot study provides insight into how to optimize telemonitoring interventions for older adults for maximum impact on behavior and health.

A cognitive/behavioral group intervention for weight loss in patients treated with atypical antipsychotics.

PubMed

Weber, Mary; Wyne, Kathleen

2006-03-01

Obesity and diabetes have caused problems for individuals with schizophrenia long before atypical antipsychotic agents. The prevalence of obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, dyslipidemia, and the Metabolic Syndrome has increased in people with schizophrenia as compared to the general population. Risk reduction studies for persons with obesity, diabetes, and cardiovascular disease indicate that cognitive/behavioral interventions that promote motivation and provide strategies to overcome the barriers in adherence to diet and activity modification are effective interventions for weight management and risk reduction. In the landmark multi-center randomized-controlled trial study, the Diabetes Prevention Project (DPP), a cognitive/behavioral intervention, was more successful in producing weight loss and preventing diabetes than the drugs metformin, troglitazone or placebo. This pilot study examined the effectiveness of a cognitive/behavioral group intervention, modified after the DPP program, in individuals with schizophrenia or schizoaffective disorder taking atypical antipsychotics in a large urban public mental health system. Outcome measures included body weight, body mass index, waist-hip ratios, and fasting glucose levels. Both groups demonstrated elevated fasting glucose levels and were obese with a mean BMI of 33. The group that received the cognitive/behavioral group intervention lost more weight than the treatment as usual group. The CB group participants lost an average of 5.4 lb or 2.9% of body weight, and those in the control group lost 1.3 lb or 0.6% body weight. The range of weight loss for the treatment group was from 1 to 20 lb. This pilot study has demonstrated that weight loss is possible with cognitive/behavioral interventions in a population with a psychotic disorder.

Strengths-Based Behavioral Intervention for Parents of Adolescents With Type 1 Diabetes Using an mHealth App (Type 1 Doing Well): Protocol for a Pilot Randomized Controlled Trial

PubMed Central

Eshtehardi, Sahar S; Minard, Charles G; Saber, Rana; Thompson, Debbe; Karaviti, Lefkothea P; Rojas, Yuliana; Anderson, Barbara J

2018-01-01

Background Supportive parent involvement for adolescents’ type 1 diabetes (T1D) self-management promotes optimal diabetes outcomes. However, family conflict is common and can interfere with collaborative family teamwork. Few interventions have used explicitly strengths-based approaches to help reinforce desired management behaviors and promote positive family interactions around diabetes care. Objective The aim of this protocol was to describe the development of a new, strengths-based behavioral intervention for parents of adolescents with T1D delivered via a mobile-friendly Web app called Type 1 Doing Well. Methods Ten adolescent-parent dyads and 5 diabetes care providers participated in a series of qualitative interviews to inform the design of the app. The 3- to 4-month pilot intervention will involve 82 parents receiving daily prompts to use the app, in which they will mark the diabetes-related strength behaviors (ie, positive attitudes or behaviors related to living with or managing T1D) their teen engaged in that day. Parents will also receive training on how to observe diabetes strengths and how to offer teen-friendly praise via the app. Each week, the app will generate a summary of the teen’s most frequent strengths from the previous week based on parent reports, and parents will be encouraged to praise their teen either in person or from a library of reinforcing text messages (short message service, SMS). Results The major outcomes of this pilot study will include intervention feasibility and satisfaction data. Clinical and behavioral outcomes will include glycemic control, regimen adherence, family relationships and conflict, diabetes burden, and health-related quality of life. Conclusions This strengths-based, mobile health (mHealth) intervention aims to help parents increase their awareness of and efforts to support their adolescents’ engagement in positive diabetes-related behaviors. If efficacious, this intervention has the potential to reduce the risk of family conflict, enhance collaborative family teamwork, and ultimately improve diabetes outcomes. Trial Registration ClinicalTrials.gov NCT02877680; https://clinicaltrials.gov/ct2/show/NCT02877680 (Archived by WebCite at http://www.webcitation.org/6xTAMN5k2) PMID:29535081

Strengths-Based Behavioral Intervention for Parents of Adolescents With Type 1 Diabetes Using an mHealth App (Type 1 Doing Well): Protocol for a Pilot Randomized Controlled Trial.

PubMed

Hilliard, Marisa E; Eshtehardi, Sahar S; Minard, Charles G; Saber, Rana; Thompson, Debbe; Karaviti, Lefkothea P; Rojas, Yuliana; Anderson, Barbara J

2018-03-13

Supportive parent involvement for adolescents' type 1 diabetes (T1D) self-management promotes optimal diabetes outcomes. However, family conflict is common and can interfere with collaborative family teamwork. Few interventions have used explicitly strengths-based approaches to help reinforce desired management behaviors and promote positive family interactions around diabetes care. The aim of this protocol was to describe the development of a new, strengths-based behavioral intervention for parents of adolescents with T1D delivered via a mobile-friendly Web app called Type 1 Doing Well. Ten adolescent-parent dyads and 5 diabetes care providers participated in a series of qualitative interviews to inform the design of the app. The 3- to 4-month pilot intervention will involve 82 parents receiving daily prompts to use the app, in which they will mark the diabetes-related strength behaviors (ie, positive attitudes or behaviors related to living with or managing T1D) their teen engaged in that day. Parents will also receive training on how to observe diabetes strengths and how to offer teen-friendly praise via the app. Each week, the app will generate a summary of the teen's most frequent strengths from the previous week based on parent reports, and parents will be encouraged to praise their teen either in person or from a library of reinforcing text messages (short message service, SMS). The major outcomes of this pilot study will include intervention feasibility and satisfaction data. Clinical and behavioral outcomes will include glycemic control, regimen adherence, family relationships and conflict, diabetes burden, and health-related quality of life. This strengths-based, mobile health (mHealth) intervention aims to help parents increase their awareness of and efforts to support their adolescents' engagement in positive diabetes-related behaviors. If efficacious, this intervention has the potential to reduce the risk of family conflict, enhance collaborative family teamwork, and ultimately improve diabetes outcomes. ClinicalTrials.gov NCT02877680; https://clinicaltrials.gov/ct2/show/NCT02877680 (Archived by WebCite at http://www.webcitation.org/6xTAMN5k2). ©Marisa E Hilliard, Sahar S Eshtehardi, Charles G Minard, Rana Saber, Debbe Thompson, Lefkothea P Karaviti, Yuliana Rojas, Barbara J Anderson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 13.03.2018.

Steps in the design, development and formative evaluation of obesity prevention-related behavior change trials.

PubMed

Baranowski, Tom; Cerin, Ester; Baranowski, Janice

2009-01-21

Obesity prevention interventions through dietary and physical activity change have generally not been effective. Limitations on possible program effectiveness are herein identified at every step in the mediating variable model, a generic conceptual framework for understanding how interventions may promote behavior change. To minimize these problems, and thereby enhance likely intervention effectiveness, four sequential types of formative studies are proposed: targeted behavior validation, targeted mediator validation, intervention procedure validation, and pilot feasibility intervention. Implementing these studies would establish the relationships at each step in the mediating variable model, thereby maximizing the likelihood that an intervention would work and its effects would be detected. Building consensus among researchers, funding agencies, and journal editors on distinct intervention development studies should avoid identified limitations and move the field forward.

Steps in the design, development and formative evaluation of obesity prevention-related behavior change trials

PubMed Central

Baranowski, Tom; Cerin, Ester; Baranowski, Janice

2009-01-01

Obesity prevention interventions through dietary and physical activity change have generally not been effective. Limitations on possible program effectiveness are herein identified at every step in the mediating variable model, a generic conceptual framework for understanding how interventions may promote behavior change. To minimize these problems, and thereby enhance likely intervention effectiveness, four sequential types of formative studies are proposed: targeted behavior validation, targeted mediator validation, intervention procedure validation, and pilot feasibility intervention. Implementing these studies would establish the relationships at each step in the mediating variable model, thereby maximizing the likelihood that an intervention would work and its effects would be detected. Building consensus among researchers, funding agencies, and journal editors on distinct intervention development studies should avoid identified limitations and move the field forward. PMID:19159476

A novel behavioral intervention in adolescents with type 1 diabetes mellitus improves glycemic control: preliminary results from a pilot randomized control trial.

PubMed

Maranda, Louise; Lau, May; Stewart, Sunita M; Gupta, Olga T

2015-04-01

The purpose of this study was to develop and pilot-test an innovative behavioral intervention in adolescents with type 1 diabetes mellitus (T1DM) incorporating structured care of a pet to improve glycemic control. Twenty-eight adolescents with A1C > 8.5% (69 mmol/mol) were randomly assigned to either the intervention group (care of a Betta splendens pet fish) or the control group (usual care). Adolescents in the intervention group were given instructions to associate daily and weekly fish care duties with diabetes self-management tasks, including blood glucose testing and parent-adolescent communication. After 3 months, the participants in the intervention group exhibited a statistically significant decrease in A1C level (-0.5%) compared with their peers in the control group, who had an increase in A1C level (0.8%) (P = .04). The younger adolescents (10-13 years of age) demonstrated a greater response to the intervention, which was statistically significant (-1.5% vs 0.6%, P = .04), compared with the older adolescents (14-17 years of age). Structured care of a pet fish can improve glycemic control in adolescents with T1DM, likely by providing cues to perform diabetes self-management behaviors. © 2015 The Author(s).

Substance use recovery outcomes among a cohort of youth participating in a mobile-based texting aftercare pilot program.

PubMed

Gonzales, Rachel; Ang, Alfonso; Murphy, Debra A; Glik, Deborah C; Anglin, M Douglas

2014-07-01

Project ESQYIR (Educating & Supporting Inquisitive Youth in Recovery) is a pilot study examining the feasibility of a 12-week mobile-based aftercare intervention for youth (ages 12 to 24) transitioning out of community-based substance abuse treatment programs. From January 2012 through July 2013, a total of 80 youth were recruited from outpatient and residential treatment programs, geographically dispersed throughout Los Angeles County, California. Results revealed that youth who participated in the texting mobile pilot intervention were significantly less likely to relapse to their primary compared to the aftercare as usual control condition (OR=0.52, p=0.002) over time (from baseline throughout the 12-week aftercare pilot program to a 90-day follow-up). Participants in the texting aftercare pilot program also reported significantly less substance use problem severity (β=-0.46, p=0.03) and were more likely to participate in extracurricular recovery behaviors (β=1.63, p=0.03) compared to participants in the standard aftercare group. Collectively, findings from this pilot aftercare study suggest that mobile texting could provide a feasible way to engage youth in recovery after substance abuse treatment to aid with reducing relapse and promoting lifestyle behavior change. Copyright © 2014 Elsevier Inc. All rights reserved.

Intensive, Manual-based Intervention for Pediatric Feeding Disorders: Results From a Randomized Pilot Trial.

PubMed

Sharp, William G; Stubbs, Kathryn H; Adams, Heyward; Wells, Brian M; Lesack, Roseanne S; Criado, Kristen K; Simon, Elizabeth L; McCracken, Courtney E; West, Leanne L; Scahill, Larry D

2016-04-01

The aim of this pilot study was to investigate feasibility and preliminary efficacy of an intensive, manual-based behavioral feeding intervention for children with chronic food refusal and dependence on enteral feeding or oral nutritional formula supplementation. Twenty children ages 13 to 72 months (12 boys and 8 girls) meeting criteria for avoidant/restrictive food intake disorder were randomly assigned to receive treatment for 5 consecutive days in a day treatment program (n = 10) or waitlist (n = 10). A team of trained therapists implemented treatment under the guidance of a multidisciplinary team. Parent training was delivered to support generalization of treatment gains. We tracked parental attrition and attendance, as well as therapist fidelity. Primary outcome measures were bite acceptance, disruptions, and grams consumed during meals. Caregivers reported high satisfaction and acceptability of the intervention. Three participants (1 intervention; 2 waitlist) dropped out of the study before endpoint. Of the expected 140 treatment meals for the intervention group, 137 (97.8%) were actually attended. The intervention group showed significantly greater improvements (P < 0.05) on all primary outcome measures (d = 1.03-2.11) compared with waitlist (d = -1.13-0.24). A 1-month follow-up suggested stability in treatment gains. Results from this pilot study corroborate evidence from single-subject and nonrandomized studies on the positive effects of behavioral intervention. Findings support the feasibility and preliminary efficacy of this manual-based approach to intervention. These results warrant a large-scale randomized trial to test the safety and efficacy of this intervention.

A pilot feasibility study of neurofeedback for children with autism.

PubMed

Steiner, Naomi J; Frenette, Elizabeth; Hynes, Caitlin; Pisarik, Elizabeth; Tomasetti, Kathryn; Perrin, Ellen C; Rene, Kirsten

2014-06-01

Neurofeedback (NFB) is an emerging treatment for children with autism spectrum disorder (ASD). This pilot study examined the feasibility of NFB for children with ASD. Ten children ages 7-12 with high functioning ASD and attention difficulties received a NFB attention training intervention. A standardized checklist captured feasibility, including focus during exercises and academic tasks, as well as off-task behaviors. Active behaviors and vocalizations were the most frequent off-task behaviors. Positive reinforcement and breaks including calm breathing exercises were the most common supports. Low motivation was associated with higher feasibility challenges, yet parental involvement and accommodations were helpful. This pilot study shows that it is feasible to conduct NFB sessions with children with high functioning autism and attention difficulties.

Cognitive Behavioral Treatment for Recurrent Binge Eating in Adolescent Girls: A Pilot Trial

ERIC Educational Resources Information Center

DeBar, Lynn L.; Wilson, G. Terence; Yarborough, Bobbi Jo; Burns, Beryl; Oyler, Barbara; Hildebrandt, Tom; Clarke, Gregory N.; Dickerson, John; Striegel, Ruth H.

2013-01-01

There is a need for treatment interventions to address the high prevalence of disordered eating throughout adolescence and early adulthood. We developed an adolescent-specific manualized CBT protocol to treat female adolescents with recurrent binge eating and tested its efficacy in a small, pilot randomized controlled trial. We present lessons…

Pilot Randomized Controlled Trial of a Mindfulness-Based Group Intervention in Adolescent Girls at Risk for Type 2 Diabetes with Depressive Symptoms

PubMed Central

Shomaker, Lauren B.; Bruggink, Stephanie; Pivarunas, Bernadette; Skoranski, Amanda; Foss, Jillian; Chaffin, Ella; Dalager, Stephanie; Annameier, Shelly; Quaglia, Jordan; Brown, Kirk Warren; Broderick, Patricia; Bell, Christopher

2017-01-01

Objective (1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Design and setting Parallel-group, randomized controlled pilot trial conducted at a university. Participants Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). Interventions Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Main outcome measures Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Results Most adolescents attended ≥80% sessions (mindfulness:92% versus cognitive-behavioral:87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05). Conclusions A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. PMID:28619307

Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia.

PubMed

Richeson, Nancy E

2003-01-01

The effects of a therapeutic recreation intervention using animal-assisted therapy (AAT) on the agitated behaviors and social interactions of older adults with dementia were examined using the Cohen-Mansfield Agitation Inventory and the Animal-Assisted Therapy Flow Sheet. In a pilot study, 15 nursing home residents with dementia participated in a daily AAT intervention for three weeks. Results showed statistically significant decreases in agitated behaviors and a statistically significant increase in social interaction pretest to post-test.

Mixed methods evaluation of a randomized control pilot trial targeting sugar-sweetened beverage behaviors.

PubMed

Zoellner, Jamie; Cook, Emily; Chen, Yvonnes; You, Wen; Davy, Brenda; Estabrooks, Paul

2013-02-01

This Excessive sugar-sweetened beverage (SSB) consumption and low health literacy skills have emerged as two public health concerns in the United States (US); however, there is limited research on how to effectively address these issues among adults. As guided by health literacy concepts and the Theory of Planned Behavior (TPB), this randomized controlled pilot trial applied the RE-AIM framework and a mixed methods approach to examine a sugar-sweetened beverage (SSB) intervention (SipSmartER), as compared to a matched-contact control intervention targeting physical activity (MoveMore). Both 5-week interventions included two interactive group sessions and three support telephone calls. Executing a patient-centered developmental process, the primary aim of this paper was to evaluate patient feedback on intervention content and structure. The secondary aim was to understand the potential reach (i.e., proportion enrolled, representativeness) and effectiveness (i.e. health behaviors, theorized mediating variables, quality of life) of SipSmartER. Twenty-five participants were randomized to SipSmartER (n=14) or MoveMore (n=11). Participants' intervention feedback was positive, ranging from 4.2-5.0 on a 5-point scale. Qualitative assessments reavealed several opportunties to improve clarity of learning materials, enhance instructions and communication, and refine research protocols. Although SSB consumption decreased more among the SipSmartER participants (-256.9 ± 622.6 kcals), there were no significant group differences when compared to control participants (-199.7 ± 404.6 kcals). Across both groups, there were significant improvements for SSB attitudes, SSB behavioral intentions, and two media literacy constructs. The value of using a patient-centered approach in the developmental phases of this intervention was apparent, and pilot findings suggest decreased SSB may be achieved through targeted health literacy and TPB strategies. Future efforts are needed to examine the potential public health impact of a large-scale trial to address health literacy and reduce SSB.

Pilot Study: Implementing a Brief DBT Skills Program in Schools to Reduce Health Risk Behaviors among Early Adolescents

ERIC Educational Resources Information Center

Zapolski, Tamika C. B.; Smith, Gregory T.

2017-01-01

A significant proportion of youth engage in health risk behaviors, which are of concern, as they are associated with adverse health consequences across development. Two factors associated with engagement in such behaviors are emotion dysregulation and impulsivity. Dialectical behavioral therapy (DBT) is an effective intervention that enhances…

Randomized controlled trial of a web-based indoor tanning intervention: Acceptability and preliminary outcomes.

PubMed

Stapleton, Jerod L; Manne, Sharon L; Darabos, Katie; Greene, Kathryn; Ray, Anne E; Turner, Amber L; Coups, Elliot J

2015-12-01

This article describes the acceptability and preliminary behavioral outcomes of a pilot randomized control trial of a web-based indoor tanning intervention for young adult women. The intervention targets indoor tanning users' perceptions of the benefits and value of tanning and addresses the role of body image-related constructs in indoor tanning. Participants were 186 young adult women who reported indoor tanning at least once in the past 12 months. The study design was a 2-arm randomized controlled trial with pre- and postintervention assessments and random assignment to an intervention or control condition. Intervention acceptability was assessed by obtaining participants' evaluation of the intervention. Regression analyses were used to test for intervention condition differences in preliminary behavioral outcomes measured at 6 weeks postintervention. Participants provided favorable evaluations of the intervention on several dimensions and a highly positive overall rating. Intervention participants were more likely to report abstaining from indoor tanning and indicated a lower likelihood of using indoor tanning in the future compared with control participants on the postintervention assessment. No differences were found for sunburns. The results of this pilot randomized controlled trial provide evidence that the indoor tanning intervention is acceptable to participants and may encourage cessation of indoor tanning behavior. The findings provide preliminary support for an indoor tanning intervention that engages tanners to challenge their beliefs about the benefits of indoor tanning. The use of a web-based indoor tanning intervention is unique and provides strong potential for dissemination. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Impact of a pilot walking school bus intervention on children's pedestrian safety behaviors: a pilot study.

PubMed

Mendoza, Jason A; Watson, Kathy; Chen, Tzu-An; Baranowski, Tom; Nicklas, Theresa A; Uscanga, Doris K; Hanfling, Marcus J

2012-01-01

Walking school buses (WSB) increased children's physical activity, but impact on pedestrian safety behaviors (PSB) is unknown. We tested the feasibility of a protocol evaluating changes to PSB during a WSB program. Outcomes were school-level street crossing PSB prior to (Time 1) and during weeks 4-5 (Time 2) of the WSB. The protocol collected 1252 observations at Time 1 and 2548 at Time 2. Mixed model analyses yielded: intervention schoolchildren had 5-fold higher odds (p<0.01) of crossing at the corner/crosswalk but 5-fold lower odds (p<0.01) of stopping at the curb. The protocol appears feasible for documenting changes to school-level PSB. Copyright © 2011 Elsevier Ltd. All rights reserved.

Teaching Young Nonverbal Children with Autism Useful Speech: A Pilot Study of the Denver Model and PROMPT Interventions

ERIC Educational Resources Information Center

Rogers, Sally J.; Hayden, Deborah; Hepburn, Susan; Charlifue-Smith, Renee; Hall, Terry; Hayes, Athena

2006-01-01

This single subject design study examined two models of intervention: Denver Model (which merges behavioral, developmental, and relationship-oriented intervention), and PROMPT (a neuro-developmental approach for speech production disorders). Ten young, nonverbal children with autism were matched in pairs and randomized to treatment. They received…

A School Intervention to Increase Prosocial Behavior and Improve Academic Performance of At-Risk Students

ERIC Educational Resources Information Center

Kilian, Janet M.; Kilian, Denis W.

2011-01-01

The purpose of this pilot study was to investigate an intervention for at-risk elementary school students who did not respond sufficiently to a universal school-wide social skills program. The manualized social skills counseling intervention was implemented for two years, and sought to create and maintain appropriate student relating and problem…

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial.

PubMed

Patterson, Paul Daniel; Moore, Charity G; Weaver, Matthew D; Buysse, Daniel J; Suffoletto, Brian P; Callaway, Clifton W; Yealy, Donald M

2014-06-21

Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes 'alertness behaviors'. The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Clinicaltrials.gov NCT02063737, Registered on 10 January 2014.

Effects of Combining a Brief Cognitive Intervention with Transcranial Direct Current Stimulation on Pain Tolerance: A Randomized Controlled Pilot Study.

PubMed

Powers, Abigail; Madan, Alok; Hilbert, Megan; Reeves, Scott T; George, Mark; Nash, Michael R; Borckardt, Jeffrey J

2018-04-01

Cognitive behavioral therapy has been shown to be effective for treating chronic pain, and a growing literature shows the potential analgesic effects of minimally invasive brain stimulation. However, few studies have systematically investigated the potential benefits associated with combining approaches. The goal of this pilot laboratory study was to investigate the combination of a brief cognitive restructuring intervention and transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex in affecting pain tolerance. Randomized, double-blind, placebo-controlled laboratory pilot. Medical University of South Carolina. A total of 79 healthy adult volunteers. Subjects were randomized into one of six groups: 1) anodal tDCS plus a brief cognitive intervention (BCI); 2) anodal tDCS plus pain education; 3) cathodal tDCS plus BCI; 4) cathodal tDCS plus pain education; 5) sham tDCS plus BCI; and 6) sham tDCS plus pain education. Participants underwent thermal pain tolerance testing pre- and postintervention using the Method of Limits. A significant main effect for time (pre-post intervention) was found, as well as for baseline thermal pain tolerance (covariate) in the model. A significant time × group interaction effect was found on thermal pain tolerance. Each of the five groups that received at least one active intervention outperformed the group receiving sham tDCS and pain education only (i.e., control group), with the exception of the anodal tDCS + education-only group. Cathodal tDCS combined with the BCI produced the largest analgesic effect. Combining cathodal tDCS with BCI yielded the largest analgesic effect of all the conditions tested. Future research might find stronger interactive effects of combined tDCS and a cognitive intervention with larger doses of each intervention. Because this controlled laboratory pilot employed an acute pain analogue and the cognitive intervention did not authentically represent cognitive behavioral therapy per se, the implications of the findings on chronic pain management remain unclear.

Randomized Controlled Trial of Behavioral Activation Smoking Cessation Treatment for Smokers with Elevated Depressive Symptoms

ERIC Educational Resources Information Center

MacPherson, Laura; Tull, Matthew T.; Matusiewicz, Alexis K.; Rodman, Samantha; Strong, David R.; Kahler, Christopher W.; Hopko, Derek R.; Zvolensky, Michael J.; Brown, Richard A.; Lejuez, C. W.

2010-01-01

Objective: Depressive symptoms are associated with poor smoking cessation outcomes, and there remains continued interest in behavioral interventions that simultaneously target smoking and depressive symptomatology. In this pilot study, we examined whether a behavioral activation treatment for smoking (BATS) can enhance cessation outcomes. Method:…

Examining the sustainability potential of a multisite pilot to integrate alcohol screening and brief intervention within three primary care systems.

PubMed

King, D K; Gonzalez, S J; Hartje, J A; Hanson, B L; Edney, C; Snell, H; Zoorob, R J; Roget, N A

2018-01-23

The U.S. Preventive Services Task Force recommends that clinicians adopt universal alcohol screening and brief intervention as a routine preventive service for adults, and efforts are underway to support its widespread dissemination. The likelihood that healthcare systems will sustain this change, once implemented, is under-reported in the literature. This article identifies factors that were important to postimplementation sustainability of an evidence-based practice change to address alcohol misuse that was piloted within three diverse primary care organizations. The Centers for Disease Control and Prevention funded three academic teams to pilot and evaluate implementation of alcohol screening and brief intervention within multiclinic healthcare systems in their respective regions. Following the completion of the pilots, teams used the Program Sustainability Assessment Tool to retrospectively describe and compare differences across eight sustainability domains, identify strengths and potential threats to sustainability, and make recommendations for improvement. Health systems varied across all domains, with greatest differences noted for Program Evaluation, Strategic Planning, and Funding Stability. Lack of funding to sustain practice change, or data monitoring to promote fit and fidelity, was an indication of diminished Organizational Capacity in systems that discontinued the service after the pilot. Early assessment of sustainability factors may identify potential threats that could be addressed prior to, or during implementation to enhance Organizational Capacity. Although this study provides a retrospective assessment conducted by external academic teams, it identifies factors that may be relevant for translating evidence-based behavioral interventions in a way that assures that they are sustained within healthcare systems. © The Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Design and methods for a pilot randomized clinical trial involving exercise and behavioral activation to treat comorbid type 2 diabetes and major depressive disorder

PubMed Central

Schneider, Kristin L.; Pagoto, Sherry L.; Handschin, Barbara; Panza, Emily; Bakke, Susan; Liu, Qin; Blendea, Mihaela; Ockene, Ira S.; Ma, Yunsheng

2011-01-01

Background The comorbidity of type 2 diabetes mellitus (T2DM) and depression is associated with poor glycemic control. Exercise has been shown to improve mood and glycemic control, but individuals with comorbid T2DM and depression are disproportionately sedentary compared to the general population and report more difficulty with exercise. Behavioral activation, an evidence-based depression psychotherapy, was designed to help people with depression make gradual behavior changes, and may be helpful to build exercise adherence in sedentary populations. This pilot randomized clinical trial will test the feasibility of a group exercise program enhanced with behavioral activation strategies among women with comorbid T2DM and depression. Methods/Design Sedentary women with inadequately controlled T2DM and depression (N=60) will be randomly assigned to one of two conditions: exercise or usual care. Participants randomized to the exercise condition will attend 38 behavioral activation-enhanced group exercise classes over 24 weeks in addition to usual care. Participants randomized to the usual care condition will receive depression treatment referrals and print information on diabetes management via diet and physical activity. Assessments will occur at baseline and 3-, 6-, and 9-months following randomization. The goals of this pilot study are to demonstrate feasibility and intervention acceptability, estimate the resources and costs required to deliver the intervention and to estimate the standard deviation of continuous outcomes (e.g., depressive symptoms and glycosylated hemoglobin) in preparation for a fully-powered randomized clinical trial. Discussion A novel intervention that combines exercise and behavioral activation strategies could potentially improve glycemic control and mood in women with comorbid type 2 diabetes and depression. Trial registration NCT01024790 PMID:21765864

Understanding the failure of a behavior change intervention to reduce risk behaviors for avian influenza transmission among backyard poultry raisers in rural Bangladesh: a focused ethnography.

PubMed

Rimi, Nadia Ali; Sultana, Rebeca; Ishtiak-Ahmed, Kazi; Rahman, Md Zahidur; Hasin, Marufa; Islam, M Saiful; Azziz-Baumgartner, Eduardo; Nahar, Nazmun; Gurley, Emily S; Luby, Stephen P

2016-08-24

The spread of the highly pathogenic avian influenza (HPAI) H5N1 virus among poultry and humans has raised global concerns and has motivated government and public health organizations to initiate interventions to prevent the transmission of HPAI. In Bangladesh, H5N1 became endemic in poultry and seven human H5N1 cases have been reported since 2007, including one fatality. This study piloted messages to increase awareness about avian influenza and its prevention in two rural communities, and explored change in villagers' awareness and behaviors attributable to the intervention. During 2009-10, a research team implemented the study in two rural villages in two districts of Bangladesh. The team used a focused ethnographic approach for data collection, including informal interviews and observations to provide detailed contextual information about community response to a newly emerging disease. They collected pre-intervention qualitative data for one month. Then another team disseminated preventive messages focused on safe slaughtering methods, through courtyard meetings and affixed posters in every household. After dissemination, the research team collected post-intervention data for one month. More villagers reported hearing about 'bird flu' after the intervention compared to before the intervention. After the intervention, villagers commonly recalled changes in the color of combs and shanks of poultry as signs of avian influenza, and perceived zoonotic transmission of avian influenza through direct contact and through inhalation. Consequently the villagers valued covering the nose and mouth while handling sick and dead poultry as a preventive measure. Nevertheless, the team did not observe noticeable change in villagers' behavior after the intervention. Villagers reported not following the recommended behaviors because of the perceived absence of avian influenza in their flocks, low risk of avian influenza, cost, inconvenience, personal discomfort, fear of being rebuked or ridiculed, and doubt about the necessity of the intervention. The villagers' awareness about avian influenza improved after the intervention, however, the intervention did not result in any measurable improvement in preventive behaviors. Low cost approaches that promote financial benefits and minimize personal discomfort should be developed and piloted.

A Pilot Study of Immune and Mood Outcomes of a Community-Based Intervention for Dementia Caregivers: The PLST Intervention

PubMed Central

Garand, Linda; Buckwalter, Kathleen C.; Lubaroff, David M.; Tripp-Reimer, Toni; Frantz, Rita A.; Ansley, Timothy N.

2010-01-01

Providing care to a family member with dementia is conceptualized as a chronic stressor with adverse psychological and physical effects. The purpose of this pilot study was to evaluate mood and immune outcomes of caregivers exposed to a community-based psychoeducational nursing intervention based on the Progressively Lowered Stress Threshold (PLST) model. The PLST intervention is designed to strengthen the psychological resources of dementia caregivers by teaching methods of preventing and/or managing behavioral problems exhibited by the person with dementia. Mood and immune outcomes were compared between caregivers randomly assigned to receive either the PLST or a comparison intervention. Results of this pilot study suggest that caregivers who received the PLST intervention demonstrated significantly stronger T-cell proliferative responses to both PHA and ConA, indicating an improvement in T-cell immune function immediately after the in-home intervention (T2) and again after six months of telephone support for application of the PLST model (T3). Findings do not support the hypothesis that the PLST intervention had a significant effect on total mood disturbance or NK cell cytotoxicity over the course of the study. PMID:12143075

Treatment of Comorbid Conduct Problems and Depression in Youth: A Pilot Study

ERIC Educational Resources Information Center

Wolff, Jennifer C.; Ollendick, Thomas H.

2012-01-01

The purpose of this study was to pilot a cognitive behavioral treatment protocol for adolescents with co-occurring conduct problems and depression. A non-concurrent multiple baseline design was used to assess the effectiveness of the intervention. A sample of five adolescents, aged 11 to 14 years, participated; all five families completed the…

The Effect of Background Music on Bullying: A Pilot Study

ERIC Educational Resources Information Center

Ziv, Naomi; Dolev, Einat

2013-01-01

School bullying is a source of growing concern. A number of intervention programs emphasize the importance of a positive school climate in preventing bullying behavior. The aim of the presented pilot study was to examine whether calming background music, through its effect on arousal and mood, could create a pleasant atmosphere and reduce bullying…

Maintenance Model of Integrated Psychosocial Treatment in Pediatric Bipolar Disorder: A Pilot Feasibility Study

ERIC Educational Resources Information Center

West, Amy E.; Henry, David B.; Pavuluri, Mani N.

2007-01-01

Objective: The chronic and refractory course of pediatric bipolar disorder merits the study of adjunctive psychosocial interventions designed to facilitate long-term improvements. The objective of this study is to conduct a pilot study of a maintenance model of the child- and family-focused cognitive-behavioral therapy program (CFF-CBT), which…

Development and Pilot Trial of an Intervention to Reduce Disclosure Recipients Negative Social Reactions and Victims Psychological Distress and Problem Drinking

ClinicalTrials.gov

2018-04-06

Social Skills; Self-Criticism; Post-traumatic Stress Disorder; Depression; Alcohol Abuse; Drinking, College; Alcohol Drinking; Alcohol; Harmful Use; Social Stigma; Social Norms; Social Responsibility; Social Behavior; Empathy; Coping Skills; Coping Behavior

Results from a Tailored SMS and Behavior-Tracking Pilot Study on Sun-Safe Behaviors in Young Women

ERIC Educational Resources Information Center

Darlow, Susan; Heckman, Carolyn

2017-01-01

Background: The elevated rates of ultraviolet radiation (UVR) exposure and low rates of sun protection in young adult women indicate a need for age- and gender-appropriate interventions that address these behaviors. Aims: To examine the effects of daily behavior tracking and individually tailored text messages on sun protection and UVR exposure…

Sexuality Education Intervention for Parents of Children with Disabilities: A Pilot Training Program

PubMed Central

Clatos, Kristen; Asare, Matthew

2016-01-01

The purpose of the study is to evaluate pilot sexuality education intervention for parents of children with disabilities between ages of 6 and 25 years old. A within subjects design was utilized and 15 parents of children with disabilities were recruited to receive a two-week sexuality education without a control group. A paired-samples t-test results showed that there was a significant difference between the participants’ pre-test and post intervention scores in their: attitude and beliefs, sexual communication, knowledge, and self-efficacy of sexuality education among children with disabilities (all p<.001). The intervention change the participants sexual communication behavior and increased knowledge about sexuality education with children with disabilities PMID:28690386

Computerized Tailored Intervention for Behavioral Sequelae of Post-Traumatic Stress Disorder in Veterans

DTIC Science & Technology

2012-10-01

pilot tested a viable Internet-based intervention to assist veterans with Post -Traumatic Stress symptoms to progress toward changing negative...veterans’ health and recovery. The three-month feasibility test was designed to assess acceptability and viability of the CTI system and the...aim of the study was to adapt and test the feasibility of a multiple behavior TTM-based CTI designed for the general adult population so that it

Pilot randomized controlled trial of a mindfulness-based group intervention in adolescent girls at risk for type 2 diabetes with depressive symptoms.

PubMed

Shomaker, Lauren B; Bruggink, Stephanie; Pivarunas, Bernadette; Skoranski, Amanda; Foss, Jillian; Chaffin, Ella; Dalager, Stephanie; Annameier, Shelly; Quaglia, Jordan; Brown, Kirk Warren; Broderick, Patricia; Bell, Christopher

2017-06-01

(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Parallel-group, randomized controlled pilot trial conducted at a university. Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05). A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. ClinicalTrials.gov identifier: NCT02218138 clinicaltrials.gov. Copyright © 2017 Elsevier Ltd. All rights reserved.

HPTN 062: A Pilot Randomized Controlled Trial Exploring the Effect of a Motivational-Interviewing Intervention on Sexual Behavior among Individuals with Acute HIV Infection in Lilongwe, Malawi.

PubMed

Pettifor, Audrey; Corneli, Amy; Kamanga, Gift; McKenna, Kevin; Rosenberg, Nora E; Yu, Xuesong; Ou, San-San; Massa, Cecilia; Wiyo, Patricia; Lynn, Diana; Tharaldson, Jenae; Golin, Carol; Hoffman, Irving

2015-01-01

We pilot tested a Motivational Interviewing (MI) -based counseling intervention for individuals with Acute HIV Infection (AHI) to reduce risky sexual behavior in Lilongwe, Malawi. Twenty-eight individuals diagnosed with AHI were randomized to receive either brief education alone, or the brief education plus the MI-based intervention, called Uphungu Wanga. Participants in Uphungu Wanga received four sessions delivered on the day of diagnosis, three days later and at weeks 1 and 2 with a booster session at week 8; participants were followed for 24 weeks from diagnosis. An interviewer administered quantitative questionnaire was conducted at baseline and at weeks 2, 4, 8, 12, 16, 20 and 24. Semi-structured qualitative interviews (SSI) were conducted at weeks 2, 8, 12, and 24. The majority of participants in both arms reported rapid and sustained behavior change following diagnosis with AHI. Very few participants reported having sex without a condom after diagnosis. Participants reported a trend towards fewer sex partners and abstaining from sex during study follow-up. Participants in the MI-based arm provided concrete examples of risk reduction strategies in the SSIs while those in the brief education arm primarily described reducing risk behavior, suggesting that the MI-based group may have acquired more risk reduction skills. Individuals in both study arms reduced risky sexual behaviors after diagnosis with AHI. We found few major differences between study arms during the 6-month follow up period in self-reported sexual behaviors therefore a MI-based intervention may not be needed to trigger behavior change following AHI. However, comparing the MI-based intervention to repeated brief education sessions made it difficult to assess the potential benefit of an MI-based intervention in a setting where standard counseling often consists of one post-test session. Nevertheless, provision of counseling immediately following diagnosis with HIV to support behavior change should remain a priority. ClinicalTrials.gov NCT01197027.

Group Music Intervention Reduces Aggression and Improves Self-esteem in Children with Highly Aggressive Behavior: A Pilot Controlled Trial

PubMed Central

Lee, Myeong Soo; Lee, Jung-Sook

2010-01-01

We investigated the effects of group music intervention on aggression and self-esteem in children with highly aggressive behavior. Forty-eight children were allocated to either a music intervention group or an untreated control group. The music intervention group received 50 min of music intervention twice weekly for 15 consecutive weeks. The outcome measures were Child Behavior Checklist Aggression Problems Scale (Parents), Child Aggression Assessment Inventory (Teachers) and Rosenberg Self-esteem Scale. After 15 weeks, the music intervention group showed significant reduction of aggression and improvement of self-esteem compared with the control group. All outcome measures were significantly lower in the music intervention group than prior to treatment, while there was no change in the control group. These findings suggest that music can reduce aggressive behavior and improve self-esteem in children with highly aggressive behavior. Music intervention is an easily accessible therapy for children and as such may be an effective intervention for aggressive behavior. Further more, objective and replicable measures are required from a randomized controlled trial with a larger sample size and active comparable control. PMID:18955314

Using mobile health technology to improve behavioral skill implementation through homework in evidence-based parenting intervention for disruptive behavior disorders in youth: study protocol for intervention development and evaluation.

PubMed

Chacko, Anil; Isham, Andrew; Cleek, Andrew F; McKay, Mary M

2016-01-01

Disruptive behavior disorders (DBDs) (oppositional defiant disorder (ODD) and conduct disorder (CD)) are prevalent, costly, and oftentimes chronic psychiatric disorders of childhood. Evidence-based interventions that focus on assisting parents to utilize effective skills to modify children's problematic behaviors are first-line interventions for the treatment of DBDs. Although efficacious, the effects of these interventions are often attenuated by poor implementation of the skills learned during treatment by parents, often referred to as between-session homework. The multiple family group (MFG) model is an evidence-based, skills-based intervention model for the treatment of DBDs in school-age youth residing in urban, socio-economically disadvantaged communities. While data suggest benefits of MFG on DBD behaviors, similar to other skill-based interventions, the effects of MFG are mitigated by the poor homework implementation, despite considerable efforts to support parents in homework implementation. This paper focuses on the study protocol for the development and preliminary evaluation of a theory-based, smartphone mobile health (mHealth) application (My MFG) to support homework implementation by parents participating in MFG. This paper describes a study design proposal that begins with a theoretical model, uses iterative design processes to develop My MFG to support homework implementation in MFG through a series of pilot studies, and a small-scale pilot randomised controlled trial to determine if the intervention can demonstrate change (preliminary efficacy) of My MFG in outpatient mental health settings in socioeconomically disadvantaged communities. This preliminary study aims to understand the implementation of mHealth methods to improve the effectiveness of evidence-based interventions in routine outpatient mental health care settings for youth with disruptive behavior and their families. Developing methods to augment the benefits of evidence-based interventions, such as MFG, where homework implementation is an essential mediator of treatment benefits is critical to full adoption/implementation of these intervention in routine practice settings and maximizing benefits for youth with DBDs and their families. ClinicalTrials.gov NCT01917838.

The Effects of Exercise Education Intervention on the Exercise Behaviour, Depression, and Fatigue Status of Chronic Kidney Disease Patients

ERIC Educational Resources Information Center

Kao, Yu-Hsiu; Huang, Yi-Ching; Chen, Pei-Ying; Wang, Kuo-Ming

2012-01-01

Purpose: The purpose of this paper is to investigate the effects of an exercise education intervention on exercise behavior, depression and fatigue status of chronic kidney disease (CKD) patients. Design/methodology/approach: This was a pilot study using an exercise education program as an intervention for CKD patients. The authors used the…

Hip Hop HEALS: Pilot Study of a Culturally Targeted Calorie Label Intervention to Improve Food Purchases of Children

ERIC Educational Resources Information Center

Williams, Olajide; DeSorbo, Alexandra; Sawyer, Vanessa; Apakama, Donald; Shaffer, Michele; Gerin, William; Noble, James

2016-01-01

Objectives: We explored the effect of a culturally targeted calorie label intervention on food purchasing behavior of elementary school students. Method: We used a quasi-experimental design with two intervention schools and one control school to assess food purchases of third through fifth graders at standardized school food sales before and after…

Effectiveness of a Fundamental Motor Skill Intervention for 4-Year-Old Children with Autism Spectrum Disorder: A Pilot Study

ERIC Educational Resources Information Center

Bremer, Emily; Balogh, Robert; Lloyd, Meghann

2015-01-01

A wait-list control experimental design was employed to investigate the effectiveness of a fundamental motor skill intervention at improving the motor skills, adaptive behavior, and social skills of 4-year-old children with autism spectrum disorder (experimental n?=?5, control n?=?4); the impact of intervention intensity was also explored. The…

A behavioral weight-loss intervention for persons with serious mental illness in psychiatric rehabilitation centers.

PubMed

Daumit, G L; Dalcin, A T; Jerome, G J; Young, D R; Charleston, J; Crum, R M; Anthony, C; Hayes, J H; McCarron, P B; Khaykin, E; Appel, L J

2011-08-01

Overweight and obesity are epidemic in populations with serious mental illnesses. We developed and pilot-tested a behavioral weight-loss intervention appropriately tailored for persons with serious mental disorders. We conducted a single-arm pilot study in two psychiatric rehabilitation day programs in Maryland, and enrolled 63 overweight or obese adults. The 6-month intervention provided group and individual weight management and group physical activity classes. The primary outcome was weight change from baseline to 6 months. A total of 64% of those potentially eligible enrolled at the centers. The mean age was 43.7 years; 56% were women; 49% were white; and over half had schizophrenia or a schizoaffective disorder. One-third had hypertension and one-fifth had diabetes. In total, 52 (82%) completed the study; others were discharged from psychiatric centers before completion of the study. Average attendance across all weight management sessions was 70% (87% on days participants attended the center) and 59% for physical activity classes (74% on days participants attended the center). From a baseline mean of 210.9 lbs (s.d. 43.9), average weight loss for 52 participants was 4.5 lb (s.d. 12.8) (P<0.014). On average, participants lost 1.9% of body weight. Mean waist circumference change was 3.1 cm (s.d. 5.6). Participants on average increased the distance on the 6-minute walk test by 8%. This pilot study documents the feasibility and preliminary efficacy of a behavioral weight-loss intervention in adults with serious mental illness who were attendees at psychiatric rehabilitation centers. The results may have implications for developing weight-loss interventions in other institutional settings such as schools or nursing homes.

Educating restaurant owners and cooks to lower their own sodium intake is a potential strategy for reducing the sodium contents of restaurant foods: a small-scale pilot study in South Korea.

PubMed

Park, Sohyun; Lee, Heeseung; Seo, Dong-Il; Oh, Kwang-Hwan; Hwang, Taik Gun; Choi, Bo Youl

2016-12-01

This study was conducted to evaluate the feasibility of a sodium reduction program at local restaurants through nutrition education and examination of the health of restaurant owners and cooks. The study was a single-arm pilot intervention using a pre-post design in one business district with densely populated restaurants in Seoul, South Korea. The intervention focused on improving nutrition behaviors and psychosocial factors through education, health examination, and counseling of restaurant personnel. Forty-eight restaurant owners and cooks completed the baseline survey and participated in the intervention. Forty participants completed the post-intervention survey. The overweight and obesity prevalences were 25.6% and 39.5%, respectively, and 74.4% of participants had elevated blood pressure. After health examination, counseling, and nutrition education, several nutrition behaviors related to sodium intake showed improvement. In addition, those who consumed less salt in their baseline diet (measured with urine dipsticks) were more likely to agree that providing healthy foods to their customers is necessary. This study demonstrated the potential to reduce the sodium contents of restaurant foods by improving restaurant owners' and cooks' psychological factors and their own health behaviors. This small pilot study demonstrated that working with restaurant owners and cooks to improve their own health and sodium intake may have an effect on participation in restaurant-based sodium reduction initiatives. Future intervention studies with a larger sample size and comparison group can focus on improving the health and perceptions of restaurant personnel in order to increase the feasibility and efficacy of restaurant-based sodium reduction programs and policies.

Educating restaurant owners and cooks to lower their own sodium intake is a potential strategy for reducing the sodium contents of restaurant foods: a small-scale pilot study in South Korea

PubMed Central

Lee, Heeseung; Seo, Dong-il; Oh, Kwang-hwan; Hwang, Taik Gun; Choi, Bo Youl

2016-01-01

BACKGROUND/OBJECTIVES This study was conducted to evaluate the feasibility of a sodium reduction program at local restaurants through nutrition education and examination of the health of restaurant owners and cooks. SUBJECTS/METHODS The study was a single-arm pilot intervention using a pre-post design in one business district with densely populated restaurants in Seoul, South Korea. The intervention focused on improving nutrition behaviors and psychosocial factors through education, health examination, and counseling of restaurant personnel. Forty-eight restaurant owners and cooks completed the baseline survey and participated in the intervention. Forty participants completed the post-intervention survey. RESULTS The overweight and obesity prevalences were 25.6% and 39.5%, respectively, and 74.4% of participants had elevated blood pressure. After health examination, counseling, and nutrition education, several nutrition behaviors related to sodium intake showed improvement. In addition, those who consumed less salt in their baseline diet (measured with urine dipsticks) were more likely to agree that providing healthy foods to their customers is necessary. This study demonstrated the potential to reduce the sodium contents of restaurant foods by improving restaurant owners' and cooks' psychological factors and their own health behaviors. CONCLUSIONS This small pilot study demonstrated that working with restaurant owners and cooks to improve their own health and sodium intake may have an effect on participation in restaurant-based sodium reduction initiatives. Future intervention studies with a larger sample size and comparison group can focus on improving the health and perceptions of restaurant personnel in order to increase the feasibility and efficacy of restaurant-based sodium reduction programs and policies. PMID:27909562

Alcohol Interventions for Mandated Students: Behavioral Outcomes From a Randomized Controlled Pilot Study

PubMed Central

Logan, Diane E; Kilmer, Jason R; King, Kevin M; Larimer, Mary E

2015-01-01

Objective: This study investigated the effectiveness of three single-session interventions with high-risk mandated students while considering the influence of motivational interviewing (MI) microskills. Method: This randomized, controlled pilot trial evaluated single-session interventions: Alcohol Skills Training Program (ASTP), Brief Alcohol Screening and Intervention for College Students (BASICS) feedback sessions, and treatment-as-usual Alcohol Diversion Program (ADP) educational groups. Participants were 61 full-time undergraduates at a southern U.S. campus sanctioned to a clinical program following violation of an on-campus alcohol policy (Mage = 19.16 years; 42.6% female). Results: Results revealed a significant effect of time for reductions in estimated blood alcohol concentration (eBAC) and number of weekly drinks but not in alcohol-related consequences. Although ASTP and BASICS participants reported significant decreases in eBAC over time, ADP participant levels did not change (with no intervention effects on quantity or consequences). MI microskills were not related to outcomes. Conclusions: Results from this study suggest equivalent behavioral impacts for the MI-based interventions, although individual differences in outcome trajectories suggest that research is needed to further customize mandated interventions. Given the overall decrease in eBAC following the sanction, the lack of reduction in the ADP condition warrants caution when using education-only interventions. PMID:25486391

Alcohol interventions for mandated students: behavioral outcomes from a randomized controlled pilot study.

PubMed

Logan, Diane E; Kilmer, Jason R; King, Kevin M; Larimer, Mary E

2015-01-01

This study investigated the effectiveness of three single-session interventions with high-risk mandated students while considering the influence of motivational interviewing (MI) microskills. This randomized, controlled pilot trial evaluated single-session interventions: Alcohol Skills Training Program (ASTP), Brief Alcohol Screening and Intervention for College Students (BASICS) feedback sessions, and treatment-as-usual Alcohol Diversion Program (ADP) educational groups. Participants were 61 full-time undergraduates at a southern U.S. campus sanctioned to a clinical program following violation of an on-campus alcohol policy (Mage = 19.16 years; 42.6% female). RESULTS revealed a significant effect of time for reductions in estimated blood alcohol concentration (eBAC) and number of weekly drinks but not in alcohol-related consequences. Although ASTP and BASICS participants reported significant decreases in eBAC over time, ADP participant levels did not change (with no intervention effects on quantity or consequences). MI microskills were not related to outcomes. RESULTS from this study suggest equivalent behavioral impacts for the MI-based interventions, although individual differences in outcome trajectories suggest that research is needed to further customize mandated interventions. Given the overall decrease in eBAC following the sanction, the lack of reduction in the ADP condition warrants caution when using education-only interventions.

Acceptability of a microenterprise intervention among female sex workers in Chennai, India.

PubMed

Sherman, Susan G; Srikrishnan, A K; Rivett, Katharine A; Liu, Su-Hsun; Solomon, Suniti; Celentano, David D

2010-06-01

Female sex workers have been central in India's HIV epidemic since it was first diagnosed among them in 1989. Female sex workers' risk of HIV is primarily economically motivated. The Pi pilot study examined the feasibility and association of a microenterprise intervention, the tailoring of canvas bags, on sexual risk behaviors among female sex workers (N = 100) in Chennai. Women were randomized to an intervention or control arm. Between-group comparisons at baseline and at six-month follow-up were performed. Multivariate linear regression with bootstrapping was conducted to estimate the intervention effect. At baseline, women were a median of 35 years old, 61% were married and they had an average of two children. Intervention participants reported a significantly lower number of sex partners and significant increases in income at the 6-month follow-up compared to control participants. In a multivariate model, intervention participants had a significantly lower number of paying clients per month at follow-up compared to control participants. By graduation, 75% of intervention arm participants had made at least one sellable canvas bag and 6 months after the study's end, 60% have continued involvement in bag production. The pilot study demonstrated that microenterprise interventions are successful in both providing FSWs with licit income opportunities and was associated with reductions in HIV risk behaviors.

A pilot study of a nurse-delivered cognitive behavioral therapy intervention (Ziphamandla) for adherence and depression in HIV in South Africa.

PubMed

Andersen, Lena S; Magidson, Jessica F; O'Cleirigh, Conall; Remmert, Jessica E; Kagee, Ashraf; Leaver, Matthew; Stein, Dan J; Safren, Steven A; Joska, John

2018-05-01

Depression is prevalent among people living with HIV in South Africa and interferes with adherence to antiretroviral therapy. This study evaluated a nurse-delivered, cognitive behavioral therapy intervention for adherence and depression among antiretroviral therapy users with depression in South Africa ( n = 14). Primary outcomes were depression, antiretroviral therapy adherence, feasibility, and acceptability. Findings support robust improvements in mood through a 3-month follow up. Antiretroviral therapy adherence was maintained during the intervention period. Participant retention supports acceptability; however, modest provider fidelity despite intensive supervision warrants additional attention to feasibility. Future effectiveness research is needed to evaluate this nurse-delivered cognitive behavioral therapy intervention for adherence and depression in this context.

Life skills: evaluation of a theory-driven behavioral HIV prevention intervention for young transgender women.

PubMed

Garofalo, Robert; Johnson, Amy K; Kuhns, Lisa M; Cotten, Christopher; Joseph, Heather; Margolis, Andrew

2012-06-01

Young transgender women are at increased risk for HIV infection due to factors related to stigma/marginalization and participation in risky sexual behaviors. To date, no HIV prevention interventions have been developed or proven successful with young transgender women. To address this gap, we developed and pilot tested a homegrown intervention "Life Skills," addressing the unique HIV prevention needs of young transgender women aged 16-24 years. Study aims included assessing the feasibility of a small group-based intervention with the study population and examining participant's engagement in HIV-related risk behaviors pre- and 3-months-post-intervention. Fifty-one (N = 51) young transgender women enrolled in the study. Our overall attendance and retention rates demonstrate that small group-based HIV prevention programs for young transgender women are both feasible and acceptable. Trends in outcome measures suggest that participation in the intervention may reduce HIV-related risk behaviors. Further testing of the intervention with a control group is warranted.

Using stand/sit workstations in classrooms: lessons learned from a pilot study in Texas.

PubMed

Blake, Jamilia J; Benden, Mark E; Wendel, Monica L

2012-01-01

Childhood obesity has grown into a national epidemic since the 1980s. Many school-based intervention efforts that target childhood obesity involve curriculum and programming that demands instructional time, which disincentivizes school participation. Stand-biased classrooms are an environmental intervention that promotes standing rather than sitting by utilizing standing height desks that allow students to stand during normal classroom activities. The quasi-experimental pilot study was conducted in 5 first-grade classrooms in a Texas elementary school, with 2 control classrooms, 2 treatment classrooms, and 1 classroom that was a control in the fall and treatment in the spring (to allow for within-group comparisons). This intervention has been shown effective in significantly increasing caloric expenditure. In addition, the present study reveals potential behavioral effects from standing. This article presents lessons learned from the pilot study that may prove useful for others implementing similar interventions and calls for additional research on the academic benefits of standing for students.

Tailored Activities to Manage Neuropsychiatric Behaviors in Persons with Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

PubMed Central

Gitlin, Laura N.; Winter, Laraine; Burke, Janice; Chernett, Nancy; Dennis, Marie P.; Hauck, Walter W.

2009-01-01

Objective To test whether the Tailored Activity Program for at-home dementia patients reduces neuropsychiatric behaviors and caregiver burden. Method A prospective, two-group controlled pilot study with 60 dyads randomized to treatment or wait-list control. Dyads were interviewed at baseline and 4 months (trial endpoint); control participants then received intervention and were reassessed 4 months later. The 8-session occupational therapy intervention involved neuropsychological and functional testing from which activities were customized and instruction in use provided to caregivers. Results At 4-months, compared to controls, intervention caregivers reported reduced frequency of behaviors (p = .010; Cohen’s d = .72), specifically for shadowing (p = .003, Cohen’s d = 3.10) and repetitive questioning (p = .23, Cohen’s d = 1.22); greater activity engagement (p = .029, Cohen’s d = .61); and ability to keep busy (p = .017, Cohen’s d = .71). Also, fewer intervention caregivers reported agitation (p = .014, Cohen’s d = .75) or argumentation (p = .010, Cohen’s d = .77). Caregiver benefits included fewer hours doing things (p = .005, Cohen’s d = 1.14) and being on duty (p = .001, Cohen’s d = 1.01), greater mastery (p = .013, Cohen’s d = .55), self-efficacy (p = .011, Cohen’s d = .74), and use of simplification techniques (p = .023, Cohen’s d = .71). Wait-list control participants showed similar benefits for behavioral frequency following intervention. Conclusions Results suggest clinically-relevant benefits for both dementia patients and caregivers, with treatment minimizing the occurrence of behaviors that commonly trigger nursing home placement. PMID:18310553

Feasibility and Efficacy of a Parent-Focused, Text Message–Delivered Intervention to Reduce Sedentary Behavior in 2- to 4-Year-Old Children (Mini Movers): Pilot Randomized Controlled Trial

PubMed Central

Salmon, Jo; Hinkley, Trina; Hnatiuk, Jill A; Hesketh, Kylie D

2018-01-01

Background Despite public health guidelines to limit sedentary behavior, many young children spend large amounts of time sedentary (eg, screen and sitting time) during waking hours. Objective The objective of this study was to test the feasibility and efficacy of a parent-focused, predominantly text message–delivered intervention to support parents to reduce the amount of time their children spend in sedentary behavior. Methods Mini Movers was a pilot randomized controlled trial delivered to parents of 2- to 4-year-old children in Melbourne, Australia. Participants were recruited through playgroups, social media, and snowball sampling. Eligibility criteria were having an ambulatory child (2-4 years), English literacy, and smartphone ownership. Participants were randomized to intervention or wait-list control on a 1:1 ratio after baseline data collection. The 6-week intervention was predominantly delivered via text messages, using a Web-based bulk text message platform managed by the interventionist. Intervention strategies focused on increasing parental knowledge, building self-efficacy, setting goals, and providing reinforcement, and were underpinned by the Coventry, Aberdeen & London-Refined taxonomy of behavior change techniques and social cognitive theory. The primary outcome was intervention feasibility, measured by recruitment, retention, intervention delivery, and fidelity; process evaluation questionnaires; and qualitative interviews with a subsample of participants. Secondary outcomes were children’s screen and restraint time (parent report), sitting time (parent report, activPAL), and potential mediators (parent report). Linear regression models were used to determine intervention effects on secondary outcomes, controlling for the child’s sex and age and clustering by playgroup; effect sizes (Cohen's d) were calculated. Results A total of 57 participants (30 intervention; 27 wait-list control) were recruited, and retention was high (93%). Process evaluation results showed that the intervention was highly acceptable to parents. The majority of intervention components were reported to be useful and relevant. Compared with children in the control group, children in the intervention group had significantly less screen time postintervention (adjusted difference [95% CI]=−35.0 [−64.1 to −5.9] min/day; Cohen's d=0.82). All other measures of sedentary behavior were in the expected direction, with small to moderate effect sizes. Conclusions Mini Movers was shown to be a feasible, acceptable, and efficacious pilot intervention for parents of young children, warranting a larger-scale randomized control trial. Trial Registration Australian New Zealand Clinical Trials registry: ACTRN12616000628448; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?ACTRN=12616000628448p (Archived by WebCite at http://www.webcitation.org/ 6wZcA3cYM) PMID:29426816

Pilot of an Elementary School Cough Etiquette Intervention: Acceptability, Feasibility, and Potential for Sustainability.

PubMed

Sultana, Farhana; Nizame, Fosiul A; Southern, Dorothy L; Unicomb, Leanne; Winch, Peter J; Luby, Stephen P

2017-12-01

Schools convene many people together for a prolonged time, facilitating spread of respiratory pathogens and amplifying epidemics. Crowded Bangladeshi schools lack the infrastructure to support optimal cough etiquette behaviors. We collected formative data on current practices from four elementary schools, and developed and piloted a low-cost cough etiquette intervention, promoting coughing and sneezing into upper sleeves at four additional schools. We trained teachers to lead behavior change sessions during regular hygiene classes for 4 weeks. We evaluated intervention acceptability, feasibility, and potential for sustainability at 1 month and at 14 months after the intervention commenced. At baseline, among 63 observed students, 58 (92%) coughed/sneezed into open air, five (8%) covered coughs/sneezes with their hands, which were not subsequently washed with soap and water as they judged this infeasible. After 4 weeks, among 70 observed students, 27 (39%) coughed/sneezed into upper sleeves, 33 (47%) into open air, and 10 (12%) covered with hands. After 14 months, among 230 observed students, 13 (6%) used upper sleeves, 154 (67%) coughed/sneezed into open air, and 59 (26%) covered with hands. Students reported that coughing/sneezing into upper sleeves was simple and protected them and their classmates from germs. This school-based intervention was acceptable and feasible, and resulted in short-term reductions in coughing/sneezing into open air, but these habits of comparatively new behavior were not sustained as teachers ceased behavior change session delivery. Strategies to support longer-term adoption of habits should be considered.

Taking Charge: A Pilot Curriculum of Self-Defense and Personal Safety Training for Female Veterans with PTSD Because of Military Sexual Trauma

ERIC Educational Resources Information Center

David, Wendy S.; Simpson, Tracy L.; Cotton, Ann J.

2006-01-01

The authors describe an overview of the pilot project Taking Charge, a 36-hour comprehensive behavioral intervention involving psychoeducation, personal safety, and self-defense training for 12 female veterans with posttraumatic stress disorder (PTSD) from military sexual trauma. Self-defense training can incorporate the benefits of repeated…

Stress Management-Augmented Behavioral Weight Loss Intervention for African American Women: A Pilot, Randomized Controlled Trial

ERIC Educational Resources Information Center

Cox, Tiffany L.; Krukowski, Rebecca; Love, ShaRhonda J.; Eddings, Kenya; DiCarlo, Marisha; Chang, Jason Y.; Prewitt, T. Elaine; West, Delia Smith

2013-01-01

The relationship between chronic stress and weight management efforts may be a concern for African American (AA) women, who have a high prevalence of obesity, high stress levels, and modest response to obesity treatment. This pilot study randomly assigned 44 overweight/obese AA women with moderate to high stress levels to either a 12-week…

Fit and healthy family cAMP for engaging families in a child obesity intervention: a community health center pilot project.

PubMed

Weaver, Sally P; Kelley, Lance; Griggs, Jackson; Weems, Suzy; Umstattd Meyer, M Renee

2014-01-01

Childhood obesity has become a significant problem in the United States, especially in poor communities, and we know that children who have at least 1 obese parent have a much higher risk of being obese. Combined behavioral lifestyle interventions and family-based intervention programs to address pediatric obesity have the strongest evidence of effectiveness. In this pilot study, we delineate our collaborative model of family group medical visits at a community health center combined with healthy living workshops involving families with at least 1 child and 1 parent or guardian who are obese as a unique approach to address obesity in children.

A Cognitive Behavioral Smoking Abstinence Intervention for Adults with Chronic Pain: A Randomized Controlled Pilot Trial

PubMed Central

Hooten, W. Michael; Townsend, Cynthia O.; Hays, J. Taylor; Ebnet, Kaye L.; Gauvin, Thomas R.; Gehin, Jessica M.; Laures, Heidi J.; Patten, Christi A.; Warner, David O.

2015-01-01

Current evidence suggests it may be difficult for patients with chronic pain to quit smoking and, based on previous formative work, a 7-session individual and group-based cognitive behavioral (CB) intervention was developed. The primary aim of this randomized controlled pilot trial was to test the hypothesis that abstinence at month 6 would be greater among patients with chronic pain who received the CB intervention compared to a control condition. Upon admission to a 3-week interdisciplinary pain treatment (IPT) program, patients were randomized to receive the CB intervention (n = 30) or the control condition (n = 30). The 7-day point prevalence of self-reported smoking status was assessed at week 3 (upon completion of the 3-week IPT program) and at month 6 in an intent-to-treat analysis. At week 3, 30% (n=9) of patients in the CB condition were abstinent from smoking compared to 10% (n=3) in the control group (P=.104). At month 6, 20% (n=6) of patients who received the CB intervention were abstinent compared to none in the control group (P=.024). At week 3, a significant group by time interaction effect was found where the CB patients experienced greater improvements in self-efficacy from baseline compared to the control group (P=.002). A greater proportion of patients randomized to the CB group completed the IPT program (P=.052). The findings of this pilot trial suggest that integration of a CB-based smoking abstinence intervention into ongoing pain therapy may be an effective treatment for smokers with chronic pain. PMID:24333035

Burnout in Nurses Working With Youth With Chronic Pain: A Pilot Intervention.

PubMed

Rodrigues, Nikita P; Cohen, Lindsey L; McQuarrie, Susanna Crowell; Reed-Knight, Bonney

2018-05-01

Nurse burnout is a significant issue, with repercussions for the nurse, patients, and health-care system. Our prior mixed-methods analyses helped inform a model of burnout in nurses working with youth with chronic pain. Our aims were to (a) detail the development of an intervention to decrease burnout; (b) evaluate the intervention's feasibility and acceptability; and (c) provide preliminary outcomes on the intervention. In total, 33 nurses working on a pediatric inpatient care unit that admits patients with chronic pain conditions participated in the single-session 90-min groups (eight to nine nurses per group). The intervention consisted of four modules including (1) helping patients view pain as multifaceted and shift attention to functioning; (2) teaching problem-solving and reflective listening skills; (3) highlighting positives about patients when venting with coworkers; and (4) improving nurses own self-care practices. Measures provided assessment of feasibility, acceptability, and effectiveness at baseline and 3 months postintervention in a single group, repeated measures design. Data support the feasibility and acceptability of the intervention. Pilot outcome results demonstrated improvements in the target behaviors of education on psychosocial influences, self-care, and venting to coworkers as well as self-compassion, general health, and burnout. There were no changes in pain beliefs or the target behaviors of focus on functioning, empathizing with patient, or highlighting positives. Our single-session tailored group treatment was feasible and acceptable, and pilot data suggest that it is beneficial, but a more comprehensive approach is encouraged to reduce burnout that might be related to multiple individual, unit, and system factors.

Vida Alegre: Preliminary Findings of a Depression Intervention for Immigrant Latino Mothers

ERIC Educational Resources Information Center

Piedra, Lissette M.; Byoun, Soo-Jung

2012-01-01

Objectives: This article reports the outcome of a pilot study of a cognitive behavioral group therapy (CBGT) intervention--"Vida Alegre" (the contented life)--designed for use with depressed immigrant mothers living in communities with small but rapidly growing Hispanic populations. Method: The study used a pretest/posttest/follow-up…

Disseminating ASD Interventions: A Pilot Study of a Distance Learning Program for Parents and Professionals

ERIC Educational Resources Information Center

Wainer, Allison L.; Ingersoll, Brooke R.

2013-01-01

There is a need for the adaptation of training in evidence-based interventions to non-traditional methods, particularly for individuals working with children with autism spectrum disorders (ASD). An internet-based self-directed distance learning program was created to teach reciprocal imitation training, a naturalistic behavioral intervention…

Feasibility Study of the Social Enterprise Intervention with Homeless Youth

ERIC Educational Resources Information Center

Ferguson, Kristin M.; Xie, Bin

2008-01-01

Objective: To reduce mental health symptoms and high-risk behaviors and increase social support and service utilization among street-living youth, the authors conducted a pilot study to assess the feasibility of the social enterprise intervention (SEI) at a homeless youth agency. Method: Convenience sampling was used to recruit 16 street-living…

Improving Social Competence in Children with Autism Spectrum Disorders through a Combined-Strategy Group Intervention: A Pilot Study

ERIC Educational Resources Information Center

Sotelo, Marlene

2009-01-01

This applied dissertation investigated whether a combined-strategy group intervention improved social competence among children with autism spectrum disorders. Individuals with autism spectrum disorders exhibit deficits in social behaviors that may negatively impact all aspects of their lives. Social competence for individuals with autism spectrum…

Outcomes of a School-Based Program for Young Children with Disruptive Behaviors

ERIC Educational Resources Information Center

Plath, Debbie; Croce, Nic; Crofts, Penny; Stuart, Graeme

2016-01-01

This article reports on outcomes of an Australian pilot school-based early intervention program called Got It! (Getting On Track In Time!). Findings contribute to evidence for the effectiveness of interventions for children with early-onset conduct problems. The Got It! program incorporates universal and targeted components for children ages five…

K-6 Early Intervention Project: Evaluation of the First Year of Implementation.

ERIC Educational Resources Information Center

McDaid, Janet L.

California's K-6 Early Intervention Project was established in 1986 under the authority of California Assembly Bill 1535, Pilot Project on Hyperactivity, to provide a system of early identification and assistance to children in kindergarten through grade 6 whose behavior problems interfere with learning. This report contains evaluation findings…

Evaluation of a residential Kundalini yoga lifestyle pilot program for addiction in India.

PubMed

Khalsa, Sat Bir S; Khalsa, Gurucharan S; Khalsa, Hargopal K; Khalsa, Mukta K

2008-01-01

Previously reported substance abuse interventions incorporating meditation and spiritual approaches are believed to provide their benefit through modulation of both psychological and pyschosocial factors. A 90-day residential group pilot treatment program for substance abuse that incorporated a comprehensive array of yoga, meditation, spiritual and mind-body techniques was conducted in Amritsar, India. Subjects showed improvements on a number of psychological self-report questionnaires including the Behavior and Symptom Identification Scale and the Quality of Recovery Index. Application of comprehensive spiritual lifestyle interventions may prove effective in treating substance abuse, particularly in populations receptive to such approaches.

"We're Changing Our Ways": Women's Coping Strategies for Obesity Risk-reducing Behaviors in American Indian Households.

PubMed

Gadhoke, Preety; Christiansen, Karina; Pardilla, Marla; Frick, Kevin; Gittelsohn, Joel

2015-01-01

This article reveals women caregivers' perceptions and coping strategies to improve households' food and physical activity habits. Results emerged from the pre-intervention formative research phase of a multi-site, multi-level obesity prevention pilot intervention on American Indian (AI) reservations. Using purposive sampling, 250 adults and children participated in qualitative research. Results reveal that having local institutional support was a key structural facilitator. 'Family connectedness' emerged as a key relational facilitator. Hegemony of systems, food deserts, transportation, and weather were key structural barriers; Childcare needs and time constraints were key relational barriers. Women's coping strategies included planning ahead, maximizing, apportioning, tempting healthy, and social support. Findings informed the development and implementation of a novel obesity prevention pilot intervention tailored for each participating AI community addressing culturally relevant messages, institutional policies, and programs. We conclude with future consideration for comparative, ethnicity-based, class-based, and gender-specific studies on women's coping strategies for household health behaviors.

Integrating HIV Prevention and Relationship Education for Young Same-Sex Male Couples: A Pilot Trial of the 2GETHER Intervention.

PubMed

Newcomb, Michael E; Macapagal, Kathryn R; Feinstein, Brian A; Bettin, Emily; Swann, Gregory; Whitton, Sarah W

2017-08-01

Young men who have sex with men are at high risk for HIV, and most new HIV infections occur in serious relationships. This pilot study assessed the feasibility, acceptability and preliminary efficacy of the 2GETHER couples-based HIV prevention and relationship education intervention for young same-sex male couples. We enrolled 57 young male couples (N = 114) into a four-session hybrid group and individual intervention. We assessed acceptability via post-session surveys and exit interviews, and we examined preliminary efficacy at a two week posttest. The vast majority of participants (93%) reported exclusively positive impressions of 2GETHER, and all components received high mean ratings. We observed decreases in HIV risk behavior, increases in information, motivation and behavioral skills related to HIV prevention, and improvement in relationship investment between pretest and posttest. Integrating relationship education and sexual health programming may be an effective way to reduce HIV transmissions in young male couples.

Extending the concept of social validity: behavior analysis for disease prevention and health promotion.

PubMed

Winett, R A; Moore, J F; Anderson, E S

1991-01-01

A broader definition of social validity is proposed wherein a socially valid behavior-change intervention is directed to a problem of verifiable importance, the intervention is valued and used appropriately by designated target groups, and the intervention as used has sufficient behavioral impact to substantially reduce the probability of the problem's occurrence in target populations. The verifiable importance of a problem is based on epidemiological data, and the value and appropriate use of an intervention are enhanced through the use of conceptual frameworks for social marketing and behavior change and considerable formative and pilot research. Behavioral impact is assessed through efficacy and effectiveness studies. Thus, the social validity of a behavior-change intervention is established through a number of interactive, a priori steps. This approach to defining social validity is related to critical analysis and intervention issues including individual and population perspectives and "top-down" and "bottom-up" approaches to intervention design. This broader definition of social validity is illustrated by a project to reduce the risk of HIV infection among adolescents. Although the various steps involved in creating socially valid interventions can be complicated, time-consuming, and expensive, following all the steps can result in interventions capable of improving a nation's health.

Pilot Testing of a Parent-Directed Intervention (Project ASPIRE) for Underserved Children Who Are Deaf or Hard of Hearing

ERIC Educational Resources Information Center

Sacks, Chana; Shay, Sophie; Repplinger, Lyra; Leffel, Kristin R.; Sapolich, Shannon G.; Suskind, Elizabeth; Tannenbaum, Sally; Suskind, Dana

2014-01-01

This pilot study explored the potential for Project ASPIRE to effect behavior change in a sample of 11 parents of children with hearing loss who were from typically underserved populations, such as families from backgrounds of low socioeconomic status or families who speak English as a second language. The study consisted of one education session,…

Asian Women's Action for Resilience and Empowerment Intervention: Stage I Pilot Study.

PubMed

Hahm, Hyeouk Chris; Chang, Stephanie Tzu-Han; Lee, Gloria Yoonseung; Tagerman, Michelle D; Lee, Christina S; Trentadue, Mia Pamela; Hien, Denise A

2017-01-01

This study describes the development and pilot test of Asian Women's Action for Resilience and Empowerment (AWARE), a culturally informed group psychotherapy intervention designed to reduce depressive symptoms, suicidality, substance use, and HIV and sexual risk behaviors among 1.5 and second generation Asian American (AA) women. To participate, AA women had to meet the criteria for posttraumatic stress disorder (PTSD) or have a history of exposure to interpersonal violence (IPV) as determined using the Clinician-Administered PTSD Scale (CAPS) and Traumatic Life Events Questionnaire (TLEQ). This article also presents the preliminary feasibility and acceptability of AWARE from its Stage I pilot study of nine Chinese, Korean, and Vietnamese American women. To foster holistic treatment, AWARE was developed based on original research findings from Stage 0 and integrated theoretical models including fractured identity theory, empowerment theory, cognitive behavioral therapy (CBT), mindfulness-based techniques, and the AIDS Risk Reduction Model (ARRM). The development of AWARE was an iterative process informed by participant feedback, which led to frequent intervention modifications for a future randomized controlled trial (RCT) in Stage II. A qualitative analysis of participant feedback informed the following modifications: further exploration of feelings, improvements in technology delivery, learning and practicing coping skills, more specific cultural tailoring related to sexual health, decreased number of sessions and increased time per session. Findings provide support for the acceptability and feasibility of AWARE as "culturally informed" for AA young women with IPV histories, high-risk behaviors, and mental health issues.

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial

PubMed Central

2014-01-01

Background Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. Methods/Design We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes ‘alertness behaviors’. Discussion The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Trial Registration Clinicaltrials.gov NCT02063737, Registered on 10 January 2014 PMID:24952387

A pilot food store intervention in the Republic of the Marshall Islands.

PubMed

Gittelsohn, Joel; Dyckman, William; Frick, Kevin D; Boggs, Malia K; Haberle, Heather; Alfred, Julia; Vastine, Amy; Palafox, Neal

2007-09-01

To improve diet and reduce risk for obesity and chronic disease, we developed, implemented and evaluated a pilot intervention trial with 23 large and small food stores in the Republic of the Marshall Islands (12 intervention, 11 control). The intervention included both mass media (radio announcements, newspaper ads, video) and in-store (cooking demonstrations, taste tests, shelf labeling) components. Consumer exposure to the mass media components was high (65% had heard half or more of the radio announcements, 74% had seen at least one of the newspaper ads). Consumer exposure to the in-store components of the intervention was moderate (61% attended at least one cooking demonstrations, 59% received at least one recipe card). After adjustment for age, sex and education level, increased exposure to the intervention was associated with higher diabetes knowledge (p<0.05) and label reading knowledge (p<0.05), but not with increased self-efficacy for performing promoted healthy behaviors. The intervention was associated with increased purchasing of certain promoted foods (p<0.005), including oatmeal, turkey chili, fish, canned fruit and local vegetables. It was also associated with improvements in healthiness of cooking methods (p<0.05). Food store centered interventions have great potential for changing cognitive and behavioral factors relating to food choice and preparation, and may contribute to lessening the burden of diet-related chronic disease worldwide.

Promoting Resilience in High-risk Children in Jamaica: A Pilot Study of a Multimodal Intervention.

PubMed

Guzder, Jaswant; Paisley, Vanessa; Robertson-Hickling, Hilary; Hickling, Frederick W

2013-05-01

To assess the effectiveness of a multimodal afterschool and summer intervention called the Dream-A-World (DAW) Project for a cohort of school-aged Jamaican children from an impoverished, disadvantaged inner-city community in Kingston, Jamaica. Children were selected by their teachers based on severe disruptive disorders and academic underachievement and compared with a matched control group. The pilot was a child focused therapeutic modality without parental intervention for disruptive conduct and academic failure. A group psychotherapeutic intervention of creative arts therapies and remedial academic support adapted for the Jamaican context was implemented with 30 children from an inner-city primary school. The intervention was implemented over 2½ years spanning grade three to six with evaluation of outcomes using the ASEBA Teacher Report Form (TRF) and end of term grades for the intervention group versus matched controls who were offered usual school supports. The intervention group made significant improvements in school social and behavior adjustment measured by the TRF, with more successful outcome amongst boys for behavioral gains. No significant improvements were made by the girls. Limitations of cohort size, lack of parent data and questions of gender disparities in outcome were unresolved interpretative issues. This multi-modal mental health and academic intervention for high-risk children living in an impoverished, violent neighbourhood, improved global functioning of boys more than girls, and raised questions for design of further preventive planning.

Behavioral Impacts of a Mindfulness Pilot Intervention for Elementary School Students

ERIC Educational Resources Information Center

Harpin, Scott B.; Rossi, AnneMarie; Kim, Amber K.; Swanson, Leah M.

2016-01-01

Elementary school students in today's urban classrooms face many life circumstances at home and in their communities that contribute to stress and coping needs. These stressors are often brought into the classroom, which impact learning, behaviors, and overall academic performance. Mindfulness has been used in classroom settings, particularly with…

Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers.

PubMed

Gordon, Judith S; Armin, Julie; D Hingle, Melanie; Giacobbi, Peter; Cunningham, James K; Johnson, Thienne; Abbate, Kristopher; Howe, Carol L; Roe, Denise J

2017-06-01

Women face particular challenges when quitting smoking, especially those with weight concerns. A multi-behavioral smoking cessation intervention addressing these concerns and incorporating guided imagery may assist women to engage in healthy lifestyle behaviors. An mHealth app can easily disseminate such an intervention. The goals of this pilot study were to develop and test the feasibility and potential of the See Me Smoke-Free ™ mHealth app to address smoking, diet, and physical activity among women smokers. We used pragmatic, direct-to-consumer methods to develop and test program content, functionality, and the user interface and conduct a pre-/post-test, 90-day pilot study. We enrolled 151 participants. Attrition was 52%, leaving 73 participants. At 90 days, 47% of participants reported 7-day abstinence and significant increases in physical activity and fruit consumption. Recruitment methods worked well, but similar to other mHealth studies, we experienced high attrition. This study suggests that a guided imagery mHealth app has the potential to address multiple behaviors. Future research should consider different methods to improve retention and assess efficacy.

Pilot trial of a dissonance-based cognitive-behavioral group depression prevention with college students.

PubMed

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M

2016-07-01

Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = 0.64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pilot Trial of a Dissonance-Based Cognitive-Behavioral Group Depression Prevention with College Students

PubMed Central

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

2016-01-01

Objective Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. Method 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Results Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = .64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Conclusions Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted. PMID:27176493

Evaluation of a pilot healthy eating intervention in restaurants and food stores of a rural community: a randomized community trial.

PubMed

Martínez-Donate, Ana P; Riggall, Ann Josie; Meinen, Amy M; Malecki, Kristen; Escaron, Anne L; Hall, Bev; Menzies, Anne; Garske, Gary; Nieto, F Javier; Nitzke, Susan

2015-02-12

Research suggests that the food environment influences individual eating practices. To date, little is known about effective interventions to improve the food environment of restaurants and food stores and promote healthy eating in rural communities. We tested "Waupaca Eating Smart " (WES), a pilot intervention to improve the food environment and promote healthy eating in restaurants and supermarkets of a rural community. WES focused on labeling, promoting, and increasing the availability of healthy foods. We conducted a randomized community trial, with two Midwestern U.S. communities randomly assigned to serve as intervention or control site. We collected process and outcome data using baseline and posttest owner and customer surveys and direct observation methods. The RE-AIM framework was used to guide the evaluation and organize the results. Seven of nine restaurants and two of three food stores invited to participate in WES adopted the intervention. On a 0-4 scale, the average level of satisfaction with WES was 3.14 (SD=0.69) for restaurant managers and 3 (SD=0.0) for store managers. On average, 6.3 (SD=1.1) out of 10 possible intervention activities were implemented in restaurants and 9.0 (SD=0.0) out of 12 possible activities were implemented in food stores. One month after the end of the pilot implementation period, 5.4 (SD=1.6) and 7.5 (SD=0.7) activities were still in place at restaurants and food stores, respectively. The intervention reached 60% of customers in participating food outlets. Restaurant food environment scores improved from 13.4 to 24.1 (p < 0.01) in the intervention community and did not change significantly in the control community. Food environment scores decreased slightly in both communities. No or minimal changes in customer behaviors were observed after a 10-month implementation period. The intervention achieved high levels of reach, adoption, implementation, and maintenance, suggesting the feasibility and acceptability of restaurant-and food store-based interventions in rural communities. Pilot outcome data indicated very modest levels of effectiveness, but additional research adequately powered to test the impact of this intervention on food environment scores and customer behaviors needs to be conducted in order to identify its potential to promote healthy eating in rural community settings.

The Development of a Brief Jail-Based Cervical Health Promotion Intervention

PubMed Central

Ramaswamy, Megha; Simmons, Rebekah; Kelly, Patricia J.

2015-01-01

The primary objective of this article was to describe the development and pilot implementation of a brief jail-based cervical health promotion intervention. The intervention was guided by a preliminary study of incarcerated women’s cervical health knowledge, awareness, and health literacy, as well as a social and feminist approach to intervention development. We developed and conducted a pilot implementation of the Sexual Health Empowerment Project to increase cervical health knowledge, reduce barriers related to beliefs about cervical cancer, and improve self-efficacy and confidence in navigating health systems. This article offers a framework for how empirically and theory-based interventions are developed and tailored for a jail setting. Future work should include the evaluation of the long-term effects of such a disease-specific program on health behaviors and outcomes among high-risk and vulnerable groups of women as they leave jails and enter communities. PMID:25063589

The development of a brief jail-based cervical health promotion intervention.

PubMed

Ramaswamy, Megha; Simmons, Rebekah; Kelly, Patricia J

2015-05-01

The primary objective of this article was to describe the development and pilot implementation of a brief jail-based cervical health promotion intervention. The intervention was guided by a preliminary study of incarcerated women's cervical health knowledge, awareness, and health literacy, as well as a social and feminist approach to intervention development. We developed and conducted a pilot implementation of the Sexual Health Empowerment Project to increase cervical health knowledge, reduce barriers related to beliefs about cervical cancer, and improve self-efficacy and confidence in navigating health systems. This article offers a framework for how empirically and theory-based interventions are developed and tailored for a jail setting. Future work should include the evaluation of the long-term effects of such a disease-specific program on health behaviors and outcomes among high-risk and vulnerable groups of women as they leave jails and enter communities. © 2014 Society for Public Health Education.

Monitoring intervention fidelity of a lifestyle behavioral intervention delivered through telehealth

PubMed Central

Sineath, Ashley; Lambert, Lauren; Verga, Catherine; Wagstaff, Miranda

2017-01-01

Background Technology-based lifestyle behavioral interventions (i.e., telehealth, mHealth, eHealth, and/or digital health) are becoming an alternative standard of care and possess several advantages over traditional clinical settings such as convenience, cost, and the ability to tailor plans and feedback to a participant’s individual needs. These technology-based interventions also present unique challenges to intervention fidelity due to extra elements involved in executing the intervention. Intervention fidelity monitoring is essential to ensure internal and external validity, yet the development and utilization of fidelity protocols is under-reported in the literature. The purpose of this paper is to describe the intervention fidelity protocol for the 24-START study, a behavior change intervention delivered through telephone and internet. This paper also discusses the results of a pilot audit conducted to determine the feasibility of monitoring adherence to the fidelity protocol. Methods The 24-START fidelity protocol was developed in accordance with the five fidelity areas outlined by the NIH Behavior Change Consortium (NIH BCC) including: design of study, provider training, delivery of treatment, receipt of treatment, and enactment of treatment. The fidelity strategies provided by the NIH BCC in each area were tailored to fit the specific design of the 24-START study. Twenty-six total fidelity strategies were developed in accordance with the five areas and a corresponding fidelity monitoring plan was created. Because these strategies are only beneficial if implemented, the fidelity monitoring plan was developed to ensure the fidelity strategies are consistently implemented over the course of the intervention. Results A pilot audit of nine participant files was conducted to test the feasibility of the fidelity protocol developed. Out of the nine participant files reviewed, 89% of scheduled phone calls between a telehealth coach and participant were successfully completed. Of the completed calls, telehealth coaches delivered the intervention as intended 85.3% of the time, and 74% of planned secondary contacts made through the internet were delivered successfully. Additionally, between treatment group dosing was found to be equal. Several weak areas in the fidelity protocol were identified for improvement. The results were satisfactory and the audit was deemed feasible for ongoing use. Conclusions The NIH BCC provides a valuable framework for telehealth interventions to develop fidelity protocols ultimately contributing to improved internal and external validity, better translation of results, increased transparency, and increased opportunities for replication within the field. The 24-START pilot audit found the fidelity protocol efficacious and feasible while also identifying areas of weakness in need of revision. The refined protocol will continue to be utilized throughout the data collection phase. Future telehealth interventions should develop and disclose fidelity protocols to improve the overall quality and standard of telehealth interventions. PMID:28894745

Monitoring intervention fidelity of a lifestyle behavioral intervention delivered through telehealth.

PubMed

Sineath, Ashley; Lambert, Lauren; Verga, Catherine; Wagstaff, Miranda; Wingo, Brooks C

2017-01-01

Technology-based lifestyle behavioral interventions (i.e., telehealth, mHealth, eHealth, and/or digital health) are becoming an alternative standard of care and possess several advantages over traditional clinical settings such as convenience, cost, and the ability to tailor plans and feedback to a participant's individual needs. These technology-based interventions also present unique challenges to intervention fidelity due to extra elements involved in executing the intervention. Intervention fidelity monitoring is essential to ensure internal and external validity, yet the development and utilization of fidelity protocols is under-reported in the literature. The purpose of this paper is to describe the intervention fidelity protocol for the 24-START study, a behavior change intervention delivered through telephone and internet. This paper also discusses the results of a pilot audit conducted to determine the feasibility of monitoring adherence to the fidelity protocol. The 24-START fidelity protocol was developed in accordance with the five fidelity areas outlined by the NIH Behavior Change Consortium (NIH BCC) including: design of study, provider training, delivery of treatment, receipt of treatment, and enactment of treatment. The fidelity strategies provided by the NIH BCC in each area were tailored to fit the specific design of the 24-START study. Twenty-six total fidelity strategies were developed in accordance with the five areas and a corresponding fidelity monitoring plan was created. Because these strategies are only beneficial if implemented, the fidelity monitoring plan was developed to ensure the fidelity strategies are consistently implemented over the course of the intervention. A pilot audit of nine participant files was conducted to test the feasibility of the fidelity protocol developed. Out of the nine participant files reviewed, 89% of scheduled phone calls between a telehealth coach and participant were successfully completed. Of the completed calls, telehealth coaches delivered the intervention as intended 85.3% of the time, and 74% of planned secondary contacts made through the internet were delivered successfully. Additionally, between treatment group dosing was found to be equal. Several weak areas in the fidelity protocol were identified for improvement. The results were satisfactory and the audit was deemed feasible for ongoing use. The NIH BCC provides a valuable framework for telehealth interventions to develop fidelity protocols ultimately contributing to improved internal and external validity, better translation of results, increased transparency, and increased opportunities for replication within the field. The 24-START pilot audit found the fidelity protocol efficacious and feasible while also identifying areas of weakness in need of revision. The refined protocol will continue to be utilized throughout the data collection phase. Future telehealth interventions should develop and disclose fidelity protocols to improve the overall quality and standard of telehealth interventions.

Evaluating the Social Validity of the Early Start Denver Model: A Convergent Mixed Methods Study

ERIC Educational Resources Information Center

Ogilvie, Emily; McCrudden, Matthew T.

2017-01-01

An intervention has social validity to the extent that it is socially acceptable to participants and stakeholders. This pilot convergent mixed methods study evaluated parents' perceptions of the social validity of the Early Start Denver Model (ESDM), a naturalistic behavioral intervention for children with autism. It focused on whether the parents…

Brief Report: Problem Solving Therapy in College Students with Autism Spectrum Disorders: Feasibility and Preliminary Efficacy

ERIC Educational Resources Information Center

Pugliese, Cara E.; White, Susan W.

2014-01-01

Students with autism spectrum disorder (ASD), though academically capable, can have difficulty succeeding in college. Evidence-based intervention to promote effective problem solving may improve quality of life, as well as success and satisfaction in college. This study adapted and piloted a group-based cognitive-behavioral intervention program,…

Pilot Study to Gauge Acceptability of a Mindfulness-Based, Family-Focused Preventive Intervention

ERIC Educational Resources Information Center

Duncan, Larissa G.; Coatsworth, J. Douglas; Greenberg, Mark T.

2009-01-01

The purpose of the present study was to conduct a test of acceptability of a new model for family-focused drug prevention programs for families of early adolescents. An existing evidence-based behavioral intervention, the Strengthening Families Program: For Parents and Youth 10-14 (SFP), was adapted to include concepts and activities related to…

Telehealth Delivery of Cognitive-Behavioral Intervention to Youth with Autism Spectrum Disorder and Anxiety: A Pilot Study

ERIC Educational Resources Information Center

Hepburn, Susan L.; Blakeley-Smith, Audrey; Wolff, Brian; Reaven, Judy A.

2016-01-01

Youth with autism spectrum disorders frequently experience significant symptoms of anxiety. Empirically supported psychosocial interventions exist, yet access is limited, especially for families in rural areas. Telehealth (i.e. videoconferencing) has potential to reduce barriers to access to care; however, little is known about the feasibility or…

Evaluating the Acceptability and Feasibility of Project ACCEPT: An Intervention for Youth Newly Diagnosed with HIV

ERIC Educational Resources Information Center

Hosek, Sybil G.; Lemos, Diana; Harper, Gary W.; Telander, Kyle

2011-01-01

Given the potential for negative psychosocial and medical outcomes following an HIV diagnosis, Project ACCEPT, a 12-session behavioral intervention, was developed and pilot-tested for youth (aged 16-24) newly diagnosed with HIV. Fifty participants recently diagnosed with HIV were enrolled from 4 sites selected through the Adolescent Medicine…

An HIV-Prevention Intervention for Sex Workers in Tijuana, Mexico: A Pilot Study

ERIC Educational Resources Information Center

Patterson, Thomas L.; Semple, Shirley J.; Fraga, Miguel; Bucardo, Jesus; Davila-Fraga, Wendy; Strathdee, Steffanie A.

2005-01-01

Female sex workers (FSW) are at high risk of acquiring sexually transmitted infections (STIs), including HIV, and putting their clients and other partners at risk for infection. There is considerable evidence that Social Cognitive Theory (SCT)?based interventions are effective in reducing high-risk sexual behavior among at-risk populations in the…

An Evaluation of a Smartphone–Assisted Behavioral Weight Control Intervention for Adolescents: Pilot Study

PubMed Central

Duncombe, Kristina M; Lott, Mark A; Hunsaker, Sanita L; Duraccio, Kara M; Woolford, Susan J

2016-01-01

Background The efficacy of adolescent weight control treatments is modest, and effective treatments are costly and are not widely available. Smartphones may be an effective method for delivering critical components of behavioral weight control treatment including behavioral self-monitoring. Objective To examine the efficacy and acceptability of a smartphone assisted adolescent behavioral weight control intervention. Methods A total of 16 overweight or obese adolescents (mean age=14.29 years, standard deviation=1.12) received 12 weeks of combined treatment that consisted of weekly in-person group behavioral weight control treatment sessions plus smartphone self-monitoring and daily text messaging. Subsequently they received 12 weeks of electronic-only intervention, totaling 24 weeks of intervention. Results On average, participants attained modest but significant reductions in body mass index standard score (zBMI: 0.08 standard deviation units, t (13)=2.22, P=.04, d=0.63) over the in-person plus electronic-only intervention period but did not maintain treatment gains over the electronic-only intervention period. Participants self-monitored on approximately half of combined intervention days but less than 20% of electronic-only intervention days. Conclusions Smartphones likely hold promise as a component of adolescent weight control interventions but they may be less effective in helping adolescents maintain treatment gains after intensive interventions. PMID:27554704

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

PubMed

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

2017-01-01

To conduct a pilot trial to test the feasibility of a guided self-help intervention for chronic orofacial pain. A pilot randomized controlled trial was conducted to compare the intervention with usual treatment. A total of 37 patients with chronic orofacial pain were randomized into either the intervention group (n = 19) or the usual treatment (control) group (n = 18). Validated outcome measures were used to measure the potential effectiveness of the intervention over a number of domains: physical and mental functioning (Short Form 36 [SF-36]); anxiety and depression (Hospital Anxiety and Depression Scale [HADS]); pain intensity and interference with life (Brief Pain Inventory [BPI]); disability (Manchester Orofacial Pain Disability Scale [MOPDS]); and illness behavior (Revised Illness Perceptions Questionnaire [IPQr]). Bootstrap confidence intervals were computed for the treatment effect (ES) posttreatment and at 3 months follow-up and adjusted for baseline values of the outcome measure by using analysis of covariance. At posttreatment and the 3-month follow-up, 11 participants in the intervention group and 7 in the control group failed to complete outcome measures. The intervention was acceptable and could be feasibly delivered face to face or over the telephone. Although the pilot trial was not powered to draw conclusions about the effectiveness, it showed significant (P < .05) effects of the intervention on physical and mental functioning and treatment control. The self-help intervention was acceptable to patients and allowed them to better understand and self-manage chronic orofacial pain. It showed potential effectiveness on outcome domains related to functioning and illness perception. Further research is needed to understand the cost effectiveness of the intervention for chronic orofacial pain.

Design and methods for "Commit to Get Fit" - a pilot study of a school-based mindfulness intervention to promote healthy diet and physical activity among adolescents.

PubMed

Salmoirago-Blotcher, Elena; Druker, Sue; Meyer, Florence; Bock, Beth; Crawford, Sybil; Pbert, Lori

2015-03-01

Cardiovascular prevention is more effective if started early in life, but available interventions to promote healthy lifestyle habits among youth have been ineffective. Impulsivity in particular has proven to be an important barrier to the adoption of healthy behaviors in youth. Observational evidence suggests that mindfulness interventions may reduce impulsivity and improve diet and physical activity. We hypothesize that mindfulness training in adjunct to traditional health education will improve dietary habits and physical activity among teenagers by reducing impulsive behavior and improving planning skills. The Commit to Get Fit study is a pilot cluster randomized controlled trial examining the feasibility, acceptability and preliminary efficacy of school-based mindfulness training in adjunct to traditional health education for promotion of a healthy diet and physical activity among adolescents. Two schools in central Massachusetts (30 students per school) will be randomized to receive mindfulness training plus standard health education (HE-M) or an attention-control intervention plus standard health education (HE-AC). Assessments will be conducted at baseline, intervention completion (2 months), and 8 months. Primary outcomes are feasibility and acceptability. Secondary outcomes include physical activity, diet, impulsivity, mood, body mass index, and quality of life. This study will provide important information about feasibility and preliminary estimates of efficacy of a school-delivered mindfulness and health education intervention to promote healthy dietary and physical activity behaviors among adolescents. Our findings will provide important insights about the possible mechanisms by which mindfulness training may contribute to behavioral change and inform future research in this important area. Copyright © 2015 Elsevier Inc. All rights reserved.

Design and methods for “Commit to Get Fit” – A pilot study of a school-based mindfulness intervention to promote healthy diet and physical activity among adolescents

PubMed Central

Salmoirago-Blotcher, Elena; Druker, Sue; Meyer, Florence; Bock, Beth; Crawford, Sybil; Pbert, Lori

2015-01-01

Introduction Cardiovascular prevention is more effective if started early in life, but available interventions to promote healthy lifestyle habits among youth have been ineffective. Impulsivity in particular has proven to be an important barrier to the adoption of healthy behaviors in youth. Observational evidence suggests that mindfulness interventions may reduce impulsivity and improve diet and physical activity. We hypothesize that mindfulness training in adjunct to traditional health education will improve dietary habits and physical activity among teenagers by reducing impulsive behavior and improving planning skills. Methods/Design The Commit to Get Fit study is a pilot cluster randomized controlled trial examining the feasibility, acceptability and preliminary efficacy of school-based mindfulness training in adjunct to traditional health education for promotion of a healthy diet and physical activity among adolescents. Two schools in central Massachusetts (30 students per school) will be randomized to receive mindfulness training plus standard health education (HE-M) or an attention-control intervention plus standard health education (HE-AC). Assessments will be conducted at baseline, intervention completion (2 months), and 8 months. Primary outcomes are feasibility and acceptability. Secondary outcomes include physical activity, diet, impulsivity, mood, body mass index, and quality of life. Conclusions This study will provide important information about feasibility and preliminary estimates of efficacy of a school-delivered mindfulness and health education intervention to promote healthy dietary and physical activity behaviors among adolescents. Our findings will provide important insights about the possible mechanisms by which mindfulness training may contribute to behavioral change and inform future research in this important area. PMID:25687667

Neural mechanisms of behavioral change in young adults with high-functioning autism receiving virtual reality social cognition training: A pilot study.

PubMed

Yang, Y J Daniel; Allen, Tandra; Abdullahi, Sebiha M; Pelphrey, Kevin A; Volkmar, Fred R; Chapman, Sandra B

2018-05-01

Measuring treatment efficacy in individuals with Autism Spectrum Disorder (ASD) relies primarily on behaviors, with limited evidence as to the neural mechanisms underlying these behavioral gains. This pilot study addresses this void by investigating neural and behavioral changes in a Phase I trial in young adults with high-functioning ASD who received an evidence-based behavioral intervention, Virtual Reality-Social Cognition Training over 5 weeks for a total of 10 hr. The participants were tested pre- and post-training with a validated biological/social versus scrambled/nonsocial motion neuroimaging task, previously shown to activate regions within the social brain networks. Three significant brain-behavior changes were identified. First, the right posterior superior temporal sulcus, a hub for socio-cognitive processing, showed increased brain activation to social versus nonsocial stimuli in individuals with greater gains on a theory-of-mind measure. Second, the left inferior frontal gyrus, a region for socio-emotional processing, tracked individual gains in emotion recognition with decreased activation to social versus nonsocial stimuli. Finally, the left superior parietal lobule, a region for visual attention, showed significantly decreased activation to nonsocial versus social stimuli across all participants, where heightened attention to nonsocial contingencies has been considered a disabling aspect of ASD. This study provides, albeit preliminary, some of the first evidence of the harnessable neuroplasticity in adults with ASD through an age-appropriate intervention in brain regions tightly linked to social abilities. This pilot trial motivates future efforts to develop and test social interventions to improve behaviors and supporting brain networks in adults with ASD. Autism Res 2018, 11: 713-725. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. This study addresses how the behavioral changes after treatment for ASD reflect underlying brain changes. Before and after receiving VR-SCT, young adults with high-functioning ASD passively viewed biological motion stimuli in a MRI scanner, tapping changes in the social brain network. The results reveal neuroplasticity in this age population, extending the window of opportunity for interventions to impact social competency in adults with ASD. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.

A Social Media Peer Group Intervention for Mothers to Prevent Obesity and Promote Healthy Growth from Infancy: Development and Pilot Trial.

PubMed

Gruver, Rachel S; Bishop-Gilyard, Chanelle T; Lieberman, Alexandra; Gerdes, Marsha; Virudachalam, Senbagam; Suh, Andrew W; Kalra, Gurpreet K; Magge, Sheela N; Shults, Justine; Schreiner, Mark S; Power, Thomas J; Berkowitz, Robert I; Fiks, Alexander G

2016-08-02

Evidence increasingly indicates that childhood obesity prevention efforts should begin as early as infancy. However, few interventions meet the needs of families whose infants are at increased obesity risk due to factors including income and maternal body mass index (BMI). Social media peer groups may offer a promising new way to provide these families with the knowledge, strategies, and support they need to adopt obesity prevention behaviors. The aim of this study is to develop and pilot test a Facebook-based peer group intervention for mothers, designed to prevent pediatric obesity and promote health beginning in infancy. We conducted in-depth semi-structured interviews with 29 mothers of infants and focus groups with 30 pediatric clinicians, to inform the development of a theory-based intervention. We then conducted a single-group pilot trial with 8 mothers to assess its feasibility and acceptability. All participants were recruited offline at pediatric primary care practices. Participants in the pilot trial joined a private Facebook group, moderated by a psychologist, with a weekly video-based curriculum, and also had the option to meet at a face-to-face event. Within the Facebook group, mothers were encouraged to chat, ask questions, and share photos and videos of themselves and babies practicing healthy behaviors. Consistent with the literature on obesity prevention, the curriculum addressed infant feeding, sleep, activity, and maternal well-being. Feasibility was assessed using the frequency and content of group participation by mothers, and acceptability was measured using online surveys and phone interviews. Based on preferences of mothers interviewed (mean BMI 35 kg/m(2), all Medicaid-insured, mean age 27, all Black), we designed the intervention to include frequent posts with new information, videos showing parents of infants demonstrating healthy behaviors, and an optional face-to-face meeting. We developed a privacy and safety plan that met the needs of participants as well as the requirements of the local institutional review board (IRB), which included use of a "secret" group and frequent screening of participant posts. Clinicians, 97% (29/30) women and 87% (26/30) pediatricians, preferred no direct involvement in the intervention, but were supportive of their patients' participation. In our 8-week, single group pilot trial, all participants (mean BMI 35 kg/m(2), all Medicaid-insured, mean age 28, all Black) viewed every weekly video post, and interacted frequently, with a weekly average of 4.4 posts/comments from each participant. All participant posts were related to parenting topics. Participants initiated conversations about behaviors related to healthy infant growth including solid food introduction, feeding volume, and managing stress. All 8 pilot group participants reported that they found the group helpful and would recommend it to others. Our methodology was feasible and acceptable to low-income mothers of infants at high risk of obesity, and could be adapted to implement peer groups through social media for underserved populations in varied settings. ClinicalTrials.gov NCT01977105; https://clinicaltrials.gov/ct2/show/NCT01977105 (Archived by WebCite at http://www.webcitation.org/6iMFfOBat).

IDEAS (Integrate, Design, Assess, and Share): A Framework and Toolkit of Strategies for the Development of More Effective Digital Interventions to Change Health Behavior

PubMed Central

Robinson, Thomas N; King, Abby C

2016-01-01

Developing effective digital interventions to change health behavior has been a challenging goal for academics and industry players alike. Guiding intervention design using the best combination of approaches available is necessary if effective technologies are to be developed. Behavioral theory, design thinking, user-centered design, rigorous evaluation, and dissemination each have widely acknowledged merits in their application to digital health interventions. This paper introduces IDEAS, a step-by-step process for integrating these approaches to guide the development and evaluation of more effective digital interventions. IDEAS is comprised of 10 phases (empathize, specify, ground, ideate, prototype, gather, build, pilot, evaluate, and share), grouped into 4 overarching stages: Integrate, Design, Assess, and Share (IDEAS). Each of these phases is described and a summary of theory-based behavioral strategies that may inform intervention design is provided. The IDEAS framework strives to provide sufficient detail without being overly prescriptive so that it may be useful and readily applied by both investigators and industry partners in the development of their own mHealth, eHealth, and other digital health behavior change interventions. PMID:27986647

A bi-level intervention to improve oral hygiene of older and disabled adults in low-income housing: results of a pilot study.

PubMed

Reisine, S; Schensul, J J; Goldblatt, R; Radda, K; Foster-Bey, C; Acosta-Glynn, C; Miron-Carcamo, L; Ioannidou, E

2016-06-01

This paper describes the results of a bi-level intervention, using a cognitive-behavioral theoretical approach, to improve the oral hygiene of older adults and the disabled in community-based low income senior housing. The bi-level pilot intervention consisted of an on-site tailored adapted motivational interviewing (AMI) session and two oral health fairs, supported by a resident campaign committee, to change community norms. All materials were available in English and Spanish. Participants completed a survey consisting of 12 domains that provided the basis for tailoring the AMI and shaping the campaigns. The domains were activities of daily living (ADLs), access to oral health information, oral hygiene status, dental knowledge, hygiene behaviors, importance of oral hygiene, self-efficacy/locus of control, diet, intentions, self-management worries/fears, perceived risk and dry mouth. Each participant received clinical assessments consisting of full-mouth plaque score (PS) and gingival index (GI) before the intervention and at three months. Twenty-seven residents with at least one tooth completed all phases of the study. The mean number of domains requiring attention was 4.5 (SD 1.6) with a range of one to seven. Mean baseline PS was 83% (SD 16%) which improved significantly to 58% (SD 31%); mean baseline GI was 1.15 (SD 0.61) and improved significantly to 0.49 (SD 0.46). This pilot study supports the feasibility and acceptability of a tailored oral hygiene intervention among older and disabled adults living in low income senior housing. Although a small sample, the study demonstrated significant improvements in both plaque and gingival scores three months after the bi-level intervention.

Feasibility of Pairing Behavioral Activation With Exercise for Women With Type 2 Diabetes and Depression: The Get It Study Pilot Randomized Controlled Trial

PubMed Central

Schneider, Kristin L.; Panza, Emily; Handschin, Barbara; Ma, Yunsheng; Busch, Andrew M.; Waring, Molly E.; Appelhans, Bradley M.; Whited, Matthew C.; Keeney, Jacey; Kern, Daniel; Blendea, Mihaela; Ockene, Ira; Pagoto, Sherry L.

2016-01-01

Major depressive disorder is often comorbid with diabetes and associated with worse glycemic control. Exercise improves glycemic control and depression, and thus could be a parsimonious intervention for patients with comorbid diabetes and major depression. Because patients with diabetes and comorbid depression are often sedentary and lack motivation to exercise, we developed a group exercise intervention that integrates strategies from behavioral activation therapy for depression to increase motivation for and enjoyment of exercise. We conducted a 6-month pilot randomized controlled trial to test the feasibility of the behavioral activation exercise intervention (EX) for women with diabetes and depression. Of the 715 individuals who contacted us about the study, 29 participants were randomized to the EX condition or an enhanced usual care condition (EUC), which represents 4.1% of participants who initially contacted us. Inclusion criteria made recruitment challenging and limits the feasibility of recruiting women with diabetes and depression for a larger trial of the intervention. Retention was 96.5% and 86.2% at 3 and 6 months. Participants reported high treatment acceptability; use of behavioral activation strategies and exercise class attendance was acceptable. No condition differences were observed for glycemic control, depressive symptoms, and physical activity, though depressive symptoms and self-reported physical activity improved over time. Compared to participants in the EUC condition, participants in the EX condition reported greater exercise enjoyment and no increase in avoidance behavior over time. Using behavioral activation strategies to increase exercise is feasible in a group exercise setting. However, whether these strategies can be delivered in a less intensive manner to a broader population of sedentary adults, for greater initiation and maintenance of physical activity, deserves further study. PMID:26956652

Feasibility of Pairing Behavioral Activation With Exercise for Women With Type 2 Diabetes and Depression: The Get It Study Pilot Randomized Controlled Trial.

PubMed

Schneider, Kristin L; Panza, Emily; Handschin, Barbara; Ma, Yunsheng; Busch, Andrew M; Waring, Molly E; Appelhans, Bradley M; Whited, Matthew C; Keeney, Jacey; Kern, Daniel; Blendea, Mihaela; Ockene, Ira; Pagoto, Sherry L

2016-03-01

Major depressive disorder is often comorbid with diabetes and associated with worse glycemic control. Exercise improves glycemic control and depression, and thus could be a parsimonious intervention for patients with comorbid diabetes and major depression. Because patients with diabetes and comorbid depression are often sedentary and lack motivation to exercise, we developed a group exercise intervention that integrates strategies from behavioral activation therapy for depression to increase motivation for and enjoyment of exercise. We conducted a 6-month pilot randomized controlled trial to test the feasibility of the behavioral activation exercise intervention (EX) for women with diabetes and depression. Of the 715 individuals who contacted us about the study, 29 participants were randomized to the EX condition or an enhanced usual care condition (EUC), which represents 4.1% of participants who initially contacted us. Inclusion criteria made recruitment challenging and limits the feasibility of recruiting women with diabetes and depression for a larger trial of the intervention. Retention was 96.5% and 86.2% at 3 and 6months. Participants reported high treatment acceptability; use of behavioral activation strategies and exercise class attendance was acceptable. No condition differences were observed for glycemic control, depressive symptoms, and physical activity, though depressive symptoms and self-reported physical activity improved over time. Compared to participants in the EUC condition, participants in the EX condition reported greater exercise enjoyment and no increase in avoidance behavior over time. Using behavioral activation strategies to increase exercise is feasible in a group exercise setting. However, whether these strategies can be delivered in a less intensive manner to a broader population of sedentary adults, for greater initiation and maintenance of physical activity, deserves further study. Copyright © 2015. Published by Elsevier Ltd.

Feasibility and impact of Creciendo Sanos, a clinic-based pilot intervention to prevent obesity among preschool children in Mexico City.

PubMed

Martínez-Andrade, Gloria Oliva; Cespedes, Elizabeth M; Rifas-Shiman, Sheryl L; Romero-Quechol, Guillermina; González-Unzaga, Marco Aurelio; Benítez-Trejo, María Amalia; Flores-Huerta, Samuel; Horan, Chrissy; Haines, Jess; Taveras, Elsie M; Pérez-Cuevas, Ricardo; Gillman, Matthew W

2014-03-20

Mexico has the highest adult overweight and obesity prevalence in the Americas; 23.8% of children <5 years old are at risk for overweight and 9.7% are already overweight or obese. Creciendo Sanos was a pilot intervention to prevent obesity among preschoolers in Instituto Mexicano del Seguro Social (IMSS) clinics. We randomized 4 IMSS primary care clinics to either 6 weekly educational sessions promoting healthful nutrition and physical activity or usual care. We recruited 306 parent-child pairs: 168 intervention, 138 usual care. Children were 2-5 years old with WHO body mass index (BMI) z-score 0-3. We measured children's height and weight and parents reported children's diet and physical activity at baseline and 3 and 6-month follow-up. We analyzed behavioral and BMI outcomes with generalized mixed models incorporating multiple imputation for missing values. 93 (55%) intervention and 96 (70%) usual care families completed 3 and 6-month follow-up. At 3 months, intervention v. usual care children increased vegetables by 6.3 servings/week (95% CI, 1.8, 10.8). In stratified analyses, intervention participants with high program adherence (5-6 sessions) decreased snacks and screen time and increased vegetables v. usual care. No further effects on behavioral outcomes or BMI were observed. Transportation time and expenses were barriers to adherence. 90% of parents who completed the post-intervention survey were satisfied with the program. Although satisfaction was high among participants, barriers to participation and retention included transportation cost and time. In intention to treat analyses, we found intervention effects on vegetable intake, but not other behaviors or BMI. ClinicalTrials.gov NCT01539070.Comisión Nacional de Investigación Científica del IMSS: 2009-785-120.

Community Wise: paving the way for empowerment in community reentry.

PubMed

Windsor, Liliane Cambraia; Jemal, Alexis; Benoit, Ellen

2014-01-01

Theoretical approaches traditionally applied in mental health and criminal justice interventions fail to address the historical and structural context that partially explains health disparities. Community Wise was developed to address this gap. It is a 12week group intervention informed by Critical Consciousness Theory and designed to prevent substance abuse, related health risk behaviors, psychological distress, and reoffending among individuals with a history of incarceration and substance abuse. This paper reports findings from the first implementation and pilot evaluation of Community Wise in two community-based organizations. This pre-posttest evaluation pilot-tested Community Wise and used findings to improve the intervention. Twenty-six participants completed a phone and clinical screening, baseline, 6- and 12-week follow-ups, and a focus group at the end of the intervention. Measures assessed participants' demographic information, psychological distress, substance use, criminal offending, HIV risk behaviors, community cohesion, community support, civic engagement, critical consciousness, ethnic identification, group cohesion, client satisfaction, and acquired treatment skills. Research methods were found to be feasible and useful in assessing the intervention. Results indicated that while Community Wise is a promising intervention, several changes need to be made in order to enhance the intervention. Community Wise is a new approach where oppressed individuals join in critical dialogue, tap into existing community resources, and devise, implement and evaluate their own community solutions to structural barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Heart health whispering: A randomized, controlled pilot study to promote nursing student perspective-taking on carers' health risk behaviors.

PubMed

Lobchuk, Michelle; Hoplock, Lisa; Halas, Gayle; West, Christina; Dika, Cheryl; Schroeder, Wilma; Ashcroft, Terri; Clouston, Kathleen Chambers; Lemoine, Jocelyne

2018-01-01

Lifestyle counseling is described as a "major breakthrough" in the control of chronic diseases. Counseling can be challenging to nurses due their lack of motivation to counsel, hesitancy to appear non-judgmental, lack of empathy, and lack of time. Nurses voice their need for more training in counseling communication skills. Our main objective was to engage in ongoing development and testing of a promising Heart Health Whispering perspective-taking intervention on nursing students' clinical empathy, perceptual understanding, and client readiness to alter health risk behaviors. In this randomized controlled pilot study, the full intervention (perspective-taking instructions, practice, and video-feedback) and partial intervention (video-feedback only) comprised 24 and 18 nursing students, respectively. Quantitative data were collected with a 10-item pre- and post-intervention clinical empathy tool, a one-item 'readiness to change' health risk behavior tool plus similarity ratings on students' empathic accuracy were calculated. Data were analyzed using Independent Samples t Tests and mixed model ANCOVA models. Students' and actors' evaluative responses toward the intervention phases were collected by handwritten notes, and analyzed using content analysis and constant comparison techniques. The main finding was that students in the full intervention group reported greater clinical empathy in the post versus baseline condition. Students underestimated their clinical empathy in comparison to carers' reports in the post-condition. In both intervention groups, carers reported more readiness to change in the post-condition. Carers identified favorable and unfavorable perceptions and outcomes of approaches taken by students . Students desired immediate and direct feedback after the video-dialogue and -tagging exercise. Heart Health Whispering is a promising intervention to help educators in basic and continuing education to bolster nurse confidence in empathic conversations on health risk behaviors. This intervention incorporates commonly used strategies to teach empathic communication along with a novel video-analysis application of a perspective-taking task. Student and carer actor comments highlighted the value in opportunities for students to engage in self-evaluation and practicing the empathic process of taking the client's perspective on health risk behaviors.

Using Video Conferencing to Deliver a Brief Motivational Intervention for Alcohol and Sex Risk to Emergency Department Patients: A Proof-of-Concept Pilot Study

PubMed Central

Celio, Mark A.; Mastroleo, Nadine R.; DiGuiseppi, Graham; Barnett, Nancy P.; Colby, Suzanne M.; Kahler, Christopher W.; Operario, Don; Suffoletto, Brian; Monti, Peter M.

2016-01-01

Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; Mage = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings. PMID:28649188

Using Video Conferencing to Deliver a Brief Motivational Intervention for Alcohol and Sex Risk to Emergency Department Patients: A Proof-of-Concept Pilot Study.

PubMed

Celio, Mark A; Mastroleo, Nadine R; DiGuiseppi, Graham; Barnett, Nancy P; Colby, Suzanne M; Kahler, Christopher W; Operario, Don; Suffoletto, Brian; Monti, Peter M

2017-01-01

Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; M age = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings.

Piloting a Savings-Led Microfinance Intervention with Women Engaging in Sex Work in Mongolia: Further Innovation for HIV Risk Reduction

PubMed Central

Tsai, Laura Cordisco; Witte, Susan S.; Aira, Toivgoo; Altantsetseg, Batsukh; Riedel, Marion

2014-01-01

This paper describes a pilot study testing the feasibility of an innovative savings-led microfinance intervention in increasing the economic empowerment and reducing the sexual risk behavior of women engaging in sex work in Mongolia. Women’s economic vulnerability may increase their risk for HIV by compromising their ability to negotiate safer sex with partners and heightening the likelihood they will exchange sex for survival. Microfinance has been considered a potentially powerful structural HIV prevention strategy with women conducting sex work, as diversification of income sources may increase women’s capacity to negotiate safer transactional sex. With 50% of all reported female HIV cases in Mongolia detected among women engaging in sex work, direct prevention intervention with women conducting sex work represents an opportunity to prevent a potentially rapid increase in HIV infection in urban Mongolia. The piloted intervention consisted of a matched savings program in which matched savings could be used for business development or vocational education, combined with financial literacy and business development training for women engaging in sex work. Results of the pilot demonstrate participants’ increased confidence in their ability to manage finances, greater hope for pursuing vocational goals, moderate knowledge gains regarding financial literacy, and an initial transition from sex work to alternative income generation for five out of nine participants. The pilot findings highlight the potential for such an intervention and the need for a clinical trial testing the efficacy of savings-led microfinance programs in reducing HIV risk for women engaging in sex work in Mongolia. PMID:24900163

Piloting a Savings-Led Microfinance Intervention with Women Engaging in Sex Work in Mongolia: Further Innovation for HIV Risk Reduction.

PubMed

Tsai, Laura Cordisco; Witte, Susan S; Aira, Toivgoo; Altantsetseg, Batsukh; Riedel, Marion

2011-12-30

This paper describes a pilot study testing the feasibility of an innovative savings-led microfinance intervention in increasing the economic empowerment and reducing the sexual risk behavior of women engaging in sex work in Mongolia. Women's economic vulnerability may increase their risk for HIV by compromising their ability to negotiate safer sex with partners and heightening the likelihood they will exchange sex for survival. Microfinance has been considered a potentially powerful structural HIV prevention strategy with women conducting sex work, as diversification of income sources may increase women's capacity to negotiate safer transactional sex. With 50% of all reported female HIV cases in Mongolia detected among women engaging in sex work, direct prevention intervention with women conducting sex work represents an opportunity to prevent a potentially rapid increase in HIV infection in urban Mongolia. The piloted intervention consisted of a matched savings program in which matched savings could be used for business development or vocational education, combined with financial literacy and business development training for women engaging in sex work. Results of the pilot demonstrate participants' increased confidence in their ability to manage finances, greater hope for pursuing vocational goals, moderate knowledge gains regarding financial literacy, and an initial transition from sex work to alternative income generation for five out of nine participants. The pilot findings highlight the potential for such an intervention and the need for a clinical trial testing the efficacy of savings-led microfinance programs in reducing HIV risk for women engaging in sex work in Mongolia.

The potential influence of a social media intervention on risky sexual behavior and Chlamydia incidence.

PubMed

Jones, Krista; Baldwin, Kathleen A; Lewis, Patricia Ryan

2012-01-01

The purpose of this descriptive pilot study was to evaluate an evidence-based social-networking intervention aimed at reducing the incidence of Chlamydia among 15- to 24-year-olds. The intervention consists of a Facebook site that addresses signs, symptoms, treatment, screening, and prevention of Chlamydia infection. Findings included a 23% self-reported increase in condom utilization, and a 54% reduction in positive Chlamydia cases among 15- to 17-year-olds. Study results support that social media may be an effective mechanism for information dissemination and the promotion of positive behavioral changes among this population. Copyright © Taylor & Francis Group, LLC

Bully Prevention in Positive Behavior Support: Preliminary Evaluation of Third-, Fourth-, and Fifth-Grade Attitudes toward Bullying

ERIC Educational Resources Information Center

Ross, Scott W.; Horner, Robert H.

2014-01-01

The current pilot study demonstrates the potential of adding simple and efficient bully prevention strategies to already established School-Wide Positive Behavior Interventions and Supports. The self-report surveys of third-, fourth-, and fifth-grade students from three elementary schools evaluated the relationship between the implementation of…

Brief Report: Integrating Social-Emotional Learning with Literacy Instruction--An Intervention for Children at Risk for Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Daunic, Ann; Corbett, Nancy; Smith, Stephen; Barnes, Tia; Santiago-Poventud, Lourdes; Chalfant, Pam; Pitts, Donna; Gleaton, Jeisha

2013-01-01

It is widely believed that children's social-emotional growth and academic learning are inextricably connected. Pressured by high-stakes assessments, however, school professionals find it difficult to devote adequate time to children's social/behavioral development. As a response, we developed and piloted Social-Emotional Learning Foundations…

Use of Text Messaging for Monitoring Sugar-Sweetened Beverages, Physical Activity, and Screen Time in Children: A Pilot Study

ERIC Educational Resources Information Center

Shapiro, Jennifer R.; Bauer, Stephanie; Hamer, Robert M.; Kordy, Hans; Ward, Dianne; Bulik, Cynthia M.

2008-01-01

Objective: To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children. Design: All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via…

Piloting a Dialectical Behavioral Therapy (DBT) Infused Skills Group in a Disciplinary Alternative Education Program (DAEP)

ERIC Educational Resources Information Center

Ricard, Richard J.; Lerma, Eunice; Heard, Courtney C. C.

2013-01-01

This study explored the impact of a 4-week skills group intervention based on the principles of Dialectical Behavior Therapy (DBT) with a sample of adolescents attending a Disciplinary Alternative Education Program. This article provides a session-by-session overview of activities adapted from DBT-specified training modules of mindfulness,…

Two-Day, Intensive Cognitive-Behavioral Therapy for Panic Disorder: A Case Study

ERIC Educational Resources Information Center

Deacon, Brett

2007-01-01

Cognitive-behavioral therapy (CBT) is a highly effective treatment for panic disorder. However, few patients have access to this treatment, particularly those living in rural areas. In a pilot study, the author previously described the efficacy of a 2-day, intensive, exposure-based CBT intervention that was developed for the purpose of delivering…

Solutions to Address Diabetes-Related Financial Burden and Cost-Related Nonadherence: Results from a Pilot Study

ERIC Educational Resources Information Center

Patel, Minal R.; Resnicow, Kenneth; Lang, Ian; Kraus, Kathleen; Heisler, Michele

2018-01-01

Background: Cost-related nonadherence (CRN) to recommended self-management behaviors among adults with chronic conditions such as diabetes is prevalent. Few behavioral interventions to mitigate CRN have been tested and evaluated. Aims: We developed a financial burden resource tool and examined its acceptability and the preliminary effects on…

Time-Limited, Structured Youth Mentoring and Adolescent Problem Behaviors

ERIC Educational Resources Information Center

Weiler, Lindsey M.; Haddock, Shelley A.; Zimmerman, Toni S.; Henry, Kimberly L.; Krafchick, Jennifer L.; Youngblade, Lise M.

2015-01-01

Youth mentoring can have a profound impact on the lives of high-risk youth. This study presents the Campus Corps program, a time-limited (12-week), structured mentoring program for high-risk youth (ages 11--18), and results from a quasi-experimental pilot evaluation. Baseline and post-intervention problem behavior data from 315 offending youth…

The Influence of Neighborhood Crime on Increases in Physical Activity during a Pilot Physical Activity Intervention in Children.

PubMed

Broyles, Stephanie T; Myers, Candice A; Drazba, Kathryn T; Marker, Arwen M; Church, Timothy S; Newton, Robert L

2016-04-01

The purpose of this study was to examine whether neighborhood crime moderated the response (increases in steps) to a pilot intervention to increase physical activity in children. Twenty-seven insufficiently active children aged 6-10 years (mean age = 8.7 years; 56 % female; 59 % African American) were randomly assigned to an intensive intervention group (IIG) or minimal intervention group (MIG). Change in average daily number of steps from baseline was regressed against an index of neighborhood crime in a multilevel repeated-measures model that included a propensity score to reduce confounding. Safer neighborhoods were associated with higher increases in steps during the pilot intervention (interaction p = 0.008). Children in the IIG living in low-crime neighborhoods significantly increased their physical activity (5275 ± 1040 steps/day) while those living in high-crime neighborhoods did not (1118 ± 1007) (p for difference = 0.046). In the IIG, the increase in daily steps was highly correlated with neighborhood crime (r = 0.58, p = 0.04). These findings suggest the need for physical activity interventions to account for participants' environments in their design and/or delivery. To promote healthy behaviors in less-supportive environments, future studies should seek to understand how environments modify intervention response and to identify mediators of the relationship between environment and intervention.

Feasibility of Behavioral Weight Loss Treatment Enhanced with Peer Support and Mobile Health Technology for Individuals with Serious Mental Illness

PubMed Central

Aschbrenner, Kelly A.; Naslund, John A.; Shevenell, Megan; Mueser, Kim T.; Bartels, Stephen J.

2016-01-01

Objective Effective and scalable lifestyle interventions are needed to address high rates of obesity in people with serious mental illness (SMI). This pilot study evaluated the feasibility of a behavioral weight loss intervention enhanced with peer support and mobile health (mHealth) technology for obese individuals with SMI. Methods The Diabetes Prevention Program Group Lifestyle Balance intervention enhanced with peer support and mHealth technology was implemented in a public mental health setting. Thirteen obese individuals with SMI participated in a pre-post pilot study of the 24-week intervention. Feasibility was assessed by program attendance, and participant satisfaction and suggestions for improving the model. Descriptive changes in weight and fitness were also explored. Results Overall attendance amounted to approximately half (56%) of weekly sessions. At 6-month follow-up, 45% of participants had lost weight, and 45% showed improved fitness by increasing their walking distance. Participants suggested a number of modifications to increase the relevance of the intervention for people with SMI, including less didactic instruction and more active learning, a simplified dietary component, more in depth technology training, and greater attention to mental health. Conclusions The principles of standard behavioral weight loss treatment provide a useful starting point for promoting weight loss in people with SMI. However, adaptions to standard weight loss curricula are needed to enhance engagement, participation, and outcomes to respond to the unique challenges of individuals with SMI. PMID:26462674

Feasibility of Behavioral Weight Loss Treatment Enhanced with Peer Support and Mobile Health Technology for Individuals with Serious Mental Illness.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Shevenell, Megan; Mueser, Kim T; Bartels, Stephen J

2016-09-01

Effective and scalable lifestyle interventions are needed to address high rates of obesity in people with serious mental illness (SMI). This pilot study evaluated the feasibility of a behavioral weight loss intervention enhanced with peer support and mobile health (mHealth) technology for obese individuals with SMI. The Diabetes Prevention Program Group Lifestyle Balance intervention enhanced with peer support and mHealth technology was implemented in a community mental health setting. Thirteen obese individuals with SMI participated in a pre-post pilot study of the 24-week intervention. Feasibility was assessed by program attendance, and participant satisfaction and suggestions for improving the model. Descriptive changes in weight and fitness were also explored. Overall attendance amounted to approximately half (56 %) of weekly sessions. At 6-month follow-up, 45 % of participants had lost weight, and 45 % showed improved fitness by increasing their walking distance. Participants suggested a number of modifications to increase the relevance of the intervention for people with SMI, including less didactic instruction and more active learning, a simplified dietary component, more in depth technology training, and greater attention to mental health. The principles of standard behavioral weight loss treatment provide a useful starting point for promoting weight loss in people with SMI. However, adaptions to standard weight loss curricula are needed to enhance engagement, participation, and outcomes to respond to the unique challenges of individuals with SMI.

A pilot RCT of an intervention to reduce HIV condomless sex and increase self-acceptance among MSM in Chennai, India

PubMed Central

Safren, Steven A.; Thomas, Beena E.; Mayer, Kenneth H.; Biello, Katie B.; Mani, Jamuna; Rajagandhi, Vijaylakshmi; Periyasamy, Murugesan; Swaminathan, Soumya; Mimiaga, Matthew J.

2014-01-01

This is a 2-arm pilot randomized controlled trial (N=96) of a behavioral intervention (4 group and 4 individual sessions) integrating risk reduction counseling with counseling to foster self-acceptance in MSM in India compared to Enhanced Standard of Care (ESOC). Both conditions involved HIV and STI testing and counseling at baseline and 6-months, and assessments of condomless sex at baseline, 3-, and 6-months. A significant condition by time interaction suggested a difference in the rate of change in number of anal sex acts without condoms in the intervention versus ESOC (p<.0001). Post-hoc contrasts suggested that the overall difference was due to intervention-response at 3-months. The incidence of bacterial STIs was 17.5% in the intervention condition and a 28.6% in ESOC. Addressing self-acceptance and related psychosocial concerns in the context sexual risk reduction counseling for MSM in India was feasible and acceptable. Testing the intervention for efficacy is justified. PMID:24770985

A pilot RCT of an intervention to reduce HIV sexual risk and increase self-acceptance among MSM in Chennai, India.

PubMed

Safren, Steven A; Thomas, Beena E; Mayer, Kenneth H; Biello, Katie B; Mani, Jamuna; Rajagandhi, Vijaylakshmi; Periyasamy, Murugesan; Swaminathan, Soumya; Mimiaga, Matthew J

2014-10-01

This is a 2-arm pilot randomized controlled trial (N = 96) of a behavioral intervention (4 group and 4 individual sessions) integrating risk reduction counseling with counseling to foster self-acceptance in MSM in India compared to enhanced standard of care (ESOC). Both conditions involved HIV and STI testing and counseling at baseline and 6-months, and assessments of condomless sex at baseline, 3-, and 6-months. A significant condition by time interaction suggested a difference in the rate of change in number of anal sex acts without condoms in the intervention versus ESOC (p < 0.0001). Post hoc contrasts suggested that the overall difference was due to intervention-response at 3-months. The incidence of bacterial STIs was 17.5 % in the intervention condition and a 28.6 % in ESOC. Addressing self-acceptance and related psychosocial concerns in the context sexual risk reduction counseling for MSM in India was feasible and acceptable. Testing the intervention for efficacy is justified.

Prevention of Postpartum Depression in Low-Income Women: Development of the "Mamas y Bebes"/Mothers and Babies Course

ERIC Educational Resources Information Center

Munoz, Ricardo F.; Le, Huynh-Nhu; Ippen, Chandra Ghosh; Diaz, Manuela A.; Urizar, Guido G., Jr.; Soto, Jose; Mendelson, Tamar; Delucchi, Kevin; Lieberman, Alicia F.

2007-01-01

A prenatal intervention designed to prevent the onset of major depressive episodes (MDEs) during pregnancy and postpartum was pilot tested at a public sector women's clinic. The "Mamas y Bebes"/Mothers and Babies Course is an intervention developed in Spanish and English that uses a cognitive-behavioral mood management framework, and incorporates…

Can Technology Decrease Sexual Risk Behaviors among Young People? Results of a Pilot Study Examining the Effectiveness of a Mobile Application Intervention

ERIC Educational Resources Information Center

Jackson, Dawnyéa D.; Ingram, Lucy Annang; Boyer, Cherrie B.; Robillard, Alyssa; Huhns, Michael N.

2016-01-01

College students represent an important population for studying and understanding factors that influence sexual risk given the populations' high risk of sexually transmitted infections and unintended pregnancies. Using a quasi-experimental design, the efficacy of a brief and theory-driven mobile application intervention designed to decrease sexual…

Enhancing the Effectiveness of a Play Intervention by Abolishing the Reinforcing Value of Stereotypy: A Pilot Study

ERIC Educational Resources Information Center

Lang, Russell; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio E.; Machalicek, Wendy; Rispoli, Mandy; White, Pamela

2009-01-01

An alternating treatments design compared one condition in which a child with autism was allowed to engage in stereotypy freely prior to the intervention (abolishing operation component) to a second condition without the free-access period. Levels of stereotypy and problem behavior were lower and levels of functional play were higher in the…

Strengths-based behavioral intervention for parents of adolescents with type 1 diabetes using an mHealth app (Type 1 Doing Well): Protocol for a pilot randomized controlled trial

USDA-ARS?s Scientific Manuscript database

Supportive parent involvement for adolescents' type 1 diabetes (T1D) self-management promotes optimal diabetes outcomes. However, family conflict is common and can interfere with collaborative family teamwork. Few interventions have used explicitly strengths-based approaches to help reinforce desire...

Effects of an Infant-Focused Relationship-Based Hospital and Home Visiting Intervention on Reducing Symptoms of Postpartum Maternal Depression: A Pilot Study

ERIC Educational Resources Information Center

Nugent, J. Kevin; Bartlett, Jessica Dym; Valim, Clarissa

2014-01-01

Relationship-based interventions are an effective means for reducing postpartum depression (PPD), but few cost-effective tools that can be administered efficiently in medical and home settings are available or well-studied. This study examines the efficacy of the Newborn Behavioral Observations (NBO), an infant-centered relationship-based…

A pilot randomized controlled trial evaluating motivationally matched pedometer feedback to increase physical activity behavior in older adults.

PubMed

Strath, Scott J; Swartz, Ann M; Parker, Sarah J; Miller, Nora E; Grimm, Elizabeth K; Cashin, Susan E

2011-09-01

Increasing physical activity (PA) levels in older adults represents an important public health challenge. The purpose of this study was to evaluate the feasibility of combining individualized motivational messaging with pedometer walking step targets to increase PA in previously inactive and insufficiently active older adults. In this 12-week intervention study older adults were randomized to 1 of 4 study arms: Group 1--control; Group 2--pedometer 10,000 step goal; Group 3--pedometer step goal plus individualized motivational feedback; or Group 4--everything in Group 3 augmented with biweekly telephone feedback. 81 participants were randomized into the study, 61 participants completed the study with an average age of 63.8 ± 6.0 years. Group 1 did not differ in accumulated steps/day following the 12-week intervention compared with participants in Group 2. Participants in Groups 3 and 4 took on average 2159 (P < .001) and 2488 (P < .001) more steps/day, respectively, than those in Group 1 after the 12-week intervention. In this 12-week pilot randomized control trial, a pedometer feedback intervention partnered with individually matched motivational messaging was an effective intervention strategy to significantly increase PA behavior in previously inactive and insufficiently active older adults.

Using smartphone video “selfies” to monitor change in toothbrushing behavior after a brief intervention: A pilot study

PubMed Central

Kumar, Parangimalai Diwakar Madan; Mohandoss, Anusa Arunachalam; Walls, Theodore; Rooban, Thavarajah; Vernon, Lance T

2018-01-01

Background Attempts to refine toothbrushing (TB) technique, an ingrained habit in adults, can meet with some challenges. Recently, the role of proactive interference as a barrier to improving the learning of proper brushing has been proposed. This pilot feasibility study was designed to investigate TB behavior and to see how it changes after training. Smartphone video “selfies” (SPVSs) are increasingly being used in the medical field to assess, monitor, and determine the progression of diseases. Materials and Methods We used SPVS to study TB skills in a small sample of volunteers. Over a period of 14 days, after a one-time group training session, we observed TB behavior of volunteers using self-captured SPVS. Results Following the brief intervention, we observed an 8% of improvement in TB skills. Discussion To the best of our knowledge, this is the first report using SPVS to study TB behavior. We demonstrated initial feasibility of using SPVS in the dental setting. We observed modest improvements in toothbrushing accuracy and quality, and we generated important experiences about the use of Selfies for TB monitoring and intervention, and some interesting insights about where in the toothbrushing is more or less effective. Conclusion Further investigation using a larger sample size is needed to thoroughly assess the effectiveness of this approach to improve TB skills and better understand the role of proactive interference. PMID:27411655

The Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) in prostate cancer patients undergoing androgen deprivation therapy: study protocol for a randomized controlled trial.

PubMed

Focht, Brian C; Lucas, Alexander R; Grainger, Elizabeth; Simpson, Christina; Thomas-Ahner, Jennifer M; Clinton, Steven K

2014-09-09

Androgen deprivation therapy (ADT) is the foundation of treatment for men with metastatic prostate cancer and is now frequently incorporated into multimodality strategies for the curative treatment of locally advanced prostate cancer. Nevertheless, the catabolic effects of ADT result in meaningful adverse effects on physiological and quality of life outcomes, which may, in turn, increase the risk of functional decline, frailty, cardiovascular disease, and metabolic syndrome. Recent evidence demonstrates that lifestyle intervention promoting change in exercise and dietary behaviors is a promising approach, and may offset, or even reverse, the adverse effects accompanying ADT. Unfortunately, the limited existing studies of the effects of exercise and dietary interventions targeting patients with prostate cancer on ADT are characterized by high attrition rates and poor postintervention maintenance of treatment effects. Consequently, the Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) is designed to contrast the effects of a lifestyle intervention designed to promote independent self-management of exercise and dietary behavior with those of standard care disease management approach in the treatment of prostate cancer. A total of 40 patients with prostate cancer undergoing ADT will be randomly assigned to lifestyle intervention or standard care. Outcomes of interest in IDEA-P include changes in self-reported and objectively assessed physical function and physical activity, dietary behavior, body composition, muscular strength, and quality of life. Outcomes will be obtained at baseline, 2-month, and 3-month assessments by trial personnel blinded to participants' randomization assignment. Findings from this study will establish the feasibility and preliminary efficacy of an innovative lifestyle intervention designed to promote progressively independent self-regulated exercise and dietary behavior change in the treatment of patients with prostate cancer undergoing ADT. ClinicalTrials.gov NCT02050906.

Development of an Internet-Based Parent Training Intervention for Children with ASD

DTIC Science & Technology

2013-10-01

daily routines and activities. In the second phase of the project (Years 2 and 3), the focus is on pilot testing two delivery methods for the online...evidence-based curriculum that uses a blend of developmental and behavioral intervention strategies during daily routines and activities. In the first...post-treatment during a 10-minute parent-child play session and a snack using the Project ImPACT intervention Fidelity Checklist (n=11). Parents are

Development of a cognitive-behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism.

PubMed

White, Susan W; Albano, Anne Marie; Johnson, Cynthia R; Kasari, Connie; Ollendick, Thomas; Klin, Ami; Oswald, Donald; Scahill, Lawrence

2010-03-01

Anxiety is a common co-occurring problem among young people with autism spectrum disorders (ASD). Characterized by deficits in social interaction, communication problems, and stereotyped behavior and restricted interests, this group of disorders is more prevalent than previously realized. When present, anxiety may compound the social deficits of young people with ASD. Given the additional disability and common co-occurrence of anxiety in ASD, we developed a manual-based cognitive-behavioral treatment program to target anxiety symptoms as well as social skill deficits in adolescents with ASD [Multimodal Anxiety and Social Skills Intervention: MASSI]. In this paper, we describe the foundation, content, and development of MASSI. We also summarize data on treatment feasibility based on a pilot study that implemented the intervention.

The influence of individualized music on patients in physical restraints: a pilot study.

PubMed

Janelli, Linda M; Kanski, Genevieve W; Wu, Yow-Wu Bill

This pilot study explored the relationship between listening to preferred music and the behavioral responses of patients who are physically restrained. Thirty patients, ranging in age from 65 to 93, participated in one of three groups. The first group included patients who were out of restraining devices while listening to preferred music. Patients in the second group were out of restraining devices and not exposed to music. The third group comprised patients who were in restraining devices while listening to preferred music. Listening to preferred music had no significant effect on decreasing patients' negative behaviors or on increasing positive behaviors observed during the intervention phase of the study. The higher mean scores for positive behaviors and lower mean scores for negative behaviors for the first group may indicate some benefits to patients who are out of restraints and listening to preferred music.

Pilot Study of Behavioral Treatment in Dementia Care Units.(practice Concepts)(author Abstract)

ERIC Educational Resources Information Center

Lichtenberg, Peter A.; Kemp-Havican, Julie; MacNeill, Susan E.; Johnson, Amanda Schafer

2005-01-01

Purpose: This article reports on the development and use of behavioral treatment as a well-being intervention for individuals with dementia residing at special care units in a nursing home. Design and Methods: The project took place upon the construction and opening of two new homelike units for dementia care in a rural community-care center.…

Changes in Attitudes, Knowledge and Behavior Associated with Implementing a Comprehensive School Health Program in a Province of China

ERIC Educational Resources Information Center

Aldinger, Carmen; Zhang, Xin-Wei; Liu, Li-Qun; Pan, Xue-Dong; Yu, Sen-Hai; Jones, Jack; Kass, Jared

2008-01-01

After successful pilot projects, Zhejiang Province, China, decided to systematically scale-up health promoting schools (HPS) over the entire province of 47 million. This study describes the interventions and self-reported changes in attitudes, knowledge and behavior during the first phase of scaling-up. Group interviews were conducted with a…

Psychosocial Outcomes of "Lunch Is in the Bag", a Parent Program for Packing Healthful Lunches for Preschool Children

ERIC Educational Resources Information Center

Sweitzer, Sara J.; Briley, Margaret E.; Roberts-Gray, Cindy; Hoelscher, Deanna M.; Harrist, Ronald B.; Staskel, Deanna M.; Almansour, Fawaz D.

2011-01-01

Objective: This pilot study evaluated effects of "Lunch is in the Bag" on behavioral constructs and their predictive relationship to lunch-packing behaviors of parents of young children. Methods: Six child care centers were pair-matched and randomly assigned to intervention (n = 3) and comparison (n = 3) groups. Parent/child dyads participated.…

THE POTENTIAL OF USING EXERCISE IN NATURE AS AN INTERVENTION TO ENHANCE EXERCISE BEHAVIOR: RESULTS FROM A PILOT STUDY.

PubMed

Calogiuri, Giovanna; Nordtug, Hildegunn; Weydahl, Andi

2015-10-01

According to attention-restoration theory (ART), natural environments can provide restorative experiences. In this pilot study, a mixed-methods approach was used to examine the potential of using exercise in a natural environment to enhance exercise behaviors. The study included an assessment study and an intervention study (overall n = 19). The participants underwent a standardized exercise program including biking and circuit strength training, either indoors or outdoors in nature. Measurements included connectedness to nature, perceived exertion, perceived environmental restorativeness, enjoyment, affect, future exercise intention, and self-reported exercise behavior. The participants also wrote a brief text describing the way in which the environment influenced their feelings while exercising. Quantitative data were analyzed using the Spearman rank correlation and linear mixed-effects modeling. The qualitative information was analyzed thematically. The integrated results indicated that, in accordance with ART, exercising in nature was associated with a greater potential for restoration and affective responses, which in some participants led to enhanced intention to exercise and increased exercise behavior. However, some perceived that the indoor exercise provided a more effective workout. Further studies on larger samples are needed.

System dynamics-based evaluation of interventions to promote appropriate waste disposal behaviors in low-income urban areas: A Baltimore case study.

PubMed

Guo, Huaqing; Hobbs, Benjamin F; Lasater, Molly E; Parker, Cindy L; Winch, Peter J

2016-10-01

Inappropriate waste disposal is a serious issue in many urban neighborhoods, exacerbating environmental, rodent, and public health problems. Governments all over the world have been developing interventions to reduce inappropriate waste disposal. A system dynamics model is proposed to quantify the impacts of interventions on residential waste related behavior. In contrast to other models of municipal solid waste management, the structure of our model is based on sociological and economic studies on how incentives and social norms interactively affect waste disposal behavior, and its parameterization is informed by field work. A case study of low-income urban neighborhoods in Baltimore, MD, USA is presented. The simulation results show the effects of individual interventions, and also identify positive interactions among some potential interventions, especially information and incentive-based policies, as well as their limitations. The model can help policy analysts identify the most promising intervention packages, and then field test those few, rather than having to pilot test all combinations. Sensitivity analyses demonstrate large uncertainties about behavioral responses to some interventions, showing where information from survey research and social experiments would improve policy making. Copyright © 2016 Elsevier Ltd. All rights reserved.

Aura interruption: the Andrews/Reiter behavioral intervention may reduce seizures and improve quality of life - a pilot trial.

PubMed

Elsas, S M; Gregory, W L; White, G; Navarro, G; Salinsky, M C; Andrews, D J

2011-12-01

Patients with epilepsy frequently experience depression and emotional stress and these may function as seizure triggers in epileptogenic frontotemporal cortex, which serves in emotional processing. Eight patients enrolled in a pilot trial of a 6-month epilepsy-specific behavioral approach comprising counseling and relaxation to recognize and eliminate emotional seizure triggers. Potential participants with psychogenic seizures were excluded by long-term EEG and/or the MMPI profile. One participant became seizure free, another had an approximately 90% reduction in seizures, and two additional participants achieved a greater than 50% reduction in seizure frequency (total responder rate=50%), stable during 6 months of observation after the intervention. All completers showed marked and stable improvement of quality of life (Quality of Life in Epilepsy-89 inventory) and temporary improvement in the Profile of Mood States. An adequately powered randomized controlled trial is needed to confirm our findings, which suggest that behavioral approaches may hold promise for motivated patients with epilepsy. Copyright © 2011 Elsevier Inc. All rights reserved.

SunSmart: evaluation of a pilot school-based sun protection intervention in Hispanic early adolescents

PubMed Central

Miller, K. A.; Langholz, B. M.; Ly, T.; Harris, S. C.; Richardson, J. L.; Peng, D. H.; Cockburn, M. G.

2015-01-01

The incidence of melanoma is rising among Hispanic populations in the United States. The purpose of this study is to evaluate the impact of a pilot sun safety educational intervention conducted from 2006 to 2012 on Hispanic early adolescents in a high ultraviolet environment. Nineteen schools with high Hispanic enrollment were recruited from urban neighborhoods in Los Angeles. The analytic sample was restricted to students identifying as Hispanic or Latino (n = 777). A mixed effects linear model was used to test mean changes from pre- to posttest on students’ sun protection knowledge, attitudes and behaviors. Significant improvements were observed across several cognitive outcomes related to sun protection, including knowledge of and attitudes toward sun protection and self-efficacy to wear sunscreen. However, changes in sun protective behaviors were not achieved. Although some improvements were observed, future studies should identify the factors that motivate sun protection in this population and develop tailored prevention strategies, as improving the sun safe behaviors of Hispanic youths may aid in reducing the risk of melanoma in adulthood in this population. PMID:25801103

Resourcefulness training intervention: a promising approach to improve mental health of mothers with technology-dependent children.

PubMed

Toly, Valerie Boebel; Musil, Carol M; Zauszniewski, Jaclene A

2014-02-01

The population of children dependent on medical technology such as mechanical ventilation, feeding tubes, and supplemental oxygen continues to grow in the United States. These children are frequently cared for by their mothers at home following hospital discharge. Research indicates that these mothers are at high risk for negative mental health outcomes that affect both caregiver and care recipient. The purpose of this randomized controlled pilot trial was to determine the feasibility, acceptability, and efficacy of resourcefulness training (RT), a cognitive-behavioral intervention, among mothers of technology-dependent children. RT was found to be a feasible and acceptable intervention with this population during the 6 week study. The effect size in this pilot study demonstrates initial efficacy and indicates areas for strengthening the intervention protocol. RT is a promising intervention that can be employed by pediatric nurses to assist mothers in the home management of technology-dependent children. Copyright © 2014 Elsevier Inc. All rights reserved.

Telephone-administered cognitive-behavioral therapy for clients with depressive symptoms in an employee assistance program: a pilot study.

PubMed

Lam, Raymond W; Lutz, Kevin; Preece, Melady; Cayley, Paula M; Bowen Walker, Anne

2011-02-01

To assess the clinical and work productivity effects of a brief intervention using telephone-administered cognitive-behavioral therapy (CBT) for clients with depressive symptoms attending an employee assistance program (EAP). Self-referred clients attending the PPC Canada EAP with clinically relevant depressive symptoms at initial assessment were offered an 8-session telephone-administered CBT program. Outcomes before and after intervention were assessed with the 9-item Personal Health Questionnaire (PHQ-9), Global Assessment of Functioning (GAF), and clinician ratings of work absence and performance impairment. Fifty clients were referred to the pilot program; 39 participated and 31 completed the telephone CBT program. Among program participants, there was significant improvement in PHQ-9 and GAF scores. There was also a significant reduction in performance impairment but not work absence. Anecdotal reports indicated high satisfaction ratings among participants. The results of this pilot study, although limited by the absence of a comparison or control group, suggest that a brief telephone-administered CBT program can improve depressive symptomatology, work productivity, and general function in depressed clients attending an EAP. Further controlled studies are needed to confirm these preliminary findings.

A Social Media Peer Group Intervention for Mothers to Prevent Obesity and Promote Healthy Growth from Infancy: Development and Pilot Trial

PubMed Central

Gruver, Rachel S; Bishop-Gilyard, Chanelle T; Lieberman, Alexandra; Gerdes, Marsha; Virudachalam, Senbagam; Suh, Andrew W; Kalra, Gurpreet K; Magge, Sheela N; Shults, Justine; Schreiner, Mark S; Power, Thomas J; Berkowitz, Robert I

2016-01-01

Background Evidence increasingly indicates that childhood obesity prevention efforts should begin as early as infancy. However, few interventions meet the needs of families whose infants are at increased obesity risk due to factors including income and maternal body mass index (BMI). Social media peer groups may offer a promising new way to provide these families with the knowledge, strategies, and support they need to adopt obesity prevention behaviors. Objective The aim of this study is to develop and pilot test a Facebook-based peer group intervention for mothers, designed to prevent pediatric obesity and promote health beginning in infancy. Methods We conducted in-depth semi-structured interviews with 29 mothers of infants and focus groups with 30 pediatric clinicians, to inform the development of a theory-based intervention. We then conducted a single-group pilot trial with 8 mothers to assess its feasibility and acceptability. All participants were recruited offline at pediatric primary care practices. Participants in the pilot trial joined a private Facebook group, moderated by a psychologist, with a weekly video-based curriculum, and also had the option to meet at a face-to-face event. Within the Facebook group, mothers were encouraged to chat, ask questions, and share photos and videos of themselves and babies practicing healthy behaviors. Consistent with the literature on obesity prevention, the curriculum addressed infant feeding, sleep, activity, and maternal well-being. Feasibility was assessed using the frequency and content of group participation by mothers, and acceptability was measured using online surveys and phone interviews. Results Based on preferences of mothers interviewed (mean BMI 35 kg/m2, all Medicaid-insured, mean age 27, all Black), we designed the intervention to include frequent posts with new information, videos showing parents of infants demonstrating healthy behaviors, and an optional face-to-face meeting. We developed a privacy and safety plan that met the needs of participants as well as the requirements of the local institutional review board (IRB), which included use of a “secret” group and frequent screening of participant posts. Clinicians, 97% (29/30) women and 87% (26/30) pediatricians, preferred no direct involvement in the intervention, but were supportive of their patients’ participation. In our 8-week, single group pilot trial, all participants (mean BMI 35 kg/m2, all Medicaid-insured, mean age 28, all Black) viewed every weekly video post, and interacted frequently, with a weekly average of 4.4 posts/comments from each participant. All participant posts were related to parenting topics. Participants initiated conversations about behaviors related to healthy infant growth including solid food introduction, feeding volume, and managing stress. All 8 pilot group participants reported that they found the group helpful and would recommend it to others. Conclusions Our methodology was feasible and acceptable to low-income mothers of infants at high risk of obesity, and could be adapted to implement peer groups through social media for underserved populations in varied settings. ClinicalTrial ClinicalTrials.gov NCT01977105; https://clinicaltrials.gov/ct2/show/NCT01977105 (Archived by WebCite at http://www.webcitation.org/6iMFfOBat) PMID:27485934

Brief report: theatre as therapy for children with autism spectrum disorder.

PubMed

Corbett, Blythe A; Gunther, Joan R; Comins, Dan; Price, Jenifer; Ryan, Niles; Simon, David; Schupp, Clayton W; Rios, Taylor

2011-04-01

The pilot investigation evaluated a theatrical intervention program, Social Emotional NeuroScience Endocrinology (SENSE) Theatre, designed to improve socioemotional functioning and reduce stress in children with autism spectrum disorder (ASD). Eight children with ASD were paired with typically developing peers that served as expert models. Neuropsychological, biological (cortisol and oxytocin), and behavioral measures were assessed in a pretest-posttest design. The intervention was embedded in a full musical theatrical production. Participants showed some improvement in face identification and theory of mind skills. The intervention shows potential promise in improving the socioemotional functioning in children with ASD through the utilization of peers, video and behavioral modeling, and a community-based theatrical setting.

Physical activity for an ethnically diverse sample of endometrial cancer survivors: a needs assessment and pilot intervention

PubMed Central

Rossi, Amerigo; Moadel-Robblee, Alyson; Garber, Carol Ewing; Kuo, Dennis; Goldberg, Gary; Einstein, Mark

2015-01-01

Objective To determine the physical activity (PA) behavior, needs and preferences for underserved, ethnically diverse women with a history of endometrial cancer (EC). Methods Women with a history of EC (41 non-Hispanic black, 40 non-Hispanic white, and 18 Hispanic) completed a needs assessment during their regular follow-up appointments at Montefiore Medical Center in Bronx, NY, USA. An 8-week pilot PA intervention based on the results of the needs assessment was conducted with 5 EC survivors. Results Mean body mass index (BMI) among the 99 respondents was 34.1±7.6 kg/m2, and 66% did not exercise regularly. Self-described weight status was significantly lower than actual BMI category (p<0.001). Of the 86% who were interested in joining an exercise program, 95% were willing to attend at least once weekly. The primary motivations were improving health, losing weight, and feeling better physically. Despite the high interest in participation, volunteer rate was very low (8%). However, adherence to the 8-week pilot PA intervention was high (83%), and there were no adverse events. Body weight decreased in all pilot participants. Conclusion These data show that ethnically diverse EC survivors have a great need for, and are highly interested in, PA interventions. However, greater care needs to be taken to assess and identify barriers to increase participation in such programs. PMID:25872894

A Mindfulness-Based Intervention Pilot Feasibility Study for Elementary School Students With Severe Learning Difficulties: Effects on Internalized and Externalized Symptoms From an Emotional Regulation Perspective

PubMed Central

Malboeuf-Hurtubise, Catherine; Lacourse, Eric; Taylor, Geneviève; Joussemet, Mireille; Ben Amor, Leila

2016-01-01

Objective. Students with severe learning disabilities often show signs of anxiety, depression, and problem behaviors such as inattention and conduct problems. Mindfulness-based interventions (MBIs) in school settings constitute a promising option to alleviate these co-occurring symptoms. This pilot study aimed to evaluate the impact of an MBI on symptoms and behaviors of elementary school students with severe learning disabilities. Method. A one-group pretest-posttest design was used. The sample comprised 14 students aged 9 to 12 years with special education needs. Both student-report and teacher-report of the Behavior Assessment System for Children, Second Edition were used. Results. Repeated-measures analyses of variance revealed a significant impact of the MBI on symptoms and behaviors such as anxiety, depression, inattention, aggression, and conduct problems. Effect sizes for all variables were considered large (partial η2 = .31-.61). Conclusion. These preliminary results indicate that MBIs can reduce the frequency of symptoms and problem behaviors often found in children with learning disabilities in elementary schools. Further multiple baseline experimental trials with a long-term follow-up are warranted to establish more robustly the effect of MBIs for children with learning disabilities.

Sun protection training based on a theater play for preschoolers: an effective method for imparting knowledge on sun protection?

PubMed

Seidel, Nadja; Stoelzel, Friederike; Garzarolli, Marlene; Herrmann, Sandra; Breitbart, Eckhard Wilhelm; Berth, Hendrik; Baumann, Michael; Ehninger, Gerhard

2013-09-01

Sun protection in childhood is important to reduce the risk of developing skin cancer later in life. The "Periods-of-Life-Program" for primary prevention of skin cancer introduces a combination of individual and environmental interventions for the preschool period. Within this pilot study, an intervention group received cognitive-behavioral and environmental interventions. A control group had solely received the environmental intervention, and a wait-control group received no intervention. Nursery school children (n = 80, 3 to 6 years of age) of four nursery schools were randomly assigned to these groups on school level. The ability of the cognitive-behavioral intervention (a theater play) to enhance sun protection knowledge was examined. The theater play improved knowledge over all age groups (p < .05 η(2) = .06). Age-specific analyses showed better results for children aged 5 to 6 (p < .05 η(2) = .20) compared to children aged 3 to 4 years (p = .17 η(2) = .04). In combining cognitive-behavioral and environmental interventions, the "Periods-of-Life-Program" is a promising strategy for primary prevention of skin cancer.

Pilot test of an emotional education intervention component for sexual risk reduction.

PubMed

Ferrer, Rebecca A; Fisher, Jeffrey D; Buck, Ross; Amico, K Rivet

2011-09-01

Emotions are key predictors of sexual risk behavior but have been largely ignored in theory-based intervention development. The present study aims to evaluate whether the addition of an emotional education intervention component to a traditional social-cognitive safer sex intervention increases intervention efficacy, compared with both a social-cognitive only intervention and a no intervention control condition. Young adults were randomized in small groups to receive the social-cognitive-emotional (SCE) intervention, the social-cognitive (SC) intervention, or standard of care. Analyses of data from 176 participants indicated that intervention arms reported similar increased condom use compared with the no intervention control arm at 3 months' postintervention (β = .06, p = .41, d = 0.08). However, at 6 months' postintervention, individuals in the SCE intervention arm reported increased condom use compared with both the SC intervention (β = .27, p = .04, d = 0.38) and control arms (β = .37, p < .01; d = 0.56), demonstrating preliminary evidence that the addition of an emotional education component may facilitate sustained behavior change. An emotional education intervention module has the potential to facilitate sustained behavior change at delayed follow-up. Additional research is necessary to replicate findings in a larger sample and to determine the mediators of emotional education intervention efficacy.

A Youth-Led, Social Marketing Intervention Run by Adolescents to Encourage Healthy Lifestyles among Younger School Peers (EYTO-Kids Project): A Protocol for Pilot Cluster Randomized Controlled Trial (Spain)

PubMed Central

Aceves-Martins, Magaly; Papell-Garcia, Ignasi; Arola, Lluís; Giralt, Montse; Solà, Rosa

2017-01-01

Introduction: The EYTO-kids (European Youth Tackling Obesity in Adolescents and Children) study aims to increase fruit and/or vegetable consumption and physical activity, decrease sedentary lifestyles, and reduce the intake of sugary drinks and fast food using an innovative methodology based on social marketing and youth involvement. Methods: This study is a pilot school-based cluster randomized controlled 10-month intervention spanning two academic years (2015–2016 and 2016–2017), with eight primary schools and three high schools randomized into and designated the control group and eight primary schools and four high schools designated the intervention group in Reus, Spain. At least 301 younger school peers per group should be included. At the intervention high schools, the adolescent creators (ACs) receive an initial 16-h training session. In total, 26–32 high school ACs (12–14 years) from the four high schools will design and implement four health-promotion activities (1 h/each) for their younger (8–10 years), primary school peers. The control group will not receive any intervention. The outcomes (fruit, vegetable, fast food and sugary drink consumption; physical activity; and sedentary behaviors) of the control and intervention groups will be measured pre- and post-intervention. Conclusion: This study describes a protocol for pilot, peer-led, social marketing and youth-involved intervention, where adolescents design and implement activities for their younger peers to promote healthy lifestyles.

Gender-Specific Combination HIV Prevention for Youth in High-Burden Settings: The MP3 Youth Observational Pilot Study Protocol

PubMed Central

Agot, Kawango

2017-01-01

Background Nearly three decades into the epidemic, sub-Saharan Africa (SSA) remains the region most heavily affected by human immunodeficiency virus (HIV), with nearly 70% of the 34 million people living with HIV globally residing in the region. In SSA, female and male youth (15 to 24 years) are at a disproportionately high risk of HIV infection compared to adults. As such, there is a need to target HIV prevention strategies to youth and to tailor them to a gender-specific context. This protocol describes the process for the multi-staged approach in the design of the MP3 Youth pilot study, a gender-specific, combination, HIV prevention intervention for youth in Kenya. Objective The objective of this multi-method protocol is to outline a rigorous and replicable methodology for a gender-specific combination HIV prevention pilot study for youth in high-burden settings, illustrating the triangulated methods undertaken to ensure that age, sex, and context are integral in the design of the intervention. Methods The mixed-methods, cross-sectional, longitudinal cohort pilot study protocol was developed by first conducting a systematic review of the literature, which shaped focus group discussions around prevention package and delivery options, and that also informed age- and sex- stratified mathematical modeling. The review, qualitative data, and mathematical modeling created a triangulated evidence base of interventions to be included in the pilot study protocol. To design the pilot study protocol, we convened an expert panel to select HIV prevention interventions effective for youth in SSA, which will be offered in a mobile health setting. The goal of the pilot study implementation and evaluation is to apply lessons learned to more effective HIV prevention evidence and programming. Results The combination HIV prevention package in this protocol includes (1) offering HIV testing and counseling for all youth; (2) voluntary medical circumcision and condoms for males; (3) pre-exposure prophylaxis (PrEP), conditional cash transfer (CCT), and contraceptives for females; and (4) referrals for HIV care among those identified as HIV-positive. The combination package platform selected is mobile health teams in an integrated services delivery model. A cross-sectional analysis will be conducted to determine the uptake of the interventions. To determine long-term impact, the protocol outlines enrolling selected participants in mutually exclusive longitudinal cohorts (HIV-positive, PrEP, CCT, and HIV-negative) followed by using mobile phone text messages (short message service, SMS) and in-person surveys to prospectively assess prevention method uptake, adherence, and risk compensation behaviors. Cross-sectional and sub-cohort analyses will be conducted to determine intervention packages uptake. Conclusions The literature review, focus groups, and modeling indicate that offering age- and gender- specific combination HIV prevention interventions that include biomedical, behavioral, and structural interventions can have an impact on HIV risk reduction. Implementing this protocol will show the feasibility of delivering these services at scale. The MP3 Youth study is one of the few combination HIV prevention intervention protocols incorporating youth- and gender-specific interventions in one delivery setting. Lessons learned from the design of the protocol can be incorporated into the national guidance for combination HIV prevention for youth in Kenya and other high-burden SSA settings. Trial Registration ClinicalTrials.gov NCT01571128; http://clinicaltrials.gov/ct2/show/NCT01571128?term=MP3+youth&rank=1 (Archived by WebCite at http://www.webcitation.org/6nmioPd54) PMID:28274904

Enhancing Shared Decision Making Through Carefully Designed Interventions That Target Patient And Provider Behavior.

PubMed

Tai-Seale, Ming; Elwyn, Glyn; Wilson, Caroline J; Stults, Cheryl; Dillon, Ellis C; Li, Martina; Chuang, Judith; Meehan, Amy; Frosch, Dominick L

2016-04-01

Patient-provider communication and shared decision making are essential for primary care delivery and are vital contributors to patient experience and health outcomes. To alleviate communication shortfalls, we designed a novel, multidimensional intervention aimed at nudging both patients and primary care providers to communicate more openly. The intervention was tested against an existing intervention, which focused mainly on changing patients' behaviors, in four primary care clinics involving 26 primary care providers and 300 patients. Study results suggest that compared to usual care, both the novel and existing interventions were associated with better patient reports of how well primary care providers engaged them in shared decision making. Future research should build on the work in this pilot to rigorously examine the comparative effectiveness and scalability of these interventions to improve shared decision making at the point of care. Project HOPE—The People-to-People Health Foundation, Inc.

Guided self-help cognitive behavioral intervention for VoicEs (GiVE): study protocol for a pilot randomized controlled trial.

PubMed

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

2016-07-26

Cognitive behavior therapy for psychosis (CBTp) is an effective intervention for people who hear distressing voices (auditory hallucinations). However, there continues to be a problem of poor access to CBTp. Constraints on health care funding require this problem to be addressed without a substantial increase in funding. One solution is to develop guided self-help forms of CBTp to improve access, and a symptom-specific focus on, for example, distressing voices (auditory verbal hallucinations) has the potential to enhance effectiveness. We term this cognitive behavior therapy for distressing voices (CBTv). This trial is an external pilot randomized controlled trial comparing the effects of 12-week guided self-help CBTv (with eight therapist support sessions) with a wait list control condition. Informed consent will be obtained from each participant. Half of the 30 participants will be randomized to receive guided self-help CBTv immediately; the remaining half will receive the intervention after a 12-week delay. All participants will continue with their usual treatment throughout the study. Outcomes will be assessed using questionnaires completed at baseline and 12 weeks postrandomization. Interviews will be offered to all those who receive therapy immediately to explore their experiences with the intervention. The outcomes of this trial, both quantitative and qualitative, will inform the design of a definitive randomized controlled trial of guided self-help CBTv. If this intervention is effective, it could help to increase access to CBT for those who hear distressing voices. ISRCTN registration number  ISRCTN77762753 . Registered on 23 July 2015.

Evaluation of a Serious Self-Regulation Game Intervention for Overweight-Related Behaviors ("Balance It"): A Pilot Study.

PubMed

Spook, Jorinde; Paulussen, Theo; Kok, Gerjo; van Empelen, Pepijn

2016-09-26

Serious games have the potential to promote health behavior. Because overweight is still a major issue among secondary vocational education students in the Netherlands, this study piloted the effects of "Balance It," a serious self-regulation game intervention targeting students' overweight-related behaviors: dietary intake and physical activity (PA). We aimed to pilot the effects of Balance It on secondary vocational education students' dietary intake and PA. In total, 501 secondary vocational education students participated at baseline (intervention: n=250; control: n=251) in this pre-post cluster randomized trial. After 4 weeks, at immediate posttest, 231 students filled in the posttest questionnaire (intervention: n=105; control: n=126). The sample had a mean age of 17.28 (SD 1.26, range 15-21) years, 62.8% (145/231) were female, and 26.8% (62/231) had a non-Dutch background. Body mass index (BMI kg/m 2 ) ranged from 14.4 to 31.1 (mean 21.1, SD 3.3). The intervention and control groups were compared on the primary (behavioral) outcomes of dietary intake (fruit and vegetable consumption, snack consumption, and soft drink consumption) and PA (moderate and vigorous). Additionally, we explored (1) differences between the intervention and control groups in determinants of dietary intake and PA, including attitude, self-efficacy, intention, barrier identification, action planning, and action control, and (2) differences between active (intervention) users and the control group in dietary intake, PA, and associated determinants. After corrections for multiple testing, we did not find significant differences between the intervention group and control group in terms of dietary intake, PA, and determinants of dietary intake and PA. Exploratory research indicated that only 27.6% (29/105) of the intervention group reported actual intervention use (ie, active users). For exploratory reasons, we compared the active users (n=29) with the control group (n=124) and corrected for multiple testing. Results showed that active users' snack consumption decreased more strongly (active users: mean change=-0.20; control group: mean change=-0.08; beta=-0.36, P=.01, R 2 change=.05), and their use of active transport had a stronger increase (active users: mean change=0.92; control group=-0.12; beta=1.58, P=.02, R 2 change=.03) than the control group. Results also revealed significant differences in action planning (active users: mean change=0.42; control group: mean change=0.07; beta=0.91, P=.01, R 2 change=.04) and action control (active users: mean change=0.63; control group: mean change=-0.05; beta=1.25, P=.001, R 2 change=.08) in terms of unhealthy eating. The Balance It intervention did not show favorable effects on dietary intake and PA compared to the control condition. However, only a small number of people in the intervention condition actually used Balance It (27.6%). Exploratory analyses did suggest that, if used as planned, Balance It could contribute to changing dietary intake and PA behaviors, albeit it remains debatable whether this would be sufficient to prevent overweight.

Evaluation of a Serious Self-Regulation Game Intervention for Overweight-Related Behaviors (“Balance It”): A Pilot Study

PubMed Central

Paulussen, Theo; Kok, Gerjo; van Empelen, Pepijn

2016-01-01

Background Serious games have the potential to promote health behavior. Because overweight is still a major issue among secondary vocational education students in the Netherlands, this study piloted the effects of “Balance It,” a serious self-regulation game intervention targeting students’ overweight-related behaviors: dietary intake and physical activity (PA). Objective We aimed to pilot the effects of Balance It on secondary vocational education students’ dietary intake and PA. Methods In total, 501 secondary vocational education students participated at baseline (intervention: n=250; control: n=251) in this pre-post cluster randomized trial. After 4 weeks, at immediate posttest, 231 students filled in the posttest questionnaire (intervention: n=105; control: n=126). The sample had a mean age of 17.28 (SD 1.26, range 15-21) years, 62.8% (145/231) were female, and 26.8% (62/231) had a non-Dutch background. Body mass index (BMI kg/m2) ranged from 14.4 to 31.1 (mean 21.1, SD 3.3). The intervention and control groups were compared on the primary (behavioral) outcomes of dietary intake (fruit and vegetable consumption, snack consumption, and soft drink consumption) and PA (moderate and vigorous). Additionally, we explored (1) differences between the intervention and control groups in determinants of dietary intake and PA, including attitude, self-efficacy, intention, barrier identification, action planning, and action control, and (2) differences between active (intervention) users and the control group in dietary intake, PA, and associated determinants. Results After corrections for multiple testing, we did not find significant differences between the intervention group and control group in terms of dietary intake, PA, and determinants of dietary intake and PA. Exploratory research indicated that only 27.6% (29/105) of the intervention group reported actual intervention use (ie, active users). For exploratory reasons, we compared the active users (n=29) with the control group (n=124) and corrected for multiple testing. Results showed that active users’ snack consumption decreased more strongly (active users: mean change=–0.20; control group: mean change=–0.08; beta=–0.36, P=.01, R2 change=.05), and their use of active transport had a stronger increase (active users: mean change=0.92; control group=–0.12; beta=1.58, P=.02, R2 change=.03) than the control group. Results also revealed significant differences in action planning (active users: mean change=0.42; control group: mean change=0.07; beta=0.91, P=.01, R2 change=.04) and action control (active users: mean change=0.63; control group: mean change=–0.05; beta=1.25, P=.001, R2 change=.08) in terms of unhealthy eating. Conclusions The Balance It intervention did not show favorable effects on dietary intake and PA compared to the control condition. However, only a small number of people in the intervention condition actually used Balance It (27.6%). Exploratory analyses did suggest that, if used as planned, Balance It could contribute to changing dietary intake and PA behaviors, albeit it remains debatable whether this would be sufficient to prevent overweight. PMID:27670222

A Cooking Intervention to Increase Vegetable Consumption by Parents With Children Enrolled in an Early Head Start Home Visiting Program: A Pilot Study in Portland, Oregon, 2013-2014.

PubMed

Izumi, Betty T; Eckhardt, Cara L; Wilson, Dara P; Cahill, Jennifer

2016-12-22

Cooking interventions may improve diet quality. Most cooking interventions are delivered in group settings. Home visiting programs may be an appropriate mechanism for delivering such interventions to low-income families with young children. We conducted a pilot study to test the feasibility of using a cooking intervention delivered by home visitors to improve attitudes and behaviors related to vegetable consumption by low-income parents with children enrolled in a home visiting program. We invited 121 parents with children enrolled in an Early Head Start Home Visiting program in Portland, Oregon, to participate. During 2013-2014, each month for 8 months, home visitors (n = 14) implemented 1 cooking activity plus 1 complementary activity focused on 12 vegetables. We collected pre- and post-intervention data on participants' cooking confidence and whether they tried and liked the selected vegetables. We also measured fidelity to protocol and home visitors' perception of intervention usability. Of 104 participants, 58 provided pre- and post-intervention data. We observed a significant increase in confidence in baking, roasting or grilling vegetables; cooking 6 of 10 vegetables; and trying 7 of 12 vegetables. Nearly all respondents participated in the monthly cooking activity (96%) and complementary activity (94%). Twelve of 14 home visitors reported that the intervention was acceptable, feasible, and easy to understand, and needed systems supports to implement. Cooking interventions may be a feasible approach to improving attitudes and behaviors related to vegetable consumption by low-income families with young children. Additional research is needed to assess the impact of such interventions on vegetable consumption.

Design and rationale for NOURISH-T: a randomized control trial targeting parents of overweight children off cancer treatment.

PubMed

Stern, Marilyn; Ewing, Lin; Davila, Esther; Thompson, Amanda L; Hale, Gregory; Mazzeo, Suzanne

2015-03-01

Approximately 40% of off-treatment pediatric cancer survivors (PCS) are overweight or obese, which increases their risk for negative long-term physical health complications. Consistent with the Institute of Medicine's (IOM) emphasis on patients transitioning from treatment to cancer survivorship and increasing long-term healthy behaviors in these survivors, we plan to conduct a pilot RCT to address the increasing overweight/obesity rates among PCS by targeting their caregivers as agents for PCS behavior change. We plan to focus on parents' behaviors, attitudes and roles in promoting healthier eating and physical activity (PA) in PCS and adapt an evidence-informed, manualized parent intervention - NOURISH - found to be effective for parents of overweight and obese children and adolescents in reducing child and adolescent BMI. We plan to adapt NOURISH for caregivers of 5-12 year old PCS (6 months-4 years off active cancer treatment). Our pilot feasibility RCT - NOURISH-T (Nourishing Our Understanding of Role modeling to Improve Support for Healthy Transitions) evaluates: 1) the preliminary efficacy of NOURISH-T for PCS, compared with an Enhanced Usual Care (EUC) control condition, and 2) factors to consider to improve future adaptations of the intervention. The project will enroll caregivers of PCS at two pediatric oncology clinics into the 6-week intervention (or EUC) with assessments occurring pre- and post-6 weeks of intervention, and at a 4-month follow-up. Copyright © 2015 Elsevier Inc. All rights reserved.

Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients with Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study

ERIC Educational Resources Information Center

Karupaiah, Tilakavati; Wong, Kimberly; Chinna, Karuthan; Arasu, Kanimolli; Chee, Winnie Siew Swee

2015-01-01

The CORFIS ("Community-Based Cardiovascular Risk Factors Intervention Strategies") program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in…

Implementation of a self-monitoring application to improve on-task behavior: A high school pilot study.

PubMed

Wills, Howard P; Mason, Benjamin A

2014-12-01

Technological innovations offer promise for improving intervention implementation in secondary, inclusive classrooms. A withdrawal design was employed with two high school students in order to assess the effectiveness of a technologically-delivered, self-monitoring intervention in improving on-task behavior in a science classroom. Two students ages 14 and 15 with diagnoses of specific learning disability (student 1) and attention deficit hyperactivity disorder (ADHD: student 2) were selected by case manager referral due to difficulties with on-task behavior despite long-term administration of psychostimulant medication. After baseline data were collected, both students were trained in the use of a self-monitoring application (I-Connect) delivered via a handheld tablet. On-task prompts were delivered at five min intervals in an ABAB withdrawal design. The intervention resulted in positive, stable improvements in the primary dependent variable of on-task behavior for both students and less clear improvement in the generalization variable of disruptive behavior.

An empowerment-based diabetes self-management education program for Hispanic/Latinos: a quasi-experimental pilot study.

PubMed

Peña-Purcell, Ninfa C; Boggess, May M; Jimenez, Natalia

2011-01-01

The purpose of this pilot study was to evaluate the effects of a culturally sensitive, empowerment-based diabetes self-management education program for Spanish-speaking Hispanic/Latinos. A prospective quasi-experimental repeated measures design tested the effectiveness of the ¡Si, Yo Puedo Controlar Mi Diabetes! diabetes self-management education program. In sum, 144 persons residing in 2 Texas counties at the Texas-Mexico border (Starr and Hidalgo) served as participants. Two groups were formed, an intervention and a control (wait list). Clinical (A1C), cognitive, attitudinal, behavioral, and cultural assessments were collected at baseline and 3 months. Demographic characteristics for the intervention and control groups were similar. Both groups were predominately female, low income, older than 40 years, and minimally acculturated. Baseline and posttest findings showed that the intervention group had a significant reduction in A1C values; median difference was 0.3 (n = 45), especially for those with higher baseline values. Participants in the intervention group also improved in their self-efficacy and self-care scores. Findings from the study suggest that additional dissemination of a diabetes self-management education program for Spanish-speaking Hispanic/Latinos is warranted to improve clinical outcomes and associated diabetes self-efficacy and self-care behaviors.

Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: nonsignificant effects in pilot effectiveness trial with college students.

PubMed

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M

2014-04-01

Conduct a pilot trial testing whether a brief cognitive-behavioral (CB) group reduced depressive symptoms and secondary outcomes relative to bibliotherapy and brochure controls in college students with elevated depressive symptoms. 82 college students (M age=19.0, SD=0.9; 70% female, 80% White) with elevated self-assessed depressive symptoms were randomized to a 6-session CB group, bibliotherapy, or educational brochure control condition, completing assessments at pretest, posttest, and at 6- and 12-month follow-up. Planned contrasts found no significant effects for CB group on depressive symptoms compared to either bibliotherapy or brochure controls at posttest (d=-.08 and .06, respectively) or over follow-up (d=-.04 and -.10, respectively). There were no intervention effects for social adjustment and substance use, though CB group participants had improved knowledge of CB concepts at posttest, versus brochure controls. Condition differences in major depression onset were nonsignificant but suggested support for CB interventions (CB group=7.4%, bibliotherapy=4.5%, brochure control=15.2%). Unexpectedly modest support was found for a brief CB group depression prevention intervention, compared to bibliotherapy or brochure control, when provided to self-selected college students, suggesting that alternative screening or interventions approaches are needed for this population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Development of a Maternal, Newborn and Child mHealth Intervention in Thai Nguyen Province, Vietnam: Protocol for the mMom Project

PubMed Central

McBride, Bronwyn; Nguyen, Liem Thanh; Wiljer, David; Vu, Nguyen C; Nguyen, Cuong K

2018-01-01

Background Ethnic minority women (EMW) living in mountainous areas of northern Vietnam have disproportionately high infant and maternal mortality rates as a result of low maternal health knowledge, poverty, and remoteness from low-capacity health centers. Objective The objective of this study was to describe the protocol for the development and evaluation of the mMom intervention, which is an integrated mobile health (mHealth) system designed to improve maternal and infant health knowledge, and behavior among women in remote areas of Thai Nguyen, Vietnam. Methods This project featured the following four phases: (1) development of an mHealth platform integrated into the existing health management information system in partnership with the provincial health department; (2) ethnographic fieldwork and intervention content development; (3) intervention piloting and implementation; and (4) evaluation of the intervention’s impact on participants’ maternal health knowledge, behavior, and interactions with the health system. Results The mMom project development process resulted in the following: (1) the successful development of the mMom system, including the mHealth platform hardware and integration, the intervention plan and content, and the monitoring and evaluation framework; (2) the piloting and implementation of the intervention as planned; and (3) the implementation of the monitoring and evaluation framework components. Conclusions This protocol outlines the development of the mMom intervention and describes critical next steps in understanding the impact of the intervention on participants and the wider health system in Thai Nguyen province, Vietnam. PMID:29326095

An Integrated HIV Risk Reduction Intervention for Women with a History of Intimate Partner Violence: Pilot Test Results.

PubMed

Mittal, Mona; Thevenet-Morrison, Kelly; Landau, Judith; Cai, Xueya; Gibson, Lindsey; Schroeder, Allison; Chaize, Janet; Carey, Michael P

2017-08-01

There are few HIV risk reduction interventions to meet the unique needs of women who experience intimate partner violence (IPV). This pilot study tested the feasibility, safety, and preliminary effects of an integrated IPV-sexual risk reduction intervention for abused women. Fifty-five women were randomized to the supporting positive and healthy relationships (SUPPORT) intervention (n = 27) or to a control group (n = 28). Assessments were conducted pre- and post-intervention and at 3-month follow-up. Post-intervention, SUPPORT participants showed a significant decrease in frequency of unprotected sex and an increase in safer sex communications with steady and other sexual partners. Compared to the control group, SUPPORT participants reported a higher number of safer sex conversations with their steady partner at the 3-month follow-up, and fewer episodes of IPV at both assessments in comparison to baseline. They showed improvements in sexual relationship power at both follow-ups and in several hypothesized antecedents of HIV-risk behavior. These encouraging preliminary findings suggest the need for a larger clinical trial.

Developing a Motion Comic for HIV/STD Prevention for Young People Ages 15-24, Part 2: Evaluation of a Pilot Intervention.

PubMed

Willis, Leigh A; Kachur, Rachel; Castellanos, Ted J; Nichols, Kristen; Mendoza, Maria C B; Gaul, Zaneta J; Spikes, Pilgrim; Gamayo, Ashley C; Durham, Marcus D; LaPlace, Lisa; Straw, Julie; Staatz, Colleen; Buge, Hadiza; Hogben, Matthew; Robinson, Susan; Brooks, John; Sutton, Madeline Y

2018-03-01

In the United States, young people (ages 15-24 years) are disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), due at least in part to inadequate or incorrect HIV/STD-related knowledge, attitudes, beliefs, and behavioral intentions (KABI). Comic book narratives are a proven method of HIV/STD prevention communication to strengthen KABI for HIV/STD prevention. Motion comics, a new type of comic media, are an engaging and low-cost means of narrative storytelling. The objective of this study was to quantitatively evaluate the effectiveness of a pilot six-episode HIV/STD-focused motion comic series to improve HIV/STD-related KABI among young people. We assessed change in HIV/STD knowledge, HIV stigma, condom attitudes, HIV/STD testing attitudes, and behavioral intentions among 138 participants in 15 focus groups immediately before and after viewing the motion comic series. We used paired t-tests and indicators of overall improvement to assess differences between surveys. We found a significant decrease in HIV stigma (p < .001) and increases in both HIV knowledge (p = .002) and behavioral intentions to engage in safe sex (p < .001). In summary, this motion comic intervention improved HIV/STD-related KABI of young adult viewers by reducing HIV stigma and increasing behavioral intentions to engage in safer sex. Our results demonstrate the promise of this novel intervention and support its use to deliver health messages to young people.

Bruxism in military pilots and non-pilots: tooth wear and psychological stress.

PubMed

Lurie, Orit; Zadik, Yehuda; Einy, Shmuel; Tarrasch, Ricardo; Raviv, Gil; Goldstein, Liav

2007-02-01

Bruxism is the diurnal or nocturnal para-functional habit of clenching or grinding the teeth and affects 5-10% of the general western population. Bruxism can cause pain and irreversible damage to the teeth, periodontium, masticatory muscles, and temporo-mandibular joint. Variables such as general stress, work-related stress, and personality traits have been increasingly considered as initiating, predisposing, and perpetuating factors for bruxism. We sought to evaluate the potential of work-related stress and personality factors to induce bruxism among military pilots and non-pilot officers. Subjects were 57 healthy male Israel Air Force officers (mean age 25.8+/-4.3 yr). Of these, 17 were jet-pilots, 18 helicopter-pilots, and 22 non-pilot officers. Tooth-wear was classified according to a six-point scale. In addition, the subjects responded to a battery of psychological questionnaires for self-assessment of stress at the workplace and their coping behavior. Bruxism of clinical importance (i.e., with dentin exposure) was found in 69% of the aircrew members but only 27% of the non-pilot group. No difference was found between groups regarding stress levels. Military aircrews may be relatively vulnerable to deleterious bruxism as well as other signs of chronic stress. Among bruxers, pilots tended to show coping strategies that were significantly more emotional and less task-oriented than non-pilots, whereas non-bruxers showed no significant differences in coping behavior. This study suggest that integrating dental and psychological preventive intervention may be helpful.

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

PubMed Central

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

2013-01-01

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

Feasibility and impact of Creciendo Sanos, a clinic-based pilot intervention to prevent obesity among preschool children in Mexico City

PubMed Central

2014-01-01

Background Mexico has the highest adult overweight and obesity prevalence in the Americas; 23.8% of children <5 years old are at risk for overweight and 9.7% are already overweight or obese. Creciendo Sanos was a pilot intervention to prevent obesity among preschoolers in Instituto Mexicano del Seguro Social (IMSS) clinics. Methods We randomized 4 IMSS primary care clinics to either 6 weekly educational sessions promoting healthful nutrition and physical activity or usual care. We recruited 306 parent-child pairs: 168 intervention, 138 usual care. Children were 2-5 years old with WHO body mass index (BMI) z-score 0-3. We measured children’s height and weight and parents reported children’s diet and physical activity at baseline and 3 and 6-month follow-up. We analyzed behavioral and BMI outcomes with generalized mixed models incorporating multiple imputation for missing values. Results 93 (55%) intervention and 96 (70%) usual care families completed 3 and 6-month follow-up. At 3 months, intervention v. usual care children increased vegetables by 6.3 servings/week (95% CI, 1.8, 10.8). In stratified analyses, intervention participants with high program adherence (5-6 sessions) decreased snacks and screen time and increased vegetables v. usual care. No further effects on behavioral outcomes or BMI were observed. Transportation time and expenses were barriers to adherence. 90% of parents who completed the post-intervention survey were satisfied with the program. Conclusions Although satisfaction was high among participants, barriers to participation and retention included transportation cost and time. In intention to treat analyses, we found intervention effects on vegetable intake, but not other behaviors or BMI. Trial registration ClinicalTrials.gov NCT01539070. Comisión Nacional de Investigación Científica del IMSS: 2009-785-120. PMID:24649831

IDEAS (Integrate, Design, Assess, and Share): A Framework and Toolkit of Strategies for the Development of More Effective Digital Interventions to Change Health Behavior.

PubMed

Mummah, Sarah Ann; Robinson, Thomas N; King, Abby C; Gardner, Christopher D; Sutton, Stephen

2016-12-16

Developing effective digital interventions to change health behavior has been a challenging goal for academics and industry players alike. Guiding intervention design using the best combination of approaches available is necessary if effective technologies are to be developed. Behavioral theory, design thinking, user-centered design, rigorous evaluation, and dissemination each have widely acknowledged merits in their application to digital health interventions. This paper introduces IDEAS, a step-by-step process for integrating these approaches to guide the development and evaluation of more effective digital interventions. IDEAS is comprised of 10 phases (empathize, specify, ground, ideate, prototype, gather, build, pilot, evaluate, and share), grouped into 4 overarching stages: Integrate, Design, Assess, and Share (IDEAS). Each of these phases is described and a summary of theory-based behavioral strategies that may inform intervention design is provided. The IDEAS framework strives to provide sufficient detail without being overly prescriptive so that it may be useful and readily applied by both investigators and industry partners in the development of their own mHealth, eHealth, and other digital health behavior change interventions. ©Sarah Ann Mummah, Thomas N Robinson, Abby C King, Christopher D Gardner, Stephen Sutton. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.12.2016.

Pairing motivational interviewing with a nutrition and physical activity assessment and counseling tool in pediatric clinical practice: a pilot study.

PubMed

Christison, Amy L; Daley, Brendan M; Asche, Carl V; Ren, Jinma; Aldag, Jean C; Ariza, Adolfo J; Lowry, Kelly W

2014-10-01

Recommendations to screen and counsel for lifestyle behaviors can be challenging to implement during well-child visits in the primary care setting. A practice intervention was piloted using the Family Nutrition and Physical Activity (FNPA) Screening Tool paired with a motivational interviewing (MI)-based counseling tool during well-child visits. Acceptability and feasibility of this intervention were assessed. Its impact on parent-reported obesigenic behavior change and provider efficacy in lifestyle counseling were also examined. This was an observational study in a pediatric primary care office. During well-child visits of 100 patients (ages 4-16 years), the FNPA tool was implemented and providers counseled patients in an MI-consistent manner based on its results. Duration of implementation, patient satisfaction of the intervention, and success of stated lifestyle goals were measured. Provider self-efficacy and acceptability were also surveyed. The FNPA assessment was efficient to administer, requiring minutes to complete and score. Patient acceptability was high, ranging from 4.0 to 4.8 on a 5-point scale. Provider acceptability was good, with the exception of duration of counseling; self-efficacy in assessing patient "readiness for change" was improved. Parent-reported success of primary lifestyle goal was 68% at 1 month and 46% at 6 months. The FNPA assessment with an MI-based counseling tool shows promise as an approach to identify and address obesigenic behaviors during pediatric well-child visits. It has the potential to improve provider efficacy in obesity prevention and also influence patient health behaviors, which can possibly impact childhood excessive weight gain. After refinement, this practice intervention will be used in a larger trial.

Effectiveness of a fundamental motor skill intervention for 4-year-old children with autism spectrum disorder: A pilot study.

PubMed

Bremer, Emily; Balogh, Robert; Lloyd, Meghann

2015-11-01

A wait-list control experimental design was employed to investigate the effectiveness of a fundamental motor skill intervention at improving the motor skills, adaptive behavior, and social skills of 4-year-old children with autism spectrum disorder (experimental n = 5, control n = 4); the impact of intervention intensity was also explored. The experimental group significantly improved their object manipulation and overall motor scores from pre- to post-intervention. The wait-list control design revealed no group-by-time interactions; however, with the groups combined time was a significant factor for all motor variables. There were no significant changes in adaptive behavior and social skills. These preliminary findings suggest that a fundamental motor skill intervention may benefit young children with autism spectrum disorder. Future research with larger samples is warranted. © The Author(s) 2014.

Pilot Feasibility Study of a Digital Storytelling Intervention for Immigrant and Refugee Adults With Diabetes.

PubMed

Wieland, Mark L; Njeru, Jane W; Hanza, Marcelo M; Boehm, Deborah H; Singh, Davinder; Yawn, Barbara P; Patten, Christi A; Clark, Matthew M; Weis, Jennifer A; Osman, Ahmed; Goodson, Miriam; Porraz Capetillo, Maria D; Hared, Abdullah; Hasley, Rachel; Guzman-Corrales, Laura; Sandler, Rachel; Hernandez, Valentina; Novotny, Paul J; Sloan, Jeff A; Sia, Irene G

2017-08-01

Purpose The purpose of this pilot feasibility project was to examine the potential effectiveness of a digital storytelling intervention designed through a community-based participatory research (CBPR) approach for immigrants and refugees with type 2 diabetes mellitus (T2DM). Methods The intervention was a 12-minute culturally and linguistically tailored video consisting of an introduction, 4 stories, and a concluding educational message. A structured interview was used to assess the intervention for acceptability, interest level, and usefulness among 25 participants with T2DM (15 Latino, 10 Somali) across 5 primary care clinical sites. After watching the video, participants rated their confidence and motivation about managing T2DM as a result of the intervention. Baseline A1C and follow-up values (up to 6 months) were abstracted from medical records. Results All participants reported that the intervention got their attention, was interesting, and was useful; 96% reported that they were more confident about managing their T2DM than before they watched the video, and 92% reported that the video motivated them to change a specific behavior related to T2DM self-management. The mean baseline A1C level for the intervention participants was 9.3% (78 mmol/mol). The change from baseline to first follow-up A1C level was -0.8% (-10 mmol/mol) ( P < .05). Conclusions Implementation of a digital storytelling intervention for T2DM among immigrant populations in primary care settings is feasible and resulted in self-rated improvement in psychosocial constructs that are associated with healthy T2DM self-management behaviors, and there was some evidence of improvement in glycemic control. A large-scale efficacy trial of the intervention is warranted.

Pilot Feasibility Study of A Digital Storytelling Intervention for Immigrant and Refugee Adults with Diabetes

PubMed Central

Wieland, Mark L.; Njeru, Jane W.; Hanza, Marcelo M.; Boehm, Deborah H.; Singh, Davinder; Yawn, Barbara P.; Patten, Christi A.; Clark, Matthew M.; Weis, Jennifer A.; Osman, Ahmed; Goodson, Miriam; Porraz-Capetillo, Maria; Hared, Abdullah; Hasley, Rachel; Guzman-Corrales, Laura; Sandler, Rachel; Hernandez, Valentina; Novotny, Paul J.; Sloan, Jeff A.; Sia, Irene G.

2018-01-01

Purpose The purpose of this pilot feasibility project was to examine the potential effectiveness of a digital storytelling intervention designed through a community-based participatory research approach for immigrants and refugees with type 2 diabetes mellitus (T2DM). Methods The intervention was a 12-minute culturally and linguistically tailored video consisting of an introduction, 4 stories, and a concluding educational message. A structured interview was used to assess the intervention for acceptability, interest level, and usefulness among 25 participants with T2DM (15 Latino, 10 Somali) across 5 primary care clinical sites. After watching the video, participants rated their confidence and motivation about managing T2DM as a result of the intervention. Baseline hemoglobin A1c (A1C) and follow-up values (up to 6 months) were abstracted from medical records. Results All participants reported that the intervention got their attention, was interesting, and was useful; 96% reported that they were more confident about managing their T2DM than before they watched the video; and 92% reported that the video motivated them to change a specific behavior related to T2DM self-management. The mean baseline A1C level for the intervention participants was 9.3% (78 mmol/mol). The change from baseline to first follow-up A1C level was −0.8% (−10 mmol/mol) (P<.05). Conclusions Implementation of a digital storytelling intervention for T2DM among immigrant populations in primary care settings is feasible and resulted in self-rated improvement in psychosocial constructs that are associated with healthy T2DM self-management behaviors, and there was some evidence of improvement in glycemic control. A large-scale efficacy trial of the intervention is warranted. PMID:28592205

The Mothers and Toddlers Program, an attachment-based parenting intervention for substance using women: Post-treatment results from a randomized clinical pilot

PubMed Central

Suchman, Nancy E.; DeCoste, Cindy; Castiglioni, Nicole; McMahon, Thomas J.; Rounsaville, Bruce; Mayes, Linda

2010-01-01

This is a report of post-treatment findings from a completed randomized pilot study testing the preliminary efficacy of The Mothers and Toddlers Program (MTP), a 12 week attachment-based individual parenting therapy for mothers enrolled in substance abuse treatment and caring for children ages birth to 36 months. Forty-seven mothers were randomized to MTP versus the Parent Education Program (PE) – a comparison intervention providing individual case management and child guidance brochures. At post-treatment, MTP mothers demonstrated better reflective functioning in the Parent Development Interview, representational coherence and sensitivity, and caregiving behavior than PE mothers. Partial support was also found for proposed mechanisms of change in the MTP model. Together, preliminary findings suggest that attachment-based interventions may be more effective than traditional parent training for enhancing relationships between substance using women and their young children. PMID:20730641

Behavior management for children and adolescents with acquired brain injury.

PubMed

Slifer, Keith J; Amari, Adrianna

2009-01-01

Behavioral problems such as disinhibition, irritability, restlessness, distractibility, and aggression are common after acquired brain injury (ABI). The persistence and severity of these problems impair the brain-injured individual's reintegration into family, school, and community life. Since the early 1980s, behavior analysis and therapy have been used to address the behavioral sequelae of ABI. These interventions are based on principles of learning and behavior that have been robustly successful when applied across a broad range of other clinical populations. Most of the research on behavioral treatment after ABI has involved clinical case studies or studies employing single-subject experimental designs across a series of cases. The literature supports the effectiveness of these interventions across ages, injury severities, and stages of recovery after ABI. Recommended guidelines for behavior management include: direct behavioral observations, systematic assessment of environmental and within-patient variables associated with aberrant behavior, antecedent management to minimize the probability of aberrant behavior, provision of functionally equivalent alternative means of controlling the environment, and differential reinforcement to shape positive behavior and coping strategies while not inadvertently shaping emergent, disruptive sequelae. This package of interventions requires direction by a highly skilled behavioral psychologist or therapist who systematically monitors target behavior to evaluate progress and guide treatment decisions. A coordinated multisite effort is needed to design intervention protocols that can be studied prospectively in randomized controlled trials. However, there will continue to be an important role for single subject experimental design for studying the results of individualized interventions and obtaining pilot data to guide subsequent randomized controlled trails. (c) 2009 Wiley-Liss, Inc.

Feasibility of a Preventive Parenting Intervention for Very Preterm Children at 18 Months Corrected Age: A Randomized Pilot Trial.

PubMed

Flierman, Monique; Koldewijn, Karen; Meijssen, Dominique; van Wassenaer-Leemhuis, Aleid; Aarnoudse-Moens, Cornelieke; van Schie, Petra; Jeukens-Visser, Martine

2016-09-01

To evaluate the feasibility and potential efficacy of an age-appropriate additional parenting intervention for very preterm born toddlers. In a randomized controlled pilot study, 60 of 94 eligible very preterm born children who had received a responsive parenting intervention in their first year were randomized to usual care or the additional intervention, consisting of 4-6 home visits between 18 and 22 months' corrected gestational age (CA). Parents were supported to responsively interact during increasingly complex daily activities and play. Parental satisfaction with the intervention was evaluated with a questionnaire. At baseline and 24 months CA, parents completed the Infant Toddler Social and Emotional Assessment, the Ages and Stages Questionnaire, and the Dutch Schlichting Lexilist for receptive language. At 24 months CA, motor, and cognitive development was measured by the Bayley Scales of Infant and Toddler Development, Third Edition Dutch version, and parent-child interaction was evaluated by the Emotional Availability Scales. Parental compliance and satisfaction with the intervention was high. Effect sizes (after correction for baseline variables) were small for internalizing and competence behavior, receptive language, and problem solving; medium for cognitive development and parent-child interaction; and large for externalizing and dysregulation behavior and motor development. After a postdischarge intervention during the first year, an additional responsive parenting support at toddler-age is feasible and associated with positive outcomes in a broad array of parental and child outcome measures. www.toetsingonline.nl: NL40208.018.12. Copyright © 2016 Elsevier Inc. All rights reserved.

Development and pilot study of a marketing strategy for primary care/internet-based depression prevention intervention for adolescents (the CATCH-IT intervention).

PubMed

Van Voorhees, Benjamin W; Watson, Natalie; Bridges, John F P; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A; Ellis, Justin; Prochaska, Micah; Bell, Carl

2010-01-01

Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. The marketing plan focused on "resiliency building" rather than "depression intervention" and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1-10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care.

Dealing With Unexpected Events on the Flight Deck: A Conceptual Model of Startle and Surprise.

PubMed

Landman, Annemarie; Groen, Eric L; van Paassen, M M René; Bronkhorst, Adelbert W; Mulder, Max

2017-12-01

A conceptual model is proposed in order to explain pilot performance in surprising and startling situations. Today's debate around loss of control following in-flight events and the implementation of upset prevention and recovery training has highlighted the importance of pilots' ability to deal with unexpected events. Unexpected events, such as technical malfunctions or automation surprises, potentially induce a "startle factor" that may significantly impair performance. Literature on surprise, startle, resilience, and decision making is reviewed, and findings are combined into a conceptual model. A number of recent flight incident and accident cases are then used to illustrate elements of the model. Pilot perception and actions are conceptualized as being guided by "frames," or mental knowledge structures that were previously learned. Performance issues in unexpected situations can often be traced back to insufficient adaptation of one's frame to the situation. It is argued that such sensemaking or reframing processes are especially vulnerable to issues caused by startle or acute stress. Interventions should focus on (a) increasing the supply and quality of pilot frames (e.g., though practicing a variety of situations), (b) increasing pilot reframing skills (e.g., through the use of unpredictability in training scenarios), and (c) improving pilot metacognitive skills, so that inappropriate automatic responses to startle and surprise can be avoided. The model can be used to explain pilot behavior in accident cases, to design experiments and training simulations, to teach pilots metacognitive skills, and to identify intervention methods.

Computer-assisted cognitive behavioral therapy for children with epilepsy and anxiety: a pilot study.

PubMed

Blocher, Jacquelyn B; Fujikawa, Mayu; Sung, Connie; Jackson, Daren C; Jones, Jana E

2013-04-01

Anxiety disorders are prevalent in children with epilepsy. The purpose of this study was to evaluate the efficacy, adaptability, and feasibility of a manual-based, computer-assisted cognitive behavioral therapy (CBT) intervention for anxiety disorders in children with epilepsy. Fifteen anxious youth (aged 8-13 years) with epilepsy completed 12 weeks of manualized computer-assisted CBT. The children and parents completed a semi-structured interview at baseline, and questionnaires assessing symptoms of anxiety, depression, and behavior problems were completed prior to treatment, at treatment midpoint, after treatment completion, and at three months posttreatment. There were significant reductions in the symptoms of anxiety and depression reported by the children at completion of the intervention and at the three-month follow-up. Similarly, the parents reported fewer symptoms of anxiety and a reduction in behavior problems. No adverse events were reported. This CBT intervention for children with epilepsy and anxiety disorders appears to be safe, effective, and feasible and should be incorporated into future intervention studies. Copyright © 2012 Elsevier Inc. All rights reserved.

Taking charge: a pilot curriculum of self-defense and personal safety training for female veterans with PTSD because of military sexual trauma.

PubMed

David, Wendy S; Simpson, Tracy L; Cotton, Ann J

2006-04-01

The authors describe an overview of the pilot project Taking Charge, a 36-hour comprehensive behavioral intervention involving psychoeducation, personal safety, and self-defense training for 12 female veterans with posttraumatic stress disorder (PTSD) from military sexual trauma. Self-defense training can incorporate the benefits of repeated exposure while teaching proactive cognitive and behavioral responses to the feared stimuli, and thus facilitate emotional and physical rescripting of and mastery over the trauma. Results up to 6 months follow-up indicate significant reductions in behavioral avoidance, PTSD hyperarousal, and depression, with significant increases in interpersonal, activity, and self-defense self-efficacy. The authors propose that this therapeutic self-defense curriculum provides an enhanced exposure therapy paradigm that may be a potent therapeutic tool in the treatment of PTSD.

Evaluation of Bikers Against Child Abuse (BACA) program: A community intervention for child abuse victims.

PubMed

Ray, Dee C; Lilly, J P; Gallina, Nancy; MacIan, Paula; Wilson, Brittany

2017-12-01

Children who have experienced physical abuse benefit from a multitude of community interventions including support programs to address emotional and behavioral stability. This pilot study evaluated the services of Bikers Against Child Abuse (BACA), a community of bikers lending intervention to abused children, using a pre/post exploratory design. Participants (N=154) were children who had been referred by parents/guardians for current or past physical and/or sexual abuse. Parents/guardians of children were interviewed four times over a course of one year. Results indicated children demonstrated substantial improvements in their overall levels of emotional distress, conduct concerns, hyperactivity, and behavioral and emotional functioning. Overall, results support the premise that services provided by BACA may serve as a unique intervention for children who have experienced abuse. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcomes of neurofeedback training in childhood obesity management: a pilot study.

PubMed

Chirita-Emandi, Adela; Puiu, Maria

2014-11-01

This pilot study sought to evaluate the neurofeedback training outcomes in childhood obesity management. The study involved 34 overweight and obese children, age 6-18 years (12 patients in the intervention group, 22 in the control group). Complete assessment of children was done before the intervention and 3 and 6 months after the intervention; eating behavior and quality-of-life questionnaires were assessed at study start and 6 months after. All children received classic lifestyle recommendations for weight management, while the intervention group also had 20 neurofeedback sessions (infra-low-frequency training). The neurofeedback intervention was associated with less weight loss compared with classic weight management. The mean change in body-mass index standard deviation score at 3 months was -0.29 for the intervention group and -0.36 for the control group (p=0.337); after 6 months, the changes were -0.30 and -0.56, respectively (p=0.035). Quality of life improved similarly for both groups. Subjective outcomes reported by patients in the intervention were less snacking, improved satiety, enhanced attention capacity, ameliorated hyperactivity, and better sleep patterns. Larger studies, with training methods involving both the left and right cortices, should further clarify the role of neurofeedback training in obesity management.

Parenting Intervention for Prevention of Behavioral Problems in Elementary School-Age Filipino-American Children: A Pilot Study in Churches.

PubMed

Javier, Joyce R; Coffey, Dean M; Schrager, Sheree M; Palinkas, Lawrence A; Miranda, Jeanne

This study aims to test an evidence-based parenting program offered in churches among Filipino-American parents and estimate effect size for a fully powered trial. Twenty-two parents of children aged 6 to 12 years were randomly assigned to either an intervention or a waiting-list control group. Parents' perceptions of child behavior, parenting practices, and parenting stress were obtained at baseline. Parents in the experimental group attended The Incredible Years School Age Program, which consisted of 12 weekly 2-hour sessions. A follow-up assessment was performed after the intervention and 12 weeks later. The intervention was subsequently repeated with the control group. Satisfaction was assessed with a 40-item measure. Analysis of covariance was used to compare the intervention group postintervention versus the control group. Paired t-tests compared mean parenting practices, parenting stress, and child behavior outcomes. Satisfaction was assessed descriptively. Twenty-two parents completed all assessments and the intervention. Analysis of variance comparing intervention and control groups with repeated measures (pre- and post-test measures) revealed that the program has a positive impact on parenting stress, parenting practices (physical punishment, positive verbal discipline), and parent's perception of their child's behavior (internalizing symptoms, externalizing symptoms, and number of problematic behaviors). Analyses of all participants comparing pre- and post intervention revealed improvements in parenting stress, positive verbal discipline, and child externalizing and total problem behaviors. Families reported high satisfaction with the content and format of the intervention. Results support the feasibility of providing an evidence-based parenting program to Filipino parents in churches to prevent future behavioral health problems.

Subjective Experiences of the Benefits and Key Elements of a Cognitive Behavioral Intervention Focused on Community Work Outcomes in Persons With Mental Illness.

PubMed

Kukla, Marina; Strasburger, Amy M; Salyers, Michelle P; Rattray, Nicholas A; Lysaker, Paul H

2017-01-01

New research suggests that group-based cognitive behavioral therapy (CBT) may help improve employment outcomes in persons with mental illness, yet the effects and potential key elements facilitating change in such interventions are unclear. Using a mixed methods approach, this study examined the perspectives of persons with mental illness after participating in a pilot study of the "CBT for Work Success" intervention. Findings demonstrate that participants valued the intervention and perceived that it assisted them in achieving work goals. Therapeutic effects included improved self-efficacy, work motivation, enhanced sense of self as workers, and increased beliefs that work success is attainable. CBT for Work Success elements perceived to be important in facilitating work goals included cognitive restructuring, behavioral coping strategies, problem solving work barriers, meaningful reflection on oneself as a worker, and important factors associated with the group process. The authors discuss the implications of these findings and future research directions.

Behavior therapy and callous-unemotional traits: Effects of a pilot study examining modified behavioral contingencies on child behavior

PubMed Central

Miller, Natalie V.; Haas, Sarah M.; Waschbusch, Daniel A.; Willoughby, Michael T.; Helseth, Sarah A.; Crum, Kathleen I.; Coles, Erika K.; Pelham, William E.

2014-01-01

The conduct problems of children with callous-unemotional traits (i.e., lack of empathy, guilt/lack of caring behaviors) (CU) are particularly resistant to current behavioral interventions, and it is possible that differential sensitivities to punishment and reward may underlie this resistance. Children with conduct problems and CU (CPCU) are less responsive to behavioral punishment techniques (e.g., time-out), however reward techniques (e.g., earning points for prizes or activities) are effective for reducing conduct problems. This study examined the efficacy of modified behavioral interventions, which de-emphasized punishment (condition B) and emphasized reward techniques (condition C), compared to a standard behavioral intervention (condition A). Interventions were delivered through a Summer Treatment Program over seven weeks with an A-B-A-C-A-BC-A design to a group of eleven children (7–11 years; 91% male). All children were diagnosed with either oppositional defiant disorder or conduct disorder, in addition to attention-deficit/hyperactivity disorder. Results revealed the best treatment response occurred during the low punishment condition, with rates of negative behavior (e.g., aggression, teasing, stealing) increasing over the seven weeks. However, there was substantial individual variability in treatment response, and several children demonstrated improvement during the modified intervention conditions. Future research is necessary to disentangle treatment effects from order effects, and implications of group treatment of CPCU children (i.e., deviancy training) are discussed. PMID:25022772

SunSmart: evaluation of a pilot school-based sun protection intervention in Hispanic early adolescents.

PubMed

Miller, K A; Langholz, B M; Ly, T; Harris, S C; Richardson, J L; Peng, D H; Cockburn, M G

2015-06-01

The incidence of melanoma is rising among Hispanic populations in the United States. The purpose of this study is to evaluate the impact of a pilot sun safety educational intervention conducted from 2006 to 2012 on Hispanic early adolescents in a high ultraviolet environment. Nineteen schools with high Hispanic enrollment were recruited from urban neighborhoods in Los Angeles. The analytic sample was restricted to students identifying as Hispanic or Latino (n = 777). A mixed effects linear model was used to test mean changes from pre- to posttest on students' sun protection knowledge, attitudes and behaviors. Significant improvements were observed across several cognitive outcomes related to sun protection, including knowledge of and attitudes toward sun protection and self-efficacy to wear sunscreen. However, changes in sun protective behaviors were not achieved. Although some improvements were observed, future studies should identify the factors that motivate sun protection in this population and develop tailored prevention strategies, as improving the sun safe behaviors of Hispanic youths may aid in reducing the risk of melanoma in adulthood in this population. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

ENHANCING THE EFFECTIVENESS OF A PLAY INTERVENTION BY ABOLISHING THE REINFORCING VALUE OF STEREOTYPY: A PILOT STUDY

PubMed Central

Lang, Russell; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio E; Machalicek, Wendy; Rispoli, Mandy; White, Pamela

2009-01-01

An alternating treatments design compared one condition in which a child with autism was allowed to engage in stereotypy freely prior to the intervention (abolishing operation component) to a second condition without the free-access period. Levels of stereotypy and problem behavior were lower and levels of functional play were higher in the condition with the abolishing operation component. These data provide preliminary support for the use of abolishing operations in interventions to increase the play skills of children with autism. PMID:20514199

Enhancing the effectiveness of a play intervention by abolishing the reinforcing value of stereotypy: a pilot study.

PubMed

Lang, Russell; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio E; Machalicek, Wendy; Rispoli, Mandy; White, Pamela

2009-01-01

An alternating treatments design compared one condition in which a child with autism was allowed to engage in stereotypy freely prior to the intervention (abolishing operation component) to a second condition without the free-access period. Levels of stereotypy and problem behavior were lower and levels of functional play were higher in the condition with the abolishing operation component. These data provide preliminary support for the use of abolishing operations in interventions to increase the play skills of children with autism.

A Mixed-Methods Approach to the Development, Refinement, and Pilot Testing of Social Networks for Improving Healthy Behaviors

PubMed Central

Turner-McGrievy, Gabrielle; Fahim, Arjang; Freix, Andrew; Wilcox, Sara; Davis, Rachel E; Huhns, Michael; Valafar, Homayoun

2016-01-01

Background Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, including connecting users for social support. Objective To develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction. Methods Adults who were overweight and obese with Android smartphones (BMI 25-49.9 kg/m2; N=9) were recruited for a 2-month weight loss pilot intervention and iterative usability testing of the Social POD app. The app prompted participants via notification to track daily weight, diet, and physical activity behaviors. Participants received the content of the behavioral weight loss intervention via podcast. In order to re-engage infrequent users (did not use the app within the previous 48 hours), the app prompted frequent users to select 1 of 3 messages to send to infrequent users targeting the behavioral theory constructs social support, self-efficacy, or negative outcome expectations. Body weight, dietary intake (2 24-hr recalls), and reported calories expended during physical activity were assessed at baseline and 2 months. All participants attended 1 of 2 focus groups to provide feedback on use of the app. Results Participants lost a mean of 0.94 kg (SD 2.22, P=.24) and consumed significantly fewer kcals postintervention (1570 kcal/day, SD 508) as compared to baseline (2384 kcal/day, SD 993, P=.01). Participants reported expending a mean of 171 kcal/day (SD 153) during intentional physical activity following the intervention as compared to 138 kcal/day (SD 139) at baseline, yet this was not a statistically significant difference (P=.57). There was not a statistically significant correlation found between total app entries and percent weight loss over the course of the intervention (r=.49, P=.19). Mean number of app entries was 77.2 (SD 73.8) per person with a range of 0 to 219. Messages targeting social support were selected most often (32/68, 47%), followed by self-efficacy (28/68, 41%), and negative outcome expectations (8/68, 12%). Themes from the focus groups included functionality issues, revisions to the messaging system, and the addition of a point system with rewards for achieving goals. Conclusions The Social POD app provides an innovative way to re-engage infrequent users by encouraging frequent users to provide social support. Although more time is needed for development, this mHealth intervention can be disseminated broadly for many years and to many individuals without the need for additional intensive in-person hours. PMID:27026535

Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study.

PubMed

Shrestha, Roman; Altice, Frederick L; Karki, Pramila; Copenhaver, Michael M

2018-03-26

This study reports the feasibility, acceptability, and preliminary efficacy of the bio-behavioral community-friendly health recovery program-an integrated, HIV prevention intervention to improve pre-exposure prophylaxis (PrEP) adherence and HIV-risk reduction behaviors among high-risk people who use drugs. We used a within-subjects, pretest-posttest follow-up design to recruit participants, who were HIV-uninfected, methadone-maintained and reported HIV-risk behaviors and had initiated PrEP (n = 40; males: 55%). Participants were assessed at baseline (T 0 ), immediately post-intervention (4 weeks: T 4 ) and 4 weeks post-intervention (T 8 ). Immediately after completing the four weekly intervention groups, participants underwent a post-intervention assessment including in-depth qualitative interviews. Feasibility was high, assessed by participant willingness to enroll (90.1%) and retention (95%). Results showed that participants were highly satisfied and perceived the intervention as valuable and acceptable [mean: 81.3 (range 0-100)]. Significant enhancements in self-reported PrEP adherence [F(2,74) = 7.500, p = 0.001] and PrEP-related knowledge [F(2,74) = 3.828, p = 0.026] were observed. Drug-related (e.g., injection of drugs, sharing of injection equipment) and sex-related (e.g., number of sexual partners, condomless sex) risk behaviors were reduced, while information, motivation, and behavioral skills (IMB) constructs increased. The results support feasibility and high acceptability and support further examination of the efficacy of this combination bio-behavioral intervention in a prospective clinical trial.

Parent training education program: a pilot study, involving families of children with Prader-Willi syndrome.

PubMed

Kodra, Yllka; Kondili, Loreta A; Ferraroni, Alessia; Serra, Maria Antonietta; Caretto, Flavia; Ricci, Maria Antonietta; Taruscio, Domenica

2016-01-01

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by severe hypotonia during the neonatal period and the first two years of life, the onset of hyperphagia with a risk of obesity during infancy and adulthood, learning difficulties and behavioral or severe psychiatric problems. This complex disease has severe consequences and difficult management issues also for patients' families. Parents of children with PWS need appropriate psychoeducational intervention in order to better manage their children with PWS. The purpose of this study was the implementation and evaluation of a PWS psychoeducational parent training program. The Italian National Center for Rare Diseases implemented a pilot parent training program offered to parents of children with PWS. The intervention's effects was evaluated using questionnaires comprised of 11 items rated on a 7 point Likert scale. The intervention was offered to 43 parents. The behavior problems management, dietary restrictions, autonomy and relationships were indicated by parents as the priority topics which needed to be addressed. Evaluations, immediately post-intervention and after 6 months, were reported by parents, fulfilling specific questionnaires. 90% of parents involved in the study, appreciated the methodology, 86% felt more informed about PWS, 47-62% felt more capable to better approach behaviour's problems, 20-25% felt better about the child's health situation and future expectations. Feeling more capable to help the child autonomy and relationships were reported in 62% and 63% of parents respectively, which decreased significantly (p < 0.05) according to the evaluation 6 months after the intervention. Younger age of parents (< 44 years of age) was significantly correlated with better understanding on how to help the child's autonomy (OR: 0.05; CI: 0.04-0.8) and to better collaborate with the child's teachers (OR: 0.02; CI: 0.001-0.9). Parent training is a promising intervention for parents of children with behavior's problems. Interventions with a behaviorally oriented program, addressed to parents of PWS affected children, is a useful tool in increasing their ability to manage the problems related to the disease.

Women's Health and Mindfulness (WHAM): A Randomized Intervention Among Older Lesbian/Bisexual Women.

PubMed

Ingraham, Natalie; Harbatkin, Dawn; Lorvick, Jennifer; Plumb, Marj; Minnis, Alexandra M

2017-05-01

Lesbian and bisexual (LB) women have higher body weight than heterosexual women. Interventions focused on health and well-being versus weight loss may be more likely to succeed among LB women. This article describes effects of Women's Health and Mindfulness, a 12-week pilot intervention addressing mindfulness, healthy eating, and physical activity, on outcomes associated with chronic disease risk among overweight and obese LB women older than 40 years. Eighty women were randomized, using a stepped-wedge design, to either an immediate- or a delayed-start intervention group; the delayed-start group served as the control. Eligible participants were aged 40 years or older, identified as LB, and had a body mass index of 27 or greater. We compared differences in biological markers of chronic disease, mindfulness, nutrition, and physical activity between immediate- and delayed-start intervention groups. We observed clinically significant improvements in low-density lipoprotein cholesterol but no change in hemoglobin A1c. We found evidence of intervention effects on improved mindfulness and mindful eating scores and on nutrition (improved vegetable intake). The Women's Health and Mindfulness pilot intervention appears to have initiated positive behavioral and physical health changes in this population. Refinements to the intervention model, such as extended intervention duration, and longer term follow-up are warranted to determine sustained effects.

Brief Behavioral Therapy for Pediatric Anxiety and Depression: Piloting an Integrated Treatment Approach

ERIC Educational Resources Information Center

Weersing, V. Robin; Gonzalez, Araceli; Campo, John V.; Lucas, Amanda N.

2008-01-01

Mood and anxiety disorders in youth are disabling, distressing, and prevalent. Furthermore, depression and anxiety frequently co-exist, may share several etiological factors, and respond to similar interventions. In this paper, we report preliminary results from a treatment adaptation project designed to condense existing cognitive behavioral…

Fit5Kids TV reduction program and Latino preschoolers' TV viewing behaviors: A pilot cluster RCT

USDA-ARS?s Scientific Manuscript database

Excessive television (TV) viewing has been associated with a greater risk of childhood obesity. Latino children watch higher amounts of TV than their peers and are disproportionately affected by childhood obesity. Since TV viewing and obesity track from preschool into adolescence, early intervention...

Tobacco Use Behavior in Grades 5-12.

ERIC Educational Resources Information Center

Lynch, Daniel O.

This study examined the responses of 3,915 Oshkosh, Wisconsin students (in grades 5 through 12) to the National Cancer Institute's (NCI) standard form of common questions for school-based interventions. Also, a pilot questionnaire of knowledge, beliefs, and attitudes concerning and predicting tobacco use was administered. NCI findings indicated an…

Effects of physical examination and diet consultation on serum cholesterol and health-behavior in the Korean pilots employed in commercial airline.

PubMed

Choi, Yun Young; Kim, Ki Youn

2013-01-01

An objective of this study is to search how physical examination and diet consultation can influence those risk factors of cardiovascular disease. The subjects were 326 pilots of the "B" airline company in Korea whose total cholesterol values were over 220 mg/dl on their regular physical examinations from April 2006 to December 2008. They were divided into two groups, one who had diet consultation (an intervention group) and a control group. The physical examination components used to each group were body mass index (BMI), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG). The behavioral, anthropometric and biomedical measurements were collected at each visit. This study compares and investigates the changes of serum cholesterol and also the health-behavior at each physical examination. Within the intervention group significant improvements were observed for total cholesterol, BMI (body mass index) and HDL (high density lipoprotein). The normalizing rates for cholesterol level to decrease down to lower than 200 mg/dl were 17.7% in intervention group and 8.7% in control group, which is statistically significantly higher among the intervention group. The odds ratio of diet consultation was 2.80 (95% CI=1.35-5.79), which indicates that it is a significantly contributing factor to normalize the serum cholesterol value down to lower than 200 mg/dl. Based on result, it is recommended to have regular physical examination and intensive management with diet and exercise consultation.

Effects of Physical Examination and Diet Consultation on Serum Cholesterol and Health-behavior in the Korean Pilots Employed in Commercial Airline

PubMed Central

CHOI, Yun Young; KIM, Ki Youn

2013-01-01

An objective of this study is to search how physical examination and diet consultation can influence those risk factors of cardiovascular disease. The subjects were 326 pilots of the “B” airline company in Korea whose total cholesterol values were over 220 mg/dl on their regular physical examinations from April 2006 to December 2008. They were divided into two groups, one who had diet consultation (an intervention group) and a control group. The physical examination components used to each group were body mass index (BMI), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG). The behavioral, anthropometric and biomedical measurements were collected at each visit. This study compares and investigates the changes of serum cholesterol and also the health-behavior at each physical examination. Within the intervention group significant improvements were observed for total cholesterol, BMI (body mass index) and HDL (high density lipoprotein). The normalizing rates for cholesterol level to decrease down to lower than 200 mg/dl were 17.7% in intervention group and 8.7% in control group, which is statistically significantly higher among the intervention group. The odds ratio of diet consultation was 2.80 (95% CI=1.35–5.79), which indicates that it is a significantly contributing factor to normalize the serum cholesterol value down to lower than 200 mg/dl. Based on result, it is recommended to have regular physical examination and intensive management with diet and exercise consultation. PMID:24131872

A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial.

PubMed

Lynch, Elizabeth B; Liebman, Rebecca; Ventrelle, Jennifer; Avery, Elizabeth F; Richardson, DeJuran

2014-05-29

The objective of this pilot 6-month randomized controlled trial was to determine the effectiveness of an intensive, community-based, group intervention that focused on diet, physical activity, and peer support for reducing weight among urban-dwelling African Americans with comorbid type 2 diabetes and hypertension. Sixty-one participants were randomized into an intervention or control group. The 6-month intervention consisted of 18 group sessions led by a dietitian in a community setting and weekly telephone calls from a peer supporter. The intervention featured culturally tailored nutrition education, behavioral skills training, and social support focused on changes to diet and physical activity. The control group consisted of two 3-hour group sessions of diabetes self-management education taught by a community health worker. Outcome measures were assessed at baseline and 6 months. The primary outcome was achievement of a 5% weight reduction at 6 months. A secondary outcome was achievement of a 0.5 percentage-point reduction in hemoglobin A1c (HbA1c). Groups did not differ in achievement of the weight-loss goal. Intervention participants lost a mean of 2.8 kg (P = .01); control participants did not lose a significant amount of weight. A greater proportion of intervention (50.0%) than control (21.4%) participants reduced HbA1c by 0.5 percentage points or more at 6 months (P = .03). The intervention was more effective than usual care (short-term diabetes education) at improving glycemic control, but not weight, in low-income African Americans with comorbid diabetes and hypertension. A community-based 6-month group class with culturally tailored education, behavioral skills training, and peer support can lead to a clinically significant reduction in HbA1c.

Rationale, design and methods of the HEALTHY study behavior intervention component

PubMed Central

Venditti, EM; Elliot, DL; Faith, MS; Firrell, LS; Giles, CM; Goldberg, L; Marcus, MD; Schneider, M; Solomon, S; Thompson, D; Yin, Z

2009-01-01

HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data informed the development of the behavior intervention component. Principles of social learning and health-related behavior change were incorporated. One element of the behavior intervention component was a sequence of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study, with the first module delivered in the second semester of the sixth grade and the last module in the second semester of the eighth grade. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills and peer involvement for health behavior change. FLASH behavioral practice incorporated individual and group self-monitoring challenges for eating and activity. Another element of the behavior intervention component was the family outreach strategy for extending changes in physical activity and healthy eating beyond the school day and for supporting the student's lifestyle change choices. Family outreach strategies included the delivery of newsletters and supplemental packages with materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and acceptable mechanism for delivering age-appropriate social learning for healthy eating and physical activity among an ethnically diverse group of middle school students across the United States. PMID:19623189

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

PubMed

Venditti, E M; Elliot, D L; Faith, M S; Firrell, L S; Giles, C M; Goldberg, L; Marcus, M D; Schneider, M; Solomon, S; Thompson, D; Yin, Z

2009-08-01

HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data informed the development of the behavior intervention component. Principles of social learning and health-related behavior change were incorporated. One element of the behavior intervention component was a sequence of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study, with the first module delivered in the second semester of the sixth grade and the last module in the second semester of the eighth grade. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills and peer involvement for health behavior change. FLASH behavioral practice incorporated individual and group self-monitoring challenges for eating and activity. Another element of the behavior intervention component was the family outreach strategy for extending changes in physical activity and healthy eating beyond the school day and for supporting the student's lifestyle change choices. Family outreach strategies included the delivery of newsletters and supplemental packages with materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and acceptable mechanism for delivering age-appropriate social learning for healthy eating and physical activity among an ethnically diverse group of middle school students across the United States.

A Group-Based Motivational Interviewing Brief Intervention to Reduce Substance Use and Sexual Risk Behavior among Homeless Young Adults

PubMed Central

Tucker, Joan S.; D’Amico, Elizabeth J.; Ewing, Brett A.; Miles, Jeremy N. V.; Pedersen, Eric R.

2017-01-01

Homeless young adults ages 18–25 exhibit high rates of alcohol and other drug (AOD) use, and sexual risk behaviors such as unprotected sex. Yet few programs exist for this population that are both effective and can be easily incorporated into settings serving this population. This pilot cluster cross-over randomized controlled trial evaluates AWARE, a voluntary four session group-based motivational interviewing (MI) intervention to reduce AOD use and sexual risk behavior. We evaluated AWARE with 200 homeless young adults using drop-in center services in Los Angeles County (mean age=21.8 years; 73% male; 79% heterosexual; 31% non-Hispanic White, 25% African American, 24% Hispanic, 21% multiracial/other). Surveys were completed at baseline and three months after program completion. Retention in the AWARE program was excellent (79% attended multiple sessions) and participants reported high levels of satisfaction with the program. AWARE participants self-reported positive change in their past 3 month and past 30 day alcohol use (ps ≤ .05), motivation to change drug use (ps < .05), and condom use self-efficacy (p = .05) compared to the control group. Among those with multiple sex partners, AWARE participants showed a decrease in unprotected sexual events (p < .05), whereas the control group did not. Results from this pilot evaluation are promising, suggesting that a brief group-MI risk reduction intervention can be effective in helping homeless young adults make positive changes in their alcohol and condom use. Further work is needed to more fully evaluate the efficacy of AWARE on AOD behavior and sexual risk behavior outcomes. PMID:28340904

Integrating alcohol response feedback in a brief intervention for young adult heavy drinkers who smoke: A pilot study.

PubMed

Fridberg, Daniel J; Cao, Dingcai; King, Andrea C

2015-10-01

More effective approaches are needed to enhance drinking and other health behavior (e.g., smoking) outcomes of alcohol brief intervention (BI). Young adult heavy drinkers often engage in other health risk behaviors and show sensitivity to alcohol's stimulating and rewarding effects, which predicts future alcohol-related problems. However, standard alcohol BIs do not address these issues. The current pilot study tested the utility of including feedback on alcohol response phenotype to improve BI outcomes among young adult heavy drinkers who smoke (HDS). Thirty-three young adult (M±SD age=23.8±2.1 years) HDS (8.7±4.3 binge episodes/month; 23.6±6.3 smoking days/month) were randomly assigned to standard alcohol BI (BI-S; n=11), standard alcohol BI with personalized alcohol response feedback (BI-ARF; n=10), or a health behavior attention control BI (AC; n=11). Alcohol responses (stimulation, sedation, reward, and smoking urge) for the BI-ARF were recorded during a separate alcohol challenge session (.8g/kg). Outcomes were past-month drinking and smoking behavior assessed at 1- and 6-months post-intervention. At 6-month follow-up, the BI-ARF produced significant reductions in binge drinking, alcohol-smoking co-use, drinking quantity and frequency, and smoking frequency, but not maximum drinks per occasion, relative to baseline. Overall, the BI-ARF produced larger reductions in drinking/smoking behaviors at follow-up than did the BI-S or AC. Including personalized feedback on alcohol response phenotype may improve BI outcomes for young adult HDS. Additional research is warranted to enhance and refine this approach in a broader sample. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cognitive Behavioral Treatment for Recurrent Binge Eating in Adolescent Girls: A Pilot Trial

PubMed Central

DeBar, Lynn L.; Wilson, G. Terence; Yarborough, Bobbi Jo; Burns, Beryl; Oyler, Barbara; Hildebrandt, Tom; Clarke, Gregory N.; Dickerson, John; Striegel, Ruth H.

2013-01-01

There is a need for treatment interventions to address the high prevalence of disordered eating throughout adolescence and early adulthood. We developed an adolescent-specific manualized CBT protocol to treat female adolescents with recurrent binge eating and tested its efficacy in a small, pilot randomized controlled trial. We present lessons learned in recruiting adolescents, a description of our treatment approach, acceptability of the treatment for teens and parents, as well as results from the pilot trial. Participants in the CBT group had significantly fewer posttreatment eating binges than those in a treatment as usual/delayed treatment (TAU-DT) control group; 100% of CBT participants were abstinent at follow-up. Our results provide preliminary support for the efficacy of this adolescent adaptation of evidence-based CBT for recurrent binge eating. The large, robust effect size estimate observed for the main outcome (NNT=2) places this among the larger effects observed for any mental health intervention. PMID:23645978

A Pilot Randomized Clinical Trial of Two Medication Adherence and Drug Use Interventions For HIV+ Crack Cocaine Users*

PubMed Central

Ingersoll, Karen S.; Farrell-Carnahan, Leah; Cohen-Filipic, Jessye; Heckman, Carolyn J.; Ceperich, Sherry D.; Hettema, Jennifer; Marzani-Nissen, Gabrielle

2011-01-01

Background Crack cocaine use undermines adherence to highly active antiretroviral therapy (HAART). This pilot randomized clinical trial tested the feasibility and efficacy of 2 interventions based on the Information-Motivation-Behavioral Skills model to improve HAART adherence and reduce crack cocaine problems. Methods Participants were 54 adults with crack cocaine use and HIV with <90% HAART adherence. Most participants were African-American (82%) heterosexual (59%), and crack cocaine dependent (92%). Average adherence was 58% in the past 2 weeks. Average viral loads (VL) were detectable (log VL 2.97). The interventions included 6 sessions of Motivational Interviewing plus feedback and skills building (MI+), or Video information plus debriefing (Video+) over 8 weeks. Primary outcomes were adherence by 14-day timeline follow-back and Addiction Severity Index (ASI) Drug Composite Scores at 3 and 6 months. Repeated measures ANOVA assessed main effects of the interventions and interactions by condition. Results Significant increases in adherence and reductions in ASI Drug Composite Scores occurred in both conditions by 3 months and were maintained at 6 months, representing medium effect sizes. No between group differences were observed. No VL changes were observed in either group. Treatment credibility, retention, and satisfaction were high and not different by condition. Conclusions A counseling and a video intervention both improved adherence and drug problems durably among people with crack cocaine use and poor adherence in this pilot study. The interventions should be tested further among drug users with poor adherence. Video interventions may be feasible and scalable for people with HIV and drug use. PMID:21306837

Development and Pilot Study of a Marketing Strategy for Primary Care/Internet–Based Depression Prevention Intervention for Adolescents (The CATCH-IT Intervention)

PubMed Central

Watson, Natalie; Bridges, John F. P.; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A.; Ellis, Justin; Prochaska, Micah; Bell, Carl

2010-01-01

Background: Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. Objective: To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. Method: A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. Results: The marketing plan focused on “resiliency building” rather than “depression intervention” and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1–10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Conclusions: Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care. PMID:20944776

Training tomorrow's global health leaders: applying a transtheoretical model to identify behavior change stages within an intervention for health leadership development.

PubMed

Daniels, Joseph; Farquhar, Carey; Nathanson, Neal; Mashalla, Yohana; Petracca, Frances; Desmond, Michelle; Green, Wendy; Davies, Luke; O'Malley, Gabrielle

2014-12-01

Training health professionals in leadership and management skills is a key component of health systems strengthening in low-resource settings. The importance of evaluating the effectiveness of these programs has received increased attention over the past several years, although such evaluations continue to pose significant challenges. This article presents evaluation data from the pilot year of the Afya Bora Fellowship, an African-based training program to increase the leadership capacity of health professionals. Firstly, we describe the goals of the Afya Bora Fellowship. Then, we present an adaptation of the transtheoretical model for behavior change called the Health Leadership Development Model, as an analytical lens to identify and describe evidence of individual leadership behavior change among training participants during and shortly after the pilot year of the program. The Health Leadership Development Model includes the following: pre-contemplation (status quo), contemplation (testing and internalizing leadership), preparation - (moving toward leadership), action (leadership in action), and maintenance (effecting organizational change). We used data from surveys, in-depth interviews, journal entries and course evaluations as data points to populate the Health Leadership Development Model. In the short term, fellows demonstrated increased leadership development during and shortly after the intervention and reflected the contemplation, preparation and action stages of the Health Leadership Development Model. However, expanded interventions and/or additional time may be needed to support behavior change toward the maintenance stages. We conclude that the Health Leadership Development Model is useful for informing health leadership training design and evaluation to contribute to sustainable health organizational change. © The Author(s) 2014.

Exploring the role of gender norms in nutrition and sexual health promotion in a piloted school-based intervention: The Philadelphia Ujima™ experience.

PubMed

Núñez, Ana; Robertson-James, Candace; Reels, Serita; Jeter, Janay; Rivera, Hilda; Yusuf, Zena; Liu

2015-08-01

Perceptions of masculinity and femininity influence behaviors and can be identified in young children and adolescents (Brannon, 2004). Thus, adolescents' engagement in health risk or promoting behaviors is influenced by perceptions of masculinity and femininity and the differences in expectations, norms and responsibilities for girls and boys (WHO, 2007). Girls and boys have different needs, and gender-based interventions that consider similarities as well as differences are needed. A gender-based nutrition and sexual health promotion program was developed and piloted by the Philadelphia Ujima Coalition in a high school setting. To explore the gender differences in adolescents' perceptions of the influence of gender norms on weight, nutrition, physical activity, and sexual health and the implication of these differences in future gender-integrated health promotion programming for youth, a content analysis of student and facilitator debriefing forms were implemented for the participating schools. The content analysis was used to identify central themes, concepts gained, and overall impact of the intervention sessions. Overall, gender norms influence healthy eating practices and activity through influencing perceptions of body type in adolescents. Gender norms also influence sexual activity and decision making through influencing perceptions of beauty, masculinity, femininity, pressures and popular concepts related to sexual activity. Thus, interventions that address gender may more effectively promote health and wellness in adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

Behavioral functionality of mobile apps in health interventions: a systematic review of the literature.

PubMed

Payne, Hannah E; Lister, Cameron; West, Joshua H; Bernhardt, Jay M

2015-02-26

Several thousand mobile phone apps are available to download to mobile phones for health and fitness. Mobile phones may provide a unique means of administering health interventions to populations. The purpose of this systematic review was to systematically search and describe the literature on mobile apps used in health behavior interventions, describe the behavioral features and focus of health apps, and to evaluate the potential of apps to disseminate health behavior interventions. We conducted a review of the literature in September 2014 using key search terms in several relevant scientific journal databases. Only English articles pertaining to health interventions using mobile phone apps were included in the final sample. The 24 studies identified for this review were primarily feasibility and pilot studies of mobile apps with small sample sizes. All studies were informed by behavioral theories or strategies, with self-monitoring as the most common construct. Acceptability of mobile phone apps was high among mobile phone users. The lack of large sample studies using mobile phone apps may signal a need for additional studies on the potential use of mobile apps to assist individuals in changing their health behaviors. Of these studies, there is early evidence that apps are well received by users. Based on available research, mobile apps may be considered a feasible and acceptable means of administering health interventions, but a greater number of studies and more rigorous research and evaluations are needed to determine efficacy and establish evidence for best practices.

Health behavior change in pregnant women: a two-phase study.

PubMed

Davis, Ann M; Wambach, Karen A; Nelson, Eve Lynn; Odar, Cathleen; Lillis, Teresa; McKinley, Amanda; Gallagher, Mia

2014-12-01

Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population. Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad(®) (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women. In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly. Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women.

Hip Hop HEALS: Pilot Study of a Culturally Targeted Calorie Label Intervention to Improve Food Purchases of Children.

PubMed

Williams, Olajide; DeSorbo, Alexandra; Sawyer, Vanessa; Apakama, Donald; Shaffer, Michele; Gerin, William; Noble, James

2016-02-01

We explored the effect of a culturally targeted calorie label intervention on food purchasing behavior of elementary school students. We used a quasi-experimental design with two intervention schools and one control school to assess food purchases of third through fifth graders at standardized school food sales before and after the intervention (immediate and delayed) in schools. The intervention comprised three 1-hour assembly-style hip-hop-themed multimedia classes. A mean total of 225 children participated in two baseline preintervention sales with and without calorie labels; 149 children participated in immediate postintervention food sales, while 133 children participated in the delayed sales. No significant change in purchased calories was observed in response to labels alone before the intervention. However, a mean decline in purchased calories of 20% (p < .01) and unhealthy foods (p < .01) was seen in immediately following the intervention compared to baseline purchases, and this persisted without significant decay after 7 days and 12 days. A 3-hour culturally targeted calorie label intervention may improve food-purchasing behavior of children. © 2015 Society for Public Health Education.

Food insecurity and effectiveness of behavioral interventions to reduce blood pressure, New York City, 2012-2013.

PubMed

Grilo, Stephanie A; Shallcross, Amanda J; Ogedegbe, Gbenga; Odedosu, Taiye; Levy, Natalie; Lehrer, Susan; Chaplin, William; Spruill, Tanya M

2015-02-12

Food insecurity is associated with diet-sensitive diseases and may be a barrier to successful chronic disease self-management. To evaluate the impact of food insecurity on blood pressure reduction in a pilot clinical trial, we tested the effectiveness of 2 behavioral interventions for hypertension in people with and without food security. A group of 28 men and women with type 2 diabetes and uncontrolled hypertension were randomized to either 1) home blood pressure telemonitoring alone or 2) home blood pressure telemonitoring plus telephone-based nurse case management. The primary outcome was 6-month change in systolic blood pressure. The 2 interventions resulted in modest, nonsignificant blood pressure reductions. Food-secure patients experienced clinically and statistically significant reductions in blood pressure, whereas no significant change was seen among food-insecure patients. Screening for food insecurity may help identify patients in need of tailored disease management interventions.

Evaluating the Social Validity of the Early Start Denver Model: A Convergent Mixed Methods Study.

PubMed

Ogilvie, Emily; McCrudden, Matthew T

2017-09-01

An intervention has social validity to the extent that it is socially acceptable to participants and stakeholders. This pilot convergent mixed methods study evaluated parents' perceptions of the social validity of the Early Start Denver Model (ESDM), a naturalistic behavioral intervention for children with autism. It focused on whether the parents viewed (a) the ESDM goals as appropriate for their children, (b) the intervention procedures as acceptable and appropriate, and (c) whether changes in their children's behavior was practically significant. Parents of four children who participated in the ESDM completed the TARF-R questionnaire and participated in a semi-structured interview. Both data sets indicated that parents rated their experiences with the ESDM positively and rated it as socially-valid. The findings indicated that what was implemented in the intervention is complemented by how it was implemented and by whom.

The South Asian heart lifestyle intervention (SAHELI) study to improve cardiovascular risk factors in a community setting: Design and methods

PubMed Central

Kandula, Namratha R.; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W.; Spring, Bonnie; Siddique, Juned

2013-01-01

Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian heart lifestyle intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved South Asians (SAs). Participants with at least one CVD risk factor will be randomized to either a lifestyle intervention or a control group. Participants in both groups will be screened in a community setting and receive a primary care referral after randomization. Intervention participants will receive 6 weeks of group classes, followed by 12 weeks of individual telephone support where they will be encouraged to initiate and maintain a healthy lifestyle goal. Control participants will receive their screening results and monthly mailings on CVD prevention. Primary outcomes will be changes in moderate/vigorous physical activity and saturated fat intake between baseline, 3-, and 6-month follow-up. Secondary outcomes will be changes in weight, clinical risk factors, primary care visits, self-efficacy, and social support. This study will be one of the first to pilot-test a lifestyle intervention for SAs, one of the fastest growing racial/ethnic groups in the U.S. and one with disparate CVD risk. Results of this pilot study will provide preliminary data about the efficacy of a lifestyle intervention on CVD risk in SAs and inform community-engaged CVD prevention efforts in an increasingly diverse U.S. population. PMID:24060673

Behavioral Activation for the Treatment of Atypical Depression: A Pilot Open Trial

ERIC Educational Resources Information Center

Weinstock, Lauren M.; Munroe, Mary K.; Miller, Ivan W.

2011-01-01

Psychosocial interventions for atypical depression (AD) have been relatively ignored in the clinical research literature, despite evidence that the atypical subtype of major depression is marked by earlier age of onset, longer duration of mood episode, greater symptom severity, and poorer response to pharmacologic treatment. Given the symptom…

Substance Use and HIV Prevention for Youth in Correctional Facilities

ERIC Educational Resources Information Center

Mouttapa, Michele; Watson, Donnie W.; McCuller, William J.; Reiber, Chris; Tsai, Winnie

2009-01-01

Evidence-based programs for substance use and HIV prevention (SUHIP) were adapted for high-risk juveniles detained at 24-hour secure correctional facilities. In this pilot study, comparisons were made between adolescents who received the SUHIP intervention and a control group on changes in: (1) knowledge of HIV prevention behaviors, (2) attitudes…

Handling PBIS with Care: Scaling up to School-Wide Implementation

ERIC Educational Resources Information Center

Cressey, James M.; Whitcomb, Sara A.; McGilvray-Rivet, Susan J.; Morrison, Rebecca J.; Shander-Reynolds, Katherine J.

2015-01-01

This case study describes the leadership of a school counselor in implementing positive behavioral interventions and supports (PBIS) in a low-income, diverse elementary school with a modest level of external supports. After initiating a grade-level pilot program, the school counselor partnered with university-based consultants to expand the PBIS…

Behavior Therapy for Tics via Videoconference Delivery: An Initial Pilot Test in Children

ERIC Educational Resources Information Center

Himle, Michael B.; Olufs, Erin; Himle, Joseph; Tucker, Benjamin T. P.; Woods, Douglas W.

2010-01-01

Habit reversal training (HRT) has been proven effective for reducing tics in children with Tourette's syndrome (TS). However, the availability of the intervention is limited. Videoconference technology represents a promising mode through which HRT may be disseminated to underserved areas. Using a multiple-baseline across participants design, the…

Preliminary Efficacy of a Cognitive-Behavioral Treatment Program for Anxious Youth with Autism Spectrum Disorders

ERIC Educational Resources Information Center

White, Susan W.; Ollendick, Thomas; Scahill, Lawrence; Oswald, Donald; Albano, Anne Marie

2009-01-01

Anxiety is a commonly occurring psychiatric concern in adolescents with autism spectrum disorders (ASD). This pilot study examined the preliminary efficacy of a manual-based intervention targeting anxiety and social competence in four adolescents with high-functioning ASD. Anxiety and social functioning were assessed at baseline, midpoint,…

Wellness Factors as Predictors of Alcohol Use among Undergraduates: Implications for Prevention and Intervention

ERIC Educational Resources Information Center

Lewis, Todd F.; Myers, Jane E.

2010-01-01

A pilot study examining holistic wellness factors and drinking behaviors among undergraduate students revealed several significant relationships. Two second-order wellness factors of the Indivisible Self model of wellness--Coping Self and Essential Self--were negatively associated with both alcohol use intensity and drinking consequences.…

Automated Behavioral Text Messaging and Face-to-Face Intervention for Parents of Overweight or Obese Preschool Children: Results From a Pilot Study.

PubMed

Militello, Lisa; Melnyk, Bernadette Mazurek; Hekler, Eric B; Small, Leigh; Jacobson, Diana

2016-03-14

Children are 5 times more likely to be overweight at the age of 12 years if they are overweight during the preschool period. The purpose of this study was to establish the feasibility, acceptability, and preliminary effects of a cognitive behavioral intervention (TEXT2COPE) synergized with tailored mobile technology (mHealth) on the healthy lifestyle behaviors of parents of overweight and obese preschoolers delivered in a primary care setting. Fifteen preschooler-parent dyads recruited through primary care clinics completed a manualized 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the TEXT2COPE intervention content and Fogg's Behavior Model guided the implementation. The intervention employed a combination of face-to-face clinic visits and ecological momentary interventions using text messaging (short message service, SMS). To enhance the intervention's relevance to the family's needs, parents dictated the wording of the text messages and also were able to adapt the frequency and timing of delivery throughout program implementation. Self-reported findings indicate that the program is feasible and acceptable in this population. The intervention showed preliminary effects with significant improvements on parental knowledge about nutrition (P=.001) and physical activity (P=.012) for their children, parental beliefs (P=.001) toward healthy lifestyles, and parental behaviors (P=.040) toward engaging in healthy lifestyle choices for their children. Effect sizes were medium to large for all variables. The timing, frequency, and wording of the text messages were tailored to the individual families, with 69% of parents (9/13) increasing the frequency of the tailored SMS from being sent once weekly to as many as 5 times a week. Utilizing a cognitive behavioral skills intervention with SMS has great potential for supporting clinical care of overweight and obese preschool children and their families. Further exploration of the potential effects on health and behavioral outcomes is warranted.

Gender-Specific Combination HIV Prevention for Youth in High-Burden Settings: The MP3 Youth Observational Pilot Study Protocol.

PubMed

Buttolph, Jasmine; Inwani, Irene; Agot, Kawango; Cleland, Charles M; Cherutich, Peter; Kiarie, James N; Osoti, Alfred; Celum, Connie L; Baeten, Jared M; Nduati, Ruth; Kinuthia, John; Hallett, Timothy B; Alsallaq, Ramzi; Kurth, Ann E

2017-03-08

Nearly three decades into the epidemic, sub-Saharan Africa (SSA) remains the region most heavily affected by human immunodeficiency virus (HIV), with nearly 70% of the 34 million people living with HIV globally residing in the region. In SSA, female and male youth (15 to 24 years) are at a disproportionately high risk of HIV infection compared to adults. As such, there is a need to target HIV prevention strategies to youth and to tailor them to a gender-specific context. This protocol describes the process for the multi-staged approach in the design of the MP3 Youth pilot study, a gender-specific, combination, HIV prevention intervention for youth in Kenya. The objective of this multi-method protocol is to outline a rigorous and replicable methodology for a gender-specific combination HIV prevention pilot study for youth in high-burden settings, illustrating the triangulated methods undertaken to ensure that age, sex, and context are integral in the design of the intervention. The mixed-methods, cross-sectional, longitudinal cohort pilot study protocol was developed by first conducting a systematic review of the literature, which shaped focus group discussions around prevention package and delivery options, and that also informed age- and sex- stratified mathematical modeling. The review, qualitative data, and mathematical modeling created a triangulated evidence base of interventions to be included in the pilot study protocol. To design the pilot study protocol, we convened an expert panel to select HIV prevention interventions effective for youth in SSA, which will be offered in a mobile health setting. The goal of the pilot study implementation and evaluation is to apply lessons learned to more effective HIV prevention evidence and programming. The combination HIV prevention package in this protocol includes (1) offering HIV testing and counseling for all youth; (2) voluntary medical circumcision and condoms for males; (3) pre-exposure prophylaxis (PrEP), conditional cash transfer (CCT), and contraceptives for females; and (4) referrals for HIV care among those identified as HIV-positive. The combination package platform selected is mobile health teams in an integrated services delivery model. A cross-sectional analysis will be conducted to determine the uptake of the interventions. To determine long-term impact, the protocol outlines enrolling selected participants in mutually exclusive longitudinal cohorts (HIV-positive, PrEP, CCT, and HIV-negative) followed by using mobile phone text messages (short message service, SMS) and in-person surveys to prospectively assess prevention method uptake, adherence, and risk compensation behaviors. Cross-sectional and sub-cohort analyses will be conducted to determine intervention packages uptake. The literature review, focus groups, and modeling indicate that offering age- and gender- specific combination HIV prevention interventions that include biomedical, behavioral, and structural interventions can have an impact on HIV risk reduction. Implementing this protocol will show the feasibility of delivering these services at scale. The MP3 Youth study is one of the few combination HIV prevention intervention protocols incorporating youth- and gender-specific interventions in one delivery setting. Lessons learned from the design of the protocol can be incorporated into the national guidance for combination HIV prevention for youth in Kenya and other high-burden SSA settings. ClinicalTrials.gov NCT01571128; http://clinicaltrials.gov/ct2/show/NCT01571128?term=MP3+youth&rank=1 (Archived by WebCite at http://www.webcitation.org/6nmioPd54). ©Jasmine Buttolph, Irene Inwani, Kawango Agot, Charles M Cleland, Peter Cherutich, James N Kiarie, Alfred Osoti, Connie L Celum, Jared M Baeten, Ruth Nduati, John Kinuthia, Timothy B Hallett, Ramzi Alsallaq, Ann E Kurth. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.03.2017.

The Development of an Internet-Based Treatment for Problem Gamblers and Concerned Significant Others: A Pilot Randomized Controlled Trial.

PubMed

Nilsson, Anders; Magnusson, Kristoffer; Carlbring, Per; Andersson, Gerhard; Gumpert, Clara Hellner

2018-06-01

Problem gambling creates significant harm for the gambler and for concerned significant others (CSOs). While several studies have investigated the effects of individual cognitive behavioral therapy (CBT) for problem gambling, less is known about the effects of involving CSOs in treatment. Behavioral couples therapy (BCT) has shown promising results when working with substance use disorders by involving both the user and a CSO. This pilot study investigated BCT for problem gambling, as well as the feasibility of performing a larger scale randomized controlled trial. 36 participants, 18 gamblers and 18 CSOs, were randomized to either BCT or individual CBT for the gambler. Both interventions were Internet-delivered self-help interventions with therapist support. Both groups of gamblers improved on all outcome measures, but there were no differences between the groups. The CSOs in the BCT group lowered their scores on anxiety and depression more than the CSOs of those randomized to the individual CBT group did. The implications of the results and the feasibility of the trial are discussed.

Feasibility, Acceptability, and Preliminary Effects of the COPE Online Cognitive-Behavioral Skill-Building Program on Mental Health Outcomes and Academic Performance in Freshmen College Students: A Randomized Controlled Pilot Study.

PubMed

Melnyk, Bernadette Mazurek; Amaya, Megan; Szalacha, Laura A; Hoying, Jacqueline; Taylor, Tiffany; Bowersox, Kristen

2015-08-01

Despite the increasing prevalence of mental health disorders in university students, few receive needed evidence-based treatment. The purpose of this study was to assess the feasibility and preliminary effects of a seven-session online cognitive-behavioral skill-building intervention (i.e., COPE, Creating Opportunities for Personal Empowerment) versus a comparison group on their anxiety, depressive symptoms, and grade performance. A randomized controlled pilot study was conducted from September 2012 to May 2013 with 121 college freshmen enrolled in a required one credit survey course. Although there were no significant differences in anxiety and depressive symptoms between the groups, only COPE students with an elevated level of anxiety at baseline had a significant decline in symptoms. Grade point average was higher in COPE versus comparison students. Evaluations indicated that COPE was a positive experience for students. COPE is a promising brief intervention that can be integrated effectively into a required freshman course. © 2015 Wiley Periodicals, Inc.

A pilot test of a self-guided, home-based intervention to improve condom-related sexual experiences, attitudes, and behaviors among young women.

PubMed

Yarber, William L; Milhausen, Robin R; Beavers, Karly A; Ryan, Rebecca; Sullivan, Margaret J; Vanterpool, Karen B; Sanders, Stephanie A; Graham, Cynthia A; Crosby, Richard A

2018-07-01

To conduct a pilot test of a brief, self-guided, home-based program designed to improve male condom use attitudes and behaviors among young women. Women aged 18-24 years from a large Midwestern University reporting having had penile-vaginal sex with two or more partners in the past 3 months. Sixty-seven enrolled; 91.0% completed the study. A repeated measures design was used, with assessments occurring at baseline, immediately  post intervention (T2), and 30 days subsequent (T3). Condom use errors and problems decreased, condom-related attitudes and self-efficacy improved, and experiences of condom-protected sex were rated more positively when comparing baseline with T2 and T3 scores. Further, the proportion of condom-protected episodes more than doubled between T1 and T3 for those in the lowest quartile for condom use at baseline. This low-resource, home-based program improved condom-related attitudes and promoted the correct and consistent use of condoms.

A descriptive evaluation of the Seattle Police Department's crisis response team officer/mental health professional partnership pilot program.

PubMed

Helfgott, Jacqueline B; Hickman, Matthew J; Labossiere, Andre P

2016-01-01

The Seattle Police Department (SPD) recently enhanced their response to individuals in behavioral crisis through a pilot Crisis Response Team (CRT) consisting of dedicated Crisis Intervention Team (CIT) officers (OFC) paired with a Mental Health Professional (MHP). This study presents results of an incident-based descriptive evaluation of the SPD's CRT pilot program, implemented from 2010 to 2012. The purpose of the evaluation was to determine the value-added by the MHP in cases involving individuals in behavioral crisis as well as the effectiveness of the CRT program with regard to resolution time, repeat contacts, and referral to services. Data were collected from SPD general offense and supplemental reports for a 12-month segment of the program. Key variables included incident location, case clearance, repeat contacts, linkages to services, and case disposition. Results of analyses of general offense and supplemental reports are presented and implications for future development of the OFC/MHP partnership are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Community-based childhood obesity prevention intervention for parents improves health behaviors and food parenting practices among Hispanic, low-income parents.

PubMed

Otterbach, Laura; Mena, Noereem Z; Greene, Geoffrey; Redding, Colleen A; De Groot, Annie; Tovar, Alison

2018-01-01

Given the current prevalence of childhood obesity among Hispanic populations, and the importance of parental feeding behaviors, we aimed to assess the impact of the evidence-based Healthy Children, Healthy Families (HCHF) intervention on responsive food parenting practices (FPPs) in a low-income Hispanic population. This community-based pilot study used a non-experimental pre/post within-subjects design. Parents ( n  = 94) of children aged 3-11 years old were recruited to participate in an 8-week, weekly group-based intervention. The intervention was delivered to nine groups of parents by trained paraprofessional educators over a two-year period. Children participated in a separate curriculum that covered topics similar to those covered in the parent intervention. Parents completed self-administered pre/post surveys, which included demographic questions, seven subscales from the Comprehensive Feeding Practices Questionnaire, and the 16-item HCHF Behavior Checklist. Descriptive statistics and paired samples t-tests were used to analyze data from parents that completed the intervention. Fifty-two, primarily Hispanic (93%) parents completed the intervention (39% attrition rate). For parents who completed the intervention, there was a significant increase in one of the feeding practice subscales: encouragement of balance and variety ( p  = 0.01). There were significant improvements in several parent and child diet and activity outcomes ( p  ≤ 0.01). Although attrition rates were high, parents completing the study reported enjoying and being satisfied with the intervention. For parents who completed the intervention, reported 'encouragement of balance and variety', in addition to several health behaviors significantly improved. Larger studies utilizing an experimental design, should further explore the impact of the HCHF curriculum on improving certain FPPs and health behaviors that contribute to obesity.

Stress and Depression in Relation to Functional Health Behaviors in African American Patients with Systemic Lupus Erythematosus.

PubMed

Williams, Edith M; Bruner, Larisa; Penfield, Megan; Kamen, Diane; Oates, James C

While increased psychological distress in SLE has been clinically and empirically reported, the relationship between emotional distress, treatment adherence, and disease activity are complex and even more unclear in African American lupus patients. In an effort to elucidate this phenomenon in these patients, this exploratory study aimed to investigate relationships between stress, depression, and various health behaviors in this group. Thirty patients invited to participate in this study were African American systemic lupus erythematosus (SLE) patients attending rheumatology clinics at the Medical University of South Carolina (MUSC). This study was part of a larger interventional pilot study, the Balancing Lupus Experiences with Stress Strategies (BLESS) study, that included a comprehensive battery of psychosocial, quality of life, and behavior change measures. When looking at the association between anxiety/stress and functionality, levels of reported stress had strong effects upon functionality, especially between health distress and functionality. When looking at the association between depressive symptoms and functionality, depressive symptoms had moderate effects upon social/role limitations and nights spent in the hospital. Not only did the larger pilot project demonstrate significant reductions in stress and depression as a result of workshop participation; this nested study also showed that those improvements were positively associated with improved health behaviors. These results could have implications for developing interventions to improve disease experience and quality of life in SLE patients with stress and depression.

Parent-directed cognitive behavioral therapy for young anxious children: a pilot study.

PubMed

van der Sluis, Cathy M; van der Bruggen, Corine O; Brechman-Toussaint, Margaret L; Thissen, Michèl A P; Bögels, Susan M

2012-09-01

Anxiety in children age 8 years and above has been successfully treated with cognitive behavioral therapy (CBT). However, the efficacy of CBT for anxious children ages 4-7 years has not, to date, been fully investigated. This paper piloted a CBT intervention targeting child anxiety that was delivered exclusively to parents of 26 children with anxiety symptoms ages 4-7 years. The intervention consisted of four 2-hour group sessions of four to six parents (couples). These group sessions were followed by four individual telephone sessions, once per week across a 4-week period. The pre- and postintervention assessment involved measures of multiple constructs of child anxiety (anxiety symptoms, children's fears, behavioral inhibition, and internalizing symptoms) from multiple informants (parents, children, and teachers). Parents also reported parenting strategies they were likely to use to manage their children's anxiety pre- and postintervention. Results indicated a significant decrease in child anxiety and behavioral inhibition as reported by parents and teachers. Furthermore, mothers reported significant increases in their use of positive reinforcement, and modeling and reassurance, and a significant decrease in their use of reinforcement of dependency directly after treatment. Taken together, parent-directed CBT appears to be an effective approach for treating children ages 4-7 years with anxiety symptoms. Limitations of the current research are discussed. Copyright © 2011. Published by Elsevier Ltd.

School-based violence prevention strategy: a pilot evaluation

PubMed Central

Thakore, Rachel V.; Apfeld, Jordan C.; Johnson, Ronald K.; Sathiyakumar, Vasanth; Jahangir, A. Alex; Sethi, Manish K.

2015-01-01

Abstract: Background: Violence has recently been reported among a primarily young, minority population in Nashville, Tennessee. School-based programs have been proven as effective methods of reducing violent behavior, beliefs, and actions that lead to violence among adolescents. Methods: Investigators implemented a rigorous search for an appropriate school-based violence prevention program for Metropolitan Nashville middle school students utilizing a systematic review and discussion group with victims of violence. 27 programs nation-wide were reviewed and 2 discussion groups with African American males under the age of 25 admitted to a level 1 trauma center for assault-related injuries were conducted. Our findings led to a single, evidence-based conflict resolution program. In conjunction with educators, we evaluated the program’s effectiveness in a pilot study in a Nashville middle school with high rates of violence. Results: 122 students completed the conflict resolution program and described their behavior and experiences with violence in a pre-test/post-test self-rate questionnaire. Results showed a significant decrease in violent behavior and an increase in students’ competencies to deal with violence (p less than 0.05). Conclusions: This study shows that a reduction in violent behavior and beliefs among middle school students can be achieved through the implementation of a targeted violence intervention program. A larger-scale intervention is needed to develop more conclusive evidence of effectiveness. PMID:24879077

School-based violence prevention strategy: a pilot evaluation.

PubMed

Thakore, Rachel V; Apfeld, Jordan C; Johnson, Ronald K; Sathiyakumar, Vasanth; Jahangir, A Alex; Sethi, Manish K

2015-07-01

Violence has recently been reported among a primarily young, minority population in Nashville, Tennessee. School-based programs have been proven as effective methods of reducing violent behavior, beliefs, and actions that lead to violence among adolescents. Investigators implemented a rigorous search for an appropriate school-based violence prevention program for Metropolitan Nashville middle school students utilizing a systematic review and discussion group with victims of violence. 27 programs nation-wide were reviewed and 2 discussion groups with African American males under the age of 25 admitted to a level 1 trauma center for assault-related injuries were conducted. Our findings led to a single, evidence-based conflict resolution program. In conjunction with educators, we evaluated the program's effectiveness in a pilot study in a Nashville middle school with high rates of violence. 122 students completed the conflict resolution program and described their behavior and experiences with violence in a pre-test/post-test self-rate questionnaire. Results showed a significant decrease in violent behavior and an increase in students' competencies to deal with violence (p less than 0.05). This study shows that a reduction in violent behavior and beliefs among middle school students can be achieved through the implementation of a targeted violence intervention program. A larger-scale intervention is needed to develop more conclusive evidence of effectiveness. © 2015 KUMS, All rights reserved.

Project Home: A Pilot Evaluation of an Emotion-Focused Intervention for Mothers Reuniting With Children After Prison

PubMed Central

Shortt, Joann Wu; Eddy, J. Mark; Sheeber, Lisa; Davis, Betsy

2014-01-01

Nearly 2 million children in the United States have a parent in prison. The circumstances related to this situation place them at increased risk for behavioral and emotional disorders. The process of reunification between mother and child after release is a stressful and emotional one. A pilot study was conducted to develop and test a new program, Emotions: Taking Care of Yourself and Your Child When You Go Home. The objective of the Emotions Program was to teach emotion regulation and emotion coaching skills to incarcerated mothers so as to assist mothers and their children to cope better with the stress associated with incarceration and the transition home from prison. Pilot participants (N = 47) had previously participated in Parenting Inside Out, an evidence-based parenting program for incarcerated parents. The participants were then assigned to the Emotions Program (n = 29) or the comparison condition of no additional treatment (n = 18). All mothers were assessed before (T1) and after the program (T2), and again 6 months after release from prison (T3). Intervention effects of the Emotions Program on mothers’ emotion regulation, emotion socialization, and adjustment were examined using repeated-measures analysis of variance with a between-subjects factor of group (Emotions Program vs. comparison) and a within-subjects factor of time (T1 vs. T2 vs. T3). Moderate time by group interaction effects were observed for aspects of emotion regulation, emotion socialization behavior, and criminal behavior in mothers, with participants in the Emotions condition showing improvement relative to those in the comparison condition. PMID:24564439

Authoritative feeding behaviors to reduce child BMI through online interventions.

PubMed

Frenn, Marilyn; Pruszynski, Jessica E; Felzer, Holly; Zhang, Jiannan

2013-01-01

PURPOSE.: The purpose of the study was to examine the feasibility and initial efficacies of parent- and/or child-focused online interventions and variables correlated with child body mass index percentile change. DESIGN AND METHODS.: A feasibility and cluster randomized controlled pilot study was used. RESULTS.: Recruitment was more effective at parent-teacher conferences compared with when materials were sent home with fifth- to eighth-grade culturally diverse students. Retention was 90% for students and 62-74% for parents. Authoritative parent feeding behaviors were associated with lower child body mass index. A larger study is warranted. PRACTICE IMPLICATIONS.: Online approaches may provide a feasible option for childhood obesity prevention and amelioration. © 2013, Wiley Periodicals, Inc.

Sun Smart Schools Nevada: Increasing Knowledge Among School Children About Ultraviolet Radiation.

PubMed

Kouzes, Emily; Thompson, Christine; Herington, Cari; Helzer, Lily

2017-11-30

Cumulative exposure to ultraviolet radiation (UV) is a risk factor for development of skin cancer. We estimated changes in knowledge, attitudes, and behaviors among Nevada school-age children following implementation of a program to decrease UV exposure. The Nevada Cancer Coalition's Sun Smart Schools pilot program was implemented in 7 Nevada schools during the 2015-2016 school year. The target population was students at participating schools. Participation in the program was voluntary. Students surveyed spanned grades from fourth to tenth. Pre-intervention surveys were conducted at the start of the school year. Post-intervention surveys were conducted at the end of the school year. Changes in knowledge, attitudes, and behaviors were assessed among study participants by using self-reported survey responses. The Sun Smart Schools pilot program was effective in increasing a broad range of knowledge, attitudes, and behaviors about protection from UV among elementary and middle school students. Students in high school reported an increase in the adoption of selected protective behaviors. However, this population also maintained a positive attitude toward the appearance of tanned skin, indicating susceptibility to competing influences. High school students also did not report any evident change in knowledge about sun protection strategies. Parents reported a decrease in knowledge about UV protection but an increase in adoption of certain protective behaviors. Our findings are similar to those of previous studies demonstrating that education about the dangers of UV exposure is most effective in younger age groups. Results were mixed in older age groups.

Group cognitive-behavioral treatment for internalized weight stigma: a pilot study.

PubMed

Pearl, Rebecca L; Hopkins, Christina H; Berkowitz, Robert I; Wadden, Thomas A

2018-06-01

This study tested a novel group-based, cognitive-behavioral intervention designed to reduce internalized weight stigma among individuals with obesity. A total of eight men and women with obesity who had experienced weight stigma and reported high levels of internalized weight stigma attended the Weight Bias Internalization and Stigma (BIAS) Program. The program provided eight weekly sessions of cognitive-behavioral treatment to cope with weight stigma. Participants completed questionnaires pre- and post-intervention, including the Weight Bias Internalization Scale (WBIS), Fat Phobia Scale, Weight Efficacy Life-Style Questionnaire (WEL), and Beck Depression Inventory-II (BDI-II). Six additional participants were included in a quasi-control group that received no intervention until after completing all study measures. Participants in the Weight BIAS Program reported significantly greater decreases in WBIS and Fat Phobia scores, and greater increases in WEL scores than participants in the quasi-control group (ps < .04). Changes in BDI-II scores did not differ between groups. Treatment-acceptability ratings were high among participants who received the intervention. Including cognitive-behavioral strategies to address weight stigma in weight management programs could potentially reduce internalized weight stigma and enhance treatment outcomes.

HIV knowledge and sexual risk behavior among pregnant couples in South Africa: the PartnerPlus project.

PubMed

Villar-Loubet, Olga M; Cook, Ryan; Chakhtoura, Nahida; Peltzer, Karl; Weiss, Stephen M; Shikwane, Molatelo Elisa; Jones, Deborah L

2013-02-01

In sub-Saharan Africa, 60 % of people living with HIV are women and most are of childbearing age. Alarmingly, seroconversion rates during pregnancy are high and increase as pregnancy progresses, highlighting the importance of increasing HIV-knowledge among pregnant women and their partners. This study compared sexual risk behavior, HIV knowledge and condom use pre- to post-partum among South African couples (n = 239 couples) randomly assigned to an intervention or an enhanced standard of care with the PMTCT protocol at rural community health antenatal clinics. Consistent condom use and HIV-related knowledge increased baseline to post-intervention and was maintained at long term follow up post-partum among participants in the intervention condition. HIV knowledge mediated the relationship between the intervention and consistent condom use. Results from this pilot study provide support for the integration of HIV risk reduction interventions for both women and men into existing PMTCT services during and following pregnancy.

Designing in the social context: using the social contextual model of health behavior change to develop a tobacco control intervention for teachers in India

PubMed Central

Nagler, Eve M.; Pednekar, Mangesh S.; Viswanath, Kasisomayajula; Sinha, Dhirendra N.; Aghi, Mira B.; Pischke, Claudia R.; Ebbeling, Cara B.; Lando, Harry A.; Gupta, Prakash C.

2013-01-01

This article provides a theory-based, step-by-step approach to intervention development and illustrates its application in India to design an intervention to promote tobacco-use cessation among school personnel in Bihar. We employed a five-step approach to develop the intervention using the Social Contextual Model of Health Behavior Change (SCM) in Bihar, which involved conducting formative research, classifying factors in the social environment as mediating mechanisms and modifying conditions, developing a creative brief, designing an intervention and refining the intervention based on pilot test results. The intervention engages users and non-users of tobacco, involves teachers in implementing and monitoring school tobacco control policies and maximizes teachers’ role as change agents in schools and communities. Intervention components include health educator visits, discussions led by lead teachers, cessation assistance, posters and other educational materials and is implemented over the entire academic year. The intervention is being tested in Bihar government schools as part of a randomized-controlled trial. SCM was a useful framework for developing a tobacco control intervention that responded to teachers’ lives in Bihar. PMID:22669010

Diabetes Empowerment Council: Integrative Pilot Intervention for Transitioning Young Adults With Type 1 Diabetes.

PubMed

Weigensberg, Marc J; Vigen, Cheryl; Sequeira, Paola; Spruijt-Metz, Donna; Juarez, Magaly; Florindez, Daniella; Provisor, Joseph; Peters, Anne; Pyatak, Elizabeth A

2018-01-01

The transition of young adults with type 1 diabetes (T1D) from pediatric to adult care is challenging and frequently accompanied by worsening of diabetes-related health. To date, there are no reports which prospectively assess the effects of theory-based psycho-behavioral interventions during the transition period neither on glycemic control nor on psychosocial factors that contribute to poor glycemic control. Therefore, the overall aim of this study was to develop and pilot test an integrative group intervention based on the underlying principles of self-determination theory (SDT), in young adults with T1D. Fifty-one young adults with T1D participated in an education and case management-based transition program, of which 9 took part in the Diabetes Empowerment Council (DEC), a 12-week holistic, multimodality facilitated group intervention consisting of "council" process based on indigenous community practices, stress-reduction guided imagery, narrative medicine modalities, simple ritual, and other integrative modalities. Feasibility, acceptability, potential mechanism of effects, and bio-behavioral outcomes were determined using mixed qualitative and quantitative methods. The intervention was highly acceptable to participants, though presented significant feasibility challenges. Participants in DEC showed significant reductions in perceived stress and depression, and increases in general well-being relative to other control participants. Reduction in perceived stress, independent of intervention group, was associated with reductions in hemoglobin A1C. A theoretical model explaining the effects of the intervention included the promotion of relatedness and autonomy support, 2 important aspects of SDT. The DEC is a promising group intervention for young adults with T1D going through transition to adult care. Future investigations will be necessary to resolve feasibility issues, optimize the multimodality intervention, determine full intervention effects, and fully test the role of the underlying theoretical model of action.ClinicalTrials.gov Registration Number NCT02807155; Registration date: June 15, 2016 (retrospectively registered).

Diabetes Empowerment Council: Integrative Pilot Intervention for Transitioning Young Adults With Type 1 Diabetes

PubMed Central

Weigensberg, Marc J; Vigen, Cheryl; Sequeira, Paola; Spruijt-Metz, Donna; Juarez, Magaly; Florindez, Daniella; Peters, Anne; Pyatak, Elizabeth A

2018-01-01

Background The transition of young adults with type 1 diabetes (T1D) from pediatric to adult care is challenging and frequently accompanied by worsening of diabetes-related health. To date, there are no reports which prospectively assess the effects of theory-based psycho-behavioral interventions during the transition period neither on glycemic control nor on psychosocial factors that contribute to poor glycemic control. Therefore, the overall aim of this study was to develop and pilot test an integrative group intervention based on the underlying principles of self-determination theory (SDT), in young adults with T1D. Methods Fifty-one young adults with T1D participated in an education and case management-based transition program, of which 9 took part in the Diabetes Empowerment Council (DEC), a 12-week holistic, multimodality facilitated group intervention consisting of “council” process based on indigenous community practices, stress-reduction guided imagery, narrative medicine modalities, simple ritual, and other integrative modalities. Feasibility, acceptability, potential mechanism of effects, and bio-behavioral outcomes were determined using mixed qualitative and quantitative methods. Results The intervention was highly acceptable to participants, though presented significant feasibility challenges. Participants in DEC showed significant reductions in perceived stress and depression, and increases in general well-being relative to other control participants. Reduction in perceived stress, independent of intervention group, was associated with reductions in hemoglobin A1C. A theoretical model explaining the effects of the intervention included the promotion of relatedness and autonomy support, 2 important aspects of SDT. Conclusions The DEC is a promising group intervention for young adults with T1D going through transition to adult care. Future investigations will be necessary to resolve feasibility issues, optimize the multimodality intervention, determine full intervention effects, and fully test the role of the underlying theoretical model of action. ClinicalTrials.gov Registration Number NCT02807155; Registration date: June 15, 2016 (retrospectively registered) PMID:29552422

The relation between child feeding problems as measured by parental report and mealtime behavior observation: A pilot study.

PubMed

van Dijk, Marijn; Bruinsma, Eke; Hauser, M Paulina

2016-04-01

Because feeding problems have clear negative consequences for both child and caretakers, early diagnosis and intervention are important. Parent-report questionnaires can contribute to early identification, because they are efficient and typically offer a 'holistic' perspective of the child's eating in different contexts. In this pilot study, we aim to explore the concurrent validity of a short screening instrument (the SEP, which is the Dutch MCH-FS) in one of its target populations (a group of premature children) by comparing the total score with the observed behavior of the child and caretaker during a regular home meal. 28 toddlers (aged 9-18 months) and their caretakers participated in the study. Video-observations of the meals were coded for categories of eating behavior and parent-child interaction. The results show that the total SEP-score correlates with food refusal, feeding efficiency, and self-feeding, but not with negative affect and parental instructions. This confirms that the SEP has a certain degree of concurrent validity in the sense that its total score is associated with specific 'benchmark' feeding behaviors: food refusal, feeding efficiency and autonomy. Future studies with larger samples are needed to generalize the findings from this pilot to a broader context. Copyright © 2016 Elsevier Ltd. All rights reserved.

A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine.

PubMed

Ramsey, Rachelle R; Holbein, Christina E; Powers, Scott W; Hershey, Andrew D; Kabbouche, Marielle A; O'Brien, Hope L; Kacperski, Joanne; Shepard, Jeffrey; Hommel, Kevin A

2018-01-01

Background Effective management of migraine requires adherence to treatment recommendations; however, adolescents with migraine take their daily medications only 75% of the time. Low-cost adherence-focused interventions using technology may improve adherence, but have not been investigated. Methods Thirty-five adolescents and young adults (13-21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone adherence-promotion application ("app") and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. Results Relative to baseline, adherence significantly improved during the first month of the intervention. Specifically, improvements existed for older participants with lower baseline adherence. Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates. Participants rated the intervention as acceptable and easy to use. Conclusions "Apps" have the potential to improve medication adherence and are a promising intervention for adolescents and young adults with low adherence. Involving parents in the intervention is also helpful. Providers should assess barriers to adherence and use of technology-based interventions, encourage parents to incorporate behavioral incentives, and provide referrals for more intensive interventions to improve long-term outcomes. Further, tracking adherence in an app may result in an underestimation of adherence. Future full-scale studies should be conducted to examine adherence promotion app interventions.

Enhancing the parent-child relationship: a Hong Kong community-based randomized controlled trial.

PubMed

Fabrizio, Cecilia S; Stewart, Sunita M; Ip, Alison K Y; Lam, Tai Hing

2014-02-01

Adolescence is a critical risk period for negative academic and behavioral outcomes, but a strong parent-child relationship can be a powerful protective factor. Our previous pilot of an academic-community agency collaborative randomized controlled trial (RCT) demonstrated initial evidence of benefit for a parenting intervention with preadolescents in Hong Kong. The present RCT assessed the effect of brief training in positive discipline parenting skills on parental satisfaction with the parent-child relationship. A community sample of 461 Hong Kong Chinese parents of children aged 10-13 years were randomized to (a) the Harmony@Home intervention, (b) an attention control, or (c) a third active intervention that shared the control group. Participants were followed for 12 months and multiple methods of assessment were used. Compared with the control group, the Harmony@Home group reported an increase in the primary outcome of satisfaction with the parent-child relationship at 3 months' postintervention. Although results are mixed, this study demonstrates how a culturally adaptive community intervention can improve the parental behaviors that serve as protective factors against negative academic and behavioral outcomes for Chinese adolescents.

Peer tutoring pilot program for the improvement of oral health behavior in underprivileged and immigrant children.

PubMed

Reinhardt, Claus H; Löpker, Nadine; Noack, Michael J; Klein, Klaus; Rosen, Evelyne

2009-01-01

Caries prevalence in underprivileged children is particularly high and, even though many efforts have been made, adherence to dental preventive programs is low. The purpose of this study was to evaluate whether a tutoring program can improve oral health behavior in underprivileged and/or immigrant children. Thirty fourth-grade children (mean age = 9.6), over 50 percent of immigrant background, participated in this longitudinal pilot study. The fourth graders were invited to develop on oral health program for their first-grade peers. For this purpose, the fourth graders learned oral health practices and developed the peer tutoring program. Prior to the intervention and after having instructed their first-grade peers, all fourth graders were interviewed about their oral health habits and their tooth-brushing was recorded on video. Toothbrushing time, performance of circular tooth-brushing movements, and systematic cleaning of all dental surfaces were analyzed before and after the intervention. After peer teaching, there was a significant increase concerning tooth-brushing time (P = .004), performance of circular tooth-brushing movements (P < .001), and systematic cleaning of all dental surfaces (P < .001). The tutoring program yielded a significant improvement in relevant oral care behavior. This approach provided an environment which, in contrast to traditional approaches, facilitates empowerment.

Impact of TimeSlips creative expression program on behavioral symptoms and psychotropic medication use in persons with dementia in long-term care: a cluster-randomized pilot study.

PubMed

Houser, Winona S; George, Daniel R; Chinchilli, Vernon M

2014-04-01

To evaluate whether involvement in TimeSlips, a creative storytelling program, reduced mood and behavioral symptoms as well as psychotropic medication use in persons with dementia. A cluster-randomized pilot study compared two discrete dementia care units in one nursing home. The control cohort (N = 10) received standard-of-care activity programming, and the intervention cohort (N = 10) received standard-of-care plus two one-hour TimeSlips sessions per week for six weeks. Data on mood and behavioral symptoms and psychotropic drug prescriptions were collected, and within-group and between-group comparisons were performed. Between-group comparisons did not reveal statistically significant differences in mood and behavioral symptoms. No differences in psychotropic drug prescriptions were found. Larger trials of longer duration are needed to determine whether involvement in TimeSlips reduces mood and behavioral symptoms that compromise quality of life for persons with dementia. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Increasing mental health awareness and appropriate service use in older Chinese Americans: a pilot intervention.

PubMed

Teng, Ellen J; Friedman, Lois C

2009-07-01

This study evaluated the effectiveness of a community intervention in increasing awareness of mental health issues and available resources among elderly Chinese Americans. Twenty-seven members of a community church received a 1-h didactic presentation, in English and Mandarin, and completed surveys regarding their help-seeking preferences before and after the intervention. Results were analyzed using a series of Wilcoxon matched-pair signed rank tests and comparing pre- and post-test scores. Findings indicated an increase (p<.05) in intention to consult a mental health professional for psychiatric symptoms at post-test. A significant increase also was found in preference for consulting a physician for physical symptoms. The pilot educational intervention increased awareness of mental health and treatment issues and the role of mental health professionals, lending support to evaluate the intervention on a larger scale. Greater awareness of mental health among Chinese Americans can be promoted via education forums provided through faith-based organizations. Stigma of mental illness leads many Chinese individuals to seek help for psychiatric problems from primary care physicians. Integrating mental health practitioners in primary care settings may help decrease stigma and encourage appropriate help-seeking behavior.

Family options for parents with mental illnesses: a developmental, mixed methods pilot study.

PubMed

Nicholson, Joanne; Albert, Karen; Gershenson, Bernice; Williams, Valerie; Biebel, Kathleen

2009-01-01

The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate significant improvements in well-being, functioning, and supports and resources at 6 months post-enrollment in Family Options. Mothers report help from Family Options staff consistent with the intervention as conceptualized, and high levels of satisfaction with the intervention as delivered. Innovative study design and analytic strategies are required to build the evidence base and promote rapid dissemination of effective interventions. Findings from this study will assist purveyors in refining the intervention, and will lay the groundwork for further replication and testing to build the evidence base for parents with serious mental illnesses and their families.

Effects of animal-assisted therapy on behavioral and/or psychological symptoms in dementia: a case report.

PubMed

Nordgren, Lena; Engström, Gabriella

2012-12-01

Recently, interest in nonpharmaceutical interventions in dementia care has increased. Animal-assisted therapy has been shown to be one promising intervention but more knowledge is needed. The present article reports on a pilot study involving an 84-year-old woman with vascular dementia who was systematically trained with a therapy dog team for 8 weeks. A quasi-experimental longitudinal interventional design with pre-post measures was used. Data were collected on 3 occasions. Descriptive statistics were used for data analysis. Some effects on the woman's ability to walk and move were identified. In addition, some effects in the woman's cognitive state were observed. Physical, psychological, and/or social training with certified therapy dog teams can have effects on behavioral and psychological symptoms in people living with dementia. Further research is needed.

The role of smartphones in encouraging physical activity in adults

PubMed Central

Stuckey, Melanie I; Carter, Shawn W; Knight, Emily

2017-01-01

Lack of physical activity is a global public health issue. Behavioral change interventions utilizing smartphone applications (apps) are considered a potential solution. The purpose of this literature review was to: 1) determine whether smartphone-based interventions encourage the initiation of, and participation in, physical activity; 2) explore the success of interventions in different populations; and 3) examine the key factors of the interventions that successfully encouraged physical activity. Eight databases (Medline, Scopus, EBM Reviews–Cochrane Central Register of Controlled Trials, EBM Reviews–Cochrane Database of Systematic Reviews, PsycInfo, SportDISCUS, CINAHL, and EMBASE) were searched and studies reporting physical activity outcomes following interventions using smartphone apps in adults were included in the narrative review. Results were mixed with eight studies reporting increased physical activity and ten reporting no change. Interventions did not appear to be successful in specific populations defined by age, sex, country, or clinical diagnosis. There was no conclusive evidence that a specific behavioral theory or behavioral change technique was superior in eliciting behavioral change. The literature remains limited primarily to short-term studies, many of which are underpowered feasibility or pilot studies; therefore, many knowledge gaps regarding the effectiveness of smartphone apps in encouraging physical activity remain. Robust studies that can accommodate the fast pace of the technology industry are needed to examine outcomes in large populations. PMID:28979157

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

PubMed Central

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

2017-01-01

Background During the postpartum visit, health care providers address issues with short- and long-term implications for maternal and child health. Women with Medicaid insurance are less likely to return for a postpartum visit compared with women with private insurance. Behavioral economics acknowledges that people do not make exclusively rational choices, rather immediate gratification, cognitive and psychological biases, and social norms influence decision making. Drawing on insights from decision science, behavioral economists have examined how these biases can be modulated through carefully designed interventions. We have developed a Web-based tool, Healthy Beyond Pregnancy, that incorporates empirically derived concepts of behavioral economics to improve adherence rates to the postpartum visit. Objectives The primary objectives of this pilot study were to (1) refine and assess the usability of Healthy Beyond Pregnancy and (2) assess the feasibility of a randomized controlled trial (RCT) of the intervention. Methods We used a multistep process and multidisciplinary team of maternal-fetal medicine physicians, a behavioral economist, and researchers with expertise in behavioral interventions to design Healthy Beyond Pregnancy. We assessed the usability of the program with the Post-Study System Usability Questionnaire (PSSUQ), a validated 7-point scale, and semistructured interviews with postpartum women. We then conducted a feasibility trial to determine the proportion of eligible women who were willing to participate in an RCT of Healthy Beyond Pregnancy and the proportion of women willing to complete the Web-based program. Exploratory outcomes of the pilot trial included attendance at the postpartum visit, uptake of long-acting reversible contraception, and uptake of any contraception. Results The median PSSUQ score for Healthy Beyond Pregnancy was 6.5 (interquartile range: 6.1-7) demonstrating high usability. Semistructured interviews (n=10) provided in-depth comments about users’ experience and further improved the program. A total of 34 postpartum women with Medicaid insurance were approached for the pilot trial, and 30 (88%) were consented and randomized. All women randomized to Healthy Beyond Pregnancy completed the Web-based program, had text-enabled cell phones, and were willing to receive text messages from the study team. Women in the Healthy Beyond Pregnancy arm were more likely to return for a postpartum visit compared with women in the control arm with 85% of women in Healthy Beyond Pregnancy returning versus 53% in the control arm (odds ratio in the Healthy Beyond Pregnancy group: 5.3; 95% CI 0.9-32.0; P=.06). Conclusions We have developed a highly usable and acceptable Web-based program designed to increase attendance at the postpartum visit. Our pilot trial demonstrates that women are willing and able to participate in a randomized trial of a Web-based program and text messaging system. Trial Registration Clinicaltrials.gov NCT03296774; https://clinicaltrials.gov/ct2/show/NCT03296774 (Archived by WebCite at http://www.webcitation.org/6tpgXFzyk) PMID:29017990

Dissonance-Based Interventions for Substance Using Alternative High-School Youth

PubMed Central

Steiker, Lori Holleran; Powell, Tara

2011-01-01

This article describes an innovative new intervention tailored to older youth who are already abusing drugs, but who are not diagnostically ready for treatment. The basic tenet of this intervention is to utilize adolescents engaged in drug use as “experts” in the prevention curriculum adaptation activity. This activity then serves as a mechanism for their dissonance-based change. This process is designed to intervene with drug abusing youth prior to their development of substance dependence. The community-based design grew from a United States federally funded NIDA project (National Institute of Drug Abuse Mentored Research Scientist Award) which found that the youth who conduct program adaptations were effectively engaged, animatedly discussing the payoffs and downsides of drug and alcohol abuse. It is maintained through this research that dissonance between their role of “Preventionist” and their own substance abuse behaviors lead to shifts in attitudes and behaviors. Dissonance-based interventions (DBIs) have been successfully utilized for positive behavioral change with a variety of disorders, but have not yet been implemented with substance abusing youth. Findings of pilot research are shared along with implications for future research and interventions. PMID:22611306

Evaluation of a pet-assisted living intervention for improving functional status in assisted living residents with mild to moderate cognitive impairment: a pilot study.

PubMed

Friedmann, Erika; Galik, Elizabeth; Thomas, Sue A; Hall, P Sue; Chung, Seon Yoon; McCune, Sandra

2015-05-01

In older adults with cognitive impairment (CI), decreased functional status and increased behavioral symptoms require relocation from assisted living (AL) to nursing homes. Studies support positive effects of pets on health/function. Evaluate the effectiveness of the Pet AL (PAL) intervention to support physical, behavioral, and emotional function in AL residents with CI. Cognitively impaired AL residents randomized to 60-90 minute sessions [PAL (n = 22) or reminiscing (n = 18)] twice/week for 12 weeks. PAL interventionist encourages residents to perform skills with the visiting dog; reminiscing interventionist encourages residents to reminisce. Monthly assessment of physical (energy expenditure, activities of daily living), emotional (depression, apathy), and behavioral (agitation) function. In linear mixed models, physical activity depressive symptoms improved more with PAL. Evidence supports that the PAL program helps preserve/enhance function of AL residents with CI. Additional study is required to evaluate the duration and predictors of effectiveness of the PAL intervention. © The Author(s) 2014.

Increasing Knowledge and Confidence in Behavioral Change: A Pilot Study.

PubMed

Frates, Elizabeth P; Xiao, Ryan C; Simeon, Kate; McCargo, Tracie; Guo, Michelle; Stern, Theodore A

2016-11-24

To assess whether and how effectively an interactive presentation about lifestyle medicine could impact the knowledge and attitudes of medical students to prepare them for managing chronic conditions in their patients. Chronic diseases are increasingly prevalent and problematic. Although chronic disease management involves lifestyle modification, few physicians are adequately trained in effective motivational interventions. We surveyed first- and second-year Harvard Medical School students in October 2015 before and after a presentation on lifestyle medicine and quantified changes in their knowledge, attitudes/confidence, and skills. Medical students learned the basics of behavioral change after a 1-hour presentation, and their confidence with regard to implementing interventions increased. Median scores of confidence in counseling patients on lifestyle changes improved as did their ability to counsel patients on exercise, nutrition, sleep, stress management, and smoking cessation. After a brief intervention, medical students can learn principles of behavioral management and how to implement the skills with patients suffering from chronic illnesses. © Copyright 2016 Physicians Postgraduate Press, Inc.

Elementary school children’s recess schedule and dietary intake at lunch: a community-based participatory research partnership pilot study

PubMed Central

2014-01-01

Background School recess before lunch (e.g., reverse recess) has been suggested as a means to improve dietary intake and classroom behavior but limited research explores this school-based policy. This pilot study tests the impact of recess scheduling on dietary intake at school lunch. Methods A mixed methods approach included assessment of dietary intake assessed by measured plate waste on five non-consecutive days at Madras Elementary School, Madras, Oregon, United States (n = 104 intervention; 157 controls). Subjects included primary school children in grades kindergarten, first and second. Logistic regression was used to test associations between recess timing and dietary intake. Four focus groups involving teachers and staff explored reactions to the intervention. Qualitative data was transcribed verbatim and assessed for key themes. Results Milk consumption was 1.3 oz greater in the intervention group (5.7 oz vs. 4.4 oz); and 20% more of the intervention participants drank the entire carton of milk (42% vs. 25%, p < 0.0001). Intervention participants were 1.5 times more likely to meet the nutritional guidelines for calcium (≥267 mg, p = 0.01) and fat (≤30% of total energy, p = 0.02). Consumption of entrees, vegetables, and fruits did not differ between groups. Teachers perceived recess before lunch beneficial to classroom behavior and readiness to concentrate following lunch. Conclusions The recess before lunch intervention yielded increased milk consumption; the nutritional and social benefits observed warrant policy change consideration. Future research should assess the impact of recess before lunch in larger districts. PMID:24520852

"KiDS and Diabetes in Schools" project: Experience with an international educational intervention among parents and school professionals.

PubMed

Bechara, Glaucia Margonari; Castelo Branco, Fernanda; Rodrigues, Avelino Luiz; Chinnici, Daniela; Chaney, David; Calliari, Luis Eduardo P; Franco, Denise Reis

2018-06-01

Although it is known that school care is a major challenge in diabetes treatment, there is still no published international initiative. The aims of this study were to introduce an international educational intervention tool, the International Diabetes Federation (IDF) KiDS and Diabetes in Schools project (KiDS project), and to describe its impact on diabetes knowledge and behavior of caregivers and school professionals. The KiDS project was developed with the support of IDF and the International Society for Pediatric and Adolescent Diabetes and provides online free material in 10 languages, directed to caregivers and school personnel. A pilot evaluation of the KiDS intervention was performed in Brazil. An educational intervention was conducted in 5 primary schools, with 42 parents and school staff, followed by 2 individual interviews after 1 and 3 months. The results were evaluated in a qualitative study with a descriptive design based on content analysis. School staff acquired new knowledge on diabetes and its treatment. They felt more confident when helping students with diabetes and said the educational intervention promoted a positive impact on the teacher-student relationship, on the caring for health, and on school infrastructure. Family members of children with diabetes stated that the educational intervention gave them an opportunity to strengthen and update information on treatment and improve their knowledge. The KiDS project is the first international tool directed to foster a safe and supportive environment and a better understanding of diabetes in schools. In this pilot evaluation, it achieved the goal of informing and changing the behavior of parents and school staff, thus improving the care provided to children with diabetes in schools. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Using brothel leadership to promote condom use among brothel-based female sex workers in Abuja, Nigeria: study protocol for a cluster randomized pilot trial.

PubMed

Okafor, Uchenna; Crutzen, Rik; Okekearu, Ifeanyi; Adebajo, Sylvia; Uzoh, Adaora; Awo, Egbe Aneotah; Chima, Chukwuemeka; Agwagwa, Ogechukwu; van den Borne, Bart

2017-01-01

The HIV prevalence among female populations involved in sex work in Nigeria has heightened interest in HIV prevention programming for this sub-population with brothel-based female sex workers (BB FSWs) having a prevalence of 27.4%, six times higher than the prevalence in the general population. The clusters in the randomized pilot trial will be brothels and female sex workers (FSWs) residing in the brothels will be the participants of the study. The participants will receive free condom distribution as well as HIV prevention messages on condom use and negotiation skills to increase self-efficacy in handling social and gender power plays within their environment. Twelve brothels will be randomized into experimental and control conditions with a minimum total sample size of 200 participants. Recruitment of participants will be carried out from within the brothels. The control condition will receive a standard intervention consisting of a minimum of six interactive sessions with peer educators (PE) engaging their peers through group discussions and one on one interaction using pre-designed HIV prevention messages. The experimental condition will receive the standard intervention as well as interactive sessions with the brothel leadership (chairladies and brothel managers) to facilitate consistent condom use and appropriate condom use policies, conditions, and messaging. Both interventions will be delivered over a maximum period of 16 weeks, and male and female condoms will be distributed during the intervention. Quantitative assessments will be carried out at baseline and at 16 weeks follow-up, and the pilot findings will inform feasibility of and sample size estimation for a phase III trial. The primary outcomes measured are recruitment rate attrition rate and adherence to the intervention. Consistent condom use outcomes by FSWs within the brothel with all partner types and enhanced self-efficacy for condom negotiation with all partner types will be the primary outcomes for the main study, and the feasibility of their measurement will be determined in this pilot trial. The manuscript describes the protocol for a pilot study to determine the feasibility of a behavioral intervention to improve consistent condom use among BB FSWs. The results of this pilot will inform a larger intervention for HIV prevention for this target group in Nigeria. The Institutional Review Board (IRB) of the Institute of Human Virology, Nigeria; Protocol Number NHREC/10/15/2014a-026.

Automated indexing of Internet stories for health behavior change: weight loss attitude pilot study.

PubMed

Manuvinakurike, Ramesh; Velicer, Wayne F; Bickmore, Timothy W

2014-12-09

Automated health behavior change interventions show promise, but suffer from high attrition and disuse. The Internet abounds with thousands of personal narrative accounts of health behavior change that could not only provide useful information and motivation for others who are also trying to change, but an endless source of novel, entertaining stories that may keep participants more engaged than messages authored by interventionists. Given a collection of relevant personal health behavior change stories gathered from the Internet, the aim of this study was to develop and evaluate an automated indexing algorithm that could select the best possible story to provide to a user to have the greatest possible impact on their attitudes toward changing a targeted health behavior, in this case weight loss. An indexing algorithm was developed using features informed by theories from behavioral medicine together with text classification and machine learning techniques. The algorithm was trained using a crowdsourced dataset, then evaluated in a 2×2 between-subjects randomized pilot study. One factor compared the effects of participants reading 2 indexed stories vs 2 randomly selected stories, whereas the second factor compared the medium used to tell the stories: text or animated conversational agent. Outcome measures included changes in self-efficacy and decisional balance for weight loss before and after the stories were read. Participants were recruited from a crowdsourcing website (N=103; 53.4%, 55/103 female; mean age 35, SD 10.8 years; 65.0%, 67/103 precontemplation; 19.4%, 20/103 contemplation for weight loss). Participants who read indexed stories exhibited a significantly greater increase in self-efficacy for weight loss compared to the control group (F1,107=5.5, P=.02). There were no significant effects of indexing on change in decisional balance (F1,97=0.05, P=.83) and no significant effects of medium on change in self-efficacy (F1,107=0.04, P=.84) or decisional balance (F1,97=0.78, P=.38). Personal stories of health behavior change can be harvested from the Internet and used directly and automatically in interventions to affect participant attitudes, such as self-efficacy for changing behavior. Such approaches have the potential to provide highly tailored interventions that maximize engagement and retention with minimal intervention development effort.

Automated Indexing of Internet Stories for Health Behavior Change: Weight Loss Attitude Pilot Study

PubMed Central

Manuvinakurike, Ramesh; Velicer, Wayne F

2014-01-01

Background Automated health behavior change interventions show promise, but suffer from high attrition and disuse. The Internet abounds with thousands of personal narrative accounts of health behavior change that could not only provide useful information and motivation for others who are also trying to change, but an endless source of novel, entertaining stories that may keep participants more engaged than messages authored by interventionists. Objective Given a collection of relevant personal health behavior change stories gathered from the Internet, the aim of this study was to develop and evaluate an automated indexing algorithm that could select the best possible story to provide to a user to have the greatest possible impact on their attitudes toward changing a targeted health behavior, in this case weight loss. Methods An indexing algorithm was developed using features informed by theories from behavioral medicine together with text classification and machine learning techniques. The algorithm was trained using a crowdsourced dataset, then evaluated in a 2×2 between-subjects randomized pilot study. One factor compared the effects of participants reading 2 indexed stories vs 2 randomly selected stories, whereas the second factor compared the medium used to tell the stories: text or animated conversational agent. Outcome measures included changes in self-efficacy and decisional balance for weight loss before and after the stories were read. Results Participants were recruited from a crowdsourcing website (N=103; 53.4%, 55/103 female; mean age 35, SD 10.8 years; 65.0%, 67/103 precontemplation; 19.4%, 20/103 contemplation for weight loss). Participants who read indexed stories exhibited a significantly greater increase in self-efficacy for weight loss compared to the control group (F 1,107=5.5, P=.02). There were no significant effects of indexing on change in decisional balance (F 1,97=0.05, P=.83) and no significant effects of medium on change in self-efficacy (F 1,107=0.04, P=.84) or decisional balance (F 1,97=0.78, P=.38). Conclusions Personal stories of health behavior change can be harvested from the Internet and used directly and automatically in interventions to affect participant attitudes, such as self-efficacy for changing behavior. Such approaches have the potential to provide highly tailored interventions that maximize engagement and retention with minimal intervention development effort. PMID:25491243

Dealing With Unexpected Events on the Flight Deck: A Conceptual Model of Startle and Surprise

PubMed Central

Landman, Annemarie; Groen, Eric L.; van Paassen, M. M. (René); Bronkhorst, Adelbert W.; Mulder, Max

2017-01-01

Objective: A conceptual model is proposed in order to explain pilot performance in surprising and startling situations. Background: Today’s debate around loss of control following in-flight events and the implementation of upset prevention and recovery training has highlighted the importance of pilots’ ability to deal with unexpected events. Unexpected events, such as technical malfunctions or automation surprises, potentially induce a “startle factor” that may significantly impair performance. Method: Literature on surprise, startle, resilience, and decision making is reviewed, and findings are combined into a conceptual model. A number of recent flight incident and accident cases are then used to illustrate elements of the model. Results: Pilot perception and actions are conceptualized as being guided by “frames,” or mental knowledge structures that were previously learned. Performance issues in unexpected situations can often be traced back to insufficient adaptation of one’s frame to the situation. It is argued that such sensemaking or reframing processes are especially vulnerable to issues caused by startle or acute stress. Conclusion: Interventions should focus on (a) increasing the supply and quality of pilot frames (e.g., though practicing a variety of situations), (b) increasing pilot reframing skills (e.g., through the use of unpredictability in training scenarios), and (c) improving pilot metacognitive skills, so that inappropriate automatic responses to startle and surprise can be avoided. Application: The model can be used to explain pilot behavior in accident cases, to design experiments and training simulations, to teach pilots metacognitive skills, and to identify intervention methods. PMID:28777917

PROMOTING SUPPORTIVE PARENTING IN NEW MOTHERS WITH SUBSTANCE-USE PROBLEMS: A PILOT RANDOMIZED TRIAL OF RESIDENTIAL TREATMENT PLUS AN ATTACHMENT-BASED PARENTING PROGRAM

PubMed Central

BERLIN, LISA J.; SHANAHAN, MEGHAN; CARMODY, KAREN APPLEYARD

2015-01-01

This pilot randomized trial tested the feasibility and efficacy of supplementing residential substance-abuse treatment for new mothers with a brief, yet rigorous, attachment-based parenting program. Twenty-one predominantly (86%) White mothers and their infants living together in residential substance-abuse treatment were randomly assigned to the program (n = 11) or control (n = 10) group. Program mothers received 10 home-based sessions of Dozier’s Attachment and Biobehavioral Catch-up (ABC) intervention. Postintervention observations revealed more supportive parenting behaviors among the randomly assigned ABC mothers. PMID:25424409

A pilot hospital-school educational program to address teen motor vehicle safety.

PubMed

Unni, Purnima; Morrow, Stephen E; Shultz, Barbara L; Tian, Tina T

2013-10-01

Texting while driving has emerged as a significant distracted driving behavior among teenage drivers. A unique hospital-school collaborative pilot intervention (called "Be in the Zone" or "BITZ") was implemented to combat this growing problem. This intervention was hypothesized to lead to a decline in texting while driving among high school students. This collaborative intervention consisted of two separate phases. In Phase 1, small groups of high school student leaders participated in a half-day interactive educational session in a pediatric hospital. Pre- and post-follow-up surveys were administered to this group. In Phase 2, these same students took the lessons they learned from the hospital to plan and implement a yearlong peer-to-peer campaign that focused on a clear "no texting while driving" message at their schools. Two unannounced driver observations were conducted to evaluate the effectiveness of the pilot program. Sixty-one high school students participated in Phase 1. Self-reported texting while driving rates decreased significantly among the participants after Phase 1. Two schools were recruited to participate in Phase 2. Unannounced driver observations were conducted before the campaign and toward the end of the campaign. Postintervention, there was a significant decrease in the percentage of drivers who texted while driving. Preliminary results from this pilot program suggest that a strategy of combining hospital-school partnerships with a peer-driven educational approach can be effective in reducing texting while driving among teenagers in the short-term.

Targeting Feeding and Eating Behaviors: Development of the Feeding Dynamic Intervention for Caregivers of 2- to 5-Year-Old Children

PubMed Central

Eneli, Ihuoma U.; Watowicz, Rosanna P.; Hummel, Jessica; Ritter, Jan; Lumeng, Julie C.

2015-01-01

Targeting feeding dynamics, a concept centered on the roles and interaction of the caregiver and child in a feeding relationship, may have significant potential for obesity intervention. The aim of this paper is to describe the 3-phase development of the Feeding Dynamics Intervention (FDI), an acceptability and feasibility study on implementing the feeding dynamic roles (Study 1), development of the FDI content (Study 2), and a pilot study on use of the 6-lesson FDI to promote behaviors consistent with a feeding dynamic approach (Study 3). Sample population was mothers with young children, 2–5 years old. An effect size (Hedges' g) greater than 0.20 was seen in more than half (57%) of maternal feeding behaviors, with the largest effect sizes (Hedges' g ≥ 0.8) occurring with behaviors that represent the mother adopting her roles of determining what food is served, not using food as a reward, and not controlling her child's intake. There was a significant decline in Pressure to Eat behaviors (2.9 versus 2.2, p < 0.01) and Monitoring (4.1 versus 3.5, p < 0.001). The FDI emerged as an acceptable and implementable intervention. Future studies need to investigate effects of the FDI on the child's eating behaviors, self-regulation of energy intake, and anthropometrics. PMID:26199741

Promoting School Success: Developing Social Skills and Early Literacy in Head Start Classrooms

ERIC Educational Resources Information Center

Gunn, Barbara; Feil, Ed; Seeley, John; Severson, Herb; Walker, Hill M.

2006-01-01

This article reports the results of a pilot intervention to improve the social skills and literacy preparation of behaviorally at-risk Head Start children. Teachers in eight Head Start classrooms in two Oregon communities participated during the 2002-03 school year. Children in eight classrooms were screened and identified for participation using…

Effects of a Food Advertising Literacy Intervention on Taiwanese Children's Food Purchasing Behaviors

ERIC Educational Resources Information Center

Liao, Li-Ling; Lai, I.-Ju; Chang, Li-Chun; Lee, Chia-Kuei

2016-01-01

Unhealthy food advertising is an important contributor to childhood obesity. The purpose of this pilot study was to evaluate the impact of a food advertising literacy program that incorporated components of health-promoting media literacy education on fifth-grade children. Participants were 140 fifth-graders (10 and 11 years old) from one school…

Feasibility of an 8-week African American Web-based Pilot Program Promoting Healthy Eating Behaviors: Family Eats

USDA-ARS?s Scientific Manuscript database

To assess log-on rates and change in mediating variables achieved from a web-based nutrition intervention for African American families, a parent and 9- to 12-year-old daughter (n=67 families) completed questionnaires measuring dietary change mediating variables. Overall log-on rate was 59%. Signifi...

A Parent-Only Group Intervention for Children with Anxiety Disorders: Pilot Study

ERIC Educational Resources Information Center

Thienemann, Margo; Moore, Phoebe; Tompkins, Kim

2006-01-01

Objective: Working to optimize treatment outcome and use resources efficiently, investigators conducted the first test of an existing parent-only group cognitive-behavioral therapy protocol to treat 24 children 7 to 16 years old with primary anxiety disorder diagnoses. Method: Over the course of 7 months, the authors evaluated a manual-based…

Reducing Sexual Risk Behaviors for HIV/STDs in Women with Alcohol Use Disorders

ERIC Educational Resources Information Center

Langhorst, Diane M.; Choi, Y. Joon; Keyser-Marcus, Lori; Svikis, Dace S.

2012-01-01

Objective: A pilot randomized clinical trial (RCT) examined effectiveness of HIV/STD Safer Sex Skills Building + Alcohol (SSB+A) intervention for women with Alcohol Use Disorders (AUDs) in a residential treatment setting. Method: After randomizing thirty-six women with AUDs and reporting having intercourse with a male partner in the past 180 days…

Patient response to insurer-led intervention for medication adherence - a pilot study based on claims data in Korea.

PubMed

Sohn, Hyun Soon; Jang, Sunmee; Lee, Ju-Yeun; Han, Euna

2016-01-01

This study was designed to investigate patient responses to a medication counseling intervention program piloted by the National Health Insurance Service (NHIS), the national health insurer in Korea, to improve medication management in patients with hypertension, hyperlipidemia, or diabetes. Interventions were conducted from July to September 2013 through direct mailing followed by two telephone-initiated counseling sessions for the medication discontinuation group (< 80% medication possession ratio (MPR) and ≥ 2 months of discontinuation) and the medication over-possession group (≥ 150% MPR). The telephone intervention was applied through two models: model 1 (counseling by NHIS staff only) and model 2 (counseling by NHIS staff with contract-based working pharmacists in community pharmacies). Multivariate logistic regression analysis was performed to identify factors affecting favorable responses of patients to the telephone-initiated intervention. Patient responses to the telephone-initiated intervention were evaluated by a counselor. In all, 891 patients were counseledvia telephone. Patient responses to the telephone-initiated intervention were favorablein 57.6%, neutral in 17.4% and not favorable in 24.9% overall. Counseling by NHIS staff together with pharmacists (model 2) produced more favorable responses from patients than counseling by NHIS staff alone (model 1) (OR 2.73, 95% CI 1.97 - 3.77). Our findings of favorable responses to interventions support a personalized approach by the NHIS to improve patient behavior for medication adherence.

Electronic behavioral interventions for headache: a systematic review.

PubMed

Minen, Mia Tova; Torous, John; Raynowska, Jenelle; Piazza, Allison; Grudzen, Corita; Powers, Scott; Lipton, Richard; Sevick, Mary Ann

2016-01-01

There is increasing interest in using electronic behavioral interventions as well as mobile technologies such as smartphones for improving the care of chronic disabling diseases such as migraines. However, less is known about the current clinical evidence for the feasibility and effectiveness of such behavioral interventions. To review the published literature of behavioral interventions for primary headache disorders delivered by electronic means suitable for use outside of the clinician's office. An electronic database search of PubMed, PsycINFO, and Embase was conducted through December 11, 2015. All eligible studies were systematically reviewed to examine the modality in which treatment was delivered (computer, smartphone, watch and other), types of behavioral intervention delivered (cognitive behavioral therapy [CBT], biofeedback, relaxation, other), the headache type being treated, duration of treatment, adherence, and outcomes obtained by the trials to examine the overall feasibility of electronic behavioral interventions for headache. Our search produced 291 results from which 23 eligible articles were identified. Fourteen studies used the internet via the computer, 2 used Personal Digital Assistants, 2 used CD ROM and 5 used other types of devices. None used smartphones or wearable devices. Four were pilot studies (N ≤ 10) which assessed feasibility. For the behavioral intervention, CBT was used in 11 (48 %) of the studies, relaxation was used in 8 (35 %) of the studies, and biofeedback was used in 5 (22 %) of the studies. The majority of studies (14/23, 61 %) used more than one type of behavioral modality. The duration of therapy ranged from 4-8 weeks for CBT with a mean of 5.9 weeks. The duration of other behavioral interventions ranged from 4 days to 60 months. Outcomes measured varied widely across the individual studies. Despite the move toward individualized medicine and mHealth, the current literature shows that most studies using electronic behavioral intervention for the treatment of headache did not use mobile devices. The studies examining mobile devices showed that the behavioral interventions that employed them were acceptable to patients. Data are limited on the dose required, long term efficacy, and issues related to the security and privacy of this health data. This study was registered at the PROSPERO International Prospective Register of Systematic Reviews (CRD42015032284) (Prospero, 2015).

Open Trial of an Acceptance-Based Behavior Therapy Intervention to Engage Newly Diagnosed HIV Patients in Care: Rationale and Evidence of Feasibility and Acceptability.

PubMed

Moitra, Ethan; Chan, Philip A; Stein, Michael D

2015-09-01

Successful linkage and retention in care of newly diagnosed individuals in the United States remains a significant gap in the HIV care continuum. This study assessed the acceptability and feasibility of an acceptance-based behavior therapy (ABBT) intervention to engage patients newly diagnosed with HIV in medical care. Nine patients were recruited over 4 months for this brief ABBT intervention, which consisted of two brief sessions, each lasting less than 20 min. The intervention was developed to promote psychological acceptance of the HIV diagnosis, thereby increasing patients' willingness to make informed disclosure of their status. Eight patients completed a 1-month follow-up assessment, and all approved of the intervention and its components. Over the 1-month period, participants showed increased acceptance, reduced perceptions of HIV stigmatization, and increased disclosure of HIV status to social supports. This pilot study provided support for the continued investigation of ABBT as an adjunctive intervention for newly diagnosed HIV patients who are at high-risk of dropping out of HIV care. © The Author(s) 2015.

Text Messaging: An Intervention to Increase Physical Activity among African American Participants in a Faith-Based, Competitive Weight Loss Program.

PubMed

McCoy, Pamela; Leggett, Sophia; Bhuiyan, Azad; Brown, David; Frye, Patricia; Williams, Bryman

2017-03-29

African American adults are less likely to meet the recommended physical activity guidelines for aerobic and muscle-strengthening activity than Caucasian adults. The purpose of this study was to assess whether a text message intervention would increase physical activity in this population. This pilot study used a pre-/post-questionnaire non-randomized design. Participants in a faith-based weight loss competition who agreed to participate in the text messaging were assigned to the intervention group ( n = 52). Participants who declined to participate in the intervention, but agreed to participate in the study, were assigned to the control group ( n = 30). The text messages provided strategies for increasing physical activity and were based on constructs of the Health Belief Model and the Information-Motivation-Behavioral Skills Model. Chi square tests determined the intervention group participants increased exercise time by approximately eight percent ( p = 0.03), while the control group's exercise time remained constant. The intervention group increased walking and running. The control group increased running. Most participants indicated that the health text messages were effective. The results of this pilot study suggest that text messaging may be an effective method for providing options for motivating individuals to increase physical activity.

Text Messaging: An Intervention to Increase Physical Activity among African American Participants in a Faith-Based, Competitive Weight Loss Program

PubMed Central

McCoy, Pamela; Leggett, Sophia; Bhuiyan, Azad; Brown, David; Frye, Patricia; Williams, Bryman

2017-01-01

African American adults are less likely to meet the recommended physical activity guidelines for aerobic and muscle-strengthening activity than Caucasian adults. The purpose of this study was to assess whether a text message intervention would increase physical activity in this population. This pilot study used a pre-/post-questionnaire non-randomized design. Participants in a faith-based weight loss competition who agreed to participate in the text messaging were assigned to the intervention group (n = 52). Participants who declined to participate in the intervention, but agreed to participate in the study, were assigned to the control group (n = 30). The text messages provided strategies for increasing physical activity and were based on constructs of the Health Belief Model and the Information-Motivation-Behavioral Skills Model. Chi square tests determined the intervention group participants increased exercise time by approximately eight percent (p = 0.03), while the control group’s exercise time remained constant. The intervention group increased walking and running. The control group increased running. Most participants indicated that the health text messages were effective. The results of this pilot study suggest that text messaging may be an effective method for providing options for motivating individuals to increase physical activity. PMID:28353650

Design and outcomes of a Mothers In Motion behavioral intervention pilot study.

PubMed

Chang, Mei-Wei; Nitzke, Susan; Brown, Roger

2010-01-01

This paper describes the design and findings of a pilot Mothers In Motion (P-MIM) program. A randomized controlled trial that collected data via telephone interviews and finger stick at 3 time points: baseline and 2 and 8 months post-intervention. Three Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites in southern Michigan. One hundred and twenty nine overweight and obese African-American and white mothers, 18-34 years old. The 10-week, theory-based, culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences. Dietary fat, fruit, and vegetable intake; physical activity; stress; feelings; body weight; and blood glucose. General linear mixed model was applied to assess treatment effects across 2 and 8 months post-intervention. No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention. However, changes in body weight and blood glucose showed apparent trends consistent with the study's hypotheses. The P-MIM showed promise for preventing weight gain in low-income overweight and obese women. However, a larger experimental trial is warranted to determine the effectiveness of this intervention. Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Pilot Randomized Trial of Integrated Cognitive-Behavioral Therapy and Neuromuscular Training for Juvenile Fibromyalgia: The FIT Teens Program.

PubMed

Kashikar-Zuck, Susmita; Black, William R; Pfeiffer, Megan; Peugh, James; Williams, Sara E; Ting, Tracy V; Thomas, Staci; Kitchen, Katie; Myer, Gregory D

2018-04-17

Cognitive-behavioral therapy (CBT) improves coping and daily functioning in adolescents with juvenile fibromyalgia (JFM), but is less effective in reducing pain. This pilot trial evaluated the efficacy of a novel intervention (Fibromyalgia Integrative Training for Teens; FIT Teens) which integrates CBT with specialized neuromuscular exercise training to enhance the effect of treatment on reducing pain and disability. Forty adolescents with JFM (12-18 years) were randomized to CBT-only or FIT Teens. Treatment was conducted in group-based sessions over 8 weeks with assessments at baseline, post-treatment, and 3-month follow-up (primary end point). Primary outcomes were pain intensity and functional disability. Secondary outcomes were depressive symptoms, fear of movement, and pain catastrophizing. Thirty-six participants (mean age=15.33 years; 90% female) completed the program. Intent to treat analysis was conducted to evaluate differences between the FIT Teens and CBT groups from baseline to 3-month follow-up, controlling for baseline group differences. Participants in the FIT Teens group showed significantly greater decreases in pain than the CBT group. FIT Teens participants also showed significant improvements in disability, but did not differ from CBT-only at the 3-month end point. Results provide preliminary evidence that the FIT Teens intervention provides added benefits beyond CBT in the treatment of JFM, particularly in pain reduction. Results from this pilot randomized controlled trial of a new combined CBT and specialized neuromuscular exercise intervention (FIT Teens), compared with CBT alone suggested that FIT Teens offers stronger treatment benefits than CBT alone at initial treatment follow-up, especially with respect to the outcome of pain reduction. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

Engaging Overweight Adolescents in a Health and Fitness Program Using Wearable Activity Trackers.

PubMed

Wilson, Marian; Ramsay, Samantha; Young, Kimberly J

Our objectives were to (a) examine feasibility and receptivity of overweight adolescents joining a community-based group fitness program and (b) test preliminary efficacy of a 12-week pilot intervention designed to promote health, fitness, and self-efficacy for the identified teens. The 12-week fitness program for overweight adolescents was developed and included planned physical activities, nutrition classes, and goal-setting sessions. A one-group pre-/posttest study design evaluated 20 participants from grades 10 through 12 who enrolled in the program pilot study. Participants were given a wearable activity tracker that captured data using an Internet-based platform. Outcome measures included body mass index, screen time, fitness, and cardiovascular measures. A community fitness program for overweight adolescents was successfully implemented. High school students were receptive to the intervention and reported high program satisfaction. Positive effects included measurements of strength, systolic blood pressure, weight, and screen time behaviors. This study provides evidence to support the feasibility, acceptance, and preliminary effects of the pilot program with overweight adolescents. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

The Effectiveness of Cognitive Behavioral Therapy and Emotional Freedom Techniques in Reducing Depression and Anxiety Among Adults: A Pilot Study

PubMed Central

Chatwin, Hannah; Stapleton, Peta; Porter, Brett; Devine, Sharon; Sheldon, Terri

2016-01-01

Context The World Health Organization (WHO) places major depressive disorder (MDD), or depression, as the fourth leading cause of disability worldwide. Some studies have found that cognitive behavioral therapy (CBT) represents the most superior approach in treating mild to severe symptoms. Recent literature has indicated a number of limitations to this therapeutic approach. An approach that has received increasing attention within the literature is the emotional freedom technique (EFT). Objective The current pilot study aimed to evaluate the effectiveness of CBT and EFT in the treatment of depression and comorbid anxiety. Design The research team designed a pilot study structured as a randomized, controlled trial with 2 intervention arms. Setting The study took place at Bond University in Gold Coast, Queensland, Australia. Participants Participants (n = 10) were local community members who had screened positive for a primary diagnosis of MDD. Intervention Participants were randomly assigned to an 8-wk CBT or EFT treatment program, the intervention groups. A sample of individuals from the community was assessed for comparative purposes (control group) (n = 57). Outcome Measures Pre- and postintervention, all participants were interviewed using the Mini-International Neuropsychiatric Interview (MINI) 6.0, and they completed the following validated questionnaires: (1) the Beck Depression Inventory, second edition (BDI-2) and (2) the Depression, Anxiety, and Stress Scales (DASS-21). Results Findings revealed that both treatment approaches produced significant reductions in depressive symptoms, with the CBT group reporting a significant reduction postintervention, which was not maintained with time. The EFT group reported a delayed effect involving a significant reduction in symptoms at the 3- and 6-mo follow-ups only. Examination of the individual cases revealed clinically significant improvements in anxiety across both interventions. Conclusions Overall, the findings provide evidence to suggest that EFT might be an effective treatment strategy worthy of further investigation. PMID:27330487

Tailored Education for Older Patients to Facilitate Engagement in Falls Prevention Strategies after Hospital Discharge—A Pilot Randomized Controlled Trial

PubMed Central

Hill, Anne-Marie; Etherton-Beer, Christopher; Haines, Terry P.

2013-01-01

Background The aims of the study were to evaluate the effect of providing tailored falls prevention education in hospital on: i) engagement in targeted falls prevention behaviors in the month after discharge: ii) patients’ self-perceived risk and knowledge about falls and falls prevention strategies after receiving the education. Methods A pilot randomized controlled trial (n = 50): baseline and outcome assessments conducted by blinded researchers. Participants: hospital inpatients 60 years or older, discharged to the community. Participants were randomized into two groups. The intervention was a tailored education package consisting of multimedia falls prevention information with trained health professional follow-up, delivered in addition to usual care. Outcome measures were engagement in falls prevention behaviors in the month after discharge measured at one month after discharge with a structured survey, and participants’ knowledge, confidence and motivation levels before and after receiving the education. The feasibility of providing the intervention was examined and falls outcomes (falls, fall-related injuries) were also collected. Results Forty-eight patients (98%) provided follow-up data. The complete package was provided to 21 (84%) intervention group participants. Participants in the intervention group were significantly more likely to plan how to safely restart functional activities [Adjusted odds ratio 3.80, 95% CI (1.07, 13.52), p = 0.04] and more likely to complete other targeted behaviors such as completing their own home exercise program [Adjusted odds ratio 2.76, 95% CI (0.72, 10.50), p = 0.14] than the control group. The intervention group was significantly more knowledgeable, confident and motivated to engage in falls prevention strategies after receiving the education than the control group. There were 23 falls (n = 5 intervention; n = 18 control) and falls rates were 5.4/1000 patient days (intervention); 18.7/1000 patient days (control). Conclusion This tailored education was received positively by older people, resulted in increased engagement in falls prevention strategies after discharge and is feasible to deliver to older hospital patients. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry; ACTRN12611000963921 on 8th November 2011. PMID:23717424

Processes of behavior change and weight loss in a theory-based weight loss intervention program: a test of the process model for lifestyle behavior change.

PubMed

Gillison, Fiona; Stathi, Afroditi; Reddy, Prasuna; Perry, Rachel; Taylor, Gordon; Bennett, Paul; Dunbar, James; Greaves, Colin

2015-01-16

Process evaluation is important for improving theories of behavior change and behavioral intervention methods. The present study reports on the process outcomes of a pilot test of the theoretical model (the Process Model for Lifestyle Behavior Change; PMLBC) underpinning an evidence-informed, theory-driven, group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. 108 people at high risk of diabetes or heart disease were randomized to a group-based weight management intervention targeting diet and physical activity plus usual care, or to usual care. The intervention comprised nine group based sessions designed to promote motivation, social support, self-regulation and understanding of the behavior change process. Weight loss, diet, physical activity and theoretically defined mediators of change were measured pre-intervention, and after four and 12 months. The intervention resulted in significant improvements in fiber intake (M between-group difference = 5.7 g/day, p < .001) but not fat consumption (-2.3 g/day, p = 0.13), that were predictive of weight loss at both four months (M between-group difference = -1.98 kg, p < .01; R(2) = 0.2, p < 0.005), and 12 months (M difference = -1.85 kg, p = 0.1; R(2) = 0.1, p < 0.01). The intervention was successful in improving the majority of specified mediators of behavior change, and the predicted mechanisms of change specified in the PMBLC were largely supported. Improvements in self-efficacy and understanding of the behavior change process were associated with engagement in coping planning and self-monitoring activities, and successful dietary change at four and 12 months. While participants reported improvements in motivational and social support variables, there was no effect of these, or of the intervention overall, on physical activity. The data broadly support the theoretical model for supporting some dietary changes, but not for physical activity. Systematic intervention design allowed us to identify where improvements to the intervention may be implemented to promote change in all proposed mediators. More work is needed to explore effective mechanisms within interventions to promote physical activity behavior.

A Community-Designed Play-Yard Intervention to Prevent Microbial Ingestion: A Baby Water, Sanitation, and Hygiene Pilot Study in Rural Zambia.

PubMed

Reid, Brie; Seu, Rie; Orgle, Jennifer; Roy, Khrist; Pongolani, Catherine; Chileshe, Modesta; Fundira, Dadirai; Stoltzfus, Rebecca

2018-06-04

Malnourished children in low-income contexts usually suffer from environmental enteric dysfunction, which is damage to the intestines caused by chronic exposure to bacterial pathogens from feces hypothesized to contribute to stunting. Many intervention studies are piloting "Baby water, sanitation, and hygiene (WASH)" to help rural farming families reduce infant and young children's (IYC's) exposure to human and free-range livestock feces. One proposed Baby WASH intervention is a play-yard, which consists of a baby-proofed structure (i.e., playpen) that caregivers can place IYC into while doing chores around the household yard. This article describes the pilot development and assessment of a community-built Baby WASH play-yard and a plastic play-yard intervention with 21 caregivers of 6- to 24-month-old IYC in rural Zambia. A modified Trials of Improved Practices approach was used to conduct three visits in each household: an introductory visit during which play-yard use was explained, a second visit consisting of a semi-structured interview and a session of behavioral counseling, and a final visit which included a 2-hour observation of play-yard use. The second and final visits also included 24-hour recalls, and all three visits included spot observations of play-yard use. Reports from caregivers suggest that the community-built play-yard protected IYC from ingesting soil and livestock feces. Barriers to intervention use included caregivers' WASH beliefs and practices, community reactions, and play-yard maintenance. More work is needed to examine the role of women's time use in their home environment, community reactions to the intervention, and the biological efficacy to reduce microbial ingestion.

The Development of a Social Networking–Based Relatedness Intervention Among Young, First-Time Blood Donors: Pilot Study

PubMed Central

Frye, Victoria; Duffy, Louisa; France, Janis L; Kessler, Debra A; Rebosa, Mark; Shaz, Beth H; Carlson, Bruce W

2018-01-01

Background Increasing repeat blood donation behavior is a critical public health goal. According to self-determination theory, the process of developing internal motivation to give blood and an associated self-identity as a blood donor may be promoted by feelings of “relatedness” or a connection to other donors, which may be enhanced through social relations and interactions. Objective The purpose of this report it to describe the development and pilot testing of a social networking-based (Facebook) intervention condition designed to increase feelings of relatedness via virtual social interaction and support. Methods To develop the intervention condition content, images, text, polls, and video content were assembled. Ohio University college students (N=127) rated the content (82 images/text) presented by computer in random order using a scale of one to five on various dimensions of relatedness. Mean ratings were calculated and analyses of variance were conducted to assess associations among the dimensions. Based on these results, the relatedness intervention was adapted and evaluated for feasibility, acceptability, and preliminary efficacy among 24 first-time donors, aged 18 to 24 years, in a 30-day pilot trial. Paired t-tests were conducted to examine change over time in relatedness and connectedness. Results The intervention condition that was developed was acceptable and feasible. Results of the uncontrolled, preintervention, and postintervention evaluation revealed that feelings of individual-level relatedness increased significantly after the intervention. Conclusions By promoting first-time blood donor relatedness, our goal is to enhance internal motivation for donating and the integration of the blood donor identity, thus increasing the likelihood of future repeat donation. Trial Registration ClinicalTrials.gov NCT02717338; https://clinicaltrials.gov/ct2/show/NCT02717338 (Archived by WebCite at http://www.webcitation.org/6ymHRBCwu) PMID:29699961

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

PubMed

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

2013-02-01

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

Project home: a pilot evaluation of an emotion-focused intervention for mothers reuniting with children after prison.

PubMed

Shortt, Joann Wu; Eddy, J Mark; Sheeber, Lisa; Davis, Betsy

2014-02-01

Nearly 2 million children in the United States have a parent in prison. The circumstances related to this situation place them at increased risk for behavioral and emotional disorders. The process of reunification between mother and child after release is a stressful and emotional one. A pilot study was conducted to develop and test a new program, Emotions: Taking Care of Yourself and Your Child When You Go Home. The objective of the Emotions Program was to teach emotion regulation and emotion coaching skills to incarcerated mothers so as to assist mothers and their children to cope better with the stress associated with incarceration and the transition home from prison. Pilot participants (N = 47) had previously participated in Parenting Inside Out, an evidence-based parenting program for incarcerated parents. The participants were then assigned to the Emotions Program (n = 29) or the comparison condition of no additional treatment (n = 18). All mothers were assessed before (T1) and after the program (T2), and again 6 months after release from prison (T3). Intervention effects of the Emotions Program on mothers' emotion regulation, emotion socialization, and adjustment were examined using repeated-measures analysis of variance with a between-subjects factor of group (Emotions Program vs. comparison) and a within-subjects factor of time (T1 vs. T2 vs. T3). Moderate time by group interaction effects were observed for aspects of emotion regulation, emotion socialization behavior, and criminal behavior in mothers, with participants in the Emotions condition showing improvement relative to those in the comparison condition. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Evaluation of a student participatory, low-intensity program to improve school wellness environment and students' eating and activity behaviors.

PubMed

Hoelscher, Deanna M; Moag-Stahlberg, Alicia; Ellis, Karen; Vandewater, Elizabeth A; Malkani, Raja

2016-05-13

Most schools have not fully implemented wellness policies, and those that have rarely incorporate meaningful student participation. The aim of the Fuel Up to Play 60 (FUTP60) program is to help schools implement wellness policies by engaging students in activities to improve access to healthful, good tasting food and drinks, and increase the number and type of opportunities for students to be physically active. The aim of this paper is to present initial student-level results from an implementation of FUTP60 in 72 schools, grades 6-9. The study used a non-controlled pretest/posttest with serial cross-sectional data. School process data and student-level data were collected in fall 2009 (pre-intervention) and spring 2010 (post-intervention). School wellness practices were captured during a baseline needs assessment survey. Validated self-administered questionnaires assessing dietary and physical activity (PA) behaviors were administered to students in grades 6-9 in the 72 pilot schools. Mixed-effects logistic regression controlling for clustering of schools and demographics was used to calculate odds ratios and confidence intervals to evaluate changes pre- and post- intervention. All 72 schools implemented FUTP60 during the 2009-2010 school year. Action strategies most frequently chosen by the schools included increasing breakfast participation and new activities before and after school. Positive and significant changes in students' behaviors (n = 32,482 at pretest and 29,839 at post-test) were noted for dairy, whole grains, fruit, and vegetable consumption and PA levels pre- and post-intervention (OR 1.05 to 1.27). Students aware of the program at post-test were significantly more likely to report healthier eating and PA behaviors than students unaware of the program (OR 1.1 to 1.34). FUTP60 pilot findings indicate that a low intensity program focused on wellness policy implementation is associated with small positive changes in student behaviors, especially when students were aware of the program. Although these initial results are promising, a more rigorous controlled study is warranted as a next step.

Effectiveness of Parent-Child Mediation in Improving Family Functioning and Reducing Adolescent Problem Behavior: Results from a Pilot Randomized Controlled Trial.

PubMed

Tucker, Joan S; Edelen, Maria Orlando; Huang, Wenjing

2017-03-01

Parent-child mediation programs are intended to resolve or manage disputes and improve family functioning, but rigorous evaluations of their effectiveness are lacking. Families referred to a community-based mediation program (N = 111) were randomized to an intervention or wait-list control group, and completed three surveys over a 12-week period. With the exception of parent-reported child delinquency (which decreased more in the intervention group), this evaluation provides little support for the short-term effectiveness of parent-child mediation for improving family functioning and reducing child problem behaviors in general. Given that this is the first randomized controlled trial of a parent-child mediation program, additional evaluations involving larger samples and longer follow-ups are needed before firm conclusions can be drawn about the effectiveness of this intervention.

Effectiveness of Parent-Child Mediation in Improving Family Functioning and Reducing Adolescent Problem Behavior: Results from a Pilot Randomized Controlled Trial

PubMed Central

Tucker, Joan S.; Edelen, Maria Orlando; Huang, Wenjing

2016-01-01

Parent-child mediation programs are intended to resolve or manage disputes and improve family functioning, but rigorous evaluations of their effectiveness are lacking. Families referred to a community-based mediation program (N=111) were randomized to an intervention or wait-list control group, and completed three surveys over a 12-week period. With the exception of parent-reported child delinquency (which decreased more in the intervention group), this evaluation provides little support for the short-term effectiveness of parent-child mediation for improving family functioning and reducing child problem behaviors in general. Given that this is the first randomized controlled trial of a parent-child mediation program, additional evaluations involving larger samples and longer follow-ups are needed before firm conclusions can be drawn about the effectiveness of this intervention. PMID:26762375

Mobile Assessment and Treatment for Schizophrenia (MATS): A Pilot Trial of An Interactive Text-Messaging Intervention for Medication Adherence, Socialization, and Auditory Hallucinations

PubMed Central

Granholm, Eric; Ben-Zeev, Dror; Bradshaw, Kristen R.; Holden, Jason L.

2012-01-01

Mobile Assessment and Treatment for Schizophrenia (MATS) employs ambulatory monitoring methods and cognitive behavioral therapy interventions to assess and improve outcomes in consumers with schizophrenia through mobile phone text messaging. Three MATS interventions were developed to target medication adherence, socialization, and auditory hallucinations. Participants received up to 840 text messages over a 12-week intervention period. Fifty-five consumers with schizophrenia or schizoaffective disorder were enrolled, but 13 consumers with more severe negative symptoms, lower functioning, and lower premorbid IQ did not complete the intervention, despite repeated prompting and training. For completers, the average valid response rate for 216 outcome assessment questions over the 12-week period was 86%, and 86% of phones were returned undamaged. Medication adherence improved significantly, but only for individuals who were living independently. Number of social interactions increased significantly and a significant reduction in severity of hallucinations was found. In addition, the probability of endorsing attitudes that could interfere with improvement in these outcomes was also significantly reduced in MATS. Lab-based assessments of more general symptoms and functioning did not change significantly. This pilot study demonstrated that low-intensity text-messaging interventions like MATS are feasible and effective interventions to improve several important outcomes, especially for higher functioning consumers with schizophrenia. PMID:22080492

More than just tracking time: Complex measures of user engagement with an internet-based health promotion intervention.

PubMed

Baltierra, Nina B; Muessig, Kathryn E; Pike, Emily C; LeGrand, Sara; Bull, Sheana S; Hightow-Weidman, Lisa B

2016-02-01

There has been a rise in internet-based health interventions without a concomitant focus on new methods to measure user engagement and its effect on outcomes. We describe current user tracking methods for internet-based health interventions and offer suggestions for improvement based on the design and pilot testing of healthMpowerment.org (HMP). HMP is a multi-component online intervention for young Black men and transgender women who have sex with men (YBMSM/TW) to reduce risky sexual behaviors, promote healthy living and build social support. The intervention is non-directive, incorporates interactive features, and utilizes a point-based reward system. Fifteen YBMSM/TW (age 20-30) participated in a one-month pilot study to test the usability and efficacy of HMP. Engagement with the intervention was tracked using a customized data capture system and validated with Google Analytics. Usage was measured in time spent (total and across sections) and points earned. Average total time spent on HMP was five hours per person (range 0-13). Total time spent was correlated with total points earned and overall site satisfaction. Measuring engagement in internet-based interventions is crucial to determining efficacy. Multiple methods of tracking helped derive more comprehensive user profiles. Results highlighted the limitations of measures to capture user activity and the elusiveness of the concept of engagement. Copyright © 2016 Elsevier Inc. All rights reserved.

Motivational interviewing in health care: results of a brief training in endocrinology.

PubMed

Bean, Melanie K; Biskobing, Diane; Francis, Gary L; Wickham, Edmond

2012-09-01

Despite the importance of lifestyle change in disease management and the growing evidence supporting motivational interviewing (MI) as an effective counseling method to promote behavioral change, to date there are few published reports about MI training in graduate medical education. The study aimed to pilot the feasibility and effectiveness of a brief MI training intervention for endocrinology fellows and other providers. We used a pretest/posttest design to evaluate a brief MI training for 5 endocrinology fellows and 9 other providers. All participants completed subjective assessments of perceived confidence and beliefs about behavioral counseling at pretest and posttest. Objective assessment of MI was conducted using fellows' audiotaped patient encounters, which were coded using a validated tool for adherence to MI before and after the training. Paired t tests examined changes in objective and subjective assessments. The training intervention was well received and feasible in the endocrinology setting. At posttest, participants reported increased endorsement of the MI spirit and improved confidence in MI skills. Objective assessment revealed relative improvements in MI skills across several domains. However, most domains, as assessed by a validated tool, did not reach competency level after the training intervention. Although more intensive training may be needed to develop MI competence, the results of our pilot study suggest that brief, targeted MI training has short-term efficacy and is well received by endocrinology fellows and other providers.

A Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms.

PubMed

Hart, Trevor A; Stratton, Natalie; Coleman, Todd A; Wilson, Holly A; Simpson, Scott H; Julien, Rick E; Hoe, David; Leahy, Bob; Maxwell, John; Adam, Barry D

2016-01-01

Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. ClinicalTrials.gov NCT02546271.

A Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms

PubMed Central

Hart, Trevor A.; Stratton, Natalie; Coleman, Todd A.; Wilson, Holly A.; Simpson, Scott H.; Julien, Rick E.; Adam, Barry D.

2016-01-01

Background Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. Method HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. Results There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. Conclusions The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. Trial Registration ClinicalTrials.gov NCT02546271 PMID:27054341

Impact of Community-Based Nutrition Education on Geophagic Behavior and Dietary Knowledge and Practices among Rural Women in Nakuru Town, Kenya: A Pilot Study.

PubMed

Iron-Segev, Sharon; Lusweti, Janerose Nasimiyu; Kamau-Mbuthia, Elizabeth; Stark, Aliza H

2018-04-01

Geophagia, the deliberate consumption of rocks, soil, or clay, is prevalent in developing countries, particularly sub-Saharan Africa. Health risks associated with this behavior include parasitosis, heavy metal poisoning, nutrient deficiencies, and poor birth outcomes. This pilot study was designed to reduce geophagic practices and improve nutrition among rural Kenyan women. The researchers used snowball sampling to recruit participants (n = 135; aged 15-49 years) from low socioeconomic areas who consumed geophagic materials. Interviews were carried out before and after a nutrition intervention implemented by trained community health volunteers. Nutrition education focusing on geophagia significantly (P < .001) decreased the practice in 77% of participants. Postintervention interviews also demonstrated substantial improvement in understanding the concept of making half the plate vegetables using the healthy plate model. Nutrition education can be useful for reducing geophagia (a largely ignored, unsafe dietary behavior) and enhancing nutritional knowledge in African women. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

eHealth Familias Unidas: Pilot Study of an Internet Adaptation of an Evidence-Based Family Intervention to Reduce Drug Use and Sexual Risk Behaviors Among Hispanic Adolescents

PubMed Central

Estrada, Yannine; Molleda, Lourdes; Murray, Ashley; Drumhiller, Kathryn; Tapia, Maria; Sardinas, Krystal; Rosen, Alexa; Pantin, Hilda; Perrino, Tatiana; Sutton, Madeline; Cano, Miguel Ángel; Dorcius, Daphney; Wendorf Muhamad, Jessica; Prado, Guillermo

2017-01-01

This paper describes the Internet adaptation of an evidenced-based intervention for Hispanic families, eHealth Familias Unidas, and explores whether an Internet-based format is feasible and acceptable to Hispanic families. Core intervention components from the evidence-based intervention, Familias Unidas, were transposed into a video format and edited for content. Additionally, interactive exercises and a soap opera series were incorporated to reinforce intervention content and optimize participant engagement and retention. To understand the feasibility and acceptability of eHealth Familias Unidas, we conducted a pilot study and examined findings from: (1) session completion rates for both e-parent group sessions and family sessions (n = 23 families); and (2) qualitative data collected from Hispanic parents (n = 29) that received the eHealth intervention. Engagement and attendance in the intervention showed that 83% of families engaged in the intervention and that there was an overall session completion rate of 78%. Qualitative interviews were conducted mid and post intervention with a combined total of 29 participants. A general inductive approach was used to derive themes from the collected data. Overall, parents expressed positive feedback in regards to the intervention and stated that there were multiple lessons learned from participating in eHealth Familias Unidas. Findings indicate that an Internet-based family intervention is not only feasible and acceptable for Hispanic families, but also offers a viable option to ameliorate barriers to participation and implementation of preventive interventions. PMID:28273862

Brief Prescriptive Psychotherapy for Depression with an Incarcerated Young Offender: An Application of Barkham's 2+1 Model.

ERIC Educational Resources Information Center

Day, Andrew

1993-01-01

Developed and evaluated psychological intervention for depression in Young Offenders. Recognizing pressure on clinical teams to be both cost and time effective, it was decided to pilot Barkham's 2+1 format in prison setting. Results suggest that depression in prisons can be treated with cognitive-behavioral techniques and that 2+1 format may be…

The Use of Message Framing to Promote Sexual Risk Reduction in Young Adolescents: A Pilot Exploratory Study

ERIC Educational Resources Information Center

Camenga, Deepa R.; Hieftje, Kimberly D.; Fiellin, Lynn E.; Edelman, E. Jennifer; Rosenthal, Marjorie S.; Duncan, Lindsay R.

2014-01-01

Few studies have explored the application of message framing to promote health behaviors in adolescents. In this exploratory study, we examined young adolescents' selection of gain- versus loss-framed images and messages when designing an HIV-prevention intervention to promote delayed sexual initiation. Twenty-six adolescents (aged 10-14 years)…

A Family and Community Focused Lifestyle Program Prevents Weight Regain in Pacific Islanders: A Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Kaholokula, Joseph Keawe'aimoku; Mau, Marjorie K.; Efird, Jimmy T.; Leake, Anne; West, Margaret; Palakiko, Donna-Marie; Yoshimura, Sheryl R.; Kekauoha, B. Puni; Rose, Charles; Gomes, Henry

2012-01-01

Preventing weight regain after the loss of excess weight is challenging for people, especially for ethnic minorities in the United States. A 6-month weight loss maintenance intervention designed for Pacific Islanders, called the PILI Lifestyle Program (PLP), was compared with a 6-month standard behavioral weight loss maintenance program (SBP) in a…

Intermittent theta-burst transcranial magnetic stimulation for autism spectrum disorder: an open-label pilot study.

PubMed

Abujadi, Caio; Croarkin, Paul E; Bellini, Bianca B; Brentani, Helena; Marcolin, Marco A

2017-12-11

Theta-burst stimulation (TBS) modulates synaptic plasticity more efficiently than standard repetitive transcranial magnetic stimulation delivery and may be a promising modality for neuropsychiatric disorders such as autism spectrum disorder (ASD). At present there are few effective interventions for prefrontal cortex dysfunction in ASD. We report on an open-label, pilot study of intermittent TBS (iTBS) to target executive function deficits and restricted, repetitive behaviors in male children and adolescents with ASD. Ten right-handed, male participants, aged 9-17 years with ASD were enrolled in an open-label trial of iTBS treatment. Fifteen sessions of neuronavigated iTBS at 100% motor threshold targeting the right dorsolateral prefrontal cortex were delivered over 3 weeks. Parent report scores on the Repetitive Behavior Scale Revised and the Yale-Brown Obsessive Compulsive Scale demonstrated improvements with iTBS treatment. Participants demonstrated improvements in perseverative errors on the Wisconsin Card Sorting Test and total time for the Stroop test. The iTBS treatments were well tolerated with no serious adverse effects. These preliminary results suggest that further controlled interventional studies of iTBS for ASD are warranted.

Behavioral interventions for improving dual-method contraceptive use.

PubMed

Lopez, Laureen M; Stockton, Laurie L; Chen, Mario; Steiner, Markus J; Gallo, Maria F

2014-03-30

Dual-method contraception refers to using condoms as well as another modern method of contraception. The latter (usually non-barrier) method is commonly hormonal (e.g., oral contraceptives) or a non-hormonal intrauterine device. Use of two methods can better prevent pregnancy and the transmission of HIV and other sexually transmitted infections (STIs) compared to single-method use. Unprotected sex increases risk for disease, disability, and mortality in many areas due to the prevalence and incidence of HIV/STI. Millions of women, especially in lower-resource areas, also have an unmet need for protection against unintended pregnancy. We examined comparative studies of behavioral interventions for improving use of dual methods of contraception. Dual-method use refers to using condoms as well as another modern contraceptive method. Our intent was to identify effective interventions for preventing pregnancy as well as HIV/STI transmission. Through January 2014, we searched MEDLINE, CENTRAL, POPLINE, EMBASE, COPAC, and Open Grey. In addition, we searched ClinicalTrials.gov and ICTRP for current trials and trials with relevant data or reports. We examined reference lists of pertinent papers, including review articles, for additional reports. Studies could be either randomized or non-randomized. They examined a behavioral intervention with an educational or counseling component to encourage or improve the use of dual methods, i.e., condoms and another modern contraceptive. The intervention had to address preventing pregnancy as well as the transmission of HIV/STI. The program or service could be targeted to individuals, couples, or communities. The comparison condition could be another behavioral intervention to improve contraceptive use, usual care, other health education, or no intervention.Studies had to report use of dual methods, i.e., condoms plus another modern contraceptive method. We focused on the investigator's assessment of consistent dual-method use or use at last sex. Outcomes had to be measured at least three months after the behavioral intervention began. Two authors evaluated abstracts for eligibility and extracted data from included studies. For the dichotomous outcomes, the Mantel-Haenszel odds ratio (OR) with 95% CI was calculated using a fixed-effect model. Where studies used adjusted analysis, we presented the results as reported by the investigators. No meta-analysis was conducted due to differences in interventions and outcome measures. We identified four studies that met the inclusion criteria: three randomized controlled trials and a pilot study for one of the included trials. The interventions differed markedly: computer-delivered, individually tailored sessions; phone counseling added to clinic counseling; and case management plus a peer-leadership program. The latter study, which addressed multiple risks, showed an effect on contraceptive use. Compared to the control group, the intervention group was more likely to report consistent dual-method use, i.e., oral contraceptives and condoms. The reported relative risk was 1.58 at 12 months (95% CI 1.03 to 2.43) and 1.36 at 24 months (95% CI 1.01 to 1.85). The related pilot study showed more reporting of consistent dual-method use for the intervention group compared to the control group (reported P value = 0.06); the investigators used a higher alpha (P < 0.10) for this pilot study. The other two trials did not show any significant difference between the study groups in reported dual-method use or in test results for pregnancy or STIs at 12 or 24 months. We found few behavioral interventions for improving dual-method contraceptive use and little evidence of effectiveness. A multifaceted program showed some effect but only had self-reported outcomes. Two trials were more applicable to clinical settings and had objective outcomes measures, but neither showed any effect. The included studies had adequate information on intervention fidelity and sufficient follow-up periods for change to occur. However, the overall quality of evidence was considered low. Two trials had design limitations and two had high losses to follow up, as often occurs in contraceptive trials. Good quality studies are still needed of carefully designed and implemented programs or services.

A culturally appropriate intervention to improve health behaviors in Hispanic mother-child dyads.

PubMed

Bender, Melinda S; Nader, Philip R; Kennedy, Christine; Gahagan, Sheila

2013-04-01

Obesity interventions targeting Hispanic preschool children are still nascent, and few are culturally appropriate. We evaluated the feasibility of a culturally relevant 9-month intervention program to improve health behaviors in low-income Mexican mothers with 3- to 5-year-old children. A community engagement approach was used to culturally and linguistically tailor an intervention program that was pilot tested with 33 mother-child dyads enrolled from a large California urban health center. A one-group, pretest-posttest design assessed changes in children's consumption of sugar-sweetened beverages (SSB), mothers' pedometer steps, and BMI. Data were collected at baseline, postintervention and at 6 months postintervention. At postintervention, SSB consumption had significantly decreased for soda and other sugary drinks with a modest reduction for 100% juice. Consumption of water had significantly increased, whereas milk had an increased trend. Maternal step counts significantly increased for weekdays by 69% and weekend days by 49%. Overall, maternal BMI decreased while children's BMI% remained stable. At 6 months postintervention, children's soda and juice consumption reverted toward baseline levels, as did maternal step counts, but children's consumption of sugary drinks remained lower, while water and milk remained higher. Findings suggest that a culturally relevant intervention was feasible for improving target health behaviors in a low-income Mexican community. Future work should assess an enhanced intervention including a maintenance phase for long-term adherence to health behavior changes and influence on maternal and child BMI.

A Culturally Appropriate Intervention To Improve Health Behaviors in Hispanic Mother–Child Dyads

PubMed Central

Nader, Philip R.; Kennedy, Christine; Gahagan, Sheila

2013-01-01

Abstract Background Obesity interventions targeting Hispanic preschool children are still nascent, and few are culturally appropriate. We evaluated the feasibility of a culturally relevant 9-month intervention program to improve health behaviors in low-income Mexican mothers with 3- to 5-year-old children. Methods A community engagement approach was used to culturally and linguistically tailor an intervention program that was pilot tested with 33 mother–child dyads enrolled from a large California urban health center. A one-group, pretest–posttest design assessed changes in children's consumption of sugar-sweetened beverages (SSB), mothers' pedometer steps, and BMI. Data were collected at baseline, postintervention and at 6 months postintervention. Results At postintervention, SSB consumption had significantly decreased for soda and other sugary drinks with a modest reduction for 100% juice. Consumption of water had significantly increased, whereas milk had an increased trend. Maternal step counts significantly increased for weekdays by 69% and weekend days by 49%. Overall, maternal BMI decreased while children's BMI% remained stable. At 6 months postintervention, children's soda and juice consumption reverted toward baseline levels, as did maternal step counts, but children's consumption of sugary drinks remained lower, while water and milk remained higher. Conclusions Findings suggest that a culturally relevant intervention was feasible for improving target health behaviors in a low-income Mexican community. Future work should assess an enhanced intervention including a maintenance phase for long-term adherence to health behavior changes and influence on maternal and child BMI. PMID:23514697

Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT.

PubMed

Young, Andrea S; Arnold, L Eugene; Wolfson, Hannah L; Fristad, Mary A

2017-07-01

This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7-14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.

19.2 RECOVERY THROUGH RELOCATION: FROM NURSING HOME TO COMMUNITY USING COGNITIVE ADAPTATION TRAINING

PubMed Central

Maples, Natalie

2018-01-01

Abstract Background Texans with severe mental illness live 29 years less than other Americans and have more health problems earlier in life. Since 2001, over 46,000 Texans have returned home under the State’s Money Follows the Person program and federal demonstration grant. Despite this impressive achievement, people with mental health and substance use conditions continue to be institutionalized in nursing facilities (NF). Nationally, the number of NF residents under age 65 with a primary diagnosis of mental illness is nearly three times that of older residents. The Texas Money Follows the Person Behavioral Health Pilot (MFP-BHP), assists nursing facility residents with co-morbid mental and physical illnesses relocate into the community. The transition from institutionalization to independent living is a crucial time for treatment intervention to maintain independence and reduce high risk adverse outcomes, including hospitalization, exacerbation of symptoms or homelessness. Methods In addition to service coordination from Managed Care Organizations, participants receive Cognitive Adaptation Training (CAT) for six months in the nursing facility and one year in the community. CAT is a home-based psychosocial treatment utilizing environmental supports such as medication containers, signs, checklists and the organization of belongings to bypass deficits in cognitive functioning and cue and sequence adaptive behavior, to improve functional outcomes for individuals with mental illness. This demonstration project assessed the effectiveness of providing CAT to improve functional and social outcomes, measured at baseline, each three months for one year, and each six months post intervention for one additional year. Results Over 500 individuals have been transitioned into the community since 2008, with 60% maintaining independence. Findings indicate a significant improvement in targeted functional outcomes post facility discharge on the Multnomah Community Ability Scale (p<.0001), Social and Occupational Functioning Scale (p<.001) and the Quality of Life Scale (p< .01). Preliminarily analyses indicate that Medicaid costs for participants are considerably lower on average than costs prior to discharge. At the end of 2015, the savings to the state via the Pilot were tens of millions. The Pilot ends in December 2017 and final cost analyses will be conducted at this time. Discussion CAT was successfully applied to persons with co-occurring mental and physical disorders relocating from nursing facilities to independent living environments with good preliminary outcomes indicating better quality of life, social and occupational role function and in overall community functioning. The majority of persons have successfully remained in the community. The MFP Behavioral Health Pilot shows Medicaid participants residing in nursing facilities with significant mental health issues can successfully maintain their residence in the community which results in significant cost savings, even taking into account the standard MFP costs plus the intervention. MFP Pilot participants improved their functional status, which extended after the intervention period ended. Current implementation efforts are in place to integrate and sustain CAT in the statewide managed care system.

Culturally-grounded mother-daughter communication-focused intervention for Thai female adolescents.

PubMed

Powwattana, Arpaporn; Thammaraksa, Pimrat; Manora, Sroy

2018-02-05

Teenage pregnancy-prevention interventions have fallen short in significantly decreasing risk of pregnancy for Thai populations. The "breaking the voice" ("rak luk khun tong pood") culture-appropriate teenage pregnancy-prevention program was developed using community-based research. Qualitative analyses of focus group data identified salient factors related to sexual communication and behavior. The integration of focus group results with theoretical constructs guided the development of an intervention to reduce risky sexual behavior by increasing communication between mothers and their adolescent daughters. A total of 157 mother-daughter dyads from congested areas in Bangkok participated in pilot testing of the intervention by the use of a survey. The findings indicated a significant increase in the frequency of and number of sexual risk communication (P < .05). There was a significant increase in perceived power in relationship control, ability to prevent sexual risk, assertiveness, and ability to decrease sexual risk among daughters (P < .05). "Breaking the voice" represents a female-focused and culturally-relevant intervention to combat teenage pregnancy. © 2018 John Wiley & Sons Australia, Ltd.

A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial.

PubMed

Chacko, Sara A; Yeh, Gloria Y; Davis, Roger B; Wee, Christina C

2016-10-01

This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery. Randomized, controlled pilot trial. Beth Israel Deaconess Medical Center, Boston, MA, USA. Bariatric patients 1-5 years post-surgery (n=18) were randomized to receive a 10-week MBI or a standard intervention. Primary outcomes were feasibility and acceptability of the MBI. Secondary outcomes included changes in weight, eating behaviors, psychosocial outcomes, and metabolic and inflammatory biomarkers. Qualitative exit interviews were conducted post-intervention. Major themes were coded and extracted. Attendance was excellent (6 of 9 patients attended ≥7 of 10 classes). Patients reported high satisfaction and overall benefit of the MBI. The intervention was effective in reducing emotional eating at 6 months (-4.9±13.7 in mindfulness vs. 6.2±28.4 in standard, p for between-group difference=0.03) but not weight. We also observed a significant increase in HbA1C (0.34±0.38 vs. -0.06±0.31, p=0.03). Objective measures suggested trends of an increase in perceived stress and symptoms of depression, although patients reported reduced stress reactivity, improved eating behaviors, and a desire for continued mindfulness-based support in qualitative interviews. This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating, although it did not improve weight or glycemic control in the short term. Longer-term studies of mindfulness-based approaches may be warranted in this population. ClinicalTrials.gov identifier NCT02603601. Copyright © 2016 Elsevier Ltd. All rights reserved.

Desarrollo de una intervención grupal para la prevención del VIH en parejas heterosexuales.

PubMed

Pérez-Jiménez, David; Escabí Montalvo, Aracelis; Del Carmen Cabrera Aponte, María

2010-01-01

HIV preventive efforts with heterosexual couples are almost nonexistent. We designed a group intervention based on the Information-Motivation-Behavioral Skills model with the aim of increasing male condom use and promoting the practice of mutual masturbation as a safer sex alternative. We carried out a pilot study with four couples to evaluate the feasibility of the intervention and the aspects of content and format that needed to be modified. Findings reflect that participants were very satisfied with the intervention and they found it entertaining and innovative. They were very comfortable with its format, as well as with the activities. The findings confirm the feasibility of this intervention and the need to direct preventive efforts to this population.

Pilot testing an internet-based STI and HIV prevention intervention with Chilean women.

PubMed

Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto

2015-03-01

The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI's preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. The study provided important information about the ability of an Internet-based intervention to reduce young women's risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. © 2014 Sigma Theta Tau International.

Pilot Testing an Internet-Based STI and HIV Prevention Intervention With Chilean Women

PubMed Central

Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto

2015-01-01

Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI’s preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women’s risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. PMID:25410132

Assessing the feasibility and fidelity of an intervention for women with violent offenses.

PubMed

Kubiak, Sheryl Pimlott; Fedock, Gina; Tillander, Elizabeth; Kim, Woo Jong; Bybee, Deborah

2014-02-01

Women convicted of assaultive or violent offenses represent a small but important subpopulation of adults involved in the criminal justice system. The limited treatment and rehabilitation programs that are available for these women are usually developed for male offenders and do not consider factors that are especially relevant to women, such as higher rates of mental health and substance use disorders as well as their likely histories of interpersonal violence. Moreover, women's trajectories into violent behavior - as well as their trajectories out - may differ from their male counterparts. Due to the absence of programs available for this unique population, a new gender-specific and trauma informed intervention, Beyond Violence, was developed. This paper describes a pilot study with a mixed-methods approach that assesses the feasibility and fidelity of the intervention within a state prison for women. Overall, various components of feasibility (i.e. engaging the target population, gaining institutional support, and finding skilled treatment staff), were realized, as were fidelity elements such as adherence to the intervention material, and high attendance and satisfaction by participants. The positive results of this pilot study increase the likelihood of dissemination of the intervention and a randomized control trial is currently underway. Copyright © 2013 Elsevier Ltd. All rights reserved.

Hematopoietic Cell Transplant and Use of Massage for Improved Symptom Management: Results from a Pilot Randomized Control Trial

PubMed Central

Mehling, Wolf E.; Lown, E. Anne; Dvorak, Christopher C.; Cowan, Morton J.; Horn, Biljana N.; Dunn, Elizabeth A.; Acree, Michael; Abrams, Donald I.; Hecht, Frederick M.

2012-01-01

Background. Pediatric hematopoietic cell transplant (HCT) is a lifesaving treatment that often results in physical and psychological discomfort. An acupressure-massage intervention may improve symptom management in this setting. Methods. This randomized controlled pilot trial compared a combined massage-acupressure intervention to usual care. Children were offered three practitioner-provided sessions per week throughout hospitalization. Parents were trained to provide additional acupressure as needed. Symptoms were assessed using nurses' reports and two questionnaires, the behavioral affective and somatic experiences scale and the Peds quality of life cancer module. Results. We enrolled 23 children, ages 5 to 18. Children receiving the intervention reported fewer days of mucositis (Hedges' g effect size ES = 0.63), lower overall symptom burden (ES = 0.26), feeling less tired and run-down (ES = 0.86), having fewer moderate/severe symptoms of pain, nausea, and fatigue (ES = 0.62), and less pain (ES = 0.42). The intervention group showed trends toward increasing contentness/serenity (ES = +0.50) and decreasing depression (ES = −0.45), but not decreased anxiety (ES = +0.42). Differences were not statistically significant. Discussion. Feasibility of studying massage-acupressure was established in children undergoing HCT. Larger studies are needed to test the efficacy of such interventions in reducing HCT-associated symptoms in children. PMID:22454665

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness.

PubMed

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-04-11

Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers' leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention's potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers' behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations. © 2016 by Kerman University of Medical Sciences

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

PubMed

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

2017-10-10

During the postpartum visit, health care providers address issues with short- and long-term implications for maternal and child health. Women with Medicaid insurance are less likely to return for a postpartum visit compared with women with private insurance. Behavioral economics acknowledges that people do not make exclusively rational choices, rather immediate gratification, cognitive and psychological biases, and social norms influence decision making. Drawing on insights from decision science, behavioral economists have examined how these biases can be modulated through carefully designed interventions. We have developed a Web-based tool, Healthy Beyond Pregnancy, that incorporates empirically derived concepts of behavioral economics to improve adherence rates to the postpartum visit. The primary objectives of this pilot study were to (1) refine and assess the usability of Healthy Beyond Pregnancy and (2) assess the feasibility of a randomized controlled trial (RCT) of the intervention. We used a multistep process and multidisciplinary team of maternal-fetal medicine physicians, a behavioral economist, and researchers with expertise in behavioral interventions to design Healthy Beyond Pregnancy. We assessed the usability of the program with the Post-Study System Usability Questionnaire (PSSUQ), a validated 7-point scale, and semistructured interviews with postpartum women. We then conducted a feasibility trial to determine the proportion of eligible women who were willing to participate in an RCT of Healthy Beyond Pregnancy and the proportion of women willing to complete the Web-based program. Exploratory outcomes of the pilot trial included attendance at the postpartum visit, uptake of long-acting reversible contraception, and uptake of any contraception. The median PSSUQ score for Healthy Beyond Pregnancy was 6.5 (interquartile range: 6.1-7) demonstrating high usability. Semistructured interviews (n=10) provided in-depth comments about users' experience and further improved the program. A total of 34 postpartum women with Medicaid insurance were approached for the pilot trial, and 30 (88%) were consented and randomized. All women randomized to Healthy Beyond Pregnancy completed the Web-based program, had text-enabled cell phones, and were willing to receive text messages from the study team. Women in the Healthy Beyond Pregnancy arm were more likely to return for a postpartum visit compared with women in the control arm with 85% of women in Healthy Beyond Pregnancy returning versus 53% in the control arm (odds ratio in the Healthy Beyond Pregnancy group: 5.3; 95% CI 0.9-32.0; P=.06). We have developed a highly usable and acceptable Web-based program designed to increase attendance at the postpartum visit. Our pilot trial demonstrates that women are willing and able to participate in a randomized trial of a Web-based program and text messaging system. Clinicaltrials.gov NCT03296774; https://clinicaltrials.gov/ct2/show/NCT03296774 (Archived by WebCite at http://www.webcitation.org/6tpgXFzyk). ©Katherine Park Himes, Heidi Donovan, Stephanie Wang, Carrie Weaver, Jillian Rae Grove, Francesca Lucia Facco. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 10.10.2017.

Cultural adaptation of an intervention to reduce sexual risk behaviors among patients attending a STI clinic in St. Petersburg, Russia.

PubMed

Grau, Lauretta E; Krasnoselskikh, Tatiana V; Shaboltas, Alla V; Skochilov, Roman V; Kozlov, Andrei P; Abdala, Nadia

2013-08-01

Cultural adaptation is an important step in the process of implementing health promotion interventions that, having been proven to be effective in one culture, are being applied in another. This study describes the results of a formative investigation to culturally adapt a STI/HIV risk reduction intervention for use in St. Petersburg, Russia. Analyses of data from brief elicitation interviews, focus groups, community experts, and a pilot test of the adapted intervention identified environmental, cognitive-information processing, and affect-motivation factors that needed to be addressed during the adaptation process. The participant/counselor relationship was adapted to reflect a hierarchical (cf. collaborative) relationship in order to accommodate Russian expectations about patient interactions with healthcare experts. Key skills building activities (e.g., identification of personal risk behaviors, role-playing) were approached gradually or indirectly in order to maintain participants' engagement in the intervention, and close-ended questions were added to assist participants in understanding unfamiliar concepts such as "triggers" and self-efficacy. Information about the prevalence of HIV/STI infections and alcohol use included data specific to St. Petersburg to increase the personal relevance of these materials and messages. Intervention components were tailored to participants' risk reduction and informational needs. No gender differences that would have justified adaptation of the intervention approach or content were noted. Examples of specific adaptations and the key issues to attend to when adapting behavioral interventions for use in Russian clinical settings are discussed.

Does the Kids Café Program's Nutrition Education Improve Children's Dietary Intake? A Pilot Evaluation Study.

PubMed

Dave, Jayna M; Liu, Yan; Chen, Tzu-An; Thompson, Deborah I; Cullen, Karen W

2018-03-01

To evaluate the Kids Café Program (KCP) nutrition education and assess its impact on children's diet quality and body mass index (BMI) percentile. An experimental design consisting of pretest-posttest comparison groups using mixed methods to evaluate a 6-session nutrition education intervention. Four Boys and Girls Club sites PARTICIPANTS: A total of 120 9- to 12-year-old children in the KCP (60 intervention and 60 comparison); 89% completed posttest evaluations. Trained KCP site staff taught the nutrition education curriculum at intervention sites. Healthy Eating Index-2010 using 24-hour dietary recall data (primary) and BMI percentile (secondary) ANALYSIS: Repeated-measures mixed-effects modeling RESULTS: Mean age of children was 10.2 years; mean BMI percentile was about 79; 95% were from food-insecure households. The total Healthy Eating Index-2010 score for both groups at baseline and posttest ranged from 50 to 60. At posttest, compared with baseline scores, children from both groups scored significantly lower for total vegetables, and greens and beans; the intervention group children had significantly higher sodium scores. Process evaluation indicated that 60-minute lecture-based sessions were too long after children were in school all day. This pilot study suggests that the KCP nutrition education curriculum needs improvement. Further research based on behavioral constructs is needed to refine the curriculum to encourage healthier food choices among children and using the MyPlate and the 2015-2020 Dietary Guidelines for Americans. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

Piloting Lead with Love: a film-based intervention to improve parents' responses to their lesbian, gay, and bisexual children.

PubMed

Huebner, David M; Rullo, Jordan E; Thoma, Brian C; McGarrity, Larissa A; Mackenzie, Jenny

2013-10-01

Lesbian, gay, and bisexual youth are at increased risk for a variety of poor health outcomes, relative to their heterosexual counterparts, and recent research implicates family responses to a child's sexual orientation as an important predictor of these health difficulties. Lead with Love is a 35-min documentary-style preventive intervention created to improve parents' behaviors toward their lesbian, gay, and bisexual (LGB) children, by providing parents with support, information, and concrete behavioral guidance. The film was made available free online, and was promoted widely with a multi-media marketing campaign. In this paper we describe the theoretical and empirical rationale for the intervention, and report findings from pilot data collected in the first year after the film's release. Specifically, we gathered data to examine the feasibility of reaching parents of LGB youth with this intervention, to determine whether it was acceptable, and to provide preliminary indicators of its potential efficacy. In the first 12 months after launch, 10,949 individuals viewed the film online. The film successfully reached parents of LGB youth (n=1,865), including the hardest to reach parents: 21% had only learned about their child's sexual orientation in the past month, 36% reported having an LGB child was "very" or "extremely" hard for them, and 86% had never obtained any other formal support for having an LGB child. Parents who completed a follow-up assessment immediately after the film reported significant pre- to post-film increases in self-efficacy for parenting an LGB child.

Piloting Lead with Love: A film-based intervention to improve parents’ responses to their lesbian, gay, and bisexual children

PubMed Central

Huebner, David M.; Rullo, Jordan E.; Thoma, Brian C.; McGarrity, Larissa; Mackenzie, Jenny

2013-01-01

Lesbian, gay, and bisexual youth are at increased risk for a variety of poor health outcomes, relative to their heterosexual counterparts, and recent research implicates family responses to a child’s sexual orientation as an important predictor of these health difficulties. Lead with Love is a 35-minute documentary-style preventive intervention created to improve parents’ behaviors toward their lesbian, gay, and bisexual (LGB) children, by providing parents with support, information, and concrete behavioral guidance. The film was made available free online, and was promoted widely with a multi-media marketing campaign. In this paper we describe the theoretical and empirical rationale for the intervention, and report findings from pilot data collected in the first year after the film’s release. Specifically, we gathered data to examine the feasibility of reaching parents of LGB youth with this intervention, to determine whether it was acceptable, and to provide preliminary indicators of its potential efficacy. In the first 12 months after launch, 10,949 individuals viewed the film online. The film successfully reached parents of LGB youth (n = 1,865), including the hardest to reach parents: 21% had only learned about their child’s sexual orientation in the past month, 36% reported having an LGB child was “very” or “extremely” hard for them, and 86% had never obtained any other formal support for having an LGB child. Parents who completed a follow-up assessment immediately after the film reported significant pre- to post-film increases in self-efficacy for parenting an LGB child. PMID:23943135

Pilot evaluation of a web-based intervention targeting sexual health service access.

PubMed

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

2016-04-01

Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Development of Young Adults Eating and Active for Health (YEAH) internet-based intervention via a community-based participatory research model.

PubMed

Kattelmann, Kendra K; White, Adrienne A; Greene, Geoffrey W; Byrd-Bredbenner, Carol; Hoerr, Sharon L; Horacek, Tanya M; Kidd, Tandalayo; Colby, Sarah; Phillips, Beatrice W; Koenings, Mallory M; Brown, Onikia N; Olfert, Melissa; Shelnutt, Karla P; Morrell, Jesse Stabile

2014-01-01

To develop a tailored, theory-based, Web-delivered intervention to prevent excessive weight gain in young adults using a Community-Based Participatory Research model. Investigators from 14 universities developed the intervention and supporting administrative portal using the 4 phases of the PRECEDE model. Steering committees were composed of the target audience (aged 19-24 years) and key health/wellness personnel were formed at each institution and provided information during each phase that was used to guide development of the intervention, Project YEAH (Young Adults Eating and Active for Health). Piloting results were used to refine the curriculum and identify and avoid barriers to delivery. Qualitative and quantitative data collected at each phase informed Project YEAH development. In Phase 1, factors of highest priority to young adults were identified. In Phase 2, environmental supports for healthful lifestyles were elucidated. In Phase 3, behavior and environmental changes considered important and changeable were identified. In Phase 4, the 10-week, theory-based, stage-tailored, interactive-learning intervention with a 10-month reinforcement period was developed. Applying the PRECEDE model with fidelity during development of Project YEAH resulted in an intervention that pilot participants found relevant and useful, gained attention, instilled confidence in the ability to apply the information, and provided a sense of satisfaction. Copyright © 2014. Published by Elsevier Inc.

A randomized pilot study of a community-based weight loss intervention for African-American women: Rationale and study design of Doing Me! Sisters Standing Together for a Healthy Mind and Body.

PubMed

Springfield, Sparkle; Buscemi, Joanna; Fitzgibbon, Marian L; Stolley, Melinda R; Zenk, Shannon N; Schiffer, Linda; Sampson, Jameika; Jones, Quiana; Murdock, Tanine; Davis, Iona; Holland, Loys; Watkins, April; Odoms-Young, Angela

2015-07-01

Despite the high prevalence of obesity among African-American women and modest success in behavioral weight loss interventions, the development and testing of weight management interventions using a community-based participatory research (CBPR) approach have been limited. Doing Me!: Sisters Standing Together for Healthy Mind and Body (Doing Me!) is an intervention adapted from an evidence-based behavioral obesity intervention using a CBPR approach. The purpose of Doing Me! is to test the feasibility and acceptability of this adapted intervention and determine its efficacy in achieving improvements in anthropometrics, diet, and physical activity. Sixty African-American women, from a low-income, urban community, aged 30-65 years will be randomized to one of two arms: 16-week Doing Me! (n = 30) or waitlist control (n = 30). Doing Me! employs CBPR methodology to involve community stakeholders and members during the planning, development, implementation, and evaluation phases of the intervention. There will be thirty-two 90-minute sessions incorporating 45 min of instruction on diet, physical activity, and/or weight management plus 45 min of physical activity. Data will be collected at baseline and post-intervention (16 weeks). Doing Me! is one of the first CBPR studies to examine the feasibility/acceptability of an adapted evidence-based behavioral weight loss intervention designed for obese African-American women. CBPR may be an effective strategy for implementing a weight management intervention among this high-risk population. Copyright © 2015 Elsevier Inc. All rights reserved.

A pilot study of a weight management program with food provision in schizophrenia.

PubMed

Jean-Baptiste, Michel; Tek, Cenk; Liskov, Ellen; Chakunta, Umesh Rao; Nicholls, Sarah; Hassan, Akm Q; Brownell, Kelly D; Wexler, Bruce E

2007-11-01

Obesity is a serious medical problem that disproportionately affects people with severe mental illness. Behavioral strategies aimed at lifestyle modification have proven effective for weight loss in general population but have not been studied adequately among persons with schizophrenia. We have conducted a randomized controlled pilot trial of an established weight loss program, modified for this specific population, and supplemented with a novel food replacement program, as well as practical, community based teaching of shopping and preparing healthy food. The program not only arrested weight gain, and produced meaningful weight loss, but also weight loss continued 6 months after the intervention is completed. Cognitive impairment had no bearing to the extent a participant benefited from the program. As a conclusion, well designed simple behavioral programs can produce lasting weight loss for patients with schizophrenia and comorbid obesity, improve metabolic indices, and possibly decrease significant medical risks associated with obesity.

The Pathways study: a model for lowering the fat in school meals

PubMed Central

Snyder, Patricia; Anliker, Jean; Cunningham-Sabo, Leslie; Dixon, Lori Beth; Altaha, Jackie; Chamberlain, Arlene; Davis, Sally; Evans, Marguerite; Hurley, Joanne; Weber, Judith L

2016-01-01

We describe the development and implementation of the Pathways school food service intervention during the feasibility phase of the Pathways study. The purpose of the intervention was to lower the amount of fat in school meals to 30% of energy to promote obesity prevention in third- through fifth-grade students. The Pathways nutrition staff and the food service intervention staff worked together to develop 5 interrelated components to implement the intervention. These components were nutrient guidelines, 8 skill-building behavioral guidelines, hands-on materials, twice yearly trainings, and monthly visits to the kitchens by the Pathways nutrition staff. The components were developed and implemented over 18 mo in a pilot intervention in 4 schools. The results of an initial process evaluation showed that 3 of the 4 schools had implemented 6 of the 8 behavioral guidelines. In an analysis of 5 d of school menus from 3 control schools, the lunch menus averaged from 34% to 40% of energy from fat; when the menus were analyzed by using the food preparation and serving methods in the behavioral guidelines, they averaged 31% of energy from total fat. This unique approach of 5 interrelated food service intervention components was accepted in the schools and is now being implemented in the full-scale phase of the Pathways study in 40 schools for 5 y. PMID:10195607

Promoting smoke-free homes: a novel behavioral intervention using real-time audio-visual feedback on airborne particle levels.

PubMed

Klepeis, Neil E; Hughes, Suzanne C; Edwards, Rufus D; Allen, Tracy; Johnson, Michael; Chowdhury, Zohir; Smith, Kirk R; Boman-Davis, Marie; Bellettiere, John; Hovell, Melbourne F

2013-01-01

Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m(3), and low noise. A linear relationship (R(2) = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m(3). Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches.

Mediators of weight loss in the 'Healthy Dads, Healthy Kids' pilot study for overweight fathers

PubMed Central

2012-01-01

Background A poor understanding of the specific lifestyle behaviors that result in weight loss has hindered the development of effective interventions. The aim of this paper was to identify potential behavioral mediators of weight loss in the Healthy Dads, Healthy Kids (HDHK) intervention for overweight fathers. Findings The three-month intervention was evaluated in a randomized controlled trial and conducted in Newcastle, New South Wales, Australia. Baseline, three month (immediate post-intervention) and six month assessments were conducted. Recruitment and follow-up occurred between October 2008 and May 2009. The study sample included 53 overweight/obese men [mean ( SD) age=40.6( 97.1) years; body mass index (BMI)=33.2 (3.9) kgm-2] and their primary school-aged children [n=71, 54% boys; age=8.2 (2.0) years] who were randomized to HDHK program or a wait-list control group. Physical activity (PA) was assessed using pedometers and dietary behaviors were measured using a validated food frequency questionnaire. The intervention resulted in significant weight loss (5.131.27kg, P<0.0001) and increased PA among fathers (2769750 steps/day, P<0.001) and their children (1486521 steps/day, P<0.01). Fathers PA mediated weight loss in the intervention (AB=2.31, 95% CI=4.63 to 0.67) and was responsible for 47% of the intervention effect. Changes in dietary behaviors were not statistically significant. Conclusions PA was an important mediator of weight loss in the HDHK intervention. Encouraging overweight fathers to be more active with their children appears to be a promising strategy for obesity treatment in men. PMID:22512861

Promoting Smoke-Free Homes: A Novel Behavioral Intervention Using Real-Time Audio-Visual Feedback on Airborne Particle Levels

PubMed Central

Klepeis, Neil E.; Hughes, Suzanne C.; Edwards, Rufus D.; Allen, Tracy; Johnson, Michael; Chowdhury, Zohir; Smith, Kirk R.; Boman-Davis, Marie; Bellettiere, John; Hovell, Melbourne F.

2013-01-01

Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m3, and low noise. A linear relationship (R2 = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m3. Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches. PMID:24009742

Efficacy of a food safety comic book on knowledge and self-reported behavior for persons living with AIDS.

PubMed

Dworkin, Mark S; Peterson, Caryn E; Gao, Weihua; Mayor, Angel; Hunter, Robert; Negron, Edna; Fleury, Alison; Besch, C Lynn

2013-01-01

Persons living with AIDS are highly vulnerable to foodborne enteric infections with the potential for substantial morbidity and mortality. Educational materials about foodborne enteric infections intended for this immunocompromised population have not been assessed for their efficacy in improving knowledge or encouraging behavior change. AIDS patients in four healthcare facilities in Chicago, New Orleans, and Puerto Rico were recruited using fliers and word of mouth to healthcare providers. Those who contacted research staff were interviewed to determine food safety knowledge gaps and risky behaviors. A food safety educational comic book that targeted knowledge gaps was created, piloted, and provided to these patients who were instructed to read it and return at least 2 weeks later for a follow-up interview. The overall food safety score was determined by the number of the 26 knowledge/belief/behavior questions from the survey answered correctly. Among 150 patients who participated in both the baseline and follow-up questionnaire, the intervention resulted in a substantial increase in the food safety score (baseline 59%, post-intervention 81%, p<0.001). The intervention produced a significant increase in all the food safety knowledge, belief, and behavior items that comprised the food safety score. Many of these increases were from baseline knowledge below 80 percent to well above 90%. Most (85%) of the patients stated they made a change to their behavior since receiving the educational booklet. This comic book format intervention to educate persons living with AIDS was highly effective. Future studies should examine to what extent long-term behavioral changes result.

A Mixed-Methods Study of a Social Emotional Curriculum for Black Male Success: A School-Based Pilot Study of the Brothers of Ujima

ERIC Educational Resources Information Center

Graves, Scott L., Jr.; Aston, Candice

2018-01-01

The purpose of this study is to evaluate the effects of a social emotional learning curriculum, "Brothers of Ujima," for children at risk for being referred for placement in emotional and behavioral support classrooms. The "Brothers of Ujima" is a strength-based culturally relevant intervention for African American boys aged…

Planning and Implementing Health Promotion in the Workplace: A Case Study of the Du Pont Company Experience.

ERIC Educational Resources Information Center

Bertera, Robert L.

1990-01-01

The PRECEDE framework was used to focus planning and evaluation of key areas of health knowledge, attitudes, and behavior in designing a workplace health promotion program for Du Pont. One pilot location experienced a 47.5 percent decline in absenteeism over six years as a result of the comprehensive needs assessment and health intervention. (SK)

Feasibility, Acceptability and Preliminary Treatment Outcomes in a School-Based CBT Intervention Program for Adolescents with ASD and Anxiety in Singapore

ERIC Educational Resources Information Center

Drmic, Irene E.; Aljunied, Mariam; Reaven, Judy

2017-01-01

Adolescents with autism spectrum disorder (ASD) are at high risk for anxiety difficulties and disorders. Clinic-based cognitive behavioral therapy (CBT) is effective; however, few published school-based CBT programs for youth with ASD exist. In this study, the Facing Your Fears CBT protocol was adapted for delivery and piloted within a school…

Effects of a Web-Based Stroke Education Program on Recurrence Prevention Behaviors among Stroke Patients: A Pilot Study

ERIC Educational Resources Information Center

Kim, Jae-Il; Lee, Sook; Kim, Jung-Hee

2013-01-01

The effectiveness of methods to prevent stroke recurrence and of education focusing on learners' needs has not been fully explored. The aims of this study were to assess the effects of such interventions among stroke patients and their primary caregivers and to evaluate the feasibility of a web-based stroke education program. The participants were…

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

PubMed Central

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B.; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-01-01

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations. PMID:27694661

A pilot study of a smartphone application supporting recovery from drug addiction.

PubMed

Liang, Di; Han, Hui; Du, Jiang; Zhao, Min; Hser, Yih-Ing

2018-05-01

Mobile health (mHealth) technologies have the potential to facilitate self-monitoring and self-management for individuals with substance use disorders (SUD). S-Health is a bilingual smartphone application based on cognitive behavioral principles and is designed to support recovery from drug addiction by trigger recognition so as to allow practice in-the-moment coping to prevent relapse. For this pilot randomized controlled study, 75 participants were recruited from methadone maintenance treatment clinics and the social worker consortium in Shanghai, China. Participants in the control group (N=25) received text messages from S-Health (e.g., HIV prevention and other educational materials). Participants in the intervention group (N=50) received both text messages and daily surveys on cravings, affects, triggers, responses to triggers, and social contexts. At the end of the 1-month study trial, 26.2% of the intervention group and 50% of the control group had positive urine test results (p=0.06). Also, the number of days using drug in the past week was significantly lower among participants in the intervention group (Mean=0.71, SD=1.87) relative to the control group (Mean=2.20, SD=3.06) (p<0.05). The two groups did not differ in slopes (i.e., rates of change in outcomes measured weekly) based on the mixed effects model. Participants in the intervention group also preferred answering questions on the cellphone (46.8%) relative to in-person interviews (36.2%). This pilot demonstrated the feasibility and potential benefits to deliver mobile health intervention among participants with SUD. Further research with larger samples over a longer period of time is needed to test the effectiveness of S-Health as a self-monitoring tool supporting recovery from addiction. Copyright © 2018 Elsevier Inc. All rights reserved.

Mobile technology for obesity prevention: a randomized pilot study in racial- and ethnic-minority girls.

PubMed

Nollen, Nicole L; Mayo, Matthew S; Carlson, Susan E; Rapoff, Michael A; Goggin, Kathy J; Ellerbeck, Edward F

2014-04-01

Mobile technologies have wide-scale reach and disseminability, but no known studies have examined mobile technologies as a stand-alone tool to improve obesity-related behaviors of at-risk youth. To test a 12-week mobile technology intervention for use and estimate effect sizes for a fully powered trial. Fifty-one low-income, racial/ethnic-minority girls aged 9-14 years were randomized to a mobile technology (n=26) or control (n=25) condition. Both conditions lasted 12 weeks and targeted fruits/vegetables (FVs; Weeks 1-4); sugar-sweetened beverages (SSBs; Weeks 5-8), and screen time (Weeks 9-12). The mobile intervention prompted real-time goal setting and self-monitoring and provided tips, feedback, and positive reinforcement related to the target behaviors. Controls received the same content in a written manual but no prompting. Outcomes included device utilization and effect size estimates of FVs, SSBs, screen time, and BMI. Data were collected and analyzed in 2011-2012. Mobile technology girls used the program on 63% of days and exhibited trends toward increased FVs (+0.88, p=0.08) and decreased SSBs (-0.33, p=0.09). The adjusted difference between groups of 1.0 servings of FVs (p=0.13) and 0.35 servings of SSBs (p=0.25) indicated small to moderate effects of the intervention (Cohen's d=0.44 and -0.34, respectively). No differences were observed for screen time or BMI. A stand-alone mobile app may produce small to moderate effects for FVs and SSBs. Given the extensive reach of mobile devices, this pilot study demonstrates the need for larger-scale testing of similar programs to address obesity-related behaviors in high-risk youth. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

DiAlert: a prevention program for overweight first degree relatives of type 2 diabetes patients: results of a pilot study to test feasibility and acceptability.

PubMed

Heideman, Wieke H; de Wit, Maartje; Middelkoop, Barend J C; Nierkens, Vera; Stronks, Karien; Verhoeff, Arnoud P; Snoek, Frank J

2012-09-27

Prevalence of type 2 diabetes mellitus is increasing due to lifestyle changes, particularly affecting those genetically at risk. We developed DiAlert as a targeted group-based intervention aimed to promote intrinsic motivation and action planning for lifestyle changes and weight loss in first degree relatives of patients with type 2 diabetes mellitus.The main objective of the pilot of the DiAlert intervention was to assess fidelity, feasibility and acceptability prior to starting the randomized controlled trial. Individuals with a family history of type 2 diabetes mellitus were self-identified and screened for eligibility. DiAlert consists of two group sessions. Feasibility, fidelity, acceptability and self-reported perceptions and behavioral determinants were evaluated in a pre-post study using questionnaires and observations. Determinants of behavior change were analyzed using paired-samples t tests and Wilcoxon signed rank tests. DiAlert was delivered to two groups of first degree relatives of patients with type 2 diabetes mellitus (N = 9 and N = 12). Feasibility and fidelity were confirmed. Overall, the DiAlert group sessions were positively evaluated (8.0 on a scale of 1 to 10) by participants. The intervention did not impact perceived susceptibility or worry about personal diabetes risk. Action planning with regard to changing diet and physical activity increased. DiAlert proved feasible and was well-accepted by participants. Positive trends in action planning indicate increased likelihood of actual behavior change following DiAlert. Testing the effectiveness in a randomized controlled trial is imperative. Netherlands National Trial Register (NTR): NTR2036.

Behavior problems, foster home integration, and evidence-based behavioral interventions: What predicts adoption of foster children?

PubMed

Leathers, Sonya J; Spielfogel, Jill E; Gleeson, James P; Rolock, Nancy

2012-05-01

Adoption is particularly important for foster children with special mental health needs who are unable to return home, as adoption increases parental support often critically needed by youth with mental health issues. Unfortunately, significant behavior problems frequently inhibit foster parents from adopting, and little is known about factors that predict adoption when a child has behavior problems. Previous research suggests that foster parent behavioral training could potentially increase rates of successful adoptions for pre-school-aged foster children with behavior problems (Fisher, Kim, & Pears, 2009), but this has not been previously tested in older samples. In older children, effective treatment of behavior problems might also increase adoption by reducing the interference of behavior problems and strengthening the child's foster home integration. This pilot study focused on this question by testing associations between behavior problems, foster home integration, an evidence-based foster parent intervention, and adoption likelihood. This study used an intent-to-treat design to compare foster home integration and adoption likelihood for 31 foster children with histories of abuse and neglect whose foster parents received a foster behavioral parenting intervention (see Chamberlain, 2003) or usual services. Random effect regression analyses were used to estimate outcomes across four time points. As expected, externalizing behavior problems had a negative effect on both integration and adoption, and foster home integration had an independent positive effect on adoption. Internalizing behavior problems (e.g., depression/anxiety) were not related to adoption or integration. However, the intervention did not have a direct effect on either foster home integration or adoption despite its positive effect on behavior problems. Results from this preliminary study provide further evidence of the negative effect of externalizing behavior problems on adoption. Its findings also suggest that foster home integration is an important dimension of foster home adaptation that appears particularly relevant to chances for adoption. While behavior problems appear to weaken foster home integration, integration is also an independent predictor of adoption likelihood. If these results are replicated in a larger study, consideration of foster home integration in case planning and future intervention studies focused on increasing permanency could potentially improve outcomes for foster children with behavior problems.

Behavior changes after minor emergency procedures.

PubMed

Brodzinski, Holly; Iyer, Srikant

2013-10-01

Procedures are common in pediatric emergency departments and frequently cause distress from pain and/or anxiety. The objective of this study was to describe the incidence, types, and magnitude of long-term behavior changes after procedures in the emergency setting. This is a descriptive pilot study to determine if children display negative behavioral changes after a minor emergency department procedure (abscess drainage or laceration repair). Behavior change was measured at 1 week by telephone follow-up using the 27-item Post Hospitalization Behavior Questionnaire, a well-validated instrument that measures behavior changes across 6 categories: general anxiety, separation anxiety, anxiety about sleep, eating disturbances, aggression toward authority, and apathy/withdrawal. Significant behavior change was defined as 5 or more negative behavior changes on the 27-item questionnaire. Twenty percent of children who underwent abscess drainage (n = 30) and 20% who underwent laceration repair (n = 30) displayed significant negative behavior change at 1 week. Children who displayed significant negative behavior change tended to be younger (3.6 vs 5.9 years) and trended toward being more likely to have received anxiolysis or sedation (16.7% vs 8.3%). Separation anxiety, sleep difficulties, and aggression toward authority were the most common behavior changes. In this pilot study, a significant percentage of children undergoing common emergency procedures exhibited an appreciable burden of negative behavior change at 1 week; these results demonstrate the need for further rigorous investigation of predictors of these changes and interventions, which can ameliorate these changes.

A Behavioral Lifestyle Intervention Enhanced With Multiple-Behavior Self-Monitoring Using Mobile and Connected Tools for Underserved Individuals With Type 2 Diabetes and Comorbid Overweight or Obesity: Pilot Comparative Effectiveness Trial.

PubMed

Wang, Jing; Cai, Chunyan; Padhye, Nikhil; Orlander, Philip; Zare, Mohammad

2018-04-10

Self-monitoring is a cornerstone of behavioral lifestyle interventions for obesity and type 2 diabetes mellitus. Mobile technology has the potential to improve adherence to self-monitoring and patient outcomes. However, no study has tested the use of a smartphone to facilitate self-monitoring in overweight or obese adults with type 2 diabetes mellitus living in the underserved community. The aim of this study was to examine the feasibility of and compare preliminary efficacy of a behavioral lifestyle intervention using smartphone- or paper-based self-monitoring of multiple behaviors on weight loss and glycemic control in a sample of overweight or obese adults with type 2 diabetes mellitus living in underserved communities. We conducted a randomized controlled trial to examine the feasibility and preliminary efficacy of a behavioral lifestyle intervention. Overweight or obese patients with type 2 diabetes mellitus were recruited from an underserved minority community health center in Houston, Texas. They were randomly assigned to one of the three groups: (1) behavior intervention with smartphone-based self-monitoring, (2) behavior intervention with paper diary-based self-monitoring, and (3) usual care group. Both the mobile and paper groups received a total of 11 face-to-face group sessions in a 6-month intervention. The mobile group received an Android-based smartphone with 2 apps loaded to help them record their diet, physical activity, weight, and blood glucose, along with a connected glucometer, whereas the paper group used paper diaries for these recordings. Primary outcomes of the study included percentage weight loss and glycated hemoglobin (HbA 1c ) changes over 6 months. A total of 26 patients were enrolled: 11 in the mobile group, 9 in the paper group, and 6 in the control group. We had 92% (24/26) retention rate at 6 months. The sample is predominantly African Americans with an average age of 56.4 years and body mass index of 38.1. Participants lost an average of 2.73% (mobile group) and 0.13% (paper group) weight at 6 months, whereas the control group had an average 0.49% weight gain. Their HbA 1c changed from 8% to 7 % in mobile group, 10% to 9% in paper group, and maintained at 9% for the control group. We found a significant difference on HbA 1c at 6 months among the 3 groups (P=.01). We did not find statistical group significance on percentage weight loss (P=.20) and HbA 1c changes (P=.44) overtime; however, we found a large effect size of 0.40 for weight loss and a medium effect size of 0.28 for glycemic control. Delivering a simplified behavioral lifestyle intervention using mobile health-based self-monitoring in an underserved community is feasible and acceptable and shows higher preliminary efficacy, as compared with paper-based self-monitoring. A full-scale randomized controlled trial is needed to confirm the findings in this pilot study. ClinicalTrials.gov NCT02858648; https://clinicaltrials.gov/ct2/show/NCT02858648 (Archived by WebCite at http://www.webcitation.org/6ySidjmT7). ©Jing Wang, Chunyan Cai, Nikhil Padhye, Philip Orlander, Mohammad Zare. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 10.04.2018.

A Behavioral Lifestyle Intervention Enhanced With Multiple-Behavior Self-Monitoring Using Mobile and Connected Tools for Underserved Individuals With Type 2 Diabetes and Comorbid Overweight or Obesity: Pilot Comparative Effectiveness Trial

PubMed Central

Cai, Chunyan; Padhye, Nikhil; Orlander, Philip; Zare, Mohammad

2018-01-01

Background Self-monitoring is a cornerstone of behavioral lifestyle interventions for obesity and type 2 diabetes mellitus. Mobile technology has the potential to improve adherence to self-monitoring and patient outcomes. However, no study has tested the use of a smartphone to facilitate self-monitoring in overweight or obese adults with type 2 diabetes mellitus living in the underserved community. Objective The aim of this study was to examine the feasibility of and compare preliminary efficacy of a behavioral lifestyle intervention using smartphone- or paper-based self-monitoring of multiple behaviors on weight loss and glycemic control in a sample of overweight or obese adults with type 2 diabetes mellitus living in underserved communities. Methods We conducted a randomized controlled trial to examine the feasibility and preliminary efficacy of a behavioral lifestyle intervention. Overweight or obese patients with type 2 diabetes mellitus were recruited from an underserved minority community health center in Houston, Texas. They were randomly assigned to one of the three groups: (1) behavior intervention with smartphone-based self-monitoring, (2) behavior intervention with paper diary-based self-monitoring, and (3) usual care group. Both the mobile and paper groups received a total of 11 face-to-face group sessions in a 6-month intervention. The mobile group received an Android-based smartphone with 2 apps loaded to help them record their diet, physical activity, weight, and blood glucose, along with a connected glucometer, whereas the paper group used paper diaries for these recordings. Primary outcomes of the study included percentage weight loss and glycated hemoglobin (HbA1c) changes over 6 months. Results A total of 26 patients were enrolled: 11 in the mobile group, 9 in the paper group, and 6 in the control group. We had 92% (24/26) retention rate at 6 months. The sample is predominantly African Americans with an average age of 56.4 years and body mass index of 38.1. Participants lost an average of 2.73% (mobile group) and 0.13% (paper group) weight at 6 months, whereas the control group had an average 0.49% weight gain. Their HbA1c changed from 8% to 7 % in mobile group, 10% to 9% in paper group, and maintained at 9% for the control group. We found a significant difference on HbA1c at 6 months among the 3 groups (P=.01). We did not find statistical group significance on percentage weight loss (P=.20) and HbA1c changes (P=.44) overtime; however, we found a large effect size of 0.40 for weight loss and a medium effect size of 0.28 for glycemic control. Conclusions Delivering a simplified behavioral lifestyle intervention using mobile health–based self-monitoring in an underserved community is feasible and acceptable and shows higher preliminary efficacy, as compared with paper-based self-monitoring. A full-scale randomized controlled trial is needed to confirm the findings in this pilot study. Trial Registration ClinicalTrials.gov NCT02858648; https://clinicaltrials.gov/ct2/show/NCT02858648 (Archived by WebCite at http://www.webcitation.org/6ySidjmT7) PMID:29636320

Acceptance and Commitment Therapy for Inpatients with Psychosis (the REACH Study): Protocol for Treatment Development and Pilot Testing

PubMed Central

Gaudiano, Brandon A.; Davis, Carter H.; Epstein-Lubow, Gary; Johnson, Jennifer E.; Mueser, Kim T.; Miller, Ivan W.

2017-01-01

Patients with schizophrenia-spectrum disorders frequently require treatment at inpatient hospitals during periods of acute illness for crisis management and stabilization. Acceptance and Commitment Therapy (ACT), a “third wave” cognitive-behavioral intervention that employs innovative mindfulness-based strategies, has shown initial efficacy in randomized controlled trials for improving acute and post-discharge outcomes in patients with psychosis when studied in acute-care psychiatric hospitals in the U.S. However, the intervention has not been widely adopted in its current form because of its use of an individual-only format and delivery by doctoral-level research therapists with extensive prior experience using ACT. The aim of the Researching the Effectiveness of Acceptance-based Coping during Hospitalization (REACH) Study is to adapt a promising acute-care psychosocial treatment for inpatients with psychosis, and to pilot test its effectiveness in a routine inpatient setting. More specifically, we describe our plans to: (a) further develop and refine the treatment and training protocols, (b) conduct an open trial and make further modifications based on the experience gained, and (c) conduct a pilot randomized controlled trial in preparation for a future fully-powered clinical trial testing the effectiveness of ACT. PMID:28475123

Assessing the feasibility, acceptability, and potential effectiveness of a behavioral-automaticity focused lifestyle intervention for African Americans with metabolic syndrome: The Pick two to Stick to protocol.

PubMed

Fritz, Heather; Brody, Aaron; Levy, Philip

2017-09-01

Metabolic syndrome (MetS) significantly increases the risk of developing diabetes and cardiovascular disease. Being physically active and eating a healthy diet can reduce MetS risk factors. Too frequently, however, studies report that the effects of interventions targeting those factors are not maintained once interventions are withdrawn. A potential solution to the problem is targeting behavioral automaticity (habit-development) to aid in initiation and maintenance of health-behavior changes. The Pick two to Stick To (P2S2), is an 8-week, theory-based hybrid (face-to-face/telecoaching) habit focused lifestyle intervention designed to increase healthful physical activity and dietary behavioral automaticity. The purpose of this article is to describe the rationale and protocol for evaluating the P2S2 program's feasibility, acceptability and potential effectiveness. Using a prospective, non-comparative design, the P2S2 program will be implemented by trained occupational therapy 'coaches' to 40 African Americans aged 40 and above with MetS recruited from the emergency department. Semi-structured interviews with participants, bi-weekly research meetings with study staff, and observations of intervention delivery will provide data for a process evaluation. Estimates of effectiveness include weight, blood pressure, waist circumference, BMI, and behavioral automaticity measures that will be collected at baseline and week 20. The P2S2 program could facilitate the development of healthful dietary and physical activity habits in an underserved population. Whether interventions aimed at changing habits can feasibly influence this automaticity, particularly for high-risk, low resource communities where other barriers exist, is not known. This pilot study, therefore, will fill an important gap, providing insight to inform subsequent trials.

Web-based Screening and Brief Intervention for Student Marijuana Use in a University Health Center: Pilot Study to Examine the Implementation of eCHECKUP TO GO in Different Contexts

PubMed Central

Palfai, Tibor P.; Saitz, Richard; Winter, Michael; Brown, Timothy A.; Kypri, Kypros; Goodness, Tracie M.; O’Brien, Lauren M.; Lu, Jon

2014-01-01

This pilot study sought to test the feasibility of procedures to screen students for marijuana use in Student Health Services (SHS) and test the efficacy of a web-based intervention designed to reduce marijuana use and consequences. Students were asked to participate in voluntary screening of health behaviors upon arrival at SHS. One hundred and twenty-three students who used marijuana at least monthly completed assessments and were randomized to one of four intervention conditions in a 2 (Intervention: Marijuana eCHECKUP TO GO vs. Control) × 2 (Site of Intervention: On-site vs. Off-site) between-groups design. Follow-up assessments were conducted online at 3 and 6 months. Latent growth modeling was used to provide effect size estimates for the influence of intervention on outcomes. One thousand and eighty undergraduate students completed screening. The intervention did not influence marijuana use frequency. However, there was evidence of a small overall intervention effect on marijuana-related consequences and a medium effect in stratified analyses in the on-site condition. Analyses of psychological variables showed that the intervention significantly reduced perceived norms regarding peer marijuana use. These findings demonstrate that it is feasible to identify marijuana users in SHS and deliver an automated web-based intervention to these students in different contexts. Effect size estimates suggest that the intervention has some promise as a means of correcting misperceptions of marijuana use norms and reducing marijuana-related consequences. Future work should test the efficacy of this intervention in a full scale randomized controlled trial. PMID:24845164

Web-based screening and brief intervention for student marijuana use in a university health center: pilot study to examine the implementation of eCHECKUP TO GO in different contexts.

PubMed

Palfai, Tibor P; Saitz, Richard; Winter, Michael; Brown, Timothy A; Kypri, Kypros; Goodness, Tracie M; O'Brien, Lauren M; Lu, Jon

2014-09-01

This pilot study sought to test the feasibility of procedures to screen students for marijuana use in Student Health Services (SHS) and test the efficacy of a web-based intervention designed to reduce marijuana use and consequences. Students were asked to participate in voluntary screening of health behaviors upon arrival at SHS. One hundred and twenty-three students who used marijuana at least monthly completed assessments and were randomized to one of four intervention conditions in a 2 (intervention: Marijuana eCHECKUP TO GO vs. control)×2 (site of intervention: on-site vs. off-site) between-groups design. Follow-up assessments were conducted online at 3 and 6 months. Latent growth modeling was used to provide effect size estimates for the influence of intervention on outcomes. One thousand and eighty undergraduate students completed screening. The intervention did not influence marijuana use frequency. However, there was evidence of a small overall intervention effect on marijuana-related consequences and a medium effect in stratified analyses in the on-site condition. Analyses of psychological variables showed that the intervention significantly reduced perceived norms regarding peer marijuana use. These findings demonstrate that it is feasible to identify marijuana users in SHS and deliver an automated web-based intervention to these students in different contexts. Effect size estimates suggest that the intervention has some promise as a means of correcting misperceptions of marijuana use norms and reducing marijuana-related consequences. Future work should test the efficacy of this intervention in a full scale randomized controlled trial. Copyright © 2014 Elsevier Ltd. All rights reserved.

Daily text messaging for weight control among racial and ethnic minority women: randomized controlled pilot study.

PubMed

Steinberg, Dori M; Levine, Erica L; Askew, Sandy; Foley, Perry; Bennett, Gary G

2013-11-18

Daily self-monitoring of diet and physical activity behaviors is a strong predictor of weight loss success. Text messaging holds promise as a viable self-monitoring modality, particularly among racial/ethnic minority populations. This pilot study evaluated the feasibility of a text messaging intervention for weight loss among predominantly black women. Fifty obese women were randomized to either a 6-month intervention using a fully automated system that included daily text messages for self-monitoring tailored behavioral goals (eg, 10,000 steps per day, no sugary drinks) along with brief feedback and tips (n=26) or to an education control arm (n=24). Weight was objectively measured at baseline and at 6 months. Adherence was defined as the proportion of text messages received in response to self-monitoring prompts. The average daily text messaging adherence rate was 49% (SD 27.9) with 85% (22/26) texting self-monitored behavioral goals 2 or more days per week. Approximately 70% (16/23) strongly agreed that daily texting was easy and helpful and 76% (16/21) felt the frequency of texting was appropriate. At 6 months, the intervention arm lost a mean of 1.27 kg (SD 6.51), and the control arm gained a mean of 1.14 kg (SD 2.53; mean difference -2.41 kg, 95% CI -5.22 to 0.39; P=.09). There was a trend toward greater text messaging adherence being associated with greater percent weight loss (r=-.36; P=.08), but this did not reach statistical significance. There was no significant association between goal attainment and text messaging adherence and no significant predictors of adherence. Given the increasing penetration of mobile devices, text messaging may be a useful self-monitoring tool for weight control, particularly among populations most in need of intervention. Clinicaltrials.gov: NCT00939081; http://clinicaltrials.gov/show/NCT00939081 (Archived by WebCite at http://www.webcitation.org/6KiIIcnk1).

Effects of a cognitive-behavioral exposure-based body image therapy for overweight females with binge eating disorder: a pilot study.

PubMed

Lewer, Merle; Kosfelder, Joachim; Michalak, Johannes; Schroeder, Dorothea; Nasrawi, Nadia; Vocks, Silja

2017-01-01

Although not part of the diagnostic criteria of the DSM-5, body image disturbance seems to be a relevant feature of Binge Eating Disorder (BED) as well as of other eating disorders such as Anorexia Nervosa (AN) or Bulimia Nervosa (BN). Hence, the aim of the present pilot study was to assess the changeability of body image disturbance in a sample of overweight females with BED by a cognitive-behavioral treatment, directly addressing body image disturbance. Overweight females ( N  = 34) with BED were randomized to a manualized body image therapy or a waiting-list control group. The final sample consisted of n  = 15 participants in the intervention group and n  = 19 in the control group due to two drop-outs in the control condition. Before and after the intervention or the waiting period, respectively, participants filled out a questionnaire battery assessing several body image and eating disorder related features. To quantify the perceptual component of body image disturbance, a digital photo distortion technique based on a picture of each participant taken in a standardized suit was applied. In a two-way ANOVA, significant Time × Group interactions were found for eating and shape concerns, drive for thinness, body dissatisfaction, depressiveness and low self-esteem. Follow-up t -tests indicated a significant symptom reduction of a generally high magnitude in the intervention group. No significant changes concerning body checking and the estimations of one's own "real", "felt" and "ideal" body dimensions were found. The strong symptom reduction in the cognitive-affective component of body image disturbance indicates that an exposure-based cognitive-behavioral body image intervention is a promising treatment module for overweight females with BED, but future research with a larger sample size is needed to quantify possible changes in all components of body image.

An Environmental Intervention to Prevent Excess Weight Gain in African American Students: A Pilot Study

PubMed Central

Newton, Robert L.; Han, Hongmei; Anton, Stephen D.; Martin, Corby K.; Stewart, Tiffany M.; Lewis, Leslie; Champagne, Catherine M.; Sothern, Melinda; Ryan, Donna; Williamson, Donald A.

2009-01-01

Purpose Examine the influence of an environmental intervention to prevent excess weight gain in African American children. Design Single-group repeated measures. Setting The intervention was delivered to a school composed of African American children. Subjects Approximately 45% (N = 77) of enrolled second through sixth grade students. Intervention The 18-month intervention was designed to alter the school environment to prevent excess weight gain by making healthier eating choices and physical activity opportunities more available. Measures Body Mass Index Percentile was the primary outcome variable. Body mass index Z-score was also calculated, and percent body fat, using bioelectrical impedance, was also measured. Total caloric intake (kcal), and percent kcal from fat, carbohydrate, and protein were measured by digital photography. Minutes of physical activity and sedentary behavior were self-reported. Analysis Mixed models analysis was used, covarying baseline values. Results Boys maintained while girls increased percent body fat over 18-months (p = .027). All children decreased percent of kcal consumed from total and saturated fat, and increased carbohydrate intake and self-reported physical activity during the intervention (p values < .025). body mass index Z-score, sedentary behavior, and total caloric intake were unchanged. Conclusion The program may have resulted in maintenance of percent body fat in boys. Girl's percent body fat steadily increased, despite similar behavioral changes as boys. School-based interventions targeting African American children should investigate strategies that can be effective across gender. PMID:20465148

A Pilot Intervention to Promote Safer Sex in Heterosexual Puerto Rican Couples

PubMed Central

Pérez-Jiménez, David; Seal, David Wyatt; Ronis, David L.

2014-01-01

Although the sexual transmission of HIV occurs in the context of an intimate relationship, preventive interventions with couples are scarce, particularly those designed for Hispanics. In this article, we present the effect of a pilot intervention directed to prevent HIV/AIDS in heterosexual couples in Puerto Rico. The intervention was theory-based and consisted of five three-hour group sessions. Primary goals included increasing male condom use and the practice of mutual masturbation as a safer sex method, and promoting favorable attitudes toward these behaviors. Twenty-six couples participated in this study. Fifteen were randomly assigned to the intervention group and eleven to a control group. Retention rates at post-intervention and follow-up were 82% for the whole sample. Results showed that there was a significant increase in the use of male condoms with main partners in the intervention group when compared with the control group. Couples in the intervention group also had better scores on secondary outcomes, such as attitudes toward condom use and mutual masturbation, HIV information, sexual decision-making, and social support. We found that these effects persisted over the three month follow up. A significant effect was also observed for the practice of mutual masturbation, but not for sexual negotiation. These results showed that promoting male condom use in dyadic interventions among heterosexual couples in Puerto Rico is feasible. Our findings suggest that because vaginal penetration has been constructed as the sexual script endpoint among many Hispanic couples, promoting other non-penetrative practices, such as mutual masturbation, may be difficult. PMID:25512880

A Pilot Intervention to Promote Safer Sex in Heterosexual Puerto Rican Couples.

PubMed

Pérez-Jiménez, David; Seal, David Wyatt; Ronis, David L

2014-09-01

Although the sexual transmission of HIV occurs in the context of an intimate relationship, preventive interventions with couples are scarce, particularly those designed for Hispanics. In this article, we present the effect of a pilot intervention directed to prevent HIV/AIDS in heterosexual couples in Puerto Rico. The intervention was theory-based and consisted of five three-hour group sessions. Primary goals included increasing male condom use and the practice of mutual masturbation as a safer sex method, and promoting favorable attitudes toward these behaviors. Twenty-six couples participated in this study. Fifteen were randomly assigned to the intervention group and eleven to a control group. Retention rates at post-intervention and follow-up were 82% for the whole sample. Results showed that there was a significant increase in the use of male condoms with main partners in the intervention group when compared with the control group. Couples in the intervention group also had better scores on secondary outcomes, such as attitudes toward condom use and mutual masturbation, HIV information, sexual decision-making, and social support. We found that these effects persisted over the three month follow up. A significant effect was also observed for the practice of mutual masturbation, but not for sexual negotiation. These results showed that promoting male condom use in dyadic interventions among heterosexual couples in Puerto Rico is feasible. Our findings suggest that because vaginal penetration has been constructed as the sexual script endpoint among many Hispanic couples, promoting other non-penetrative practices, such as mutual masturbation, may be difficult.

Cortisol Patterns for Young Children Displaying Disruptive Behavior: Links to a Teacher-Child, Relationship-Focused Intervention.

PubMed

Hatfield, Bridget E; Williford, Amanda P

2017-01-01

Supportive and close relationships that young children have with teachers have lasting effects on children's behavior and academic success, and this is particularly true for children with challenging behaviors. These relationships are also important for children's developing stress response system, and children in child care may be more likely to display atypical cortisol patterns at child care. However, warm, supportive relationships with teachers may buffer these negative effects of child care. While many relationship-focused early childhood interventions demonstrate changes in child behavior, associations with children's stress response system are unknown. This study assessed children's activity in the hypothalamic-pituitary-adrenal axis via salivary cortisol as a function of their participation in a dyadic intervention intended to improve a teacher's interaction quality with a particular child. Seventy teachers and 113 preschool children participated who were part of a larger study of teachers and children were randomly assigned at the classroom level across three intervention conditions: Banking Time, Time-Control Comparison (Child Time), and Business-as-Usual. At the end of the school year, children in the Banking Time condition displayed a significantly greater decline in cortisol across the morning during preschool compared to children in Business-as-Usual condition. These pilot results are among the first to provide preliminary evidence that school-based interventions that promote sensitive and responsive interactions may improve young children's activity in the stress response system within the child care/early education context.

The tailored activity program (TAP) to address behavioral disturbances in frontotemporal dementia: a feasibility and pilot study.

PubMed

O'Connor, Claire M; Clemson, Lindy; Brodaty, Henry; Low, Lee-Fay; Jeon, Yun-Hee; Gitlin, Laura N; Piguet, Olivier; Mioshi, Eneida

2017-10-15

To explore the feasibility of implementing the Tailored Activity Program with a cohort of people with frontotemporal dementia and their carers (dyads). The Tailored Activity Program is an occupational therapy based intervention that involves working collaboratively with family carers and prescribes personalized activities for behavioral management in people with dementia. Twenty dyads randomized into the study (Tailored Activity Program: n = 9; Control: n = 11) were assessed at baseline and 4-months. Qualitative analyzes evaluated feasibility and acceptability of the program for the frontotemporal dementia cohort, and quantitative analyzes (linear mixed model analyzes, Spearman's rho correlations) measured the impact of the program on the dyads. The Tailored Activity Program was an acceptable intervention for the frontotemporal dementia dyads. Qualitative analyses identified five themes: "carer perceived benefits", "carer readiness to change", "strategies used by carer to engage person with dementia", "barriers to the Tailored Activity Program uptake/implementation", and "person with dementia engagement". Quantitative outcomes showed an overall reduction of behavioral symptoms (F 18.34  = 8.073, p = 0.011) and maintenance of functional performance in the person with dementia (F 18.03  = 0.375, p = 0.548). This study demonstrates the potential for using an activity-based intervention such as the Tailored Activity Program in frontotemporal dementia. Service providers should recognize that while people with frontotemporal dementia present with challenging issues, tailored therapies may support their function and reduce their behavioral symptoms. Implications for rehabilitation The Tailored Activity Program is an occupational therapy based intervention that involves prescribing personalized activities for behavioral management in dementia. The Tailored Activity Program is an acceptable and feasible intervention approach to address some of the unique behavioral and functional impairments inherent in frontotemporal dementia.

Using Facebook in a Healthy Lifestyle Intervention: Feasibility and Preliminary Efficacy.

PubMed

Ling, Jiying; Robbins, Lorraine B; Zhang, Nanhua; Kerver, Jean M; Lyons, Haley; Wieber, Nicole; Zhang, Mi

2018-02-01

The purpose of this pilot quasi-experimental study was to examine the feasibility and preliminary efficacy of using Facebook in a 10-week lifestyle intervention with Head Start caregiver-preschooler dyads to improve healthy behaviors and reduce body mass index. Sixty-nine dyads participated with 39 in the intervention group. Average preschooler attendance rate for the Head Start center-based program was 77%, and caregiver participation rate was 87%. About 94% of the caregivers were satisfied with the program, and 97% would recommend the program to others and/or participate again. The intervention decreased preschoolers' body mass index z score (Cohen's d = -.30) and screen time ( d = -.21), and increased their fruit and vegetable intake ( d = .40) and moderate-to-vigorous physical activity ( d = .42). The intervention increased caregivers' fruit and vegetable intake ( d = .40). The intervention is feasible, and preliminary efficacy is encouraging, but further investigation using a rigorous study design is warranted.

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives

PubMed Central

Eisen, Jeffrey C.; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy

2013-01-01

Objective: To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. Method: The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). Results: While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Conclusion: Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. Trial Registration: ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912 PMID:24800110

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives.

PubMed

Eisen, Jeffrey C; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy; Van Voorhees, Benjamin W

2013-01-01

To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912.

Desarrollo de una intervención grupal para la prevención del VIH en parejas heterosexuales1

PubMed Central

Pérez-Jiménez, David; Escabí Montalvo, Aracelis; del Carmen Cabrera Aponte, María

2012-01-01

HIV preventive efforts with heterosexual couples are almost nonexistent. We designed a group intervention based on the Information-Motivation-Behavioral Skills model with the aim of increasing male condom use and promoting the practice of mutual masturbation as a safer sex alternative. We carried out a pilot study with four couples to evaluate the feasibility of the intervention and the aspects of content and format that needed to be modified. Findings reflect that participants were very satisfied with the intervention and they found it entertaining and innovative. They were very comfortable with its format, as well as with the activities. The findings confirm the feasibility of this intervention and the need to direct preventive efforts to this population. PMID:23847716

Motivational Interviewing in Health Care: Results of a Brief Training in Endocrinology

PubMed Central

Bean, Melanie K.; Biskobing, Diane; Francis, Gary L.; Wickham, Edmond

2012-01-01

Background Despite the importance of lifestyle change in disease management and the growing evidence supporting motivational interviewing (MI) as an effective counseling method to promote behavioral change, to date there are few published reports about MI training in graduate medical education. Objective The study aimed to pilot the feasibility and effectiveness of a brief MI training intervention for endocrinology fellows and other providers. Methods We used a pretest/posttest design to evaluate a brief MI training for 5 endocrinology fellows and 9 other providers. All participants completed subjective assessments of perceived confidence and beliefs about behavioral counseling at pretest and posttest. Objective assessment of MI was conducted using fellows' audiotaped patient encounters, which were coded using a validated tool for adherence to MI before and after the training. Paired t tests examined changes in objective and subjective assessments. Results The training intervention was well received and feasible in the endocrinology setting. At posttest, participants reported increased endorsement of the MI spirit and improved confidence in MI skills. Objective assessment revealed relative improvements in MI skills across several domains. However, most domains, as assessed by a validated tool, did not reach competency level after the training intervention. Conclusions Although more intensive training may be needed to develop MI competence, the results of our pilot study suggest that brief, targeted MI training has short-term efficacy and is well received by endocrinology fellows and other providers. PMID:23997882

Pilot testing of the "First You Should Get Stronger" program among caregivers of older adults with dementia.

PubMed

Lök, Neslihan; Bademli, Kerime

In this study, randomized controlled interventional study pattern was used to examine the effects of the "First You Should Get Stronger" program on the caregiving burden and healthy life style behavior of caregivers of dementia patients. "Zarit Caregiver Burden Scale" and "Healthy Life Style Behavior Scale" were used. The study was completed with 40 caregivers in total with 20 in the intervention group and 20 in the control group. A statistically significant difference was determined between the "Zarit Caregiving Burden Scale" and "Healthy Life Style Behavior Scale" score averages of the intervention group that participated in the "First You Should Get Stronger" program in comparison with those of the control group. It is important for the healths of caregivers to include similar programs for the caregivers of dementia patients in continuous and regular applications. The results highlight the importance of the "First You Should Get Stronger" program significantly decreased the caregiving burden and significantly developed the healthy lifestyle behaviors of caregivers in the intervention group. Since dementia is a difficult neurological syndrome with patients cared at home, it generally wears out the caregivers significantly. It is suggested that the nurses and healthcare professionals working with dementia patients are evaluated separately and that they carry out caregiving applications within the scope of the "First You Should Get Stronger" program. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial

PubMed Central

Burzinski, Cindy A.; Cox, Jennifer; Kloke, John; Stegner, Aaron; Cook, Dane B.; Singles, Janice; Mirgain, Shilagh; Coe, Christopher L.; Bačkonja, Miroslav

2016-01-01

Objective. To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). Design. 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). Setting. Outpatient. Subjects. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months. Methods. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein). Results. Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen’s d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits. Conclusions. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP. PMID:26968850

Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial.

PubMed

Zgierska, Aleksandra E; Burzinski, Cindy A; Cox, Jennifer; Kloke, John; Stegner, Aaron; Cook, Dane B; Singles, Janice; Mirgain, Shilagh; Coe, Christopher L; Bačkonja, Miroslav

2016-10-01

To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). Outpatient. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein). Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen's d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A weight-loss intervention program designed for Mexican-American women: cultural adaptations and results.

PubMed

Lindberg, Nangel M; Stevens, Victor J; Vega-López, Sonia; Kauffman, Tia L; Calderón, Mariana Rosales; Cervantes, María Antonieta

2012-12-01

This study assessed the feasibility of a culturally-appropriate weight-loss intervention targeting obese Spanish-speaking Mexican women. This 12-month weight-loss program was based on behavioral interventions previously used successfully with English-speaking participants. Cultural adaptations included: female interventionists, minimal written materials, emphasis on group activities, focus on Mexican traditions and beliefs, and skill-building approach to food measurement. All sessions were conducted in Spanish. The study had few exclusionary criteria, which allowed participation of women with a wide range of literacy levels. Recruitment exceeded expectations, with 47 participants enrolling in the program. Not counting participants who became pregnant during the study, attendance at 6 and 12 months was 62 and 50 % respectively. Mean weight loss at 6 and 12 months was 5.3 and 7.2 kg, respectively, with a mean reduction in BMI of 4.0 and 5.5 kg/m(2) from baseline to 6 and 12 months, respectively. This pilot study shows that it is feasible to develop and implement culturally-appropriate behavioral lifestyle interventions for obesity treatment in Mexican-American women.

The design and progress of a multidomain lifestyle intervention to improve brain health in middle-aged persons to reduce later Alzheimer's disease risk: The Gray Matters randomized trial.

PubMed

Norton, Maria C; Clark, Christine J; Tschanz, JoAnn T; Hartin, Phillip; Fauth, Elizabeth B; Gast, Julie A; Dorsch, Travis E; Wengreen, Heidi; Nugent, Chris; Robinson, W David; Lefevre, Michael; McClean, Sally; Cleland, Ian; Schaefer, Sydney Y; Aguilar, Sheryl

2015-06-01

Most Alzheimer's disease (AD) prevention studies focus on older adults or persons with existing cognitive impairment. This study describes the design and progress of a novel pilot intervention, the Gray Matters study. This proof-of-concept randomized controlled trial tests an evidence-based multidomain lifestyle intervention in 146 persons aged 40 to 64 years, in northern Utah. Data collectors were blinded to participants' randomization to treatment (n = 104) or control (n = 42). Intervention targeted physical activity, food choices, social engagement, cognitive simulation, sleep quality, and stress management, and uses a custom smartphone application, activity monitor, and educational materials. Secondary outcomes include biomarkers, body mass index, cognitive testing, and psychological surveys. Midway through the study, achievements include a 98.7% retention rate, a 96% rate of compliance with app data entry, and positive trends in behavioral change. Participants were empowered, learning that lifestyle might impact AD risk, exhibiting positive behavioral changes thus far.

Pilot study of the Korean Parent Training Program using a partial group randomized experimental study

PubMed Central

Kim, Eunjung; Cain, Kevin; Boutain, Doris; Chun, Jin-Joo; Kim, Sangho; Im, Hyesang

2017-01-01

Problems Korean American (KA) children experience mental health problems due to difficulties in parenting dysfunction complicated by living in two cultures. Methods Korean Parent Training Program (KPTP) was pilot tested with 48 KA mothers of children (ages 3–8) using partial group randomized controlled experimental study design. Self-report survey and observation data were gathered. Findings Analyses using generalized estimating equation indicated the intervention group mothers increased effective parenting and their children decreased behavior problems and reported less acculturation conflict with mothers. Conclusions The KPTP is a promising way to promote effective parenting and increase positive child mental health in KA families. PMID:24645901

The role of situation assessment and flight experience in pilots' decisions to continue visual flight rules flight into adverse weather.

PubMed

Wiegmann, Douglas A; Goh, Juliana; O'Hare, David

2002-01-01

Visual flight rules (VFR) flight into instrument meteorological conditions (IMC) is a major safety hazard in general aviation. In this study we examined pilots' decisions to continue or divert from a VFR flight into IMC during a dynamic simulation of a cross-country flight. Pilots encountered IMC either early or later into the flight, and the amount of time and distance pilots flew into the adverse weather prior to diverting was recorded. Results revealed that pilots who encountered the deteriorating weather earlier in the flight flew longer into the weather prior to diverting and had more optimistic estimates of weather conditions than did pilots who encountered the deteriorating weather later in the flight. Both the time and distance traveled into the weather prior to diverting were negatively correlated with pilots' previous flight experience. These findings suggest that VFR flight into IMC may be attributable, at least in part, to poor situation assessment and experience rather than to motivational judgment that induces risk-taking behavior as more time and effort are invested in a flight. Actual or potential applications of this research include the design of interventions that focus on improving weather evaluation skills in addition to addressing risk-taking attitudes.

An Evaluation of the Effectiveness of the National Aeronautics and Space Administration Mission-X Child Health Promotion Program in the United States.

PubMed

Min, Jungwon; Tan, Zhengqi; Abadie, Laurie; Townsend, Scott; Xue, Hong; Wang, Youfa

2017-01-01

To examine the effects of the National Aeronautics and Space Administration Mission-X: Train Like an Astronaut program (MX) on children's health-related knowledge and behaviors of a sample of US participants. A nonexperimental pilot intervention study in 5 cities with a pre-post comparison of children's health-related knowledge and behaviors in the United States in 2014 and 2015. Children (n = 409) with a mean age (standard deviation) of 10.1 (1.7) years. Children answered pre- and postintervention questionnaires. We measured the differences in children's health knowledge on nutrition and physical fitness and behaviors on diet and physical activity as scores. A 6-week web- and school-based intervention for a healthier lifestyle by introducing physical fitness and science activities based on actual astronaut training under a teacher's supervision. Nonparametric analysis and logistic regression models. Participants significantly improved both of their health behaviors on physical activity ( P < .001) and diet ( P = .06) and their health knowledge regarding nutrition ( P < .001) and physical fitness ( P < .001) after the intervention. The improvement in children's behaviors ( P < .001), knowledge ( P < .001), and the total score ( P < .001) after intervention did not significantly vary by sex or age, after adjusting for year of participation and state of residency. The MX seems effective in improving health behaviors and health knowledge of participating children, which may serve as a model for sustainable global child health promotion program. Further research is needed to test its long-term effects on child health.

Results of a Pilot Study to Investigate Community College Student Perceptions of the Value of an Online Health-Risk Reduction Program

ERIC Educational Resources Information Center

Donovan, Elizabeth; Hernandez, Jack; Chiauzzi, Emil; DasMahapatra, Pronabesh; Achilles, Tyler; Hemm, Amanda

2012-01-01

Health is associated with academic success. Universal, web-based interventions to reduce risks associated with alcohol and other drug use have been found to be effective at changing four-year college students' health behaviors. An online health program may also be well-suited to a community college population, as it can reach students off campus…

A pilot demonstration of comprehensive mental health services in inner-city public schools.

PubMed

Walter, Heather J; Gouze, Karen; Cicchetti, Colleen; Arend, Richard; Mehta, Tara; Schmidt, Janet; Skvarla, Madelynn

2011-04-01

National policy statements increasingly espouse the delivery of comprehensive mental health services in schools. In response to the limited evidence supporting this recommendation, the purpose of this study was to assess the need for, and feasibility, desirability, and outcomes of a full model of comprehensive mental health services in 2 public elementary schools in inner-city neighborhoods. The program, based upon a national model for comprehensive school mental health services, comprised universal and indicated preventive as well as clinical interventions designed to target needs identified in a baseline screening survey. The program was implemented over 1 school year by mental health professionals in collaboration with school teachers. Mental health outcomes comparing baseline to follow-up data were assessed in multiple domains among students and teachers. After 1 year of intervention, students had significantly fewer mental health difficulties, less functional impairment, and improved behavior, and reported improved mental health knowledge, attitudes, beliefs, and behavioral intentions. Teachers reported significantly greater proficiency in managing mental health problems in their classrooms. School staff overwhelmingly endorsed satisfaction with the program. If the observed favorable findings from this pilot demonstration can be replicated in methodologically rigorous studies, additional support would be garnered for national policy recommendations about comprehensive school mental health services. © 2011, American School Health Association.

Participant recruitment and retention in a pilot program to prevent weight gain in low-income overweight and obese mothers.

PubMed

Chang, Mei-Wei; Brown, Roger; Nitzke, Susan

2009-11-21

Recruitment and retention are key functions for programs promoting nutrition and other lifestyle behavioral changes in low-income populations. This paper describes strategies for recruitment and retention and presents predictors of early (two-month post intervention) and late (eight-month post intervention) dropout (non retention) and overall retention among young, low-income overweight and obese mothers participating in a community-based randomized pilot trial called Mothers In Motion. Low-income overweight and obese African American and white mothers ages 18 to 34 were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in southern Michigan. Participants (n = 129) were randomly assigned to an intervention (n = 64) or control (n = 65) group according to a stratification procedure to equalize representation in two racial groups (African American and white) and three body mass index categories (25.0-29.9 kg/m(2), 30.0-34.9 kg/m(2), and 35.0-39.9 kg/m(2)). The 10-week theory-based culturally sensitive intervention focused on healthy eating, physical activity, and stress management messages that were delivered via an interactive DVD and reinforced by five peer-support group teleconferences. Forward stepwise multiple logistic regression was performed to examine whether dietary fat, fruit and vegetable intake behaviors, physical activity, perceived stress, positive and negative affect, depression, and race predicted dropout as data were collected two-month and eight-month after the active intervention phase. Trained personnel were successful in recruiting subjects. Increased level of depression was a predictor of early dropout (odds ratio = 1.04; 95% CI = 1.00, 1.08; p = 0.03). Greater stress predicted late dropout (odds ratio = 0.20; 95% CI = 0.00, 0.37; p = 0.01). Dietary fat, fruit, and vegetable intake behaviors, physical activity, positive and negative affect, and race were not associated with either early or late dropout. Less negative affect was a marginal predictor of participant retention (odds ratio = 0.57; 95% CI = 0.31, 1.03; p = 0.06). Dropout rates in this study were higher for participants who reported higher levels of depression and stress. Current Controlled Trials NCT00944060.

Chronic disease self-management: a hybrid concept analysis.

PubMed

Miller, Wendy R; Lasiter, Sue; Bartlett Ellis, Rebecca; Buelow, Janice M

2015-01-01

Chronic diseases require chronic disease self-management (CDSM). Existing CDSM interventions, while improving outcomes, often do not lead to long-lasting effects. To render existing and new CDSM interventions more effective, an exploration of the concept of CDSM from both the literature and patient perspectives is needed. The purpose of this study was to describe the current conceptualization of CDSM in the literature, identify potential inadequacies in this conceptualization based on a comparison of literature- and patient-based CDSM descriptions, and to offer a more comprehensive definition of CDSM. A hybrid concept analysis was completed. In the literature, CDSM is defined as behaviors influenced by individual characteristics. Patients in the fieldwork phase discussed aspects of CDSM not well represented in the literature. CDSM is a complex process involving behaviors at multiple levels of a person's environment. Pilot work to develop and test CDSM interventions based on both individual and external characteristics is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial

PubMed Central

Oliveira-Filho, Alfredo D.; Morisky, Donald E.; Costa, Francisco A.; Pacheco, Sara T.; Neves, Sabrina F.; Lyra-Jr, Divaldo P.

2014-01-01

Background Effective interventions to improve medication adherence are usually complex and expensive. Objective To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD. Method A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates. Results 61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups. Conclusion The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes. PMID:25590930

The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention.

PubMed

Jortberg, Bonnie T; Rosen, Raquel; Roth, Sarah; Casias, Luke; Dickinson, L Miriam; Coombs, Letoynia; Awadallah, Nida S; Bernardy, Meaghann K; Dickinson, W Perry

2016-01-01

Childhood obesity has increased dramatically over several decades, and the American Academy of Pediatrics has recommended primary care practices as ideal sites for the identification, education, and implementation of therapeutic interventions. The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care-based childhood obesity intervention. A single-intervention pilot project that trains primary care practices on childhood obesity guidelines and implementation of a family-focused behavior modification curriculum. A total of 29 family medicine and pediatric community practices in Colorado participated. Participants included 290 patients, aged 6 to 12 years, with a body mass index (BMI) above the 85th percentile. The main outcome measure included the feasibility of implementation of a childhood obesity program in primary care; secondary outcomes were changes in BMI percentile, BMI z-scores, blood pressure, and changes in lifestyle factors related to childhood obesity. Implementation of FFC is feasible, statically significant changes were seen for decreases in BMI percentile and BMI z-scores for participants who completed 9 to 15 months of follow-up; lifestyle factors related to childhood obesity in proved Spanish-speaking families and food insecurity were associated with less follow-up time (P < .01). A primary care-based childhood obesity intervention may result in significant clinical and lifestyle changes. © Copyright 2016 by the American Board of Family Medicine.

Randomized clinical trial to change parental practices for drug use in a telehealth prevention program: a pilot study.

PubMed

Valente, Juliana Y; Moreira, Tais Campos; Ferigolo, Maristela; Barros, Helena M T

2018-03-21

Programs for parents have been found to have a direct positive impact on reducing the consumption of psychoactive substances by adolescents, as well as having an indirect impact on reducing risk factors and increasing protective factors. The present study aimed to verify if a telehealth prevention program based on a brief motivational intervention helps to reduce parental risk practices and increase parental protective practices for drug use in comparison with psychoeducation. A pilot randomized controlled trial was performed at the National Service of Guidance and Information on Drug Use (Ligue 132), from September 2014 to December 2015, with the parents of adolescents (n=26). The outcome measures were parental style, risk, and protective parental practices. The brief motivational intervention was found to be more effective than psychoeducation in reducing the negligent behavior of parents. Furthermore, when comparing pre- and post-intervention data, the brief motivational intervention helped to change parental style and the large majority of parental practices: increasing positive monitoring, as well as decreasing physical abuse, relaxed discipline, inconsistent punishment, and negative monitoring. These results demonstrate that the telehealth intervention is effective in modifying the parental practices known to help in preventing drug use. Studies with more number of subjects are required so that the results can be substantiated and generalized. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The effect of a yoga intervention on alcohol and drug abuse risk in veteran and civilian women with posttraumatic stress disorder.

PubMed

Reddy, Shivani; Dick, Alexandra M; Gerber, Megan R; Mitchell, Karen

2014-10-01

Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse. Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies. The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests. The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy. Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.

Mobile Health Technology Using a Wearable Sensorband for Female College Students With Problem Drinking: An Acceptability and Feasibility Study

PubMed Central

Silverman, Michelle; Sherpa, Dawa Phuti; Naegle, Madeline A; Kim, Hyorim; Coffman, Donna L; Ferdschneider, Marcy

2017-01-01

Background An increasing number of mobile app interventions have been developed for problem drinking among college students; however, few studies have examined the integration of a mobile app with continuous physiological monitoring and alerting of affective states related to drinking behaviors. Objective The aim of this paper was to evaluate the acceptability and feasibility of Mind the Moment (MtM), a theoretically based intervention for female college students with problem drinking that combines brief, in-person counseling with ecological momentary intervention (EMI) on a mobile app integrated with a wearable sensorband. Methods We recruited 10 non-treatment seeking, female undergraduates from a university health clinic who scored a 3 or higher on the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) to participate in this pilot study. Study activities involved an in-person baseline intake and 1 follow-up assessment, 2 in-person alcohol brief intervention counseling sessions, and use of MtM technology components (sensorband and EMI on a mobile app) for approximately 3-4 weeks. The intervention used motivational interviewing (MI) and cognitive behavioral therapy (CBT) strategies for reducing risks associated with drinking. We used both qualitative and quantitative assessments to measure acceptability of the intervention and feasibility of delivery. Use patterns of the sensorband and mobile app were also collected. Results Quantitative and qualitative data indicated high levels of acceptability for the MtM intervention. Altogether, participants made reports on the app on 26.7% (78/292) the days the technology was available to them and completed a total of 325 reports with wide variation between participants. Qualitative findings indicated that sensorband-elicited alerts promoted an increase in awareness of thoughts, feelings, and behaviors related to current environmental stressors and drinking behaviors in theoretically meaningful ways. Specific challenges related to functionality and form of the sensorband were identified. Conclusions Delivering intervention material “just-in-time,” at the moment participants need to use behavioral strategies has great potential to individualize behavioral interventions for reducing problem drinking and other health behaviors. These findings provide initial evidence for the promise of wearable sensors for increasing potency of theoretically grounded mobile health interventions and point to directions for future research and uptake of these technologies. PMID:28687533

Esuba: a psychoeducation group for incarcerated survivors of abuse.

PubMed

Roe-Sepowitz, Dominique E; Bedard, Laura E; Pate, Kerensa N; Hedberg, E C

2014-02-01

This study examined the effects associated with a trauma and abuse-focused psychoeducation group for incarcerated women on decreasing trauma symptoms. A total of 320 women participated in 34 groups in five prisons that followed a manualized intervention. A one-group pretest-posttest design was used to examine changes on 10 Trauma Symptom Inventory subscales (Anxious Arousal, Depression, Anger/Irritability, Intrusive Experiences, Defensive Avoidance, Dissociation, Sexual Concerns, Dysfunctional Sexual Behavior, Impaired Self-Reference, and Tension Reduction Behavior). Analyses indicated significant improvement on all 10 trauma subscales. Small effect sizes were found on all of the subscales. The findings of this study are encouraging and are the first step toward more rigorous evaluation of this pilot program. These findings provide initial support for the use of group psychoeducation intervention to address traumatic stress symptoms with incarcerated women.

Team play with a powerful and independent agent: a full-mission simulation study.

PubMed

Sarter, N B; Woods, D D

2000-01-01

One major problem with pilot-automation interaction on modern flight decks is a lack of mode awareness; that is, a lack of knowledge and understanding of the current and future status and behavior of the automation. A lack of mode awareness is not simply a pilot problem; rather, it is a symptom of a coordination breakdown between humans and machines. Recent changes in automation design can therefore be expected to have an impact on the nature of problems related to mode awareness. To examine how new automation properties might affect pilot-automation coordination, we performed a full-mission simulation study on one of the most advanced automated aircraft, the Airbus A-320. The results of this work indicate that mode errors and "automation surprises" still occur on these advanced aircraft. However, there appear to be more opportunities for delayed or missing interventions with undesirable system activities, possibly because of higher system autonomy and coupling.

An Evaluation of the Hoʻouna Pono Curriculum: A Pilot Study of Culturally Grounded Substance Abuse Prevention for Rural Hawaiian Youth

PubMed Central

Okamoto, Scott K.; Kulis, Stephen; Helm, Susana; Lauricella, Michela; Valdez, Jessica K.

2016-01-01

This pilot study evaluated the Hoʻouna Pono curriculum, which is a culturally grounded, school-based, drug prevention curriculum tailored to rural Native Hawaiian youth. The curriculum focuses on culturally relevant drug resistance skills training and is aligned with the State of Hawaiʻi academic standards. Six Hawaiʻi Island public middle/intermediate schools randomly assigned to intervention or treatment-as-usual comparison conditions (N = 213) were evaluated in this study. Paired sample t-tests separating intervention and comparison groups were conducted, as well as mixed models that adjusted for random effects (nesting) at the school level. Findings suggested that the curriculum was effective in maintaining youths’ use of culturally relevant drug resistance skills, as well as decreasing girls’ aggressive behaviors, at six-month follow up. Unanticipated findings also suggested areas for curricular improvement, including more emphasis on normative drug education. Implications for future research and development of the curriculum are discussed. PMID:27180710

Personalized Treatment of Mothers With ADHD and Their Young At-Risk Children: A SMART Pilot.

PubMed

Chronis-Tuscano, Andrea; Wang, Christine H; Strickland, Jennifer; Almirall, Daniel; Stein, Mark A

2016-01-01

Young children of mothers with adult attention-deficit/hyperactivity disorder (ADHD) are at risk for ADHD by virtue of genetics and environmental factors. Moreover, parent ADHD is associated with maladaptive parenting and poor child behavioral treatment response. Thus, a combined approach consisting of behavioral parent training (BPT) and maternal stimulant medication (MSM) may be needed to effectively treat ADHD within families. However, providing combined BPT+MSM initially to all families may be unnecessarily burdensome because not all families likely need combined treatment. The purpose of this study is to examine how to combine, sequence, and personalize treatment for these multiplex families in order to yield benefits to both the parent and child, thereby impacting the course of child ADHD and disruptive behavior symptoms. This article presents our rationale for, design of, and preliminary experiences (based on 26 participants) with an ongoing pilot Sequential Multiple Assessment Randomized Trial (SMART) designed to answer questions regarding the feasibility and acceptability of study protocols and interventions. This article also describes how the subsequent full-scale SMART might change based on what is learned in the SMART pilot and illustrates how the full-scale SMART could be used to inform clinical decision making about how to combine, sequence, and personalize treatment for complex children and families in which a parent has ADHD.

Testing a Risky Sex Behavior Intervention Pilot Website for Adolescents

PubMed Central

Starling, Randall; Helme, Don; Nodulman, Jessica A.; Bryan, Angela D.; Buller, David B.; Donohew, Robert Lewis; Woodall, W. Gill

2015-01-01

Background and Purpose Each year, teenagers account for about one-fifth of all unintended pregnancies in the United States. As such, delivering sexual risk reduction educational materials to teens in a timely fashion is of critical importance. Web-based delivery of these materials shows promise for reaching and persuading teens away from risky sexual and substance abuse behaviors. The purpose of this study was to pilot test a web-based program aimed at reducing risky sexual behavior and related outcomes among adolescents in a high school setting. Methods A beta-test of the website was conducted in three public schools in New Mexico, USA with 173 students in 9th and 10th grades recruited from existing health education classes. Participants spent approximately three hours over a period of two days completing the online program in school computer labs. Results Pretest to posttest results indicated that self-efficacy for condom use and condom use intentions, two theoretical mediators of changes in condom use behavior, were significantly changed. Adolescents also reported high satisfaction with the website content. Conclusion BReady4it provided an innovative sex and substance abuse education to teenagers that revealed promising positive changes in cognitive constructs that are inversely related to risky sexual behavior among users. PMID:26167134

The Development of a Social Networking-Based Relatedness Intervention Among Young, First-Time Blood Donors: Pilot Study.

PubMed

Frye, Victoria; Duffy, Louisa; France, Janis L; Kessler, Debra A; Rebosa, Mark; Shaz, Beth H; Carlson, Bruce W; France, Christopher R

2018-04-26

Increasing repeat blood donation behavior is a critical public health goal. According to self-determination theory, the process of developing internal motivation to give blood and an associated self-identity as a blood donor may be promoted by feelings of “relatedness” or a connection to other donors, which may be enhanced through social relations and interactions. The purpose of this report it to describe the development and pilot testing of a social networking-based (Facebook) intervention condition designed to increase feelings of relatedness via virtual social interaction and support. To develop the intervention condition content, images, text, polls, and video content were assembled. Ohio University college students (N=127) rated the content (82 images/text) presented by computer in random order using a scale of one to five on various dimensions of relatedness. Mean ratings were calculated and analyses of variance were conducted to assess associations among the dimensions. Based on these results, the relatedness intervention was adapted and evaluated for feasibility, acceptability, and preliminary efficacy among 24 first-time donors, aged 18 to 24 years, in a 30-day pilot trial. Paired t-tests were conducted to examine change over time in relatedness and connectedness. The intervention condition that was developed was acceptable and feasible. Results of the uncontrolled, preintervention, and postintervention evaluation revealed that feelings of individual-level relatedness increased significantly after the intervention. By promoting first-time blood donor relatedness, our goal is to enhance internal motivation for donating and the integration of the blood donor identity, thus increasing the likelihood of future repeat donation. ClinicalTrials.gov NCT02717338; https://clinicaltrials.gov/ct2/show/NCT02717338 (Archived by WebCite at http://www.webcitation.org/6ymHRBCwu) ©Victoria Frye, Louisa Duffy, Janis L France, Debra A Kessler, Mark Rebosa, Beth H Shaz, Bruce W Carlson, Christopher R. France. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 26.04.2018.

A true challenge for any superhero: an evaluation of a comic book obesity prevention program.

PubMed

Branscum, Paul; Sharma, Manoj; Wang, Lihshing Leigh; Wilson, Bradley R A; Rojas-Guyler, Liliana

2013-01-01

The purpose of this study was to pilot test the Comics for Health program, a theory-based nutrition and physical activity intervention for children. Twelve after-school programs were randomized to either a theory-based (n = 37) or a knowledge-based (n = 34 children) version of the intervention. Pretests, posttests, and 3-month follow-up tests were administered to evaluate the programmatic effects on body mass index percentile, obesity-related behaviors, and constructs of social cognitive theory. Both interventions found significant, yet modest effects for fruit and vegetable consumption (P < .005), physical activities (P < .004), and water and sugar-free beverage consumption (P < .001) and self-efficacy for fruit and vegetable consumption (P < .015) and physical activities (P < .009).

A pilot crossover study: effects of an intervention using an activity monitor with computerized game functions on physical activity and body composition.

PubMed

Nishiwaki, Masato; Kuriyama, Akinori; Ikegami, Yumi; Nakashima, Nana; Matsumoto, Naoyuki

2014-12-02

Wearing an activity monitor as a motivational tool and incorporating a behavior-based reward system or a computerized game element might have a synergistic effect on an increase in daily physical activity, thereby inducing body fat reduction. This pilot crossover study aimed to examine the effects of a short-term lifestyle intervention using an activity monitor with computerized game functions on physical activity and body composition. Twenty healthy volunteers (31 ± 3 years) participated in a 12-week crossover study. The participants were randomly assigned to either Group A (a 6-week game intervention followed by a 6-week normal intervention) or Group B (a 6-week normal intervention followed by a 6-week game intervention). The participants wore both a normal activity monitor (Lifecorder EX) and an activity monitor with computerized game functions (Yuuhokei) during the game intervention, whereas they only wore a normal activity monitor during the normal intervention. Before, during, and after the intervention, body composition was assessed. Significantly more daily steps were recorded for the game intervention than for the normal intervention (10,520 ± 562 versus 8,711 ± 523 steps/day, P < 0.01). The participants performed significantly more physical activity at an intensity of ≥ 3 metabolic equivalents (METs) in the game intervention than in the normal intervention (3.1 ± 0.2 versus 2.4 ± 0.2 METs · hour/day, P < 0.01). Although body mass and fat were significantly reduced in both periods (P < 0.01), the difference in body fat reduction was significantly greater in the game intervention than in the normal intervention (P < 0.05). A short-term intervention using an activity monitor with computerized game functions increases physical activity and reduces body fat more effectively than an intervention using a standard activity monitor.

Restoring effective sleep tranquility (REST): A feasibility and pilot study.

PubMed

Eakman, Aaron M; Schmid, Arlene A; Henry, Kimberly L; Rolle, Natalie R; Schelly, Catherine; Pott, Christine E; Burns, Joshua E

2017-06-01

The purpose of this pilot study was to establish the feasibility of completing a future controlled trial of a multi-component cognitive behavioral therapy for insomnia program for military veterans with sleep disturbance. This was a single-arm feasibility and pilot study. Participants were United States post-9/11 veterans with service-connected injuries, university students, and had self-reported sleep disturbances. Restoring Effective Sleep Tranquility was a multi-component cognitive behavioral therapy for insomnia intervention consisting of seven sessions of group therapy and eight 1:1 sessions delivered by occupational therapists. Feasibility and pilot indicators were process, resources, management, and scientific, including pre-post-assessments of sleep difficulties, dysfunctional sleep beliefs, participation, and pain interference. Indicators were supportive of feasibility, including reduced sleep difficulties (for example Medical Outcomes Study Sleep Measure [ t  = 3.29, p  = .02]), reduced nightmares: t  = 2.79, p  = .03; fewer dysfunctional sleep beliefs: t  = 3.63, p  = .01, and greater ability to participate in social roles: t  = -2.86, p  = .03, along with trends towards improved satisfaction with participation and reduced pain interference. The Restoring Effective Sleep Tranquility program may reduce sleep difficulties and improve participation in US veterans with service-connected injuries, and evidence indicates a controlled trial would be feasible to deliver.

Restoring effective sleep tranquility (REST): A feasibility and pilot study

PubMed Central

Schmid, Arlene A; Henry, Kimberly L; Rolle, Natalie R; Schelly, Catherine; Pott, Christine E; Burns, Joshua E

2017-01-01

Introduction The purpose of this pilot study was to establish the feasibility of completing a future controlled trial of a multi-component cognitive behavioral therapy for insomnia program for military veterans with sleep disturbance. Method This was a single-arm feasibility and pilot study. Participants were United States post-9/11 veterans with service-connected injuries, university students, and had self-reported sleep disturbances. Restoring Effective Sleep Tranquility was a multi-component cognitive behavioral therapy for insomnia intervention consisting of seven sessions of group therapy and eight 1:1 sessions delivered by occupational therapists. Feasibility and pilot indicators were process, resources, management, and scientific, including pre–post-assessments of sleep difficulties, dysfunctional sleep beliefs, participation, and pain interference. Findings Indicators were supportive of feasibility, including reduced sleep difficulties (for example Medical Outcomes Study Sleep Measure [t = 3.29, p = .02]), reduced nightmares: t = 2.79, p = .03; fewer dysfunctional sleep beliefs: t = 3.63, p = .01, and greater ability to participate in social roles: t = –2.86, p = .03, along with trends towards improved satisfaction with participation and reduced pain interference. Conclusion The Restoring Effective Sleep Tranquility program may reduce sleep difficulties and improve participation in US veterans with service-connected injuries, and evidence indicates a controlled trial would be feasible to deliver. PMID:28626295

Efficacy of a Food Safety Comic Book on Knowledge and Self-Reported Behavior for Persons Living with AIDS

PubMed Central

Dworkin, Mark S.; Peterson, Caryn E.; Gao, Weihua; Mayor, Angel; Hunter, Robert; Negron, Edna; Fleury, Alison; Besch, C. Lynn

2013-01-01

Introduction Persons living with AIDS are highly vulnerable to foodborne enteric infections with the potential for substantial morbidity and mortality. Educational materials about foodborne enteric infections intended for this immunocompromised population have not been assessed for their efficacy in improving knowledge or encouraging behavior change. Methods/Results AIDS patients in four healthcare facilities in Chicago, New Orleans, and Puerto Rico were recruited using fliers and word of mouth to healthcare providers. Those who contacted research staff were interviewed to determine food safety knowledge gaps and risky behaviors. A food safety educational comic book that targeted knowledge gaps was created, piloted, and provided to these patients who were instructed to read it and return at least 2 weeks later for a follow-up interview. The overall food safety score was determined by the number of the 26 knowledge/belief/behavior questions from the survey answered correctly. Among 150 patients who participated in both the baseline and follow-up questionnaire, the intervention resulted in a substantial increase in the food safety score (baseline 59%, post-intervention 81%, p<0.001). The intervention produced a significant increase in all the food safety knowledge, belief, and behavior items that comprised the food safety score. Many of these increases were from baseline knowledge below 80 percent to well above 90%. Most (85%) of the patients stated they made a change to their behavior since receiving the educational booklet. Conclusion This comic book format intervention to educate persons living with AIDS was highly effective. Future studies should examine to what extent long-term behavioral changes result. PMID:24124447

The effects of an early motor skill intervention on motor skills, levels of physical activity, and socialization in young children with autism spectrum disorder: A pilot study.

PubMed

Ketcheson, Leah; Hauck, Janet; Ulrich, Dale

2017-05-01

Despite evidence suggesting one of the earliest indicators of an eventual autism spectrum disorder diagnoses is an early motor delay, there remain very few interventions targeting motor behavior as the primary outcome for young children with autism spectrum disorder. The aim of this pilot study was to measure the efficacy of an intensive motor skill intervention on motor skills (Test of Gross Motor Development-2), physical activity (accelerometers), and socialization (Playground Observation of Peer Engagement) in young children with autism spectrum disorder. A total of 20 children with autism spectrum disorder aged 4-6 years participated. The experimental group ( n = 11) participated in an 8-week intervention consisting of motor skill instruction for 4 h/day, 5 days/week. The control group ( n = 9) did not receive the intervention. A repeated-measures analysis of covariance revealed statistically significant differences between groups in all three motor outcomes, locomotor ( F(1, 14) = 10.07, p < 0.001, partial η 2  = 0.42), object control ( F(1, 14) = 12.90, p < 0.001, partial η 2  = 0.48), and gross quotient ( F(1, 14) = 15.61, p < 0.01, partial η 2  = 0.53). Findings shed light on the importance of including motor programming as part of the early intervention services delivered to young children with autism spectrum disorder.

Evaluation of a community health worker pilot intervention to improve diabetes management in Bangladeshi immigrants with type 2 diabetes in New York City.

PubMed

Islam, Nadia S; Wyatt, Laura C; Patel, Shilpa D; Shapiro, Ephraim; Tandon, S Darius; Mukherji, B Runi; Tanner, Michael; Rey, Mariano J; Trinh-Shevrin, Chau

2013-01-01

The purpose of this study is to explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve diabetes management among Bangladeshi-American individuals with type 2 diabetes living in New York City. Participants were recruited at clinic- and community-based venues. The intervention consisted of 6 monthly, CHW-facilitated group sessions on topics related to management of diabetes. Surveys were collected at baseline and follow-up time points. Study outcomes included clinical, behavioral, and satisfaction measures for participants, as well as qualitative measures from CHWs. Improvements were seen in diabetes knowledge, exercise and diet to control diabetes, frequency of checking feet, medication compliance, and self-efficacy of health and physical activity from baseline to 12 months. Additionally, there were decreases in A1C, weight, and body mass index. Program evaluation revealed a high acceptability of the intervention, and qualitative findings indicated that CHWs helped overcome barriers and facilitated program outcomes through communal concordance, trust, and leadership. The intervention demonstrated high acceptability and suggested efficacy in improving diabetes management outcomes among Bangladeshi immigrants in an urban setting. The US Bangladeshi population will continue to increase, and given the high rates of diabetes, as well as linguistic and economic barriers faced by this community, effective and culturally tailored health interventions are needed to overcome barriers and provide support for diabetes management.

Evaluation of a Community Health Worker Pilot Intervention to Improve Diabetes Management in Bangladeshi Immigrants with Type 2 Diabetes in New York City

PubMed Central

Islam, Nadia S.; Wyatt, Laura C.; Patel, Shilpa D.; Shapiro, Ephraim; Tandon, S.Darius; Mukherji, B. Runi; Tanner, Michael; Rey, Mariano J.; Trinh-Shevrin, Chau

2014-01-01

Purpose The purpose of this study is to explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve diabetes management among Bangladeshi-American individuals with Type 2 diabetes living in New York City. Methods Participants were recruited at clinic- and community-based venues. The intervention consisted of six monthly, CHW facilitated group sessions on topics related to management of diabetes. Surveys were collected at baseline and follow-up time points. Study outcomes included clinical, behavioral, and satisfaction measures for participants, as well as qualitative measures from CHWs. Results Improvements were seen in diabetes knowledge, exercise and diet to control diabetes, frequency of checking feet, medication compliance, and self-efficacy of health and physical activity from baseline to 12 months. Additionally, there were decreases in A1C, weight, and BMI. Program evaluation revealed a high acceptability of the intervention, and qualitative findings indicated that CHWs helped overcome barriers and facilitated program outcomes through communal concordance, trust and leadership. Conclusions The intervention demonstrated high acceptability and suggested efficacy in improving diabetes management outcomes among Bangladeshi immigrants in an urban setting. The U.S. Bangladeshi population will continue to increase, and given the high rates of diabetes, as well as linguistic and economic barriers faced by this community, effective and culturally-tailored health interventions are needed to overcome barriers and provide support for diabetes management. PMID:23749774

Feasibility and acceptability of an early childhood obesity prevention intervention: results from the healthy homes, healthy families pilot study.

PubMed

Keita, Akilah Dulin; Risica, Patricia M; Drenner, Kelli L; Adams, Ingrid; Gorham, Gemma; Gans, Kim M

2014-01-01

This study examined the feasibility and acceptability of a home-based early childhood obesity prevention intervention designed to empower low-income racially/ethnically diverse parents to modify their children's health behaviors. We used a prospective design with pre-/posttest evaluation of 50 parent-child pairs (children aged 2 to 5 years) to examine potential changes in dietary, physical activity, and sedentary behaviors among children at baseline and four-month follow-up. 39 (78%) parent-child pairs completed evaluation data at 4-month follow-up. Vegetable intake among children significantly increased at follow-up (0.54 cups at 4 months compared to 0.28 cups at baseline, P = 0.001) and ounces of fruit juice decreased at follow-up (11.9 ounces at 4 months compared to 16.0 ounces at baseline, P = 0.036). Sedentary behaviors also improved. Children significantly decreased time spent watching TV on weekdays (P < 0.01) and also reduced weekend TV time. In addition, the number of homes with TV sets in the child's bedroom also decreased (P < 0.0013). The findings indicate that a home-based early childhood obesity prevention intervention is feasible, acceptable and demonstrates short-term effects on dietary and sedentary behaviors of low-income racially/ethnically diverse children.

Arab-American adolescent tobacco use: four pilot studies.

PubMed

Rice, Virginia Hill; Templin, Thomas; Kulwicki, Anahid

2003-11-01

Four pilot studies were conducted to determine the (1) current tobacco use patterns and predictors among 14- to 18-year-old Arab-American youths; (2) psychometric properties of study measures (English and Arabic); (3) cultural appropriateness of Project Toward No Tobacco (TNT) for intervention; (4) accessible population for a longitudinal study. Three studies were descriptive and one used a pretest-posttest design. From four Pilot Focus groups (N = 28 smokers) key tobacco use themes emerged along with information on study measures and the Project TNT intervention; Pilot Intervention tested the tailored Project TNT intervention with 9 Arab-American teens; Pilot Clinic (N = 44) determined the characteristics of the accessible teen health clinic population; and Pilot School (N = 119) obtained tobacco use data only. From Pilot Focus seven themes (being cool, "nshar ma'a al shabab" [hanging out with the guys], present [time] orientation, smoking feels and tastes good, keeps your mind off trouble, easy to get, and (many) "barriers to quitting") emerged from the data. In the Pilot Intervention a 37.5% cessation rate was found. In the Pilot Clinic study, 24% males and 17% females smoked. The current smoking rate in the Pilot School (N = 119) sample was 17%; 34% admitted to having ever smoked (even a puff). Significant predictors for current tobacco use included poor grades, stress, having many family members and peers who smoke, being exposed to many hours of smoking each day, receiving offers of tobacco products, advertising and mail, and believing that tobacco can help one to make friends. The four pilots contributed unique and essential knowledge for designing a longitudinal clinical trial on tobacco use by Arab-American adolescents.

"Knowing That You're Not the Only One": Perspectives on Group-Based Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD) in Adults With Type 1 Diabetes.

PubMed

Esbitt, Sabrina A; Batchelder, Abigail W; Tanenbaum, Molly L; Shreck, Erica; Gonzalez, Jeffrey S

2015-08-01

Depression and illness-specific distress are more common among adults with Type 1 diabetes (T1DM) than the general population and have been associated with poorer control of blood glucose and increased risk for serious diabetes-related complications. Treatment nonadherence has also been associated with depressive symptoms and diabetes-related distress, and has repeatedly been suggested as an important modifiable behavioral pathway linking depression and diabetes outcomes. The present study reports on the feasibility and acceptability of a pilot intervention using group-based cognitive-behavioral therapy to improve treatment adherence among adults with T1DM and elevated levels of diabetes-related distress or depressive symptoms. We describe the components of the intervention and utilize qualitative data along with descriptive outcome data. Our findings suggest that participation in the group was acceptable and associated with reductions in depressive symptoms and diabetes-specific distress. Challenges to feasibility and future directions are discussed.

Feasibility study of a peer-facilitated low intensity cognitive-behavioral intervention for mild to moderate depression and anxiety in older adults.

PubMed

Seeley, John R; Manitsas, Tara; Gau, Jeff M

2017-09-01

The majority of older adults experiencing depression and/or anxiety do not receive adequate treatment due to limited access to evidence-based practices. Low intensity cognitive-behavioral intervention has been established as an evidence-based practice with the potential to increase the reach to older adults. The purpose of the current study is to evaluate the feasibility, acceptability, and potential efficacy of a low intensity, peer-supported, cognitive-behavioral intervention for mild to moderate depression and/or anxiety delivered by a local intergovernmental agency serving older adults. Sixty-two older adults (81% female) between 55 and 96 years of age were randomly assigned to either a peer-facilitated cognitive-behavioral bibliotherapy condition (n = 31) or a wait-list control condition (n = 31). The 10-week feasibility trial data indicated that (1) a majority of the participants were highly engaged in the intervention with an average number of 7.3 peer sessions attended and 2.1 workbooks completed, (2) the participants were quite satisfied with the peer mentoring sessions and moderately satisfied with the workbooks, and (3) there were clinically meaningful reductions in depressive symptoms for those assigned to the treatment condition compared to those that were wait-listed (d = .43), though the effect was non-significant (p = .099) due to the small sample size. The evidence for the impact on reducing anxiety symptoms was more equivocal with a non-significant, small effect size favoring the treatment condition. The pilot study provided preliminary evidence for the feasibility, acceptability, and potential efficacy of the peer-facilitated low intensity cognitive-behavioral therapy intervention approach.

Reducing sexual risk behavior among high-risk couples in Northern India.

PubMed

Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M

2013-09-01

With a population of 1.1 billion, India is considered to be a country in which effective prevention interventions could contain the development of a human immunodeficiency virus (HIV) epidemic. Heterosexual transmission accounts for 85 % of the extant HIV infections. This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self-efficacy, knowledge, conflict resolution, and coping among high-risk heterosexual couples in Northern India. This pilot study was conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high-risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in 1 month of three weekly gender-concordant behavioral intervention groups and were individually administered assessments preintervention and post-intervention. The intervention was tailored to the Northern Indian context and addressed sexual barrier use, human immunodeficiency virus (HIV)/sexually transmitted infection transmission, and cognitive behavioral skill building focusing on sexual negotiation and communication. The participants had a mean age of 32 years (men) and 29 years (women), and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (<100 % of the time; 64 % of women, 59 % of men). Post-intervention, nearly all participants reported consistent condom use (100 % of the time; 100 % of men, 97 % of women). Participants also reported decreased verbal aggression, increased self-efficacy, and increased HIV-related knowledge, and women increased their use of positive coping tactics. The results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high-risk couples may be an important adjunct to preventing the development of a generalized epidemic in India.

Get+Connected: Development and Pilot Testing of an Intervention to Improve Computer and Internet Attitudes and Internet Use Among Women Living With HIV.

PubMed

Seplovich, Gabriela; Horvath, Keith J; Haughton, Lorlette J; Blackstock, Oni J

2017-03-31

For persons living with chronic medical conditions, the Internet can be a powerful tool for health promotion, and allow for immediate access to medical information and social support. However, women living with human immunodeficiency virus (HIV) in the United States face numerous barriers to computer and Internet use. Health behavior change models suggest that the first step towards adopting a new health behavior is to improve attitudes towards that behavior. To develop and pilot test Get+Connected, an intervention to improve computer and Internet attitudes and Internet use among women living with HIV. To develop Get+Connected, we reviewed the extant literature, adapted an existing curriculum, and conducted a focus group with HIV-positive women (n=20) at a community-based organization in the Bronx, New York. Get+Connected was comprised of five weekly sessions covering the following topics: basic computer knowledge and skills, identifying reliable health-related websites, setting up and using email and Facebook accounts, and a final review session. We recruited 12 women to participate in pilot testing. At baseline, we collected data about participants' sociodemographic information, clinical characteristics, and technology device ownership and use. At baseline, intervention completion, and three months postintervention, we collected data regarding attitudes towards computers and the Internet (Attitudes Towards Computers and the Internet Questionnaire [ATCIQ]; possible scores range from 5-50) as well as frequency of Internet use (composite measure). To examine changes in ATCIQ scores and Internet use over time, we used generalized estimating equations. We also collected qualitative data during intervention delivery. Among women in our sample, the median age was 56 years (interquartile range=52-63). All participants were black/African American and/or Latina. Seven participants (7/12, 58%) had a high school diploma (or equivalent) or higher degree. Ten participants (10/12, 83%) reported owning a mobile phone, while only one (1/12, 8%) reported owning a computer or tablet. Only one participant (1/12, 8%) reported having ever used the Internet or email. Internet nonusers cited lack of computer/Internet knowledge (6/11, 54%) and lack of access to a computer or similar device (4/11, 36%) as the main barriers to use. Over time, we observed an improvement in attitudes towards computers and the Internet (ATCIQ scores: 33.5 at baseline, 35 at intervention completion, and 36 at three months postintervention; P=.008). No significant increase in Internet use was observed (P=.61). Qualitative findings indicated excitement and enthusiasm for the intervention. In our sample of urban, technology-inexperienced HIV-positive women, participation in Get+Connected was associated with an improvement in attitudes towards computers and the Internet, but not Internet use. Changing attitudes is the first step in many health behavior change models, indicating that with improved access to computer and Internet resources, frequency of Internet use may also have increased. Future studies should consider addressing issues of access to technology in conjunction with Get+Connected. ©Gabriela Seplovich, Keith J Horvath, Lorlette J Haughton, Oni J Blackstock. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 31.03.2017.

Get+Connected: Development and Pilot Testing of an Intervention to Improve Computer and Internet Attitudes and Internet Use Among Women Living With HIV

PubMed Central

Seplovich, Gabriela; Horvath, Keith J; Haughton, Lorlette J

2017-01-01

Background For persons living with chronic medical conditions, the Internet can be a powerful tool for health promotion, and allow for immediate access to medical information and social support. However, women living with human immunodeficiency virus (HIV) in the United States face numerous barriers to computer and Internet use. Health behavior change models suggest that the first step towards adopting a new health behavior is to improve attitudes towards that behavior. Objective To develop and pilot test Get+Connected, an intervention to improve computer and Internet attitudes and Internet use among women living with HIV. Methods To develop Get+Connected, we reviewed the extant literature, adapted an existing curriculum, and conducted a focus group with HIV-positive women (n=20) at a community-based organization in the Bronx, New York. Get+Connected was comprised of five weekly sessions covering the following topics: basic computer knowledge and skills, identifying reliable health-related websites, setting up and using email and Facebook accounts, and a final review session. We recruited 12 women to participate in pilot testing. At baseline, we collected data about participants’ sociodemographic information, clinical characteristics, and technology device ownership and use. At baseline, intervention completion, and three months postintervention, we collected data regarding attitudes towards computers and the Internet (Attitudes Towards Computers and the Internet Questionnaire [ATCIQ]; possible scores range from 5-50) as well as frequency of Internet use (composite measure). To examine changes in ATCIQ scores and Internet use over time, we used generalized estimating equations. We also collected qualitative data during intervention delivery. Results Among women in our sample, the median age was 56 years (interquartile range=52-63). All participants were black/African American and/or Latina. Seven participants (7/12, 58%) had a high school diploma (or equivalent) or higher degree. Ten participants (10/12, 83%) reported owning a mobile phone, while only one (1/12, 8%) reported owning a computer or tablet. Only one participant (1/12, 8%) reported having ever used the Internet or email. Internet nonusers cited lack of computer/Internet knowledge (6/11, 54%) and lack of access to a computer or similar device (4/11, 36%) as the main barriers to use. Over time, we observed an improvement in attitudes towards computers and the Internet (ATCIQ scores: 33.5 at baseline, 35 at intervention completion, and 36 at three months postintervention; P=.008). No significant increase in Internet use was observed (P=.61). Qualitative findings indicated excitement and enthusiasm for the intervention. Conclusions In our sample of urban, technology-inexperienced HIV-positive women, participation in Get+Connected was associated with an improvement in attitudes towards computers and the Internet, but not Internet use. Changing attitudes is the first step in many health behavior change models, indicating that with improved access to computer and Internet resources, frequency of Internet use may also have increased. Future studies should consider addressing issues of access to technology in conjunction with Get+Connected. PMID:28363879

Family self-tailoring: Applying a systems approach to improving family healthy living behaviors.

PubMed

Moore, Shirley M; Jones, Lenette; Alemi, Farrokh

2016-01-01

The adoption and maintenance of healthy living behaviors by individuals and families is a major challenge. We describe a new model of health behavior change, SystemCHANGE (SC), which focuses on the redesign of family daily routines using system improvement methods. In the SC intervention, families are taught a set of skills to engage in a series of small, family self-designed experiments to test ideas to change their daily routines. The family system-oriented changes brought about by these experiments build healthy living behaviors into family daily routines so that these new behaviors happen as a matter of course, despite wavering motivation, willpower, or personal effort on the part of individuals. Case stories of the use of SC to improve family healthy living behaviors are provided. Results of several pilot tests of SC indicate its potential effectiveness to change health living behaviors across numerous populations. Copyright © 2016 Elsevier Inc. All rights reserved.

Family Self-tailoring: Applying a Systems Approach to Improving Family Healthy Living Behaviors

PubMed Central

Moore, Shirley M.; Jones, Lenette; Alemi, Farrokh

2016-01-01

The adoption and maintenance of healthy living behaviors by individuals and families is a major challenge. We describe a new model of health behavior change, SystemCHANGE™ (SC), which focuses on the redesign of family daily routines using system improvement methods. In the SC intervention families are taught a set of skills to engage in a series of small, family self-designed experiments to test ideas to change their daily routines. The family system-oriented changes brought about by these experiments build healthy living behaviors into family daily routines so that these new behaviors happen as a matter of course, despite wavering motivation, willpower or personal effort on the part of individuals. Case stories of the use of SC to improve family healthy living behaviors are provided. Results of several pilot tests of SC indicate its potential effectiveness to change health living behaviors across numerous populations. PMID:27301950

Development of a Guided Internet-based Psycho-education Intervention Using Cognitive Behavioral Therapy and Self-Management for Individuals with Chronic Pain.

PubMed

Perry, Jennifer; VanDenKerkhof, Elizabeth G; Wilson, Rosemary; Tripp, Dean A

2017-04-01

Evidence-based chronic pain treatment includes nonpharmacologic therapies. When addressing barriers to treatment, there is a need to deliver these therapies in a way that is accessible to all individuals who may benefit. To develop a guided Internet-based intervention for individuals with chronic pain, program content and sequence of evidence-based treatments for chronic pain, traditionally delivered via in-person sessions, were identified to be adapted for Internet delivery. With consideration to historical barriers to treatment, and through use of a concept map, therapeutic components and educational material were situated, in an ordered sequence, into six modules. An Internet-based chronic pain intervention was constructed to improve access to evidence-based chronic pain therapies. Research using this intervention, in the form of a pilot study for intervention refinement, was conducted, and a large-scale study to assess effectiveness is necessary prior to implementation. As clients may face barriers to multimodal treatment for chronic pain, nurses could introduce components of education, cognitive behavioral therapy and self-management to clients and prepare them for the "work" of managing chronic pain, through use of this Internet-based intervention. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Enhancing the Capacity of School Nurses to Reduce Excessive Anxiety in Children: Development of the CALM Intervention.

PubMed

Drake, Kelly L; Stewart, Catherine E; Muggeo, Michela A; Ginsburg, Golda S

2015-08-01

Excessive anxiety is among the most common psychiatric problems facing youth. Because anxious youth tend to have somatic complaints, many seek help from the school nurse. Thus, school nurses are in an ideal position to provide early intervention. This study addresses this problem and describes the plans to develop and test a new intervention (Child Anxiety Learning Modules; CALM), delivered by school nurses, to reduce child anxiety and improve academic functioning. An iterative development process including consultation with an expert panel, two open trials, and a pilot randomized controlled study comparing CALM to usual care is proposed. Feedback will be solicited from all participants during each phase and data on outcome measures will be provided by children, parents, teachers, and independent evaluators. Data will be collected on intervention satisfaction and feasibility. Primary outcomes that include child anxiety symptoms, classroom behavior, and school performance (e.g., attendance, grades, standardized test scores) will be collected at pre- and post-interventions and at a 3-month follow-up evaluation. Pediatric anxiety is a common problem that school nurses frequently encounter. Consequently, they are well positioned to play a key role in enhancing access to behavioral health interventions to reduce anxiety and may therefore make a significant positive public health impact. © 2015 Wiley Periodicals, Inc.

Adaptation of a Counseling Intervention to Address Multiple Cancer Risk Factors Among Overweight/Obese Latino Smokers

PubMed Central

Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Robles, Eden Hernandez; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.

2015-01-01

More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social cognitive theory and principles of motivational interviewing originally developed for smoking cessation to also address physical activity and fruit/vegetable consumption among Latinos exhibiting multiple health risk behaviors. Literature reviews, focus groups, expert consultation, pretesting, and pilot testing were used to inform adaptation decisions. We identified common mechanisms underlying change in smoking, physical activity, and diet used as treatment targets; identified practical models of patient-centered cross-cultural service provision; and identified that family preferences and support as particularly strong concerns among the priority population. Adaptations made to the original intervention are described. The current study is a practical example of how an intervention can be adapted to maximize relevance and acceptability and also maintain the core elements of the original evidence-based intervention. The intervention has significant potential to influence cancer prevention efforts among Latinos in the United States and is being evaluated in a sample of 400 Latino overweight/obese smokers. PMID:25527143

Total skin self-examination at home for people treated for cutaneous melanoma: development and pilot of a digital intervention

PubMed Central

Murchie, Peter; Allan, Julia L; Brant, William; Dennis, Matthew; Hall, Susan; Masthoff, Judith; Walter, Fiona M; Johnston, Marie

2015-01-01

Objectives To develop a digital intervention to prompt, support, and respond to the outcomes of total skin self-examinations (TSSEs) at home by people treated for cutaneous melanoma. Design A complex intervention development study. Setting Northeast Scotland. Participants Semistructured scoping interviews; people previously treated for cutaneous melanoma (n=21). Pilot testing: people treated for melanoma stages 0–2C (n=20); general practitioners (n=6); and a nurse specialist in dermatology (n=1). Intervention A tablet-based digital intervention designed to prompt and support TSSEs comprising instructional videos and electronic reporting (including photographs) to a clinical nurse specialist in dermatology, with subsequent clinical triage. Primary and secondary outcome measures Qualitative assessment of intervention feasibility and acceptability, and quantitative assessment of intentions and confidence to perform TSSEs in pilot participants. Results The majority of pilot participants were strongly positive and adhered well to the intervention (n=15), with 7 of these reporting symptoms of concern at some point during the 6-month pilot. 4 patients complied intermittently, 3 reporting skin problems at least once during the pilot, and 1 withdrew. 2 patients underwent skin surgery as a result of participating in the pilot, with 1 diagnosed as having a recurrent melanoma and the other, a benign lesion. A number of practical issues to improve the usability of the intervention were identified. The proportion of participants reporting intention to check their skin at least monthly increased during the intervention as did confidence to conduct a skin check. Conclusions People previously treated for cutaneous melanoma are prepared to use digital technology to support them in conducting TSSE. An intervention has been developed which is practical, effective and safe, and after addressing minor practical issues, could now be evaluated for clinical outcomes in a randomised clinical trial. PMID:26251412

Evaluating a Culturally Tailored HIV Risk Reduction Intervention Among Latina Immigrants in the Farmworker Community.

PubMed

Sanchez, Mariana; Rojas, Patria; Li, Tan; Ravelo, Gira; Cyrus, Elena; Wang, Weize; Kanamori, Mariano; Peragallo, Nilda P; De La Rosa, Mario R

2016-09-01

Latina immigrants in the farmworker community are a vulnerable and understudied population at risk of acquiring HIV. Employing a CBPR framework, this pilot study was the first to evaluate the efficacy of SEPA, a CDC evidenced-based and culturally tailored HIV risk reduction intervention on a cohort of N = 110 predominantly undocumented Latina immigrants in a farmworker community. Findings revealed SEPA was effective in increasing HIV knowledge and decreasing HIV risk behaviors. However, no changes in self-efficacy were found in the present sample. We posit specific socio-cultural and structural barriers specific to the farmworker community not targeted in the original intervention may have hindered the program's capacity to influence changes in self-efficacy among this less acculturated population. Possible socio-cultural adaptations of the intervention to the target population and policy implications are discussed.

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

PubMed

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

2017-08-27

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (P<0.001). Conclusions: IM is a useful process in the design of a theory-based intervention addressing CRC screening among Iranian population. Creative Commons Attribution License

Process evaluation of a tailored mobile health intervention aiming to reduce fatigue in airline pilots.

PubMed

van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; Smid, Tjabe; van der Beek, Allard J

2016-08-26

MORE Energy is a mobile health intervention which aims to reduce fatigue and improve health in airline pilots. The primary objective of this process evaluation was to assess the reach, dose delivered, compliance, fidelity, barriers and facilitators, and satisfaction of the intervention. The second objective was to investigate the associations of adherence to the intervention with compliance and with participant satisfaction. Thirdly, we investigated differences between the subgroups within the target population. The intervention consisted of a smartphone application, supported by a website. It provided advice on optimal light exposure, sleep, nutrition, and physical activity, tailored to flight and personal characteristics. The reach of the intervention was determined by comparing the intervention group participants and the airline pilots who did not participate. The dose delivered was defined as the total number of participants that was sent an instruction email. Objective compliance was measured through the Control Management System of the application. To determine the fidelity, an extensive log was kept throughout the intervention period. Subjective compliance, satisfaction, barriers, facilitators, and adherence were assessed using online questionnaires. Associations between the extent to which the participants applied the advice in daily life (adherence), compliance, and satisfaction were analysed as well. Finally, outcomes of participants of different age groups and haul types were compared. A total of 2222 pilots were made aware of the study. From this group, 502 pilots met the inclusion criteria and did agree to participate. The reach of the study proved to be 22 % and the dose delivered was 99 %. The included pilots were randomized into the intervention group (n = 251) or the control group (n = 251). Of the intervention group participants, 81 % consulted any advice, while 17 % did this during four weeks or more. Fidelity was 67 %. The participants rated the intervention with a 6.4 (SD 1.6). Adherence was not associated with compliance, but was associated with satisfaction (p ≤ 0.001). Pilots of 35 to 45 year old were significantly more interested in advice regarding physical activity than their colleagues, and short-haul pilots were more interested in advice regarding nutrition compared to long-haul pilots. The MORE Energy intervention was well received, resulting in an adequate reach and a high dose delivered. The compliance and satisfaction scores indicate that engagement and functionality should be enhanced, and the content and applicability of the advices should be improved to appeal all subgroups of the target population. Nederlands Trial Register NTR2722 . Registered 27 January 2011.

Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study.

PubMed

Pagoto, Sherry; Tulu, Bengisu; Agu, Emmanuel; Waring, Molly E; Oleski, Jessica L; Jake-Schoffman, Danielle E

2018-06-20

Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2). ©Sherry Pagoto, Bengisu Tulu, Emmanuel Agu, Molly E Waring, Jessica L Oleski, Danielle E Jake-Schoffman. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 20.06.2018.

Models of Pilot Behavior and Their Use to Evaluate the State of Pilot Training

NASA Astrophysics Data System (ADS)

Jirgl, Miroslav; Jalovecky, Rudolf; Bradac, Zdenek

2016-07-01

This article discusses the possibilities of obtaining new information related to human behavior, namely the changes or progressive development of pilots' abilities during training. The main assumption is that a pilot's ability can be evaluated based on a corresponding behavioral model whose parameters are estimated using mathematical identification procedures. The mean values of the identified parameters are obtained via statistical methods. These parameters are then monitored and their changes evaluated. In this context, the paper introduces and examines relevant mathematical models of human (pilot) behavior, the pilot-aircraft interaction, and an example of the mathematical analysis.

Increased gut microbiota diversity and abundance of Faecalibacterium prausnitzii and Akkermansia after fasting: a pilot study.

PubMed

Remely, Marlene; Hippe, Berit; Geretschlaeger, Isabella; Stegmayer, Sonja; Hoefinger, Ingrid; Haslberger, Alexander

2015-05-01

An impaired gut microbiota has been reported as an important factor in the pathogenesis of obesity. Weight reduction has already been mentioned to improve gut microbial subpopulations involved in inflammatory processes, though other subpopulations still need further investigation. Thus, weight reduction in the context of a fasting program together with a probiotic intervention may improve the abundance and diversity of gut microbiota. In this pilot study, overweight people underwent a fasting program with laxative treatment for 1 week followed by a 6 week intervention with a probiotic formula. Gut microbiota were analyzed on the basis of 16s rDNA with a quantitative real time polymerase chain reaction. Additionally, a food frequency questionnaire with questions about nutritional behavior, lifestyle, and physical activity was administered before and after the intervention. We observed an increase in microbial diversity over the study period. No significant changes in abundance of total bacteria, or of Bacteroidetes, Prevotella, Clostridium cluster XIVa, or Clostridium cluster IV were found, although Faecalibacterium prausnitzii showed an increase over the study period. In addition, Akkermanisa and Bifidobacteria increased in abundance due to intervention. The inflammation-associated gut microbes Enterobacteria and Lactobacilli increased during the first week and then declined by the end of the intervention. Two-thirds of the study participants harbored Archaea. No significant improvements of eating habits were reported, although physical activity improved due to the intervention. Our results show that caloric restriction affects gut microbiota by proliferating mucin-degrading microbial subpopulations. An additional intervention with a probiotic formula increased probiotic-administered gut microbial populations.

Pilot test of a home-based program to prevent perceived insufficient milk.

PubMed

Wood, Natsuko K; Sanders, Elizabeth A; Lewis, Frances M; Woods, Nancy F; Blackburn, Susan T

2017-12-01

Although the World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for the first six months, only 22% of U.S. mothers do so. Mothers' perceived insufficient milk (PIM) is the primary reason for breastfeeding discontinuation globally. There are two changeable causes of PIM: (1) mothers' misinterpretation of their infant's behavior, and (2) mothers' lack of confidence in their ability to breastfeed. The purpose of this study was to evaluate the short-term effect of a home-based intervention designed to prevent and/or reduce PIM. A mixed-methods, single-group, pretest-midtest-posttest design was used for evaluating a home-based breastfeeding program. The program was implemented during three 1.0- to 1.5-h home intervention sessions at 6, 13, and 27 days postpartum, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. We found significant increases over time in mothers' sensitivity to infant behavior and breastfeeding self-efficacy as well as significant decreased attribution of infant crying to PIM. Exit interviews indicated that the program was accepted by participating mothers. This is the first intervention study that has directly targeted the causes of PIM. The home-based intervention has the potential to add to maternal competencies both in correctly assessing their infants' behavior, thereby preventing erroneous attribution of infant behavior to PIM, as well as simultaneously bolstering maternal confidence in breastfeeding skills. By building maternal competencies, the home-based intervention has a longer-range potential to prevent breastfeeding discontinuation. Further evaluation is warranted. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Evaluation of a group-based behavioral intervention to promote adherence in adolescents with inflammatory bowel disease.

PubMed

Hommel, Kevin A; Hente, Elizabeth A; Odell, Shannon; Herzer, Michele; Ingerski, Lisa M; Guilfoyle, Shanna M; Denson, Lee A

2012-01-01

To pilot test the feasibility and acceptability of a family-based group behavioral intervention and to improve medication adherence in adolescents diagnosed with inflammatory bowel disease. Participants were 40 adolescents aged 11-18 years diagnosed with inflammatory bowel disease and their primary caregivers, who were randomized to either a four-session Family-Based Group Behavioral Treatment or Usual Care over a 6-week period. Adherence was measured using a multi-method, multi-informant assessment involving caregiver-report and patient-report, pill count data, and electronic monitoring. Adherence rates ranged from 66 to 89% for 6-mercaptopurine/azathioprine and 51 to 93% for mesalamine across assessment methods. The intervention was feasible, as evidenced by the 99% treatment session attendance rate, and acceptable based on patient and caregiver report. Repeated measures analysis of variance tests revealed nonsignificant differences between the conditions from baseline to post-treatment assessments for pill count, electronic monitor, and primary caregiver-reported adherence (P's>0.05). There was a statistically significant improvement in patient-reported mesalamine adherence represented by a significant main effect for Condition (F=22.24, P<0.01; δ=0.79) and Condition×Time interaction (F=13.32, P<0.05; δ=0.69). Findings suggest potential for use of behavioral intervention to improve medication adherence in this population. This intervention may be more effective with more complex regimens (e.g. multiple doses per day) such as those prescribed with mesalamine. Further research is needed to examine this type of intervention in more diverse samples with more active disease. Use of alternative adherence measurement approaches, including electronic pill boxes and/or real-time self-report (e.g. by text messaging, electronic diaries, etc.) is also recommended.

Dissemination of an evidence-based intervention to parents of children with behavioral problems in a developing country.

PubMed

Fayyad, John A; Farah, Lynn; Cassir, Youmna; Salamoun, Mariana M; Karam, Elie G

2010-08-01

This project describes the dissemination of an evidence-based parenting skills intervention by training social and health workers with little or no mental health background so that they themselves train mothers of children with behavioral problems in impoverished communities in a developing country. The Strengths and Difficulties Questionnaire was completed by mothers to screen for children with behavioral problems and was repeated at the end of the intervention. Pre- and post-tests of knowledge and parenting attitudes were administered to mothers. Mental health workers trained social and health workers in social development centers and dispensaries. Each social and health worker trained mothers of children with behavioral problems under supervision utilizing an Arabic adaptation of the treatment manual for externalizing disorders "Helping Challenging Children" developed by the Integrated Services Taskforce of the World Psychiatric Association Child Mental Health Presidential Programme. A total of 20 workers and 87 mothers participated in the training. The proportion of children who obtained an SDQ total difficulties score in the abnormal range decreased from 54.4 to 19.7% after the training. Whereas 40.2% of mothers used severe corporal punishment with their children before the intervention, this decreased to 6.1% post-intervention. Three-fourths of mothers related that the program helped them develop new parenting skills. This pilot project demonstrated the feasibility of dissemination of a manual-based intervention and training of workers who have little background in mental health to offer effective services to families in impoverished communities who otherwise would have not received them. Successful replication in other developing countries would pave the way to incorporating such programs in national policies given their potential sustainability and cost-effectiveness.

A metacognitive strategy for reducing disruptive behavior in children with fetal alcohol spectrum disorders: GoFAR pilot.

PubMed

Coles, Claire D; Kable, Julie A; Taddeo, Elles; Strickland, Dorothy C

2015-11-01

Fetal alcohol spectrum disorders (FASD) are often characterized by disruptive behavior problems and there are few effective interventions available. GoFAR is a novel, 3-part intervention designed to improve self-regulation and adaptive living skills of children with FASD by improving metacognitive control of emotions and arousal. The intervention has 3 components: (i) GoFAR: a "serious game" designed to teach a metacognitive control strategy in a computer game environment; (ii) parent training on child behavioral regulation; and (iii) Behavior Analog Therapy (BAT) sessions, a practical application of the metacognitive learning methodology by parent and child in the context of learning adaptive skills. The learning strategy (FAR) teaches the child to Focus and make a plan, Act out the plan, and Reflect back on the plan. Thirty families were randomized to 3 groups: (i) GoFAR (n = 10); (ii) FACELAND (n = 10); or (iii) CONTROL (n = 10). The 2 intervention groups, GoFAR and FACELAND, used computer games to instruct children. Both groups also received 5 sessions of parent training followed by 5 sessions of joint parent/child therapy (BAT). Assessment of disruptive behavior, including frequency of temper tantrums, frustration tolerance, impulsivity, destructiveness, aggression, and maintaining attention were carried out before enrollment at Mid-Treatment, when game play and parent training were completed, and finally, after completing the BAT sessions. Parental report of disruptive behavior overall was significantly reduced in the GoFAR group after the first components, game play and parent training, and after the BAT sessions in the FACELAND group with no changes in the CONTROL group over time. The GoFAR(®) game was well received by children and effective in teaching the required skills. Mastering the FAR metacognitive strategy was associated with a reduction in disruptive behaviors in children with FASD suggesting that effective interventions can improve outcomes for this high-risk group. Copyright © 2015 by the Research Society on Alcoholism.

Behavioral cessation treatment of waterpipe smoking: The first pilot randomized controlled trial

PubMed Central

Asfar, Taghrid; Ali, Radwan Al; Rastam, Samer; Maziak, Wasim; Ward, Kenneth D.

2014-01-01

Background Waterpipe use has increased dramatically in the Middle East and other parts of the world. Many users exhibit signs of dependence, including withdrawal and difficulty quitting, but there is no evidence base to guide cessation efforts. Methods We developed a behavioral cessation program for willing-to-quit waterpipe users, and evaluated its feasibility and efficacy in a pilot, two arm, parallel group, randomized, open label trial in Aleppo, Syria. Fifty adults who smoked waterpipe ≥3 times per week in the last year, did not smoke cigarettes, and were interested in quitting were randomized to receive either brief (1 in-person session and 3 phone calls) or intensive (3 in-person sessions and 5 phone calls) behavioral cessation treatment delivered by a trained physician in a clinical setting. The primary efficacy end point of the developed interventions was prolonged abstinence at three months post-quit day, assessed by self-report and exhaled carbon monoxide levels of <10 ppm. Secondary end points were 7 day point-prevalent abstinence and adherence to treatment. Results Thirty percent of participants were fully adherent to treatment, which did not vary by treatment group. The proportions of participants in the brief and intensive interventions with prolonged abstinence at the 3-month assessment were 30.4% and 44.4%, respectively. Previous success in quitting (OR = 3.57; 95% CI = 1.03–12.43) predicted cessation. Higher baseline readiness to quit, more confidence in quitting, and being unemployed predicted a better adherence to treatment (all p-values <0.05). Conclusions Brief behavioral cessation treatment for waterpipe users appears to be feasible and effective. PMID:24629480

Double-blind, controlled, clinical trial planned in germany to investigate the efficacy of psychotherapy combined with triptorelin in adult male patients with severe pedophilic disorders: presentation of the study protocol.

PubMed

Briken, Peer; Berner, Wolfgang

2012-01-01

The treatment of paraphilias, especially of pedophilia, centers upon cognitive-behavioral psychotherapy and pharmacologic interventions. Two open, uncontrolled clinical studies using the synthetic LHRH-agonist triptorelin suggested that, combined with psychotherapy, antiandrogen treatment reduced deviant sexual fantasies, urges, and behaviors in paraphilic patients. There is a need for further research using controlled, randomized trials to examine the effectiveness of sexual offender treatment including psychotherapeutic and pharmacologic interventions. The aim of this pilot study is to evaluate the efficacy and tolerability of cognitive-behavioral psychotherapy together with intramuscular (IM) 3-monthly injections of triptorelin in adult men with severe pedophilia. In this multicenter, forensic psychiatric hospital-based, double-blind, controlled, parallel group phase IV trial conducted in Germany, convicted male sexual offenders aged ≥ 18 years with pedophilia, as defined by DSM-IV-TR criteria, will be randomized to receive study-specific psychotherapy together either with triptorelin or placebo for 12 months (total of 4 injections). This is a pilot study, therefore exploratory data analyses will be carried out of three different target parameters: 1. Changes in psychosexual characteristics using the Multiphasic Sex Inventory (scale: sexual abuse of children) 2. Changes in the risk of violent sexual behavior using the Sexual Violence Risk-20 total score 3. Changes in serum testosterone concentration Treatment effects will be assessed by comparing baseline values with those at the final examination (month 12). The absence of real-life stimulants to test for actual recidivism limits possible findings. The study will be conducted in agreement with the European GCP-guideline, all relevant legal requirements, and the legal framework for voluntary treatment of convicted sexual offenders in Germany.

RHAPSODY - Internet-based support for caregivers of people with young onset dementia: program design and methods of a pilot study.

PubMed

Kurz, Alexander; Bakker, Christian; Böhm, Markus; Diehl-Schmid, Janine; Dubois, Bruno; Ferreira, Catarina; Gage, Heather; Graff, Caroline; Hergueta, Thierry; Jansen, Sabine; Jones, Bridget; Komar, Alexander; de Mendonça, Alexandre; Metcalfe, Anna; Milecka, Katrina; Millenaar, Joany; Orrung Wallin, Anneli; Oyebode, Jan; Schneider-Schelte, Helga; Saxl, Susanna; de Vugt, Marjolein

2016-12-01

Young Onset Dementia (YOD), defined by first symptoms of cognitive or behavioral decline occurring before the age of 65 years, is relatively rare compared to dementia of later onset, but it is associated with diagnostic difficulty and heavy burden on affected individuals and their informal carers. Existing health and social care structures rarely meet the needs of YOD patients. Internet-based interventions are a novel format of delivering health-related education, counseling, and support to this vulnerable yet underserved group. The RHAPSODY (Research to Assess Policies and Strategies for Dementia in the Young) project is a European initiative to improve care for people with YOD by providing an internet-based information and skill-building program for family carers. The e-learning program focuses on managing problem behaviors, dealing with role change, obtaining support, and looking after oneself. It will be evaluated in a pilot study in three countries using a randomized unblinded design with a wait-list control group. Participants will be informal carers of people with dementia in Alzheimer's disease or behavioral-variant Frontotemporal degeneration with an onset before the age of 65 years. The primary outcome will be caregiving self-efficacy after 6 weeks of program use. As secondary outcomes, caregivers' stress and burden, carer health-related quality of life, caring-related knowledge, patient problem behaviors, and user satisfaction will be assessed. Program utilization will be monitored and a health-economic evaluation will also be performed. The RHAPSODY project will add to the evidence on the potential and limitations of a conveniently accessible, user-friendly, and comprehensive internet-based intervention as an alternative for traditional forms of counseling and support in healthcare, aiming to optimize care and support for people with YOD and their informal caregivers.

Online and smartphone based cognitive behavioral therapy for bariatric surgery patients: Initial pilot study.

PubMed

Zhang, Melvyn W B; Ho, Roger C M; Cassin, Stephanie E; Hawa, Raed; Sockalingam, Sanjeev

2015-01-01

The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Despite the success of Bariatric surgery, studies have proposed that it has neglected the contributions of other factors, such as psychological factors in the causation as well as the maintenance of obesity amongst individuals. Cognitive behavioral therapy (CBT) is largely a psychosocial intervention that has been shown to be efficacious, as studies have demonstrated that even brief CBT interventions could help in the reduction of binge eating and maintenance of weight loss. Previously identified problems with regards to the integration and the provision of such interventions include that of geographical barriers. In order to overcome the geographical barriers, telephone-based CBT has been conceptualized. Over the past decade, there has been massive advancement and development in Internet, Web-based and smartphone technologies, but there is still a paucity of applications in this area. Our current research objective is to determine if bariatric surgery patients will be receptive towards an online and smartphone based CBT intervention. The Bariatric Surgery Online CBT portal and Smartphone companion application was developed between July 2013 and December 2013. A low-cost methodology of developing the online portal was adopted. In terms of development, 4 core development phases were adopted. These included that of: a) Formulation of users' requirements, b) System design and development, c) System evaluation and d) System deployment and pilot application. The bariatric surgery workgroup from the Toronto Western Hospital helped with the recruitment of the subjects from the outpatient specialist service. Links to the web-portal was provided to each of the participants recruited. Since the inception of the online portal to date, in terms of usage rates, there have been a total of 2408 visitors to the online portal. The majority of the visitors are from Canada (n= 1879). From the analytics, a total of 8 users have participated in the pre-assessment questionnaire and have attempted and tried to use the individual modules. Since the inception of the pilot study from January 2014 till October 2014, 4 individuals have completed at least 3 modules available on the online portal. This is one of the first few studies that have demonstrated the potential feasibility of having an online and smartphone cognitive behavioral portal to serve the psychological needs of bariatric surgery patients.

Integrated Behavior Therapy for Selective Mutism: a randomized controlled pilot study.

PubMed

Bergman, R Lindsey; Gonzalez, Araceli; Piacentini, John; Keller, Melody L

2013-10-01

To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech. A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains. Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up. IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Adapting and Pilot Testing a Parenting Intervention for Homeless Families in Transitional Housing.

PubMed

Holtrop, Kendal; Holcomb, Jamila E

2018-01-24

Intervention adaptation is a promising approach for extending the reach of evidence-based interventions to underserved families. One highly relevant population in need of services are homeless families. In particular, homeless families with children constitute more than one third of the total homeless population in the United States and face several unique challenges to parenting. The purpose of this study was to adapt and pilot test a parenting intervention for homeless families in transitional housing. An established adaptation model was used to guide this process. The systematic adaptation efforts included: (a) examining the theory of change in the original intervention, (b) identifying population differences relevant to homeless families in transitional housing, (c) adapting the content of the intervention, and (d) adapting the evaluation strategy. Next, a pilot test of the adapted intervention was conducted to examine implementation feasibility and acceptability. Feasibility data indicate an intervention spanning several weeks may be difficult to implement in the context of transitional housing. Yet, acceptability of the adapted intervention among participants was consistently high. The findings of this pilot work suggest several implications for informing continued parenting intervention research and practice with homeless families in transitional housing. © 2018 Family Process Institute.

Use of Community Readiness Model to Develop and Evaluate a Pilot Culinary Training Program for School Nutrition Staff.

PubMed

Hildebrand, Deana A; Blevins, Priscilla; Carl, Lillian; Brown, Barbara; Betts, Nancy M; Poe, Tiffany

2018-02-01

Use the Community Readiness Model (CRM) to develop and evaluate a contextually appropriate pilot culinary training program for school nutrition staff members. Mixed methods to guide intervention development. Six school districts in rural and urban areas of a southwestern state. School nutrition staff (n = 36; female; <1 to >20 years' experience). Pre- and post-training assessments used the CRM. Findings from the pre-assessment were used to develop the pilot culinary training intervention. Readiness to integrate new food preparation methods into existing practices. The researchers used t and Wilcoxon tests to compare overall readiness and dimension scores (P ≤ .05). Thematic analysis was used to identify themes from the discussion component of the assessments. Overall readiness increased from vague awareness to preparation (P = .02). Improved dimensions were knowledge of efforts (P = .004), leadership (P = .05), and knowledge of issues (P = .04). Themes included barriers, leadership, and motivation. The CRM was useful for developing and evaluating a contextually appropriate and effective culinary training program for school nutrition staff. Future efforts should address the provision of additional resources such as on-site chefs, small equipment grants, and engaging school stakeholders. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2018-03-22

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

Behavior problems, foster home integration, and evidence-based behavioral interventions: What predicts adoption of foster children?

PubMed Central

Leathers, Sonya J.; Spielfogel, Jill E.; Gleeson, James P.; Rolock, Nancy

2015-01-01

Objectives Adoption is particularly important for foster children with special mental health needs who are unable to return home, as adoption increases parental support often critically needed by youth with mental health issues. Unfortunately, significant behavior problems frequently inhibit foster parents from adopting, and little is known about factors that predict adoption when a child has behavior problems. Previous research suggests that foster parent behavioral training could potentially increase rates of successful adoptions for pre-school-aged foster children with behavior problems (Fisher, Kim, & Pears, 2009), but this has not been previously tested in older samples. In older children, effective treatment of behavior problems might also increase adoption by reducing the interference of behavior problems and strengthening the child’s foster home integration. This pilot study focused on this question by testing associations between behavior problems, foster home integration, an evidence-based foster parent intervention, and adoption likelihood. Methods This study used an intent-to-treat design to compare foster home integration and adoption likelihood for 31 foster children with histories of abuse and neglect whose foster parents received a foster behavioral parenting intervention (see Chamberlain, 2003) or usual services. Random effect regression analyses were used to estimate outcomes across four time points. Results As expected, externalizing behavior problems had a negative effect on both integration and adoption, and foster home integration had an independent positive effect on adoption. Internalizing behavior problems (e.g., depression/anxiety) were not related to adoption or integration. However, the intervention did not have a direct effect on either foster home integration or adoption despite its positive effect on behavior problems. Conclusions Results from this preliminary study provide further evidence of the negative effect of externalizing behavior problems on adoption. Its findings also suggest that foster home integration is an important dimension of foster home adaptation that appears particularly relevant to chances for adoption. While behavior problems appear to weaken foster home integration, integration is also an independent predictor of adoption likelihood. If these results are replicated in a larger study, consideration of foster home integration in case planning and future intervention studies focused on increasing permanency could potentially improve outcomes for foster children with behavior problems. PMID:26617425

Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention

PubMed Central

Mundorf, Norbert; Redding, Colleen A.; Paiva, Andrea L.

2018-01-01

Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices. PMID:29346314

Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention.

PubMed

Mundorf, Norbert; Redding, Colleen A; Paiva, Andrea L

2018-01-18

Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices.

Development and Pilot of the Caregiver Strategies Inventory.

PubMed

Kirby, Anne V; Little, Lauren M; Schultz, Beth; Watson, Linda R; Zhang, Wanqing; Baranek, Grace T

2016-01-01

Children with autism spectrum disorder often demonstrate unusual behavioral responses to sensory stimuli (i.e., sensory features). To manage everyday activities, caregivers may implement strategies to address these features during family routines. However, investigation of specific strategies used by caregivers is limited by the lack of empirically developed measures. In this study, we describe the development and pilot results of the Caregiver Strategies Inventory (CSI), a supplement to the Sensory Experiences Questionnaire Version 3.0 (SEQ 3.0; Baranek, 2009) that measures caregivers' strategies in response to their children's sensory features. Three conceptually derived and empirically grounded strategy types were tested: cognitive-behavioral, sensory-perceptual, and avoidance. Results indicated that the CSI demonstrated good internal consistency and that strategy use was related to child age and cognition. Moreover, parent feedback after completing the CSI supported its utility and social validity. The CSI may be used alongside the SEQ 3.0 to facilitate a family-centered approach to assessment and intervention planning. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Pilot randomized controlled trial of dialectical behavior therapy group skills training for ADHD among college students.

PubMed

Fleming, Andrew P; McMahon, Robert J; Moran, Lyndsey R; Peterson, A Paige; Dreessen, Anthony

2015-03-01

ADHD affects between 2% and 8% of college students and is associated with broad functional impairment. No prior randomized controlled trials with this population have been published. The present study is a pilot randomized controlled trial evaluating dialectical behavior therapy (DBT) group skills training adapted for college students with ADHD. Thirty-three undergraduates with ADHD between ages 18 and 24 were randomized to receive either DBT group skills training or skills handouts during an 8-week intervention phase. ADHD symptoms, executive functioning (EF), and related outcomes were assessed at baseline, post-treatment, and 3-month follow-up. Participants receiving DBT group skills training showed greater treatment response rates (59-65% vs. 19-25%) and clinical recovery rates (53-59% vs. 6-13%) on ADHD symptoms and EF, and greater improvements in quality of life. DBT group skills training may be efficacious, acceptable, and feasible for treating ADHD among college students. A larger randomized trial is needed for further evaluation. © 2014 SAGE Publications.

Short-term cognitive behavioral partial hospital treatment: a pilot study.

PubMed

Neuhaus, Edmund C; Christopher, Michael; Jacob, Karen; Guillaumot, Julien; Burns, James P

2007-09-01

Brief, cost-contained, and effective psychiatric treatments benefit patients and public health. This naturalistic pilot study examined the effectiveness of a 2-week, cognitive-behavioral therapy (CBT) oriented partial hospital program. Study participants were 57 patients with mood, anxiety, and/or personality disorders receiving treatment in a private psychiatric partial hospital (PH) setting. A flexible treatment model was used that adapts evidence-based CBT treatment interventions to the PH context with emphases on psychoeducation and skills training. Participants completed self-report measures at admission and after 1 and 2 weeks, to assess stabilization and functional improvements, with added attention to the acquisition of cognitive and behavioral skills. The data were analyzed using repeated measures analyses of variance and correlation. Participants reported a decrease in symptoms and negative thought patterns, improved satisfaction with life, and acquisition and use of cognitive and behavioral skills. Skill acquisition was correlated with symptom reduction, reduced negative thought patterns, and improved satisfaction with life. Results of this pilot study suggest that a 2-week PH program can be effective for a heterogeneous patient population with mood, anxiety, and/or personality disorders. These findings are promising given the prevalence of treatments of such brief duration in private sector PH programs subject to the managed care marketplace. Future studies are planned to test this flexible PH treatment model, with particular attention to the effectiveness of the CBT approach for the treatment of different disorders and to whether effectiveness is sustained at follow-up. Further study should also examine whether skill acquisition is a mechanism of change for symptom reduction and functional improvements.

Direct costs of preventive headache treatments: comparison of behavioral and pharmacologic approaches.

PubMed

Schafer, Allison M; Rains, Jeanetta C; Penzien, Donald B; Groban, Leanne; Smitherman, Todd A; Houle, Timothy T

2011-06-01

This study provides preliminary data and a framework to facilitate cost comparisons for pharmacologic vs behavioral approaches to headache prophylactic treatment. There are few empirical demonstrations of cumulative costs for pharmacologic and behavioral headache treatments, and there are no direct comparisons of short- and long-range (5-year) costs for pharmacologic vs behavioral headache treatments. Two separate pilot surveys were distributed to a convenience sample of behavioral specialists and physicians identified from the membership of the American Headache Society. Costs of prototypical regimens for preventive pharmacologic treatment (PPT), clinic-based behavioral treatment (CBBT), minimal contact behavioral treatment (MCBT), and group behavioral treatment were assessed. Each survey addressed total cost accumulated during treatment (ie, intake, professional fees) excluding costs of acute medications. The total costs of preventive headache therapy by type of treatment were then evaluated and compared over time. During the initial months of treatment, PPT with inexpensive mediations (<0.75 $/day) represents the least costly regimen and is comparable to MCBT in expense until 6 months. After 6 months, PPT is expected to become more costly, particularly when medication cost exceeds 0.75$ a day. When using an expensive medication (>3 $/day), preventive drug treatment becomes more expensive than CBBT after the first year. Long-term, and within year 1, MCBT was found to be the least costly approach to migraine prevention. Through year 1 of treatment, inexpensive prophylactic medications (such as generically available beta-blocker or tricyclic antidepressant medications) and behavioral interventions utilizing limited delivery formats (MCBT) are the least costly of the empirically validated interventions. This analysis suggests that, relative to pharmacologic options, limited format behavioral interventions are cost-competitive in the early phases of treatment and become more cost-efficient as the years of treatment accrue. © 2011 American Headache Society.

Unused opioid analgesics and drug disposal following outpatient dental surgery: A randomized controlled trial.

PubMed

Maughan, Brandon C; Hersh, Elliot V; Shofer, Frances S; Wanner, Kathryn J; Archer, Elizabeth; Carrasco, Lee R; Rhodes, Karin V

2016-11-01

Individuals who abuse prescription opioids often use leftover pills that were prescribed for friends or family members. Dental surgery has been identified as a common source of opioid prescriptions. We measured rates of used and unused opioids after dental surgery for a pilot program to promote safe drug disposal. We conducted a randomized controlled trial of opioid use patterns among patients undergoing surgical tooth extraction at a university-affiliated oral surgery practice. The primary objective was to describe opioid prescribing and consumption patterns, with the number of unused opioid pills remaining on postoperative day 21 serving as the primary outcome. The secondary aim was to measure the effect of a behavioral intervention (informing patients of a pharmacy-based opioid disposal program) on the proportion of patients who disposed or reported intent to dispose of unused opioids. (NCT02814305) Results: We enrolled 79 patients, of whom 72 filled opioid prescriptions. On average, patients received 28 opioid pills and had 15 pills (54%) left over, for a total of 1010 unused pills among the cohort. The behavioral intervention was associated with a 22% absolute increase in the proportion of patients who disposed or reported intent to dispose of unused opioids (Fisher's exact p=0.11). Fifty-four percent of opioids prescribed in this pilot study were not used. The pharmacy-based drug disposal intervention showed a robust effect size but did not achieve statistical significance. Dentists and oral surgeons could potentially reduce opioid diversion by moderately reducing the quantity of opioid analgesics prescribed after surgery. Copyright © 2016. Published by Elsevier Ireland Ltd.

Making an IMPACT: effect of a school-based pilot intervention.

PubMed

Muth, Natalie Digate; Chatterjee, Avik; Williams, Donna; Cross, Alan; Flower, Kori

2008-01-01

Poor nutrition and inactivity are widespread and contribute to the epidemic problem of childhood obesity. This study examined the effectiveness of a school-based pilot program to improve nutrition and activity in elementary (ES) and high school (HS) students. The Improving Meals and Physical Activity in Children and Teens (IMPACT) school-based curriculum used a train-the-trainer model to improve activity and nutrition. Nine students were recruited from one rural North Carolina high school and trained in the IMPACT curriculum and leadership skills. Four 4th grade classes at a neighboring elementary school were randomized to receive the IMPACT curriculum delivered by the HS students over 12 weeks (two classrooms, 38 students) versus the standard curriculum (two classrooms, 37 students). Pre- and post-intervention surveys were used to assess program effectiveness. ES students in the intervention classes reported increased fruit and vegetable intake (+0.85 servings/day compared with controls; p < 0.05) and improved knowledge of the food group in which to eat the most servings (p < 0.01). ES students who participated in the IMPACT curriculum also reported increased intake of calcium-rich foods and grains, though these results were not statistically significant. Similar though nonsignificant improvements in diet behaviors were reported by the HS students who assisted in delivering the 4th grade curriculum. Study limitations include small sample size, risk of cross-contamination, and short program duration. ES students who participated in the IMPACT curriculum reported improved dietary behaviors and knowledge. School-based curricula such as IMPACT may help improve nutrition among ES students.

The immediate effect of a brief energy psychology intervention (Emotional Freedom Techniques) on specific phobias: a pilot study.

PubMed

Salas, Martha M; Brooks, Audrey J; Rowe, Jack E

2011-01-01

Specific phobia is one of the most prevalent anxiety disorders. Emotional Freedom Techniques (EFT) has been shown to improve anxiety symptoms; however, their application to specific phobias has received limited attention. This pilot study examined whether EFT, a brief exposure therapy that combines cognitive and somatic elements, had an immediate effect on the reduction of anxiety and behavior associated with specific phobias. The study utilized a crossover design with participants randomly assigned to either diaphragmatic breathing or EFT as the first treatment. The study was conducted at a regional university in the Southwestern United States. Twenty-two students meeting criteria for a phobic response to a specific stimulus (≥8 on an 11-point subjective units of distress scale). Participants completed a total of five two-minute rounds in each treatment intervention. Study measures included a behavioral approach test (BAT), Subjective Units of Distress Scale (SUDS), and Beck Anxiety Inventory (BAI). Emotional Freedom Techniques significantly reduced phobia-related anxiety (BAI P = .042; SUDS P = .002) and ability to approach the feared stimulus (BAT P = .046) whether presented as an initial treatment or following diaphragmatic breathing. When presented as the initial treatment, the effects of EFT remained through the presentation of the comparison intervention. The efficacy of EFT in treating specific phobias demonstrated in several earlier studies is corroborated by the current investigation. Comparison studies between EFT and the most effective established therapies for treating specific phobias are recommended. Copyright © 2011 Elsevier Inc. All rights reserved.

Total skin self-examination at home for people treated for cutaneous melanoma: development and pilot of a digital intervention.

PubMed

Murchie, Peter; Allan, Julia L; Brant, William; Dennis, Matthew; Hall, Susan; Masthoff, Judith; Walter, Fiona M; Johnston, Marie

2015-08-06

To develop a digital intervention to prompt, support, and respond to the outcomes of total skin self-examinations (TSSEs) at home by people treated for cutaneous melanoma. A complex intervention development study. Northeast Scotland. Semistructured scoping interviews; people previously treated for cutaneous melanoma (n=21). Pilot testing: people treated for melanoma stages 0-2C (n=20); general practitioners (n=6); and a nurse specialist in dermatology (n=1). A tablet-based digital intervention designed to prompt and support TSSEs comprising instructional videos and electronic reporting (including photographs) to a clinical nurse specialist in dermatology, with subsequent clinical triage. Qualitative assessment of intervention feasibility and acceptability, and quantitative assessment of intentions and confidence to perform TSSEs in pilot participants. The majority of pilot participants were strongly positive and adhered well to the intervention (n=15), with 7 of these reporting symptoms of concern at some point during the 6-month pilot. 4 patients complied intermittently, 3 reporting skin problems at least once during the pilot, and 1 withdrew. 2 patients underwent skin surgery as a result of participating in the pilot, with 1 diagnosed as having a recurrent melanoma and the other, a benign lesion. A number of practical issues to improve the usability of the intervention were identified. The proportion of participants reporting intention to check their skin at least monthly increased during the intervention as did confidence to conduct a skin check. People previously treated for cutaneous melanoma are prepared to use digital technology to support them in conducting TSSE. An intervention has been developed which is practical, effective and safe, and after addressing minor practical issues, could now be evaluated for clinical outcomes in a randomised clinical trial. 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.

Developing Items to Measure Theory of Planned Behavior Constructs for Opioid Administration for Children: Pilot Testing.

PubMed

Vincent, Catherine; Riley, Barth B; Wilkie, Diana J

2015-12-01

The Theory of Planned Behavior (TpB) is useful to direct nursing research aimed at behavior change. As proposed in the TpB, individuals' attitudes, perceived norms, and perceived behavior control predict their intentions to perform a behavior and subsequently predict their actual performance of the behavior. Our purpose was to apply Fishbein and Ajzen's guidelines to begin development of a valid and reliable instrument for pediatric nurses' attitudes, perceived norms, perceived behavior control, and intentions to administer PRN opioid analgesics when hospitalized children self-report moderate to severe pain. Following Fishbein and Ajzen's directions, we were able to define the behavior of interest and specify the research population, formulate items for direct measures, elicit salient beliefs shared by our target population and formulate items for indirect measures, and prepare and test our questionnaire. For the pilot testing of internal consistency of measurement items, Cronbach alphas were between 0.60 and 0.90 for all constructs. Test-retest reliability correlations ranged from 0.63 to 0.90. Following Fishbein and Ajzen's guidelines was a feasible and organized approach for instrument development. In these early stages, we demonstrated good reliability for most subscales, showing promise for the instrument and its use in pain management research. Better understanding of the TpB constructs will facilitate the development of interventions targeted toward nurses' attitudes, perceived norms, and/or perceived behavior control to ultimately improve their pain behaviors toward reducing pain for vulnerable children. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.