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.

More Useful, or Not so Bad? Evaluating the Effects of Interventions to Reduce Perceived Cost and Increase Utility Value with College Physics Students

ERIC Educational Resources Information Center

Rosenzweig, Emily Quinn

2017-01-01

In the present study I developed and evaluated the effects of two interventions designed to target students' motivation to learn in an introductory college physics course. One intervention was designed to improve students' perceptions of utility value and the other was designed to reduce students' perceptions of cost. Utility value and cost both…

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

PubMed

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

2018-04-04

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

Evaluating the Effects of School Health Interventions on School Performance. Design Report.

ERIC Educational Resources Information Center

Devaney, Barbara; And Others

This evaluation design report presents a general framework for assessing the effects of school health interventions on students' school performance in order to guide efforts to develop strong empirical evidence. The report begins with an overview of eight general types of school health interventions: school health education, health services,…

Effects of Feedback in an Online Algebra Intervention

ERIC Educational Resources Information Center

Bokhove, Christian; Drijvers, Paul

2012-01-01

The design and arrangement of appropriate automatic feedback in digital learning environment is a widely recognized issue. In this article, we investigate the effect of feedback on the design and the results of a digital intervention for algebra. Three feedback principles guided the intervention: timing and fading, crises, and feedback variation.…

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach

PubMed Central

2012-01-01

Background Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. Methods We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Results Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Conclusions Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru. PMID:22269578

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach.

PubMed

Huicho, Luis; Adam, Taghreed; Rosales, Edmundo; Paca-Palao, Ada; López, Luis; Luna, Diego; Miranda, J Jaime

2012-01-23

Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru.

Defining, Designing, Implementing, and Evaluating Phase 4 HIV Prevention Effectiveness Trials for Vulnerable Populations

PubMed Central

Kelly, Jeffrey A.; Spielberg, Freya; McAuliffe, Timothy L.

2008-01-01

Summary The efficacy of behavioral HIV prevention interventions has been convincingly demonstrated in a large number of randomized controlled phase 3 research outcome trials. Little research attention has been directed toward studying the effectiveness of the same interventions when delivered by providers to their own clients or community members, however. This article argues for the need to conduct phase 4 effectiveness trials of HIV prevention interventions that have been found efficacious in the research arena. Such trials can provide important information concerning the impact of interventions when applied in heterogeneous “real-world” circumstances. This article raises design issues and methodologic questions that need to be addressed in the conduct of phase 4 trials of behavioral interventions. These issues include the selection and training of service providers engaged in such trials, maintenance of fidelity to intervention protocol in provider-delivered interventions, determination of intervention core elements versus aspects that require tailoring, selection of relevant phase 4 study outcomes, interpretation of findings indicative of field effectiveness, sustainability, and other aspects of phase 4 trial design. PMID:18301131

Theory of Change: a theory-driven approach to enhance the Medical Research Council's framework for complex interventions

PubMed Central

2014-01-01

Background The Medical Research Councils’ framework for complex interventions has been criticized for not including theory-driven approaches to evaluation. Although the framework does include broad guidance on the use of theory, it contains little practical guidance for implementers and there have been calls to develop a more comprehensive approach. A prospective, theory-driven process of intervention design and evaluation is required to develop complex healthcare interventions which are more likely to be effective, sustainable and scalable. Methods We propose a theory-driven approach to the design and evaluation of complex interventions by adapting and integrating a programmatic design and evaluation tool, Theory of Change (ToC), into the MRC framework for complex interventions. We provide a guide to what ToC is, how to construct one, and how to integrate its use into research projects seeking to design, implement and evaluate complex interventions using the MRC framework. We test this approach by using ToC within two randomized controlled trials and one non-randomized evaluation of complex interventions. Results Our application of ToC in three research projects has shown that ToC can strengthen key stages of the MRC framework. It can aid the development of interventions by providing a framework for enhanced stakeholder engagement and by explicitly designing an intervention that is embedded in the local context. For the feasibility and piloting stage, ToC enables the systematic identification of knowledge gaps to generate research questions that strengthen intervention design. ToC may improve the evaluation of interventions by providing a comprehensive set of indicators to evaluate all stages of the causal pathway through which an intervention achieves impact, combining evaluations of intervention effectiveness with detailed process evaluations into one theoretical framework. Conclusions Incorporating a ToC approach into the MRC framework holds promise for improving the design and evaluation of complex interventions, thereby increasing the likelihood that the intervention will be ultimately effective, sustainable and scalable. We urge researchers developing and evaluating complex interventions to consider using this approach, to evaluate its usefulness and to build an evidence base to further refine the methodology. Trial registration Clinical trials.gov: NCT02160249 PMID:24996765

Theory of Change: a theory-driven approach to enhance the Medical Research Council's framework for complex interventions.

PubMed

De Silva, Mary J; Breuer, Erica; Lee, Lucy; Asher, Laura; Chowdhary, Neerja; Lund, Crick; Patel, Vikram

2014-07-05

The Medical Research Councils' framework for complex interventions has been criticized for not including theory-driven approaches to evaluation. Although the framework does include broad guidance on the use of theory, it contains little practical guidance for implementers and there have been calls to develop a more comprehensive approach. A prospective, theory-driven process of intervention design and evaluation is required to develop complex healthcare interventions which are more likely to be effective, sustainable and scalable. We propose a theory-driven approach to the design and evaluation of complex interventions by adapting and integrating a programmatic design and evaluation tool, Theory of Change (ToC), into the MRC framework for complex interventions. We provide a guide to what ToC is, how to construct one, and how to integrate its use into research projects seeking to design, implement and evaluate complex interventions using the MRC framework. We test this approach by using ToC within two randomized controlled trials and one non-randomized evaluation of complex interventions. Our application of ToC in three research projects has shown that ToC can strengthen key stages of the MRC framework. It can aid the development of interventions by providing a framework for enhanced stakeholder engagement and by explicitly designing an intervention that is embedded in the local context. For the feasibility and piloting stage, ToC enables the systematic identification of knowledge gaps to generate research questions that strengthen intervention design. ToC may improve the evaluation of interventions by providing a comprehensive set of indicators to evaluate all stages of the causal pathway through which an intervention achieves impact, combining evaluations of intervention effectiveness with detailed process evaluations into one theoretical framework. Incorporating a ToC approach into the MRC framework holds promise for improving the design and evaluation of complex interventions, thereby increasing the likelihood that the intervention will be ultimately effective, sustainable and scalable. We urge researchers developing and evaluating complex interventions to consider using this approach, to evaluate its usefulness and to build an evidence base to further refine the methodology. Clinical trials.gov: NCT02160249.

Does understanding relational terminology mediate effects of intervention on compare word problems?

PubMed

Schumacher, Robin F; Fuchs, Lynn S

2012-04-01

The purpose of this study was to assess whether understanding relational terminology (i.e., more, less, and fewer) mediates the effects of intervention on compare word problems. Second-grade classrooms (N=31) were randomly assigned to one of three conditions: researcher-designed word-problem intervention, researcher-designed calculation intervention, or business-as-usual (teacher-designed) control. Students in word-problem intervention classrooms received instruction on the compare problem type, which included a focus on understanding relational terminology within compare word problems. Analyses, which accounted for variance associated with classroom clustering, indicated that (a) compared with the calculation intervention and business-as-usual conditions, word-problem intervention significantly increased performance on all three subtypes of compare problems and on understanding relational terminology, and (b) the intervention effect was fully mediated by students' understanding of relational terminology for one subtype of compare problems and partially mediated by students' understanding of relational terminology for the other two subtypes. Copyright © 2011 Elsevier Inc. All rights reserved.

Writing Simple Sentences and Descriptive Paragraphs: Effects of an Intervention on Adolescents with Writing Difficulties

ERIC Educational Resources Information Center

Datchuk, Shawn M.

2016-01-01

The present study investigated the effects of a multicomponent intervention on the writing behavior of adolescents with writing difficulties. A single-case design consisting of a combination of multiple-probe design across participants and pre-post test was used. Four participants completed two intervention phases: (a) sentence instruction and…

Are interventions to enhance communication performance in allied health professionals effective, and how should they be delivered? Direct and indirect evidence.

PubMed

Parry, Ruth

2008-11-01

(1) To systematically review direct evidence about effects of interventions to improve communication performance amongst allied health professionals (AHPs). (2) To summarise indirect evidence pertinent to design, delivery, effects, and evaluation of such interventions. (1) Systematic search and narrative review of evaluations of interventions for AHPs. (2) Systematic search and narrative summary of reviews of corresponding interventions in medicine and nursing. Five reports of interventions for AHPs were included. All reported positive effects of training. Strongest evidence was from two small-n within-subjects controlled studies that evaluated highly specific training for qualified therapists in brain injury rehabilitation environments. Indirect evidence from nine systematic reviews in medicine and nursing indicated positive effects of communication training. Robust designs yielded smallest effect sizes. Interventions based on strong conceptual and empirical foundations and targeting specific areas of practice appeared more effective. Strongest evidence is for performance-based training for clinicians already working with patients. More empirical and conceptual understandings about AHPs' communication practices are required so as to improve the design, delivery and subsequent evaluation of communication training amongst these important healthcare workers. Preliminary and indirect evidence suggest it is possible to positively influence AHP clinicians' performance and patients' outcomes if training interventions are specific, founded on evidence about effective practice and delivered using practical modalities.

Accumulating Knowledge: When Are Reading Intervention Results Meaningful?

ERIC Educational Resources Information Center

Fletcher, Jack M.; Wagner, Richard K.

2014-01-01

The three target articles provide examples of intervention studies that are excellent models for the field. They rely on rigorous and elegant designs, the interventions are motivated by attention to underlying theoretical mechanisms, and longitudinal designs are used to examine the duration of effects of interventions that occur. When studies are…

Efficacy of Two Mathematics Interventions for Enhancing Fluency with Elementary Students

ERIC Educational Resources Information Center

Mong, Michael D.; Mong, Kristi W.

2010-01-01

An alternating treatments design was used to evaluate two curriculum-based mathematics interventions designed to enhance fluency with three elementary school students. Results indicate that both the Math to Mastery (MTM) intervention and the Cover, Copy, Compare (CCC) intervention were effective at increasing mathematics fluency, as measured by…

Designing and Scaling Highly Effective Interventions That Produce BIG Improvement: "Counter-Intuitive Lessons from the Higher Order Thinking Skills (HOTS) Project." Conference Paper

ERIC Educational Resources Information Center

Pogrow, Stanley

2015-01-01

There is little discussion in the Design-Based Research (DBR) literature on how to design an intervention that has the potential to be highly effective. The act of designing is usually viewed as engineering something from theory or research on best practices. This paper challenges that universal belief and presents successful design as an…

Precision of Curriculum-Based Measurement Reading Data: Considerations for Multiple-Baseline Designs

ERIC Educational Resources Information Center

Klingbeil, David A.; Van Norman, Ethan R.; Nelson, Peter M.

2017-01-01

Single-case designs provide an established technology for evaluating the effects of academic interventions. Researchers interested in studying the long-term effects of reading interventions often use curriculum-based measures of reading (CBM-R) as they possess many of the desirable characteristics for use in a time-series design. The reliability…

Job design, employment practices and well-being: a systematic review of intervention studies.

PubMed

Daniels, Kevin; Gedikli, Cigdem; Watson, David; Semkina, Antonina; Vaughn, Oluwafunmilayo

2017-09-01

There is inconsistent evidence that deliberate attempts to improve job design realise improvements in well-being. We investigated the role of other employment practices, either as instruments for job redesign or as instruments that augment job redesign. Our primary outcome was well-being. Where studies also assessed performance, we considered performance as an outcome. We reviewed 33 intervention studies. We found that well-being and performance may be improved by: training workers to improve their own jobs; training coupled with job redesign; and system wide approaches that simultaneously enhance job design and a range of other employment practices. We found insufficient evidence to make any firm conclusions concerning the effects of training managers in job redesign and that participatory approaches to improving job design have mixed effects. Successful implementation of interventions was associated with worker involvement and engagement with interventions, managerial commitment to interventions and integration of interventions with other organisational systems. Practitioner Summary: Improvements in well-being and performance may be associated with system-wide approaches that simultaneously enhance job design, introduce a range of other employment practices and focus on worker welfare. Training may have a role in initiating job redesign or augmenting the effects of job design on well-being.

Check-In Check-Out + Social Skills: Enhancing the Effects of Check-In Check-Out for Students With Social Skill Deficits

ERIC Educational Resources Information Center

Ross, Scott W.; Sabey, Christian V.

2015-01-01

Check-In Check-Out is a Tier 2 intervention designed to reduce problem behavior and increase prosocial behavior. Although the intervention has demonstrated effects in several studies, few research efforts have considered how the intervention can be modified to support students with social skill deficits. Through a multiple baseline design across…

Effects of Automated Tier 2 Storybook Intervention on Vocabulary and Comprehension Learning in Preschool Children with Limited Oral Language Skills

ERIC Educational Resources Information Center

Kelley, Elizabeth Spencer; Goldstein, Howard; Spencer, Trina D.; Sherman, Amber

2015-01-01

This early efficacy study examined the effects of an automated storybook intervention designed to promote school readiness among at-risk prekindergarten children. Story Friends is a small-group intervention in which vocabulary and question-answering lessons are embedded in a series of storybooks.A randomized group design with an embedded…

Workplace physical activity interventions: a systematic review.

PubMed

To, Quyen G; Chen, Ted T L; Magnussen, Costan G; To, Kien G

2013-01-01

To assess the effectiveness of workplace interventions in improving physical activity. EBSCO research database (and all subdatabases). Articles were published from 2000 to 2010 in English, had appropriate designs, and measured employees' physical activity, energy consumption, and/or body mass index (BMI) as primary outcomes. Articles that did not meet the inclusion criteria were excluded. Data extracted included study design, study population, duration, intervention activities, outcomes, and results. Data were synthesized into one table. Results of each relevant outcome including p values were combined. Twelve (60%) of 20 selected interventions reported an improvement in physical activity level, steps, or BMI, and there was one slowed step reduction in the intervention group. Among these, 10 were less than 6 months in duration; 9 used pedometers; 6 applied Internet-based approaches; and 5 included activities targeting social and environmental levels. Seven of 8 interventions with pre-posttest and quasi-experimental controlled design showed improvement on at least one outcome. However, 7 of 12 randomized controlled trials (RCTs) did not prove effective in any outcome. Interventions that had less rigorous research designs, used pedometers, applied Internet-based approaches, and included activities at social and environmental levels were more likely to report being effective than those without these characteristics.

Psycho-educational strategies to promote fluid adherence in adult hemodialysis patients: a review of intervention studies.

PubMed

Welch, Janet L; Thomas-Hawkins, Charlotte

2005-07-01

We reviewed psycho-educational intervention studies that were designed to reduce interdialytic weight gain (IDWG) in adult hemodialysis patients. Our goals were to critique research methods, describe the effectiveness of tested interventions, and make recommendations for future research. Medline, PsychInfo, and the Cumulative Index to Nursing and Applied Health (CINAHL) databases were searched to identify empirical work. Each study was evaluated in terms of sample, design, theoretical framework, intervention delivery, and outcome. Nine studies were reviewed. Self-monitoring appears to be a promising strategy to be considered to reduce IDWG. Theory was not usually used to guide interventions, designs generally had control groups, interventions were delivered individually, more than one intervention was delivered at a time, the duration of the intervention varied greatly, there was no long-term follow-up, IDWG was the only outcome, and IDWG was operationalized in different ways. Theoretical models and methodological rigor are needed to guide future research. Specific recommendations on design, measurement, and conceptual issues are offered to enhance the effectiveness of future research.

Simulations for designing and interpreting intervention trials in infectious diseases.

PubMed

Halloran, M Elizabeth; Auranen, Kari; Baird, Sarah; Basta, Nicole E; Bellan, Steven E; Brookmeyer, Ron; Cooper, Ben S; DeGruttola, Victor; Hughes, James P; Lessler, Justin; Lofgren, Eric T; Longini, Ira M; Onnela, Jukka-Pekka; Özler, Berk; Seage, George R; Smith, Thomas A; Vespignani, Alessandro; Vynnycky, Emilia; Lipsitch, Marc

2017-12-29

Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods. Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process. In an increasingly complex world, simulations can explicitly represent transmission dynamics, which are critical for proper trial design and interpretation. Certain ethical aspects of a trial can also be quantified using simulations. Further, after a trial has been conducted, simulations can be used to explore the possible explanations for the observed effects. Much is to be gained through a multidisciplinary approach that builds collaborations among experts in infectious disease dynamics, epidemiology, statistical science, economics, simulation methods, and the conduct of clinical trials.

Flexible workspace design and ergonomics training: impacts on the psychosocial work environment, musculoskeletal health, and work effectiveness among knowledge workers.

PubMed

Robertson, Michelle M; Huang, Yueng-Hsiang; O'Neill, Michael J; Schleifer, Lawrence M

2008-07-01

A macroergonomics intervention consisting of flexible workspace design and ergonomics training was conducted to examine the effects on psychosocial work environment, musculoskeletal health, and work effectiveness in a computer-based office setting. Knowledge workers were assigned to one of four conditions: flexible workspace (n=121), ergonomics training (n=92), flexible workspace+ergonomics training (n=31), and a no-intervention control (n=45). Outcome measures were collected 2 months prior to the intervention and 3 and 6 months post-intervention. Overall, the study results indicated positive, significant effects on the outcome variables for the two intervention groups compared to the control group, including work-related musculoskeletal discomfort, job control, environmental satisfaction, sense of community, ergonomic climate, communication and collaboration, and business process efficiency (time and costs). However, attrition of workers in the ergonomics training condition precluded an evaluation of the effects of this intervention. This study suggests that a macroergonomics intervention is effective among knowledge workers in office settings.

Caring for the Elderly at Work and Home: Can a Randomized Organizational Intervention Improve Psychological Health?

PubMed

Kossek, Ellen Ernst; Thompson, Rebecca J; Lawson, Katie M; Bodner, Todd; Perrigino, Matthew B; Hammer, Leslie B; Buxton, Orfeu M; Almeida, David M; Moen, Phyllis; Hurtado, David A; Wipfli, Brad; Berkman, Lisa F; Bray, Jeremy W

2017-12-07

Although job stress models suggest that changing the work social environment to increase job resources improves psychological health, many intervention studies have weak designs and overlook influences of family caregiving demands. We tested the effects of an organizational intervention designed to increase supervisor social support for work and nonwork roles, and job control in a results-oriented work environment on the stress and psychological distress of health care employees who care for the elderly, while simultaneously considering their own family caregiving responsibilities. Using a group-randomized organizational field trial with an intent-to-treat design, 420 caregivers in 15 intervention extended-care nursing facilities were compared with 511 caregivers in 15 control facilities at 4 measurement times: preintervention and 6, 12, and 18 months. There were no main intervention effects showing improvements in stress and psychological distress when comparing intervention with control sites. Moderation analyses indicate that the intervention was more effective in reducing stress and psychological distress for caregivers who were also caring for other family members off the job (those with elders and those "sandwiched" with both child and elder caregiving responsibilities) compared with employees without caregiving demands. These findings extend previous studies by showing that the effect of organizational interventions designed to increase job resources to improve psychological health varies according to differences in nonwork caregiving demands. This research suggests that caregivers, especially those with "double-duty" elder caregiving at home and work and "triple-duty" responsibilities, including child care, may benefit from interventions designed to increase work-nonwork social support and job control. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A practical limit to trials needed in one-person randomized controlled experiments.

PubMed

Alemi, Roshan; Alemi, Farrokh

2007-01-01

Recently in this journal, J. Olsson and colleagues suggested the use of factorial experimental designs to guide a patient's efforts to choose among multiple interventions. These authors argue that factorial design, where every possible combination of the interventions is tried, is superior to sequential trial and errors. Factorial design is efficient in identifying the effectiveness of interventions (factor effect). Most patients care only about feeling better and not why their conditions are improving. If the goal of the patient is to get better and not to estimate the factor effect, then no control groups are needed. In this article, we show a modification in the factorial design of experiments proposed by Olsson and colleagues where a full-factorial design is planned, but experimentation is stopped when the patient's condition improves. With this modification, the number of trials is radically fewer than those needed by factorial design. For example, a patient trying out 4 different interventions with a median probability of success of .50 is expected to need 2 trials before stopping the experimentation in comparison with 32 in a full-factorial design.

Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact.

PubMed

Curran, Geoffrey M; Bauer, Mark; Mittman, Brian; Pyne, Jeffrey M; Stetler, Cheryl

2012-03-01

This study proposes methods for blending design components of clinical effectiveness and implementation research. Such blending can provide benefits over pursuing these lines of research independently; for example, more rapid translational gains, more effective implementation strategies, and more useful information for decision makers. This study proposes a "hybrid effectiveness-implementation" typology, describes a rationale for their use, outlines the design decisions that must be faced, and provides several real-world examples. An effectiveness-implementation hybrid design is one that takes a dual focus a priori in assessing clinical effectiveness and implementation. We propose 3 hybrid types: (1) testing effects of a clinical intervention on relevant outcomes while observing and gathering information on implementation; (2) dual testing of clinical and implementation interventions/strategies; and (3) testing of an implementation strategy while observing and gathering information on the clinical intervention's impact on relevant outcomes. The hybrid typology proposed herein must be considered a construct still in evolution. Although traditional clinical effectiveness and implementation trials are likely to remain the most common approach to moving a clinical intervention through from efficacy research to public health impact, judicious use of the proposed hybrid designs could speed the translation of research findings into routine practice.

Reach and Effectiveness of an Integrated Community-Based Intervention on Physical Activity and Healthy Eating of Older Adults in a Socioeconomically Disadvantaged Community

ERIC Educational Resources Information Center

Luten, Karla A.; Reijneveld, Sijmen A.; Dijkstra, Arie; de Winter, Andrea F.

2016-01-01

The aim of this study is to assess the reach and effectiveness of an integrated community-based intervention designed to promote physical activity and healthy eating among older adults in a socioeconomically disadvantaged community in the Netherlands. The intervention was evaluated with a controlled pre-post quasi-experimental design, with 430…

Prevention Programs to Augment Family and Child Resilience Can Have Lasting Effects on Suicidal Risk.

PubMed

Brent, David

2016-04-01

In this commentary, the effects of four family-based preventive interventions designed to augment parent and child resilience, originally designed to prevent mental health and substance abuse, on suicide ideation and attempts are reviewed. Three of the preventive interventions showed a beneficial effect either on child suicide ideation or attempts, and one found a beneficial effect on parental suicidal ideation. The duration of effects in two of these studies was well longer than a decade. These studies suggest that interventions to augment family and child resiliency originally designed to prevent mental health and substance abuse disorders can also have beneficial, often long-term, effects on suicidal ideation and behavior. © 2016 The American Association of Suicidology.

Effect of a workplace design and training intervention on individual performance, group effectiveness and collaboration: the role of environmental control.

PubMed

Robertson, Michelle M; Huang, Yueng-Hsiang

2006-01-01

The effects of a workplace design and training intervention and the relationships between perceived satisfaction of office workplace design factors (layout and storage) and work performance measures (individual performance, group collaboration and effectiveness) were studied with 120 office workers using the Workplace Environment Questionnaire. Further, we examined whether environmental control had a direct effect on work performance, and then explored whether environmental control mediated or moderated the relationship between workplace design factors and work performance. Results showed a significant, positive impact of the intervention on environmental satisfaction for workstation layout. Satisfaction with workstation layout had a significant relationship with individual performance, group collaboration and effectiveness; and satisfaction with workstation storage had a significant relationship with individual performance and group collaboration. Environmental control had a direct impact on individual performance and group collaboration; whereas, the mediating and moderating effects of environmental control on the relationship between workplace design factors and outcome variables were not significant.

Can a Costly Intervention Be Cost-effective?

PubMed Central

Foster, E. Michael; Jones, Damon

2009-01-01

Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

Assessment of a web-based Guided Self-Determination intervention for adults with type 2 diabetes in general practice: a study protocol

PubMed Central

Karlsen, Bjørg; Oftedal, Bjørg; Stangeland Lie, Silje; Rokne, Berit; Peyrot, Mark; Zoffmann, Vibeke; Graue, Marit

2016-01-01

Introduction Self-management is deemed the cornerstone in overall diabetes management. Web-based self-management interventions have potential to support adults with type 2 diabetes (T2DM) in managing their disease. Owing to somewhat ambiguous results of such interventions, interventions should be theory-based and incorporate well-defined counselling methods and techniques for behavioural change. This study is designed to assess the effectiveness of a theory-driven web-based Guided Self-Determination (GSD) intervention among adults with T2DM in general practice to improve diabetes self-management behaviours and glycosylated haemoglobin (HbA1c). Methods and analysis A complex intervention design based on the framework of the UK Medical Research Council is employed as a guide for developing the intervention, assessing its feasibility and evaluating its effectiveness. The study consists of three phases: (1) the modelling phase adapting the original GSD programme for adults with T2DM, using a qualitative design, (2) feasibility assessment of the adapted intervention on the web, employing qualitative and quantitative methods and (3) evaluating the effectiveness of the intervention on diabetes self-management behaviours and HbA1c, using a quasi-experimental design. The first phase, which is completed, and the second phase, which is underway, will provide important information about the development of the intervention and its acceptability, whereas the third phase will assess the effectiveness of this systematically developed intervention. Ethics and dissemination The Norwegian Regional Committee for Medical and Health Research Ethics (REK west number 2015/60) has approved the study design. Patients recruited in the different phases will fill out an informed consent form prior to inclusion and will be guaranteed anonymity and the right to withdraw from the study at any time. The results of the study will be published in peer-reviewed journals, electronically and in print, and presented at research conferences. Trial registration number: NCT02575599. PMID:27965253

Evaluation design for a complex intervention program targeting loneliness in non-institutionalized elderly Dutch people

PubMed Central

2010-01-01

Background The aim of this paper is to provide the rationale for an evaluation design for a complex intervention program targeting loneliness among non-institutionalized elderly people in a Dutch community. Complex public health interventions characteristically use the combined approach of intervening on the individual and on the environmental level. It is assumed that the components of a complex intervention interact with and reinforce each other. Furthermore, implementation is highly context-specific and its impact is influenced by external factors. Although the entire community is exposed to the intervention components, each individual is exposed to different components with a different intensity. Methods/Design A logic model of change is used to develop the evaluation design. The model describes what outcomes may logically be expected at different points in time at the individual level. In order to address the complexity of a real-life setting, the evaluation design of the loneliness intervention comprises two types of evaluation studies. The first uses a quasi-experimental pre-test post-test design to evaluate the effectiveness of the overall intervention. A control community comparable to the intervention community was selected, with baseline measurements in 2008 and follow-up measurements scheduled for 2010. This study focuses on changes in the prevalence of loneliness and in the determinants of loneliness within individuals in the general elderly population. Complementarily, the second study is designed to evaluate the individual intervention components and focuses on delivery, reach, acceptance, and short-term outcomes. Different means of project records and surveys among participants are used to collect these data. Discussion Combining these two evaluation strategies has the potential to assess the effectiveness of the overall complex intervention and the contribution of the individual intervention components thereto. PMID:20836840

Comparing Single Case Design Overlap-Based Effect Size Metrics from Studies Examining Speech Generating Device Interventions

ERIC Educational Resources Information Center

Chen, Mo; Hyppa-Martin, Jolene K.; Reichle, Joe E.; Symons, Frank J.

2016-01-01

Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with…

School Physical Education: The Effectiveness of Health-Related Interventions and Recommendations for Health-Promotion Practice

ERIC Educational Resources Information Center

Quitério, Ana Luísa Dias

2013-01-01

Objective: To assess the effectiveness of physical education (PE) interventions designed to foster health features among school-aged children, and to present a qualitative perspective of the different approaches that are most effective in promoting health among youth. Design: Systematic review. Method: An extensive electronic literature search was…

Design, analysis and presentation of factorial randomised controlled trials

PubMed Central

Montgomery, Alan A; Peters, Tim J; Little, Paul

2003-01-01

Background The evaluation of more than one intervention in the same randomised controlled trial can be achieved using a parallel group design. However this requires increased sample size and can be inefficient, especially if there is also interest in considering combinations of the interventions. An alternative may be a factorial trial, where for two interventions participants are allocated to receive neither intervention, one or the other, or both. Factorial trials require special considerations, however, particularly at the design and analysis stages. Discussion Using a 2 × 2 factorial trial as an example, we present a number of issues that should be considered when planning a factorial trial. The main design issue is that of sample size. Factorial trials are most often powered to detect the main effects of interventions, since adequate power to detect plausible interactions requires greatly increased sample sizes. The main analytical issues relate to the investigation of main effects and the interaction between the interventions in appropriate regression models. Presentation of results should reflect the analytical strategy with an emphasis on the principal research questions. We also give an example of how baseline and follow-up data should be presented. Lastly, we discuss the implications of the design, analytical and presentational issues covered. Summary Difficulties in interpreting the results of factorial trials if an influential interaction is observed is the cost of the potential for efficient, simultaneous consideration of two or more interventions. Factorial trials can in principle be designed to have adequate power to detect realistic interactions, and in any case they are the only design that allows such effects to be investigated. PMID:14633287

Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites.

PubMed

Lim, Megan S C; Wright, Cassandra J C; Carrotte, Elise R; Pedrana, Alisa E

2016-02-01

Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

The Role of Transfer in Designing Games and Simulations for Health: Systematic Review

PubMed Central

Terlouw, Gijs; Wartena, Bard O; van 't Veer, Job TB; Prins, Jelle T; Pierie, Jean Pierre EN

2017-01-01

Background The usefulness and importance of serious games and simulations in learning and behavior change for health and health-related issues are widely recognized. Studies have addressed games and simulations as interventions, mostly in comparison with their analog counterparts. Numerous complex design choices have to be made with serious games and simulations for health, including choices that directly contribute to the effects of the intervention. One of these decisions is the way an intervention is expected to lead to desirable transfer effects. Most designs adopt a first-class transfer rationale, whereas the second class of transfer types seems a rarity in serious games and simulations for health. Objective This study sought to review the literature specifically on the second class of transfer types in the design of serious games and simulations. Focusing on game-like interventions for health and health care, this study aimed to (1) determine whether the second class of transfer is recognized as a road for transfer in game-like interventions, (2) review the application of the second class of transfer type in designing game-like interventions, and (3) assess studies that include second-class transfer types reporting transfer outcomes. Methods A total of 6 Web-based databases were systematically searched by titles, abstracts, and keywords using the search strategy (video games OR game OR games OR gaming OR computer simulation*) AND (software design OR design) AND (fidelity OR fidelities OR transfer* OR behaviour OR behavior). The databases searched were identified as relevant to health, education, and social science. Results A total of 15 relevant studies were included, covering a range of game-like interventions, all more or less mentioning design parameters aimed at transfer. We found 9 studies where first-class transfer was part of the design of the intervention. In total, 8 studies dealt with transfer concepts and fidelity types in game-like intervention design in general; 3 studies dealt with the concept of second-class transfer types and reported effects, and 2 of those recognized transfer as a design parameter. Conclusions In studies on game-like interventions for health and health care, transfer is regarded as a desirable effect but not as a basic principle for design. None of the studies determined the second class of transfer or instances thereof, although in 3 cases a nonliteral transfer type was present. We also found that studies on game-like interventions for health do not elucidate design choices made and rarely provide design principles for future work. Games and simulations for health abundantly build upon the principles of first-class transfer, but the adoption of second-class transfer types proves scarce. It is likely to be worthwhile to explore the possibilities of second-class transfer types, as they may considerably influence educational objectives in terms of future serious game design for health. PMID:29175812

The effect of health education interventions on child malaria treatment-seeking practices among mothers in rural refugee villages in Belize, Central America.

PubMed

Cropley, Lorelei

2004-12-01

This paper reports on a study conducted to examine the effect of health education interventions on mothers' treatment-seeking behaviors for their children's malaria fevers. The study used a quasi-experimental post-test community-based design with an intervention and control group. A post-intervention survey was conducted to assess knowledge, attitudes and child fever and malaria treatment-seeking behaviors and access and exposure to health messages. Survey results indicated that some health education interventions, especially interpersonal communication, appeared to have a positive impact on fever and malaria beliefs and attitudes and on positive treatment-seeking behaviors. While some interventions appeared to have a positive impact on fever and malaria beliefs and attitudes and on positive treatment-seeking behaviors, limitations in the study design made assigning specific effects to the interventions difficult. However, health education interventions remain a valuable tool in addressing malaria in children.

Design Specification Issues in Time-Series Intervention Models.

ERIC Educational Resources Information Center

Huitema, Bradley E.; McKean, Joseph W.

2000-01-01

Presents examples of egregious errors of interpretation in time-series intervention models and makes recommendations regarding the correct specification of the design matrix. Discusses the profound effects of variants of the slope change variable in the design matrix. (SLD)

Using engineering control principles to inform the design of adaptive interventions: a conceptual introduction.

PubMed

Rivera, Daniel E; Pew, Michael D; Collins, Linda M

2007-05-01

The goal of this paper is to describe the role that control engineering principles can play in developing and improving the efficacy of adaptive, time-varying interventions. It is demonstrated that adaptive interventions constitute a form of feedback control system in the context of behavioral health. Consequently, drawing from ideas in control engineering has the potential to significantly inform the analysis, design, and implementation of adaptive interventions, leading to improved adherence, better management of limited resources, a reduction of negative effects, and overall more effective interventions. This article illustrates how to express an adaptive intervention in control engineering terms, and how to use this framework in a computer simulation to investigate the anticipated impact of intervention design choices on efficacy. The potential benefits of operationalizing decision rules based on control engineering principles are particularly significant for adaptive interventions that involve multiple components or address co-morbidities, situations that pose significant challenges to conventional clinical practice.

Using Engineering Control Principles to Inform the Design of Adaptive Interventions: A Conceptual Introduction

PubMed Central

Rivera, Daniel E.; Pew, Michael D.; Collins, Linda M.

2007-01-01

The goal of this paper is to describe the role that control engineering principles can play in developing and improving the efficacy of adaptive, time-varying interventions. It is demonstrated that adaptive interventions constitute a form of feedback control system in the context of behavioral health. Consequently, drawing from ideas in control engineering has the potential to significantly inform the analysis, design, and implementation of adaptive interventions, leading to improved adherence, better management of limited resources, a reduction of negative effects, and overall more effective interventions. This article illustrates how to express an adaptive intervention in control engineering terms, and how to use this framework in a computer simulation to investigate the anticipated impact of intervention design choices on efficacy. The potential benefits of operationalizing decision rules based on control engineering principles are particularly significant for adaptive interventions that involve multiple components or address co-morbidities, situations that pose significant challenges to conventional clinical practice. PMID:17169503

Interventions to Improve Medication Adherence in Hypertensive Patients: Systematic Review and Meta-analysis.

PubMed

Conn, Vicki S; Ruppar, Todd M; Chase, Jo-Ana D; Enriquez, Maithe; Cooper, Pamela S

2015-12-01

This systematic review applied meta-analytic procedures to synthesize medication adherence interventions that focus on adults with hypertension. Comprehensive searching located trials with medication adherence behavior outcomes. Study sample, design, intervention characteristics, and outcomes were coded. Random-effects models were used in calculating standardized mean difference effect sizes. Moderator analyses were conducted using meta-analytic analogues of ANOVA and regression to explore associations between effect sizes and sample, design, and intervention characteristics. Effect sizes were calculated for 112 eligible treatment-vs.-control group outcome comparisons of 34,272 subjects. The overall standardized mean difference effect size between treatment and control subjects was 0.300. Exploratory moderator analyses revealed interventions were most effective among female, older, and moderate- or high-income participants. The most promising intervention components were those linking adherence behavior with habits, giving adherence feedback to patients, self-monitoring of blood pressure, using pill boxes and other special packaging, and motivational interviewing. The most effective interventions employed multiple components and were delivered over many days. Future research should strive for minimizing risks of bias common in this literature, especially avoiding self-report adherence measures.

An SEM Approach for the Evaluation of Intervention Effects Using Pre-Post-Post Designs

ERIC Educational Resources Information Center

Mun, Eun Young; von Eye, Alexander; White, Helene R.

2009-01-01

This study analyzes latent change scores using latent curve models (LCMs) for evaluation research with pre-post-post designs. The article extends a recent article by Willoughby, Vandergrift, Blair, and Granger (2007) on the use of LCMs for studies with pre-post-post designs, and demonstrates that intervention effects can be better tested using…

The incident user design in comparative effectiveness research.

PubMed

Johnson, Eric S; Bartman, Barbara A; Briesacher, Becky A; Fleming, Neil S; Gerhard, Tobias; Kornegay, Cynthia J; Nourjah, Parivash; Sauer, Brian; Schumock, Glen T; Sedrakyan, Art; Stürmer, Til; West, Suzanne L; Schneeweiss, Sebastian

2013-01-01

Comparative effectiveness research includes cohort studies and registries of interventions. When investigators design such studies, how important is it to follow patients from the day they initiated treatment with the study interventions? Our article considers this question and related issues to start a dialogue on the value of the incident user design in comparative effectiveness research. By incident user design, we mean a study that sets the cohort's inception date according to patients' new use of an intervention. In contrast, most epidemiologic studies enroll patients who were currently or recently using an intervention when follow-up began. We take the incident user design as a reasonable default strategy because it reduces biases that can impact non-randomized studies, especially when investigators use healthcare databases. We review case studies where investigators have explored the consequences of designing a cohort study by restricting to incident users, but most of the discussion has been informed by expert opinion, not by systematic evidence. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

Sexual health education interventions for young people: a methodological review.

PubMed Central

Oakley, A.; Fullerton, D.; Holland, J.; Arnold, S.; France-Dawson, M.; Kelley, P.; McGrellis, S.

1995-01-01

OBJECTIVES--To locate reports of sexual health education interventions for young people, assess the methodological quality of evaluations, identify the subgroup with a methodologically sound design, and assess the evidence with respect to the effectiveness of different approaches to promoting young people's sexual health. DESIGN--Survey of reports in English by means of electronic databases and hand searches for relevant studies conducted in the developed world since 1982. Papers were reviewed for eight methodological qualities. The evidence on effectiveness generated by studies meeting four core criteria was assessed. Judgments on effectiveness by reviewers and authors were compared. PAPERS--270 papers reporting sexual health interventions. MAIN OUTCOME MEASURE--The methodological quality of evaluations. RESULTS--73 reports of evaluations of sexual health interventions examining the effectiveness of these interventions in changing knowledge, attitudes, or behavioural outcomes were identified, of which 65 were separate outcome evaluations. Of these studies, 45 (69%) lacked random control groups, 44 (68%) failed to present preintervention and 38 (59%) postintervention data, and 26 (40%) omitted to discuss the relevance of loss of data caused by drop outs. Only 12 (18%) of the 65 outcome evaluations were judged to be methodologically sound. Academic reviewers were more likely than authors to judge studies as unclear because of design faults. Only two of the sound evaluations recorded interventions which were effective in showing an impact on young people's sexual behaviour. CONCLUSIONS--The design of evaluations in sexual health intervention needs to be improved so that reliable evidence of the effectiveness of different approaches to promoting young people's sexual health may be generated. PMID:7833754

The Value of Interrupted Time-Series Experiments for Community Intervention Research

PubMed Central

Biglan, Anthony; Ary, Dennis; Wagenaar, Alexander C.

2015-01-01

Greater use of interrupted time-series experiments is advocated for community intervention research. Time-series designs enable the development of knowledge about the effects of community interventions and policies in circumstances in which randomized controlled trials are too expensive, premature, or simply impractical. The multiple baseline time-series design typically involves two or more communities that are repeatedly assessed, with the intervention introduced into one community at a time. It is particularly well suited to initial evaluations of community interventions and the refinement of those interventions. This paper describes the main features of multiple baseline designs and related repeated-measures time-series experiments, discusses the threats to internal validity in multiple baseline designs, and outlines techniques for statistical analyses of time-series data. Examples are given of the use of multiple baseline designs in evaluating community interventions and policy changes. PMID:11507793

Application of Regression-Discontinuity Analysis in Pharmaceutical Health Services Research

PubMed Central

Zuckerman, Ilene H; Lee, Euni; Wutoh, Anthony K; Xue, Zhenyi; Stuart, Bruce

2006-01-01

Objective To demonstrate how a relatively underused design, regression-discontinuity (RD), can provide robust estimates of intervention effects when stronger designs are impossible to implement. Data Sources/Study Setting Administrative claims from a Mid-Atlantic state Medicaid program were used to evaluate the effectiveness of an educational drug utilization review intervention. Study Design Quasi-experimental design. Data Collection/Extraction Methods A drug utilization review study was conducted to evaluate a letter intervention to physicians treating Medicaid children with potentially excessive use of short-acting β2-agonist inhalers (SAB). The outcome measure is change in seasonally-adjusted SAB use 5 months pre- and postintervention. To determine if the intervention reduced monthly SAB utilization, results from an RD analysis are compared to findings from a pretest–posttest design using repeated-measure ANOVA. Principal Findings Both analyses indicated that the intervention significantly reduced SAB use among the high users. Average monthly SAB use declined by 0.9 canisters per month (p<.001) according to the repeated-measure ANOVA and by 0.2 canisters per month (p<.001) from RD analysis. Conclusions Regression-discontinuity design is a useful quasi-experimental methodology that has significant advantages in internal validity compared to other pre–post designs when assessing interventions in which subjects' assignment is based on cutoff scores for a critical variable. PMID:16584464

Effective techniques in healthy eating and physical activity interventions: a meta-regression.

PubMed

Michie, Susan; Abraham, Charles; Whittington, Craig; McAteer, John; Gupta, Sunjai

2009-11-01

Meta-analyses of behavior change (BC) interventions typically find large heterogeneity in effectiveness and small effects. This study aimed to assess the effectiveness of active BC interventions designed to promote physical activity and healthy eating and investigate whether theoretically specified BC techniques improve outcome. Interventions, evaluated in experimental or quasi-experimental studies, using behavioral and/or cognitive techniques to increase physical activity and healthy eating in adults, were systematically reviewed. Intervention content was reliably classified into 26 BC techniques and the effects of individual techniques, and of a theoretically derived combination of self-regulation techniques, were assessed using meta-regression. Valid outcomes of physical activity and healthy eating. The 122 evaluations (N = 44,747) produced an overall pooled effect size of 0.31 (95% confidence interval = 0.26 to 0.36, I(2) = 69%). The technique, "self-monitoring," explained the greatest amount of among-study heterogeneity (13%). Interventions that combined self-monitoring with at least one other technique derived from control theory were significantly more effective than the other interventions (0.42 vs. 0.26). Classifying interventions according to component techniques and theoretically derived technique combinations and conducting meta-regression enabled identification of effective components of interventions designed to increase physical activity and healthy eating. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Participatory action research in corrections: The HITEC 2 program.

PubMed

Cherniack, Martin; Dussetschleger, Jeffrey; Dugan, Alicia; Farr, Dana; Namazi, Sara; El Ghaziri, Mazen; Henning, Robert

2016-03-01

HITEC 2 (Health Improvement through Employee Control 2) is the follow-up to HITEC, a participatory action research (PAR) program that integrates health and work conditions interventions designed by the workforce. HITEC 2 compares intervention programs between two correctional sites, one using a pure workforce level design team and the other using a more structured and time delineated labor-management kaizen effectiveness team. HITEC 2 utilizes a seven step participatory Intervention Design and Analysis Scorecard (IDEAS) for planning interventions. Consistent with PAR, process and intervention efficacy measures are developed and administered through workforce representation. Participation levels, robustness of participatory structures and sophistication of interventions have increased at each measured interval. Health comparisons between 2008 and 2013 showed increased hypertension, static weight maintenance, and increased 'readiness to change'. The PAR approaches are robust and sustained. Their long-term effectiveness in this population is not yet clear. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Evaluation of occupational health interventions using a randomized controlled trial: challenges and alternative research designs.

PubMed

Schelvis, Roosmarijn M C; Oude Hengel, Karen M; Burdorf, Alex; Blatter, Birgitte M; Strijk, Jorien E; van der Beek, Allard J

2015-09-01

Occupational health researchers regularly conduct evaluative intervention research for which a randomized controlled trial (RCT) may not be the most appropriate design (eg, effects of policy measures, organizational interventions on work schedules). This article demonstrates the appropriateness of alternative designs for the evaluation of occupational health interventions, which permit causal inferences, formulated along two study design approaches: experimental (stepped-wedge) and observational (propensity scores, instrumental variables, multiple baseline design, interrupted time series, difference-in-difference, and regression discontinuity). For each design, the unique characteristics are presented including the advantages and disadvantages compared to the RCT, illustrated by empirical examples in occupational health. This overview shows that several appropriate alternatives for the RCT design are feasible and available, which may provide sufficiently strong evidence to guide decisions on implementation of interventions in workplaces. Researchers are encouraged to continue exploring these designs and thus contribute to evidence-based occupational health.

Designing "Educationally Effective" Discussion

ERIC Educational Resources Information Center

Swann, Joan

2007-01-01

This paper analyses data from a curriculum intervention project designed to introduce new forms of discussion, seen as educationally effective, into the primary classroom. While the introduction of talk as an aid to learning is premised on a social approach to learning, such interventions are often evaluated in terms of cognitive benefits and…

Evaluation design for a complex intervention program targeting loneliness in non-institutionalized elderly Dutch people.

PubMed

de Vlaming, Rianne; Haveman-Nies, Annemien; Van't Veer, Pieter; de Groot, Lisette Cpgm

2010-09-13

The aim of this paper is to provide the rationale for an evaluation design for a complex intervention program targeting loneliness among non-institutionalized elderly people in a Dutch community. Complex public health interventions characteristically use the combined approach of intervening on the individual and on the environmental level. It is assumed that the components of a complex intervention interact with and reinforce each other. Furthermore, implementation is highly context-specific and its impact is influenced by external factors. Although the entire community is exposed to the intervention components, each individual is exposed to different components with a different intensity. A logic model of change is used to develop the evaluation design. The model describes what outcomes may logically be expected at different points in time at the individual level. In order to address the complexity of a real-life setting, the evaluation design of the loneliness intervention comprises two types of evaluation studies. The first uses a quasi-experimental pre-test post-test design to evaluate the effectiveness of the overall intervention. A control community comparable to the intervention community was selected, with baseline measurements in 2008 and follow-up measurements scheduled for 2010. This study focuses on changes in the prevalence of loneliness and in the determinants of loneliness within individuals in the general elderly population. Complementarily, the second study is designed to evaluate the individual intervention components and focuses on delivery, reach, acceptance, and short-term outcomes. Different means of project records and surveys among participants are used to collect these data. Combining these two evaluation strategies has the potential to assess the effectiveness of the overall complex intervention and the contribution of the individual intervention components thereto.

Using a Regression Discontinuity Design to Determine the Effectiveness of a Vocabulary Intervention for At-Risk First-Grade Readers

ERIC Educational Resources Information Center

Ashworth, Kristen E.

2012-01-01

The purposes of this study were to determine the effectiveness of a vocabulary intervention for first-grade students at risk for reading and language difficulties and to compare the results of a regression discontinuity design to those of an experimental design. The specific research questions were: (1) Do first-graders who are at risk of reading…

Designing Studies That Would Address the Multilayered Nature of Health Care

PubMed Central

Pennell, Michael; Rhoda, Dale; Hade, Erinn M.; Paskett, Electra D.

2010-01-01

We review design and analytic methods available for multilevel interventions in cancer research with particular attention to study design, sample size requirements, and potential to provide statistical evidence for causal inference. The most appropriate methods will depend on the stage of development of the research and whether randomization is possible. Early on, fractional factorial designs may be used to screen intervention components, particularly when randomization of individuals is possible. Quasi-experimental designs, including time-series and multiple baseline designs, can be useful once the intervention is designed because they require few sites and can provide the preliminary evidence to plan efficacy studies. In efficacy and effectiveness studies, group-randomized trials are preferred when randomization is possible and regression discontinuity designs are preferred otherwise if assignment based on a quantitative score is possible. Quasi-experimental designs may be used, especially when combined with recent developments in analytic methods to reduce bias in effect estimates. PMID:20386057

A Customized Intervention for Dementia Caregivers: A Quasi-Experimental Design.

PubMed

Wawrziczny, Emilie; Larochette, Clotilde; Papo, David; Constant, Emilie; Ducharme, Francine; Kergoat, Marie-Jeanne; Pasquier, Florence; Antoine, Pascal

2018-04-01

The aim of this study is to test the effects of a customized intervention on distress among caregivers of persons with dementia (PWD) using a quasi-experimental design. Fifty-one spouse caregivers in the experimental group and 51 in the control group participated in the study. The effects of the intervention were examined by comparing caregivers' responses with questionnaires at pre-intervention baseline (T0) and immediately after intervention (T1). Differences were quantified using repeated-measures ANOVA. The analyses indicated a stabilizing effect of the intervention on caregivers' perceptions of PWD's daily functioning, self-esteem related to caregiving, quality of family support, and feeling of distress. Linear increases were observed regarding sense of preparedness and impact on daily routine, while no differences (interaction and linear effects) were observed for degree of self-efficacy, depression, impact on finances, or self-rated health. These findings show a preliminary efficacy of the intervention proposed in this study to prevent the exacerbation of caregivers' distress.

Improvements in musculoskeletal health and computing behaviors: Effects of a macroergonomics office workplace and training intervention.

PubMed

Robertson, Michelle M; Huang, Yueng Hsiang; Lee, Jin

2017-07-01

Computer use and its association with musculoskeletal and visual symptoms is an escalating concern. Organizations are shifting to a more proactive injury prevention perspective. Accordingly, a macroergonomics intervention consisting of flexible workplace design and office ergonomics training was designed to examine the effects on worker's computing behaviors, postures, and musculoskeletal discomfort, and their relationship to psychosocial factors. Participants were assigned to either group: 1) no-intervention control 2) flexible Workplace-only (WP-only), and 3) flexible Workplace + Training (WP+T). Observational findings indicate both intervention groups experienced positive, significant changes in improved workstation arrangements and computing postures, with the WP+T intervention group exhibiting a higher, significant change of behavioral translation. Also, significant, positive relationships between observed postures and musculoskeletal discomfort/pain were found. The intervention effect was stronger when management was responsive to workers' ergonomics needs. This study suggests that a macroergonomics intervention can produce beneficial effects for office and computer workers and organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of caregiver-friendly workplace policy (CFWPs) interventions on the health of full-time caregiver employees (CEs): implementation and cost-benefit analysis.

PubMed

Williams, Allison M; Tompa, Emile; Lero, Donna S; Fast, Janet; Yazdani, Amin; Zeytinoglu, Isik U

2017-09-20

Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (economic) and workers (health) of caregiver-friendly workplace policy intervention(s) for full-time caregiver-employees? What are the impacts for employers, workers and society of the caregiver-friendly workplace policy intervention(s) in each participating workplace? What contextual factors impact the successful implementation of caregiver-friendly workplace policy intervention(s)? Using a pre-post-test comparative case study design, Study A will determine the effectiveness of newly implemented caregiver-friendly workplace policy intervention(s) across two workplaces to determine impacts on caregiver-employee health. A quasi-experimental pre-post design will allow the caregiver-friendly workplace policy intervention(s) to be tested with respect to potential impacts on health, and specifically on caregiver employee mental, psychosocial, and physical health. Framed within a comparative case study design, Study B will utilize cost-benefit and cost-effectiveness analysis approaches to evaluate the economic impacts of the caregiver-friendly workplace policy intervention(s) for each of the two participating workplaces. Framed within a comparative case study design, Study C will undertake an implementation analysis of the caregiver-friendly workplace policy intervention(s) in each participating workplace in order to determine: the degree of support for the intervention(s) (reflected in the workplace culture); how sex and gender are implicated; co-workers' responses to the chosen intervention(s), and; other nuances at play. It is hypothesized that the benefits of the caregiver-friendly workplace policy intervention(s) will include improvements in caregiver-employees' mental, psychosocial and physical health, as well as evidence of cost-benefit and cost-effectiveness for the employer. The expected project results will provide the research evidence for extensive knowledge translation work, to be carried out in collaboration with our knowledge transition partners, to the employer/human resources and occupational health/safety target populations. ISRCTN16187974 Registered August 25, 2016.

Effectiveness and uptake of screening programmes for coronary heart disease and diabetes: a realist review of design components used in interventions

PubMed Central

Holland, Carol; Cooper, Yvonne; Shaw, Rachel; Pattison, Helen; Cooke, Richard

2013-01-01

Objective To evaluate behavioural components and strategies associated with increased uptake and effectiveness of screening for coronary heart disease and diabetes with an implementation science focus. Design Realist review. Data sources PubMed, Web of Knowledge, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register and reference chaining. Searches limited to English language studies published since 1990. Eligibility criteria Eligible studies evaluated interventions designed to increase the uptake of cardiovascular disease (CVD) and diabetes screening and examined behavioural and/or strategic designs. Studies were excluded if they evaluated changes in risk factors or cost-effectiveness only. Results In 12 eligible studies, several different intervention designs and evidence-based strategies were evaluated. Salient themes were effects of feedback on behaviour change or benefits of health dialogues over simple feedback. Studies provide mixed evidence about the benefits of these intervention constituents, which are suggested to be situation and design specific, broadly supporting their use, but highlighting concerns about the fidelity of intervention delivery, raising implementation science issues. Three studies examined the effects of informed choice or loss versus gain frame invitations, finding no effect on screening uptake but highlighting opportunistic screening as being more successful for recruiting higher CVD and diabetes risk patients than an invitation letter, with no differences in outcomes once recruited. Two studies examined differences between attenders and non-attenders, finding higher risk factors among non-attenders and higher diagnosed CVD and diabetes among those who later dropped out of longitudinal studies. Conclusions If the risk and prevalence of these diseases are to be reduced, interventions must take into account what we know about effective health behaviour change mechanisms, monitor delivery by trained professionals and examine the possibility of tailoring programmes according to contexts such as risk level to reach those most in need. Further research is needed to determine the best strategies for lifelong approaches to screening. PMID:24202056

Behavior change theory, content and delivery of interventions to enhance adherence in chronic respiratory disease: A systematic review.

PubMed

McCullough, Amanda R; Ryan, Crístín; Macindoe, Christopher; Yii, Nathan; Bradley, Judy M; O'Neill, Brenda; Elborn, J Stuart; Hughes, Carmel M

2016-07-01

We sought to describe the theory used to design treatment adherence interventions, the content delivered, and the mode of delivery of these interventions in chronic respiratory disease. We included randomized controlled trials of adherence interventions (compared to another intervention or control) in adults with chronic respiratory disease (8 databases searched; inception until March 2015). Two reviewers screened and extracted data: post-intervention adherence (measured objectively); behavior change theory, content (grouped into psychological, education and self-management/supportive, telemonitoring, shared decision-making); and delivery. "Effective" studies were those with p < 0.05 for adherence rate between groups. We conducted a narrative synthesis and assessed risk of bias. 12,488 articles screened; 46 included studies (n = 42,91% in OSA or asthma) testing 58 interventions (n = 27, 47% were effective). Nineteen (33%) interventions (15 studies) used 12 different behavior change theories. Use of theory (n = 11,41%) was more common amongst effective interventions. Interventions were mainly educational, self-management or supportive interventions (n = 27,47%). They were commonly delivered by a doctor (n = 20,23%), in face-to-face (n = 48,70%), one-to-one (n = 45,78%) outpatient settings (n = 46,79%) across 2-5 sessions (n = 26,45%) for 1-3 months (n = 26,45%). Doctors delivered a lower proportion (n = 7,18% vs n = 13,28%) and pharmacists (n = 6,15% vs n = 1,2%) a higher proportion of effective than ineffective interventions. Risk of bias was high in >1 domain (n = 43, 93%) in most studies. Behavior change theory was more commonly used to design effective interventions. Few adherence interventions have been developed using theory, representing a gap between intervention design recommendations and research practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Role of Transfer in Designing Games and Simulations for Health: Systematic Review.

PubMed

Kuipers, Derek A; Terlouw, Gijs; Wartena, Bard O; van 't Veer, Job Tb; Prins, Jelle T; Pierie, Jean Pierre En

2017-11-24

The usefulness and importance of serious games and simulations in learning and behavior change for health and health-related issues are widely recognized. Studies have addressed games and simulations as interventions, mostly in comparison with their analog counterparts. Numerous complex design choices have to be made with serious games and simulations for health, including choices that directly contribute to the effects of the intervention. One of these decisions is the way an intervention is expected to lead to desirable transfer effects. Most designs adopt a first-class transfer rationale, whereas the second class of transfer types seems a rarity in serious games and simulations for health. This study sought to review the literature specifically on the second class of transfer types in the design of serious games and simulations. Focusing on game-like interventions for health and health care, this study aimed to (1) determine whether the second class of transfer is recognized as a road for transfer in game-like interventions, (2) review the application of the second class of transfer type in designing game-like interventions, and (3) assess studies that include second-class transfer types reporting transfer outcomes. A total of 6 Web-based databases were systematically searched by titles, abstracts, and keywords using the search strategy (video games OR game OR games OR gaming OR computer simulation*) AND (software design OR design) AND (fidelity OR fidelities OR transfer* OR behaviour OR behavior). The databases searched were identified as relevant to health, education, and social science. A total of 15 relevant studies were included, covering a range of game-like interventions, all more or less mentioning design parameters aimed at transfer. We found 9 studies where first-class transfer was part of the design of the intervention. In total, 8 studies dealt with transfer concepts and fidelity types in game-like intervention design in general; 3 studies dealt with the concept of second-class transfer types and reported effects, and 2 of those recognized transfer as a design parameter. In studies on game-like interventions for health and health care, transfer is regarded as a desirable effect but not as a basic principle for design. None of the studies determined the second class of transfer or instances thereof, although in 3 cases a nonliteral transfer type was present. We also found that studies on game-like interventions for health do not elucidate design choices made and rarely provide design principles for future work. Games and simulations for health abundantly build upon the principles of first-class transfer, but the adoption of second-class transfer types proves scarce. It is likely to be worthwhile to explore the possibilities of second-class transfer types, as they may considerably influence educational objectives in terms of future serious game design for health. ©Derek A Kuipers, Gijs Terlouw, Bard O Wartena, Job TB van 't Veer, Jelle T Prins, Jean Pierre EN Pierie. Originally published in JMIR Serious Games (http://games.jmir.org), 24.11.2017.

The effect of sex education on adolescents' use of condoms: applying the Solomon four-group design.

PubMed

Kvalem, I L; Sundet, J M; Rivø, K I; Eilertsen, D A; Bakketeig, L S

1996-02-01

A school-based sex education program was developed in order to prevent sexually transmitted diseases and unwanted pregnancies. A Solomon four-group design, with random assignment to the different conditions, was used to evaluate an intervention based on cognitive social learning theory and social influence theory. The main goal of the intervention was to increase use of condoms. A stratified sample of 124 classes (2,411 students) was drawn at random from all the upper secondary schools (high schools/colleges) in one county in Norway. The results indicate a consistent interaction between pretest and intervention, which seems to have an effect on condom use. Pretest or intervention alone did not contribute to this effect. The interaction effect appeared among the students with few sexual partners. Several possible explanations to the observed interaction effect and the implication for future interventions are discussed.

Leveraging contact network structure in the design of cluster randomized trials.

PubMed

Harling, Guy; Wang, Rui; Onnela, Jukka-Pekka; De Gruttola, Victor

2017-02-01

In settings like the Ebola epidemic, where proof-of-principle trials have provided evidence of efficacy but questions remain about the effectiveness of different possible modes of implementation, it may be useful to conduct trials that not only generate information about intervention effects but also themselves provide public health benefit. Cluster randomized trials are of particular value for infectious disease prevention research by virtue of their ability to capture both direct and indirect effects of intervention, the latter of which depends heavily on the nature of contact networks within and across clusters. By leveraging information about these networks-in particular the degree of connection across randomized units, which can be obtained at study baseline-we propose a novel class of connectivity-informed cluster trial designs that aim both to improve public health impact (speed of epidemic control) and to preserve the ability to detect intervention effects. We several designs for cluster randomized trials with staggered enrollment, in each of which the order of enrollment is based on the total number of ties (contacts) from individuals within a cluster to individuals in other clusters. Our designs can accommodate connectivity based either on the total number of external connections at baseline or on connections only to areas yet to receive the intervention. We further consider a "holdback" version of the designs in which control clusters are held back from re-randomization for some time interval. We investigate the performance of these designs in terms of epidemic control outcomes (time to end of epidemic and cumulative incidence) and power to detect intervention effect, by simulating vaccination trials during an SEIR-type epidemic outbreak using a network-structured agent-based model. We compare results to those of a traditional Stepped Wedge trial. In our simulation studies, connectivity-informed designs lead to a 20% reduction in cumulative incidence compared to comparable traditional study designs, but have little impact on epidemic length. Power to detect intervention effect is reduced in all connectivity-informed designs, but "holdback" versions provide power that is very close to that of a traditional Stepped Wedge approach. Incorporating information about cluster connectivity in the design of cluster randomized trials can increase their public health impact, especially in acute outbreak settings. Using this information helps control outbreaks-by minimizing the number of cross-cluster infections-with very modest cost in terms of power to detect effectiveness.

Interventions to prevent youth violence in Latin America: a systematic review.

PubMed

Atienzo, Erika E; Baxter, Susan K; Kaltenthaler, Eva

2017-01-01

This review aims to summarise evidence on the effectiveness of interventions to prevent youth violence in Latin America. A systematic search on 13 academic databases was conducted to locate studies evaluating a primary or secondary prevention intervention in Latin America. Studies could use any type of quantitative design to assess outcomes related to youth violence. A search of websites, references and citation searching was also carried out. The quality of each study was assessed. Nine studies were identified. Most documented positive effects of the interventions on the perception of youth violence present in the community/school. Evidence was found of a reduction in homicides and juvenile crimes in three studies, two of which evaluated a community-based intervention. There were mixed results for the self-report of participation on violent acts. The majority of the studies lacked of a rigorous design. Most of the interventions had some promising results, including the reduction of homicides within communities. Community-based programmes were the most consistent regarding an effectiveness to prevent violence. However, the evidence for Latin America is still scarce and relies on non-rigorously designed studies.

Advancing the evidence base in cancer: psychosocial multicenter trials

PubMed Central

2012-01-01

Background The diagnosis and treatment of cancer is associated with significant distress and psychosocial morbidity. Although psychosocial interventions have been developed in an attempt to improve psychosocial outcomes in cancer patients and survivors, there is continued debate about whether there is adequate high-level evidence to establish the effectiveness of these interventions. The evidence base is limited as a result of numerous challenges faced by those attempting to conduct psychosocial intervention trials within the health system. Barriers include insufficient participant recruitment, difficulty generalizing from single-trial studies, difficulty in building and managing research teams with multidisciplinary expertise, lack of research design expertise and a lack of incentives for researchers conducting intervention research. To strengthen the evidence base, more intervention studies employing methodologically rigorous research designs are necessary. Methods In order to advance the evidence base of interventions designed to improve psychosocial outcomes for cancer patients and survivors, we propose the formation of a collaborative trials group that conducts multicenter trials to test the effectiveness of such interventions. Results Establishment of such a group would improve the quality of the evidence base in psychosocial research in cancer patients, by increasing support for conducting intervention research and providing intervention research training opportunities. A multidisciplinary collaborative group conducting multicenter trials would have the capacity to overcome many of the barriers that currently exist. Conclusions A stronger evidence base is necessary to identify effective psychosocial interventions for cancer patients. The proposed formation of a psycho-oncology collaborative trials group that conducts multicenter trials to test the effectiveness of psychosocial interventions would assist in achieving this outcome. PMID:22992443

Stroke Survivors' Evaluations of a Stroke Workbook-Based Intervention Designed to Increase Perceived Control over Recovery

ERIC Educational Resources Information Center

Joice, Sara; Johnston, Marie; Bonetti, Debbie; Morrison, Val; MacWalter, Ron

2012-01-01

Objective: To report stroke survivors' experiences and perceived usefulness of an effective self-help workbook-based intervention. Design: A cross-sectional study involving the intervention group of an earlier randomized controlled trial. Setting: At the participants' homes approximately seven weeks post-hospital discharge. Method: Following the…

Effects of an Alternative to Suspension Intervention in a Therapeutic High School

ERIC Educational Resources Information Center

Hernandez-Melis, Claudia; Fenning, Pamela; Lawrence, Elizabeth

2016-01-01

The purpose of the current study was to assess the effects of an alternative to suspension intervention on students' subsequent major referrals. The intervention included activities designed to teach social coping strategies as well as mediation to resolve interpersonal conflicts. The intervention was implemented in a therapeutic high school, and…

Effects of Two Interventions on Solving Basic Fact Problems by Second Graders with Mathematics Learning Disabilities

ERIC Educational Resources Information Center

Dennis, Minyi Shih; Sorrells, Audrey McCray; Falcomata, Terry S.

2016-01-01

This study used a multiple probe across participants design, replicated across two interventions and counterbalanced across participant groups to examine the effects of number sense intervention and extensive practice intervention on strategy transformation when students with mathematics learning disabilities (MLD) solved basic fact problems. In…

Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos

PubMed Central

2018-01-01

Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS) study was a randomized controlled trial designed to measure the impact of the United Nations Children’s Fund (UNICEF) Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils’ school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times. PMID:29565302

Design of effective interventions for smoking cessation through financial and non-financial incentives.

PubMed

Balderrama, Fanor; Longo, Christopher J

2017-11-01

Smoking has a tremendous negative impact on the Canadian economy and contributes to growing costs in the healthcare system. Efforts to reduce smoking rates may therefore reduce strain on the healthcare system and free up scarce resources. Academic literature on economic smoking cessation incentives presents a countless variety of interventions that have met with varying degrees of success. This study reviews six different variables used in the design of incentives in smoking cessation interventions: direction, form, magnitude, certainty, recipient grouping, and target demographic. The purpose of this study is to provide analysis and recommendations about the contribution of each variable into the overall effectiveness of smoking cessation programs and help health leaders design better interventions according to their specific needs.

Changing drug users' risk environments: peer health advocates as multi-level community change agents.

PubMed

Weeks, Margaret R; Convey, Mark; Dickson-Gomez, Julia; Li, Jianghong; Radda, Kim; Martinez, Maria; Robles, Eduardo

2009-06-01

Peer delivered, social oriented HIV prevention intervention designs are increasingly popular for addressing broader contexts of health risk beyond a focus on individual factors. Such interventions have the potential to affect multiple social levels of risk and change, including at the individual, network, and community levels, and reflect social ecological principles of interaction across social levels over time. The iterative and feedback dynamic generated by this multi-level effect increases the likelihood for sustained health improvement initiated by those trained to deliver the peer intervention. The Risk Avoidance Partnership (RAP), conducted with heroin and cocaine/crack users in Hartford, Connecticut, exemplified this intervention design and illustrated the multi-level effect on drug users' risk and harm reduction at the individual level, the social network level, and the larger community level. Implications of the RAP program for designing effective prevention programs and for analyzing long-term change to reduce HIV transmission among high-risk groups are discussed from this ecological and multi-level intervention perspective.

A Meta-Analysis of Educator Training to Improve Implementation of Interventions for Students with Disabilities

ERIC Educational Resources Information Center

Brock, Matthew E.; Carter, Erik W.

2017-01-01

Teachers and paraprofessionals need effective training to improve their implementation of interventions for students with disabilities. Reviews of the single-case design literature have identified some features associated with effective training for these educators, but the group-design literature has received little attention. This meta-analysis…

75 FR 34997 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... trial research designs to evaluate the effectiveness of interventions or practices. NIDRR believes that randomized control trial research designs can be appropriate for research that involves evaluating specific interventions. However, in complex service delivery settings, other scientifically rigorous research designs may...

Interventions aimed at improving the nursing work environment: a systematic review

PubMed Central

2010-01-01

Background Nursing work environments (NWEs) in Canada and other Western countries have increasingly received attention following years of restructuring and reported high workloads, high absenteeism, and shortages of nursing staff. Despite numerous efforts to improve NWEs, little is known about the effectiveness of interventions to improve NWEs. The aim of this study was to review systematically the scientific literature on implemented interventions aimed at improving the NWE and their effectiveness. Methods An online search of the databases CINAHL, Medline, Scopus, ABI, Academic Search Complete, HEALTHstar, ERIC, Psychinfo, and Embase, and a manual search of Emerald and Longwoods was conducted. (Quasi-) experimental studies with pre/post measures of interventions aimed at improving the NWE, study populations of nurses, and quantitative outcome measures of the nursing work environment were required for inclusion. Each study was assessed for methodological strength using a quality assessment and validity tool for intervention studies. A taxonomy of NWE characteristics was developed that would allow us to identify on which part of the NWE an intervention targeted for improvement, after which the effects of the interventions were examined. Results Over 9,000 titles and abstracts were screened. Eleven controlled intervention studies met the inclusion criteria, of which eight used a quasi-experimental design and three an experimental design. In total, nine different interventions were reported in the included studies. The most effective interventions at improving the NWE were: primary nursing (two studies), the educational toolbox (one study), the individualized care and clinical supervision (one study), and the violence prevention intervention (one study). Conclusions Little is known about the effectiveness of interventions aimed at improving the NWE, and published studies on this topic show weaknesses in their design. To advance the field, we recommend that investigators use controlled studies with pre/post measures to evaluate interventions that are aimed at improving the NWE. Thereby, more evidence-based knowledge about the implementation of interventions will become available for healthcare leaders to use in rebuilding nursing work environments. PMID:20423492

Are There Scenarios When the Use of Non-Placebo-Control Groups in Experimental Trial Designs Increase Expected Value to Society?

PubMed

Uyei, Jennifer; Braithwaite, R Scott

2016-01-01

Despite the benefits of the placebo-controlled trial design, it is limited by its inability to quantify total benefits and harms. Such trials, for example, are not designed to detect an intervention's placebo or nocebo effects, which if detected could alter the benefit-to-harm balance and change a decision to adopt or reject an intervention. In this article, we explore scenarios in which alternative experimental trial designs, which differ in the type of control used, influence expected value across a range of pretest assumptions and study sample sizes. We developed a decision model to compare 3 trial designs and their implications for decision making: 2-arm placebo-controlled trial ("placebo-control"), 2-arm intervention v. do nothing trial ("null-control"), and an innovative 3-arm trial design: intervention v. do nothing v. placebo trial ("novel design"). Four scenarios were explored regarding particular attributes of a hypothetical intervention: 1) all benefits and no harm, 2) no biological effect, 3) only biological effects, and 4) surreptitious harm (no biological benefit or nocebo effect). Scenario 1: When sample sizes were very small, the null-control was preferred, but as sample sizes increased, expected value of all 3 designs converged. Scenario 2: The null-control was preferred regardless of sample size when the ratio of placebo to nocebo effect was >1; otherwise, the placebo-control was preferred. Scenario 3: When sample size was very small, the placebo-control was preferred when benefits outweighed harms, but the novel design was preferred when harms outweighed benefits. Scenario 4: The placebo-control was preferred when harms outweighed placebo benefits; otherwise, preference went to the null-control. Scenarios are hypothetical, study designs have not been tested in a real-world setting, blinding is not possible in all designs, and some may argue the novel design poses ethical concerns. We identified scenarios in which alternative experimental study designs would confer greater expected value than the placebo-controlled trial design. The likelihood and prevalence of such situations warrant further study. © The Author(s) 2015.

Perception of Safety and Liking Associated to the Colour Intervention of Bike Lanes: Contribution from the Behavioural Sciences to Urban Design and Wellbeing

PubMed Central

Vera-Villarroel, Pablo; Contreras, Daniela; Lillo, Sebastián; Segovia, Ariel; Rojo, Natalia; Moreno, Sandra; Oyarzo, Francisco

2016-01-01

The perception of colour and its subjective effects are key issues to designing safe and enjoyable bike lanes. This paper addresses the relationship between the colours of bike lane interventions—in particular pavement painting and intersection design—and the subjective evaluation of liking, visual saliency, and perceived safety related to such an intervention. Utilising images of three real bike lane intersections modified by software to change their colour (five in total), this study recruited 538 participants to assess their perception of all fifteen colour-design combinations. A multivariate analysis of covariance (MANCOVA) with the Bonferroni post hoc test was performed to assess the effect of the main conditions (colour and design) on the dependent variables (liking towards the intervention, level of visual saliency of the intersection, and perceived safety of the bike lane). The results showed that the colour red was more positively associated to the outcome variables, followed by yellow and blue. Additionally, it was observed that the effect of colour widely outweighs the effect of design, suggesting that the right choice and use of colour would increase the effectiveness on bike-lanes pavement interventions. Limitations and future directions are discussed. PMID:27548562

Comparing Single Case Design Overlap-Based Effect Size Metrics From Studies Examining Speech Generating Device Interventions

PubMed Central

Chen, Mo; Hyppa-Martin, Jolene K.; Reichle, Joe E.; Symons, Frank J.

2017-01-01

Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with intellectual and developmental disabilities (IDD) with moderate to profound levels of impairment. The effect size metrics included percent of data points exceeding the median (PEM), percent of nonoverlapping data (PND), improvement rate difference (IRD), percent of all nonoverlapping data (PAND), Phi, nonoverlap of all pairs (NAP), and Taunovlap. Results showed that among the seven effect size metrics, PAND, Phi, IRD, and PND were more effective in quantifying intervention effects for the data sample (N = 285 phase or condition contrasts). Results are discussed with respect to issues concerning extracting and calculating effect sizes, visual analysis, and SCD intervention research in IDD. PMID:27119210

To Be or Not to Be in Thrall to the March of Smart Products

PubMed Central

Van den Hende, Ellis A.

2016-01-01

ABSTRACT This article explores how perceived disempowerment impacts the intention to adopt smart autonomous products. Empirically, the paper builds on three studies to show this impact. Study 1 explores the relevance of the perceived disempowerment in respect of smart autonomous products. Study 2 manipulates autonomy of smart products and finds that perceived disempowerment mediates the link between smart products’ autonomy and adoption intention. Study 3 indicates that an intervention design―that is, a product design that allows consumers to intervene in the actions of an autonomous smart product―can reduce their perceived disempowerment in respect of autonomous smart products. Further, Study 3 reveals that personal innovativeness moderates the role that an intervention design plays in product adoption: an intervention design shows a positive effect on adoption intention for individuals with low personal innovativeness, but for those with high personal innovativeness no effect of an intervention design is present on adoption intention. The authors suggest that managers consider consumers’ perceived disempowerment when designing autonomous smart products, because (1) perceived disempowerment reduces adoption and (2) when targeted at consumers with low personal innovativeness, an intervention design reduces their perceived disempowerment. PMID:27980356

Design of trials for interrupting the transmission of endemic pathogens.

PubMed

Silkey, Mariabeth; Homan, Tobias; Maire, Nicolas; Hiscox, Alexandra; Mukabana, Richard; Takken, Willem; Smith, Thomas A

2016-06-06

Many interventions against infectious diseases have geographically diffuse effects. This leads to contamination between arms in cluster-randomized trials (CRTs). Pathogen elimination is the goal of many intervention programs against infectious agents, but contamination means that standard CRT designs and analyses do not provide inferences about the potential of interventions to interrupt pathogen transmission at maximum scale-up. A generic model of disease transmission was used to simulate infections in stepped wedge cluster-randomized trials (SWCRTs) of a transmission-reducing intervention, where the intervention has spatially diffuse effects. Simulations of such trials were then used to examine the potential of such designs for providing generalizable causal inferences about the impact of such interventions, including measurements of the contamination effects. The simulations were applied to the geography of Rusinga Island, Lake Victoria, Kenya, the site of the SolarMal trial on the use of odor-baited mosquito traps to eliminate Plasmodium falciparum malaria. These were used to compare variants in the proposed SWCRT designs for the SolarMal trial. Measures of contamination effects were found that could be assessed in the simulated trials. Inspired by analyses of trials of insecticide-treated nets against malaria when applied to the geography of the SolarMal trial, these measures were found to be robust to different variants of SWCRT design. Analyses of the likely extent of contamination effects supported the choice of cluster size for the trial. The SWCRT is an appropriate design for trials that assess the feasibility of local elimination of a pathogen. The effects of incomplete coverage can be estimated by analyzing the extent of contamination between arms in such trials, and the estimates also support inferences about causality. The SolarMal example illustrates how generic transmission models incorporating spatial smoothing can be used to simulate such trials for a power calculation and optimization of cluster size and randomization strategies. The approach is applicable to a range of infectious diseases transmitted via environmental reservoirs or via arthropod vectors.

Replicated Findings of an Evaluation of a Brief Intervention Designed to Prevent High-Risk Drinking among First-Year College Students: Implications for Social Norming Theory

ERIC Educational Resources Information Center

Stamper, Georgia Ann; Smith, Bradley H.; Gant, Rick; Bogle, Kristin E.

2004-01-01

College students were randomly assigned to receive either (a) standard alcohol programming (SAP) or (b) SAP plus an intervention designed to change perceptions of alcohol norms (PAN). Effects of the intervention delivered during one class period (i.e., 55 minutes) were assessed using pre- and post-intervention surveys about personal alcohol use…

Effects of friendship closeness in an adolescent group HIV prevention intervention.

PubMed

Morrison, Diane M; Casey, Erin A; Beadnell, Blair A; Hoppe, Marilyn J; Gillmore, Mary Rogers; Wilsdon, Anthony; Higa, Darrel; Carlisle, Shauna; Wells, Elizabeth A

2007-12-01

Although many interventions for youth rely, explicitly or implicitly, on group effects, sparse theoretical or empirical attention has been paid to the rationale for choosing a small-group design. The present study assesses the role of friendship closeness among youth in prevention intervention groups in shaping their HIV risk-related attitudes, intentions, perceived self-efficacy and perceived norms. Data from an experimental test of a group HIV prevention intervention are used to assess the relationship of friendship on cognitive outcomes at posttest and 6-month follow-up, in a multilevel regression design. Friendship among group members was assessed at baseline and post-intervention, for youth in the experimental intervention and in a control, career exploration, condition. Level of friendship within the group was positively related to attendance and enjoyment of the intervention in the control group only. Most cognitive outcomes were unaffected by individual or group levels of friendship closeness, but those effects observed were opposite to those desired. Friendly groups were no more likely to converge in their cognitions over time than were less-friendly groups. The need for more research on the effects of friendship on intervention outcomes, and for multilevel analyses of group effects, are discussed.

A review of the methodological challenges in assessing the cost effectiveness of pharmacist interventions.

PubMed

Elliott, Rachel A; Putman, Koen; Davies, James; Annemans, Lieven

2014-12-01

Pharmacists' roles are shifting away from medicines supply and the provision of patient education involving acute medications towards consultation-type services for chronic medications. Determining the cost effectiveness of pharmacist interventions has been complicated by methodological challenges. A critique of 31 economic evaluations carried out alongside comparative studies of pharmacist interventions published between 2003 and 2013 (12 from the UK, six from the USA) found a range of disease-specific and cross-therapeutic interventions targeting both patients and prescribers in a range of settings evaluated through a variety of study designs. Only ten were full economic evaluations, five of which were based on randomized controlled trials (RCTs). The intervention was usually quite well described, but the comparator was not always clearly described, and some interventions are very context specific due to the variability in pharmacist services available in different countries and practice settings. Complex multidirectional aims of most pharmacist interventions have led to many process, intermediate and longer-term outcomes being included in any one study. Quality of resource use and cost data varied. Most incremental cost-effectiveness ratios (ICERs) were generated from process indicators such as errors and adherence, with only four studies reporting cost per quality-adjusted life-year (QALY). Very few studies examined the effect of uncertainty, and methods used were not very clear in some cases. The principal finding from our critique is that poor RCT study design or analysis precludes many studies from finding pharmacist interventions effective or cost effective. We conclude with a set of recommendations for future study design.

Antibiotic stewardship: does it work in hospital practice? A review of the evidence base.

PubMed

Hulscher, M E J L; Prins, J M

2017-11-01

Guidelines for developing and implementing stewardship programmes include recommendations on appropriate antibiotic use to guide the stewardship team's choice of potential stewardship objectives. They also include recommendations on behavioural change interventions to guide the team's choice of potential interventions to ensure that professionals actually use antibiotics appropriately in daily practice. To summarize the evidence base of both appropriate antibiotic use recommendations (the 'what') and behavioural change interventions (the 'how') in hospital practice. Published systematic reviews/Medline. The literature shows low-quality evidence of the positive effects of appropriate antibiotic use in hospital patients. The literature shows that any behavioural change intervention might work to ensure that professionals actually perform appropriate antibiotic use recommendations in daily practice. Although effects were overall positive, there were large differences in improvement between studies that tested similar change interventions. The literature showed a clear need for studies that apply appropriate study designs- (randomized) controlled designs-to test the effectiveness of appropriate antibiotic use on achieving meaningful outcomes. Most current studies used designs prone to confounding by indication. In the process of selecting behavioural change interventions that might work best in a chosen setting, much should be learned from behavioural sciences. The challenge for stewardship teams lies in selecting change interventions on the careful assessment of barriers and facilitators, and on a theoretical base while linking determinants to change interventions. Future studies should apply more robust designs and evaluations when assessing behavioural change interventions. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

A systematic review of training programs for parents of children with autism spectrum disorders: single subject contributions.

PubMed

Patterson, Stephanie Y; Smith, Veronica; Mirenda, Pat

2012-09-01

The purpose of this systematic review was to examine research utilizing single subject research designs (SSRD) to explore the effectiveness of interventions designed to increase parents' ability to support communication and social development in children with autism spectrum disorders (ASDs). Included studies were systematically assessed for methodological quality (Logan et al., 2008; Smith et al., 2007) and intervention effects. Data examining participant characteristics, study methodology, outcomes, and analysis were systematically extracted. Eleven SSRD parent-training intervention studies examining 44 participants with ASD were included. Overall, the studies were of moderate quality and reported increases in parent skills and child language and communication outcomes. The results supported by improvement rate difference (IRD) analysis indicated several interventions demonstrated positive effects for both parent and child outcomes. However, limited generalization and follow-up data suggested only one intervention demonstrated parents' accurate and ongoing intervention implementation beyond training.

Testing the Intervention Effect in Single-Case Experiments: A Monte Carlo Simulation Study

ERIC Educational Resources Information Center

Heyvaert, Mieke; Moeyaert, Mariola; Verkempynck, Paul; Van den Noortgate, Wim; Vervloet, Marlies; Ugille, Maaike; Onghena, Patrick

2017-01-01

This article reports on a Monte Carlo simulation study, evaluating two approaches for testing the intervention effect in replicated randomized AB designs: two-level hierarchical linear modeling (HLM) and using the additive method to combine randomization test "p" values (RTcombiP). Four factors were manipulated: mean intervention effect,…

Does Working Memory Moderate the Effects of Fraction Intervention? An Aptitude-Treatment Interaction

ERIC Educational Resources Information Center

Fuchs, Lynn S.; Schumacher, Robin F.; Sterba, Sonya K.; Long, Jessica; Namkung, Jessica; Malone, Amelia; Hamlett, Carol L.; Jordan, Nancy C.; Gersten, Russell; Siegler, Robert S.; Changas, Paul

2014-01-01

This study investigated whether individual differences in working memory (WM) moderate effects of 2 variations of intervention designed to improve at-risk 4th graders' fraction knowledge. We also examined the effects of each intervention condition against a business-as-usual control group and assessed whether children's measurement interpretation…

Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses.

PubMed

Colquhoun, Heather L; Carroll, Kelly; Eva, Kevin W; Grimshaw, Jeremy M; Ivers, Noah; Michie, Susan; Sales, Anne; Brehaut, Jamie C

2017-09-29

Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions. Using purposive sampling, semi-structured 60-90-min telephone interviews were conducted with experts in theories related to A&F from a range of fields (e.g., cognitive, health and organizational psychology, medical decision-making, economics). Guided by detailed descriptions of A&F interventions from the health care literature, interviewees described how they would approach the problem of designing improved A&F interventions. Specific, theory-informed hypotheses about the conditions for effective design and delivery of A&F interventions were elicited from the interviews. The resulting hypotheses were assigned by three coders working independently into themes, and categories of themes, in an iterative process. We conducted 28 interviews and identified 313 theory-informed hypotheses, which were placed into 30 themes. The 30 themes included hypotheses related to the following five categories: A&F recipient (seven themes), content of the A&F (ten themes), process of delivery of the A&F (six themes), behavior that was the focus of the A&F (three themes), and other (four themes). We have identified a set of testable, theory-informed hypotheses from a broad range of behavioral and social science that suggest conditions for more effective A&F interventions. This work demonstrates the breadth of perspectives about A&F from non-healthcare-specific disciplines in a way that yields testable hypotheses for healthcare A&F interventions. These results will serve as the foundation for further work seeking to set research priorities among the A&F research community.

Designing for Dissemination: Lessons in Message Design From “1-2-3 Pap”

PubMed Central

Cohen, Elisia L.; Head, Katharine J.; McGladrey, Margaret J.; Hoover, Anna G.; Vanderpool, Robin C.; Bridger, Colleen; Carman, Angela; Crosby, Richard A.; Darling, Elaine; Tucker-McLaughlin, Mary; Winterbauer, Nancy

2016-01-01

Despite a large number of evidence-based health communication interventions tested in private, public, and community health settings, there is a dearth of research on successful secondary dissemination of these interventions to other audiences. This article presents the case study of “1-2-3 Pap,” a health communication intervention to improve human papillomavirus (HPV) vaccination uptake and Pap testing outcomes in Eastern Kentucky, and explores strategies used to disseminate this intervention to other populations in Kentucky, North Carolina, and West Virginia. Through this dissemination project, we identified several health communication intervention design considerations that facilitated our successful dissemination to these other audiences; these intervention design considerations include (a) developing strategies for reaching other potential audiences, (b) identifying intervention message adaptations that might be needed, and (c) determining the most appropriate means or channels by which to reach these potential future audiences. Using “1-2-3 Pap” as an illustrative case study, we describe how careful planning and partnership development early in the intervention development process can improve the potential success of enhancing the reach and effectiveness of an intervention to other audiences beyond the audience for whom the intervention messages were originally designed. PMID:25470444

The effectiveness of social marketing interventions for health improvement: what's the evidence?

PubMed

Gordon, Ross; McDermott, Laura; Stead, Martine; Angus, Kathryn

2006-12-01

To review the effectiveness of social marketing interventions designed to improve diet, increase physical activity, and tackle substance misuse. This article describes three reviews of systematic reviews and primary studies that evaluate social marketing effectiveness. All three reviews used pre-defined search and inclusion criteria and defined social marketing interventions as those which adopted six key social marketing principles. The reviews provide evidence that social marketing interventions can be effective in improving diet, increasing exercise, and tackling the misuse of substances like alcohol, tobacco, and illicit drugs. There is evidence that social marketing interventions can work with a range of target groups, in different settings, and can work upstream as well as with individuals. Social marketing provides a very promising framework for improving health both at the individual level and at wider environmental and policy-levels. Problems with research design, lack of conceptual understanding or implementation are valid research concerns.

Effectiveness-implementation Hybrid Designs

PubMed Central

Curran, Geoffrey M.; Bauer, Mark; Mittman, Brian; Pyne, Jeffrey M.; Stetler, Cheryl

2013-01-01

Objectives This study proposes methods for blending design components of clinical effectiveness and implementation research. Such blending can provide benefits over pursuing these lines of research independently; for example, more rapid translational gains, more effective implementation strategies, and more useful information for decision makers. This study proposes a “hybrid effectiveness-implementation” typology, describes a rationale for their use, outlines the design decisions that must be faced, and provides several real-world examples. Results An effectiveness-implementation hybrid design is one that takes a dual focus a priori in assessing clinical effectiveness and implementation. We propose 3 hybrid types: (1) testing effects of a clinical intervention on relevant outcomes while observing and gathering information on implementation; (2) dual testing of clinical and implementation interventions/strategies; and (3) testing of an implementation strategy while observing and gathering information on the clinical intervention’s impact on relevant outcomes. Conclusions The hybrid typology proposed herein must be considered a construct still in evolution. Although traditional clinical effectiveness and implementation trials are likely to remain the most common approach to moving a clinical intervention through from efficacy research to public health impact, judicious use of the proposed hybrid designs could speed the translation of research findings into routine practice. PMID:22310560

The Effect of a "Mindful Restaurant Eating" Intervention on Weight Management in Women

ERIC Educational Resources Information Center

Timmerman, Gayle M.; Brown, Adama

2012-01-01

Objective: To evaluate the effect of a "Mindful Restaurant Eating" intervention on weight management. Design: Randomized control trial. Setting: Greater metropolitan area of Austin, Texas. Participants: Women (n = 35) 40-59 years old who eat out at least 3 times per week. Intervention: The intervention, using 6 weekly 2-hour, small group…

Effects of a Tier 3 Phonological Awareness Intervention on Preschoolers' Emergent Literacy

ERIC Educational Resources Information Center

Noe, Sean; Spencer, Trina D.; Kruse, Lydia; Goldstein, Howard

2014-01-01

This multiple baseline design study examined the effects of a Tier 3 early literacy intervention on low-income preschool children's phonological awareness (PA). Seven preschool children who did not make progress on identifying first sounds in words during a previous Tier 2 intervention participated in a more intensive Tier 3 intervention. Children…

Impact of a Community-Based Intervention on Serving and Intake of Vegetables among Low-Income, Rural Appalachian Families

ERIC Educational Resources Information Center

Wenrich, Tionni R.; Brown, J. Lynne; Wilson, Robin Taylor; Lengerich, Eugene J.

2012-01-01

Objective: To evaluate the effectiveness of a community-based intervention promoting the serving and eating of deep-orange, cruciferous, and dark-green leafy vegetables. Design: Randomized, parallel-group, community-based intervention with a baseline/postintervention/3-month follow-up design. Setting and Participants: Low-income food preparers (n…

Antecedent Social Skills Interventions for Individuals with ASD: What Works, for Whom, and under What Conditions?

ERIC Educational Resources Information Center

Ledford, Jennifer R.; King, Seth; Harbin, Emilee R.; Zimmerman, Kathleen N.

2018-01-01

Social skills interventions designed to increase pro-social interactions for individuals with autism spectrum disorders are critical, but the relative effectiveness of these interventions is not well understood. More than 250 single-case design studies in 113 articles were reviewed and described in terms of participants, settings, arrangements,…

Life Design Counseling Group Intervention with Portuguese Adolescents: A Process and Outcome Study

ERIC Educational Resources Information Center

Cardoso, Paulo; Janeiro, Isabel Nunes; Duarte, Maria Eduarda

2018-01-01

This article examines the process and outcome of a life design counseling group intervention with students in Grades 9 and 12. First, we applied a quasi-experimental methodology to analyze the intervention's effectiveness in promoting career certainty, career decision-making, self-efficacy, and career adaptability in a sample of 236 students.…

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

PubMed

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

2018-03-01

Although caregiver-delivered social communication interventions have been considered scientifically proven practices for individuals with autism spectrum disorders, it is not well examined if these types of intervention modes are truly effective in promoting skill generalization and maintenance within those individuals with autism spectrum disorders. The purpose of this meta-analysis was to evaluate the status of the extant literature regarding the measures on generalization and/or maintenance of effects of caregiver-delivered communication interventions for children with autism spectrum disorders. This systematic literature review and meta-analysis evaluated peer-reviewed research regarding the effects of caregiver-implemented interventions on the maintenance and generalization of the social-communication skills for children with autism spectrum disorders. A total of 34 articles were included following a systematic search. Articles were summarized according to the following categories: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) generalization/maintenance teaching strategy, and (e) latency to maintenance probes. After application of design standards, aggregate Tau-U and non-overlap of pairs effect sizes were calculated with a total of 67 separate contrasts across seven studies. Overall, effect size scores ranged from small to large effects across all comparisons. On average, most of the baseline to maintenance and generalization comparisons produced moderate to large effects. Whereas, small to moderate or even deteriorate effects were found in most of the intervention to maintenance and generalization comparisons. The findings in this review suggest that caregiver-delivered social-communication interventions are likely to result in mixed effects on skill generalization and maintenance within children with autism spectrum disorders. Implications for future research and practice are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effective, clinically feasible and sustainable: Key design features of psycho-educational and supportive care interventions to promote individualised self-management in cancer care.

PubMed

Schofield, Penelope; Chambers, Suzanne

2015-05-01

As the global burden of cancer increases healthcare services will face increasing challenges in meet the complex needs of these patients, their families and the communities in which they live. This raises the question of how to meet patient need where direct clinical contact may be constrained or not readily available. Patients and families require resources and skills to manage their illness outside of the hospital setting within their own communities. To propose a framework for the development and delivery of psycho-educational and supportive care interventions drawing on theoretical principles of behaviour change and evidence-based interventions, and based on extensive experience in developing and testing complex interventions in oncology. At the core of this intervention framework are considerations of efficiency: interventions are designed to cater for individuals' unique needs; to place minimal demands on the health system infrastructure and to be rapidly disseminated into usual care if successful. There are seven key features: 1) Targeting cancer type and stage; 2) Tailoring to unique individual needs; 3) Promotion of patient self-management of their disease and treatment side effects; 4) Efficient delivery of the intervention; 5) Training and adherence to protocol; 6) Ensuring the intervention is evidence-based; 7) Confirming stakeholder acceptability of the intervention. A case study of a randomised controlled trial which tested psycho-educational oncology interventions using this framework is presented. These interventions were designed to cater for individuals' unique needs and promote self-management while placing minimal demands on the acute health care setting. Innovative ways to realise the potentially major impact that psycho-educational and supportive care interventions can have on psychological morbidity, coping, symptoms and quality of life in serious and chronic illness are needed. This framework, which is driven by theory, evidence, and experience, is designed to ensure that interventions are effective, clinically feasible and sustainable.

Balancing health, work, and daily life: design and evaluation of a pilot intervention for persons with HIV/AIDS.

PubMed

Bedell, Gary

2008-01-01

To design and evaluate a pilot intervention to promote self-management skills and work transition for persons with HIV/AIDS. The seven-week group intervention consisted of 1.5-hour bi-weekly sessions focused on goal setting and developing strategies to manage health, work and daily life routines while participating in a job skills training program in New York City. Six successive groups received the intervention over the course of two years (n = 53). Existing and newly-developed measures were used to examine key outcomes. Differences between pre-intervention and post-intervention scores on outcome measures were examined using paired-tests and effect sizes. Employment outcomes and participant satisfaction were examined post-intervention. The intervention was feasible to implement and sessions were viewed favorably by the majority of participants. Moderate to large effect sizes were found immediately post-intervention in participants' perceived ability to work and balance health, work and daily life. Fifty two percent of the participants were working part or full time and 41% were actively searching for employment at three to five months follow-up. Small effect sizes demonstrating improved outcomes at follow-up were found in symptom severity, self-advocacy and medication adherence self-efficacy. Small effect sizes demonstrating a potential decrement in outcomes at follow-up were found in participants' need satisfaction and perceived symptom impact on work performance. The results are promising, but further research is needed due to design limitations and the preliminary nature of the intervention and measures used. The potential decrement in outcomes might reflect a shift in participants' needs or view of how their health affected work performance and suggests that ongoing supports were needed post-intervention.

Community-based restaurant interventions to promote healthy eating: a systematic review.

PubMed

Valdivia Espino, Jennifer N; Guerrero, Natalie; Rhoads, Natalie; Simon, Norma-Jean; Escaron, Anne L; Meinen, Amy; Nieto, F Javier; Martinez-Donate, Ana P

2015-05-21

Eating in restaurants is associated with high caloric intake. This review summarizes and evaluates the evidence supporting community-based restaurant interventions. We searched all years of PubMed and Web of Knowledge through January 2014 for original articles describing or evaluating community-based restaurant interventions to promote healthy eating. We extracted summary information and classified the interventions into 9 categories according to the strategies implemented. A scoring system was adapted to evaluate the evidence, assigning 0 to 3 points to each intervention for study design, public awareness, and effectiveness. The average values were summed and then multiplied by 1 to 3 points, according to the volume of research available for each category. These summary scores were used to determine the level of evidence (insufficient, sufficient, or strong) supporting the effectiveness of each category. This review included 27 interventions described in 25 studies published since 1979. Most interventions took place in exclusively urban areas of the United States, either in the West or the South. The most common intervention categories were the use of point-of-purchase information with promotion and communication (n = 6), and point-of-purchase information with increased availability of healthy choices (n = 6). Only the latter category had sufficient evidence. The remaining 8 categories had insufficient evidence because of interventions showing no, minimal, or mixed findings; limited reporting of awareness and effectiveness; low volume of research; or weak study designs. No intervention reported an average negative impact on outcomes. Evidence about effective community-based strategies to promote healthy eating in restaurants is limited, especially for interventions in rural areas. To expand the evidence base, more studies should be conducted using robust study designs, standardized evaluation methods, and measures of sales, behavior, and health outcomes.

Community-Based Restaurant Interventions to Promote Healthy Eating: A Systematic Review

PubMed Central

Valdivia Espino, Jennifer N.; Guerrero, Natalie; Rhoads, Natalie; Simon, Norma-Jean; Escaron, Anne L.; Meinen, Amy; Nieto, F. Javier

2015-01-01

Introduction Eating in restaurants is associated with high caloric intake. This review summarizes and evaluates the evidence supporting community-based restaurant interventions. Methods We searched all years of PubMed and Web of Knowledge through January 2014 for original articles describing or evaluating community-based restaurant interventions to promote healthy eating. We extracted summary information and classified the interventions into 9 categories according to the strategies implemented. A scoring system was adapted to evaluate the evidence, assigning 0 to 3 points to each intervention for study design, public awareness, and effectiveness. The average values were summed and then multiplied by 1 to 3 points, according to the volume of research available for each category. These summary scores were used to determine the level of evidence (insufficient, sufficient, or strong) supporting the effectiveness of each category. Results This review included 27 interventions described in 25 studies published since 1979. Most interventions took place in exclusively urban areas of the United States, either in the West or the South. The most common intervention categories were the use of point-of-purchase information with promotion and communication (n = 6), and point-of-purchase information with increased availability of healthy choices (n = 6). Only the latter category had sufficient evidence. The remaining 8 categories had insufficient evidence because of interventions showing no, minimal, or mixed findings; limited reporting of awareness and effectiveness; low volume of research; or weak study designs. No intervention reported an average negative impact on outcomes. Conclusion Evidence about effective community-based strategies to promote healthy eating in restaurants is limited, especially for interventions in rural areas. To expand the evidence base, more studies should be conducted using robust study designs, standardized evaluation methods, and measures of sales, behavior, and health outcomes. PMID:25996986

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

PubMed

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

2016-08-24

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

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

PubMed Central

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

2016-01-01

Background Adherence to effective Web-based interventions for common mental disorders (CMDs) and well-being remains a critical issue, with clear potential to increase effectiveness. Continued identification and examination of “active” technological components within Web-based interventions has been called for. Gamification is the use of game design elements and features in nongame contexts. Health and lifestyle interventions have implemented a variety of game features in their design in an effort to encourage engagement and increase program adherence. The potential influence of gamification on program adherence has not been examined in the context of Web-based interventions designed to manage CMDs and well-being. Objective This study seeks to review the literature to examine whether gaming features predict or influence reported rates of program adherence in Web-based interventions designed to manage CMDs and well-being. Methods A systematic review was conducted of peer-reviewed randomized controlled trials (RCTs) designed to manage CMDs or well-being and incorporated gamification features. Seven electronic databases were searched. Results A total of 61 RCTs met the inclusion criteria and 47 different intervention programs were identified. The majority were designed to manage depression using cognitive behavioral therapy. Eight of 10 popular gamification features reviewed were in use. The majority of studies utilized only one gamification feature (n=58) with a maximum of three features. The most commonly used feature was story/theme. Levels and game leaders were not used in this context. No studies explicitly examined the role of gamification features on program adherence. Usage data were not commonly reported. Interventions intended to be 10 weeks in duration had higher mean adherence than those intended to be 6 or 8 weeks in duration. Conclusions Gamification features have been incorporated into the design of interventions designed to treat CMD and well-being. Further research is needed to improve understanding of gamification features on adherence and engagement in order to inform the design of future Web-based health interventions in which adherence to treatment is of concern. Conclusions were limited by varied reporting of adherence and usage data. PMID:27558893

More Useful, or Not So Bad? Evaluating the Effects of Interventions to Reduce Perceived Cost and Increase Utility Value with College Physics Students

NASA Astrophysics Data System (ADS)

Rosenzweig, Emily Quinn

In the present study I developed and evaluated the effects of two interventions designed to target students' motivation to learn in an introductory college physics course. One intervention was designed to improve students' perceptions of utility value and the other was designed to reduce students' perceptions of cost. Utility value and cost both are central constructs from Eccles and colleagues' expectancy-value theory of motivation (Eccles-Parsons et al., 1983). Students (N = 148) were randomly assigned to receive the cost intervention, the utility value intervention, or one of two control conditions. Compared to a survey control condition, neither intervention impacted overall students' motivation, measured at 3 time points over the semester, or their course outcomes. In moderation analyses, neither intervention impacted any students' perceptions of utility value. However, both interventions impacted some students' perceptions of cost, competence-related beliefs, and course outcomes positively while impacting these variables for other students negatively. The cost intervention benefitted consistently and in different ways students who had low baseline competence-related beliefs, low prior achievement, strong malleable beliefs about intelligence, or who were female. However, the intervention showed consistent undermining effects on motivation and/or achievement for students with strong fixed beliefs about intelligence. The utility value intervention benefitted consistently the course outcomes of students who had low baseline competence-related beliefs, low prior achievement, or who were female. The intervention showed less consistent undermining effects on motivation for students with strong fixed beliefs about intelligence, high baseline competence-related beliefs, or high prior achievement. Prior researchers have shown that utility value interventions improve course outcomes for some students who are at risk for underachievement. The present study extends prior work by showing that utility value interventions benefit similar students in college physics courses. It also demonstrates that a cost intervention is a viable way to impact at-risk students' physics course outcomes. Future researchers should consider carefully moderating variables and how to mitigate potential undermining effects for some students when implementing future expectancy-value-theory-based interventions in college physics courses.

Outcomes of the Smoker's Health Project: A Pragmatic Comparative Effectiveness Trial of Tobacco-Dependence Interventions Based on Self-Determination Theory

ERIC Educational Resources Information Center

Williams, Geoffrey C.; Niemiec, Christopher P.; Patrick, Heather; Ryan, Richard M.; Deci, Edward L.

2016-01-01

A pragmatic comparative effectiveness trial examined whether extending the duration of a cost-effective, intensive tobacco-dependence intervention designed to support autonomy will facilitate long-term tobacco abstinence. Participants were randomly assigned to one of three tobacco-dependence interventions based on self-determination theory,…

Using a Changing-Criterion Design to Evaluate the Effects of Check-In/Check-Out with Goal Modification

ERIC Educational Resources Information Center

McDaniel, Sara C.; Bruhn, Allison L.

2016-01-01

Check-in/check-out (CICO) is a Tier 2 behavioral intervention that has demonstrated effectiveness for students with challenging behavior in a variety of educational settings. Existing research has focused primarily on testing the intervention's effectiveness and the role of behavioral function in moderating response to intervention. Only a handful…

Multilevel Interventions: Study Design and Analysis Issues

PubMed Central

Gross, Cary P.; Zaslavsky, Alan M.; Taplin, Stephen H.

2012-01-01

Multilevel interventions, implemented at the individual, physician, clinic, health-care organization, and/or community level, increasingly are proposed and used in the belief that they will lead to more substantial and sustained changes in behaviors related to cancer prevention, detection, and treatment than would single-level interventions. It is important to understand how intervention components are related to patient outcomes and identify barriers to implementation. Designs that permit such assessments are uncommon, however. Thus, an important way of expanding our knowledge about multilevel interventions would be to assess the impact of interventions at different levels on patients as well as the independent and synergistic effects of influences from different levels. It also would be useful to assess the impact of interventions on outcomes at different levels. Multilevel interventions are much more expensive and complicated to implement and evaluate than are single-level interventions. Given how little evidence there is about the value of multilevel interventions, however, it is incumbent upon those arguing for this approach to do multilevel research that explicates the contributions that interventions at different levels make to the desired outcomes. Only then will we know whether multilevel interventions are better than more focused interventions and gain greater insights into the kinds of interventions that can be implemented effectively and efficiently to improve health and health care for individuals with cancer. This chapter reviews designs for assessing multilevel interventions and analytic ways of controlling for potentially confounding variables that can account for the complex structure of multilevel data. PMID:22623596

Combining Users’ Needs With Health Behavior Models in Designing an Internet- and Mobile-Based Intervention for Physical Activity in Cardiac Rehabilitation

PubMed Central

2014-01-01

Background Internet-based physical activity interventions have great potential in supporting patients in cardiac rehabilitation. Health behavior change theories and user input are identified as important contributors in the effectiveness of the interventions, but they are rarely combined in a systematic way in the design of the interventions. Objective The aim of this study is to identify the appropriate theoretical framework, along with the needs of the users of a physical activity intervention for cardiac rehabilitation, and to combine them into an effective Internet- and mobile-based intervention. Methods We explain the theoretical framework of the intervention in a narrative overview of the existing health behavior change literature as it applies to physical activity. We also conducted a focus group with 11 participants of a cardiac rehabilitation program and used thematic analysis to identify and analyze patterns of meaning in the transcribed data. Results We chose stage-based approaches, specifically the transtheoretical model and the health action process approach as our main framework for tailoring, supplemented with other theoretical concepts such as regulatory focus within the appropriate stages. From the thematic analysis of the focus group data, we identified seven themes: (1) social, (2) motivation, (3) integration into everyday life, (4) information, (5) planning, (6) monitoring and feedback, and (7) concerns and potential problems. The final design of the intervention was based on both the theoretical review and the user input, and it is explained in detail. Conclusions We applied a combination of health behavioral theory and user input in designing our intervention. We think this is a promising design approach with the potential to combine the high efficacy of theory-based interventions with the higher perceived usefulness of interventions designed according to user input. Trial Registration Clinicaltrials.gov NCT01223170; http://clinicaltrials.gov/show/NCT01223170 (Archived by WebCite at http://www.webcitation.org/6M5FqT9Q2). PMID:24413185

Systematic review of the design, implementation and effectiveness of mass media and nutrition education interventions for infant and young child feeding.

PubMed

Graziose, Matthew M; Downs, Shauna M; O'Brien, Quentin; Fanzo, Jessica

2018-02-01

To systematically review the design, implementation and effectiveness of mass media and nutrition education interventions for improving infant and young child feeding (IYCF) practices and related psychosocial factors. A search of PubMed, Embase and PsycINFO databases, a Google search, and a consultation with experts in the field of IYCF performed in July 2016. Low- and middle-income countries, as defined by the World Bank Group. Eligible studies: included a mass media component (with or without nutrition education); conducted a pre-post evaluation (with or without a control group); assessed IYCF knowledge, attitudes, beliefs and/or practices; and were published in English between 2000 and present. Eighteen unique studies were identified that examined the effect of mass media (types included: television; print; voice and/or SMS (text) messages; radio; megaphones/loudspeakers; videos; social media; songs/dramas) and nutrition education interventions on IYCF practices within thirteen countries. Of these, fifteen studies reported improvements in breast- and/or complementary feeding practices, using indicators recommended by the WHO, and six studies reported improvements in related psychosocial factors. However, little detail was provided on the use of formative research, a formal behaviour change theory and behaviour change techniques. Few studies reported both dose delivered and participants' exposure to the intervention. Despite evidence of effectiveness, few common elements in the design of interventions were identified. Future research should consistently report these details to open the 'black box' of IYCF interventions, identify effective design components and ensure replicability.

Comparative effectiveness of colony-stimulating factors in febrile neutropenia prophylaxis: how results are affected by research design.

PubMed

Henk, Henry J; Li, Xiaoyan; Becker, Laura K; Xu, Hairong; Gong, Qi; Deeter, Robert G; Barron, Richard L

2015-01-01

To examine the impact of research design on results in two published comparative effectiveness studies. Guidelines for comparative effectiveness research have recommended incorporating disease process in study design. Based on the recommendations, we develop a checklist of considerations and apply the checklist in review of two published studies on comparative effectiveness of colony-stimulating factors. Both studies used similar administrative claims data, but different methods, which resulted in directionally different estimates. Major design differences between the two studies include: whether the timing of intervention in disease process was identified and whether study cohort and outcome assessment period were defined based on this temporal relationship. Disease process and timing of intervention should be incorporated into the design of comparative effectiveness studies.

Carotid Intima-Media Thickness Studies: Study Design and Data Analysis

PubMed Central

Bots, Michiel L.

2013-01-01

Background Carotid intima-media thickness (CIMT) measurements have been widely used as primary endpoint in studies into the effects of new interventions as alternative for cardiovascular morbidity and mortality. There are no accepted standards on the use of CIMT measurements in intervention studies and choices in the design and analysis of a CIMT study are generally based on experience and expert opinion. In the present review, we provide an overview of the current evidence on several aspects in the design and analysis of a CIMT study on the early effects of new interventions. Summary of Issues A balanced evaluation of the carotid segments, carotid walls, and image view to be used as CIMT study endpoint; the reading method (manual or semi-automated and continuously or in batch) to be employed, the required sample size, and the frequency of ultrasound examinations is provided. We also discuss the preferred methods to analyse longitudinal CIMT data and address the possible impact of, and methods to deal with missing and biologically implausible CIMT values. Conclusions Linear mixed effects models are the preferred way to analyse CIMT data and do appropriately handle missing and biologically implausible CIMT values. Furthermore, we recommend to use extensive CIMT designs that measure CIMT at regular points during the multiple carotid sites as such approach is likely to increase the success rates of CIMT intervention studies designed to evaluate the effects of new interventions on atherosclerotic burden. PMID:24324938

Finding harmony so the music plays on: pragmatic trial design considerations to promote organizational sustainment of an empirically-supported behavior therapy.

PubMed

Hartzler, Bryan; Peavy, K Michelle; Jackson, T Ron; Carney, Molly

2016-01-22

Pragmatic trials of empirically-supported behavior therapies may inform clinical and policy decisions concerning therapy sustainment. This retrospective trial design paper describes and discusses pragmatic features of a hybrid type III implementation/effectiveness trial of a contingency management (CM) intervention at an opioid treatment program. Prior reporting (Hartzler et al., J Subst Abuse Treat 46:429-438, 2014; Hartzler, Subst Abuse Treat Prev Policy 10:30, 2015) notes success in recruiting program staff for voluntary participation, durable impacts of CM training on staff-level outcomes, provisional setting implementation of the intervention, documentation of clinical effectiveness, and post-trial sustainment of CM. Six pragmatic design features, and both scientific and practical bases for their inclusion in the trial, are presented: (1) a collaborative intervention design process, (2) voluntary recruitment of program staff for therapy training and implementation, (3) serial training outcome assessments, with quasi-experimental staff randomization to either single or multiple baseline assessment conditions, (4) designation of a 90-day period immediately after training in which the setting implemented the intervention on a provisional basis, (5) inclusive patient eligibility for receipt of the CM intervention, and (6) designation of two staff as local implementation leaders to oversee clinical/administrative issues in provisional implementation. Each pragmatic trial design feature is argued to have contributed to sustainment of CM. Contributions implicate the building of setting proprietorship for the CM intervention, culling of internal staff expertise in its delivery, iterative use of assessment methods that limited setting burden, documentation of setting-specific clinical effectiveness, expanded penetration of CM among staff during provisional implementation, and promotion of setting self-reliance in the oversight of sustainable implementation procedures. It is hoped this discussion offers ideas for how to impact local clinical and policy decisions via effective behavior therapy dissemination.

Effects of In-Service Training on Early Intervention Practitioners' Use of Family-Systems Intervention Practices in the USA

ERIC Educational Resources Information Center

Dunst, Carl J.; Trivette, Carol M.; Deal, Angela G.

2011-01-01

The effectiveness of three types of in-service training designed to improve early intervention practitioners' abilities to use family-systems intervention practices was evaluated in the study of 473 participants. Participants attended either conference presentations or one of two types of workshops (half day/full day or multi-day), or received one…

Adult community health-promoting interventions in primary health care: A systematic review.

PubMed

March, Sebastià; Torres, Elena; Ramos, María; Ripoll, Joana; García, Atanasio; Bulilete, Oana; Medina, David; Vidal, Clara; Cabeza, Elena; Llull, Micaela; Zabaleta-del-Olmo, Edurne; Aranda, José Manuel; Sastre, Silvia; Llobera, Joan

2015-07-01

To examine evidence on the effectiveness of health-promoting community interventions carried out in primary health care. Systematic review of originals and systematic reviews of health-promoting community interventions with the participation of primary health care. A working definition of community activities was used in the inclusion criteria. Databases searched up to 2013: PUBMED, EMBASE, CINHAL, Web of SCIENCE, IBECS, IME, and PSICODOC. No restrictions on year of publication or design. Articles were reviewed by separate researchers to identify risks of bias. Fifty-one articles published between 1966 and 2013 were included: 11 systematic reviews and 40 originals that described 39 community interventions. There is evidence on the effectiveness of community interventions in reducing cardiovascular risk factors, encouraging physical exercise, preventing falls and improving self-care among chronic patients compared with usual individual care. The effectiveness of some interventions increases when the community is involved in their development. Most assessments show positive results despite design limitations. The community approach may be more effective than the individual in usual preventive interventions in primary care. There is a lack of evidence on many community interventions in primary care and further research is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

Can a school-wide bullying prevention program improve the plight of victims? Evidence for risk × intervention effects.

PubMed

Juvonen, Jaana; Schacter, Hannah L; Sainio, Miia; Salmivalli, Christina

2016-04-01

This study was designed to examine whether a school-wide antibullying program, effective in reducing incidents of bullying, can also reduce the harm associated with victimization. Specifically, we test whether baseline victimization moderates the KiVa program intervention effects on school perceptions, depression, and self-esteem. Relying on a randomized control sample consisting of 7,010 fourth to sixth grade Finnish elementary school students, self-report data were examined using multilevel modeling across 39 intervention and 38 control schools over a 12-month period. The KiVa program was particularly effective in facilitating perceptions of a caring school climate among students who were most victimized before the intervention, while program benefits on attitudes toward school did not vary by level of victimization. The intervention effects on depression and self-esteem were strongest only among the most victimized sixth graders. The results suggest that antibullying programs designed to improve the school ecology can alleviate the plight of the victimized and underscore that harm reduction should be assessed by testing risk × intervention effects when evaluating effectiveness of such programs. (c) 2016 APA, all rights reserved).

Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS) a pragmatic three-arm cluster randomised trial: designing the intervention (ClinicalTrials.gov registration NCT01602705).

PubMed

Barnett, Karen N; Bennie, Marion; Treweek, Shaun; Robertson, Christopher; Petrie, Dennis J; Ritchie, Lewis D; Guthrie, Bruce

2014-10-11

High-risk prescribing in primary care is common and causes considerable harm. Feedback interventions have small/moderate effects on clinical practice, but few trials explicitly compare different forms of feedback. There is growing recognition that intervention development should be theory-informed, and that comprehensive reporting of intervention design is required by potential users of trial findings. The paper describes intervention development for the Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS) study, a pragmatic three-arm cluster randomised trial in 262 Scottish general practices. The NHS chose to implement a feedback intervention to utilise a new resource, new Prescribing Information System (newPIS). The development phase required selection of high-risk prescribing outcome measures and design of intervention components: (1) educational material (the usual care comparison), (2) feedback of practice rates of high-risk prescribing received by both intervention arms and (3) a theory-informed behaviour change component to be received by one intervention arm. Outcome measures, educational material and feedback design, were developed with a National Health Service Advisory Group. The behaviour change component was informed by the Theory of Planned Behaviour and the Health Action Process Approach. A focus group elicitation study and an email Delphi study with general practitioners (GPs) identified key attitudes and barriers of responding to the prescribing feedback. Behaviour change techniques were mapped to the psychological constructs, and the content was informed by the results of the elicitation and Delphi study. Six high-risk prescribing measures were selected in a consensus process based on importance and feasibility. Educational material and feedback design were based on current NHS Scotland practice and Advisory Group recommendations. The behaviour change component was resource constrained in development, mirroring what is feasible in an NHS context. Four behaviour change interventions were developed and embedded in five quarterly rounds of feedback targeting attitudes, subjective norms, perceived behavioural control and action planning (2×). The paper describes a process which is feasible to use in the resource-constrained environment of NHS-led intervention development and documents the intervention to make its design and implementation explicit to potential users of the trial findings. ClinicalTrials.gov: NCT01602705.

Activating schoolyards: study design of a quasi-experimental schoolyard intervention study.

PubMed

Andersen, Henriette Bondo; Pawlowski, Charlotte Skau; Scheller, Hanne Bebendorf; Troelsen, Jens; Toftager, Mette; Schipperijn, Jasper

2015-05-31

The aim of the Activating Schoolyards Study is to develop, implement, document and assess a comprehensive schoolyard intervention to promote physical activity (PA) during school recess for primary school children (grade 4-8). The intervention is designed to implement organizational and structural changes in the physical environment. The study builds on a quasi-experimental study design using a mixed method approach including: 1) an exploratory study aimed at providing input for the developing process; 2) an evaluation of the effect of the interventions using a combination of accelerometer, GPS and GIS; 3) a process evaluation facilitating the intervention development process and identifying barriers and facilitators in the implementation process; 4) a post-intervention end-user evaluation aimed at exploring who uses the schoolyards and how the schoolyards are used. The seven project schools (cases) were selected by means of an open competition and the interventions were developed using a participatory bottom-up approach. The participatory approach and case selection strategy make the study design novel. The use of a mixed methods design including qualitative as well as quantitative methods can be seen as a strength, as the different types of data complement each other and results of one part of the study informed the following parts. A unique aspect of our study is the use of accelerometers in combination with GPS and GIS in the effect evaluation to objectively determine where and how active the students are in the schoolyard, before and after the intervention. This provides a type of data that, to our knowledge, has not been used before in schoolyard interventions. Exploring the change in behavior in relation to specific intervention elements in the schoolyard will lead to recommendations for schools undergoing schoolyard renovations at some point in the future.

Effects of Critical Thinking Intervention for Early Childhood Teacher Candidates

ERIC Educational Resources Information Center

Han, Heejeong Sophia; Brown, E. Todd

2013-01-01

This study is based on an intervention designed to enhance early childhood teacher candidates' critical thinking abilities. The concept, elements, standards, and traits of critical thinking were integrated into the main course contents, and the effects of the intervention were examined. The results indicated that early childhood teacher…

Train the Trainer Effectiveness Trials of Behavioral Intervention for Individuals with Autism: A Systematic Review

ERIC Educational Resources Information Center

Shire, Stephanie Yoshiko; Kasari, Connie

2014-01-01

This systematic review examines train the trainer (TTT) effectiveness trials of behavioral interventions for individuals with autism spectrum disorder (ASD). Published methodological quality scales were used to assess studies including participant description, research design, intervention, outcomes, and analysis. Twelve studies including 9 weak…

Theories of Student Success: Evaluating the Effectiveness of an Intervention Strategy

ERIC Educational Resources Information Center

Royal, Kenneth D.; Tabor, Alison J.

2008-01-01

Institutions of higher education have developed a host of interventions to increase the retention of first-year students whose academic performance is inadequate. This study evaluated the overall effectiveness of an intervention strategy designed for first-year students on academic probation at a mid-western research university. A…

The Effectiveness of an Emergent Literacy Intervention for Teenage Parents

ERIC Educational Resources Information Center

Scott, Amy; van Bysterveldt, Anne; McNeill, Brigid

2016-01-01

This study determined the effectiveness of an experimental emergent literacy intervention, targeting teenage mothers attending an educational facility. Using a pretest/posttest research design, 27 participants completed a 7­-week intervention based in the classroom, targeting a range of emergent literacy skills that they could utilize when reading…

Measuring Intervention Effectiveness: The Benefits of an Item Response Theory Approach

ERIC Educational Resources Information Center

McEldoon, Katherine; Cho, Sun-Joo; Rittle-Johnson, Bethany

2012-01-01

Assessing the effectiveness of educational interventions relies on quantifying differences between interventions groups over time in a between-within design. Binary outcome variables (e.g., correct responses versus incorrect responses) are often assessed. Widespread approaches use percent correct on assessments, and repeated measures analysis of…

The importance of preservation of the ethical principle of equipoise in the design of clinical trials: relative impact of the methodological quality domains on the treatment effect in randomized controlled trials.

PubMed

Djulbegovic, Benjamin; Cantor, Alan; Clarke, Mike

2003-01-01

Previous research has identified methodological problems in the design and conduct of randomized trials that could, if left unaddressed, lead to biased results. In this report we discuss one such problem, inadequate control intervention, and argue that it can be by far the most important design characteristic of randomized trials in overestimating the effect of new treatments. Current guidelines for the design and reporting of randomized trials, such as the Consolidated Standards of Reporting Trials (CONSORT) statement, do not address the choice of the comparator intervention. We argue that an adequate control intervention can be selected if people designing a trial explicitly take into consideration the ethical principle of equipoise, also known as "the uncertainty principle."

The Relationship between Teacher Training, Intervention Strategies, and Students' Academic Achievement in the Classroom with K-5 ADHD Students

ERIC Educational Resources Information Center

Cooper, Nancy A.

2014-01-01

The primary intent of this study was to explore the effect between teachers' training, intervention strategies, and the academic achievement of K-5 ADHD students. The study design employed a mixed research design. The quantitative method focused on collecting data from certified regular and special-education teachers. Additionally, effects were…

Effects of an Automated Telephone Support System on Caregiver Burden and Anxiety: Findings from the REACH for TLC Intervention Study

ERIC Educational Resources Information Center

Mahoney, Diane Feeney; Tarlow, Barbara J.; Jones, Richard N.

2003-01-01

Purpose: We determine the main outcome effects of a 12-month computer-mediated automated interactive voice response (IVR) intervention designed to assist family caregivers managing persons with disruptive behaviors related to Alzheimer's disease (AD). Design and Methods: We conducted a randomized controlled study of 100 caregivers, 51 in the usual…

Designing Studies to Test Causal Questions About Early Math: The Development of Making Pre-K Count.

PubMed

Mattera, Shira K; Morris, Pamela A; Jacob, Robin; Maier, Michelle; Rojas, Natalia

2017-01-01

A growing literature has demonstrated that early math skills are associated with later outcomes for children. This research has generated interest in improving children's early math competencies as a pathway to improved outcomes for children in elementary school. The Making Pre-K Count study was designed to test the effects of an early math intervention for preschoolers. Its design was unique in that, in addition to causally testing the effects of early math skills, it also allowed for the examination of a number of additional questions about scale-up, the influence of contextual factors and the counterfactual environment, the mechanism of long-term fade-out, and the role of measurement in early childhood intervention findings. This chapter outlines some of the design considerations and decisions put in place to create a rigorous test of the causal effects of early math skills that is also able to answer these questions in early childhood mathematics and intervention. The study serves as a potential model for how to advance science in the fields of preschool intervention and early mathematics. © 2017 Elsevier Inc. All rights reserved.

An Educational Intervention to Train Community Pharmacists in Providing Specialized Asthma Care

PubMed Central

Smith, Lorraine; Armour, Carol; Krass, Ines

2006-01-01

Objectives The development, implementation, and evaluation of an educational intervention to facilitate specialized asthma care provision by community pharmacists. Design Formative evaluation and a parallel group repeated measures design were used to test the effect of an educational intervention on pharmacist satisfaction and practice behavior as well as patient outcomes. The educational intervention was based on practitioner needs and principles of adult learning using flexible delivery formats. Assessment In the intervention area, 15 pharmacists were trained with the educational intervention, and they provided specialized asthma care to 52 patients over 6 months, while in the control area, 12 pharmacists provided “usual care” to 50 patients. The intervention pharmacists were highly satisfied with the education received and rated most aspects highly. Improvements in patient clinical, humanistic, and economic outcomes in the intervention area were obtained. Conclusion The positive results of the educational intervention demonstrate the effectiveness of an educational approach grounded in the theory that inducing behavioral changes in pharmacy practitioners results in improved patient outcomes. PMID:17149447

The Effects of Tailoring Knowledge Acquisition on Colorectal Cancer Screening Self-Efficacy

PubMed Central

Jerant, Anthony; To, Patricia; Franks, Peter

2015-01-01

Interventions tailored to psychological factors such as personal and vicarious behavioral experiences can enhance behavioral self-efficacy, but are complex to develop and implement. Information seeking theory suggests tailoring acquisition of health knowledge (without concurrent psychological factor tailoring) could enhance self-efficacy, simplifying the design of tailored behavior change interventions. To begin to examine this issue, the authors conducted exploratory analyses of data from a randomized controlled trial, comparing the effects of an experimental colorectal cancer (CRC) screening intervention tailoring knowledge acquisition with the effects of a non-tailored control on CRC screening knowledge and self-efficacy in 1159 patients comprising three ethnicity/language strata (Hispanic/Spanish 23.4%, Hispanic/English 27.2%, non-Hispanic/English 49.3%) and five recruitment center strata. Adjusted for study strata, the mean post-intervention knowledge score was significantly higher in the experimental group versus control. Adjusted experimental intervention exposure (B = 0.22, 95% CI [0.14, 0.30]), pre-intervention knowledge (B = 0.11, 95% CI [0.05, 0.16]), and post-intervention knowledge (B = 0.03, 95% CI [0.01, 0.05]) were independently associated with subsequent CRC screening self-efficacy (p < .001 all associations). These exploratory findings suggest tailoring knowledge acquisition may enhance self-efficacy, with potential implications for tailored intervention design, but require confirmation in studies specifically designed to examine this issue. PMID:25928315

Design of a study evaluating the effects, health economics, and stakeholder perspectives of a multi-component occupational rehabilitation program with an added workplace intervention - a  study protocol.

PubMed

Rise, Marit B; Skagseth, Martin; Klevanger, Nina E; Aasdahl, Lene; Borchgrevink, Petter; Jensen, Chris; Tenggren, Hanne; Halsteinli, Vidar; Jacobsen, Trym N; Løland, Svein B; Johnsen, Roar; Fimland, Marius S

2018-02-05

Recent research has suggested that interventions at the workplace might be the most potent ingredient in return to work interventions, but few studies have investigated the different effects of workplace interventions as part of occupational rehabilitation programs. The comprehensive design described in this article includes effect (on return to work and health outcomes), and health economic evaluations of a workplace intervention added to a multicomponent rehabilitation program. Qualitative and mixed method studies will investigate sick-listed persons', rehabilitation therapists' and employers' perspectives on the usability and outcomes of the rehabilitation program and the workplace intervention. The program and intervention are provided to patients with musculoskeletal, psychological or general and unspecified diagnoses. The program is multi-component and includes Acceptance and Commitment Therapy, physical exercise, patient education and creating a plan for increased work participation. Persons who are employed, aged from 18 to 60 years, with a current sick leave status of 50% or more and a diagnosis within the musculoskeletal, psychological or general and unspecified chapters of International Classification of Primary Care-2 (ICPC-2) will be recruited to a researcher-blinded parallel-group randomized controlled trial. All participants take part in an in-patient occupational rehabilitation program, while the intervention group also takes part in an intervention at the workplace. The effect and economic evaluation will investigate the effect of the added workplace intervention. The primary outcome measures will be time until full sustainable return to work and total number of sickness absence days in the 12 months after inclusion. Health economic evaluations will investigate the cost-effectiveness and cost-utility. Qualitative studies will investigate rehabilitation therapists' experiences with working towards return to work within an ACT-approach and stakeholders' experiences with the workplace intervention. A mixed methods study will combine quantitative and qualitative findings on the participants' expectations and motivation for return to work. The outline of this comprehensive study could represent an important addition to the standard designs of return to work evaluation. The mixed methods design, with qualitative approaches as well as a rigorous randomized controlled trial, might prove useful to shed light on contextual factors. ClinicalTrials.gov : NCT02541890 . September 4, 2015.

The effect of an intervention combining self-efficacy theory and pedometers on promoting physical activity among adolescents.

PubMed

Lee, Ling-Ling; Kuo, Yu-Chi; Fanaw, Dilw; Perng, Shoa-Jen; Juang, Ian-Fei

2012-04-01

To study the effect of an intervention combining self-efficacy theory and pedometers on promoting physical activity among adolescents. The beneficial effects of regular physical activity on health in youths are well-documented. However, adolescence is found to be the age of greatest decline in physical activity participation. Physical activity participation among girls was generally less frequent and less intense than boys. Therefore, there is a strong need for effective interventions that can help promote physical activity in this population. An experimental design. Two classes of female junior college students (mean age = 16) were randomly sampled from a total of four classes and, of those, one each was randomly assigned to either the intervention (n = 46) or the control group (n = 48). Self-efficacy was used as a core theoretical foundation of the intervention design, and pedometers were provided to the students in the intervention group. Distances between each domestic scenic spot were illustrated graphically in a walking log for students to mark the extent of their walking or running. Students in the control group participated in a usual physical education programme. The primary outcome was a change in the number of aerobic steps. The secondary outcomes were changes in cardiopulmonary endurance and exercise self-efficacy. At 12-week follow-up, the mean change in aerobic steps was 371 steps and 108 steps in the intervention and control group, respectively. The difference in mean change between the two groups was 467 steps. Effects of the intervention on changes of cardiopulmonary endurance and perceived exercise self-efficacy scores were not found. Among adolescent girls, a 12-week intervention designed on the theoretical foundation of self-efficacy theory and provision of pedometers was found to have an effect on increasing their physical activity. The intervention, using graphs of domestic scenic spots to represent the distance of walking or running as monitored by pedometers, might enhance motivation regarding physical activity. It is important for health professionals, including school health nurses, involved in the care of adolescent health, to design and provide a physical activity intervention combining self-efficacy theory and provision of pedometer to promote physical activity. © 2011 Blackwell Publishing Ltd.

The importance of educational theories for facilitating learning when using technology in medical education.

PubMed

Sandars, John; Patel, Rakesh S; Goh, Poh Sun; Kokatailo, Patricia K; Lafferty, Natalie

2015-01-01

There is an increasing use of technology for teaching and learning in medical education but often the use of educational theory to inform the design is not made explicit. The educational theories, both normative and descriptive, used by medical educators determine how the technology is intended to facilitate learning and may explain why some interventions with technology may be less effective compared with others. The aim of this study is to highlight the importance of medical educators making explicit the educational theories that inform their design of interventions using technology. The use of illustrative examples of the main educational theories to demonstrate the importance of theories informing the design of interventions using technology. Highlights the use of educational theories for theory-based and realistic evaluations of the use of technology in medical education. An explicit description of the educational theories used to inform the design of an intervention with technology can provide potentially useful insights into why some interventions with technology are more effective than others. An explicit description is also an important aspect of the scholarship of using technology in medical education.

Preventing Smoking in Young People: A Systematic Review of the Impact of Access Interventions

PubMed Central

Richardson, Lindsay; Hemsing, Natalie; Greaves, Lorraine; Assanand, Sunaina; Allen, Patrice; McCullough, Lucy; Bauld, Linda; Humphries, Karin; Amos, Amanda

2009-01-01

Aims: To examine existing evidence on the effectiveness of interventions that are designed to prevent the illegal sale of tobacco to young people. The review considers specific sub-questions related to the factors that might influence effectiveness, any differential effects for different sub-populations of youth, and barriers and facilitators to implementation. Methods: A review of studies on the impact of interventions on young people under the age of 18 was conducted. It included interventions that were designed to prevent the illegal sale of tobacco to children and young people. The review was conducted in July 2007, and included 20 papers on access restriction studies. The quality of the papers was assessed and the relevant data was extracted. Results: The evidence obtained from the review indicates that access restriction interventions may produce significant reductions in the rate of illegal tobacco sales to youth. However, lack of enforcement and the ability of youth to acquire cigarettes from social sources may undermine the effectiveness of these interventions. Conclusions: When access interventions are applied in a comprehensive manner, they can affect young people’s access to tobacco. However, further research is required to examine the effects of access restriction interventions on young people’s smoking behaviour. PMID:19440530

Interventions for compassionate nursing care: A systematic review.

PubMed

Blomberg, Karin; Griffiths, Peter; Wengström, Yvonne; May, Carl; Bridges, Jackie

2016-10-01

Compassion has been identified as an essential element of nursing and is increasingly under public scrutiny in the context of demands for high quality health care. While primary research on effectiveness of interventions to support compassionate nursing care has been reported, no rigorous critical overview exists. To systematically identify, describe and analyse research studies that evaluate interventions for compassionate nursing care; assess the descriptions of the interventions for compassionate care, including design and delivery of the intervention and theoretical framework; and to evaluate evidence for the effectiveness of interventions. Published international literature written in English up to June 2015 was identified from CINAHL, Medline and Cochrane Library databases. Primary research studies comparing outcomes of interventions to promote compassionate nursing care with a control condition were included. Studies were graded according to relative strength of methods and quality of description of intervention. Narrative description and analysis was undertaken supported by tabulation of key study data including study design, outcomes, intervention type and results. 25 interventions reported in 24 studies were included in the review. Intervention types included staff training (n=10), care model (n=9) and staff support (n=6). Intervention description was generally weak, especially in relation to describing participants and facilitators, and the proposed mechanisms for change were often unclear. Most interventions were associated with improvements in patient-based, nurse-based and/or quality of care outcomes. However, overall methodological quality was low with most studies (n=16) conducted as uncontrolled before and after studies. The few higher quality studies were less likely to report positive results. No interventions were tested more than once. None of the studies reviewed reported intervention description in sufficient detail or presented sufficiently strong evidence of effectiveness to merit routine implementation of any of these interventions into practice. The positive outcomes reported suggest that further investigation of some interventions may be merited, but high caution must be exercised. Preference should be shown for further investigating interventions reported as effective in studies with a stronger design such as randomised controlled trials. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Methodological Overview of an African American Couple-Based HIV/STD Prevention Trial

PubMed Central

2010-01-01

Objective To provide an overview of the NIMH Multisite HIV/STD Prevention Trial for African American Couples conducted in four urban areas: Atlanta, Los Angeles, New York, and Philadelphia. The rationale, study design methods, proposed data analyses, and study management are described. Design This is a two arm randomized Trial, implementing a modified randomized block design, to evaluate the efficacy of a couples based intervention designed for HIV serodiscordant African American couples. Methods The study phases consisted of formative work, pilot studies, and a randomized clinical trial. The sample is 535 HIV serodiscordant heterosexual African American couples. There are two theoretically derived behavioral interventions with eight group and individual sessions: the Eban HIV/STD Risk Reduction Intervention (treatment) versus the Eban Health Promotion Intervention (control). The treatment intervention was couples based and focused on HIV/STD risk reduction while the control was individual based and focused on health promotion. The two study conditions were structurally similar in length and types of activities. At baseline, participants completed an Audio Computer-assisted Self Interview (ACASI) interview as well as interviewer-administered questionnaire, and provided biological specimens to assess for STDs. Similar follow-up assessments were conducted immediately after the intervention, at 6 months, and at 12 months. Results The Trial results will be analyzed across the four sites by randomization assignment. Generalized estimating equations (GEE) and mixed effects modeling (MEM) are planned to test: (1) the effects of the intervention on STD incidence and condom use as well as on mediator variables of these outcomes, and (2) whether the effects of the intervention differ depending on key moderator variables (e.g., gender of the HIV-seropositive partners, length of relationship, psychological distress, sexual abuse history, and substance abuse history). Conclusions The lessons learned from the design and conduct of this clinical trial provide guidelines for future couples based clinical trials in HIV/STD risk reduction and can be generalized to other couples based behavioral interventions. PMID:18724188

Systematic review: what interventions improve dignity for older patients in hospital?

PubMed

Zahran, Zainab; Tauber, Marcelle; Watson, Holly Howe; Coghlan, Phoebe; White, Sarah; Procter, Sue; Addis, Gulen; Norton, Christine

2016-02-01

To review the evidence for interventions to improve dignity for older patients in acute care. High profile cases have highlighted failure to provide dignified care for older people in hospitals. There is good evidence on what older people consider is important for dignified care and abundant recommendations on improving dignity, but it is unclear which interventions are effective. Narrative systematic review. The Cochrane library, MEDLINE, EMBASE, CINAHL, BNI and HMIC electronic databases were searched for intervention studies of any design aiming to improve inpatients' dignity. The main population of interest was older patients, but the search included all patients. Studies that focused on 'dignity therapy' were excluded. There were no intervention studies found in any country which aimed to improve patient dignity in hospitals which included evaluation of the effect. A narrative overview of papers that described implementing dignity interventions in practice but included no formal evaluation was, therefore, undertaken. Five papers were identified. Three themes were identified: knowing the person; partnership between older people and health care professionals; and, effective communication and clinical leadership. The effect on dignity of improving these is untested. There are currently no studies that have tested interventions to improve the dignity of older people (nor anyone else) in hospitals. Further research using well designed trials of interventions is needed. There is also a need to develop and validate outcome measures for interventions to improve dignity. At present nurses lack robust evidence on how to improve dignity. There is ample evidence on what undermines patients' dignity and there is a need to develop and test interventions designed to improve patient dignity. © 2016 John Wiley & Sons Ltd.

Preliminary effects of parent-implemented behavioural interventions for stereotypy.

PubMed

Lanovaz, Marc J; Rapp, John T; Maciw, Isabella; Dorion, Catherine; Prégent-Pelletier, Émilie

2016-06-01

The purpose of our study was to replicate and extend previous research on using multicomponent behavioural interventions designed to reduce engagement in stereotypy by examining their effects when implemented by parents over several months. We used an alternating treatment design to examine the effects of the parent-implemented interventions on engagement in stereotypy and appropriate behaviour in three children with autism and other developmental disabilities. The parent-implemented multicomponent treatments reduced vocal stereotypy in all three participants and increased engagement in appropriate behaviour in two participants. These effects persisted up to 24 weeks following the parent training sessions. Altogether, our preliminary results support (a) the involvement of parents as behaviour change agents to reduce engagement in stereotypy and (b) the scheduling of regular, but infrequent (i.e. weekly to monthly), follow-up meetings to monitor the effects of behavioural interventions in outpatient and home-based service delivery models.

The effect of an Internet-based intervention designed to reduce HIV/AIDS sexual risk among Mexican adolescents.

PubMed

Castillo-Arcos, Lubia Del Carmen; Benavides-Torres, Raquel Alicia; López-Rosales, Fuensanta; Onofre-Rodríguez, Dora Julia; Valdez-Montero, Carolina; Maas-Góngora, Lucely

2016-01-01

The purpose of the study was to evaluate the effect of an Internet-based intervention to reduce sexual risk behaviors and increase resilience to sexual risk behaviors among Mexican adolescents, a key HIV/AIDS risk group. The study had a quasi-experimental design with single-stage cluster sampling. Participants ages 14-17 were stratified by gender and randomly assigned to either receive intervention "Connect" (which included face-to-face and Internet-based sessions designed to reduce sexual risk behaviors and increase resilience to sexual risk) or control (a general educational video on reducing health risks). A total of 9 survey instruments were administered online through SurveyMonkey pre- and post-intervention to assess changes in sexual risk and protective factors as well as two outcomes of interest: risky sexual behaviors and resilience. Pearson correlation assessed instrument reliability while multivariable linear regression models assessed two study hypotheses: (1) the effect of the intervention on sexual behavior and resilience is mediated by adolescent age, gender, and sexual experience and (2) risk and protective factors are mediators between the intervention and sexual behavior. The sample was composed of 193 adolescents between 14 and 17 years old (n = 96 in the control group and n = 97 in the experimental group). Survey instruments were reliable. Age was associated with pre-to-post test changes in sexual resilience (β = -6.10, p = .019), which partially mediated the effect of the intervention on sexual resilience (β = 5.70, p = .034). Social support was associated with pre-to-post test changes in risky sexual behavior (β = -0.17, p = .039). Intervention "Connect" was independently associated with improved self-reported resilience to risky sexual behaviors, though not with a reduction in those behaviors in multivariate analyses. This is the first Internet-based intervention designed to reduce HIV/AIDS sexual risk among Mexican adolescents.

Design of a RCT evaluating the (cost-) effectiveness of a lifestyle intervention for male construction workers at risk for cardiovascular disease: The Health under Construction study

PubMed Central

Groeneveld, Iris F; Proper, Karin I; van der Beek, Allard J; van Duivenbooden, Cor; van Mechelen, Willem

2008-01-01

Background Of all workers in Dutch construction industry, 20% has an elevated risk of cardiovascular disease (CVD). A major risk factor for CVD risk is an unhealthy lifestyle. The aim of our study is to design a lifestyle intervention for construction workers with an elevated CVD risk, and to evaluate its (cost-) effectiveness. Methods/Design In a RCT, 692 participants will be randomised to either the control or the intervention group. The control group will receive usual care. For the intervention group, a lifestyle intervention has been designed based on interviews and current literature. The intervention will last 6 months and will comprise 3 face-to-face and 4 telephone contacts, consisting of individual counselling aimed at increasing daily physical activity (PA) and improving dietary behaviour, and/or smoking cessation. Counselling will take place at the Occupational Health Service (OHS), and will be done according to motivational interviewing (MI). Additional written information about healthy lifestyle will also be provided to those in the intervention group. At baseline, after 6 and after 12 months, measurements will take place. Primary outcome variables will be the lifestyle behaviours of concern, i.e. daily PA, dietary intake, and smoking status. Secondary outcome variables will be body mass index (BMI), systolic and diastolic blood pressure, total and HDL blood cholesterol, Hba1c and cardio-respiratory fitness (CRF). Sickness absenteeism and cost-effectiveness will be assessed as well. Multilevel analysis will be performed to compare all outcome measures between the intervention group and the control group. Discussion By improving lifestyle, CVD risk may be lowered, yielding benefits for both employee and employer. If proven effective, this lifestyle intervention will be implemented on a larger scale within the Occupational Health Services in construction industry. Trial registration Current Controlled Trials ISRCTN60545588 PMID:18173844

Disease management interventions: what's in the black box?

PubMed

Linden, Ariel; Roberts, Nancy

2004-01-01

In discussing evaluation techniques to assess disease management (DM) program outcomes, it is often assumed that DM program interventions are premised on sound clinical judgment, an understanding of the disease process, and knowledge of the psychosocial models of behavioral change that must be used to effect those processes and ultimately improve the health outcomes that are being evaluated. This paper describes eight commonly used behavioral change models applied in the healthcare industry today. They represent programs designed to address individual, interpersonal, and community level factors as well as "packaged" comprehensive approaches. These models illustrate the breadth of approaches to consider when designing or assessing DM program interventions. Careful consideration of the type of behavioral change desired and the theories of how to effect such change should be an integral part of designing disease management program interventions.

Mobile eHealth interventions for obesity: a timely opportunity to leverage convergence trends.

PubMed

Tufano, James T; Karras, Bryant T

2005-12-20

Obesity is often cited as the most prevalent chronic health condition and highest priority public health problem in the United States. There is a limited but growing body of evidence suggesting that mobile eHealth behavioral interventions, if properly designed, may be effective in promoting and sustaining successful weight loss and weight maintenance behavior changes. This paper reviews the current literature on the successes and failures of public health, provider-administered, and self-managed behavioral health interventions for weight loss. The prevailing theories of health behavior change are discussed from the perspective of how this knowledge can serve as an evidence base to inform the design of mobile eHealth weight loss interventions. Tailored informational interventions, which, in recent years, have proven to be the most effective form of conventional health behavior intervention for weight loss, are discussed. Lessons learned from the success of conventional tailored informational interventions and the early successes of desktop computer-assisted self-help weight management interventions are presented, as are design principles suggested by Social Cognitive Theory and the Social Marketing Model. Relevant computing and communications technology convergence trends are also discussed. The recent trends in rapid advancement, convergence, and public adoption of Web-enabled cellular telephone and wireless personal digital assistant (PDA) devices provide timely opportunities to deliver the mass customization capabilities, reach, and interactivity required for the development, administration, and adoption of effective population-level eHealth tailored informational interventions for obesity.

Integrating psychological theory into the design of an online intervention for sexual health: the sexunzipped website.

PubMed

Carswell, Kenneth; McCarthy, Ona; Murray, Elizabeth; Bailey, Julia V

2012-11-19

The Internet can provide a confidential and convenient medium for sexual health promotion for young people. This paper describes the development of an interactive, theory-based website (Sexunzipped) aimed at increasing safe sexual behavior of young people, as well as an outline of the evaluation protocol. The website focuses on safer sex, relationships, and sexual pleasure. An overview of the site is provided, including a description of the theoretical constructs which form the basis of the site development. An integrated behavioral model was chosen as the guiding theory for the Sexunzipped intervention. A randomized trial design will be used to evaluate the site quantitatively. The content of the site is described in detail with examples of the main content types: information pages, quizzes, and decision-making activities. We describe the protocol for quantitative evaluation of the website using a randomized trial design and discuss the principal challenges involved in developing the site, including the challenge of balancing the requirements of theory with young people's views on website content and design. Considerations for future interventions are discussed. Developing an online behavior-change intervention is costly and time consuming. Given the large public health potential, the cost involved in developing online interventions, and the need for attractive design, future interventions may benefit from collaborating with established sites that already have a user base, a brand, and a strong Internet presence. It is vital to involve users in decisions about intervention content, design, and features, paying attention to aspects that will attract and retain users' interest. A central challenge in developing effective Internet-based interventions for young people is to find effective ways to operationalize theory in ways that address the views and perspectives of young people.

Integrating Psychological Theory Into the Design of an Online Intervention for Sexual Health: The Sexunzipped Website

PubMed Central

2012-01-01

Background The Internet can provide a confidential and convenient medium for sexual health promotion for young people. Objective This paper describes the development of an interactive, theory-based website (Sexunzipped) aimed at increasing safe sexual behavior of young people, as well as an outline of the evaluation protocol. Methods The website focuses on safer sex, relationships, and sexual pleasure. An overview of the site is provided, including a description of the theoretical constructs which form the basis of the site development. An integrated behavioral model was chosen as the guiding theory for the Sexunzipped intervention. A randomized trial design will be used to evaluate the site quantitatively. Results The content of the site is described in detail with examples of the main content types: information pages, quizzes, and decision-making activities. We describe the protocol for quantitative evaluation of the website using a randomized trial design and discuss the principal challenges involved in developing the site, including the challenge of balancing the requirements of theory with young people’s views on website content and design. Conclusions Considerations for future interventions are discussed. Developing an online behavior-change intervention is costly and time consuming. Given the large public health potential, the cost involved in developing online interventions, and the need for attractive design, future interventions may benefit from collaborating with established sites that already have a user base, a brand, and a strong Internet presence. It is vital to involve users in decisions about intervention content, design, and features, paying attention to aspects that will attract and retain users’ interest. A central challenge in developing effective Internet-based interventions for young people is to find effective ways to operationalize theory in ways that address the views and perspectives of young people. PMID:23612122

Paraprofessional Support and Perceptions of a Function-Based Classroom Intervention

ERIC Educational Resources Information Center

Hendrix, Nicole M.; Vancel, Samantha M.; Bruhn, Allison L.; Wise, Sara; Kang, Sungeun

2018-01-01

Paraprofessionals carry out behavior interventions for students with challenging behavior in inclusive classroom settings. Examination of paraprofessional involvement in behavior interventions informs how paraprofessionals may best support intervention implementation. The researchers used a withdrawal design to evaluate the effects of a…

Mississippi communities for healthy living: implementing a nutrition intervention effectiveness study in a rural health disparate region

USDA-ARS?s Scientific Manuscript database

Intervention research in rural, health disparate communities presents unique challenges for study design, implementation, and evaluation. Challenges include: 1) culturally appropriate intervention components; 2) participant recruitment and retention; 3) treatment cross-contamination; 4) intervention...

Participatory Research as One Piece of the Puzzle: A Systematic Review of Consumer Involvement in Design of Technology-Based Youth Mental Health and Well-Being Interventions.

PubMed

Orlowski, Simone Kate; Lawn, Sharon; Venning, Anthony; Winsall, Megan; Jones, Gabrielle M; Wyld, Kaisha; Damarell, Raechel A; Antezana, Gaston; Schrader, Geoffrey; Smith, David; Collin, Philippa; Bidargaddi, Niranjan

2015-07-09

Despite the potential of technology-based mental health interventions for young people, limited uptake and/or adherence is a significant challenge. It is thought that involving young people in the development and delivery of services designed for them leads to better engagement. Further research is required to understand the role of participatory approaches in design of technology-based mental health and well-being interventions for youth. To investigate consumer involvement processes and associated outcomes from studies using participatory methods in development of technology-based mental health and well-being interventions for youth. Fifteen electronic databases, using both resource-specific subject headings and text words, were searched describing 2 broad concepts-participatory research and mental health/illness. Grey literature was accessed via Google Advanced search, and relevant conference Web sites and reference lists were also searched. A first screening of titles/abstracts eliminated irrelevant citations and documents. The remaining citations were screened by a second reviewer. Full text articles were double screened. All projects employing participatory research processes in development and/or design of (ICT/digital) technology-based youth mental health and well-being interventions were included. No date restrictions were applied; English language only. Data on consumer involvement, research and design process, and outcomes were extracted via framework analysis. A total of 6210 studies were reviewed, 38 full articles retrieved, and 17 included in this study. It was found that consumer participation was predominantly consultative and consumerist in nature and involved design specification and intervention development, and usability/pilot testing. Sustainable participation was difficult to achieve. Projects reported clear dichotomies around designer/researcher and consumer assumptions of effective and acceptable interventions. It was not possible to determine the impact of participatory research on intervention effectiveness due to lack of outcome data. Planning for or having pre-existing implementation sites assisted implementation. The review also revealed a lack of theory-based design and process evaluation. Consumer consultations helped shape intervention design. However, with little evidence of outcomes and a lack of implementation following piloting, the value of participatory research remains unclear.

Participatory Research as One Piece of the Puzzle: A Systematic Review of Consumer Involvement in Design of Technology-Based Youth Mental Health and Well-Being Interventions

PubMed Central

Lawn, Sharon; Venning, Anthony; Winsall, Megan; Jones, Gabrielle M; Wyld, Kaisha; Damarell, Raechel A; Antezana, Gaston; Schrader, Geoffrey; Smith, David; Collin, Philippa; Bidargaddi, Niranjan

2015-01-01

Background Despite the potential of technology-based mental health interventions for young people, limited uptake and/or adherence is a significant challenge. It is thought that involving young people in the development and delivery of services designed for them leads to better engagement. Further research is required to understand the role of participatory approaches in design of technology-based mental health and well-being interventions for youth. Objective To investigate consumer involvement processes and associated outcomes from studies using participatory methods in development of technology-based mental health and well-being interventions for youth. Methods Fifteen electronic databases, using both resource-specific subject headings and text words, were searched describing 2 broad concepts-participatory research and mental health/illness. Grey literature was accessed via Google Advanced search, and relevant conference Web sites and reference lists were also searched. A first screening of titles/abstracts eliminated irrelevant citations and documents. The remaining citations were screened by a second reviewer. Full text articles were double screened. All projects employing participatory research processes in development and/or design of (ICT/digital) technology-based youth mental health and well-being interventions were included. No date restrictions were applied; English language only. Data on consumer involvement, research and design process, and outcomes were extracted via framework analysis. Results A total of 6210 studies were reviewed, 38 full articles retrieved, and 17 included in this study. It was found that consumer participation was predominantly consultative and consumerist in nature and involved design specification and intervention development, and usability/pilot testing. Sustainable participation was difficult to achieve. Projects reported clear dichotomies around designer/researcher and consumer assumptions of effective and acceptable interventions. It was not possible to determine the impact of participatory research on intervention effectiveness due to lack of outcome data. Planning for or having pre-existing implementation sites assisted implementation. The review also revealed a lack of theory-based design and process evaluation. Conclusions Consumer consultations helped shape intervention design. However, with little evidence of outcomes and a lack of implementation following piloting, the value of participatory research remains unclear. PMID:27025279

Consultation-based academic interventions for children with ADHD: effects on reading and mathematics achievement.

PubMed

DuPaul, George J; Jitendra, Asha K; Volpe, Robert J; Tresco, Katy E; Lutz, J Gary; Vile Junod, Rosemary E; Cleary, Kristi S; Flammer, Lizette M; Mannella, Mark C

2006-10-01

The purpose of this investigation was to evaluate the relative efficacy of two consultation-based models for designing academic interventions to enhance the educational functioning of children with attention-deficit/hyperactivity disorder (ADHD). Children (N=167) meeting DSM-IV criteria for ADHD were randomly assigned to one of two consultation groups: Individualized Academic Intervention (IAI; interventions designed using a data-based decision-making model that involved ongoing feedback to teachers) and Generic Academic Intervention (GAI; interventions designed based on consultant-teacher collaboration, representing "consultation as usual"). Teachers implemented academic interventions over 15 months. Academic outcomes (e.g., standardized achievement test, and teacher ratings of academic skills) were assessed on four occasions (baseline, 3 months, 12 months, 15 months). Hierarchical linear modeling analyses indicated significant positive growth for 8 of the 14 dependent variables; however, trajectories did not differ significantly across consultation groups. Interventions in the IAI group were delivered with significantly greater integrity; however, groups did not differ with respect to teacher ratings of treatment acceptability. The results of this study provide partial support for the effectiveness of consultation-based academic interventions in enhancing educational functioning in children with ADHD; however, the relative advantages of an individualized model over "consultation as usual" have yet to be established.

Preventing Smoking in Open Public Places in University Campus Settings: A Situational Crime Prevention Approach

ERIC Educational Resources Information Center

Sun, Jing; Prenzler, Tim; Buys, Nicholas; McMeniman, Marilyn

2012-01-01

Purpose: The purpose of the study was to evaluate the effectiveness of interventions using situational crime prevention approaches to reduce the smoking rate in outdoor areas of a university campus. Design/methodology/approach: A prospective intervention design was designed for the study. Surveys and observations were used to measure the impacts…

An Evaluation of Organization Effectiveness: A Longitudinal Investigation of the Effects of Survey Feedback as an Action Research Intervention on Unit Efficiency, Employee Affective Response, Intergroup Relations and Supervisory Consideration in the U.S. Army

DTIC Science & Technology

1977-12-01

Effects of Survey Feedback as an Action Research Jan. 1977- Dec. 1977 Intervention on Unit Efficiency, Employee Afecti-0’ PERFORMINI ORG. REPORT NUMBER R...INTERVENTION, SATISFACTION, OREANIZATION, EFFECTIVENESS, CONSULTATION, EVALUATION RESEARCH 20. ABSTRACT (Continue on reverse side It necessary and identify...by block number) A six month action research project designed to evaluate the effects of survey feedback u:;edl as an intervention strategy wittin

EAT-UP™ Family-Centered Feeding Intervention to Promote Food Acceptance and Decrease Challenging Behaviors: A Single-Case Experimental Design Replicated Across Three Families of Children with Autism Spectrum Disorder.

PubMed

Cosbey, Joanna; Muldoon, Deirdre

2017-03-01

This study evaluated the effectiveness of a family-centered feeding intervention, Easing Anxiety Together with Understanding and Perseverance (EAT-UP™), for promoting food acceptance of children with autism spectrum disorder at home. A concurrent multiple-baseline design was used with systematic replication across three families. Baseline was followed by an 'Intervention-Coaching' phase and then an 'Intervention-Independent' phase. Using direct observation and pre- and post-intervention questionnaires, data on acceptance of less preferred foods and challenging mealtime behaviors were collected. Procedural fidelity was monitored throughout all study phases. Data were analyzed using visual analysis and measures of effect size. All children demonstrated increases in food acceptance (effect size >0.90) and dietary diversity and decreased challenging behaviors. Implications for practice and research are discussed.

Obesity prevention and obesogenic behavior interventions in child care: A systematic review.

PubMed

Sisson, Susan B; Krampe, Megan; Anundson, Katherine; Castle, Sherri

2016-06-01

Review peer-reviewed interventions designed to reduce obesity and improve obesogenic behaviors, including physical activity, diet, and screen time, at child care centers. Interventions components and outcomes, study design, duration, use of behavioral theory, and level of social ecological influence are detailed. Article searches were conducted from March 2014, October 2014, March 2015, January 2016 across three databases. Eligible interventions were conducted in child care settings, included 3-to-5-year-old children, included an outcome measure of obesity or obesogenic behavior, and published in English. Study design quality was assessed using Stetler's Level of Quantitative Evidence. All unique records were screened (n=4589): 237 articles were assessed for eligibility. Of these, 97 articles describing 71 interventions met inclusion criteria. Forty-four articles included multi-level interventions. Twenty-nine interventions included an outcome measure of obesity. Forty-one interventions included physical activity. Forty-five included diet. Eight included screen time. Fifty-five percent of interventions were Level II (randomized controlled trials), while 37% were Level III (quasi-experimental or pre-post only study design), and 8% were Level IV (non-experimental or natural experiments). Most interventions had the intended effect on the target: obesity 48% (n=14), physical activity 73% (n=30), diet 87% (n=39), and screen time 63% (n=5). Summarizing intervention strategies and assessing their effectiveness contributes to the existing literature and may provide direction for practitioners and researchers working with young children in child care. Most interventions produced the targeted changes in obesity and obesity-associated behaviors, supporting current and future efforts to collaborate with early-care centers and professionals for obesity prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

An Intervention for HPV Risk Reduction Based on the Theory of Planned Behavior: An Exploratory Study with College-Aged Women

ERIC Educational Resources Information Center

Sweeney, Jocelyn Brineman; McAnulty, Richard D.; Reeve, Charlie; Cann, Arnie

2015-01-01

The goal of the study was to examine the effectiveness of a group intervention in reducing risks of contracting human papillomavirus (HPV) among college-aged women. Using a randomized design, the study examined the effectiveness of an HPV educational group intervention guided by the Theory of Planned Behavior. The intervention was provided in a…

Move the Neighbourhood: Study design of a community-based participatory public open space intervention in a Danish deprived neighbourhood to promote active living.

PubMed

Pawlowski, Charlotte Skau; Winge, Laura; Carroll, Sidse; Schmidt, Tanja; Wagner, Anne Margrethe; Nørtoft, Kamilla Pernille Johansen; Lamm, Bettina; Kural, René; Schipperijn, Jasper; Troelsen, Jens

2017-05-19

A limited amount of research has examined the effect of changing public open spaces on active living. This paper will present the study protocol of a community-based intervention study co-designed in an interdisciplinary collaboration with community members to develop urban installations highly tailored to promote active living among children (10-13-years-old) and seniors (>60-years-old) in a deprived neighbourhood in Copenhagen. The study builds on a quasi-experimental study design with two sub-studies: 1) a children study and 2) a senior study. The interventions will be developed, designed and implemented in collaboration with local children and seniors, respectively, using different co-design tools and methods. We will evaluate the effect of the interventions on children's and senior's use of the new-built urban installations using accelerometers in combination with GPS as well as systematic observation using the System for Observing Play and Recreation in Communities (SOPARC). A process evaluation with focus groups consisting of the various stakeholders in the two sub-studies will be used to gain knowledge of the intervention processes. The paper presents new approaches in the field of public open space interventions through interdisciplinary collaboration, participatory co-design approach and combination of measurements. Using both effect and process evaluations the study will provide unique insights in the role and importance of the interdisciplinary collaboration, participatory processes, and tailoring changes in public open space to local needs and wishes. These results can be used to guide urban renewal projects in deprived neighbourhoods in the future. Retrospectively registered with study ID ISRCTN50036837 . Date of registration: 16 December 2016.

Effects of a bereavement intervention program on depression and life satisfaction in middle aged widows in Korea.

PubMed

Yoo, Yang Sook; Kang, Hee Young

2006-12-01

This study was designed to examine the effects of a bereavement intervention program on levels of depression and life satisfaction in middle aged widows in Korea. A quasi-experimental design with non-equivalent control-group pretest-posttest was used. The subjects (control group, n = 10; intervention group, n = 17) were bereaved less than 6 months in G City and J Province, Korea. The bereavement intervention program consisted of Dan-jeon breathing, self-help group activities and a health examination. The experimental group attended 10 sessions of a bereavement intervention program. The control group had a health examination without the intervention program. For both groups, the level of depression and life satisfaction levels were measured before and after the experiment. The decrement of depression level in the experimental group was significantly greater than in the control group (p<.001). The increment in life satisfaction in the experimental group was significantly greater than in the control group (p<.001). The results suggested that the bereavement intervention program was effective in decreasing level of depression and in increasing the life satisfaction of widows. Accordingly, a bereavement intervention program can be applied as an intervention to help widows.

Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men.

PubMed

Johnson, Wayne D; Diaz, Rafael M; Flanders, William D; Goodman, Michael; Hill, Andrew N; Holtgrave, David; Malow, Robert; McClellan, William M

2008-07-16

Men who have sex with men (MSM) remain at great risk for HIV infection. Program planners and policy makers need descriptions of interventions and quantitative estimates of intervention effects to make informed decisions concerning prevention funding and research. The number of intervention strategies for MSM that have been examined with strong research designs has increased substantially in the past few years. 1. To locate and describe outcome studies evaluating the effects of behavioral HIV prevention interventions for MSM.2. To summarize the effectiveness of these interventions in reducing unprotected anal sex.3. To identify study characteristics associated with effectiveness.4. To identify gaps and indicate future research, policy, and practice needs. We searched electronic databases, current journals, manuscripts submitted by researchers, bibliographies of relevant articles, conference proceedings, and other reviews for published and unpublished reports from 1988 through December 2007. We also asked researchers working in HIV prevention about new and ongoing studies. Studies were considered in scope if they examined the effects of behavioral interventions aimed at reducing risk for HIV or STD transmission among MSM. We reviewed studies in scope for criteria of outcome relevance (measurement of at least one of a list of behavioral or biologic outcomes, e.g., unprotected sex or incidence of HIV infections) and methodologic rigor (randomized controlled trials or certain strong quasi-experimental designs with comparison groups). We used fixed and random effects models to summarize rate ratios (RR) comparing intervention and control groups with respect to count outcomes (number of occasions of or partners for unprotected anal sex), and corresponding prevalence ratios (PR) for dichotomous outcomes (any unprotected anal sex vs. none). We used published formulas to convert effect sizes and their variances for count and dichotomous outcomes where necessary. We accounted for intraclass correlation (ICC) in community-level studies and adjusted for baseline conditions in all studies. We present separate results by intervention format (small group, individual, or community-level) and by type of intervention delivered to the comparison group (minimal or no HIV prevention in the comparison condition versus standard or other HIV prevention in the comparison condition). We examine rate ratios stratified according to characteristics of participants, design, implementation, and intervention content. For small group and individual-level interventions we used a stepwise selection process to identify a multivariable model of predictors of reduction in occasions of or partners for unprotected anal sex. We used funnel plots to examine publication bias, and Q (a chi-squared statistic with degrees of freedom = number of interventions minus 1) to test for heterogeneity. We found 44 studies evaluating 58 interventions with 18,585 participants. Formats included 26 small group interventions, 21 individual-level interventions, and 11 community-level interventions. Sixteen of the 58 interventions focused on HIV-positives. The 40 interventions that were measured against minimal to no HIV prevention intervention reduced occasions of or partners for unprotected anal sex by 27% (95% confidence interval [CI] = 15% to 37%). The other 18 interventions reduced unprotected anal sex by 17% beyond changes observed in standard or other interventions (CI = 5% to 27%). Intervention effects were statistically homogeneous, and no independent variable was statistically significantly associated with intervention effects at alpha=.05. However, a multivariable model selected by backward stepwise elimination identified four study characteristics associated with reduction in occasions of or partners for unprotected anal sex among small group and individual-level interventions at alpha=.10. The most favorable reductions in episodes of or partners for unprotected anal sex (33% to 35% decreases) were observed among studies with count outcomes, those with shorter intervention spans (<=1 month), those with better retention in the intervention condition than in the comparison condition, and those with minimal to no HIV prevention intervention delivered to the comparison condition. Because there were only 11 community-level studies we did not search for a multivariable model for community-level interventions. In stratified analyses including only one variable at a time, the greatest reductions (40% to 54% decreases) in number of episodes of or partners for unprotected anal sex among community-level interventions were observed among studies where groups were assigned randomly rather than by convenience, studies with shorter recall periods and longer follow-up, studies with more than 25% non-gay identifying MSM, studies in which at least 90% of participants were white, and studies in which the intervention addressed development of personal skills. Behavioral interventions reduce self-reported unprotected anal sex among MSM. These results indicate that HIV prevention for this population can work and should be supported. Results of previous studies provide a benchmark for expectations in new studies. Meta-analysis can inform future design and implementation in terms of sample size, target populations, settings, goals for process measures, and intervention content. When effects differ by design variables, which are deliberately selected and planned, awareness of these characteristics may be beneficial to future designs. Researchers designing future small group and individual-level studies should keep in mind that to date, effects of the greatest magnitude have been observed in studies that used count outcomes and a shorter intervention span (up to 1 month). Among small group and individual-level studies, effects were also greatest when the comparison condition included minimal to no HIV prevention content. Nevertheless, statistically significant favorable effects were also seen when the comparison condition included standard or other HIV prevention content. Researchers choosing the latter option for new studies should plan for larger sample sizes based on the smaller expected net intervention effect noted above. When effects differ by implementation variables, which become evident as the study is conducted but are not usually selected or planned, caution may be advised so that future studies can reduce bias. Because intervention effects were somewhat stronger (though not statistically significantly so) in studies with a greater attrition in the comparison condition, differential retention may be a threat to validity. Extra effort should be given to retaining participants in comparison conditions. Among community-level interventions, intervention effects were strongest among studies with random assignment of groups or communities. Therefore the inclusion of studies where assignment of groups or communities was by convenience did not exaggerate the summary effect. The greater effectiveness of interventions including more than 25% non-gay identifying MSM suggests that when they can be reached, these men may be more responsive than gay-identified men to risk reduction efforts. Non-gay identified MSM may have had less exposure to previous prevention messages, so their initial exposure may have a greater impact. The greater effectiveness of interventions that include efforts to promote personal skills such as keeping condoms available and behavioral self-management indicates that such content merits strong consideration in development and delivery of new interventions for MSM. And the finding that interventions were most effective for majority white populations underscores the critical need for effective interventions for MSM of African and Latino descent. Further research measuring the incidence of HIV and other STDs is needed. Because most studies were conducted among mostly white men in the US and Europe, more evaluations of interventions are needed for African American and Hispanic MSM as well as MSM in the developing world. More research is also needed to further clarify which behavioral strategies (e.g., reducing unprotected anal sex, having oral sex instead of anal sex, reducing number of partners, avoiding serodiscordant partners, strategic positioning, or reducing anal sex even with condom use) are most effective in reducing transmission among MSM, the messages most effective in promoting these behaviors, and the methods and settings in which these messages can be most effectively delivered.

Childhood obesity prevention in rural settings: background, rationale, and study design of ‘4-Health,’ a parent-only intervention

PubMed Central

2012-01-01

Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent–child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program) or a “best-practices” (Healthy Living Information) control group. Discussion This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents’ ability to intervene effectively in the lives of their families during this critical developmental period. Trial registration ClinicalTrials.gov ID: NCT01510587 PMID:22471650

Information Technology-Based Interventions to Improve Drug-Drug Interaction Outcomes: A Systematic Review on Features and Effects.

PubMed

Nabovati, Ehsan; Vakili-Arki, Hasan; Taherzadeh, Zhila; Saberi, Mohammad Reza; Medlock, Stephanie; Abu-Hanna, Ameen; Eslami, Saeid

2017-01-01

The purpose of this systematic review was to identify features and effects of information technology (IT)-based interventions on outcomes related to drug-drug interactions (DDI outcomes). A literature search was conducted in Medline, EMBASE, and the Cochrane Library for published English-language studies. Studies were included if a main outcome was related to DDIs, the intervention involved an IT-based system, and the study design was experimental or observational with controls. Study characteristics, including features and effects of IT-based interventions, were extracted. Nineteen studies comprising five randomized controlled trials (RCT), five non-randomized controlled trials (NRCT) and nine observational studies with controls (OWC) were included. Sixty-four percent of prescriber-directed interventions, and all non-prescriber interventions, were effective. Each of the following characteristics corresponded to groups of studies of which a majority were effective: automatic provision of recommendations within the providers' workflow, intervention at the time of decision-making, integration into other systems, and requiring the reason for not following the recommendations. Only two studies measured clinical outcomes: an RCT that showed no significant improvement and an OWC that showed improvement, but did not statistically assess the effect. Most studies that measured surrogate outcomes (e.g. potential DDIs) and other outcomes (e.g. adherence to alerts) showed improvements. IT-based interventions improve surrogate clinical outcomes and adherence to DDI alerts. However, there is lack of robust evidence about their effectiveness on clinical outcomes. It is recommended that researchers consider the identified features of effective interventions in the design of interventions and evaluate the effectiveness on DDI outcomes, particularly clinical outcomes.

A Structured Career Intervention Program for Academically Challenged Students

ERIC Educational Resources Information Center

Salleh, Amla; Abdullah, Syed Mohamad; Mahmud, Zuria; Ghavifekr, Simin; Ishak, Noriah

2013-01-01

A study was carried out to test the effects of a 2-week structured intervention program on academically challenged students' career development. A quasi-experimental study was designed using pre-tests, post-tests, and a control group approach to examine the effects of the intervention program. Data were collected from both the experimental and…

A Synthesis of Research on Informational Text Reading Interventions for Elementary Students with Learning Disabilities

ERIC Educational Resources Information Center

Ciullo, Stephen; Lo, Yu-Ling Sabrina; Wanzek, Jeanne; Reed, Deborah K.

2016-01-01

This research synthesis was conducted to understand the effectiveness of interventions designed to improve learning from informational text for students with learning disabilities in elementary school (K-5). The authors identified 18 studies through a comprehensive search. The interventions were evaluated to determine treatment effects and to…

Meta-Analysis of the Effects of Academic Interventions and Modifications on Student Behavior Outcomes

ERIC Educational Resources Information Center

Warmbold-Brann, Kristy; Burns, Matthew K.; Preast, June L.; Taylor, Crystal N.; Aguilar, Lisa N.

2017-01-01

The current study examined the effect of academic interventions and modifications on behavioral outcomes in a meta-analysis of 32 single-case design studies. Academic interventions included modifying task difficulty, providing instruction in reading, mathematics, or writing, and contingent reinforcement for academic performance. There was an…

Hybrid Implementation Model of Community-Partnered Early Intervention for Toddlers with Autism: A Randomized Trial

ERIC Educational Resources Information Center

Shire, Stephanie Y.; Chang, Ya-Chih; Shih, Wendy; Bracaglia, Suzanne; Kodjoe, Maria; Kasari, Connie

2017-01-01

Background: Interventions found to be effective in research settings are often not as effective when implemented in community settings. Considering children with autism, studies have rarely examined the efficacy of laboratory-tested interventions on child outcomes in community settings using randomized controlled designs. Methods: One hundred and…

Effects of Coaching on Teachers' Use of Function-Based Interventions for Students with Severe Disabilities

ERIC Educational Resources Information Center

Bethune, Keri S.; Wood, Charles L.

2013-01-01

This study used a delayed multiple-baseline across-participants design to analyze the effects of coaching on special education teachers' implementation of function-based interventions with students with severe disabilities. This study also examined the extent to which teachers could generalize function-based interventions to different situations.…

Systematic Individualized Narrative Language Intervention on the Personal Narratives of Children with Autism

ERIC Educational Resources Information Center

Petersen, Douglas B.; Brown, Catherine L.; Ukrainetz, Teresa A.; Wise, Christine; Spencer, Trina D.

2014-01-01

Purpose: The purpose of this study was to investigate the effect of an individualized, systematic language intervention on the personal narratives of children with autism. Method: A single-subject, multiple-baseline design across participants and behaviors was used to examine the effect of the intervention on language features of personal…

A Meta-Analysis of School-Based Social Skills Interventions for Children With Autism Spectrum Disorders

ERIC Educational Resources Information Center

Bellini, Scott; Peters, Jessica K.; Benner, Lauren; Hopf, Andrea

2007-01-01

Social skills deficits are a central feature of autism spectrum disorders (ASD). This meta-analysis of 55 single-subject design studies examined the effectiveness of school-based social skills interventions for children and adolescents with ASD. Intervention, maintenance, and generalization effects were measured by computing the percentage of…

Designing Studies to Evaluate Parent-Mediated Interventions for Toddlers with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Siller, Michael; Morgan, Lindee; Turner-Brown, Lauren; Baggett, Kathleen M.; Baranek, Grace T.; Brian, Jessica; Bryson, Susan E.; Carter, Alice S.; Crais, Elizabeth R.; Estes, Annette; Kasari, Connie; Landa, Rebecca J.; Lord, Catherine; Messinger, Daniel S.; Mundy, Peter; Odom, Samuel L.; Reznick, J. Steven; Roberts, Wendy; Rogers, Sally J.; Schertz, Hannah H.; Smith, Isabel M.; Stone, Wendy L.; Watson, Linda R.; Wetherby, Amy M.; Yoder, Paul J.; Zwaigenbaum, Lonnie

2013-01-01

Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a…

Effectiveness of a Computer-Assisted Intervention for Young Children with Attention and Reading Problems

ERIC Educational Resources Information Center

Walcott, Christy M.; Marett, Katherine; Hessel, Amanda B.

2014-01-01

Children who are significantly inattentive and poor early readers require intervention, and traditional tutoring approaches may not be effective with this group. Using a single-subject, multiple-baseline-across-participants design, Study 1 examines whether a computer-assisted reading intervention increases performance for three first-grade…

Effects of an Early Numeracy Intervention on Struggling Kindergarteners' Mathematics Performance

ERIC Educational Resources Information Center

Bryant, Brian R.; Bryant, Diane Pedrotty; Roberts, Greg; Fall, Anna-Maria

2016-01-01

The purpose of this study was to investigate the effects of an early numeracy intervention delivered by kindergarten teachers to students identified as having mathematics difficulties. A multigroup growth-modeling-with-random-assignment-to-intervention-condition design was employed. Thirty-two teachers were randomly assigned to the treatment or…

HRD Interventions, Employee Competencies and Organizational Effectiveness: An Empirical Study

ERIC Educational Resources Information Center

Potnuru, Rama Krishna Gupta; Sahoo, Chandan Kumar

2016-01-01

Purpose: The purpose of the study is to examine the impact of human resource development (HRD) interventions on organizational effectiveness by means of employee competencies which are built by some of the selected HRD interventions. Design/methodology/approach: An integrated research model has been developed by combining the principal factors…

Effect of an Educational Intervention Related to Health and Nutrition on Pregnant Women in the Villages of Central Java Province, Indonesia

ERIC Educational Resources Information Center

Wijaya-Erhardt, Maria; Muslimatun, Siti; Erhardt, Juergen G.

2014-01-01

Objective: To assess the effects of a health and nutrition educational intervention on maternal knowledge, attitudes and practices. Design: Pre- and post-test design using structured interviews of pregnant women. Setting: Thirty-nine villages in Central Java Province, Indonesia. Method: Pregnant women (N = 252) at 12-20 weeks of gestation were…

V.I.K. (Very Important Kids): A School-Based Program Designed to Reduce Teasing and Unhealthy Weight-Control Behaviors

ERIC Educational Resources Information Center

Haines, Jess; Neumark-Sztainer, Dianne; Perry, Cheryl L.; Hannan, Peter J.; Levine, Michael P.

2006-01-01

The purpose of this study was to evaluate the feasibility and effectiveness of V.I.K. (Very Important Kids), a school-based, multi-component intervention designed to prevent teasing and unhealthy weight-control behaviors among fourth through sixth grade students. The effectiveness of the V.I.K. intervention was evaluated using a pre-post…

Detecting Intervention Effects in a Cluster-Randomized Design Using Multilevel Structural Equation Modeling for Binary Responses

ERIC Educational Resources Information Center

Cho, Sun-Joo; Preacher, Kristopher J.; Bottge, Brian A.

2015-01-01

Multilevel modeling (MLM) is frequently used to detect group differences, such as an intervention effect in a pre-test--post-test cluster-randomized design. Group differences on the post-test scores are detected by controlling for pre-test scores as a proxy variable for unobserved factors that predict future attributes. The pre-test and post-test…

HIV Interventions to Reduce HIV/AIDS Stigma: A Systematic Review

PubMed Central

Banks, Bahby; Jonas, Dan; Miles, Margaret Shandor; Smith, Giselle Corbie

2011-01-01

We reviewed the literature to determine the effectiveness of HIV-related interventions in reducing HIV/AIDS stigma. Studies selected had randomized controlled trial (RCT), pretest–posttest with a non-randomized control group, or pretest–posttest one group study designs in which HIV-related interventions were being evaluated, and in which HIV/AIDS stigma was one of the outcomes being measured. A checklist was used to extract data from accepted studies, assess their internal validity, and overall quality. Data were extracted from 19 studies, and 14 of these studies demonstrated effectiveness in reducing HIV/ AIDS stigma. Only 2 of these 14 effective studies were considered good studies, based on quality, the extent to which the intervention focused on reducing HIV/AIDS stigma, and the statistics reported to demonstrate effectiveness. Future studies to reduce HIV/AIDS stigma could improve by designing interventions that pay greater attention to internal validity, use validated HIV/AIDS stigma instruments, and achieve both statistical and public health significance. PMID:21088989

HIV interventions to reduce HIV/AIDS stigma: a systematic review.

PubMed

Sengupta, Sohini; Banks, Bahby; Jonas, Dan; Miles, Margaret Shandor; Smith, Giselle Corbie

2011-08-01

We reviewed the literature to determine the effectiveness of HIV-related interventions in reducing HIV/AIDS stigma. Studies selected had randomized controlled trial (RCT), pretest-posttest with a non-randomized control group, or pretest-posttest one group study designs in which HIV-related interventions were being evaluated, and in which HIV/AIDS stigma was one of the outcomes being measured. A checklist was used to extract data from accepted studies, assess their internal validity, and overall quality. Data were extracted from 19 studies, and 14 of these studies demonstrated effectiveness in reducing HIV/AIDS stigma. Only 2 of these 14 effective studies were considered good studies, based on quality, the extent to which the intervention focused on reducing HIV/AIDS stigma, and the statistics reported to demonstrate effectiveness. Future studies to reduce HIV/AIDS stigma could improve by designing interventions that pay greater attention to internal validity, use validated HIV/AIDS stigma instruments, and achieve both statistical and public health significance.

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals.

PubMed

Colquhoun, Heather L; Lamontagne, Marie-Eve; Duncan, Edward As; Fiander, Michelle; Champagne, Catherine; Grimshaw, Jeremy M

2017-03-01

To determine the types and effectiveness of interventions to increase the knowledge about, attitudes towards, and use of standardized outcome measures in rehabilitation professionals. An electronic search using Medline, EMBASE, PsycINFO, CINAHL, Ergonomics Abstracts, Sports Discus. The search is current to February 2016. All study designs testing interventions were included as were all provider and patient types. Two reviewers independently conducted a title and abstract review, followed by a full-text review. Two reviewers independently extracted a priori variables and used consensus for disagreements. Quality assessment was conducted using the Assessment of Quantitative Studies published by the Effective Public Health Practice Group. We identified 11 studies involving at least 1200 providers. Nine of the studies showed improvements in outcome measure use rates but only three of these studies used an experimental or quasi-experimental design. Eight of the studies used an educational approach in the intervention and three used audit and feedback. Poor intervention description and quality of studies limited recommendations. Increased attention to testing interventions focused on known barriers, matched to behavior change techniques, and with stronger designs is warranted.

76 FR 28788 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

... studies have been quasi-experimental designs focused on short term workload assessments as outcomes. The... experimental research to define further the effectiveness and cost-benefit of MSD control interventions. A... prospective experimental design (multiple baselines across groups with randomization). These interventions...

Using Teacher Impression Journals to Improve Intervention Effectiveness

ERIC Educational Resources Information Center

Yu, SeonYeong; Ostrosky, Michaelene M.; Meyer, Lori E.; Favazza, Paddy C.; Mouzourou, Chryso; van Luling, Lisa

2016-01-01

This article describes the use of "Teacher Impression Journals" during a larger study that examined the efficacy of an intervention program designed to promote kindergarteners' positive attitudes toward peers with disabilities (i.e., the "Special Friends" program). The journals were designed to gather information about…

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation

PubMed Central

Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

2016-01-01

Objectives To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Design Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. Eligibility criteria for selecting studies Study design: randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. Intervention: any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. Results 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 ‘strong’, 4 ‘moderate’ and 9 ‘weak’. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Conclusions Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services. PMID:26928025

Quasi experimental designs in pharmacist intervention research.

PubMed

Krass, Ines

2016-06-01

Background In the field of pharmacist intervention research it is often difficult to conform to the rigorous requirements of the "true experimental" models, especially the requirement of randomization. When randomization is not feasible, a practice based researcher can choose from a range of "quasi-experimental designs" i.e., non-randomised and at time non controlled. Objective The aim of this article was to provide an overview of quasi-experimental designs, discuss their strengths and weaknesses and to investigate their application in pharmacist intervention research over the previous decade. Results In the literature quasi experimental studies may be classified into five broad categories: quasi-experimental design without control groups; quasi-experimental design that use control groups with no pre-test; quasi-experimental design that use control groups and pre-tests; interrupted time series and stepped wedge designs. Quasi-experimental study design has consistently featured in the evolution of pharmacist intervention research. The most commonly applied of all quasi experimental designs in the practice based research literature are the one group pre-post-test design and the non-equivalent control group design i.e., (untreated control group with dependent pre-tests and post-tests) and have been used to test the impact of pharmacist interventions in general medications management as well as in specific disease states. Conclusion Quasi experimental studies have a role to play as proof of concept, in the pilot phases of interventions when testing different intervention components, especially in complex interventions. They serve to develop an understanding of possible intervention effects: while in isolation they yield weak evidence of clinical efficacy, taken collectively, they help build a body of evidence in support of the value of pharmacist interventions across different practice settings and countries. However, when a traditional RCT is not feasible for logistical and/or ethical reasons researchers should endeavour to use the more robust of the quasi experimental designs.

Community-based HIV/AIDS interventions to promote psychosocial well-being among people living with HIV/AIDS: a literature review

PubMed Central

Wu, Liyun; Li, Xiaoming

2013-01-01

Background: This review explores the current community-based psychosocial interventions among people living with HIV/AIDS (PLWHA) across the globe. Methods: Evaluation studies were retrieved and reviewed regarding study location, characteristics of participants, study design, intervention strategies, outcome indicators, and intervention findings. Results: The 28 studies spanned a broad range of intervention strategies, including coping skills, treatment and cure, cultural activities, community involvement, knowledge education, voluntary counseling and testing, peer-group support, three-layered service provision, child-directed group intervention, adult mentoring, and support group interventions. Regardless of study designs, all studies reported positive intervention effects, ranging from a reduction in HIV/AIDS stigma, loneliness, marginalization, distress, depression, anger, and anxiety to an increase in self-esteem, self-efficacy, coping skills, and quality of life. Conclusion: Although the existing studies have limitation with regard to program coverage, intensity, scope, and methodological challenges, they underscore the importance of developing community-based interventions to promote psychosocial well-being among PLWHA. Future studies need to employ more rigorous methodology and integrate contextual and institutional factors when implementing effective interventions. PMID:25264499

An eighteen-month follow-up of a pilot parent-delivered play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder and their playmates.

PubMed

Cantrill, Alycia; Wilkes-Gillan, Sarah; Bundy, Anita; Cordier, Reinie; Wilson, Nathan J

2015-06-01

Children with attention deficit hyperactivity disorder (ADHD) experience significant ongoing social difficulties which occur in multiple contexts. Interventions designed to improve these social difficulties have demonstrated minimal effectiveness. Thus, there is a clear need to establish interventions that are effective in addressing the social difficulties of children with ADHD across contexts and in the long term. To examine the long-term effectiveness and appropriateness of a pilot parent-delivered intervention designed to improve the social play skills of children with ADHD and their playmates. Participants included five children with ADHD who had completed the intervention 18-months prior, their typically developing playmates and mothers of children with ADHD. Blinded ratings from the Test of Playfulness were used to measure children's social play: post-intervention and 18-months following the intervention in the home and clinic. Wilcoxon signed-ranks and Cohen's-d calculations were used to measure effectiveness. Parents' perspectives of the appropriateness of the intervention were explored through semi-structured interviews and data were analysed thematically. The social play skills of children with ADHD and their playmates were maintained following the intervention in the home and clinic. Thematic analysis revealed four core-themes against an intervention appropriateness framework: new parenting tools, a social shift, adapting strategies over time and the next developmental challenge. The parent-delivered intervention demonstrated long-term effectiveness and appropriateness for improving children's social play skills. These preliminary results are promising as maintaining treatment effects and achieving generalisation across contexts has remained an unachieved goal for most psycho-social interventions. © 2015 Occupational Therapy Australia.

SLIMMER: a randomised controlled trial of diabetes prevention in Dutch primary health care: design and methods for process, effect, and economic evaluation

PubMed Central

2014-01-01

Background Implementation of interventions in real-life settings requires a comprehensive evaluation approach. The aim of this article is to describe the evaluation design of the SLIMMER diabetes prevention intervention in a Dutch real-life setting. Methods/Design The SLIMMER study is a randomised, controlled intervention study including subjects aged 40 through 70 years with impaired fasting glucose or high risk of diabetes. The 10-month SLIMMER intervention involves a dietary and physical activity intervention, including case management and a maintenance programme. The control group receives usual health care and written information about a healthy lifestyle. A logic model of change is composed to link intervention activities with intervention outcomes in a logical order. Primary outcome is fasting insulin. Measurements are performed at baseline and after 12 and 18 months and cover quality of life, cardio-metabolic risk factors (e.g. glucose tolerance, serum lipids, body fatness, and blood pressure), eating and physical activity behaviour, and behavioural determinants. A process evaluation gives insight in how the intervention was delivered and received by participants and health care professionals. The economic evaluation consists of a cost-effectiveness analysis and a cost-utility analysis. Costs are assessed from both a societal and health care perspective. Discussion This study is expected to provide insight in the effectiveness, including its cost-effectiveness, and delivery of the SLIMMER diabetes prevention intervention conducted in Dutch primary health care. Results of this study provide valuable information for primary health care professionals, researchers, and policy makers. Trial registration The SLIMMER study is registered with ClinicalTrials.gov (NCT02094911) since March 19, 2014. PMID:24928217

Effectiveness of interventions to reduce flour dust exposures in supermarket bakeries in South Africa.

PubMed

Baatjies, Roslynn; Meijster, Tim; Heederik, Dick; Sander, Ingrid; Jeebhay, Mohamed F

2014-12-01

A recent study of supermarket bakery workers in South Africa demonstrated that 25% of workers were sensitised to flour allergens and 13% had baker's asthma. Evidence on exposure reduction strategies using specifically designed interventions aimed at reducing the risk of baker's asthma is scarce. The aim of this study was to evaluate the effectiveness of different control measures to reduce airborne flour dust exposure using a randomised design. A group-randomised study design was used to assign 30 bakeries of a large supermarket chain store to two intervention groups and a control group, of which 15 bakeries were studied. Full-shift environmental personal samples were used to characterise exposure to flour dust and wheat and rye allergens levels pre-intervention (n=176) and post-intervention (n=208). The overall intervention effect revealed a 50% decrease in mean flour dust, wheat and rye allergen exposure. The reduction in exposure was highest for managers (67%) and bakers (47%), and lowest for counterhands (23%). For bakers, the greatest reduction in flour dust was associated with control measures such as the use of the mixer lid (67%), divider oil (63%) or focused training (54%). However, the greatest reduction (80%) was observed when using a combination of all control measures. A specially designed intervention strategy reduced both flour dust and allergen levels. Best results were observed when combining both engineering controls and training. Further studies will investigate the long-term health impact of these interventions on reducing the disease burden among this group of bakers. 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.

Designing mental health interventions informed by child development and human biology theory: A social ecology intervention for child soldiers in Nepal

PubMed Central

Kohrt, Brandon A.; Jordans, Mark J.D.; Koirala, Suraj; Worthman, Carol M.

2017-01-01

The anthropological study of human biology, health, and child development provides a model with potential to address the gap in population-wide mental health interventions. Four key concepts from human biology can inform public mental health interventions: life history theory and tradeoffs, redundancy and plurality of pathways, cascades and multiplier effects in biological systems, and proximate feedback systems. A public mental health intervention for former child soldiers in Nepal is used to illustrate the role of these concepts in intervention design and evaluation. Future directions and recommendations for applying human biology theory in pursuit of public mental health interventions are discussed. PMID:25380194

Designing mental health interventions informed by child development and human biology theory: a social ecology intervention for child soldiers in Nepal.

PubMed

Kohrt, Brandon A; Jordans, Mark J D; Koirala, Suraj; Worthman, Carol M

2015-01-01

The anthropological study of human biology, health, and child development provides a model with potential to address the gap in population-wide mental health interventions. Four key concepts from human biology can inform public mental health interventions: life history theory and tradeoffs, redundancy and plurality of pathways, cascades and multiplier effects in biological systems, and proximate feedback systems. A public mental health intervention for former child soldiers in Nepal is used to illustrate the role of these concepts in intervention design and evaluation. Future directions and recommendations for applying human biology theory in pursuit of public mental health interventions are discussed. © 2014 Wiley Periodicals, Inc.

VIP in construction: systematic development and evaluation of a multifaceted health programme aiming to improve physical activity levels and dietary patterns among construction workers

PubMed Central

2012-01-01

Background The prevalence of both overweight and musculoskeletal disorders (MSD) in the construction industry is high. Many interventions in the occupational setting aim at the prevention and reduction of these health problems, but it is still unclear how these programmes should be designed. To determine the effectiveness of interventions on these health outcomes randomised controlled trials (RCTs) are needed. The aim of this study is to systematically develop a tailored intervention for prevention and reduction of overweight and MSD among construction workers and to describe the evaluation study regarding its (cost-)effectiveness. Methods/Design The Intervention Mapping (IM) protocol was applied to develop and implement a tailored programme aimed at the prevention and reduction of overweight and MSD. The (cost-) effectiveness of the intervention programme will be evaluated using an RCT. Furthermore, a process evaluation will be conducted. The research population will consist of blue collar workers of a large construction company in the Netherlands. Intervention The intervention programme will be aimed at improving (vigorous) physical activity levels and healthy dietary behaviour and will consist of tailored information, face-to-face and telephone counselling, training instruction (a fitness "card" to be used for exercises), and materials designed for the intervention (overview of the company health promoting facilities, waist circumference measuring tape, pedometer, BMI card, calorie guide, recipes, and knowledge test). Main study parameters/endpoints The intervention effect on body weight and waist circumference (primary outcome measures), as well as on lifestyle behaviour, MSD, fitness, CVD risk indicators, and work-related outcomes (i.e. productivity, sick leave) (secondary outcome measures) will be assessed. Discussion The development of the VIP in construction intervention led to a health programme tailored to the needs of construction workers. This programme, if proven effective, can be directly implemented. Trial registration Netherlands Trial Register (NTR): NTR2095 PMID:22289212

Building a bonfire that remains stoked: sustainment of a contingency management intervention developed through collaborative design.

PubMed

Hartzler, Bryan

2015-08-06

Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. The adaptability of contingency management renders it an exemplary therapy to model this collaborative design process. At conclusion of an implementation/effectiveness hybrid trial conducted at an opiate treatment program, a group elicitation interview was conducted with the setting's five managerial staff to cull qualitative impressions of a collaboratively-designed contingency management intervention after 90 days of provisional implementation in the setting. Two independent raters reviewed the audio-recording and conducted a phenomenological narrative analysis, extracting themes and selecting excerpts to correspond with innovation attributes (i.e., relative advantage, compatibility, complexity, trialability, observability) of a well-known implementation science framework. This qualitative analysis suggested the intervention was regarded as: (1) cost-effective and clinically useful relative to prior practices, (2) a strong fit with existing service structure and staffing resources, (3) procedurally uncomplicated, with staff consistently implementing it as intended, (4) providing site-specific data to sufficiently inform decisions about its sustainment, and (5) offering palpable benefits to staff-patient interactions. The current work complements prior reports of positive implementation outcomes and intervention effectiveness for the parent trial, mapping qualitative managerial accounts of this contingency management intervention to a set of attributes thought to influence the speed and effectiveness with which an innovative practice is disseminated. Findings support the incorporation of collaborative design processes in future efforts to transport contingency management to the addiction treatment community.

A Meta-Analysis of Interventions for Struggling Readers in Grades 4–12: 1980–2011

PubMed Central

Scammacca, Nancy K.; Roberts, Greg; Vaughn, Sharon; Stuebing, Karla K.

2013-01-01

This meta-analysis synthesizes the literature on interventions for struggling readers in Grades 4 through 12 published between 1980 and 2011. It updates Scammacca et al.’s analysis of studies published between 1980 and 2004. The combined corpus of 82 study-wise effect sizes was meta-analyzed to determine (a) the overall effectiveness of reading interventions studied over the past 30 years, (b) how the magnitude of the effect varies based on student, intervention, and research design characteristics, and (c) what differences in effectiveness exist between more recent interventions and older ones. The analysis yielded a mean effect of 0.49, considerably smaller than the 0.95 mean effect reported in 2007. The mean effect for standardized measures was 0.21, also much smaller than the 0.42 mean effect reported in 2007. The mean effects for reading comprehension measures were similarly diminished. Results indicated that the mean effects for the 1980–2004 and 2005–2011 groups of studies were different to a statistically significant degree. The decline in effect sizes over time is attributed at least in part to increased use of standardized measures, more rigorous and complex research designs, differences in participant characteristics, and improvements in the school’s “business-as-usual” instruction that often serves as the comparison condition in intervention studies. PMID:24092916

A Meta-Analysis of Interventions for Struggling Readers in Grades 4-12: 1980-2011.

PubMed

Scammacca, Nancy K; Roberts, Greg; Vaughn, Sharon; Stuebing, Karla K

2015-01-01

This meta-analysis synthesizes the literature on interventions for struggling readers in Grades 4 through 12 published between 1980 and 2011. It updates Scammacca et al.'s analysis of studies published between 1980 and 2004. The combined corpus of 82 study-wise effect sizes was meta-analyzed to determine (a) the overall effectiveness of reading interventions studied over the past 30 years, (b) how the magnitude of the effect varies based on student, intervention, and research design characteristics, and (c) what differences in effectiveness exist between more recent interventions and older ones. The analysis yielded a mean effect of 0.49, considerably smaller than the 0.95 mean effect reported in 2007. The mean effect for standardized measures was 0.21, also much smaller than the 0.42 mean effect reported in 2007. The mean effects for reading comprehension measures were similarly diminished. Results indicated that the mean effects for the 1980-2004 and 2005-2011 groups of studies were different to a statistically significant degree. The decline in effect sizes over time is attributed at least in part to increased use of standardized measures, more rigorous and complex research designs, differences in participant characteristics, and improvements in the school's "business-as-usual" instruction that often serves as the comparison condition in intervention studies. © Hammill Institute on Disabilities 2013.

Developing the content of two behavioural interventions: Using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #1

PubMed Central

Hrisos, Susan; Eccles, Martin; Johnston, Marie; Francis, Jill; Kaner, Eileen FS; Steen, Nick; Grimshaw, Jeremy

2008-01-01

Background Evidence shows that antibiotics have limited effectiveness in the management of upper respiratory tract infection (URTI) yet GPs continue to prescribe antibiotics. Implementation research does not currently provide a strong evidence base to guide the choice of interventions to promote the uptake of such evidence-based practice by health professionals. While systematic reviews demonstrate that interventions to change clinical practice can be effective, heterogeneity between studies hinders generalisation to routine practice. Psychological models of behaviour change that have been used successfully to predict variation in behaviour in the general population can also predict the clinical behaviour of healthcare professionals. The purpose of this study was to design two theoretically-based interventions to promote the management of upper respiratory tract infection (URTI) without prescribing antibiotics. Method Interventions were developed using a systematic, empirically informed approach in which we: selected theoretical frameworks; identified modifiable behavioural antecedents that predicted GPs intended and actual management of URTI; mapped these target antecedents on to evidence-based behaviour change techniques; and operationalised intervention components in a format suitable for delivery by postal questionnaire. Results We identified two psychological constructs that predicted GP management of URTI: "Self-efficacy," representing belief in one's capabilities, and "Anticipated consequences," representing beliefs about the consequences of one's actions. Behavioural techniques known to be effective in changing these beliefs were used in the design of two paper-based, interactive interventions. Intervention 1 targeted self-efficacy and required GPs to consider progressively more difficult situations in a "graded task" and to develop an "action plan" of what to do when next presented with one of these situations. Intervention 2 targeted anticipated consequences and required GPs to respond to a "persuasive communication" containing a series of pictures representing the consequences of managing URTI with and without antibiotics. Conclusion It is feasible to systematically develop theoretically-based interventions to change professional practice. Two interventions were designed that differentially target generalisable constructs predictive of GP management of URTI. Our detailed and scientific rationale for the choice and design of our interventions will provide a basis for understanding any effects identified in their evaluation. Trial registration Clinicaltrials.gov NCT00376142 PMID:18194527

The effect of an intervention aimed at reducing errors when administering medication through enteral feeding tubes in an institution for individuals with intellectual disability.

PubMed

Idzinga, J C; de Jong, A L; van den Bemt, P M L A

2009-11-01

Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to be effective in reducing these feeding tube-related medication errors, but the effect of such a programme within an institution for clients with an ID is unknown. Therefore, a study was designed to measure the influence of such an intervention programme on the number of medication administration errors in clients with an ID who also have enteral feeding tubes. A before-after study design with disguised observation to document administration errors was used. The study was conducted from February to June 2008 within an institution for individuals with an ID in the Western part of The Netherlands. Included were clients with enteral feeding tubes. The intervention consisted of advice on medication administration through enteral feeding tubes by the pharmacist, a training programme and introduction of a 'medication through tube' box containing proper materials for crushing and suspending tablets. The outcome measure was the frequency of medication administration errors, comparing the pre-intervention period with the post-intervention period. A total of 245 medication administrations in six clients (by 23 nurse attendants) have been observed in the pre-intervention measurement period and 229 medication administrations in five clients (by 20 nurse attendants) have been observed in the post-intervention period. Before the intervention, 158 (64.5%) medication administration errors were observed, and after the intervention, this decreased to 69 (30.1%). Of all potential confounders and effect modifiers, only 'medication dispensed in automated dispensing system ("robot") packaging' contributed to the multivariate model; effect modification was shown for this determinant. Multilevel analysis using this multivariate model resulted in an odds ratio of 0.33 (95% confidence interval 0.13-0.71) for the error percentage in the post-intervention period compared with the pre-intervention period. The intervention was found to be effective in an institution for clients with an ID. However, additional efforts are needed to reduce the proportion of administration errors which is still high after the intervention.

Prevention of low back pain and its consequences among nurses’ aides in elderly care: a stepped-wedge multi-faceted cluster-randomized controlled trial

PubMed Central

2013-01-01

Background A high prevalence of low back pain has persisted over the years despite extensive primary prevention initiatives among nurses’ aides. Many single-faceted interventions addressing just one aspect of low back pain have been carried out at workplaces, but with low success rate. This may be due to the multi-factorial origin of low back pain. Participatory ergonomics, cognitive behavioral training and physical training have previously shown promising effects on prevention and rehabilitation of low back pain. Therefore, the main aim of this study is to examine whether a multi-faceted workplace intervention consisting of participatory ergonomics, physical training and cognitive behavioral training can prevent low back pain and its consequences among nurses’ aides. External resources for the participating workplace and a strong commitment from the management and the organization support the intervention. Methods/design To overcome implementation barriers within usual randomized controlled trial designed workplace interventions, this study uses a stepped-wedge cluster-randomized controlled trial design with 4 groups. The intervention is delivered to the groups at random along four successive time periods three months apart. The intervention lasts three months and integrates participatory ergonomics, physical training and cognitive behavioral training tailored to the target group. Local physiotherapists and occupational therapists conduct the intervention after having received standardized training. Primary outcomes are low back pain and its consequences measured monthly by text messages up to three months after initiation of the intervention. Discussion Intervention effectiveness trials for preventing low back pain and its consequences in workplaces with physically demanding work are few, primarily single-faceted, with strict adherence to a traditional randomized controlled trial design that may hamper implementation and compliance, and have mostly been unsuccessful. By using a stepped wedge design, and obtain high management commitment and support we intend to improve implementation and aim to establish the effectiveness of a multi-faceted intervention to prevent low back pain. This study will potentially provide knowledge of prevention of low back pain and its consequences among nurses’ aides. Results are expected to be published in 2015–2016. Trial registration The study is registered as ISRCTN78113519. PMID:24261985

Introducing rapid diagnostic tests for malaria into drug shops in Uganda: design and implementation of a cluster randomized trial.

PubMed

Mbonye, Anthony K; Magnussen, Pascal; Chandler, Clare I R; Hansen, Kristian S; Lal, Sham; Cundill, Bonnie; Lynch, Caroline A; Clarke, Siân E

2014-07-29

An intervention was designed to introduce rapid diagnostics tests for malaria (mRDTs) into registered drug shops in Uganda to encourage rational and appropriate treatment of malaria with artemisinin-based combination therapy (ACT). We conducted participatory training of drug shop vendors and implemented supporting interventions to orientate local communities (patients) and the public sector (health facility staff and district officials) to the behavioral changes in diagnosis, treatment and referral being introduced in drug shops. The intervention was designed to be evaluated through a cluster randomized trial. In this paper, we present detailed design, implementation and evaluation experiences in order to help inform future studies of a complex nature. Three preparatory studies (formative, baseline and willingness-to-pay) were conducted to explore perceptions on diagnosis and treatment of malaria at drug shops, and affordable prices for mRDTs and ACTs in order to inform the design of the intervention and implementation modalities. The intervention required careful design with the intention to be acceptable, sustainable and effective. Critical components of intervention were: community sensitization and creating awareness, training of drug shop vendors to diagnose malaria with mRDTs, treat and refer customers to formal health facilities, giving pre-referral rectal artesunate and improved record-keeping. The primary outcome was the proportion of patients receiving appropriately-targeted treatment with ACT, evaluated against microscopy on a research blood slide. Introducing mRDTs in drug shops may seem simple, but our experience of intervention design, conduct and evaluation showed this to be a complex process requiring multiple interventions and evaluation components drawing from a combination of epidemiological, social science and health economics methodologies. The trial was conducted in phases sequenced such that each benefited from the other. The main challenges in designing this trial were maintaining a balance between a robust intervention to support effective behaviour change and introducing practices that would be sustainable in a real-life situation in tropical Africa; as well as achieving a detailed evaluation without inadvertently influencing prescribing behaviour. NCT01194557 registered with ClinicalTrials.gov 2 September 2010.

Effectiveness of a Walking Group Intervention to Promote Physical Activity and Cardiovascular Health in Predominantly Non-Hispanic Black and Hispanic Urban Neighborhoods: Findings from the Walk Your Heart to Health Intervention

ERIC Educational Resources Information Center

Schulz, Amy J.; Israel, Barbara A.; Mentz, Graciela B.; Bernal, Cristina; Caver, Deanna; DeMajo, Ricardo; Diaz, Gregoria; Gamboa, Cindy; Gaines, Causandra; Hoston, Bernadine; Opperman, Alisha; Reyes, Angela G.; Rowe, Zachary; Sand, Sharon L.; Woods, Sachiko

2015-01-01

Objectives: The purpose of this study was to evaluate the effectiveness of the "Walk Your Heart to Health" ("WYHH") intervention, one component of the multilevel Community Approaches to Cardiovascular Health: Pathways to Heart Health (CATCH:PATH) intervention designed to promote physical activity and reduce cardiovascular risk…

How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis

PubMed Central

Liu, Mingli; Wu, Lang; Ming, Qingsen

2015-01-01

Objective To perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression. Design A meta-analysis and meta-regression. Method Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were: (1) intervention should be supervised physical activity, (2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept, (3) participants’ ages ranged from 3 to 20 years, and (4) a control or comparison group was included. For each study, study design, intervention design and participant characteristics were extracted. R software (version 3.1.3) and Stata (version 12.0) were used to synthesize effect sizes and perform moderation analyses for determining moderators. Results Twenty-five randomized controlled trial (RCT) studies and 13 non-randomized controlled trial (non-RCT) studies including a total of 2991 cases were identified. Significant positive effects were found in RCTs for intervention of physical activity alone on general self outcomes (Hedges’ g = 0.29, 95% confidence interval [CI]: 0.14 to 0.45; p = 0.001), self-concept (Hedges’ g = 0.49, 95%CI: 0.10 to 0.88, p = 0.014) and self-worth (Hedges’ g = 0.31, 95%CI: 0.13 to 0.49, p = 0.005). There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies. Meta-regression analysis revealed that higher treatment effects were associated with setting of intervention in RCTs (β = 0.31, 95%CI: 0.07 to 0.55, p = 0.013). Conclusion Intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings. PMID:26241879

A randomised study of leadership interventions for healthcare managers.

PubMed

Lornudd, Caroline; Bergman, David; Sandahl, Christer; von Thiele Schwarz, Ulrica

2016-10-03

Purpose The purpose of this paper was to assess two different leader development interventions by comparing their effects on leadership behaviour and evaluating their combined impact after two years, from the viewpoints of both the participating managers and external raters. Design/methodology/approach The study was a longitudinal randomised controlled trial with a cross-over design. Health care managers ( n = 177) were first randomised to either of two 10-month interventions and a year later were switched to the other intervention. Leadership behaviour was rated at pre-test and 12 and 24 months by participating managers and their superiors, colleagues and subordinates using a 360-degree instrument. Analysis of variance and multilevel regression analysis was performed. Findings No difference in effect on leadership behaviour was found between the two interventions. The evaluation of the combined effect of the interventions on leadership behaviour showed inconsistent (i.e. both increased and decreased) ratings by the various rater sources. Practical implications This study provides some evidence that participation in leadership development programmes can improve managers' leadership behaviours, but the results also highlight the interpretive challenges connected with using a 360-degree instrument to evaluate such development. Originality/value The longitudinal randomised controlled design and the large sample comprising both managers and external raters make this study unusually rigorous in the field of leadership development evaluations.

A Meta-Analysis of Interventions to Reduce Loneliness

PubMed Central

Masi, Christopher M.; Chen, Hsi-Yuan; Hawkley, Louise C.; Cacioppo, John T.

2013-01-01

Social and demographic trends are placing an increasing number of adults at risk for loneliness, an established risk factor for physical and mental illness. The growing costs of loneliness have led to a number of loneliness reduction interventions. Qualitative reviews have identified four primary intervention strategies: 1) improving social skills, 2) enhancing social support, 3) increasing opportunities for social contact, and 4) addressing maladaptive social cognition. An integrative meta-analysis of loneliness reduction interventions was conducted to quantify the effects of each strategy and to examine the potential role of moderator variables. Results revealed that single group pre-post and non-randomized comparison studies yielded larger mean effect sizes relative to randomized comparison studies. Among studies that used the latter design, the most successful interventions addressed maladaptive social cognition. This is consistent with current theories regarding loneliness and its etiology. Theoretical and methodological issues associated with designing new loneliness reduction interventions are discussed. PMID:20716644

Self-regulated learning in simulation-based training: a systematic review and meta-analysis.

PubMed

Brydges, Ryan; Manzone, Julian; Shanks, David; Hatala, Rose; Hamstra, Stanley J; Zendejas, Benjamin; Cook, David A

2015-04-01

Self-regulated learning (SRL) requires an active learner who has developed a set of processes for managing the achievement of learning goals. Simulation-based training is one context in which trainees can safely practise learning how to learn. The purpose of the present study was to evaluate, in the simulation-based training context, the effectiveness of interventions designed to support trainees in SRL activities. We used the social-cognitive model of SRL to guide a systematic review and meta-analysis exploring the links between instructor supervision, supports or scaffolds for SRL, and educational outcomes. We searched databases including MEDLINE and Scopus, and previous reviews, for material published until December 2011. Studies comparing simulation-based SRL interventions with another intervention for teaching health professionals were included. Reviewers worked independently and in duplicate to extract information on learners, study quality and educational outcomes. We used random-effects meta-analysis to compare the effects of supervision (instructor present or absent) and SRL educational supports (e.g. goal-setting study guides present or absent). From 11,064 articles, we included 32 studies enrolling 2482 trainees. Only eight of the 32 studies included educational supports for SRL. Compared with instructor-supervised interventions, unsupervised interventions were associated with poorer immediate post-test outcomes (pooled effect size: -0.34, p = 0.09; n = 19 studies) and negligible effects on delayed (i.e. > 1 week) retention tests (pooled effect size: 0.11, p = 0.63; n = 8 studies). Interventions including SRL supports were associated with small benefits compared with interventions without supports on both immediate post-tests (pooled effect size: 0.23, p = 0.22; n = 5 studies) and delayed retention tests (pooled effect size: 0.44, p = 0.067; n = 3 studies). Few studies in the simulation literature have designed SRL training to explicitly support trainees' capacity to self-regulate their learning. We recommend that educators and researchers shift from thinking about SRL as learning alone to thinking of SRL as comprising a shared responsibility between the trainee and the instructional designer (i.e. learning using designed supports that help prepare individuals for future learning). © 2015 John Wiley & Sons Ltd.

An Exploratory Study of Specific Factors in a Prison Environment That Affect a Manpower Training Project.

ERIC Educational Resources Information Center

Barton, Marlin C.; And Others

An exploratory study of a prison community is presented. The study employed a three-phase design: (1) a pre-survey of the prison community, (2) limited intervention, based on findings of the pre-survey, and (3) a post-survey to determine effects of intervention and to validate findings of the pre-survey for which no intervention had been designed.…

Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis

PubMed Central

Schmidt, Wolf-Peter; Rabie, Tamer; Roberts, Ian; Cairncross, Sandy

2007-01-01

Objective To assess the effectiveness of interventions to improve the microbial quality of drinking water for preventing diarrhoea. Design Systematic review. Data sources Cochrane Infectious Diseases Group's trials register, CENTRAL, Medline, Embase, LILACS; hand searching; and correspondence with experts and relevant organisations. Study selection Randomised and quasirandomised controlled trials of interventions to improve the microbial quality of drinking water for preventing diarrhoea in adults and in children in settings with endemic disease. Data extraction Allocation concealment, blinding, losses to follow-up, type of intervention, outcome measures, and measures of effect. Pooled effect estimates were calculated within the appropriate subgroups. Data synthesis 33 reports from 21 countries documenting 42 comparisons were included. Variations in design, setting, and type and point of intervention, and variations in defining, assessing, calculating, and reporting outcomes limited the comparability of study results and pooling of results by meta-analysis. In general, interventions to improve the microbial quality of drinking water are effective in preventing diarrhoea. Effectiveness was not conditioned on the presence of improved water supplies or sanitation in the study setting and was not enhanced by combining the intervention with instructions on basic hygiene, a water storage vessel, or improved sanitation or water supplies—other common environmental interventions intended to prevent diarrhoea. Conclusion Interventions to improve water quality are generally effective for preventing diarrhoea in all ages and in under 5s. Significant heterogeneity among the trials suggests that the level of effectiveness may depend on a variety of conditions that research to date cannot fully explain. PMID:17353208

The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing: the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress

PubMed Central

2014-01-01

Background Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes. Methods/Design 339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-to-face group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations. Discussion This study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value–based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions. Trial registration Current Clinical Trials NCT01738256, Registered 17 August, 2012. PMID:24708617

Assisting the bereaved: A systematic review of the evidence for grief counselling.

PubMed

Waller, Amy; Turon, Heidi; Mansfield, Elise; Clark, Katherine; Hobden, Bree; Sanson-Fisher, Rob

2016-02-01

Supporting people after bereavement is a priority area for many health services. Investment in bereavement care must be supported by a rigorous evidence-base. To examine the (1) relative proportion of descriptive, measurement and intervention research in grief counselling and (2) quality and effectiveness of intervention studies. Systematic review of studies published in the area of grief counselling. MEDLINE, Embase, Cochrane Library and PsycINFO databases were searched for studies published between 2000 and 2013. Eligible papers were categorised into descriptive, measurement, review, commentaries and intervention studies. Intervention studies were assessed against the Cochrane Effective Practice and Organisation of Care methodological criteria, and papers meeting criteria were assessed for quality. The impact of interventions on grief, psychological morbidity and quality of life was examined. A total of 126 data-based papers, including 47 descriptive, 3 measurement and 76 grief counselling intervention studies were included. Only 59% (n = 45) of intervention studies met Effective Practice and Organisation of Care design criteria. Overall, study quality was poor, with the majority of interventions showing a risk of bias in several key areas. The three studies that met all criteria showed mixed effectiveness. Grief counselling interventions require a strong rationale for design, and a systematic approach to development and evaluation. Descriptive research efforts should inform this process, focusing on homogeneity in sample, identification of risk factors for complicated grief and the impact of extraneous factors on intervention effects. Interventions should include comparisons to usual care, as well as replication to confirm positive findings. © The Author(s) 2015.

Appraisal of comparative single-case experimental designs for instructional interventions with non-reversible target behaviors: Introducing the CSCEDARS ("Cedars").

PubMed

Schlosser, Ralf W; Belfiore, Phillip J; Sigafoos, Jeff; Briesch, Amy M; Wendt, Oliver

2018-05-28

Evidence-based practice as a process requires the appraisal of research as a critical step. In the field of developmental disabilities, single-case experimental designs (SCEDs) figure prominently as a means for evaluating the effectiveness of non-reversible instructional interventions. Comparative SCEDs contrast two or more instructional interventions to document their relative effectiveness and efficiency. As such, these designs have great potential to inform evidence-based decision-making. To harness this potential, however, interventionists and authors of systematic reviews need tools to appraise the evidence generated by these designs. Our literature review revealed that existing tools do not adequately address the specific methodological considerations of comparative SCEDs that aim to compare instructional interventions of non-reversible target behaviors. The purpose of this paper is to introduce the Comparative Single-Case Experimental Design Rating System (CSCEDARS, "cedars") as a tool for appraising the internal validity of comparative SCEDs of two or more non-reversible instructional interventions. Pertinent literature will be reviewed to establish the need for this tool and to underpin the rationales for individual rating items. Initial reliability information will be provided as well. Finally, directions for instrument validation will be proposed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Design element alternatives for stress-management intervention websites.

PubMed

Williams, Reg A; Gatien, Gary; Hagerty, Bonnie

2011-01-01

Typical public and military-sponsored websites on stress and depression tend to be prescriptive. Some require users to complete lengthy questionnaires. Others reproduce printed flyers, papers, or educational materials not adapted for online use. Some websites require users to follow a prescribed path through the material. Stress Gym was developed as a first-level, evidence-based, website intervention to help U.S. military members learn how to manage mild to moderate stress and depressive symptoms using a self-help intervention with progress tracking and 24/7 availablility. It was designed using web-based, health-management intervention design elements that have been proven effective and users reported they prefer. These included interactivity, self-pacing, and pleasing aesthetics. Users learned how to manage stress by accessing modules they choose, and by practicing proven stress management strategies interactively immediately after login. Test results of Stress Gym with Navy members demonstrated that it was effective, with significant decreases in reported perceived stress levels from baseline to follow-up assessment. Stress Gym used design elements that may serve as a model for future websites to emulate and improve upon, and as a template against which to compare and contrast the design and functionality of future online, health-intervention websites. Copyright © 2011 Elsevier Inc. All rights reserved.

Mobile technology-based interventions for adult users of alcohol: A systematic review of the literature.

PubMed

Fowler, Lauren A; Holt, Sidney L; Joshi, Deepti

2016-11-01

Worldwide, 16% of people aged 15 and older engage in harmful use of alcohol. Harmful alcohol use leads to a host of preventable negative social and health consequences. Mobile technology-based interventions provide a particularly promising avenue for the widespread and cost-effective delivery of treatment that is accessible, affordable, individualized, and destigmatized to both alcohol-dependent and nondependent individuals. The present review sought to summarize the current literature on mobile technology-based interventions among adult users of alcohol and determine the efficacy of such interventions. Five databases were searched in December 2015 (Jan. 2004-Dec. 2015). Inclusion criteria were: participants aged 18 or older, interventions delivered through mobile-technology, and outcome measurement of alcohol reduction/cessation. Eight studies met inclusion criteria. The majority of the studies reviewed found positive effects of the intervention, even though the interventions themselves varied in design, length, dosage, and target population, and were pilot or preliminary in nature. Findings from this review highlight the promising, yet preliminary state of research in this area. Studies with adequate power and valid design are necessary to evaluate the potential of mobile technology-based interventions on long-term alcohol behavior outcomes. Furthermore, future research should elucidate what the most effective length of time is for a mobile technology-based intervention, how often individuals should receive messages for maximum benefit, and determine the comparative effectiveness of mobile technology interventions with other efficacious interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Obesity Prevention: A Systematic Review of Setting-Based Interventions from Nordic Countries and the Netherlands

PubMed Central

Tanggaard Andersen, Pernille; Aro, Arja R.

2018-01-01

Aim Effective evidence-based interventions have an important role in obesity prevention. Our aim was to present a qualitative synthesis of setting-based health promotion interventions on obesity, from Nordic countries and the Netherlands. Methods A systematic review of the literature was completed for studies in the community, schools, and worksite, with BMI as an outcome. A descriptive analysis was completed for all full-text articles meeting the inclusion criteria. Results Thirty-three articles were identified: 7 whole of community, 3 worksite, and 23 school-based interventions. The studies were largely quasiexperimental in design (21/33), with follow-up from 4 months to 8 years. The explicit use of theory was not featured in many of the studies (20/33). No consistent direction for BMI change could be identified in the whole of community interventions (2/7 positive, 2/7 negative, and 3/7 no effect) and no effect for worksite (3/3 no effect) or many of the school-based interventions (1/23 negative, 4/23 positive, 15/23 no effect, 1/23 BMI significant increase only for control group and 3/23 no data available). Conclusions There is a need to prioritise interventions with study designs of high quality, theory, and a participatory approach, for optimal implementation and evaluation of obesity prevention interventions. PMID:29808116

Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

PubMed Central

2013-01-01

Background Knowledge translation strategies are an approach to increase the use of evidence within policy and practice decision-making contexts. In clinical and health service contexts, knowledge translation strategies have focused on individual behavior change, however the multi-system context of public health requires a multi-level, multi-strategy approach. This paper describes the design of and implementation plan for a knowledge translation intervention for public health decision making in local government. Methods Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan. Results The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these inputs and strategies with a set of outcomes to measure the intervention’s effectiveness based on the theoretical frameworks, evaluation studies, and decision-maker experiences. Conclusion Documenting the design of and implementation plan for this knowledge translation intervention provides a transparent, theoretical, and practical approach to a complex intervention. It provides significant insights into how practitioners might engage with evidence in public health decision making. While this intervention model was designed for the local government context, it is likely to be applicable and generalizable across sectors and settings. Trial registration Australia New Zealand Clinical Trials Register ACTRN12609000953235. PMID:24107358

Long-Term Effects of Bereavement and Caregiver Intervention on Dementia Caregiver Depressive Symptoms

ERIC Educational Resources Information Center

Haley, William E.; Bergman, Elizabeth J.; Roth, David L.; McVie, Theresa; Gaugler, Joseph E.; Mittelman, Mary S.

2008-01-01

Purpose: The purpose of this study was to examine the joint effects of bereavement and caregiver intervention on caregiver depressive symptoms. Design and Methods: Alzheimer's caregivers from a randomized trial of an enhanced caregiver support intervention versus usual care who had experienced the death of their spouse (n = 254) were repeatedly…

The Role of Need for Contraception in the Evaluation of Interventions to Improve Access to Family-Planning Methods

ERIC Educational Resources Information Center

Leon, Federico R.; Lundgren, Rebecka; Sinai, Irit; Jennings, Victoria

2011-01-01

A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on…

Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

ERIC Educational Resources Information Center

Bandayrel, Kristofer; Wong, Sharon

2011-01-01

Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

Effects of Coaching on the Implementation of Functional Assessment-Based Parent Intervention in Reducing Challenging Behaviors

ERIC Educational Resources Information Center

Fettig, Angel; Schultz, Tia R.; Sreckovic, Melissa A.

2015-01-01

This study examined the effects of coaching on the implementation of functional assessment--based parent intervention in reducing children's challenging behaviors. A multiple baseline across participants design was used with three parent-child dyads with children between the ages of 2 and 5 years. The intervention consisted of training and delayed…

Incorporating Prototyping and Iteration into Intervention Development: A Case Study of a Dining Hall-Based Intervention

ERIC Educational Resources Information Center

McClain, Arianna D.; Hekler, Eric B.; Gardner, Christopher D.

2013-01-01

Background: Previous research from the fields of computer science and engineering highlight the importance of an iterative design process (IDP) to create more creative and effective solutions. Objective: This study describes IDP as a new method for developing health behavior interventions and evaluates the effectiveness of a dining hall--based…

Class-Wide Function-Related Intervention Teams: Effects of Group Contingency Programs in Urban Classrooms

ERIC Educational Resources Information Center

Kamps, Debra; Wills, Howard P.; Heitzman-Powell, Linda; Laylin, Jeff; Szoke, Carolyn; Petrillo, Tai; Culey, Amy

2011-01-01

The purpose of the study was to determine the effectiveness of the Class-Wide Function-related Intervention Teams (CW-FIT) program, a group contingency intervention for whole classes, and for students with disruptive behaviors who are at risk for emotional/behavioral disorders (EBD). The CW-FIT program includes four elements designed from…

The Effects of Task Clarification, Visual Prompts, and Graphic Feedback on Customer Greeting and Up-Selling in a Restaurant

ERIC Educational Resources Information Center

Squires, James; Wilder, David A.; Fixsen, Amanda; Hess, Erica; Rost, Kristen; Curran, Ryan; Zonneveld, Kimberly

2007-01-01

An intervention consisting of task clarification, visual prompts, and graphic feedback was evaluated to increase customer greeting and up-selling in a restaurant. A combination multiple baseline and reversal design was used to evaluate intervention effects. Although all interventions improved performance over baseline, the delivery of graphic…

Effect of Nutrition Intervention Using a General Nutrition Course for Promoting Fruit and Vegetable Consumption among College Students

ERIC Educational Resources Information Center

Ha, Eun-Jeong; Caine-Bish, Natalie

2009-01-01

Objective: To evaluate the effectiveness of implementing nutrition intervention using a general nutrition class to promote consumption of fruits and vegetables in college students. Design: 3-day food records were collected, verified, and analyzed before and after the intervention. Setting: A midwestern university. Participants: 80 college…

Selecting Effective Interventions to Increase Math Computation Fluency via Brief Experimental Analyses

ERIC Educational Resources Information Center

Reisener, Carmen D.; Dufrene, Brad A.; Clark, Chelsi R.; Olmi, D. Joe; Tingstrom, Daniel H.

2016-01-01

In a response to intervention RtI paradigm, the use of brief experimental analyses (BEAs) for identifying effective interventions for elementary and middle school students struggling with math is a relatively new area of research. This investigation includes two studies, both of which employed a brief multielement design and an extended analysis…

User-Centered Design for Developing Interventions to Improve Clinician Recommendation of Human Papillomavirus Vaccination

PubMed Central

Henninger, Michelle L; McMullen, Carmit K; Firemark, Alison J; Naleway, Allison L; Henrikson, Nora B; Turcotte, Joseph A

2017-01-01

Introduction Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and is associated with multiple types of cancer. Although effective HPV vaccines have been available since 2006, coverage rates in the US remain much lower than with other adolescent vaccinations. Prior research has shown that a strong recommendation from a clinician is a critical determinant in HPV vaccine uptake and coverage. However, few published studies to date have specifically addressed the issue of helping clinicians communicate more effectively with their patients about the HPV vaccine. Objective To develop one or more novel interventions for helping clinicians make strong and effective recommendations for HPV vaccination. Methods Using principles of user-centered design, we conducted qualitative interviews, interviews with persons from analogous industries, and a data synthesis workshop with multiple stakeholders. Results Five potential intervention strategies targeted at health care clinicians, youth, and their parents were developed. The two most popular choices to pursue were a values-based communication strategy and a puberty education workbook. Conclusion User-centered design is a useful strategy for developing potential interventions to improve the rate and success of clinicians recommending the HPV vaccine. Further research is needed to test the effectiveness and acceptability of these interventions in clinical settings. PMID:28898195

User-Centered Design for Developing Interventions to Improve Clinician Recommendation of Human Papillomavirus Vaccination.

PubMed

Henninger, Michelle L; Mcmullen, Carmit K; Firemark, Alison J; Naleway, Allison L; Henrikson, Nora B; Turcotte, Joseph A

2017-01-01

Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and is associated with multiple types of cancer. Although effective HPV vaccines have been available since 2006, coverage rates in the US remain much lower than with other adolescent vaccinations. Prior research has shown that a strong recommendation from a clinician is a critical determinant in HPV vaccine uptake and coverage. However, few published studies to date have specifically addressed the issue of helping clinicians communicate more effectively with their patients about the HPV vaccine. To develop one or more novel interventions for helping clinicians make strong and effective recommendations for HPV vaccination. Using principles of user-centered design, we conducted qualitative interviews, interviews with persons from analogous industries, and a data synthesis workshop with multiple stakeholders. Five potential intervention strategies targeted at health care clinicians, youth, and their parents were developed. The two most popular choices to pursue were a values-based communication strategy and a puberty education workbook. User-centered design is a useful strategy for developing potential interventions to improve the rate and success of clinicians recommending the HPV vaccine. Further research is needed to test the effectiveness and acceptability of these interventions in clinical settings.

Simulation-based power calculation for designing interrupted time series analyses of health policy interventions.

PubMed

Zhang, Fang; Wagner, Anita K; Ross-Degnan, Dennis

2011-11-01

Interrupted time series is a strong quasi-experimental research design to evaluate the impacts of health policy interventions. Using simulation methods, we estimated the power requirements for interrupted time series studies under various scenarios. Simulations were conducted to estimate the power of segmented autoregressive (AR) error models when autocorrelation ranged from -0.9 to 0.9 and effect size was 0.5, 1.0, and 2.0, investigating balanced and unbalanced numbers of time periods before and after an intervention. Simple scenarios of autoregressive conditional heteroskedasticity (ARCH) models were also explored. For AR models, power increased when sample size or effect size increased, and tended to decrease when autocorrelation increased. Compared with a balanced number of study periods before and after an intervention, designs with unbalanced numbers of periods had less power, although that was not the case for ARCH models. The power to detect effect size 1.0 appeared to be reasonable for many practical applications with a moderate or large number of time points in the study equally divided around the intervention. Investigators should be cautious when the expected effect size is small or the number of time points is small. We recommend conducting various simulations before investigation. Copyright © 2011 Elsevier Inc. All rights reserved.

Systematic review of universal school-based resilience interventions targeting adolescent tobacco, alcohol or illicit drug use: review protocol

PubMed Central

Hodder, Rebecca Kate; Freund, Megan; Wolfenden, Luke; Bowman, Jenny; Gillham, Karen; Dray, Julia; Wiggers, John

2014-01-01

Introduction Tobacco, alcohol and illicit drug use contribute significantly to global rates of morbidity and mortality. Despite evidence suggesting interventions designed to increase adolescent resilience may represent a means of reducing adolescent substance use, and schools providing a key opportunity to implement such interventions, existing systematic reviews assessing the effectiveness of school-based interventions targeting adolescent substance use have not examined this potential. Methods and analysis The aim of the systematic review is to determine whether universal interventions focused on enhancing the resilience of adolescents are effective in reducing adolescent substance use. Eligible studies will: include participants 5–18 years of age; report tobacco use, alcohol consumption or illicit drug use as outcomes; and implement a school-based intervention designed to promote internal (eg, self-esteem) and external (eg, school connectedness) resilience factors. Eligible study designs include randomised controlled trials, cluster randomised controlled trials, staggered enrolment trials, stepped wedged trials, quasi-randomised trials, quasi-experimental trials, time series/interrupted time-series trials, preference trials, regression discontinuity trials and natural experiment studies with a parallel control group. A search strategy including criteria for participants, study design, outcome, setting and intervention will be implemented in various electronic databases and information sources. Two reviewers will independently screen studies to assess eligibility, as well as extract data from, and assess risk of bias of included studies. A third reviewer will resolve any discrepancies. Attempts will be made to quantify trial effects by meta-analysis. Binary outcomes will be pooled and effect size reported using ORs. For continuous data, effect size of trials will be reported using a mean difference where trial outcomes report the same outcome using a consistent measure, or standardised mean difference where trials report a comparable measure. Otherwise, trial outcomes will be described narratively. Dissemination Review findings will be disseminated via peer-reviewed journals and conferences. PMID:24861548

Do educational interventions improve nurses' clinical decision making and judgement? A systematic review.

PubMed

Thompson, Carl; Stapley, Sally

2011-07-01

Despite the growing popularity of decision making in nursing curricula, the effectiveness of educational interventions to improve nursing judgement and decision making is unknown. We sought to synthesise and summarise the comparative evidence for educational interventions to improve nursing judgements and clinical decisions. A systematic review. Electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL and PsycINFO, Social Sciences Citation Index, OpenSIGLE conference proceedings and hand searching nursing journals. Studies published since 1960, reporting any educational intervention that aimed to improve nurses' clinical judgements or decision making were included. Studies were assessed for relevance and quality. Data extracted included study design; educational setting; the nature of participants; whether the study was concerned with the clinical application of skills or the application of theory; the type of decision targeted by the intervention (e.g. diagnostic reasoning) and whether the evaluation of the intervention focused on efficacy or effectiveness. A narrative approach to study synthesis was used due to heterogeneity in interventions, study samples, outcomes and settings and incomplete reporting of effect sizes. From 5262 initial citations 24 studies were included in the review. A variety of educational approaches were reported. Study quality and content reporting was generally poor. Pedagogical theories were widely used but use of decision theory (with the exception of subjective expected utility theory implicit in decision analysis) was rare. The effectiveness and efficacy of interventions was mixed. Educational interventions to improve nurses' judgements and decisions are complex and the evidence from comparative studies does little to reduce the uncertainty about 'what works'. Nurse educators need to pay attention to decision, as well as pedagogical, theory in the design of interventions. Study design and reporting requires improvement to maximise the information contained in reports of educational interventions. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Effectiveness of Teamwork Training on Teamwork Behaviors and Team Performance: A Systematic Review and Meta-Analysis of Controlled Interventions

PubMed Central

McEwan, Desmond; Ruissen, Geralyn R.; Eys, Mark A.; Zumbo, Bruno D.; Beauchamp, Mark R.

2017-01-01

The objective of this study was to conduct a systematic review and meta-analysis of teamwork interventions that were carried out with the purpose of improving teamwork and team performance, using controlled experimental designs. A literature search returned 16,849 unique articles. The meta-analysis was ultimately conducted on 51 articles, comprising 72 (k) unique interventions, 194 effect sizes, and 8439 participants, using a random effects model. Positive and significant medium-sized effects were found for teamwork interventions on both teamwork and team performance. Moderator analyses were also conducted, which generally revealed positive and significant effects with respect to several sample, intervention, and measurement characteristics. Implications for effective teamwork interventions as well as considerations for future research are discussed. PMID:28085922

Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS): rationale and design for meta-analyses of individual patient data of randomized controlled trials that evaluate the effect of physical activity and psychosocial interventions on health-related quality of life in cancer survivors

PubMed Central

2013-01-01

Background Effective interventions to improve quality of life of cancer survivors are essential. Numerous randomized controlled trials have evaluated the effects of physical activity or psychosocial interventions on health-related quality of life of cancer survivors, with generally small sample sizes and modest effects. Better targeted interventions may result in larger effects. To realize such targeted interventions, we must determine which interventions that are presently available work for which patients, and what the underlying mechanisms are (that is, the moderators and mediators of physical activity and psychosocial interventions). Individual patient data meta-analysis has been described as the ‘gold standard’ of systematic review methodology. Instead of extracting aggregate data from study reports or from authors, the original research data are sought directly from the investigators. Individual patient data meta-analyses allow for adequate statistical analysis of intervention effects and moderators of such effects. Here, we report the rationale and design of the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) Consortium. The primary aim of POLARIS is 1) to conduct meta-analyses based on individual patient data to evaluate the effect of physical activity and psychosocial interventions on the health-related quality of life of cancer survivors; 2) to identify important demographic, clinical, personal, or intervention-related moderators of the effect; and 3) to build and validate clinical prediction models identifying the most relevant predictors of intervention success. Methods/Design We will invite investigators of randomized controlled trials that evaluate the effects of physical activity and/or psychosocial interventions on health-related quality of life compared with a wait-list, usual care or attention control group among adult cancer survivors to join the POLARIS consortium and share their data for use in pooled analyses that will address the proposed aims. We are in the process of identifying eligible randomized controlled trials through literature searches in four databases. To date, we have identified 132 eligible and unique trials. Discussion The POLARIS consortium will conduct the first individual patient data meta-analyses in order to generate evidence essential to targeting physical activity and psychosocial programs to the individual survivor’s characteristics, capabilities, and preferences. Registration PROSPERO: International prospective register of systematic reviews, CRD42013003805 PMID:24034173

Childhood obesity prevention in rural settings: background, rationale, and study design of '4-Health,' a parent-only intervention.

PubMed

Lynch, Wesley C; Martz, Jill; Eldridge, Galen; Bailey, Sandra J; Benke, Carrie; Paul, Lynn

2012-04-02

Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent-child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program) or a "best-practices" (Healthy Living Information) control group. This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents' ability to intervene effectively in the lives of their families during this critical developmental period. ClinicalTrials.gov ID: NCT01510587.

Large Group Narrative Intervention in Head Start Preschools: Implications for Response to Intervention

ERIC Educational Resources Information Center

Spencer, Trina D.; Petersen, Douglas B.; Slocum, Timothy A.; Allen, Melissa M.

2015-01-01

This study investigated the effect of a large group narrative intervention on diverse preschoolers' narrative language skills with aims to explore questions of treatment efficacy and differential response to intervention. A quasi-experimental, pretest/posttest comparison group research design was employed with 71 preschool children. Classrooms…

Enhancing the Intercultural Effectiveness of Exchange Programmes: Formal and Non-Formal Educational Interventions

ERIC Educational Resources Information Center

Almeida, Joana; Fantini, Alvino E.; Simões, Ana Raquel; Costa, Nilza

2016-01-01

This paper examines how the addition of intercultural interventions carried out throughout European credit-bearing exchange programmes can enhance sojourners' development of intercultural competencies, and it explores how both formal and non-formal pedagogical interventions may be designed and implemented. Such interventions were conducted at a…

A Meta-Analysis of the Long-Term Effects of Phonemic Awareness, Phonics, Fluency, and Reading Comprehension Interventions.

PubMed

Suggate, Sebastian P

2016-01-01

Much is known about short-term--but very little about the long-term--effects of reading interventions. To rectify this, a detailed analysis of follow-up effects as a function of intervention, sample, and methodological variables was conducted. A total of 71 intervention-control groups were selected (N = 8,161 at posttest) from studies reporting posttest and follow-up data (M = 11.17 months) for previously established reading interventions. The posttest effect sizes indicated effects (dw = 0.37) that decreased to follow-up (dw = 0.22). Overall, comprehension and phonemic awareness interventions showed good maintenance of effect that transferred to nontargeted skills, whereas phonics and fluency interventions, and those for preschool and kindergarten children, tended not to. Several methodological features also related to effect sizes at follow-up, namely experimental design and dosage, and sample attrition, risk status, and gender balance. © Hammill Institute on Disabilities 2014.

Learning What Works in Sensory Disabilities: Establishing Causal Inference

ERIC Educational Resources Information Center

Cooney, John B.; Young, John, III; Luckner, John L.; Ferrell, Kay Alicyn

2015-01-01

This article is intended to assist teachers and researchers in designing studies that examine the efficacy of a particular intervention or strategy with students with sensory disabilities. Ten research designs that can establish causal inference (the ability to attribute any effects to the intervention) with and without randomization are discussed.

Instructional Interventions for Improving Proofreading and Editing Skills of College Students

ERIC Educational Resources Information Center

Enos, Marcella F.

2010-01-01

This article summarizes a dissertation study designed to determine the effectiveness of instructional interventions that focus on proofreading and editing skills of first-year college students enrolled in business communication courses. The study used a pretest-posttest quasiexperimental control group design and collected data from 56 participants…

Mindfulness-based interventions with youth: A comprehensive meta-analysis of group-design studies.

PubMed

Klingbeil, David A; Renshaw, Tyler L; Willenbrink, Jessica B; Copek, Rebecca A; Chan, Kai Tai; Haddock, Aaron; Yassine, Jordan; Clifton, Jesse

2017-08-01

The treatment effects of Mindfulness-Based Interventions (MBIs) with youth were synthesized from 76 studies involving 6121 participants. A total of 885 effect sizes were aggregated using meta-regression with robust variance estimation. Overall, MBIs were associated with small treatment effects in studies using pre-post (g=0.305, SE=0.039) and controlled designs (g=0.322, SE=0.040). Treatment effects were measured after a follow-up period in 24 studies (n=1963). Results demonstrated that treatment effects were larger at follow-up than post-treatment in pre-post (g=0.462, SE=0.118) and controlled designs (g=0.402, SE=0.081). Moderator analyses indicated that intervention setting and intervention dosage were not meaningfully related to outcomes after controlling for study design quality. With that said, the between-study heterogeneity in the intercept-only models was consistently small, thus limiting the amount of variance for the moderators to explain. A series of exploratory analyses were used to investigate the differential effectiveness of MBIs across four therapeutic process domains and seven therapeutic outcome domains. Small, positive results were generally observed across the process and outcome domains. Notably, MBIs were associated with moderate effects on the process variable of mindfulness in controlled studies (n=1108, g=0.510). Limitations and directions for future research and practice are discussed. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia

PubMed Central

Badawy, Sherif M; Morrone, Kerry; Thompson, Alexis; Palermo, Tonya M

2018-01-01

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia, including: evaluating the effects of using computer and mobile technology interventions for medication adherence and disease management on health and behavioural outcomes;identifying and assessing the effects of computer and mobile technology interventions specific to different age groups (children, adolescents and adults) and type of modality (e.g. cell phone, the Internet). PMID:29861660

Short-term effects of the "Together at School" intervention program on children's socio-emotional skills: a cluster randomized controlled trial.

PubMed

Kiviruusu, Olli; Björklund, Katja; Koskinen, Hanna-Leena; Liski, Antti; Lindblom, Jallu; Kuoppamäki, Heini; Alasuvanto, Paula; Ojala, Tiina; Samposalo, Hanna; Harmes, Nina; Hemminki, Elina; Punamäki, Raija-Leena; Sund, Reijo; Santalahti, Päivi

2016-05-26

Together at School is a universal intervention program designed to promote socio-emotional skills among primary-school children. It is based on a whole school approach, and implemented in school classes by teachers. The aim of the present study is to examine the short-term effects of the intervention program in improving socio-emotional skills and reducing psychological problems among boys and girls. We also examine whether these effects depend on grade level (Grades 1 to 3) and intervention dosage. This cluster randomized controlled trial design included 79 Finnish primary schools (40 intervention and 39 control) with 3 704 children. The outcome measures were the Strengths and Difficulties Questionnaire (SDQ) and the Multisource Assessment of Social Competence Scale (MASCS) with teachers as raters. The intervention dosage was indicated by the frequencies six central tools were used by the teachers. The data was collected at baseline and 6 months later. Intervention effects were analyzed using multilevel modeling. When analyzed across all grades no intervention effect was observed in improving children's socio-emotional skills or in reducing their psychological problems at 6-month follow-up. Among third (compared to first) graders the intervention decreased psychological problems. Stratified analyses by gender showed that this effect was significant only among boys and that among them the intervention also improved third graders' cooperation skills. Among girls the intervention effects were not moderated by grade. Implementing the intervention with intended intensity (i.e. a high enough dosage) had a significant positive effect on cooperation skills. When analyzed separately among genders, this effect was significant only in girls. These first, short-term results of the Together at School intervention program did not show any main effects on children's socio-emotional skills or psychological problems. This lack of effects may be due to the relatively short follow-up period given the universal, whole school-based approach of the program. The results suggest that the grade level where the intervention is started might be a factor in the program's effectiveness. Moreover, the results also suggest that for this type of intervention program to be effective, it needs to be delivered with a high enough dosage. ClinicalTrials.gov identifier: NCT02178332 ; Date of registration: 03-April-2014.

Symptom Dimensions as Outcomes in Interventions for Patients With Cancer: A Systematic Review

PubMed

Henoch, Ingela; Olsson, Cecilia; Larsson, Maria; Ahlberg, Karin

2018-03-01

Symptom experience in patients with cancer consists of several dimensions, often measured descriptively within various populations but seldom used as intervention outcomes. This review aims at describing symptom dimensions as outcomes of interventions designed to alleviate symptoms in patients with cancer and to describe these interventions' effects on at least two symptom dimensions. 
. The PRISMA statement for reporting systematic reviews was used. Searches were undertaken in various indexing sites.
. Extracted data included design, participants, intervention and control group treatment, targeted symptom dimension, and summary of results.
. 2,041 articles were identified and 15 were included. The symptom dimensions were intensity, distress, prevalence, frequency, consequences, and quality. Eleven interventions had significant effect on symptom dimensions, mostly on intensity and distress.
. Oncology nurses need clinical skills to be able to understand patients' experiences through their narratives. Various interventions are targeted at symptoms, and these need to be implemented to provide evidence-based symptom management.

Healthy Eating Strategies in the Workplace

PubMed Central

Quintiliani, Lisa; Poulsen, Signe; Sorensen, Glorian

2013-01-01

Purpose There is a clear link between dietary behavior and a range of chronic diseases, and overweight and obesity constitute an indirect risk in relation to these diseases. The worksite is a central venue for influencing dietary behavior. The purpose of this paper is to provide an overview of workplace influences on worker dietary patterns. Design/methodology/approach The paper reviews the evidence of the effectiveness of dietary health promotion, and provides a brief overview of appropriate theoretical frameworks to guide intervention design and evaluation. The findings are illustrated through research examples. Findings Through case studies and published research, it is found that workplace dietary interventions are generally effective, especially fruit and vegetable interventions. There is less consistent evidence on the long term effectiveness of workplace weight management interventions, underscoring the need for further research in this area. This paper also reports evidence that changes in the work environment, including through health and safety programs, may contribute to enhancing the effectiveness of workplace health promotion, including dietary interventions. Organizational factors such as work schedule may also influence dietary patterns. The social ecological model, the social contextual model and political process approach are presented as exemplar conceptual models that may be useful when designing or assessing the effects of workplace health promotion. Originality/value Using the worksite as setting for influencing health by influencing dietary patterns holds considerable promise and may be instrumental in reducing workers’ risk of chronic diseases. PMID:23935706

Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research.

PubMed

Handley, Margaret A; Lyles, Courtney R; McCulloch, Charles; Cattamanchi, Adithya

2018-04-01

Interventional researchers face many design challenges when assessing intervention implementation in real-world settings. Intervention implementation requires holding fast on internal validity needs while incorporating external validity considerations (such as uptake by diverse subpopulations, acceptability, cost, and sustainability). Quasi-experimental designs (QEDs) are increasingly employed to achieve a balance between internal and external validity. Although these designs are often referred to and summarized in terms of logistical benefits, there is still uncertainty about (a) selecting from among various QEDs and (b) developing strategies to strengthen the internal and external validity of QEDs. We focus here on commonly used QEDs (prepost designs with nonequivalent control groups, interrupted time series, and stepped-wedge designs) and discuss several variants that maximize internal and external validity at the design, execution and implementation, and analysis stages.

A practical Bayesian stepped wedge design for community-based cluster-randomized clinical trials: The British Columbia Telehealth Trial.

PubMed

Cunanan, Kristen M; Carlin, Bradley P; Peterson, Kevin A

2016-12-01

Many clinical trial designs are impractical for community-based clinical intervention trials. Stepped wedge trial designs provide practical advantages, but few descriptions exist of their clinical implementational features, statistical design efficiencies, and limitations. Enhance efficiency of stepped wedge trial designs by evaluating the impact of design characteristics on statistical power for the British Columbia Telehealth Trial. The British Columbia Telehealth Trial is a community-based, cluster-randomized, controlled clinical trial in rural and urban British Columbia. To determine the effect of an Internet-based telehealth intervention on healthcare utilization, 1000 subjects with an existing diagnosis of congestive heart failure or type 2 diabetes will be enrolled from 50 clinical practices. Hospital utilization is measured using a composite of disease-specific hospital admissions and emergency visits. The intervention comprises online telehealth data collection and counseling provided to support a disease-specific action plan developed by the primary care provider. The planned intervention is sequentially introduced across all participating practices. We adopt a fully Bayesian, Markov chain Monte Carlo-driven statistical approach, wherein we use simulation to determine the effect of cluster size, sample size, and crossover interval choice on type I error and power to evaluate differences in hospital utilization. For our Bayesian stepped wedge trial design, simulations suggest moderate decreases in power when crossover intervals from control to intervention are reduced from every 3 to 2 weeks, and dramatic decreases in power as the numbers of clusters decrease. Power and type I error performance were not notably affected by the addition of nonzero cluster effects or a temporal trend in hospitalization intensity. Stepped wedge trial designs that intervene in small clusters across longer periods can provide enhanced power to evaluate comparative effectiveness, while offering practical implementation advantages in geographic stratification, temporal change, use of existing data, and resource distribution. Current population estimates were used; however, models may not reflect actual event rates during the trial. In addition, temporal or spatial heterogeneity can bias treatment effect estimates. © The Author(s) 2016.

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

PubMed

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

2016-06-23

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

Strategies to reduce plate waste in primary schools - experimental evaluation.

PubMed

Liz Martins, Margarida; Rodrigues, Sara Sp; Cunha, Luís M; Rocha, Ada

2016-06-01

To determine and compare the effect of two interventions in reducing the plate waste of school lunches. A between-group analysis was conducted among children from three primary schools: (i) a group receiving intervention A, designed for children and focusing on nutrition education and food waste; (ii) a group receiving intervention B, intended for teachers and focusing on the causes and consequences of food waste; and (iii) a control group with no intervention. For each child, physical weighing of individual meals and leftovers was performed on three non-consecutive weeks at baseline (T0), 1 week (T1, short term) and 3 months (T2, medium term) following the intervention. Plate waste was recorded for a total of 1742 lunches during 14 d over eight different menus. Portuguese public primary schools in the city of Porto. All fourth-grade children (n 212) attending the three preselected schools. After intervention A focusing on nutrition education designed for children, a decrease in soup waste was observed compared with the control group. The effect was greater at T1 (-11·9 (se 2·8) %; P<0·001) than at T2 (-5·8 (se 4·4) %; P=0·103). The plate waste of identical main dishes decreased strongly at T1 (-33·9 (se 4·8) %; P<0·001). However, this effect was not found at T2 (-13·7 (se 3·2) %; P<0·001). After intervention B involving teachers, plate waste decreased at T2 (-5·5 (se 1·9) % for soup; -5·4 (se 2·4) % for identical main dishes). Nutrition education designed for children was more effective in the short than the medium term. Thus, this kind of intervention was not effective in reducing food waste in the medium term. In contrast, an intervention focusing on teachers revealed better results in the medium term than in the short term.

[Developing and testing the effects of a psychosocial intervention on stress response and coping in Korean breast cancer survivors: a pilot study].

PubMed

Kim, Cho-Ja; Hur, Hea-Kung; Kang, Duck-Hee; Kim, Bo-Hwan

2004-10-01

The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies. One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly (90 min) for 6 weeks. There was a significant decrease in stress scores following the intervention (Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress. Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.

Interventions designed to improve the quality and efficiency of medication use in managed care: A critical review of the literature – 2001–2007

PubMed Central

Lu, Christine Y; Ross-Degnan, Dennis; Soumerai, Stephen B; Pearson, Sallie-Anne

2008-01-01

Background Managed care organizations use a variety of strategies to reduce the cost and improve the quality of medication use. The effectiveness of such policies is not well understood. The objective of this research was to update a previous systematic review of interventions, published between 1966 and 2001, to improve the quality and efficiency of medication use in the US managed care setting. Methods We searched MEDLINE and EMBASE for publications from July 2001 to January 2007 describing interventions targeting drug use conducted in the US managed care setting. We categorized studies by intervention type and adequacy of research design using commonly accepted criteria. We summarized the outcomes of well-controlled strategies and documented the significance and magnitude of effects for key study outcomes. Results We identified 164 papers published during the six-year period. Predominant strategies were: educational interventions (n = 20, including dissemination of educational materials, and group or one-to-one educational outreach); monitoring and feedback (n = 22, including audit/feedback and computerized monitoring); formulary interventions (n = 66, including tiered formulary and patient copayment); collaborative care involving pharmacists (n = 15); and disease management with pharmacotherapy as a primary focus (n = 41, including care for depression, asthma, and peptic ulcer disease). Overall, 51 studies met minimum criteria for methodological adequacy. Effective interventions included one-to-one academic detailing, computerized alerts and reminders, pharmacist-led collaborative care, and multifaceted disease management. Further, changes in formulary tier-design and related increases in copayments were associated with reductions in medication use and increased out-of-pocket spending by patients. The dissemination of educational materials alone had little or no impact, while the impact of group education was inconclusive. Conclusion There is good evidence for the effectiveness of several strategies in changing drug use in the managed care environment. However, little is known about the cost-effectiveness of these interventions. Computerized alerts showed promise in improving short-term outcomes but little is known about longer-term outcomes. Few well-designed, published studies have assessed the potential negative clinical effects of formulary-related interventions despite their widespread use. However, some evidence suggests increases in cost sharing reduce access to essential medicines for chronic illness. PMID:18394200

Interventions designed to improve the quality and efficiency of medication use in managed care: a critical review of the literature - 2001-2007.

PubMed

Lu, Christine Y; Ross-Degnan, Dennis; Soumerai, Stephen B; Pearson, Sallie-Anne

2008-04-07

Managed care organizations use a variety of strategies to reduce the cost and improve the quality of medication use. The effectiveness of such policies is not well understood. The objective of this research was to update a previous systematic review of interventions, published between 1966 and 2001, to improve the quality and efficiency of medication use in the US managed care setting. We searched MEDLINE and EMBASE for publications from July 2001 to January 2007 describing interventions targeting drug use conducted in the US managed care setting. We categorized studies by intervention type and adequacy of research design using commonly accepted criteria. We summarized the outcomes of well-controlled strategies and documented the significance and magnitude of effects for key study outcomes. We identified 164 papers published during the six-year period. Predominant strategies were: educational interventions (n = 20, including dissemination of educational materials, and group or one-to-one educational outreach); monitoring and feedback (n = 22, including audit/feedback and computerized monitoring); formulary interventions (n = 66, including tiered formulary and patient copayment); collaborative care involving pharmacists (n = 15); and disease management with pharmacotherapy as a primary focus (n = 41, including care for depression, asthma, and peptic ulcer disease). Overall, 51 studies met minimum criteria for methodological adequacy. Effective interventions included one-to-one academic detailing, computerized alerts and reminders, pharmacist-led collaborative care, and multifaceted disease management. Further, changes in formulary tier-design and related increases in copayments were associated with reductions in medication use and increased out-of-pocket spending by patients. The dissemination of educational materials alone had little or no impact, while the impact of group education was inconclusive. There is good evidence for the effectiveness of several strategies in changing drug use in the managed care environment. However, little is known about the cost-effectiveness of these interventions. Computerized alerts showed promise in improving short-term outcomes but little is known about longer-term outcomes. Few well-designed, published studies have assessed the potential negative clinical effects of formulary-related interventions despite their widespread use. However, some evidence suggests increases in cost sharing reduce access to essential medicines for chronic illness.

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

Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care

PubMed Central

2013-01-01

Background It is well-known that health care workers in today’s general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. Methods/Design A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1) a longitudinal web-based survey study, and (2) a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. Discussion The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1) how a balance between job demands, job resources, and recovery from work can be optimized, (2) the short-term and long-term effects of tailored work-oriented effects, and (3) indicators for successful or unsuccessful implementation of interventions. PMID:23421647

Psychosocial constructs were not mediators of intervention effects for dietary and physical activity outcomes in a church-based lifestyle intervention: Delta Body and Soul III.

PubMed

Thomson, Jessica L; Tussing-Humphreys, Lisa M; Zoellner, Jamie M; Goodman, Melissa H

2016-08-01

Evaluating an intervention's theoretical basis can inform design modifications to produce more effective interventions. Hence the present study's purpose was to determine if effects from a multicomponent lifestyle intervention were mediated by changes in the psychosocial constructs decisional balance, self-efficacy and social support. Delta Body and Soul III, conducted from August 2011 to May 2012, was a 6-month, church-based, lifestyle intervention designed to improve diet quality and increase physical activity. Primary outcomes, diet quality and aerobic and strength/flexibility physical activity, as well as psychosocial constructs, were assessed via self-report, interviewer-administered surveys at baseline and post intervention. Mediation analyses were conducted using ordinary least squares (continuous outcomes) and maximum likelihood logistic (dichotomous outcomes) regression path analysis. Churches (five intervention and three control) were recruited from four counties in the Lower Mississippi Delta region of the USA. Rural, Southern, primarily African-American adults (n 321). Based upon results from the multiple mediation models, there was no evidence that treatment (intervention v. control) indirectly influenced changes in diet quality or physical activity through its effects on decisional balance, self-efficacy and social support. However, there was evidence for direct effects of social support for exercise on physical activity and of self-efficacy for sugar-sweetened beverages on diet quality. Results do not support the hypothesis that the psychosocial constructs decisional balance, self-efficacy and social support were the theoretical mechanisms by which the Delta Body and Soul III intervention influenced changes in diet quality and physical activity.

Effectiveness of a combined social and physical environmental intervention on presenteeism, absenteeism, work performance, and work engagement in office employees.

PubMed

Coffeng, Jennifer K; Hendriksen, Ingrid J M; Duijts, Saskia F A; Twisk, Jos W R; van Mechelen, Willem; Boot, Cécile R L

2014-03-01

To investigate the effectiveness of a combined social and physical environmental intervention as well as the effectiveness of both separate interventions. In a 2 × 2 factorial design, 412 office employees were allocated to the combined social and physical environmental intervention, to the social environmental intervention only, to the physical environmental intervention only, or were part of the control group. Data on presenteeism, absenteeism, work performance, and work engagement were obtained with questionnaires at baseline, 6, and 12 months. Multilevel analyses were performed. The combined intervention showed a decrease in contextual performance and dedication. The social environmental intervention showed an improvement in task performance. The physical environmental intervention revealed an improvement in absorption. Although the study showed some promising results, it is not recommended to implement the current interventions.

Using an Analysis of Behavior Change to Inform Effective Digital Intervention Design: How Did the PRIMIT Website Change Hand Hygiene Behavior Across 8993 Users?

PubMed

Ainsworth, B; Steele, M; Stuart, B; Joseph, J; Miller, S; Morrison, L; Little, P; Yardley, L

2017-06-01

In designing digital interventions for healthcare, it is important to understand not just whether interventions work but also how and for whom-including whether individual intervention components have different effects, whether a certain usage threshold is required to change behavior in each intervention and whether usage differs across population subgroups. We investigated these questions using data from a large trial of the digital PRimary care trial of a website based Infection control intervention to Modify Influenza-like illness and respiratory tract infection Transmission) (PRIMIT) intervention, which aimed to reduce respiratory tract infections (RTIs) by increasing hand hygiene behavior. Baseline and follow-up questionnaires measured behaviors, intentions and attitudes in hand hygiene. In conjunction with objective measures of usage of the four PRIMIT sessions, we analysed these observational data to examine mechanisms of behavior change in 8993 intervention users. We found that the PRIMIT intervention changed behavior, intentions and attitudes, and this change was associated with reduced RTIs. The largest hand hygiene change occurred after the first session, with incrementally smaller changes after each subsequent session, suggesting that engagement with the core behavior change techniques included in the first session was necessary and sufficient for behavior change. The intervention was equally effective for men and women, older and younger people and was particularly effective for those with lower levels of education. Our well-powered analysis has implications for intervention development. We were able to determine a 'minimum threshold' of intervention engagement that is required for hand hygiene change, and we discuss the potential implications this (and other analyses of this type) may have for further intervention development. We also discuss the application of similar analyses to other interventions.

The Effect of Pharmacist Intervention on Herpes Zoster Vaccination in Community Pharmacies

PubMed Central

Wang, Junling; Ford, Lindsay J.; Wingate, La’Marcus; Uroza, Sarah Frank; Jaber, Nina; Smith, Cindy T.; Randolph, Richard; Lane, Steve; Foster, Stephan L.

2012-01-01

OBJECTIVE To evaluate the effectiveness of community pharmacy-based interventions in increasing vaccination rates for the herpes zoster vaccine. DESIGN Prospective intervention study with a pre-post design. SETTING Three independent community pharmacies in Tennessee. PATIENTS Patients whose pharmacy profiles indicated they were eligible for the vaccine and patients presenting to receive the vaccine at study sites. INTERVENTIONS Interventions initiated by pharmacists to promote the herpes zoster vaccine included a press release published in local newspapers, a flyer accompanying each prescription dispensed at participating pharmacies, and a personalized letter mailed to patients whose pharmacy profiles indicated they were eligible for the vaccine. MAIN OUTCOME MEASURES Comparison of vaccination rates for the herpes zoster vaccine during the control period and intervention period and patients’ indication for their sources of education and influence in receiving the vaccine. RESULTS Vaccination rates increased from 0.37% (n=59/16121) during the control period to 1.20% (n=193/16062) during the intervention period (P<0.0001). Cochran-Armitage Trend analyses including the months before and after the interventions confirmed a significantly higher vaccination rate during the intervention month than other months analyzed. More patients indicated that they were educated about the herpes zoster vaccine by one of the pharmacist-driven interventions than by a physician, family/friend, or other source during the intervention period (P<0.0001 for all comparisons). Also, more patients were influenced to receive the vaccination as a result of one of the pharmacist-driven interventions rather than a physician (P=0.0260) or other source (P<0.0001). No difference in the effectiveness of patient influence was found when the pharmacy interventions were compared with family/friends (P=0.1025). CONCLUSION The three pharmacist-driven interventions were effective in increasing vaccination rates for the herpes zoster vaccine. PMID:23636155

The effectiveness of the "Brainwork Intervention" in reducing sick leave for unemployed workers with psychological problems: design of a controlled clinical trial.

PubMed

Audhoe, Selwin S; Nieuwenhuijsen, Karen; Hoving, Jan L; Sluiter, Judith K; Frings-Dresen, Monique H W

2015-04-14

Among the working population, unemployed, temporary agency and expired fixed-term contract workers having psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. Studies investigating the effectiveness of return-to-work (RTW) interventions on these workers, who are without an employment contract, are scarce. Therefore, a RTW intervention called 'Brainwork' was developed. The objective of this paper is to describe the 'Brainwork Intervention' and the trial design evaluating its effectiveness in reducing the duration of sick leave compared to usual care. The 'Brainwork Intervention' is designed to assist unemployed, temporary agency and expired fixed-term contract workers who are sick-listed due to psychological problems, with their return to work. The 'Brainwork Intervention' uses an activating approach: in the early stage of sick leave, workers are encouraged to exercise and undertake activities aimed at regaining control and functional recovery while job coaches actively support their search for (temporary) jobs. The content of the intervention is tailored to the severity of the psychological problems and functional impairments, as well as the specific psychosocial problems encountered by the sick-listed worker. The intervention study is designed as a quasi-randomized controlled clinical trial with a one-year follow-up and is being conducted in the Netherlands. The control group receives care as usual with minimal involvement of occupational health professionals. Outcomes are measured at baseline, and 4, 8 and 12 months after initiation of the program. The primary outcome measure is the duration of sick leave. Secondary outcome measures are: the proportion of subjects who returned to work at 8 and 12 months; the number of days of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. The cost-benefit analysis will be evaluated from an insurer's perspective. The methodological considerations of the study design are discussed. In this trial we evaluate the effectiveness of an intervention in real occupational health practice, rather than under highly controlled circumstances. The results will be published in 2015. NTR4190. Date of registration: September 27(th) 2013.

An intervention modelling experiment to change GPs' intentions to implement evidence-based practice: using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #2

PubMed Central

Hrisos, Susan; Eccles, Martin; Johnston, Marie; Francis, Jill; Kaner, Eileen FS; Steen, Nick; Grimshaw, Jeremy

2008-01-01

Background Psychological theories of behaviour may provide a framework to guide the design of interventions to change professional behaviour. Behaviour change interventions, designed using psychological theory and targeting important motivational beliefs, were experimentally evaluated for effects on the behavioural intention and simulated behaviour of GPs in the management of uncomplicated upper respiratory tract infection (URTI). Methods The design was a 2 × 2 factorial randomised controlled trial. A postal questionnaire was developed based on three theories of human behaviour: Theory of Planned Behaviour; Social Cognitive Theory and Operant Learning Theory. The beliefs and attitudes of GPs regarding the management of URTI without antibiotics and rates of prescribing on eight patient scenarios were measured at baseline and post-intervention. Two theory-based interventions, a "graded task" with "action planning" and a "persuasive communication", were incorporated into the post-intervention questionnaire. Trial groups were compared using co-variate analyses. Results Post-intervention questionnaires were returned for 340/397 (86%) GPs who responded to the baseline survey. Each intervention had a significant effect on its targeted behavioural belief: compared to those not receiving the intervention GPs completing Intervention 1 reported stronger self-efficacy scores (Beta = 1.41, 95% CI: 0.64 to 2.25) and GPs completing Intervention 2 had more positive anticipated consequences scores (Beta = 0.98, 95% CI = 0.46 to 1.98). Intervention 2 had a significant effect on intention (Beta = 0.90, 95% CI = 0.41 to 1.38) and simulated behaviour (Beta = 0.47, 95% CI = 0.19 to 0.74). Conclusion GPs' intended management of URTI was significantly influenced by their confidence in their ability to manage URTI without antibiotics and the consequences they anticipated as a result of doing so. Two targeted behaviour change interventions differentially affected these beliefs. One intervention also significantly enhanced GPs' intentions not to prescribe antibiotics for URTI and resulted in lower rates of prescribing on patient scenarios compared to a control group. The theoretical frameworks utilised provide a scientific rationale for understanding how and why the interventions had these effects, improving the reproducibility and generalisability of these findings and offering a sound basis for an intervention in a "real world" trial. Trial registration Clinicaltrials.gov NCT00376142 PMID:18194526

The advocacy in action study a cluster randomized controlled trial to reduce pedestrian injuries in deprived communities.

PubMed

Lyons, R A; Towner, E; Christie, N; Kendrick, D; Jones, S J; Hayes, M; Kimberlee, R; Sarvotham, T; Macey, S; Brussoni, M; Sleney, J; Coupland, C; Phillips, C

2008-04-01

Road traffic-related injury is a major global public health problem. In most countries, pedestrian injuries occur predominantly to the poorest in society. A number of evaluated interventions are effective in reducing these injuries. Very little research has been carried out into the distribution and determinants of the uptake of these interventions. Previous research has shown an association between local political influence and the distribution of traffic calming after adjustment for historical crash patterns. This led to the hypothesis that advocacy could be used to increase local politicians knowledge of pedestrian injury risk and effective interventions, ultimately resulting in improved pedestrian safety. To design an intervention to improve the uptake of pedestrian safety measures in deprived communities. Electoral wards in deprived areas of England and Wales with a poor record of pedestrian safety for children and older adults. Design mixedmethods study, incorporating a cluster randomized controlled trial. Data mixture of Geographical Information Systems data collision locations, road safety interventions, telephone interviews, and questionnaires. Randomization 239 electoral wards clustered within 57 local authorities. Participants 615 politicians representing intervention and control wards. Intervention a package of tailored information including maps of pedestrian injuries was designed for intervention politicians, and a general information pack for controls. Primary outcome number of road safety interventions 25 months after randomization. Secondary outcomes politicians interest and involvement in injury prevention cost of interventions. Process evaluation use of advocacy pack, facilitators and barriers to involvement, and success.

Increasing money-counting skills with a student with brain injury: skill and performance deficits.

PubMed

Fienup, Daniel M; Mudgal, Dipti; Pace, Gary

2013-01-01

Two studies examined the effectiveness of interventions designed to increase money-counting skills of a student with brain injury. Both skill and performance hypotheses were examined. Single subject designs were used to evaluate interventions, including a multiple-baseline across counting paper and coin money (study 1) and a changing criterion design (study 2). In study 1, it was hypothesized that the student had a skill deficit; thus, the participant was taught organizational strategies for counting money. In study 2, a performance deficit was hypothesized and the effects of contingent rewards were evaluated. In study 1, organizational strategies increased organized counting of money, but did not affect counting accuracy. In study 2, contingent rewards increased accurate money counting. When dealing with multi-step behaviours, different components of behaviour can be controlled by different variables, such as skill and performance deficits. Effective academic interventions may need to consider both types of deficits.

Effectiveness of an occupational health intervention program to reduce whole body vibration exposure: an evaluation study with a controlled pretest-post-test design.

PubMed

Tiemessen, Ivo J H; Hulshof, Carel T J; Frings-Dresen, Monique H W

2009-12-01

An effective intervention program aiming to reduce whole body vibration (WBV) exposure at work will reduce the number of low back complaints in the near future. An evaluation study with a controlled pretest-post-test design. Nine companies and 126 drivers were included in the study. Cluster randomization on company level divided the drivers and their employers in an intervention group and a "care-as-usual" group. At baseline (T0) and intervention program was implemented and evaluated after 7 months (T1). The main outcome measure was WBV exposure. Process measures included knowledge, attitude, and (intended) behavior towards reduction of WBV exposure for the drivers and knowledge and WBV policy for the employers. At T1, no significant reduction was found in WBV exposure within both groups compared with T0. Probably due to poor to moderate compliance, the intervention program was not effective in reducing the WBV exposure on group level but small reductions in WBV exposure are possible when intervention compliance is high. Copyright 2009 Wiley-Liss, Inc.

Weight Control Intervention for Truck Drivers: The SHIFT Randomized Controlled Trial, United States

PubMed Central

Wipfli, Brad; Thompson, Sharon V.; Elliot, Diane L.; Anger, W. Kent; Bodner, Todd; Hammer, Leslie B.; Perrin, Nancy A.

2016-01-01

Objectives. To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. Methods. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. Results. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = −0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Conclusions. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers. PMID:27463067

Weight Control Intervention for Truck Drivers: The SHIFT Randomized Controlled Trial, United States.

PubMed

Olson, Ryan; Wipfli, Brad; Thompson, Sharon V; Elliot, Diane L; Anger, W Kent; Bodner, Todd; Hammer, Leslie B; Perrin, Nancy A

2016-09-01

To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = -0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers.

Team Knowledge Sharing Intervention Effects on Team Shared Mental Models and Student Performance in an Undergraduate Science Course

ERIC Educational Resources Information Center

Sikorski, Eric G.; Johnson, Tristan E.; Ruscher, Paul H.

2012-01-01

The purpose of this study was to examine the effects of a shared mental model (SMM) based intervention on student team mental model similarity and ultimately team performance in an undergraduate meteorology course. The team knowledge sharing (TKS) intervention was designed to promote team reflection, communication, and improvement planning.…

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…

Effect of a School-Based Test Anxiety Intervention in Ethnic Minority Youth Exposed to Hurricane Katrina

ERIC Educational Resources Information Center

Weems, Carl F.; Taylor, Leslie K.; Costa, Natalie M.; Marks, Allison B.; Romano, Dawn M.; Verrett, Shannon L.; Brown, Darlene M.

2009-01-01

This study tested the effects of a school-based test anxiety intervention among ethnic minority youth. The study used a prospective intervention design with a sample of (N = 94) ninth graders from New Orleans exposed to Hurricane Katrina and its aftermath. Thirty youth with elevated test anxiety completed a primarily behavioral (e.g., relaxation…

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…

Reading Intervention with K-4 Struggling Readers: The Effect of Using Minimally Trained Tutors in One Inner-City Public School

ERIC Educational Resources Information Center

Lipsey, Tammy

2010-01-01

The purpose of this quasi-experimental study was to evaluate the effectiveness of an early reading intervention method designed for students who were in need of extra help in reading. The early reading intervention (tutoring) was conducted for Kindergarten through fourth grade students. Specifically, this dissertation investigated the question: To…

Effects of a Strategic Intervention with iPad Practice on the Multiplication Fact Performance of Fifth-Grade Students with Learning Disabilities

ERIC Educational Resources Information Center

Ok, Min Wook; Bryant, Diane Pedrotty

2016-01-01

This study investigated the effects of explicit, strategic intervention with iPad application practice on the multiplication fact performance and strategy use of elementary students with learning disabilities (LD) using a single-case, multiple probe design across participants. Four fifth-grade students with LD received 15 1:1 intervention sessions…

Advancing Work Practices: Rethinking Online Professional Development in the Context of the Intervention-Based Sustainable Change

ERIC Educational Resources Information Center

Noesgaard, Signe Schack

2016-01-01

Purpose: The paper aims to discuss the effectiveness of e-Learning in advancing work practices. The paper investigates the assumption that e-Learning is as effective as face-to-face interventions when stimulating change. It also examines the assumption that well-designed and well-executed instructional interventions will advance work practices.…

Using instructional design process to improve design and development of Internet interventions.

PubMed

Hilgart, Michelle M; Ritterband, Lee M; Thorndike, Frances P; Kinzie, Mable B

2012-06-28

Given the wide reach and extensive capabilities of the Internet, it is increasingly being used to deliver comprehensive behavioral and mental health intervention and prevention programs. Their goals are to change user behavior, reduce unwanted complications or symptoms, and improve health status and health-related quality of life. Internet interventions have been found efficacious in addressing a wide range of behavioral and mental health problems, including insomnia, nicotine dependence, obesity, diabetes, depression, and anxiety. Despite the existence of many Internet-based interventions, there is little research to inform their design and development. A model for behavior change in Internet interventions has been published to help guide future Internet intervention development and to help predict and explain behavior changes and symptom improvement outcomes through the use of Internet interventions. An argument is made for grounding the development of Internet interventions within a scientific framework. To that end, the model highlights a multitude of design-related components, areas, and elements, including user characteristics, environment, intervention content, level of intervention support, and targeted outcomes. However, more discussion is needed regarding how the design of the program should be developed to address these issues. While there is little research on the design and development of Internet interventions, there is a rich, related literature in the field of instructional design (ID) that can be used to inform Internet intervention development. ID models are prescriptive models that describe a set of activities involved in the planning, implementation, and evaluation of instructional programs. Using ID process models has been shown to increase the effectiveness of learning programs in a broad range of contexts. ID models specify a systematic method for assessing the needs of learners (intervention users) to determine the gaps between current knowledge and behaviors, and desired outcomes. Through the ID process, designers focus on the needs of learners, taking into account their prior knowledge; set measurable learning objectives or performance requirements; assess learners' achievement of the targeted outcomes; and employ cycles of continuous formative evaluation to ensure that the intervention meets the needs of all stakeholders. The ID process offers a proven methodology for the design of instructional programs and should be considered an integral part of the creation of Internet interventions. By providing a framework for the design and development of Internet interventions and by purposefully focusing on these aspects, as well as the underlying theories supporting these practices, both the theories and the interventions themselves can continue to be refined and improved. By using the behavior change model for Internet interventions along with the best research available to guide design practice and inform development, developers of Internet interventions will increase their ability to achieve desired outcomes.

Using Instructional Design Process to Improve Design and Development of Internet Interventions

PubMed Central

Hilgart, Michelle M; Thorndike, Frances P; Kinzie, Mable B

2012-01-01

Given the wide reach and extensive capabilities of the Internet, it is increasingly being used to deliver comprehensive behavioral and mental health intervention and prevention programs. Their goals are to change user behavior, reduce unwanted complications or symptoms, and improve health status and health-related quality of life. Internet interventions have been found efficacious in addressing a wide range of behavioral and mental health problems, including insomnia, nicotine dependence, obesity, diabetes, depression, and anxiety. Despite the existence of many Internet-based interventions, there is little research to inform their design and development. A model for behavior change in Internet interventions has been published to help guide future Internet intervention development and to help predict and explain behavior changes and symptom improvement outcomes through the use of Internet interventions. An argument is made for grounding the development of Internet interventions within a scientific framework. To that end, the model highlights a multitude of design-related components, areas, and elements, including user characteristics, environment, intervention content, level of intervention support, and targeted outcomes. However, more discussion is needed regarding how the design of the program should be developed to address these issues. While there is little research on the design and development of Internet interventions, there is a rich, related literature in the field of instructional design (ID) that can be used to inform Internet intervention development. ID models are prescriptive models that describe a set of activities involved in the planning, implementation, and evaluation of instructional programs. Using ID process models has been shown to increase the effectiveness of learning programs in a broad range of contexts. ID models specify a systematic method for assessing the needs of learners (intervention users) to determine the gaps between current knowledge and behaviors, and desired outcomes. Through the ID process, designers focus on the needs of learners, taking into account their prior knowledge; set measurable learning objectives or performance requirements; assess learners’ achievement of the targeted outcomes; and employ cycles of continuous formative evaluation to ensure that the intervention meets the needs of all stakeholders. The ID process offers a proven methodology for the design of instructional programs and should be considered an integral part of the creation of Internet interventions. By providing a framework for the design and development of Internet interventions and by purposefully focusing on these aspects, as well as the underlying theories supporting these practices, both the theories and the interventions themselves can continue to be refined and improved. By using the behavior change model for Internet interventions along with the best research available to guide design practice and inform development, developers of Internet interventions will increase their ability to achieve desired outcomes. PMID:22743534

Improving the governance of patient safety in emergency care: a systematic review of interventions

PubMed Central

Hesselink, Gijs; Berben, Sivera; Beune, Thimpe

2016-01-01

Objectives To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility. Design A systematic review of the literature. Methods PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews and PsychInfo were searched for studies published between January 1990 and July 2014. We included studies evaluating interventions relevant for higher management to oversee and manage patient safety, in prehospital emergency medical service (EMS) organisations and hospital-based emergency departments (EDs). Two reviewers independently selected candidate studies, extracted data and assessed study quality. Studies were categorised according to study quality, setting, sample, intervention characteristics and findings. Results Of the 18 included studies, 13 (72%) were non-experimental. Nine studies (50%) reported data on the reliability and/or validity of the intervention. Eight studies (44%) reported on the feasibility of the intervention. Only 4 studies (22%) reported statistically significant effects. The use of a simulation-based training programme and well-designed incident reporting systems led to a statistically significant improvement of safety knowledge and attitudes by ED staff and an increase of incident reports within EDs, respectively. Conclusions Characteristics of the interventions included in this review (eg, anonymous incident reporting and validation of incident reports by an independent party) could provide useful input for the design of an effective tool to govern patient safety in EMS organisations and EDs. However, executives cannot rely on a robust set of evidence-based and feasible tools to govern patient safety within their emergency care organisation and in the chain of emergency care. Established strategies from other high-risk sectors need to be evaluated in emergency care settings, using an experimental design with valid outcome measures to strengthen the evidence base. PMID:26826151

Dealing with daily challenges in dementia (deal-id study): effectiveness of the experience sampling method intervention 'Partner in Sight' for spousal caregivers of people with dementia: design of a randomized controlled trial.

PubMed

van Knippenberg, Rosalia J M; de Vugt, Marjolein E; Ponds, Rudolf W; Myin-Germeys, Inez; Verhey, Frans R J

2016-05-11

There is an urgent need for psychosocial interventions that effectively support dementia caregivers in daily life. The Experience Sampling Methodology (ESM) offers the possibility to provide a more dynamic view of caregiver functioning. ESM-derived feedback may help to redirect caregivers' behavior towards situations that elicit positive emotions and to increase their feelings of competence in the caretaking process. This paper presents the design of a study that evaluates the process characteristics and effects of the ESM-based intervention 'Partner in Sight'. A randomized controlled trial with 90 spousal caregivers of people with dementia will be conducted. Participants will be randomly assigned to the experimental (6-week ESM intervention including feedback), pseudo-experimental (6-week ESM intervention without feedback), or control group (care as usual). Assessments will be performed pre- and post-intervention and at 2-, and 6-month follow-up. Main outcomes will be sense of competence, perceived control, momentary positive affect, and psychological complaints (depressive symptoms, perceived stress, anxiety, momentary negative affect). In addition to the effect evaluation, a process and economic evaluation will be conducted to investigate the credibility and generalizability of the intervention, and its cost-effectiveness. The potential effects of the ESM intervention may help caregivers to endure their care responsibilities and prevent them from becoming overburdened. This is the first ESM intervention for caregivers of people with dementia. The results of this study, therefore, provide a valuable contribution to the growing knowledge on m-health interventions for dementia caregivers. Dutch Trial Register NTR4847 ; date registered Oct 9, 2014.

Evaluation of a Person-Centered, Theory-Based Intervention to Promote Health Behaviors.

PubMed

Worawong, Chiraporn; Borden, Mary Jo; Cooper, Karen M; Pérez, Oscar A; Lauver, Diane

Effective promotion of health behaviors requires strong interventions. Applying person-centered approaches and concepts synthesized from two motivational theories could strengthen the effects of such interventions. The aim of the study was to report the effect sizes, fidelity, and acceptability of a person-centered, health behavior intervention based on self-regulation and self-determination theories. Using a pre- and postintervention design, with a 4-week follow-up, advanced practice registered nurses made six weekly contacts with 52 volunteer participants. Most participants were educated White women. Advanced practice registered nurses elicited participant motives and particular goals for either healthy diet or physical activity behaviors. Minutes and type of activity and servings of fat and fruit/vegetables were assessed. Effect sizes for engaging in moderate aerobic activity and in fruit/vegetable and fat intake were 0.53, 0.82, and -0.57, respectively. The fidelity of delivery was 80-97% across contacts, and fidelity of participants' receipt of intervention components was supported. Participant acceptance of the intervention was supported by positive ratings on aspects of relevance and usefulness. To advance the science of health behavior change and improve client health status, person-centered approaches and concepts synthesized from motivational theories can be applied and tested with a randomized, controlled design and diverse samples to replicate and extend this promising behavioral intervention.

[Mixed design for the evaluation of the Mesoamerica Health 2015 initiative].

PubMed

Gutiérrez, Juan Pablo; Téllez-Rojo, Marta María; Torres, Pilar; Romero, Martín; Bertozzi, Stefano M

2011-01-01

Since the Salud Mesoamerica 2015 initiative (SM-2015) aim is to improve health and nutrition conditions of those most vulnerable in Mesoamerica, the goal of the evaluation is to generate evidence of the joint effectiveness of a package of interventions designed to improve the health conditions. We propose a mix design for the evaluation, which will allow to know the magnitude of changes attributable to the interventions, as well as the meanings of these changes for the target population, taking into account the specificities of each country. The main axis of this design is a locality panel where information about individuals, households, and health facilities (first and second level) will also be collected. The evaluation design described in this paper was developed between June and December, 2009, and it was integrated during workshops in Cuernavaca (Mexico), Managua (Nicaragua), and San Jose (Costa Rica). The proposed design will allow to generate evidence about the joint effectiveness of the package of interventions proposed for the SM-2015. The success of this design rests on the political commitment of countries and donors.

The Targeted Reading Intervention (TRI): A Classroom Teacher Tier 2 Intervention to Help Struggling Readers in Early Elementary School

ERIC Educational Resources Information Center

Vernon-Feagans, Lynne; Amendum, Steve; Kainz, Kirsten; Ginsburg, Marnie

2009-01-01

The two studies presented in this report were designed to test the effectiveness of a new diagnostic-based reading intervention for classroom teachers, called the Targeted Reading Intervention (TRI). This TRI Tier 2 intervention stressed diagnostic teaching as the key to helping struggling readers make rapid progress in reading in the regular…

Alcohol Interventions for Mandated College Students: A Meta-Analytic Review

PubMed Central

Carey, Kate B.; Scott-Sheldon, Lori A. J.; Garey, Lorra; Elliott, Jennifer C.; Carey, Michael P.

2016-01-01

Objective When college students violate campus alcohol policies, they typically receive disciplinary sanctions that include alcohol education or counseling. This meta-analysis evaluated the efficacy of these “mandated interventions” to prevent future alcohol misuse. Methods Studies were included if they evaluated an individual- or group-level intervention, sampled students mandated to an alcohol program, used a pretest-posttest design, and assessed alcohol use as an outcome. Thirty-one studies with 68 separate interventions (N = 8,621 participants; 35% women; 85% White) were coded by independent raters with respect to sample, design, methodological features, and intervention content; the raters also calculated weighted mean effect sizes, using random-effects models. A priori predictors were examined to explain variability in effect sizes. Results In the five studies that used assessment-only control groups, mandated students reported significantly less drinking relative to controls (between-group contrasts), d+ ranged from 0.13-0.20 for quantity and intoxication outcomes. In the 31 studies that provided within-group contrasts, significant effects were observed for all outcomes in the short-term (i.e., ≤ 3 months post-intervention), with d+ ranging from 0.14-0.27; however, fewer significant effects appeared at longer follow-ups. Four commercially-available intervention protocols (i.e., BASICS, e-CHUG, Alcohol 101, and Alcohol Skills Training Program) were associated with risk reduction. Conclusions Providing mandated interventions to students who violate campus alcohol policies is an effective short-term risk reduction strategy. Continued research is needed to maintain initial gains, identify the most useful intervention components, and determine the cost-effectiveness of delivery modes. PMID:27100126

A systematic review of interventions for promoting active transportation to school

PubMed Central

2011-01-01

Background Active transportation to school is an important contributor to the total physical activity of children and adolescents. However, active school travel has declined over time, and interventions are needed to reverse this trend. The purpose of this paper is to review intervention studies related to active school transportation to guide future intervention research. Methods A systematic review was conducted to identify intervention studies of active transportation to school published in the scientific literature through January 2010. Five electronic databases and a manual search were conducted. Detailed information was extracted, including a quantitative assessment comparing the effect sizes, and a qualitative assessment using an established evaluation tool. Results We identified 14 interventions that focused on active transportation to school. These interventions mainly focused on primary school children in the United States, Australia, and the United Kingdom. Almost all the interventions used quasi-experimental designs (10/14), and most of the interventions reported a small effect size on active transportation (6/14). Conclusion More research with higher quality study designs and measures should be conducted to further evaluate interventions and to determine the most successful strategies for increasing active transportation to school. PMID:21320322

Effect assessment in work environment interventions: a methodological reflection.

PubMed

Neumann, W P; Eklund, J; Hansson, B; Lindbeck, L

2010-01-01

This paper addresses a number of issues for work environment intervention (WEI) researchers in light of the mixed results reported in the literature. If researchers emphasise study quality over intervention quality, reviews that exclude case studies with high quality and multifactorial interventions may be vulnerable to 'quality criteria selection bias'. Learning from 'failed' interventions is inhibited by both publication bias and reporting lengths that limit information on relevant contextual and implementation factors. The authors argue for the need to develop evaluation approaches consistent with the complexity of multifactorial WEIs that: a) are owned by and aimed at the whole organisation; and b) include intervention in early design stages where potential impact is highest. Context variety, complexity and instability in and around organisations suggest that attention might usefully shift from generalisable 'proof of effectiveness' to a more nuanced identification of intervention elements and the situations in which they are more likely to work as intended. STATEMENT OF RELEVANCE: This paper considers ergonomics interventions from perspectives of what constitutes quality and 'proof". It points to limitations of traditional experimental intervention designs and argues that the complexity of organisational change, and the need for multifactorial interventions that reach deep into work processes for greater impact, should be recognised.

A systematic review of interventions for promoting active transportation to school.

PubMed

Chillón, Palma; Evenson, Kelly R; Vaughn, Amber; Ward, Dianne S

2011-02-14

Active transportation to school is an important contributor to the total physical activity of children and adolescents. However, active school travel has declined over time, and interventions are needed to reverse this trend. The purpose of this paper is to review intervention studies related to active school transportation to guide future intervention research. A systematic review was conducted to identify intervention studies of active transportation to school published in the scientific literature through January 2010. Five electronic databases and a manual search were conducted. Detailed information was extracted, including a quantitative assessment comparing the effect sizes, and a qualitative assessment using an established evaluation tool. We identified 14 interventions that focused on active transportation to school. These interventions mainly focused on primary school children in the United States, Australia, and the United Kingdom. Almost all the interventions used quasi-experimental designs (10/14), and most of the interventions reported a small effect size on active transportation (6/14). More research with higher quality study designs and measures should be conducted to further evaluate interventions and to determine the most successful strategies for increasing active transportation to school. © 2011 Chillón P et al; licensee BioMed Central Ltd.

A Packaged Intervention To Reduce Disruptive Behaviors in General Education Students.

ERIC Educational Resources Information Center

De Martini-Scully, Diane; Bray, Melissa A.; Kehle, Thomas J.

2000-01-01

Examines the effects of a packaged intervention designed to reduce disruptive behaviors in two 8-year-old female students. The intervention was delivered through a contingency contract and was comprised of precision requests, antecedent strategies, and the reductive technique of response costs. The intervention resulted in reduction of disruptive…

The development of effective behaviour change interventions to support the use of malaria rapid diagnostic tests by Tanzanian clinicians

PubMed Central

2014-01-01

Background Parasitological confirmation is now recommended for all cases of suspected malaria. The roll-out of rapid diagnostic tests (RDTs) is hoped to enable this goal in low resource settings through point of care testing. However, simply making RDTs available has not led to high uptake of the tests or adherence to results by clinicians, with malaria continuing to be overdiagnosed in many settings. We undertook to design an evidence-based intervention package that would be sufficient to support the introduction of RDTs at dispensaries in Tanzania, to be evaluated through the Targeting Artemisinin Combination Therapy (TACT) cluster randomised controlled trial. Methods We describe five steps in our intervention design: formative research, review of existing evidence and theory, a workshop to define the intervention approach and content and results of formative research, engagement with behaviour change theory and literature, detailed design of intervention materials and piloting and pretesting of intervention materials. This involved fieldwork with a total of 19 health workers and 212 community members in northeast Tanzania. Results The formative research suggested that RDTs were a potential source of conflict in the health worker-patient interaction, but that health workers used various techniques to resolve this, including provision of antimalarial drugs for RDT-negative patients. Our reviews showed that evidence was mixed regarding the effectiveness of different methods and theories to support change in prescribing practice. Our design process is presented, drawing from this collective evidence. We describe the final TACT intervention package (including interactive small group workshops, feedback text messages, motivational text messages and patient information leaflets and posters) in terms of its programme theory and implementation theory. Conclusions Our study suggests that evidence-based design of complex interventions is possible. The use of formative research to understand malaria overdiagnosis in context was central to the design of the intervention as well as empirical research to test materials and methods prior to implementation. The TACT interventions may be appropriate for other settings where clinicians face similar challenges with malaria diagnostics. Trial registration NCT01292707. PMID:24969367

Physical activity interventions and children's mental function: An introduction and overview

PubMed Central

Tomporowski, Phillip D.; Lambourne, Kate; Okumura, Michelle S.

2011-01-01

Background This review provides a historical overview of physical activity interventions designed by American educators and an evaluation of research that has assessed the effects of exercise on children's mental function. Method Historical descriptions of the emergence of American physical education doctrine throughout the 20th century were evaluated. Prior reviews of studies that assessed the effects of single acute bouts of exercise and the effects of chronic exercise training on children's mental function were examined and the results of recent studies were summarized. Results Physical activity interventions designed for American children have reflected two competing views: activities should promote physical fitness and activities should promote social, emotional, and intellectual development. Research results indicate that exercise fosters the emergence of children's mental function; particularly executive functioning. The route by which physical activity impacts mental functioning is complex and is likely moderated by several variables, including physical fitness level, health status, and numerous psycho-social factors. Conclusion Physical activity interventions for children should be designed to meet multiple objectives; e.g., optimize physical fitness, promote health-related behaviors that offset obesity, and facilitate mental development. PMID:21420981

The FIT Game: preliminary evaluation of a gamification approach to increasing fruit and vegetable consumption in school.

PubMed

Jones, Brooke A; Madden, Gregory J; Wengreen, Heidi J

2014-11-01

Incentive-based interventions designed to increase fruit and vegetable (FV) consumption tend to yield positive, short-term outcomes. Because consumption most often returns to baseline levels when incentives are removed, sustainable long-duration interventions may be needed to impact public health. Anticipating that low-cost interventions will be more appealing to schools, the present study explored a low-cost, game-based intervention. An alternating-treatments design was used to evaluate the effects of the FIT Game on objectively measured FV consumption in one elementary school (n=251) in Utah. During the Fall 2013 semester, game-based rewards were provided to heroic characters within a fictional narrative read by teachers on days when the school, as a whole, met a fruit or vegetable consumption goal in accord with the alternating-treatments design. On intervention days, fruit and vegetable consumption increased by 39% and 33%, (p<0.01, p<0.05; binomial tests), respectively. Teacher surveys indicated that students enjoyed the game and grade 1-3 teachers recommended its use in other schools. This game-based intervention provides a promising step towards developing a low-cost, effective, and sustainable FV intervention that schools can implement without outside assistance. Copyright © 2014 Elsevier Inc. All rights reserved.

The Effects of a Tier 3 Intervention on the Mathematics Performance of Second Grade Students With Severe Mathematics Difficulties.

PubMed

Bryant, Brian R; Bryant, Diane Pedrotty; Porterfield, Jennifer; Dennis, Minyi Shih; Falcomata, Terry; Valentine, Courtney; Brewer, Chelsea; Bell, Kathy

2016-01-01

The purpose of this study was to determine the effectiveness of a systematic, explicit, intensive Tier 3 (tertiary) intervention on the mathematics performance of students in second grade with severe mathematics difficulties. A multiple-baseline design across groups of participants showed improved mathematics performance on number and operations concepts and procedures, which are the foundation for later mathematics success. In the previous year, 12 participants had experienced two doses (first and second semesters) of a Tier 2 intervention. In second grade, the participants continued to demonstrate low performance, falling below the 10th percentile on a researcher-designed universal screener and below the 16th percentile on a distal measure, thus qualifying for the intensive intervention. A project interventionist, who met with the students 5 days a week for 10 weeks (9 weeks for one group), conducted the intensive intervention. The intervention employed more intensive instructional design features than the previous Tier 2 secondary instruction, and also included weekly games to reinforce concepts and skills from the lessons. Spring results showed significantly improved mathematics performance (scoring at or above the 25th percentile) for most of the students, thus making them eligible to exit the Tier 3 intervention. © Hammill Institute on Disabilities 2014.

Research design issues for evaluating complex multicomponent interventions in neighborhoods and communities.

PubMed

Komro, Kelli A; Flay, Brian R; Biglan, Anthony; Wagenaar, Alexander C

2016-03-01

Major advances in population health will not occur unless we translate existing knowledge into effective multicomponent interventions, implement and maintain these in communities, and develop rigorous translational research and evaluation methods to ensure continual improvement and sustainability. We discuss challenges and offer approaches to evaluation that are key for translational research stages 3 to 5 to advance optimized adoption, implementation, and maintenance of effective and replicable multicomponent strategies. The major challenges we discuss concern (a) multiple contexts of evaluation/research, (b) complexity of packages of interventions, and (c) phases of evaluation/research questions. We suggest multiple alternative research designs that maintain rigor but accommodate these challenges and highlight the need for measurement systems. Longitudinal data collection and a standardized continuous measurement system are fundamental to the evaluation and refinement of complex multicomponent interventions. To be useful to T3-T5 translational research efforts in neighborhoods and communities, such a system would include assessments of the reach, implementation, effects on immediate outcomes, and effects of the comprehensive intervention package on more distal health outcomes.

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

NASA Astrophysics Data System (ADS)

Schütte, Kerstin; Köller, Olaf

2015-09-01

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

Effects of Workplace Intervention on Affective Well-Being in Employees' Children

ERIC Educational Resources Information Center

Lawson, Katie M.; Davis, Kelly D.; McHale, Susan M.; Almeida, David M.; Kelly, Erin L.; King, Rosalind B.

2016-01-01

Using a group-randomized field experimental design, this study tested whether a workplace intervention--designed to reduce work-family conflict--buffered against potential age-related decreases in the affective well-being of employees' children. Daily diary data were collected from 9- to 17-year-old children of parents working in an information…

Adolescents' Attitudes about Obesity and What They Want in Obesity Prevention Programs

ERIC Educational Resources Information Center

Wilson, Louise F.

2007-01-01

Obesity is a major pediatric public health problem. Adolescents are a priority population for intervention strategies. School nurses are in key positions to design intervention strategies to promote healthy lifestyles and prevent adolescent obesity in the students they serve. To design effective programs, school nurses need to know what components…

Understanding the behavioral linkages needed for designing effective interventions to increase fruit and vegetable intake in diverse populations

USDA-ARS?s Scientific Manuscript database

The design of interventions to increase fruit and vegetable consumption in a population (e.g. all men, all elementary school students) requires an underlying model that organizes the relevant literatures and provides an audience. The mediating-moderating variable model is a statistical analysis tech...

Colour Size Illusion on Liquid Crystal Displays and Design Guidelines for Bioinformatics Tools

ERIC Educational Resources Information Center

Yoo, Hyun Seung; Smith-Jackson, Tonya L.

2011-01-01

Although the influence of colour on size perception has been known for a century, there is only limited research on interventions that can reduce this effect. This study was therefore undertaken in order to identify appropriate interventions and propose design guidelines for information visualisation, especially in applications where size…

The Study Review Process. WWC Process Brief

ERIC Educational Resources Information Center

What Works Clearinghouse, 2017

2017-01-01

Many studies of education interventions make claims about impacts on students' outcomes. Some studies have designs that enable readers to make causal inferences about the effects of an intervention but others have designs that do not permit these types of conclusions. To help policymakers, practitioners, and others make sense of study results, the…

Evaluation of a Local Designated Driver and Responsible Server Program to Prevent Drinking and Driving.

ERIC Educational Resources Information Center

Simons-Morton, Bruce G.; Cummings, Sharon Snider

1997-01-01

Evaluates the impact of beverage servers' interventions at five establishments participating in the Houston Techniques for Effective Alcohol Management (TEAM) program. The intervention included server training, a designated-driver program, and "Safe Ride Home" taxi vouchers. Findings are discussed within the context of scant public and…

Impact of alternative interventions on changes in generic dispensing rates.

PubMed

O'Malley, A James; Frank, Richard G; Kaddis, Atheer; Rothenberg, Barbara M; McNeil, Barbara J

2006-10-01

To evaluate the effectiveness of four alternative interventions (member mailings, advertising campaigns, free generic drug samples to physicians, and physician financial incentives) used by a major health insurer to encourage its members to switch to generic drugs. Using claim-level data from Blue Cross Blue Shield of Michigan, we evaluated the success of four interventions implemented during 2000-2003 designed to increase the use of generic drugs among its members. Around 13 million claims involving seven important classes of drugs were used to assess the effectiveness of the interventions. For each intervention a control group was developed that most closely resembled the corresponding intervention group. Logistic regression models with interaction effects between the treatment group (intervention versus control) and the status of the intervention (active versus not active) were used to evaluate if the interventions had an effect on the generic dispensing rate (GDR). Because the mail order pharmacy was considered more aggressive at converting prescriptions to generics, separate generic purchasing models were fitted to retail and mail order claims. In secondary analyses separate models were also fitted to claims involving a new condition and claims refilled for preexisting conditions. The interventions did not appear to increase the market penetration of generic drugs for either retail or mail order claims, or for claims involving new or preexisting conditions. In addition, we found that the ratio of copayments for brand name to generic drugs had a large positive effect on the GDR. The interventions did not appear to directly influence the GDR. Financial incentives expressed to consumers through benefit designs have a large influence on their switching to generic drugs and on the less-costly mail-order mode of purchase.

Using a gamified monitoring app to change adolescents' snack intake: the development of the REWARD app and evaluation design.

PubMed

Van Lippevelde, W; Vangeel, J; De Cock, N; Lachat, C; Goossens, L; Beullens, K; Vervoort, L; Braet, C; Maes, L; Eggermont, S; Deforche, B; Van Camp, J

2016-08-05

As the snacking pattern of European adolescents is of great concern, effective interventions are necessary. Till now health promotion efforts in children and adolescents have had only limited success in changing adolescents' eating patterns and anthropometrics. Therefore, the present study proposes an innovative approach to influence dietary behaviors in youth based on new insights on effective behavior change strategies and attractive intervention channels to engage adolescents. This article describes the rationale, the development, and evaluation design of the 'Snack Track School' app. The aim of the app is to improve the snacking patterns of Flemish 14- to 16-year olds. The development of the app was informed by the systematic, stepwise, iterative, and collaborative principles of the Intervention Mapping protocol. A four week mHealth intervention was developed based on the dual-system model with behavioral change strategies targeting both the reflective (i.e., active learning, advance organizers, mere exposure, goal-setting, monitoring, and feedback) and automatic processes (i.e., rewards and positive reinforcement). This intervention will be evaluated via a controlled pre-post design in Flemish schools among 1400 adolescents. When this intervention including strategies focused on both the reflective and automatic pathway proves to be effective, it will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion (i.e., incorporation of learning theories in intervention programs). NCT02622165 registrated November 15, 2015 on clinicaltrials.gov.

Using participatory methods to design an mHealth intervention for a low income country, a case study in Chikwawa, Malawi.

PubMed

Laidlaw, Rebecca; Dixon, Diane; Morse, Tracy; Beattie, Tara K; Kumwenda, Save; Mpemberera, Grant

2017-07-05

mHealth holds the potential to educate rural communities in developing countries such as Malawi, on issues which over-burdened and under staffed health centres do not have the facilities to address. Previous research provides support that mHealth could be used as a vehicle for health education campaigns at a community level; however the limited involvement of potential service users in the research process endangers both user engagement and intervention effectiveness. This two stage qualitative study used participatory action research to inform the design and development of an mHealth education intervention. First, secondary analysis of 108 focus groups (representing men, women, leadership, elderly and male and female youth) identified four topics where there was a perceived health education need. Second, 10 subsequent focus groups explored details of this perceived need and the acceptability and feasibility of mHealth implementation in Chikwawa, Malawi. Stage 1 and Stage 2 informed the design of the intervention in terms of target population, intervention content, intervention delivery and the frequency and timing of the intervention. This has led to the design of an SMS intervention targeting adolescents with contraceptive education which they will receive three times per week at 4 pm and will be piloted in the next phase of this research. This study has used participatory methods to identify a need for contraception education in adolescents and inform intervention design. The focus group discussions informed practical considerations for intervention delivery, which has been significantly influenced by the high proportion of users who share mobile devices and the intervention has been designed to allow for message sharing as much as possible.

A motivational counseling approach to improving heart failure self-care: mechanisms of effectiveness.

PubMed

Riegel, Barbara; Dickson, Victoria V; Hoke, Linda; McMahon, Janet P; Reis, Brendali F; Sayers, Steven

2006-01-01

Self-care is an integral component of successful heart failure (HF) management. Engaging patients in self-care can be challenging. Fifteen patients with HF enrolled during hospitalization received a motivational intervention designed to improve HF self-care. A mixed method, pretest posttest design was used to evaluate the proportion of patients in whom the intervention was beneficial and the mechanism of effectiveness. Participants received, on average, 3.0 +/- 1.5 home visits (median 3, mode 3, range 1-6) over a three-month period from an advanced practice nurse trained in motivational interviewing and family counseling. Quantitative and qualitative data were used to judge individual patients in whom the intervention produced a clinically significant improvement in HF self-care. Audiotaped intervention sessions were analyzed using qualitative methods to assess the mechanism of intervention effectiveness. Congruence between quantitative and qualitative judgments of improved self-care revealed that 71.4% of participants improved in self-care after receiving the intervention. Analysis of transcribed intervention sessions revealed themes of 1) communication (reflective listening, empathy); 2) making it fit (acknowledging cultural beliefs, overcoming barriers and constraints, negotiating an action plan); and, 3) bridging the transition from hospital to home (providing information, building skills, activating support resources). An intervention that incorporates the core elements of motivational interviewing may be effective in improving HF self-care, but further research is needed.

A minimal-contact intervention for cardiac inpatients: long-term effects on smoking cessation.

PubMed

Bolman, Catherine; de Vries, Hein; van Breukelen, Gerard

2002-08-01

This study examined the 1-year effects of a minimal-contact smoking cessation intervention for cardiac inpatients. The multicenter study included cardiac inpatients who had smoked prior to hospitalization. A pretest-posttest quasi-experimental design was used. Patients' experimental condition depended on the hospital they were assigned to. The design was partially randomized: 4 of the 11 hospitals selected the experimental condition themselves (2 experimental, 2 control), while the remaining 7 hospitals were randomly assigned. The experimental group consisted of patients of 5 hospitals (N = 388). Patients of 6 other hospitals served as the control group (N = 401). The intervention included stop-smoking advice by the cardiologist, brief counseling by the nurse, the provision of self-help materials, and aftercare by the cardiologist. Logistic regression analyses controlling for baseline differences and covariates did not show significant intervention effects on point prevalence and continuous abstinence. The study also showed that the outcomes were not significantly related to the way hospitals were assigned to the experimental condition. While short-term effects were found, the minimal-contact intervention did not result in significant effects after 12 months, at least if patients lost to follow-up were treated as posttest smokers. Efforts should be made to improve the intervention, especially the aftercare.

Should structural interventions be evaluated using RCTs? The case of HIV prevention.

PubMed

Bonell, Christopher; Hargreaves, James; Strange, Vicki; Pronyk, Paul; Porter, John

2006-09-01

Structural interventions addressing macro-social determinants of risk have been suggested as potentially important adjuncts to biomedical and behavioural interventions for the prevention of HIV and other diseases. A few interventions of this type have been evaluated using randomised controlled trials (RCTs), the most rigorous design to evaluate the effects of biomedical and behavioural interventions. The appropriateness of applying RCTs to structural interventions is however debated. This paper considers whether issues of ethics, feasibility and utility preclude the use of RCTs in evaluations of structural interventions for HIV prevention. We conclude there is nothing particular to this category of interventions prohibiting use of RCTs. However, we suggest that RCTs may prove unacceptable, unfeasible or not useful in certain circumstances, such as where an intervention brings important benefits other than HIV prevention (such as increased income); where leaders of clusters do not allow decisions about macro-social policies to be determined randomly; where the unit of social organization addressed by an intervention is so large that recruitment of adequate numbers of clusters is impossible; and where the period required to trial interventions extends beyond practical decision-making time-scales. In such cases, alternative evaluative designs must be assessed for their ability to provide evidence of intervention effectiveness.

Design and implementation of the Exercise for Health trial -- a pragmatic exercise intervention for women with breast cancer.

PubMed

Hayes, Sandra; Rye, Sheree; Battistutta, Diana; Yates, Patsy; Pyke, Chris; Bashford, John; Eakin, Elizabeth

2011-07-01

Exercise for Health was a pragmatic, randomised, controlled trial comparing the effect of an eight-month exercise intervention on function, treatment-related side effects and quality of life following breast cancer, compared with usual care. The intervention commenced six weeks post-surgery, and two modes of delivering the same intervention was compared with usual care. The purpose of this paper is to describe the study design, along with outcomes related to recruitment, retention and representativeness, and intervention participation. Women newly diagnosed with breast cancer and residing in a major metropolitan city of Queensland, Australia, were eligible to participate. Consenting women were randomised to a face-to-face-delivered exercise group (FtF, n = 67), telephone-delivered exercise group (Tel, n = 67) or usual care group (UC, n = 60) and were assessed pre-intervention (5-weeks post-surgery), mid-intervention (6 months post-surgery) and 10 weeks post-intervention (12 months post-surgery). Each intervention arm entailed 16 sessions with an Exercise Physiologist. Of 318 potentially eligible women, 63% (n = 200) agreed to participate, with a 12-month retention rate of 93%. Participants were similar to the Queensland breast cancer population with respect to disease characteristics, and the randomisation procedure was mostly successful at attaining group balance, with the few minor imbalances observed unlikely to influence intervention effects given balance in other related characteristics. Median participation was 14 (min and max: 0 and 16) and 13 (min and max: 3 and 16) intervention sessions for the FtF and Tel, respectively, with 68% of those in Tel and 82% in FtF participating in at least 75% of sessions. Participation in both intervention arms during and following treatment for breast cancer was feasible and acceptable to women. Future work, designed to inform translation into practice, will evaluate the quality of life, clinical, psychosocial and behavioural outcomes associated with each mode of delivery. Copyright © 2011 Elsevier Inc. All rights reserved.

Food Choice Architecture: An Intervention in a Secondary School and its Impact on Students' Plant-based Food Choices.

PubMed

Ensaff, Hannah; Homer, Matt; Sahota, Pinki; Braybrook, Debbie; Coan, Susan; McLeod, Helen

2015-06-02

With growing evidence for the positive health outcomes associated with a plant-based diet, the study's purpose was to examine the potential of shifting adolescents' food choices towards plant-based foods. Using a real world setting of a school canteen, a set of small changes to the choice architecture was designed and deployed in a secondary school in Yorkshire, England. Focussing on designated food items (whole fruit, fruit salad, vegetarian daily specials, and sandwiches containing salad) the changes were implemented for six weeks. Data collected on students' food choice (218,796 transactions) enabled students' (980 students) selections to be examined. Students' food choice was compared for three periods: baseline (29 weeks); intervention (six weeks); and post-intervention (three weeks). Selection of designated food items significantly increased during the intervention and post-intervention periods, compared to baseline (baseline, 1.4%; intervention 3.0%; post-intervention, 2.2%) χ(2)(2) = 68.1, p < 0.001. Logistic regression modelling also revealed the independent effect of the intervention, with students 2.5 times as likely (p < 0.001) to select the designated food items during the intervention period, compared to baseline. The study's results point to the influence of choice architecture within secondary school settings, and its potential role in improving adolescents' daily food choices.

The effect of a researcher designated music intervention on hospitalised psychiatric patients with different levels of anxiety.

PubMed

Yang, Chyn-Yng; Miao, Nae-Fang; Lee, Tso-Ying; Tsai, Jui-Chen; Yang, Hui-Ling; Chen, Wen-Chun; Chung, Min-Huey; Liao, Yuan-Mei; Chou, Kuei-Ru

2016-03-01

The purpose of this study was to investigate the effects of a music intervention on hospitalised psychiatric patients with different levels of anxiety. In clinical practice, psychiatric inpatients and nurses routinely suffer from anxiety. A music intervention may possibly be useful, but knowledge as to how useful and how effective it is in patients with different levels of anxiety is limited. The study design was a three-group, repeated-measures experimental study. Subjects were 22 psychiatric patients who were divided into three groups based on their level of anxiety. They listened to 20 minutes of music each day for 10 days and were assessed using the Beck Anxiety Inventory before and after the music intervention and at a one-week follow-up; an electroencephalogram and finger temperature were monitored before and during the music intervention. Anxiety levels of all three groups showed a significant difference (p = 0·0339) after the intervention. The difference alpha and beta electroencephalogram percentages for all three groups showed a significant difference (p = 0·04; p = 0·01). The finger temperature showed a non-significant difference (p = 0·41). A music intervention can effectively alleviate the anxiety of hospitalised psychiatric patients who suffer from all levels of anxiety. The study recommends a practice in alleviating anxiety. Effective lower-cost interventions to reduce anxiety in psychiatric inpatient settings would be of interest to nurses and benefit patients. © 2016 John Wiley & Sons Ltd.

Neighborhood Effects in a Behavioral Randomized Controlled Trial

PubMed Central

Pruitt, Sandi L.; Leonard, Tammy; Murdoch, James; Hughes, Amy; McQueen, Amy; Gupta, Samir

2015-01-01

Randomized controlled trials (RCTs) of interventions intended to modify health behaviors may be influenced by neighborhood effects which can impede unbiased estimation of intervention effects. Examining a RCT designed to increase colorectal cancer (CRC) screening (N=5,628), we found statistically significant neighborhood effects: average CRC test use among neighboring study participants was significantly and positively associated with individual patient’s CRC test use. This potentially important spatially-varying covariate has not previously been considered in a RCT. Our results suggest that future RCTs of health behavior interventions should assess potential social interactions between participants, which may cause intervention arm contamination and may bias effect size estimation. PMID:25456014

Systematic Review of Interventions to Prevent Spread of Sexually Transmitted Infections, Including HIV, Among Young People in Europe

PubMed Central

Lazarus, Jeffrey V.; Sihvonen-Riemenschneider, Henna; Laukamm-Josten, Ulrich; Wong, Fiona; Liljestrand, Jerker

2010-01-01

Aim To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STI), including HIV, among young people in the European Union. Methods For this systematic review, we examined interventions that aimed at STI risk reduction and health promotion conducted in schools, clinics, and in the community for reported effectiveness (in changing sexual behavior and/or knowledge) between 1995 and 2005. We also reviewed study design and intervention methodology to discover how these factors affected the results, and we compiled a list of characteristics associated with successful and unsuccessful programs. Studies were eligible if they employed a randomized control design or intervention-only design that examined change over time and measured behavioral, biologic, or certain psychosocial outcomes. Results Of the 19 studies that satisfied our review criteria, 11 reported improvements in the sexual health knowledge and/or attitudes of young people. Ten of the 19 studies aimed to change sexual risk behavior and 3 studies reported a significant reduction in a specific aspect of sexual risk behavior. Two of the interventions that led to behavioral change were peer-led and the other was teacher-led. Only 1 of the 8 randomized controlled trials reported any statistically significant change in sexual behavior, and then only for young females. Conclusion The young people studied were more accepting of peer-led than teacher-led interventions. Peer-led interventions were also more successful in improving sexual knowledge, though there was no clear difference in their effectiveness in changing behavior. The improvement in sexual health knowledge does not necessarily lead to behavioral change. While knowledge may help improve health-seeking behavior, additional interventions are needed to reduce STIs among young people. PMID:20162748

Supermarket and grocery store-based interventions to promote healthful food choices and eating practices: a systematic review.

PubMed

Escaron, Anne L; Meinen, Amy M; Nitzke, Susan A; Martinez-Donate, Ana P

2013-04-11

Increasingly high rates of obesity have heightened interest among researchers and practitioners in identifying evidence-based interventions to increase access to healthful foods and beverages. Because most food purchasing decisions are made in food stores, such settings are optimal for interventions aimed at influencing these decisions. The objective of this review was to synthesize the evidence on supermarket and grocery store interventions to promote healthful food choices. We searched PubMed through July 2012 to identify original research articles evaluating supermarket and grocery store interventions that promoted healthful food choices. We categorized each intervention by type of intervention strategy and extracted and summarized data on each intervention. We developed a scoring system for evaluating each intervention and assigned points for study design, effectiveness, reach, and availability of evidence. We averaged points for each intervention category and compared the strength of the evidence for each category. We identified 58 articles and characterized 33 interventions. We found 7 strategies used alone or in combination. The most frequently used strategy was the combination of point-of-purchase and promotion and advertising (15 interventions); evidence for this category was scored as sufficient. On average, of 3 points possible, the intervention categories scored 2.6 for study design, 1.1 for effectiveness, 0.3 for reach, and 2 for availability of evidence. Three categories showed sufficient evidence; 4 showed insufficient evidence; none showed strong evidence. More rigorous testing of interventions aimed at improving food and beverage choices in food stores, including their effect on diet and health outcomes, is needed.

Supermarket and Grocery Store–Based Interventions to Promote Healthful Food Choices and Eating Practices: A Systematic Review

PubMed Central

Meinen, Amy M.; Nitzke, Susan A.; Martinez-Donate, Ana P.

2013-01-01

Introduction Increasingly high rates of obesity have heightened interest among researchers and practitioners in identifying evidence-based interventions to increase access to healthful foods and beverages. Because most food purchasing decisions are made in food stores, such settings are optimal for interventions aimed at influencing these decisions. The objective of this review was to synthesize the evidence on supermarket and grocery store interventions to promote healthful food choices. Methods We searched PubMed through July 2012 to identify original research articles evaluating supermarket and grocery store interventions that promoted healthful food choices. We categorized each intervention by type of intervention strategy and extracted and summarized data on each intervention. We developed a scoring system for evaluating each intervention and assigned points for study design, effectiveness, reach, and availability of evidence. We averaged points for each intervention category and compared the strength of the evidence for each category. Results We identified 58 articles and characterized 33 interventions. We found 7 strategies used alone or in combination. The most frequently used strategy was the combination of point-of-purchase and promotion and advertising (15 interventions); evidence for this category was scored as sufficient. On average, of 3 points possible, the intervention categories scored 2.6 for study design, 1.1 for effectiveness, 0.3 for reach, and 2 for availability of evidence. Three categories showed sufficient evidence; 4 showed insufficient evidence; none showed strong evidence. Conclusion More rigorous testing of interventions aimed at improving food and beverage choices in food stores, including their effect on diet and health outcomes, is needed. PMID:23578398

Group interventions for co-morbid insomnia and osteoarthritis pain in primary care: the lifestyles cluster randomized trial design.

PubMed

Von Korff, Michael; Vitiello, Michael V; McCurry, Susan M; Balderson, Benjamin H; Moore, Amy L; Baker, Laura D; Yarbro, Patricia; Saunders, Kathleen; Keefe, Francis J; Rybarczyk, Bruce D

2012-07-01

Six weekly sessions of group cognitive-behavioral therapy for insomnia and osteoarthritis pain (CBT-PI), and for osteoarthritis pain alone (CBT-P) were compared to an education only control (EOC). Basic education about pain and sleep was comparable, so EOC controlled for information and group participation. Active interventions differed from EOC in training pain coping skills (CBT-P and CBT-PI) and sleep enhancement techniques (CBT-PI). Persons with osteoarthritis age 60 or older were screened for osteoarthritis pain and insomnia severity via mailed survey. Primary outcomes were pain severity (pain intensity and interference ratings from the Graded Chronic Pain Scale) and insomnia severity (Insomnia Severity Index). Secondary outcomes were arthritis pain (AIMS-2 symptom scale) and sleep efficiency assessed by wrist actigraphy. Ancillary outcomes included: cognitive function, depression, and health care use. A clustered randomized design provided adequate power to identify moderate effects on primary outcomes (effect size>0.35). Modified intent to treat analyses, including all participants who attended the first session, assessed effects across CBT-PI, CBT-P, and EOC groups. Treatment effects were assessed post-intervention (2 months) and at 9 months, with durability of intervention effects evaluated at 18 months. The trial was executed in 6 primary clinics, randomizing 367 participants, with 93.2% of randomized patients attending at least 4 group sessions. Response rates for post-intervention and 9 month assessments were 96.7% and 92.9% respectively. This hybrid efficacy-effectiveness trial design evaluates whether interventions yield specific benefits for clinical and behavioral outcomes relative to an education only control when implemented in a primary care setting. Copyright © 2012 Elsevier Inc. All rights reserved.

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.

Moderators of wellbeing interventions: Why do some people respond more positively than others?

PubMed Central

Nelson-Coffey, S. Katherine; Layous, Kristin; Jacobs Bao, Katherine; Davis, Oliver S. P.; Haworth, Claire M. A.

2017-01-01

Interventions rarely have a universal effect on all individuals. Reasons ranging from participant characteristics, context and fidelity of intervention completion could cause some people to respond more positively than others. Understanding these individual differences in intervention response may provide clues to the mechanisms behind the intervention, as well as inform future designs to make interventions maximally beneficial for all. Here we focus on an intervention designed to improve adolescent wellbeing, and explore potential moderators using a representative and well-powered sample. 16-year old participants (N = 932) in the Twins Wellbeing Intervention Study logged online once a week to complete control and wellbeing-enhancing activities consecutively. Throughout the study participants also provided information about a range of potential moderators of intervention response including demographics, seasonality, personality, baseline characteristics, activity fit, and effort. As expected, some individuals gained more from the intervention than others; we used multi-level modelling to test for moderation effects that could explain these individual differences. Of the 15 moderators tested, none significantly explained individual differences in intervention response in the intervention and follow-up phases. Self-reported effort and baseline positive affect had a notable effect in moderating response in the control phase, during which there was no overall improvement in wellbeing and mental health. Our results did not replicate the moderation effects that have been suggested by previous literature and future work needs to reconcile these differences. They also show that factors that have previously been shown to influence baseline wellbeing do not also influence an individual’s ability to benefit from a wellbeing intervention. Although future research should continue to explore potential moderators of intervention efficacy, our results suggest that the beneficial effect of positive activities in adolescents were universal across such factors as sex and socioeconomic status, bolstering claims of the scalability of positive activities to increase adolescent wellbeing. PMID:29107994

Moderators of wellbeing interventions: Why do some people respond more positively than others?

PubMed

Wang, R Adele H; Nelson-Coffey, S Katherine; Layous, Kristin; Jacobs Bao, Katherine; Davis, Oliver S P; Haworth, Claire M A

2017-01-01

Interventions rarely have a universal effect on all individuals. Reasons ranging from participant characteristics, context and fidelity of intervention completion could cause some people to respond more positively than others. Understanding these individual differences in intervention response may provide clues to the mechanisms behind the intervention, as well as inform future designs to make interventions maximally beneficial for all. Here we focus on an intervention designed to improve adolescent wellbeing, and explore potential moderators using a representative and well-powered sample. 16-year old participants (N = 932) in the Twins Wellbeing Intervention Study logged online once a week to complete control and wellbeing-enhancing activities consecutively. Throughout the study participants also provided information about a range of potential moderators of intervention response including demographics, seasonality, personality, baseline characteristics, activity fit, and effort. As expected, some individuals gained more from the intervention than others; we used multi-level modelling to test for moderation effects that could explain these individual differences. Of the 15 moderators tested, none significantly explained individual differences in intervention response in the intervention and follow-up phases. Self-reported effort and baseline positive affect had a notable effect in moderating response in the control phase, during which there was no overall improvement in wellbeing and mental health. Our results did not replicate the moderation effects that have been suggested by previous literature and future work needs to reconcile these differences. They also show that factors that have previously been shown to influence baseline wellbeing do not also influence an individual's ability to benefit from a wellbeing intervention. Although future research should continue to explore potential moderators of intervention efficacy, our results suggest that the beneficial effect of positive activities in adolescents were universal across such factors as sex and socioeconomic status, bolstering claims of the scalability of positive activities to increase adolescent wellbeing.

Music-based interventions to reduce internalizing symptoms in children and adolescents: A meta-analysis.

PubMed

Geipel, Josephine; Koenig, Julian; Hillecke, Thomas K; Resch, Franz; Kaess, Michael

2018-01-01

Existing systematic reviews provide evidence that music therapy is an effective intervention in the treatment of children and adolescents with psychopathology. The objective of the present review was to systematically review and quantify the effects of music-based interventions in reducing internalizing symptoms (i.e., depression and anxiety) in children and adolescents using a meta-analytical approach. Databases and journals were systematically screened for studies eligible for inclusion in meta-analysis on the effects of music-based interventions in reducing internalizing symptoms. A random-effect meta-analysis using standardized mean differences (SMD) was conducted. Five studies were included. Analysis of data from (randomized) controlled trials, yielded a significant main effect (Hedge's g = -0.73; 95%CI [-1.42;-0.04], Z = 2.08, p = 0.04, k = 5), indicating a greater reduction of internalizing symptoms in youth receiving music-based interventions (n = 100) compared to different control group interventions (n = 95). The existing evidence is limited to studies of low power and methodological quality. Included studies were highly heterogeneous with respect to the nature of the intervention, the measurements applied, the samples studied, and the study design. Findings indicate that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents. While these results are encouraging with respect to the application of music-based intervention, rigorous research is necessary to replicate existing findings and provide a broader base of evidence. More research adopting well controlled study designs of high methodological quality is needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Quasi-experimental designs in practice-based research settings: design and implementation considerations.

PubMed

Handley, Margaret A; Schillinger, Dean; Shiboski, Stephen

2011-01-01

Although randomized controlled trials are often a gold standard for determining intervention effects, in the area of practice-based research (PBR), there are many situations in which individual randomization is not possible. Alternative approaches to evaluating interventions have received increased attention, particularly those that can retain elements of randomization such that they can be considered "controlled" trials. Methodological design elements and practical implementation considerations for two quasi-experimental design approaches that have considerable promise in PBR settings--the stepped-wedge design, and a variant of this design, a wait-list cross-over design, are presented along with a case study from a recent PBR intervention for patients with diabetes. PBR-relevant design features include: creation of a cohort over time that collects control data but allows all participants (clusters or patients) to receive the intervention; staggered introduction of clusters; multiple data collection points; and one-way cross-over into the intervention arm. Practical considerations include: randomization versus stratification, training run in phases; and extended time period for overall study completion. Several design features of practice based research studies can be adapted to local circumstances yet retain elements to improve methodological rigor. Studies that utilize these methods, such as the stepped-wedge design and the wait-list cross-over design, can increase the evidence base for controlled studies conducted within the complex environment of PBR.

A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students.

PubMed

Gallagher, Ruth W; Polanin, Joshua R

2015-02-01

Increasing professional nurses' and nursing students cultural competence has been identified as one way to decrease the disparity of care for vulnerable and minority groups, but effectiveness of training programs to increase competence remains equivocal. The purpose of this project is to synthesize educational interventions designed to increase cultural competence in professional nurses and nursing students. A systematic review and meta-analysis was conducted to synthesize all existing studies on increasing cultural competence. A comprehensive search and screen procedures was conducted to locate all cultural competence interventions implemented with professional nurses and nursing students. Two independent researchers screened and coded the included studies. Effect sizes were calculated for each study and a random-effects meta-analysis was conducted. A total of 25 studies were included in the review. Two independent syntheses were conducted given the disparate nature of the effect size metrics. For the synthesis of treatment-control designed studies, the results revealed a non-statistically significant increase in cultural competence (g¯=.38, 95% CI: -.05, .79, p=.08). Moderator analyses indicated significant variation as a function of the measurements, participant types, and funding source. The pretest-posttest effect size synthesis revealed a significant increase in overall cultural competence (g¯=.45, 95% CI: .24, .66, p<.01). Moderator analyses indicated, however, that the effect sizes varied as functions of the measurement, funding source, and publication type. Interventions to increase cultural competence have shown varied effectiveness. Greater research is required to improve these interventions and promote cultural competence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rigorously Assessing Whether the Data Backs the Back School

PubMed Central

Vinh, David T.; Johnson, Craig W.; Phelps, Cynthia L.

2003-01-01

A rigorous between-subjects methodology employing independent random samples and having broad clinical applicability was designed and implemented to evaluate the effectiveness of back safety and patient transfer training interventions for both hospital nurses and nursing assistants. Effects upon self-efficacy, cognitive, and affective measures are assessed for each of three back safety procedures. The design solves the problem of obtaining randomly assigned independent controls where all experimental subjects must participate in the training interventions. PMID:14728544

Methodology Series Module 4: Clinical Trials.

PubMed

Setia, Maninder Singh

2016-01-01

In a clinical trial, study participants are (usually) divided into two groups. One group is then given the intervention and the other group is not given the intervention (or may be given some existing standard of care). We compare the outcomes in these groups and assess the role of intervention. Some of the trial designs are (1) parallel study design, (2) cross-over design, (3) factorial design, and (4) withdrawal group design. The trials can also be classified according to the stage of the trial (Phase I, II, III, and IV) or the nature of the trial (efficacy vs. effectiveness trials, superiority vs. equivalence trials). Randomization is one of the procedures by which we allocate different interventions to the groups. It ensures that all the included participants have a specified probability of being allocated to either of the groups in the intervention study. If participants and the investigator know about the allocation of the intervention, then it is called an "open trial." However, many of the trials are not open - they are blinded. Blinding is useful to minimize bias in clinical trials. The researcher should familiarize themselves with the CONSORT statement and the appropriate Clinical Trials Registry of India.

Methodology Series Module 4: Clinical Trials

PubMed Central

Setia, Maninder Singh

2016-01-01

In a clinical trial, study participants are (usually) divided into two groups. One group is then given the intervention and the other group is not given the intervention (or may be given some existing standard of care). We compare the outcomes in these groups and assess the role of intervention. Some of the trial designs are (1) parallel study design, (2) cross-over design, (3) factorial design, and (4) withdrawal group design. The trials can also be classified according to the stage of the trial (Phase I, II, III, and IV) or the nature of the trial (efficacy vs. effectiveness trials, superiority vs. equivalence trials). Randomization is one of the procedures by which we allocate different interventions to the groups. It ensures that all the included participants have a specified probability of being allocated to either of the groups in the intervention study. If participants and the investigator know about the allocation of the intervention, then it is called an “open trial.” However, many of the trials are not open – they are blinded. Blinding is useful to minimize bias in clinical trials. The researcher should familiarize themselves with the CONSORT statement and the appropriate Clinical Trials Registry of India. PMID:27512184

Effects of a Randomized Couple-Based Intervention on Quality of Life of Breast Cancer Patients and Their Partners

ERIC Educational Resources Information Center

Kayser, Karen; Feldman, Barry N.; Borstelmann, Nancy A.; Daniels, Ann A.

2010-01-01

The purpose of this study was to determine the effectiveness of a couple-based intervention on the quality of life (QOL) of early-stage breast cancer patients and their partners. A randomized controlled design was used to assign couples to either the hospital standard social work services (SSWS) or a couple-based intervention, the Partners in…

The Effects of Working at Gaining Employment Skills on the Social and Vocational Skills of Adolescents with Disabilities: A School-Based Intervention

ERIC Educational Resources Information Center

Murray, Christopher; Doren, Bonnie

2013-01-01

The current investigation was designed to evaluate the effects of the Working at Gaining Employment Skills (WAGES) curriculum on the social and occupational skills of adolescents with disabilities. Adolescents with disabilities were assigned to either an intervention or control condition. Youth in the intervention group were exposed to the WAGES…

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…

The Effectiveness of Using a Social Story Intervention to Improve Social Interaction Skills of Students with Autism

ERIC Educational Resources Information Center

Al zyoudi, Mohammed; Al Murhairi, Oshua; Sartaiwi, AbedAlziz; Olimat, Enas; Al zyoudi, Abedsalm

2016-01-01

The aim of this study was to evaluate the effectiveness of using a social story intervention to improve social interaction skills in three students with autism aged between 7-8 years. A multiple-baseline-across participants design was used. To achieve the purpose of the study, the social stories were implemented. The intervention included reading…

Lifestyle interventions and independence for elders study: Recruitment and baseline characteristics

USDA-ARS?s Scientific Manuscript database

Recruitment of older adults into long-term clinical trials involving behavioral interventions is a significant challenge. The Lifestyle Interventions and Independence for Elders (LIFE) Study is a Phase 3 multicenter randomized controlled multisite trial, designed to compare the effects of a moderate...

Mindfulness-based Intervention in Elementary School Students With Anxiety and Depression: A Series of n-of-1 Trials on Effects and Feasibility

PubMed Central

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

2017-01-01

Mindfulness-based interventions constitute a promising option to address anxiety and depression in elementary school students. This study evaluated the effect of a mindfulness-based intervention on anxiety and depression in elementary school students with a diagnosis of anxiety or depression disorder. A single-subject experimental A-B-A design was used. Participants were three elementary school students from grades three and four, along with their teacher. Anxiety and depression were measured on 10 occasions at baseline, during the intervention, and at follow-up. Primary hypotheses were tested using a univariate single case multilevel modeling strategy and visual analysis. Following intervention, 2 participants reported improvements on anxiety and depression, while their teachers reported deteriorating scores on these variables. Results from this n-of-1 trial design is consistent with other work suggesting caution with regard to the overall impact and efficacy of mindfulness-based interventions as a universal treatment option for youth. Future research is warranted. PMID:28853297

Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis.

PubMed

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

2017-08-15

Online and mobile telephone applications ('apps') have the potential to improve the scalability of effective interventions for suicidal ideation and self-harm. The aim of this review was therefore to investigate the effectiveness of digital interventions for the self-management of suicidal ideation or self-harm. Seven databases (Applied Science & Technology; CENTRAL; CRESP; Embase; Global Health; PsycARTICLES; PsycINFO; Medline) were searched to 31 March, 2017. Studies that examined the effectiveness of digital interventions for suicidal ideation and/or self-harm, or which reported outcome data for suicidal ideation and/or self-harm, within a randomised controlled trial (RCT), pseudo-RCT, or observational pre-test/post-test design were included in the review. Fourteen non-overlapping studies were included, reporting data from a total of 3,356 participants. Overall, digital interventions were associated with reductions for suicidal ideation scores at post-intervention. There was no evidence of a treatment effect for self-harm or attempted suicide. Most studies were biased in relation to at least one aspect of study design, and particularly the domains of participant, clinical personnel, and outcome assessor blinding. Performance and detection bias therefore cannot be ruled out. Digital interventions for suicidal ideation and self-harm may be more effective than waitlist control. It is unclear whether these reductions would be clinically meaningful at present. Further evidence, particularly with regards to the potential mechanisms of action of these interventions, as well as safety, is required before these interventions could recommended.

The Perils of Ignoring Design Effects in Experimental Studies: Lessons from a Mammography Screening Trial

PubMed Central

Glenn, Beth A.; Bastani, Roshan; Maxwell, Annette E.

2013-01-01

Objective Threats to external validity including pretest sensitization and the interaction of selection and an intervention are frequently overlooked by researchers despite their potential to significantly influence study outcomes. The purpose of this investigation was to conduct secondary data analyses to assess the presence of external validity threats in the setting of a randomized trial designed to promote mammography use in a high risk sample of women. Design During the trial, recruitment and intervention implementation took place in three cohorts (with different ethnic composition), utilizing two different designs (pretest-posttest control group design; posttest only control group design). Results Results reveal that the intervention produced different outcomes across cohorts, dependent upon the research design used and the characteristics of the sample. Conclusion These results illustrate the importance of weighing the pros and cons of potential research designs before making a selection and attending more closely to issues of external validity. PMID:23289517

The Effects of the Mystery Motivator Intervention in an Urban Classroom

ERIC Educational Resources Information Center

Beeks, Amirah; Graves, Scott, Jr.

2016-01-01

The purpose of this project was to examine the effect of the implementation of the Mystery Motivator intervention as an interdependent group contingency to decrease disruptive behavior in an urban eighth-grade general education science classroom. The study was conducted using an A-B changing criterion design. The effectiveness of the intervention…

A Meta-Analytic Review of Obesity Prevention Programs for Children and Adolescents: The Skinny on Interventions that Work

ERIC Educational Resources Information Center

Stice, Eric; Shaw, Heather; Marti, C. Nathan

2006-01-01

This meta-analytic review summarizes obesity prevention programs and their effects and investigates participant, intervention, delivery, and design features associated with larger effects. A literature search identified 64 prevention programs seeking to produce weight gain prevention effects, of which 21% produced significant prevention effects…

Relative Effects of Interventions Supporting the Social Competence of Young Children with Disabilities.

ERIC Educational Resources Information Center

Odom, Samuel L.; McConnell, Scott R.; McEvoy, Mary A.; Peterson, Carla; Ostrosky, Michaelene; Chandler, Lynette K.; Spicuzza, Richard J.; Skellenger, Annette; Creighton, Michelle; Favazza, Paddy C.

1999-01-01

A study compared the effects of different intervention approaches designed to promote peer-related social competence of 83 preschool children with disabilities. Analyses indicated that the peer-mediated condition had the greatest and most sustained effect on children's participation in social interaction and on the quality of interaction.…

Effectiveness and Acceptability of Parent-Implemented Behavior Interventions for Children with Autism in Three African American Families

ERIC Educational Resources Information Center

Robertson, Rachel E.

2016-01-01

No studies of parent-implemented behavior interventions for children with autism spectrum disorders (ASD) have purposefully examined their effectiveness and acceptability with African American families. The present study used a multiple baseline across participants design to evaluate the effectiveness of parent-implemented differential…

Providing Classroom-Based Intervention to At-Risk Students to Support Their Academic Engagement and Interactions with Peers

ERIC Educational Resources Information Center

Ornelles, Cecily

2007-01-01

In this study, the author used a multiple baseline design to evaluate the effects of a structured intervention on the engagement and initiations of 3 children identified as at-risk for school difficulty. The intervention had two phases. During intervention (Phase 1) the students received 9 15-min instructional sessions. The intervention had 3…

Web-Based Positive Psychology Interventions: A Reexamination of Effectiveness.

PubMed

Woodworth, Rosalind J; O'Brien-Malone, Angela; Diamond, Mark R; Schüz, Benjamin

2017-03-01

Seligman, Steen, Park, and Peterson (2005) suggested that positive psychology interventions (PPIs) contain specific, powerful, therapeutic ingredients that effect greater increases in happiness and reductions in depression than a placebo control. This study reexamined the three PPIs that Seligman et al. found to be most effective when delivered over the internet. Three PPIs and a placebo control, identical with the interventions used by Seligman et al., were examined in a web-based, randomized assignment design. Mixed-design analysis of variance and multilevel modeling showed that all interventions, including the placebo, led to significant increases in happiness and reductions in depression. The effects of PPIs were indistinguishable from those of the placebo control. Using web-based delivery, both PPIs and theoretically neutral placebos can increase happiness and reduce depression in self-selected populations. Possible explanations include that non-specific factors common to most therapeutic treatments are responsible for the observed changes, or that cultural or other context-related variables operate to account for the divergent findings. © 2016 Wiley Periodicals, Inc.

A Methodological Framework for Model Selection in Interrupted Time Series Studies.

PubMed

Lopez Bernal, J; Soumerai, S; Gasparrini, A

2018-06-06

Interrupted time series is a powerful and increasingly popular design for evaluating public health and health service interventions. The design involves analysing trends in the outcome of interest and estimating the change in trend following an intervention relative to the counterfactual (the expected ongoing trend if the intervention had not occurred). There are two key components to modelling this effect: first, defining the counterfactual; second, defining the type of effect that the intervention is expected to have on the outcome, known as the impact model. The counterfactual is defined by extrapolating the underlying trends observed before the intervention to the post-intervention period. In doing this, authors must consider the pre-intervention period that will be included, any time varying confounders, whether trends may vary within different subgroups of the population and whether trends are linear or non-linear. Defining the impact model involves specifying the parameters that model the intervention, including for instance whether to allow for an abrupt level change or a gradual slope change, whether to allow for a lag before any effect on the outcome, whether to allow a transition period during which the intervention is being implemented and whether a ceiling or floor effect might be expected. Inappropriate model specification can bias the results of an interrupted time series analysis and using a model that is not closely tailored to the intervention or testing multiple models increases the risk of false positives being detected. It is important that authors use substantive knowledge to customise their interrupted time series model a priori to the intervention and outcome under study. Where there is uncertainty in model specification, authors should consider using separate data sources to define the intervention, running limited sensitivity analyses or undertaking initial exploratory studies. Copyright © 2018. Published by Elsevier Inc.

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.

Prevention of depression and anxiety in later life: design of a randomized controlled trial for the clinical and economic evaluation of a life-review intervention

PubMed Central

Korte, Jojanneke; Bohlmeijer, Ernst T; Smit, Filip

2009-01-01

Background Depressive and anxiety symptoms in older adults could develop into significant health problems with detrimental effects on quality of life and a possibly poor prognosis. Therefore, there is a need for preventive interventions which are at once effective, acceptable and economic affordable. Methods and design This paper describes the design of a study evaluating "The stories we live by", a preventive life-review group intervention, which was recently developed for adults of 55 years and over with depressive and anxiety symptoms. Both clinical and economic effectiveness will be evaluated in a pragmatic randomized controlled trial. The participants in the intervention condition will receive the 8-session preventive intervention. The participants in the control condition will have access to usual care. Clinical end-terms are depressive and anxiety symptoms, current major depressive episode, quality of life and positive mental health post-treatment (3 months after baseline) and at follow-ups (6 and 12 months after baseline). Additional goals of this study are to identify groups for whom the intervention is particularly effective and to identify the therapeutic pathways that are vital in inducing clinical change. This will be done by analyzing if treatment response is moderated by demographics, personality, past major depressive episodes, important life events and chronically disease, and mediated by reminiscence functions, perceived control, automatic positive thoughts and meaning in life. Finally the cost-effectiveness of the intervention relative to care as usual will be assessed by computing incremental costs per case of depression and anxiety avoided (cost-effectiveness) and per quality adjusted life year (QALY) (cost utility). Discussion It is expected that both the life-review intervention and its evaluation will contribute to the existing body of knowledge in several ways. First, the intervention is unique in linking life-review with narrative therapy and in its focus on specific, positive memories. Second, the evaluation is likely to answer questions regarding the acceptability and cost-effectiveness of life-review that have not been addressed thoroughly until now. Positive results of this study will make available a new evidence-based intervention to improve public health among people of 55 years and over. Trial registration Nederlands Trial Register TC = 1860. PMID:19619284

School-based peer-related social competence interventions for children with autism spectrum disorder: a meta-analysis and descriptive review of single case research design studies.

PubMed

Whalon, Kelly J; Conroy, Maureen A; Martinez, Jose R; Werch, Brittany L

2015-06-01

The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old with an ASD, and took place in school settings. Articles were analyzed descriptively and using the evaluative method to determine study quality. Additionally, effect size estimates were calculated using nonoverlap of all pairs method and Tau-U. A total of 37 studies including 105 children were reviewed. Overall, ES estimates ranged from weak to strong, but on average, the reviewed interventions produced a moderate to strong effect, and quality ratings were generally in the acceptable to high range. Findings suggest that children with ASD can benefit from social skill interventions implemented with peers in school settings.

Responses to Struggling, K-2 Readers and Writers: Early Literacy Intervention in Three Urban Schools

ERIC Educational Resources Information Center

Mooney, Kathleen C.

2009-01-01

An abundance of research on early literacy intervention indicates that struggling, K-2 readers and writers can be effectively supported through the receipt of intervention services in school; however, research in the area has not yet addressed study of the unique, contextualized design and implementation of early literacy intervention in different…

Decreasing Uncorrected Refractive Error in the Classroom through a Multifactorial Pilot Intervention

ERIC Educational Resources Information Center

Kodjebacheva, Gergana; Maliski, Sally; Yu, Fei; Oelrich, Faye; Coleman, Anne L.

2014-01-01

The study assessed the effectiveness of a pilot intervention to promote the use of eyeglasses in one school in California. The intervention used a one-group pretest, posttest design. Between January and June 2011, during the intervention, all first- and second-grade children received eye evaluations and the children with refractive error received…

The Effectiveness of a Technologically Facilitated Classroom-Based Early Reading Intervention: The Targeted Reading Intervention

ERIC Educational Resources Information Center

Amendum, Steven J.; Vernon-Feagans, Lynne; Ginsberg, Marnie C.

2011-01-01

The purpose of this study was to evaluate the efficacy of a classroom-teacher-delivered reading intervention for struggling readers called the Targeted Reading Intervention (TRI), designed particularly for kindergarten and first-grade teachers and their struggling students in rural, low-wealth communities. The TRI was delivered via an innovative…

Using e-Coaching to Support an Early Intervention Provider's Implementation of a Functional Assessment-Based Intervention

ERIC Educational Resources Information Center

Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.

2016-01-01

This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…

Learning Rates and Known-to-Unknown Flash-Card Ratios: Comparing Effectiveness While Holding Instructional Time Constant

ERIC Educational Resources Information Center

Forbes, Bethany E.; Skinner, Christopher H.; Black, Michelle P.; Yaw, Jared; Booher, Joshua; Delisle, Jean

2013-01-01

Using alternating treatments designs, we compared learning rates across 2 computer-based flash-card interventions (3?min each): a traditional drill intervention with 15 unknown words and an interspersal intervention with 12 known words and 3 unknown words. Each student acquired more words under the traditional drill intervention. Discussion…

Experimental Design and Primary Data Analysis Methods for Comparing Adaptive Interventions

PubMed Central

Nahum-Shani, Inbal; Qian, Min; Almirall, Daniel; Pelham, William E.; Gnagy, Beth; Fabiano, Greg; Waxmonsky, Jim; Yu, Jihnhee; Murphy, Susan

2013-01-01

In recent years, research in the area of intervention development is shifting from the traditional fixed-intervention approach to adaptive interventions, which allow greater individualization and adaptation of intervention options (i.e., intervention type and/or dosage) over time. Adaptive interventions are operationalized via a sequence of decision rules that specify how intervention options should be adapted to an individual’s characteristics and changing needs, with the general aim to optimize the long-term effectiveness of the intervention. Here, we review adaptive interventions, discussing the potential contribution of this concept to research in the behavioral and social sciences. We then propose the sequential multiple assignment randomized trial (SMART), an experimental design useful for addressing research questions that inform the construction of high-quality adaptive interventions. To clarify the SMART approach and its advantages, we compare SMART with other experimental approaches. We also provide methods for analyzing data from SMART to address primary research questions that inform the construction of a high-quality adaptive intervention. PMID:23025433

Physical activity interventions differentially affect exercise task and barrier self-efficacy: a meta-analysis.

PubMed

Higgins, Torrance J; Middleton, Kathryn R; Winner, Larry; Janelle, Christopher M

2014-08-01

Researchers have yet to establish how interventions to increase physical activity influence specific self-efficacy beliefs. The current study sought to quantify the effect of interventions to increase physical activity among healthy adults on exercise task (EXSE) and barrier self-efficacy (BSE) via meta-analysis. Intervention characteristics associated with self-efficacy and physical activity changes were also identified. A systematic database search and manual searches through reference lists of related publications were conducted for articles on randomized, controlled physical activity interventions. Published intervention studies reporting changes in physical activity behavior and either EXSE or BSE in healthy adults were eligible for inclusion. Of the 1,080 studies identified, 20 were included in the meta-analyses. Interventions had a significant effect of g = 0.208, 95% confidence interval (CI) [0.027, 0.388], p < .05, on EXSE; g = 0.128, 95% CI [0.05, 0.20], p < .05 on BSE; and g = 0.335 95% CI [0.196, 0.475], p < .001, on physical activity. Moderator analyses indicated shorter interventions that did not include structured exercise sessions effectively increased EXSE and physical activity, whereas long interventions improved BSE. Interventions that did not provide support increased BSE and physical activity levels. Further, interventions that did not require the use of daily exercise logs improved EXSE and physical activity behavior. Interventions designed to increase physical activity differentially influenced EXSE and BSE. EXSE appeared to play a more significant role during exercise adoption, whereas BSE was involved in the maintenance of exercise behavior. Recommendations are offered for the design of future interventions.

Analyzing the Effect of Metaconceptual Teaching Practices on Students' Understanding of Force and Motion Concepts

ERIC Educational Resources Information Center

Yuruk, Nejla; Beeth, Michael E.; Andersen, Christopher

2009-01-01

This study investigated the effect of metaconceptual teaching interventions on students' understanding of force and motion concepts. A multimethod research design including quasi-experimental design and case study designs was employed to compare the effect of the metaconceptual activities and traditional instruction and investigate students'…

Design of the DIRECT-project: interventions to increase job resources and recovery opportunities to improve job-related health, well-being, and performance outcomes in nursing homes

PubMed Central

2010-01-01

Background Because of high demands at work, nurses are at high risk for occupational burnout and physical complaints. The presence of job resources (such as job autonomy or social support) and recovery opportunities could counteract the adverse effect of high job demands. However, it is still unclear how job resources and recovery opportunities can be translated into effective workplace interventions aiming to improve employee health, well-being, and performance-related outcomes. The aim of the current research project is developing and implementing interventions to optimize job resources and recovery opportunities, which may lead to improved health, well-being and performance of nurses. Methods/design The DIRECT-project (DIsc Risk Evaluating Controlled Trial) is a longitudinal, quasi-experimental field study. Nursing home staff of 4 intervention wards and 4 comparison wards will be involved. Based on the results of a base-line survey, interventions will be implemented to optimize job resources and recovery opportunities. After 12 and 24 month the effect of the interventions will be investigated with follow-up surveys. Additionally, a process evaluation will be conducted to map factors that either stimulated or hindered successful implementation as well as the effectiveness of the interventions. Discussion The DIRECT-project fulfils a strong need for intervention research in the field of work, stress, performance, and health. The results could reveal (1) how interventions can be tailored to optimize job resources and recovery opportunities, in order to counteract job demands, and (2) what the effects of these interventions will be on health, well-being, and performance of nursing staff. PMID:20509923

Brief motivational intervention with homeless adolescents: evaluating effects on substance use and service utilization.

PubMed

Baer, John S; Garrett, Sharon B; Beadnell, Blair; Wells, Elizabeth A; Peterson, Peggy L

2007-12-01

A brief motivational intervention with 117 homeless adolescents was evaluated using a randomized design and 3-month follow-up. The intervention was designed to raise youths' concerns about their substance use, support harm reduction, and encourage greater service utilization at a collaborating agency. The study was designed to strengthen initial promising results of an earlier study (P. L. Peterson, J. S. Baer, E. A. Wells, J. A. Ginzler, & S. B. Garrett, 2006). Several modifications in the clinical protocol were included to enhance engagement with the intervention. Analyses revealed no significant benefits for intervention participants when homeless youths' substance use rates were compared with those of control participants. Service utilization during the intervention period increased for those receiving the intervention but returned to baseline levels at follow-up. Participants reported overall reductions in substance use over time. Differences between sampling methods for the current and previous study are discussed, as are the limitations of brief interventions with this population. Future research needs to elucidate mechanisms of change and service engagement for highly vulnerable youth.

What Lies beyond Effectiveness and Efficiency? Adventure Learning Design

ERIC Educational Resources Information Center

Doering, Aaron; Veletsianos, George

2008-01-01

Educational technology and instructional design research has focused on evaluating interventions and innovations in terms of their effectiveness, efficiency, and appeal. While such indicators of learning outcomes are important, designers should also strive for engaging, socially just, and transformational instruction. To illuminate the…

Initial Design of Culturally Informed Behavioral Intervention Technologies: Developing an mHealth Intervention for Young Sexual Minority Men With Generalized Anxiety Disorder and Major Depression

PubMed Central

Montague, Enid; Mohr, David C

2013-01-01

Background To our knowledge, there is no well-articulated process for the design of culturally informed behavioral intervention technologies. Objective This paper describes the early stages of such a process, illustrated by the methodology for the ongoing development of a behavioral intervention technology targeting generalized anxiety disorder and major depression among young sexual minority men. Methods We integrated instructional design for Internet behavioral intervention technologies with greater detail on information sources that can identify user needs in understudied populations, as well as advances in the understanding of technology-specific behavioral intervention technology dimensions that may need to be culturally tailored. Results General psychological theory describing how to effect change in the clinical target is first integrated with theory describing potentially malleable factors that help explain the clinical problem within the population. Additional information sources are then used to (1) evaluate the theory, (2) identify population-specific factors that may affect users’ ability to relate to and benefit from the behavioral intervention technology, and (3) establish specific skills, attitudes, knowledge, etc, required to change malleable factors posited in the theory. User needs result from synthesis of this information. Product requirements are then generated through application of the user needs to specific behavioral intervention technology dimensions (eg, technology platform). We provide examples of considerations relevant to each stage of this process and how they were applied. Conclusions This process can guide the initial design of other culturally informed behavioral intervention technologies. This first attempt to create a systematic design process can spur development of guidelines for design of behavioral intervention technologies aimed to reduce health disparities. PMID:24311444

Reach and effectiveness of an integrated community-based intervention on physical activity and healthy eating of older adults in a socioeconomically disadvantaged community

PubMed Central

Luten, Karla A.; Reijneveld, Sijmen A.; Dijkstra, Arie; de Winter, Andrea F.

2016-01-01

The aim of this study is to assess the reach and effectiveness of an integrated community-based intervention designed to promote physical activity and healthy eating among older adults in a socioeconomically disadvantaged community in the Netherlands. The intervention was evaluated with a controlled pre–post quasi-experimental design, with 430 randomly selected older adults participating in the intervention group and 213 in a control group at baseline. The intervention included a local media campaign and environmental approaches (e.g. community involvement) and was implemented during a 3-month high-intensity period, followed by a 6-month low-intensity one. Levels of physical activity and fruit and vegetable consumption were assessed at baseline and at 3 and 9 months after baseline. At the follow-up measurements, the intervention had reached respectively 68 and 69% of the participants in the intervention group. No significant differences were found between the intervention group and the control group in changes to any outcome except for transport-related PA at 3 and 9 months follow-up. The systematically developed community-based intervention reached a relatively large proportion of the participants, but had only small effects on the levels of physical activity and healthy eating in older adults in the short and medium term. PMID:26675175

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

PubMed

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

2015-12-01

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

Motivational interviewing interventions and alcohol abuse among college students: a systematic review.

PubMed

Appiah-Brempong, Emmanuel; Okyere, Paul; Owusu-Addo, Ebenezer; Cross, Ruth

2014-01-01

The study sought to assess the effectiveness of Motivational Interviewing (MI) interventions in reducing alcohol consumption among college students, as compared to no intervention or alternative interventions. It also sought to identify the potential moderators to MI intervention effects. Database sources consulted included Cochrane Central Register of Control Trials, PsycINFO, PsycARTICLE, PsycLIT, CINAHL, and MEDLINE. Included studies were (1) underpinned by experimental, quasi-experimental, and nonexperimental designs; (2) studies in which participants were either college males only or females only or both; and (3) studies in which adaptations of MI were based on key MI principles. Excluded studies were (1) non-English language studies; (2) studies not published from 2000-2012; (3) studies in which participants were not college students; (4) studies in which intervention was not delivered by face-to-face approach; and (5) studies that failed to embark on postintervention follow-ups. A total of 115 abstracts were screened. These were narrowed down to 13 studies from which data for the study were extracted. Selected studies were underpinned by experimental, quasi-experimental, and nonexperimental designs. Owing to the heterogeneity in selected studies, a narrative synthesis was used. MI interventions were found to be effective in reducing alcohol consumption among college students, when compared to alternative interventions or no intervention. Potential moderators of MI intervention effects were identified to include practitioner's adherence to MI techniques and individual's drinking motives. MI presents itself as a promising tool that can augment the many existing social-environmental strategies of health promotion.

School-based secondary prevention programmes for preventing violence.

PubMed

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

2006-07-19

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

Does Racial/Ethnic Identity Influence the Effectiveness of a Community Health Worker Intervention for African American and Latino Adults With Type 2 Diabetes?

PubMed

Murayama, Hiroshi; Spencer, Michael S; Sinco, Brandy R; Palmisano, Gloria; Kieffer, Edith C

2017-06-01

Community health worker (CHW) interventions are known to be an effective strategy to improve health behaviors and outcomes in relation to diabetes, particularly for racial/ethnic communities. Although understanding the function of identity with same race/ethnicity among clients of CHW interventions could contribute to more effective program design, few studies have explored whether levels of racial/ethnic identity among participants can influence the effectiveness of CHW interventions. We tested the relationship between level of racial/ethnic identity and changes in hemoglobin A1c and diabetes self-efficacy among low-income African American and Latino adults with type 2 diabetes who participated in a CHW intervention. Data came from a randomized controlled trial of the CHW intervention with a 6-month delayed control group design for 164 African American and Latino adults in Detroit, Michigan. Racial/ethnic identity was created from two items and classified into high, moderate, and low. We combined the two arms (immediate and delayed) into one because there was no significant difference in baseline characteristics, other than age and postintervention self-efficacy, and multivariable linear regression models were applied in the analysis. Possession of high racial/ethnic identity was associated with greater improvement both in hemoglobin A1c and diabetes self-efficacy at 6 months. Moreover, among those with high hemoglobin A1c at preintervention, higher racial/ethnic identity had a greater impact on hemoglobin A1c improvement, compared with those with lower identity. This study suggests the importance of considering racial/ethnic identity of the participants in designing and operating the CHW intervention for racial/ethnic minority population.

Establishing Interventions via a Theory-Driven Single Case Design Research Cycle

ERIC Educational Resources Information Center

Kilgus, Stephen P.; Riley-Tillman, T. Chris; Kratochwill, Thomas R.

2016-01-01

Recent studies have suggested single case design (SCD) intervention research is subject to publication bias, wherein studies are more likely to be published if they possess large or statistically significant effects and use rigorous experimental methods. The nature of SCD and the purposes for which it might be used could suggest that large effects…

Promoting Handwriting Fluency in Fifth Graders with Slow Handwriting: A Single-Subject Design Study

ERIC Educational Resources Information Center

Limpo, Teresa; Parente, Naiana; Alves, Rui A.

2018-01-01

This study used a multiple-probe design across three participants to test the effectiveness of a handwriting intervention for fifth graders (age 10-11) displaying less handwriting fluency than their peers, but without spelling disorders. The 5-h handwriting intervention provided students with explicit instruction and intensive practice in writing…

Effects of A 2.5-Year Campus-Wide Intervention to Reduce College Drinking

ERIC Educational Resources Information Center

Seo, Dong-Chul; Owens, Dee; Gassman, Ruth; Kingori, Caroline

2013-01-01

Objective: The present study reports on the results of a 2.5-year college-wide, coordinated intervention that was implemented from June 2007 to December 2009 to reduce the amount and frequency of students' alcohol consumption. Design: Quasi-experimental study using a one-group (freshmen living on campus) pretest/posttest design ("N" =…

The Effect of Lactation Educators Implementing a Telephone-Based Intervention among Low-Income Hispanics: A Randomised Trial

ERIC Educational Resources Information Center

Efrat, Merav W.; Esparza, Salvador; Mendelson, Sherri G.; Lane, Christianne J.

2015-01-01

Objectives: To assess whether a telephone-based breastfeeding intervention delivered by lactation educators influenced exclusive breastfeeding rates among low-income Hispanic women in the USA. Design: Randomised two-group design. Setting: Pregnant low-income Hispanic women (298) were recruited from community health clinics in Los Angeles County…

Prescriber preferences for behavioural economics interventions to improve treatment of acute respiratory infections: a discrete choice experiment

PubMed Central

Gong, Cynthia L; Hay, Joel W; Meeker, Daniella; Doctor, Jason N

2016-01-01

Objective To elicit prescribers' preferences for behavioural economics interventions designed to reduce inappropriate antibiotic prescribing, and compare these to actual behaviour. Design Discrete choice experiment (DCE). Setting 47 primary care centres in Boston and Los Angeles. Participants 234 primary care providers, with an average 20 years of practice. Main outcomes and measures Results of a behavioural economic intervention trial were compared to prescribers' stated preferences for the same interventions relative to monetary and time rewards for improved prescribing outcomes. In the randomised controlled trial (RCT) component, the 3 computerised prescription order entry-triggered interventions studied included: Suggested Alternatives (SA), an alert that populated non-antibiotic treatment options if an inappropriate antibiotic was prescribed; Accountable Justifications (JA), which prompted the prescriber to enter a justification for an inappropriately prescribed antibiotic that would then be documented in the patient's chart; and Peer Comparison (PC), an email periodically sent to each prescriber comparing his/her antibiotic prescribing rate with those who had the lowest rates of inappropriate antibiotic prescribing. A DCE study component was administered to determine whether prescribers felt SA, JA, PC, pay-for-performance or additional clinic time would most effectively reduce their inappropriate antibiotic prescribing. Willingness-to-pay (WTP) was calculated for each intervention. Results In the RCT, PC and JA were found to be the most effective interventions to reduce inappropriate antibiotic prescribing, whereas SA was not significantly different from controls. In the DCE however, regardless of treatment intervention received during the RCT, prescribers overwhelmingly preferred SA, followed by PC, then JA. WTP estimates indicated that each intervention would be significantly cheaper to implement than pay-for-performance incentives of $200/month. Conclusions Prescribing behaviour and stated preferences are not concordant, suggesting that relying on stated preferences alone to inform intervention design may eliminate effective interventions. Trial registration number NCT01454947; Results. PMID:27660322

Design of Economic Evaluations of Mindfulness-Based Interventions: Ten Methodological Questions of Which to Be Mindful.

PubMed

Edwards, Rhiannon Tudor; Bryning, Lucy; Crane, Rebecca

Mindfulness-based interventions (MBIs) are being increasingly applied in a variety of settings. A growing body of evidence to support the effectiveness of these interventions exists and there are a few published cost-effectiveness studies. With limited resources available within public sectors (health care, social care, and education), it is necessary to build in concurrent economic evaluations alongside trials in order to inform service commissioning and policy. If future research studies are well-designed, they have strong potential to investigate the economic impact of MBIs. The particular challenge to the health economist is how best to capture the ways that MBIs help people adjust to or build resilience to difficult life circumstances, and to disseminate effectively to enable policy makers to judge the value of the contribution that MBIs can make within the context of the limited resourcing of public services. In anticipation of more research worldwide evaluating MBIs in various settings, this article suggests ten health economics methodological design questions that researchers may want to consider prior to conducting MBI research. These questions draw on both published standards of good methodological practice in economic evaluation of medical interventions, and on the authors' knowledge and experience of mindfulness-based practice. We argue that it is helpful to view MBIs as both complex interventions and as public health prevention initiatives. Our suggestions for well-designed economic evaluations of MBIs in health and other settings, mirror current thinking on the challenges and opportunities of public health economics.

Risk assessment and subsequent nursing interventions in a forensic mental health inpatient setting: Associations and impact on aggressive behaviour.

PubMed

Maguire, Tessa; Daffern, Michael; Bowe, Steven J; McKenna, Brian

2018-03-01

To examine associations between risk of aggression and nursing interventions designed to prevent aggression. There is scarce empirical research exploring the nature and effectiveness of interventions designed to prevent inpatient aggression. Some strategies may be effective when patients are escalating, whereas others may be effective when aggression is imminent. Research examining level of risk for aggression and selection and effectiveness of interventions and impact on aggression is necessary. Archival case file. Data from clinical files of 30 male and 30 female patients across three forensic acute units for the first 60 days of hospitalisation were collected. Risk for imminent aggression as measured by the Dynamic Appraisal of Situational Aggression, documented nursing interventions following each assessment, and acts of aggression within the 24-hours following assessment were collected. Generalised estimating equations were used to investigate whether intervention strategies were associated with reduction in aggression. When a Dynamic Appraisal of Situational Aggression assessment was completed, nurses intervened more frequently compared to days when no Dynamic Appraisal of Situational Aggression assessment was completed. Higher Dynamic Appraisal of Situational Aggression assessments were associated with a greater number of interventions. The percentage of interventions selected for males differed from females; males received more pro re nata medication and observation, and females received more limit setting, one-to-one nursing and reassurance. Pro re nata medication was the most commonly documented intervention (35.9%) in this study. Pro re nata medication, limit setting and reassurance were associated with an increased likelihood of aggression in some risk bands. Structured risk assessment prompts intervention, and higher risk ratings result in more interventions. Patient gender influences the type of interventions. Some interventions are associated with increased aggression, although this depends upon gender and risk level. When structured risk assessments are used, there is greater likelihood of intervention. Intervention should occur early using least restrictive interventions. © 2017 John Wiley & Sons Ltd.

Interventions to increase HPV vaccination coverage: A systematic review

PubMed Central

Smulian, Elizabeth A.; Mitchell, Krista R.; Stokley, Shannon

2016-01-01

ABSTRACT We reviewed intervention studies designed to increase human papillomavirus (HPV) vaccination coverage to further understand the impact interventions can have on HPV vaccination coverage. We searched 5 databases for intervention studies published from June 2006 to May 2015. Studies were included if they quantitatively measured HPV vaccination coverage as an outcome and were conducted in the United States. We abstracted outcomes, methods, and results from each study and classified by type of intervention conducted. Findings from 34 studies suggest many types of intervention strategies can increase HPV vaccination coverage in different settings, and with modest cost. Interventions were effective especially when implemented in combination at both provider and community levels. However, not all interventions showed significant effects on coverage. More research is needed to identify the best methods for widespread implementation of effective strategies. PMID:26838959

A culturally adapted lifestyle intervention addressing a Middle Eastern immigrant population at risk of diabetes, the MEDIM (impact of Migration and Ethnicity on Diabetes In Malmö): study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Studies have shown that lifestyle interventions are effective in preventing or delaying the onset of type 2 diabetes in high-risk patients. However, research on the effectiveness of lifestyle interventions in high-risk immigrant populations with different cultural and socioeconomic backgrounds is scarce. The aim was to design a culturally adapted lifestyle intervention for an immigrant population and to evaluate its effectiveness and cost-effectiveness. Methods/design In this randomized controlled trial, 308 participants (born in Iraq, living in Malmö, Sweden and at high risk of type 2 diabetes) will be allocated to either a culturally adapted intervention or a control group. The intervention will consist of 10 group counseling sessions focusing on diet, physical activity and behavioral change over 6 months, and the offer of exercise sessions. Cultural adaptation includes gender-specific exercise sessions, and counseling by a health coach community member. The control group will receive the information about healthy lifestyle habits provided by the primary health care center. The primary outcome is change in fasting glucose level. Secondary outcomes are changes in body mass index, insulin sensitivity, physical activity, food habits and health-related quality of life. Measurements will be taken at baseline, after 3 and 6 months. Data will be analyzed by the intention-to-treat approach. The cost-effectiveness during the trial period and over the longer term will be assessed by simulation modeling from patient, health care and societal perspectives. Discussion This study will provide a basis to measure the effectiveness of a lifestyle intervention designed for immigrants from the Middle East in terms of improvement in glucose metabolism, and will also assess its cost-effectiveness. Results from this trial may help health care providers and policy makers to adapt and implement lifestyle interventions suitable for this population group that can be conducted in the community. Trial registration ClinicalTrials.gov, NCT01420198 PMID:24006857

Healthy Learning Mind - a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial.

PubMed

Volanen, Salla-Maarit; Lassander, Maarit; Hankonen, Nelli; Santalahti, Päivi; Hintsanen, Mirka; Simonsen, Nina; Raevuori, Anu; Mullola, Sari; Vahlberg, Tero; But, Anna; Suominen, Sakari

2016-07-11

Mindfulness has shown positive effects on mental health, mental capacity and well-being among adult population. Among children and adolescents, previous research on the effectiveness of mindfulness interventions on health and well-being has shown promising results, but studies with methodologically sound designs have been called for. Few intervention studies in this population have compared the effectiveness of mindfulness programs to alternative intervention programs with adequate sample sizes. Our primary aim is to explore the effectiveness of a school-based mindfulness intervention program compared to a standard relaxation program among a non-clinical children and adolescent sample, and a non-treatment control group in school context. In this study, we systematically examine the effects of mindfulness intervention on mental well-being (primary outcomes being resilience; existence/absence of depressive symptoms; experienced psychological strengths and difficulties), cognitive functions, psychophysiological responses, academic achievements, and motivational determinants of practicing mindfulness. The design is a cluster randomized controlled trial with three arms (mindfulness intervention group, active control group, non-treatment group) and the sample includes 59 Finnish schools and approx. 3 000 students aged 12-15 years. Intervention consists of nine mindfulness based lessons, 45 mins per week, for 9 weeks, the dose being identical in active control group receiving standard relaxation program called Relax. The programs are delivered by 14 educated facilitators. Students, their teachers and parents will fill-in the research questionnaires before and after the intervention, and they will all be followed up 6 months after baseline. Additionally, students will be followed 12 months after baseline. For longer follow-up, consent to linking the data to the main health registers has been asked from students and their parents. The present study examines systematically the effectiveness of a school-based mindfulness program compared to a standard relaxation program, and a non-treatment control group. A strength of the current study lies in its methodologically rigorous, randomized controlled study design, which allows novel evidence on the effectiveness of mindfulness over and above a standard relaxation program. ISRCTN18642659 . Retrospectively registered 13 October 2015.

Design-Comparable Effect Sizes in Multiple Baseline Designs: A General Modeling Framework

ERIC Educational Resources Information Center

Pustejovsky, James E.; Hedges, Larry V.; Shadish, William R.

2014-01-01

In single-case research, the multiple baseline design is a widely used approach for evaluating the effects of interventions on individuals. Multiple baseline designs involve repeated measurement of outcomes over time and the controlled introduction of a treatment at different times for different individuals. This article outlines a general…

Walk well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

PubMed Central

2013-01-01

Background Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities. Trial registration ISRCTN: ISRCTN50494254 PMID:23816316

Aging, the Central Nervous System, and Mobility in Older Adults: Interventions

PubMed Central

Hausdorff, Jeffrey M.; Studenski, Stephanie A.; Rosano, Caterina; Camicioli, Richard; Alexander, Neil B.; Chen, Wen G.; Lipsitz, Lewis A.; Carlson, Michelle C.

2016-01-01

Background: Research suggests that the central nervous system (CNS) and mobility are closely linked. CNS-mediated mobility impairment may represent a potentially new and prevalent syndrome within the older adult populations. Interventions targeting this group may have the potential to improve mobility and cognition and prevent disability. Methods: In 2012, the Gerontological Society of America (GSA) and the National Institute on Aging (NIA) sponsored a 3-year conference workshop series, “Aging, the CNS, and Mobility.” The goal of this third and final conference was to (i) report on the state of the science of interventions targeting CNS-mediated mobility impairment among community-dwelling older adults and (ii) partnering with the NIA, explore the future of research and intervention design focused on a potentially novel aging syndrome. Results: Evidence was presented in five main intervention areas: (i) pharmacology and diet; (ii) exercise; (iii) electrical stimulation; (iv) sensory stimulation/deprivation; and (v) a combined category of multimodal interventions. Workshop participants identified important gaps in knowledge and key recommendations for future interventions related to recruitment and sample selection, intervention design, and methods to measure effectiveness. Conclusions: In order to develop effective preventive interventions for this prevalent syndrome, multidisciplinary teams are essential particularly because of the complex nature of the syndrome. Additionally, integrating innovative methods into the design of interventions may help researchers better measure complex mechanisms, and finally, the value of understanding the link between the CNS and mobility should be conveyed to researchers across disciplines in order to incorporate cognitive and mobility measurements into study protocols. PMID:27154905

Toward rigorous idiographic research in prevention science: comparison between three analytic strategies for testing preventive intervention in very small samples.

PubMed

Ridenour, Ty A; Pineo, Thomas Z; Maldonado Molina, Mildred M; Hassmiller Lich, Kristen

2013-06-01

Psychosocial prevention research lacks evidence from intensive within-person lines of research to understand idiographic processes related to development and response to intervention. Such data could be used to fill gaps in the literature and expand the study design options for prevention researchers, including lower-cost yet rigorous studies (e.g., for program evaluations), pilot studies, designs to test programs for low prevalence outcomes, selective/indicated/adaptive intervention research, and understanding of differential response to programs. This study compared three competing analytic strategies designed for this type of research: autoregressive moving average, mixed model trajectory analysis, and P-technique. Illustrative time series data were from a pilot study of an intervention for nursing home residents with diabetes (N = 4) designed to improve control of blood glucose. A within-person, intermittent baseline design was used. Intervention effects were detected using each strategy for the aggregated sample and for individual patients. The P-technique model most closely replicated observed glucose levels. ARIMA and P-technique models were most similar in terms of estimated intervention effects and modeled glucose levels. However, ARIMA and P-technique also were more sensitive to missing data, outliers and number of observations. Statistical testing suggested that results generalize both to other persons as well as to idiographic, longitudinal processes. This study demonstrated the potential contributions of idiographic research in prevention science as well as the need for simulation studies to delineate the research circumstances when each analytic approach is optimal for deriving the correct parameter estimates.

Toward Rigorous Idiographic Research in Prevention Science: Comparison Between Three Analytic Strategies for Testing Preventive Intervention in Very Small Samples

PubMed Central

Pineo, Thomas Z.; Maldonado Molina, Mildred M.; Lich, Kristen Hassmiller

2013-01-01

Psychosocial prevention research lacks evidence from intensive within-person lines of research to understand idiographic processes related to development and response to intervention. Such data could be used to fill gaps in the literature and expand the study design options for prevention researchers, including lower-cost yet rigorous studies (e.g., for program evaluations), pilot studies, designs to test programs for low prevalence outcomes, selective/indicated/ adaptive intervention research, and understanding of differential response to programs. This study compared three competing analytic strategies designed for this type of research: autoregressive moving average, mixed model trajectory analysis, and P-technique. Illustrative time series data were from a pilot study of an intervention for nursing home residents with diabetes (N=4) designed to improve control of blood glucose. A within-person, intermittent baseline design was used. Intervention effects were detected using each strategy for the aggregated sample and for individual patients. The P-technique model most closely replicated observed glucose levels. ARIMA and P-technique models were most similar in terms of estimated intervention effects and modeled glucose levels. However, ARIMA and P-technique also were more sensitive to missing data, outliers and number of observations. Statistical testing suggested that results generalize both to other persons as well as to idiographic, longitudinal processes. This study demonstrated the potential contributions of idiographic research in prevention science as well as the need for simulation studies to delineate the research circumstances when each analytic approach is optimal for deriving the correct parameter estimates. PMID:23299558

Design and Evaluation of Ergonomic Interventions for the Prevention of Musculoskeletal Disorders in India

PubMed Central

2014-01-01

Background Improper workstation, work procedures and tools are found to be the risk factors for the development of musculoskeletal disorders among the informal sector workers of the developing countries. Low cost ergonomic interventions can effectively improve such adverse conditions. Case presentation In the present article some studies related to design interventions in different informal and agricultural sectors were discussed and their efficacies were analyzed. It was observed that with the help of appropriate interventions musculoskeletal disorders were reduced, adverse physiological conditions were improved when awkward postures were corrected and ultimately the organisational productivity was increased. Conclusion Proper implementation of ergonomic interventions can ultimately improve the economy of the nation. PMID:25009740

Effects of Video Modeling on Treatment Integrity of Behavioral Interventions

ERIC Educational Resources Information Center

DiGennaro-Reed, Florence D.; Codding, Robin; Catania, Cynthia N.; Maguire, Helena

2010-01-01

We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased…

Using a Mnemonic to Develop Effective Incentive Systems

ERIC Educational Resources Information Center

Forbringer, Linda L.

2007-01-01

Special educators frequently provide consultation for parents and general education teachers who are struggling to manage student behavior. One intervention often discussed is the use of rewards to increase student motivation. While research has shown that well-designed incentive systems can provide an effective intervention, poorly designed…

Integrated solutions for sustainable fall prevention in primary care, the iSOLVE project: a type 2 hybrid effectiveness-implementation design.

PubMed

Clemson, Lindy; Mackenzie, Lynette; Roberts, Chris; Poulos, Roslyn; Tan, Amy; Lovarini, Meryl; Sherrington, Cathie; Simpson, Judy M; Willis, Karen; Lam, Mary; Tiedemann, Anne; Pond, Dimity; Peiris, David; Hilmer, Sarah; Pit, Sabrina Winona; Howard, Kirsten; Lovitt, Lorraine; White, Fiona

2017-02-07

Despite strong evidence giving guidance for effective fall prevention interventions in community-residing older people, there is currently no clear model for engaging general medical practitioners in fall prevention and routine use of allied health professionals in fall prevention has been slow, limiting widespread dissemination. This protocol paper outlines an implementation-effectiveness study of the Integrated Solutions for Sustainable Fall Prevention (iSOLVE) intervention which has developed integrated processes and pathways to identify older people at risk of falls and engage a whole of primary care approach to fall prevention. This protocol paper presents the iSOLVE implementation processes and change strategies and outlines the study design of a blended type 2 hybrid design. The study consists of a two-arm cluster randomized controlled trial in 28 general practices and recruiting 560 patients in Sydney, Australia, to evaluate effectiveness of the iSOLVE intervention in changing general practitioner fall management practices and reducing patient falls and the cost effectiveness from a healthcare funder perspective. Secondary outcomes include change in medications known to increase fall risk. We will simultaneously conduct a multi-methodology evaluation to investigate the workability and utility of the implementation intervention. The implementation evaluation includes in-depth interviews and surveys with general practitioners and allied health professionals to explore acceptability and uptake of the intervention, the coherence of the proposed changes for those in the work setting, and how to facilitate the collective action needed to implement changes in practice; social network mapping will explore professional relationships and influences on referral patterns; and, a survey of GPs in the geographical intervention zone will test diffusion of evidence-based fall prevention practices. The project works in partnership with a primary care health network, state fall prevention leaders, and a community of practice of fall prevention advocates. The design is aimed at providing clear direction for sustainability and informing decisions about generalization of the iSOLVE intervention processes and change strategies. While challenges exist in hybrid designs, there is a potential for significant outcomes as the iSOLVE pathways project brings together practice and research to collectively solve a major national problem with implications for policy service delivery. Australian New Zealand Clinial Trials Registry ACTRN12615000401550.

Improving Collaborative Play Between Children with Autism Spectrum Disorders and Their Siblings: The Effectiveness of a Robot-Mediated Intervention Based on Lego® Therapy.

PubMed

Huskens, Bibi; Palmen, Annemiek; Van der Werff, Marije; Lourens, Tino; Barakova, Emilia

2015-11-01

The aim of the study was to investigate the effectiveness of a brief robot-mediated intervention based on Lego(®) therapy on improving collaborative behaviors (i.e., interaction initiations, responses, and play together) between children with ASD and their siblings during play sessions, in a therapeutic setting. A concurrent multiple baseline design across three child-sibling pairs was in effect. The robot-intervention resulted in no statistically significant changes in collaborative behaviors of the children with ASD. Despite limited effectiveness of the intervention, this study provides several practical implications and directions for future research.

Sample size requirements for separating out the effects of combination treatments: randomised controlled trials of combination therapy vs. standard treatment compared to factorial designs for patients with tuberculous meningitis.

PubMed

Wolbers, Marcel; Heemskerk, Dorothee; Chau, Tran Thi Hong; Yen, Nguyen Thi Bich; Caws, Maxine; Farrar, Jeremy; Day, Jeremy

2011-02-02

In certain diseases clinical experts may judge that the intervention with the best prospects is the addition of two treatments to the standard of care. This can either be tested with a simple randomized trial of combination versus standard treatment or with a 2 x 2 factorial design. We compared the two approaches using the design of a new trial in tuberculous meningitis as an example. In that trial the combination of 2 drugs added to standard treatment is assumed to reduce the hazard of death by 30% and the sample size of the combination trial to achieve 80% power is 750 patients. We calculated the power of corresponding factorial designs with one- to sixteen-fold the sample size of the combination trial depending on the contribution of each individual drug to the combination treatment effect and the strength of an interaction between the two. In the absence of an interaction, an eight-fold increase in sample size for the factorial design as compared to the combination trial is required to get 80% power to jointly detect effects of both drugs if the contribution of the less potent treatment to the total effect is at least 35%. An eight-fold sample size increase also provides a power of 76% to detect a qualitative interaction at the one-sided 10% significance level if the individual effects of both drugs are equal. Factorial designs with a lower sample size have a high chance to be underpowered, to show significance of only one drug even if both are equally effective, and to miss important interactions. Pragmatic combination trials of multiple interventions versus standard therapy are valuable in diseases with a limited patient pool if all interventions test the same treatment concept, it is considered likely that either both or none of the individual interventions are effective, and only moderate drug interactions are suspected. An adequately powered 2 x 2 factorial design to detect effects of individual drugs would require at least 8-fold the sample size of the combination trial. Current Controlled Trials ISRCTN61649292.

Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach.

PubMed

Band, Rebecca; Bradbury, Katherine; Morton, Katherine; May, Carl; Michie, Susan; Mair, Frances S; Murray, Elizabeth; McManus, Richard J; Little, Paul; Yardley, Lucy

2017-02-23

This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Person-Based Approach to intervention development emphasises the use of qualitative research to ensure that the intervention is acceptable, persuasive, engaging and easy to implement. Our intervention planning process comprised two parallel, integrated work streams, which combined theory-, evidence- and person-based elements. The first work stream involved collating evidence from a mixed methods feasibility study, a systematic review and a synthesis of qualitative research. This evidence was analysed to identify likely barriers and facilitators to uptake and implementation as well as design features that should be incorporated in the HOME BP intervention. The second work stream used three complementary approaches to theoretical modelling: developing brief guiding principles for intervention design, causal modelling to map behaviour change techniques in the intervention onto the Behaviour Change Wheel and Normalisation Process Theory frameworks, and developing a logic model. The different elements of our integrated approach to intervention planning yielded important, complementary insights into how to design the intervention to maximise acceptability and ease of implementation by both patients and health professionals. From the primary and secondary evidence, we identified key barriers to overcome (such as patient and health professional concerns about side effects of escalating medication) and effective intervention ingredients (such as providing in-person support for making healthy behaviour changes). Our guiding principles highlighted unique design features that could address these issues (such as online reassurance and procedures for managing concerns). Causal modelling ensured that all relevant behavioural determinants had been addressed, and provided a complete description of the intervention. Our logic model linked the hypothesised mechanisms of action of our intervention to existing psychological theory. Our integrated approach to intervention development, combining theory-, evidence- and person-based approaches, increased the clarity, comprehensiveness and confidence of our theoretical modelling and enabled us to ground our intervention in an in-depth understanding of the barriers and facilitators most relevant to this specific intervention and user population.

Intervention fidelity in primary care complex intervention trials: qualitative study using telephone interviews of patients and practitioners.

PubMed

Dyas, Jane V; Togher, Fiona; Siriwardena, A Niroshan

2014-01-01

Treatment fidelity has previously been defined as the degree to which a treatment or intervention is delivered to participants as intended. Underreporting of fidelity in primary care randomised controlled trials (RCTs) of complex interventions reduces our confidence that findings are due to the treatment or intervention being investigated, rather than unknown confounders. We aimed to investigate treatment fidelity (for the purpose of this paper, hereafter referred to as intervention fidelity), of an educational intervention delivered to general practice teams and designed to improve the primary care management of insomnia. We conducted telephone interviews with patients and practitioners participating in the intervention arm of the trial to explore trial fidelity. Qualitative analysis was undertaken using constant comparison and a priori themes (categories): 'adherence to the delivery of the intervention', 'patients received and understood intervention' and 'patient enactment'. If the intervention protocol was not adhered to by the practitioner then patient receipt, understanding and enactment levels were reduced. Recruitment difficulties in terms of the gap between initially being recruited into the study and attending an intervention consultation also reduced the effectiveness of the intervention. Patient attributes such as motivation to learn and engage contributed to the success of the uptake of the intervention. Qualitative methods using brief telephone interviews are an effective way of collecting the depth of data required to assess intervention fidelity. Intervention fidelity monitoring should be an important element of definitive trial design. ClinicalTrials. gov id isrctn 55001433 - www.controlled-trials.com/isrctn55001433.

Using Intervention Mapping for child development and wellbeing programs in early childhood education and care settings.

PubMed

O'Connor, Amanda; Blewitt, Claire; Nolan, Andrea; Skouteris, Helen

2018-06-01

Supporting children's social and emotional learning benefits all elements of children's development and has been associated with positive mental health and wellbeing, development of values and life skills. However, literature relating to the creation of interventions designed for use within the early childhood education and care settings to support children's social and emotional skills and learning is lacking. Intervention Mapping (IM) is a systematic intervention development framework, utilising principles centred on participatory co-design methods, multiple theoretical approaches and existing literature to enable effective decision-making during the development process. Early childhood pedagogical programs are also shaped by these principles; however, educators tend to draw on implicit knowledge when working with families. IM offers this sector the opportunity to formally incorporate theoretical, evidence-based research into the development of early childhood education and care social and emotional interventions. Emerging literature indicates IM is useful for designing health and wellbeing interventions for children within early childhood education and care settings. Considering the similar underlying principles of IM, existing applications within early childhood education and care and development of interventions beyond health behaviour change, it is recommended IM be utilised to design early childhood education and care interventions focusing on supporting children's social and emotional development. Copyright © 2018 Elsevier Ltd. All rights reserved.

Packaging interventions to increase medication adherence: systematic review and meta-analysis

PubMed Central

Conn, Vicki S.; Ruppar, Todd M.; Chan, Keith C.; Dunbar-Jacob, Jacqueline; Pepper, Ginette A.; De Geest, Sabina

2015-01-01

Objective Inadequate medication adherence is a widespread problem that contributes to increase chronic disease complications and health care expenditures. Packaging interventions using pill boxes and blister packs have been widely recommended to address the medication adherence issue. This meta-analysis review determined the overall effect of packaging interventions on medication adherence and health outcomes. In addition, we tested whether effects vary depending on intervention, sample, and design characteristics. Research design and methods Extensive literature search strategies included examination of 13 computerized databases and 19 research registries, hand searches of 57 journal, and author and ancestry searches. Eligible studies included either pill-boxes or blister packaging interventions to increase medication adherence. Primary study characteristics and outcomes were reliably coded. Random-effects analyses were used to calculate overall effect sizes and conduct moderator analyses. Results Data were synthesized across 22,858 subjects from 52 reports. The overall mean weighted standardized difference effect size for two-group comparisons was 0.593 (favoring treatment over control), which is consistent with the mean of 71% adherence for treatment subjects compared to 63% among control subjects. We found using moderator analyses that interventions were most effective when they used blister packs and were delivered in pharmacies, while interventions were less effective when studies included older subjects and those with cognitive impairment. Methodological moderator analyses revealed significantly larger effect sizes in studies reporting continuous data outcomes instead of dichotomous results and in studies using pharmacy refill medication adherence measures as compared to studies with self-report measures. Conclusions Overall, meta-analysis findings support the use of packaging interventions to effectively increase medication adherence. Limitations of the study include the exclusion of packaging interventions other than pill boxes and blister packs, evidence of publication bias, and primary study sparse reporting of health outcomes and potentially interesting moderating variables such as the number of prescribed medications. PMID:25333709

Alternatives for randomization in lifestyle intervention studies in cancer patients were not better than conventional randomization.

PubMed

Velthuis, Miranda J; May, Anne M; Monninkhof, Evelyn M; van der Wall, Elsken; Peeters, Petra H M

2012-03-01

Assessing effects of lifestyle interventions in cancer patients has some specific challenges. Although randomization is urgently needed for evidence-based knowledge, sometimes it is difficult to apply conventional randomization (i.e., consent preceding randomization and intervention) in daily settings. Randomization before seeking consent was proposed by Zelen, and additional modifications were proposed since. We discuss four alternatives for conventional randomization: single and double randomized consent design, two-stage randomized consent design, and the design with consent to postponed information. We considered these designs when designing a study to assess the impact of physical activity on cancer-related fatigue and quality of life. We tested the modified Zelen design with consent to postponed information in a pilot. The design was chosen to prevent drop out of participants in the control group because of disappointment about the allocation. The result was a low overall participation rate most likely because of perceived lack of information by eligible patients and a relatively high dropout in the intervention group. We conclude that the alternatives were not better than conventional randomization. Copyright © 2012 Elsevier Inc. All rights reserved.

The Community-based Participatory Intervention Effect of “HIV-RAAP”

PubMed Central

Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

2012-01-01

Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

The community-based participatory intervention effect of "HIV-RAAP".

PubMed

Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

2012-07-01

To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

Effects of a preschool staff intervention on children's sun protection: outcomes of sun protection is fun!

PubMed

Gritz, Ellen R; Tripp, Mary K; James, Aimee S; Harrist, Ronald B; Mueller, Nancy H; Chamberlain, Robert M; Parcel, Guy S

2007-08-01

The preschool is an important yet understudied setting for sun-protection interventions. This study evaluates the effects of Sun Protection is Fun! (SPF) on preschool staff behavioral and psychosocial outcomes related to protecting children from sun exposure. Twenty preschools participated in a 2-year, group-randomized trial to evaluate SPF, a behavioral intervention grounded in social cognitive theory and designed to be more extensive than previous preschool sun-protection interventions. The staff intervention included training, a video, newsletters, a curriculum, and sunscreen. Cross-sectional samples of staff completed surveys at baseline (N= 245), a 12 month intervention assessment (N = 192), and a 24-month intervention assessment (N = 225). At the 12-month and 24-month assessments, significant behavioral effects were seen for use of sunscreen, protective clothing, and shade. Knowledge, self-efficacy, and norms were among the psychosocial variables most affected by the intervention. This study demonstrates that the SPF intervention is effective in improving staff outcomes related to children's sun protection.

The effect of electrical stimulation on corticospinal excitability is dependent on application duration: a same subject pre-post test design.

PubMed

Andrews, Rebecca K; Schabrun, Siobhan M; Ridding, Michael C; Galea, Mary P; Hodges, Paul W; Chipchase, Lucinda S

2013-06-10

In humans, corticospinal excitability is known to increase following motor electrical stimulation (ES) designed to mimic a voluntary contraction. However, whether the effect is equivalent with different application durations and whether similar effects are apparent for short and long applications is unknown. The aim of this study was to investigate whether the duration of peripheral motor ES influenced its effect on corticospinal excitability. The excitability of the corticomotor pathway to abductor pollicis brevis (APB) was measured in fourteen health subjects using transcranial magnetic stimulation before, immediately after and 10 minutes after three different durations (20-, 40-, 60-min) of motor ES (30Hz, ramped). This intervention was designed to mimic a voluntary contraction in APB. To control for effects of motor ES on the peripheral elements (muscle fibre, membrane, neuromuscular junction), maximum compound muscle actions potentials (M-waves) were also recorded at each time point. Results were analysed using a repeated measures analysis of variance. Peripheral excitability was reduced following all three motor ES interventions. Conversely, corticospinal excitability was increased immediately following 20- and 40-min applications of motor ES and this increase was maintained at least 20-min following the intervention. A 60-min application of motor ES did not alter corticospinal excitability. A 20-min application of motor ES that is designed to mimic voluntary muscle contraction is as effective as that applied for 40-min when the aim of the intervention is to increase corticospinal excitability. Longer motor ES durations of 60-min do not influence corticospinal excitability, possibly as a result of homeostatic plasticity mechanisms.

The perils of ignoring design effects in experimental studies: lessons from a mammography screening trial.

PubMed

Glenn, Beth A; Bastani, Roshan; Maxwell, Annette E

2013-01-01

Threats to external validity, including pretest sensitisation and the interaction of selection and an intervention, are frequently overlooked by researchers despite their potential to significantly influence study outcomes. The purpose of this investigation was to conduct secondary data analyses to assess the presence of external validity threats in the setting of a randomised trial designed to promote mammography use in a high-risk sample of women. During the trial, recruitment and intervention, implementation took place in three cohorts (with different ethnic composition), utilising two different designs (pretest-posttest control group design and posttest only control group design). Results reveal that the intervention produced different outcomes across cohorts, dependent upon the research design used and the characteristics of the sample. These results illustrate the importance of weighing the pros and cons of potential research designs before making a selection and attending more closely to issues of external validity.

How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis.

PubMed

Liu, Mingli; Wu, Lang; Ming, Qingsen

2015-01-01

To perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression. A meta-analysis and meta-regression. Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were: (1) intervention should be supervised physical activity, (2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept, (3) participants' ages ranged from 3 to 20 years, and (4) a control or comparison group was included. For each study, study design, intervention design and participant characteristics were extracted. R software (version 3.1.3) and Stata (version 12.0) were used to synthesize effect sizes and perform moderation analyses for determining moderators. Twenty-five randomized controlled trial (RCT) studies and 13 non-randomized controlled trial (non-RCT) studies including a total of 2991 cases were identified. Significant positive effects were found in RCTs for intervention of physical activity alone on general self outcomes (Hedges' g = 0.29, 95% confidence interval [CI]: 0.14 to 0.45; p = 0.001), self-concept (Hedges' g = 0.49, 95%CI: 0.10 to 0.88, p = 0.014) and self-worth (Hedges' g = 0.31, 95%CI: 0.13 to 0.49, p = 0.005). There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies. Meta-regression analysis revealed that higher treatment effects were associated with setting of intervention in RCTs (β = 0.31, 95%CI: 0.07 to 0.55, p = 0.013). Intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings.

A worksite prevention program for construction workers: design of a randomized controlled trial.

PubMed

Oude Hengel, Karen M; Joling, Catelijne I; Proper, Karin I; Blatter, Birgitte M; Bongers, Paulien M

2010-06-14

A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers. The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1) two individual training sessions of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted. The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry. NTR1278.

Feasibility, appropriateness, meaningfulness and effectiveness of patient participation at bedside shift reporting: mixed-method research protocol.

PubMed

Malfait, Simon; Eeckloo, Kristof; Lust, Elisa; Van Biesen, Wim; Van Hecke, Ann

2017-02-01

To evaluate the feasibility, appropriateness, meaningfulness and effectiveness of bedside shift reporting in a minimum of five interventions and five control wards. Hospitals continually improve their quality of care. Next to improvements in clinical performance, more patient participation is stimulated through different methods. Methods to enhance patient participation such as bedside shift reporting lack rigorously performed research to determine their feasibility, appropriateness, meaningfulness and effectiveness. Small-scale research and a previous pilot study indicate that bedside shift reporting improves patient participation, nurse-nurse communication and nurse-patient communication. The development, implementation and evaluation of bedside shift report are based on the Medical Research Council framework for complex interventions in health care. A matched, controlled, mixed-method, longitudinal study design will be used. The Feasibility-Appropriateness-Meaningfulness-Effectiveness framework will be applied for the quantitative and qualitative evaluation of bedside shift report. A tailored intervention and implementation process for bedside shift report will be developed using diagnostic interviews, co-design and acceptability testing. The intervention will be evaluated before implementation and three times after implementation. Individual and focus group interviews will be performed. Questionnaires, observations and analysis of the medical records and administrative databases will be completed. This study was funded in October 2015. Research Ethics Committee approval was granted in March 2016. There is a pressing need for rigorous research into the effects of interventions for improving patient participation. This study addresses the significance of bedside shift report as an intervention to improve quality of care, communication and patient participation within a large-scale, matched, controlled research design. © 2016 John Wiley & Sons Ltd.

A worksite prevention program for construction workers: design of a randomized controlled trial

PubMed Central

2010-01-01

Background A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers. Methods The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1) two individual training sessions of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted. Discussion The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry. Trial Registration NTR1278 PMID:20546568

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

PubMed

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

2006-04-01

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

RelAte: pilot study of the effects of a mealtime intervention on social cognitive factors and energy intake among older adults living alone.

PubMed

McHugh Power, Joanna E; Lee, Olga; Aspell, Niamh; McCormack, Emma; Loftus, Michelle; Connolly, Leona; Lawlor, Brian; Brennan, Sabina

2016-11-01

Mealtime interventions typically focus on institutionalised older adults, but we wanted to investigate whether they may also be effective among those living independently. Using a randomised controlled trial design, we assessed the effects of a novel mealtime intervention on self-efficacy, food enjoyment and energy intake. A total of 100 adults living alone aged over 60 years were randomised to the treatment or control conditions: all received a guidebook on nutrition and culinary skills. Treatment group participants received a weekly visit from a trained volunteer who prepared and shared a meal with them. Participants in the treatment group showed improvements relative to those in the control group at borderline significance (P=0·054) for self-efficacy and at significance for food enjoyment. Significant improvements were observed in female participants in the treatment but not in the control group in energy intake (although following corrections for multiple comparisons, only the effect on food enjoyment remained significant). These findings will inform the design of future complex interventions. For this type of intervention to be successful, more focus has to be placed on making interventions more personalised, potentially according to sex. Findings are important for nutritional sciences as they indicate that, in order to improve energy intake and food enjoyment among older adults, multimodal nutritional interventions including social components may be successful.

Waiting list randomized controlled trial within a case-finding design: methodological considerations.

PubMed

Ronaldson, Sarah; Adamson, Joy; Dyson, Lisa; Torgerson, David

2014-10-01

Randomized controlled trials (RCTs) are widely used in health care research to provide high-quality evidence of effectiveness of an intervention. However, sometimes a study does not require an RCT in order to answer its primary objective; a case-finding design may be more appropriate. The aim of this paper was to introduce a new study design that nests a waiting list RCT within a case-finding study. An example of the new study design is the DOC Study, which primarily aims to determine the diagnostic accuracy of lung function tests for chronic obstructive pulmonary disease. It also investigates the impact of lung function tests on smoking behaviour through use of a waiting list design. The first step of the study design is to obtain participants' consent. Individuals are then randomized to one of two groups; either the 'intervention now' group or the 'intervention later' group, that is, participants are placed on a waiting list. All participants receive the same intervention; the only difference between the groups is the timing of the intervention. The design addresses patient preference issues and recruitment issues that can arise in other trial designs. Potential limitations include differential attrition between study groups and potential demoralization for the 'intervention later' group. The 'waiting list case-finding trial' design is a valuable method that could be applied to case-finding studies; the design enables the case-finding component of a study to be maintained while simultaneously exploring additional hypotheses through conducting a trial. © 2014 John Wiley & Sons, Ltd.

The Effects of a Cluster Randomized Controlled Workplace Intervention on Sleep and Work-Family Conflict Outcomes in an Extended Care Setting

PubMed Central

Marino, Miguel; Killerby, Marie; Lee, Soomi; Klein, Laura Cousino; Moen, Phyllis; Olson, Ryan; Kossek, Ellen Ernst; King, Rosalind; Erickson, Leslie; Berkman, Lisa F.; Buxton, Orfeu M.

2016-01-01

Objectives To evaluate the effects of a workplace-based intervention on actigraphic and self-reported sleep outcomes in an extended care setting. Design Cluster randomized trial. Setting Extended-care (nursing) facilities. Participants US employees and managers at nursing homes. Nursing homes were randomly selected to intervention or control settings. Intervention The Work, Family and Health Study developed an intervention aimed at reducing work-family conflict within a 4-month work-family organizational change process. Employees participated in interactive sessions with facilitated discussions, role-playing, and games designed to increase control over work processes and work time. Managers completed training in family-supportive supervision. Measurements Primary actigraphic outcomes included: total sleep duration, wake after sleep onset, nighttime sleep, variation in nighttime sleep, nap duration, and number of naps. Secondary survey outcomes included work-to-family conflict, sleep insufficiency, insomnia symptoms and sleep quality. Measures were obtained at baseline, 6-months and 12-months post-intervention. Results A total of 1,522 employees and 184 managers provided survey data at baseline. Managers and employees in the intervention arm showed no significant difference in sleep outcomes over time compared to control participants. Sleep outcomes were not moderated by work-to-family conflict or presence of children in the household for managers or employees. Age significantly moderated an intervention effect on nighttime sleep among employees (p=0.040), where younger employees benefited more from the intervention. Conclusion In the context of an extended-care nursing home workplace, the intervention did not significantly alter sleep outcomes in either managers or employees. Moderating effects of age were identified where younger employees’ sleep outcomes benefited more from the intervention. PMID:28239635

Mathematics Intervention for First- and Second-Grade Students with Mathematics Difficulties: The Effects of Tier 2 Intervention Delivered as Booster Lessons

ERIC Educational Resources Information Center

Bryant, Diane Pedrotty; Bryant, Brian R.; Gersten, Russell; Scammacca, Nancy; Chavez, Melissa M.

2008-01-01

This study sought to examine the effects of Tier 2 intervention in a multitiered model on the performance of first- and second-grade students who were identified as having mathematics difficulties. A regression discontinuity design was utilized. Participants included 126 (Tier 2, n = 26) first graders and 140 (Tier 2, n = 25) second graders. Tier…

Effective preventive interventions to support parents of young children: Illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD).

PubMed

Juffer, Femmie; Struis, Estelle; Werner, Claudia; Bakermans-Kranenburg, Marian J

2017-01-01

Secure attachment relationships are essential for children's current and later development. From attachment theory and research, it can be derived that sensitive parenting is the key to positive parent-child relationships. Is it possible to design effective interventions to enhance sensitive parenting? In this article, we review elements that are crucial for effective attachment-based interventions, and we proceed with illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). We describe how this intervention program was developed, how it has been implemented in practice in different types of families and in daycare settings, and how effective the program is. We conclude that intervention programs like the VIPP-SD could play an important role in the community by serving families in need of parenting support.

Neighborhood effects in a behavioral randomized controlled trial.

PubMed

Pruitt, Sandi L; Leonard, Tammy; Murdoch, James; Hughes, Amy; McQueen, Amy; Gupta, Samir

2014-11-01

Randomized controlled trials (RCTs) of interventions intended to modify health behaviors may be influenced by neighborhood effects which can impede unbiased estimation of intervention effects. Examining a RCT designed to increase colorectal cancer (CRC) screening (N=5628), we found statistically significant neighborhood effects: average CRC test use among neighboring study participants was significantly and positively associated with individual patient's CRC test use. This potentially important spatially-varying covariate has not previously been considered in a RCT. Our results suggest that future RCTs of health behavior interventions should assess potential social interactions between participants, which may cause intervention arm contamination and may bias effect size estimation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Barriers to the sustainability of an intervention designed to improve patient engagement within NHS mental health rehabilitation units: a qualitative study nested within a randomised controlled trial.

PubMed

Lean, Melanie; Leavey, Gerard; Killaspy, Helen; Green, Nicholas; Harrison, Isobel; Cook, Sarah; Craig, Thomas; Holloway, Frank; Arbuthnott, Maurice; King, Michael

2015-09-02

We undertook a cluster randomised controlled trial to assess the effectiveness of a staff training intervention to improve patient engagement in activities in inpatient mental health rehabilitation units. Concurrently, we undertook a qualitative study to investigate the experiences of staff within the intervention units and the contextual issues that may have influenced the effectiveness of the intervention. We conducted focus groups with staff working in the inpatient units that received the intervention, sampled using a maximum variation strategy. The intervention was accepted by staff. However, the skills gained, and changes to the unit's processes and structures that were agreed with the intervention team were not sustained after they left. The main reasons for this were a) external factors (economic recession, resource limitations); b) organisation level factors (lack of senior staff support; competing priorities); c) limitations of the intervention itself (length of intensive training period; reinforcement of skills). This study illustrates some of the inter-related factors which operate at different levels within and outside of NHS organisations that may impact on the success of complex interventions. These factors need to be considered when designing interventions to ensure adequate buy-in from senior staff. Current Controlled Trials ISRCTN25898179 (Registered 23 April 2010).

Mujeres en accion: design and baseline data.

PubMed

Keller, Colleen; Fleury, Julie; Perez, Adriana; Belyea, Michael; Castro, Felipe G

2011-10-01

The majority of programs designed to promote physical activity in older Hispanic women includes few innovative theory-based interventions that address cultural relevant strategies. The purpose of this report is to describe the design and baseline data for Mujeres en Accion, a physical activity intervention to increase regular physical activity, and cardiovascular health outcomes among older Hispanic women. Mujeres en Accion [Women in Action for Health], a 12 month randomized controlled trial to evaluate the effectiveness of a social support physical activity intervention in midlife and older Hispanic women. This study tests an innovative intervention, Mujeres en Accion, and includes the use of a theory-driven approach to intervention, explores social support as a theoretical mediating variable, use of a Promotora model and a Community Advisory group to incorporate cultural and social approaches and resources, and use of objective measures of physical activity in Hispanic women.

Mujeres en Accion: Design and Baseline Data

PubMed Central

Fleury, Julie; Perez, Adriana; Belyea, Michael; Castro, Felipe G.

2015-01-01

The majority of programs designed to promote physical activity in older Hispanic women includes few innovative theory-based interventions that address cultural relevant strategies. The purpose of this report is to describe the design and baseline data for Mujeres en Accion, a physical activity intervention to increase regular physical activity, and cardiovascular health outcomes among older Hispanic women. Mujeres en Accion [Women in Action for Health], a 12 month randomized controlled trial to evaluate the effectiveness of a social support physical activity intervention in midlife and older Hispanic women. This study tests an innovative intervention, Mujeres en Accion, and includes the use of a theory-driven approach to intervention, explores social support as a theoretical mediating variable, use of a Promotora model and a Community Advisory group to incorporate cultural and social approaches and resources, and use of objective measures of physical activity in Hispanic women. PMID:21298400

Improving the participation of youth with physical disabilities in community activities: An interrupted time series design.

PubMed

Law, Mary; Anaby, Dana; Imms, Christine; Teplicky, Rachel; Turner, Laura

2015-04-01

Youth with physical disabilities experience restrictions to participation in community-based leisure activities; however, there is little evidence about how to improve their involvement. This study examined whether an intervention to remove environmental barriers and develop strategies using a coaching approach improved youth participation in leisure activities. An Interrupted Time Series design was employed, where replication of the intervention effect was examined across individualised participation goals and across participants. Six adolescents with a physical disability participated in a 12-week intervention. An occupational therapist worked with each youth and his/her family to set three leisure goals based on problems identified using the Canadian Occupational Performance Measure (COPM). A coaching approach was used to collaboratively identify and implement strategies to remove environmental barriers. Interventions for each goal were introduced at different time points. Outcomes were evaluated using the COPM. Improvements in COPM performance scores were clinically significant for 83% of the identified activities; an average change of 4.5 points in the performance scale (SD = 1.95) was observed. Statistical analysis using the celeration line demonstrated that the proportion of data points falling above the line increased in the intervention phase for 94% of the activities, indicating a significant treatment effect. This study is the first to examine an intervention aimed at increasing leisure participation by changing only the environment. The results indicate that environment-focussed interventions are feasible and effective in promoting youth participation. Such findings can inform the design of a larger study and guide occupational therapy practice. © 2015 Occupational Therapy Australia.

Systematic review of stigma reducing interventions for African/Black diasporic women

PubMed Central

Loutfy, Mona; Tharao, Wangari; Logie, Carmen; Aden, Muna A; Chambers, Lori A; Wu, Wei; Abdelmaseh, Marym; Calzavara, Liviana

2015-01-01

Introduction Literature indicates that racism, sexism, homophobia and HIV-related stigma have adverse impacts on health, well-being, and quality of life among HIV-positive women of African descent (African/Black diaspora). However, limited evidence exists on the effectiveness of interventions aimed at reducing stigma tailored for these women. This study systematically reviewed randomized controlled trials (RCTs), non-randomized observational and quasi-experimental studies evaluating the effectiveness of interventions aimed at reducing stigma experienced by this population. Methods The Cochrane methodology was used to develop a search strategy in consultation with a librarian scientist. Databases searched included the Cochrane Library, Ovid EMBASE, PsycInfo, and 10 others. Two reviewers independently assessed the studies for potential relevance and conducted the Cochrane grading of RCTs to assess risk of bias and the Newcastle–Ottawa scale to assess the quality of non-randomized studies. Eligible papers were selected if they employed an intervention design with African/Black diasporic women living with HIV as the target population and had a primary outcome of stigma reduction. Results Of the five studies that met all of the eligibility criteria, four demonstrated the effectiveness of interventions in reducing HIV-related stigma. Only two of the five studies were designed specifically for HIV-positive African/Black diasporic women. Limitations included the absence of interventions addressing other forms of stigma and discrimination (e.g. gender discrimination, racism, heterosexism). Conclusions Our findings suggest that there are limited interventions designed to address multiple forms of stigma, including gender and racial discrimination, experienced by HIV-positive African/Black diasporic women. PMID:25862565

Systematic review of stigma reducing interventions for African/Black diasporic women.

PubMed

Loutfy, Mona; Tharao, Wangari; Logie, Carmen; Aden, Muna A; Chambers, Lori A; Wu, Wei; Abdelmaseh, Marym; Calzavara, Liviana

2015-01-01

Literature indicates that racism, sexism, homophobia and HIV-related stigma have adverse impacts on health, well-being, and quality of life among HIV-positive women of African descent (African/Black diaspora). However, limited evidence exists on the effectiveness of interventions aimed at reducing stigma tailored for these women. This study systematically reviewed randomized controlled trials (RCTs), non-randomized observational and quasi-experimental studies evaluating the effectiveness of interventions aimed at reducing stigma experienced by this population. The Cochrane methodology was used to develop a search strategy in consultation with a librarian scientist. Databases searched included the Cochrane Library, Ovid EMBASE, PsycInfo, and 10 others. Two reviewers independently assessed the studies for potential relevance and conducted the Cochrane grading of RCTs to assess risk of bias and the Newcastle-Ottawa scale to assess the quality of non-randomized studies. Eligible papers were selected if they employed an intervention design with African/Black diasporic women living with HIV as the target population and had a primary outcome of stigma reduction. Of the five studies that met all of the eligibility criteria, four demonstrated the effectiveness of interventions in reducing HIV-related stigma. Only two of the five studies were designed specifically for HIV-positive African/Black diasporic women. Limitations included the absence of interventions addressing other forms of stigma and discrimination (e.g. gender discrimination, racism, heterosexism). Our findings suggest that there are limited interventions designed to address multiple forms of stigma, including gender and racial discrimination, experienced by HIV-positive African/Black diasporic women.

Obesity interventions for people with a learning disability: an integrative literature review.

PubMed

Jinks, Annette; Cotton, Angela; Rylance, Rebecca

2011-03-01

This paper is a review of the effectiveness of non-surgical, non-pharmaceutical interventions designed to promote weight loss in people with a learning disability and how qualitative evidence on people's experiences and motivations can help understanding of the quantitative research outcomes. The health risks of obesity underline the importance of effective evidence-based weight loss interventions for people with learning disabilities as they are at increased risk of being overweight. Papers published from 1998 to 2009 were identified through searches of the Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), PSYCHINFO databases, and the Cochrane Library. An integrative review method was used. Studies included were non-surgical or non-pharmaceutical interventions aimed at weight reduction for people with a learning disability. Synthesis of the findings related to study design, participants, types of interventions, outcome measures and participant perspectives. Twelve studies met the inclusion criteria. The most common research design was quasi-experimental pretest and post-test. Few researchers used a clinical trial approach, and there was only one predominantly qualitative study. Interventions were mainly focused on energy intake, energy expenditure or health promotion. Only a few studies incorporated behaviour modification approaches. Nurses who work with clients with learning disabilities have a key role to play in the management of obesity. Future research needs to focus on qualitative studies of the perceptions of clients and their families, controlled trials investigating the effectiveness of interventions and their costs and sustainability, and longitudinal studies examining weight loss over time. © 2010 Blackwell Publishing Ltd.

Design of an impact evaluation using a mixed methods model--an explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi.

PubMed

Brenner, Stephan; Muula, Adamson S; Robyn, Paul Jacob; Bärnighausen, Till; Sarker, Malabika; Mathanga, Don P; Bossert, Thomas; De Allegri, Manuela

2014-04-22

In this article we present a study design to evaluate the causal impact of providing supply-side performance-based financing incentives in combination with a demand-side cash transfer component on equitable access to and quality of maternal and neonatal healthcare services. This intervention is introduced to selected emergency obstetric care facilities and catchment area populations in four districts in Malawi. We here describe and discuss our study protocol with regard to the research aims, the local implementation context, and our rationale for selecting a mixed methods explanatory design with a quasi-experimental quantitative component. The quantitative research component consists of a controlled pre- and post-test design with multiple post-test measurements. This allows us to quantitatively measure 'equitable access to healthcare services' at the community level and 'healthcare quality' at the health facility level. Guided by a theoretical framework of causal relationships, we determined a number of input, process, and output indicators to evaluate both intended and unintended effects of the intervention. Overall causal impact estimates will result from a difference-in-difference analysis comparing selected indicators across intervention and control facilities/catchment populations over time.To further explain heterogeneity of quantitatively observed effects and to understand the experiential dimensions of financial incentives on clients and providers, we designed a qualitative component in line with the overall explanatory mixed methods approach. This component consists of in-depth interviews and focus group discussions with providers, service user, non-users, and policy stakeholders. In this explanatory design comprehensive understanding of expected and unexpected effects of the intervention on both access and quality will emerge through careful triangulation at two levels: across multiple quantitative elements and across quantitative and qualitative elements. Combining a traditional quasi-experimental controlled pre- and post-test design with an explanatory mixed methods model permits an additional assessment of organizational and behavioral changes affecting complex processes. Through this impact evaluation approach, our design will not only create robust evidence measures for the outcome of interest, but also generate insights on how and why the investigated interventions produce certain intended and unintended effects and allows for a more in-depth evaluation approach.

The application of latent curve analysis to testing developmental theories in intervention research.

PubMed

Curran, P J; Muthén, B O

1999-08-01

The effectiveness of a prevention or intervention program has traditionally been assessed using time-specific comparisons of mean levels between the treatment and the control groups. However, many times the behavior targeted by the intervention is naturally developing over time, and the goal of the treatment is to alter this natural or normative developmental trajectory. Examining time-specific mean levels can be both limiting and potentially misleading when the behavior of interest is developing systematically over time. It is argued here that there are both theoretical and statistical advantages associated with recasting intervention treatment effects in terms of normative and altered developmental trajectories. The recently developed technique of latent curve (LC) analysis is reviewed and extended to a true experimental design setting in which subjects are randomly assigned to a treatment intervention or a control condition. LC models are applied to both artificially generated and real intervention data sets to evaluate the efficacy of an intervention program. Not only do the LC models provide a more comprehensive understanding of the treatment and control group developmental processes compared to more traditional fixed-effects models, but LC models have greater statistical power to detect a given treatment effect. Finally, the LC models are modified to allow for the computation of specific power estimates under a variety of conditions and assumptions that can provide much needed information for the planning and design of more powerful but cost-efficient intervention programs for the future.

A “SMART” Design for Building Individualized Treatment Sequences

PubMed Central

Lei, H.; Nahum-Shani, I.; Lynch, K.; Oslin, D.; Murphy, S.A.

2013-01-01

Interventions often involve a sequence of decisions. For example, clinicians frequently adapt the intervention to an individual’s outcomes. Altering the intensity and type of intervention over time is crucial for many reasons, such as to obtain improvement if the individual is not responding or to reduce costs and burden when intensive treatment is no longer necessary. Adaptive interventions utilize individual variables (severity, preferences) to adapt the intervention and then dynamically utilize individual outcomes (response to treatment, adherence) to readapt the intervention. The Sequential Multiple Assignment Randomized Trial (SMART)provides high-quality data that can be used to construct adaptive interventions. We review the SMART and highlight its advantages in constructing and revising adaptive interventions as compared to alternative experimental designs. Selected examples of SMART studies are described and compared. A data analysis method is provided and illustrated using data from the Extending Treatment Effectiveness of Naltrexone SMART study. PMID:22224838

Key influences in the design and implementation of mental health information systems in Ghana and South Africa.

PubMed

Ahuja, S; Mirzoev, T; Lund, C; Ofori-Atta, A; Skeen, S; Kufuor, A

2016-01-01

Strengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is limited published evidence exploring the design and implementation of MHIS in these settings. This paper aims to identify and assess the key factors affecting the design and implementation of MHIS, as perceived by the key stakeholders in Ghana and South Africa. We report findings from the Mental Health and Poverty Project, a 5-year research programme implemented within four African countries. The MHIS strengthening in South Africa and Ghana included two related components: intervention and research. The intervention component aimed to strengthen MHIS in the two countries, and the research component aimed to document interventions in each country, including the key influences. Data were collected using semi structured interviews with key stakeholders and reviews of key documents and secondary data from the improved MHIS. We analyzed the qualitative data using a framework approach. Key components of the MHIS intervention involved the introduction of a redesigned patient registration form, entry into computers for analysis every 2 months by clinical managerial staff, and utilization of data in hospital management meetings in three psychiatric hospitals in Ghana; and the introduction of a new set of mental health indicators and related forms and tally sheets at primary care clinics and district hospitals in five districts in the KwaZulu-Natal and Northern Cape provinces in South Africa. Overall, the key stakeholders perceived the MHIS strengthening as an effective intervention in both countries with an enhanced set of indicators in South Africa and introduction of a computerized system in Ghana. Influences on the design and implementation of MHIS interventions in Ghana and South Africa relate to resources, working approaches (including degree of consultations during the design stage and communication during implementation stage) and the low priority of mental health. Although the influencing factors represent similar categories, more influences were identified on MHIS implementation, compared with the design stage. Different influences appear to be related within, and across, the MHIS design and implementation and may reinforce or negate each other thus leading to the multiplier or minimization effects. The wider context, similar to other studies, is important in ensuring the success of such interventions. Future MHIS strengthening interventions can consider three policy implications which emerged from our analysis and experience: enhancing consultations during the intervention design, better consideration of implementation challenges during design, and better recognition of relations between different influences.

Interventions to Improve Medication Adherence among Older Adults: Meta-Analysis of Adherence Outcomes among Randomized Controlled Trials

ERIC Educational Resources Information Center

Conn, Vicki S.; Hafdahl, Adam R.; Cooper, Pamela S.; Ruppar, Todd M.; Mehr, David R.; Russell, Cynthia L.

2009-01-01

Purpose: This study investigated the effectiveness of interventions to improve medication adherence (MA) in older adults. Design and Methods: Meta-analysis was used to synthesize results of 33 published and unpublished randomized controlled trials. Random-effects models were used to estimate overall mean effect sizes (ESs) for MA, knowledge,…

The Relationship between Teacher Orientation and Consultation Terminology, Intervention Acceptability, Evaluation of Effectiveness, and Willingness to Implement

ERIC Educational Resources Information Center

Heuser, Robin Rachelle

2012-01-01

The current study was designed to expand on previous research examining the effect of terminology on ratings of intervention acceptability and to investigate the effects of terminology on judgments of outcome data and willingness to implement. Secondarily, this study explored teacher beliefs and instructional style. The sample for this study…

Mindfulness-Based Stress Reduction for the Treatment of Adolescent Psychiatric Outpatients: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Biegel, Gina M.; Brown, Kirk Warren; Shapiro, Shauna L.; Schubert, Christine M.

2009-01-01

Research has shown that mindfulness-based treatment interventions may be effective for a range of mental and physical health disorders in adult populations, but little is known about the effectiveness of such interventions for treating adolescent conditions. The present randomized clinical trial was designed to assess the effect of the…

The Effectiveness of Verbal Counseling VS. Social Interaction Counseling of College Males. Final Report.

ERIC Educational Resources Information Center

Stewart, Norman R.; Hay, Nancy M.

The purpose of this investigation was to assess the effectiveness of three different short-term treatment interventions with college males characterized by little or no dating behavior and fears about dating. The treatments were designed to produce evidence concerning the effectiveness of: (1) lay versus professional action interventions, (2)…

Effects of a Group Contingency Strategy on Middle School Physical Education Students' Heart Rates

ERIC Educational Resources Information Center

Vidoni, Carla; Azevedo, Liane; Eberline, Andrew

2012-01-01

The purpose of this study was to assess the effects of a dependent group contingency on eighth-grade students' heart rates. Participants were 18 male and female students. A multielement research design was used to examine the intervention effects. The intervention consisted of: (a) teacher explanation about effort; (b) students' suggestions to…

Evaluating Effectiveness of Two Types of Chinese Remedial Materials for Low-Achieving and Disadvantaged Second Graders

ERIC Educational Resources Information Center

Chen, Shu-Li; Shih-Jay, Tzeng; Chu, Szu-Yin

2015-01-01

Having access to research-based materials is an essential component for designing effective interventions for low-achieving and disadvantaged students. The purpose of this study was to compare the effectiveness of two types of reading material intervention for low-achieving and disadvantaged students. The students were divided into experimental…

Beauty and Hope: A Moral Beauty Intervention

ERIC Educational Resources Information Center

Diessner, Rhett; Rust, Teri; Solom, Rebecca C.; Frost, Nellie; Parsons, Lucas

2006-01-01

Pedagogical intervention regarding engagement with natural, artistic and moral beauty can lead to an increase in trait hope. In a quasi-experimental design with college students the intervention group showed significantly higher gain scores on trait hope than did the comparison group; the effect size was moderate. The experimental group also…

Reducing Rape-Myth Acceptance in Male College Students: A Meta-Analysis of Intervention Studies.

ERIC Educational Resources Information Center

Flores, Stephen A.; Hartlaub, Mark G.

1998-01-01

Studies evaluating interventions designed to reduce rape-supportive beliefs are examined to identify effective strategies. Searches were conducted on several databases from 1980 to present. Results indicate that human-sexuality courses, workshops, video interventions, and other formats appear to be successful strategies, although these…

Conceptually Based Vocabulary Intervention: Second Graders' Development of Vocabulary Words

ERIC Educational Resources Information Center

Dimling, Lisa M.

2010-01-01

An instructional strategy was investigated that addressed the needs of deaf and hard of hearing students through a conceptually based sign language vocabulary intervention. A single-subject multiple-baseline design was used to determine the effects of the vocabulary intervention on word recognition, production, and comprehension. Six students took…

Do Instructional Interventions Influence College Students' Critical Thinking Skills? A Meta-Analysis

ERIC Educational Resources Information Center

Niu, Lian; Behar-Horenstein, Linda S.; Garvan, Cyndi W.

2013-01-01

Promoting students' critical thinking skills is an important task of higher education. Colleges and universities have designed various instructional interventions to enhance students' critical thinking skills. Empirical studies have yielded inconsistent results in terms of the effects of such interventions. This meta-analysis presents a synthesis…

Randomized Study of a Prebirth Coparenting Intervention with Adolescent and Young Fathers

ERIC Educational Resources Information Center

Fagan, Jay

2008-01-01

This randomized study tested the effects of 2 prebirth interventions, Minnesota Early Learning Design coparenting and childbirth curricula, on young African American and Hispanic fathers and their adolescent partners (N = 154). The coparenting intervention (n = 44) was associated with changing fathers' perceptions of their coparenting behavior…

Working Memory Interventions with Children: Classrooms or Computers?

ERIC Educational Resources Information Center

Colmar, Susan; Double, Kit

2017-01-01

The importance of working memory to classroom functioning and academic outcomes has led to the development of many interventions designed to enhance students' working memory. In this article we briefly review the evidence for the relative effectiveness of classroom and computerised working memory interventions in bringing about measurable and…

Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial

ERIC Educational Resources Information Center

Goodkind, Jessica R.; Amer, Suha; Christian, Charlisa; Hess, Julia Meredith; Bybee, Deborah; Isakson, Brian L.; Baca, Brandon; Ndayisenga, Martin; Greene, R. Neil; Shantzek, Cece

2017-01-01

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants' intervention experiences, and their…

An Evaluation of Interventions to Facilitate Algebra Problem Solving

ERIC Educational Resources Information Center

Mayfield, Kristin H.; Glenn, Irene M.

2008-01-01

Three participants were trained on 6 target algebra skills and subsequently received a series of 5 instructional interventions (cumulative practice, tiered feedback, feedback plus solution sequence instruction, review practice, and transfer training) in a multiple baseline across skills design. The effects of the interventions on the performance…

Proactive and integrated primary care for frail older people: design and methodological challenges of the Utrecht primary care PROactive frailty intervention trial (U-PROFIT).

PubMed

Bleijenberg, Nienke; Drubbel, Irene; Ten Dam, Valerie H; Numans, Mattijs E; Schuurmans, Marieke J; de Wit, Niek J

2012-04-25

Currently, primary care for frail older people is reactive, time consuming and does not meet patients' needs. A transition is needed towards proactive and integrated care, so that daily functioning and a good quality of life can be preserved. To work towards these goals, two interventions were developed to enhance the care of frail older patients in general practice: a screening and monitoring intervention using routine healthcare data (U-PRIM) and a nurse-led multidisciplinary intervention program (U-CARE). The U-PROFIT trial was designed to evaluate the effectiveness of these interventions. The aim of this paper is to describe the U-PROFIT trial design and to discuss methodological issues and challenges. The effectiveness of U-PRIM and U-CARE is being tested in a three-armed, cluster randomized trial in 58 general practices in the Netherlands, with approximately 5000 elderly individuals expected to participate. The primary outcome is the effect on activities of daily living as measured with the Katz ADL index. Secondary outcomes are quality of life, mortality, nursing home admission, emergency department and out-of-hours General Practice (GP), surgery visits, and caregiver burden. In a large, pragmatic trial conducted in daily clinical practice with frail older patients, several challenges and methodological issues will occur. Recruitment and retention of patients and feasibility of the interventions are important issues. To enable broad generalizability of results, careful choices of the design and outcome measures are required. Taking this into account, the U-PROFIT trial aims to provide robust evidence for a structured and integrated approach to provide care for frail older people in primary care. NTR2288.

A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8.

PubMed

Steinert, Yvonne; Mann, Karen; Centeno, Angel; Dolmans, Diana; Spencer, John; Gelula, Mark; Prideaux, David

2006-09-01

Preparing healthcare professionals for teaching is regarded as essential to enhancing teaching effectiveness. Although many reports describe various faculty development interventions, there is a paucity of research demonstrating their effectiveness. To synthesize the existing evidence that addresses the question: "What are the effects of faculty development interventions on the knowledge, attitudes and skills of teachers in medical education, and on the institutions in which they work?" The search, covering the period 1980-2002, included three databases (Medline, ERIC and EMBASE) and used the keywords: staff development; in-service training; medical faculty; faculty training/development; continuing medical education. Manual searches were also conducted. Articles with a focus on faculty development to improve teaching effectiveness, targeting basic and clinical scientists, were reviewed. All study designs that included outcome data beyond participant satisfaction were accepted. From an initial 2777 abstracts, 53 papers met the review criteria. Data were extracted by six coders, using the standardized BEME coding sheet, adapted for our use. Two reviewers coded each study and coding differences were resolved through discussion. Data were synthesized using Kirkpatrick's four levels of educational outcomes. Findings were grouped by type of intervention and described according to levels of outcome. In addition, 8 high-quality studies were analysed in a 'focused picture'. The majority of the interventions targeted practicing clinicians. All of the reports focused on teaching improvement and the interventions included workshops, seminar series, short courses, longitudinal programs and 'other interventions'. The study designs included 6 randomized controlled trials and 47 quasi-experimental studies, of which 31 used a pre-test-post-test design. Despite methodological limitations, the faculty development literature tends to support the following outcomes: Overall satisfaction with faculty development programs was high. Participants consistently found programs acceptable, useful and relevant to their objectives. Participants reported positive changes in attitudes toward faculty development and teaching. Participants reported increased knowledge of educational principles and gains in teaching skills. Where formal tests of knowledge were used, significant gains were shown. Changes in teaching behavior were consistently reported by participants and were also detected by students. Changes in organizational practice and student learning were not frequently investigated. However, reported changes included greater educational involvement and establishment of collegiate networks. Key features of effective faculty development contributing to effectiveness included the use of experiential learning, provision of feedback, effective peer and colleague relationships, well-designed interventions following principles of teaching and learning, and the use of a diversity of educational methods within single interventions. Methodological issues: More rigorous designs and a greater use of qualitative and mixed methods are needed to capture the complexity of the interventions. Newer methods of performance-based assessment, utilizing diverse data sources, should be explored, and reliable and valid outcome measures should be developed. The maintenance of change over time should also be considered, as should process-oriented studies comparing different faculty development strategies. Faculty development activities appear highly valued by participants, who also report changes in learning and behavior. Notwithstanding the methodological limitations in the literature, certain program characteristics appear to be consistently associated with effectiveness. Further research to explore these associations and document outcomes, at the individual and organizational level, is required.

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

PubMed Central

2012-01-01

Background Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking. Methods & design This paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years) entitled ‘Fun without Smokes’. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT) with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils’ smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the ‘Fun without Smokes’ website. The main outcome measures will be ever smoking and the utilisation of the ‘Fun without Smokes’ website. Measurements will be carried out at baseline, 12 months and 24 months of follow-up. Discussion The present study protocol describes the purpose, intervention design and study protocol of ‘Fun without Smokes’. Expectations are that pupils receiving tailored advice will be less likely to smoke after 24 months in contrast to pupils in the control condition. Furthermore, tailored feedback letters and prompting is expected to be more effective than providing tailored feedback letters only. Trial registration Dutch Trial Register NTR3116 PMID:22490110

Methodological Issues in Trials of Complementary and Alternative Medicine Interventions

PubMed Central

Sikorskii, Alla; Wyatt, Gwen; Victorson, David; Faulkner, Gwen; Rahbar, Mohammad Hossein

2010-01-01

Background Complementary and alternative medicine (CAM) use is widespread among cancer patients. Information on safety and efficacy of CAM therapies is needed for both patients and health care providers. Well-designed randomized clinical trials (RCTs) of CAM therapy interventions can inform both clinical research and practice. Objectives To review important issues that affect the design of RCTs for CAM interventions. Methods Using the methods component of the Consolidated Standards for Reporting Trials (CONSORT) as a guiding framework, and a National Cancer Institute-funded reflexology study as an exemplar, methodological issues related to participants, intervention, objectives, outcomes, sample size, randomization, blinding, and statistical methods were reviewed. Discussion Trials of CAM interventions designed and implemented according to appropriate methodological standards will facilitate the needed scientific rigor in CAM research. Interventions in CAM can be tested using proposed methodology, and the results of testing will inform nursing practice in providing safe and effective supportive care and improving the well-being of patients. PMID:19918155

Considerations in the Efficacy and Effectiveness of Virtual Reality Interventions for Stroke Rehabilitation: Moving the Field Forward

PubMed Central

Lange, Belinda

2015-01-01

In the past 2 decades, researchers have demonstrated the potential for virtual reality (VR) technologies to provide engaging and motivating environments for stroke rehabilitation interventions. Much of the research has been focused on the exploratory phase, and jumps to intervention efficacy trials and scale-up evaluation have been made with limited understanding of the active ingredients in a VR intervention for stroke. The rapid pace of technology development is an additional challenge for this emerging field, providing a moving target for researchers developing and evaluating potential VR technologies. Recent advances in customized games and cutting-edge technology used for VR are beginning to allow for researchers to understand and control aspects of the intervention related to motivation, engagement, and motor control and learning. This article argues for researchers to take a progressive, step-wise approach through the stages of intervention development using evidence-based principles, take advantage of the data that can be obtained, and utilize measurement tools to design effective VR interventions for stroke rehabilitation that can be assessed through carefully designed efficacy and effectiveness trials. This article is motivated by the recent calls in the field of rehabilitation clinical trials research for carefully structured clinical trials that have progressed through the phases of research. PMID:25343960

Considerations in the efficacy and effectiveness of virtual reality interventions for stroke rehabilitation: moving the field forward.

PubMed

Proffitt, Rachel; Lange, Belinda

2015-03-01

In the past 2 decades, researchers have demonstrated the potential for virtual reality (VR) technologies to provide engaging and motivating environments for stroke rehabilitation interventions. Much of the research has been focused on the exploratory phase, and jumps to intervention efficacy trials and scale-up evaluation have been made with limited understanding of the active ingredients in a VR intervention for stroke. The rapid pace of technology development is an additional challenge for this emerging field, providing a moving target for researchers developing and evaluating potential VR technologies. Recent advances in customized games and cutting-edge technology used for VR are beginning to allow for researchers to understand and control aspects of the intervention related to motivation, engagement, and motor control and learning. This article argues for researchers to take a progressive, step-wise approach through the stages of intervention development using evidence-based principles, take advantage of the data that can be obtained, and utilize measurement tools to design effective VR interventions for stroke rehabilitation that can be assessed through carefully designed efficacy and effectiveness trials. This article is motivated by the recent calls in the field of rehabilitation clinical trials research for carefully structured clinical trials that have progressed through the phases of research. © 2015 American Physical Therapy Association.

Using Theater to Teach Clinical Empathy: A Pilot Study

PubMed Central

Leong, David; Anderson, Aaron; Wenzel, Richard P.

2007-01-01

Background Clinical empathy, a critical skill for the doctor–patient relationship, is infrequently taught in graduate medical education. No study has tested if clinical empathy can be taught effectively. Objective To assess whether medicine residents can learn clinical empathy techniques from theater professors. Design A controlled trial of a clinical empathy curriculum taught and assessed by 4 theater professors. Setting Virginia Commonwealth University, Richmond, Virginia, a large urban university and health system. Participants Twenty Internal Medicine residents: 14 in the intervention group, 6 in the control group. Intervention Six hours of classroom instruction and workshop time with professors of theater. Measurements Scores derived from an instrument with 6 subscores designed to measure empathy in real-time patient encounters. Baseline comparisons were made using two-sample T tests. A mixed-effects analysis of variance model was applied to test for significance between the control and intervention groups. Results The intervention group demonstrated significant improvement (p ≤ .011) across all 6 subscores between pre-intervention and post-intervention observations. Compared to the control group, the intervention group had better posttest scores in 5 of 6 subscores (p ≤ .01). Limitations The study was neither randomized nor blinded. Conclusions Collaborative efforts between the departments of theater and medicine are effective in teaching clinical empathy techniques. PMID:17486385

Effects of a long-term psychosocial nursing intervention on adolescents exposed to catastrophic stress.

PubMed

Hardin, Sally Brosz; Weinrich, Sally; Weinrich, Martin; Garrison, Carol; Addy, Cheryl; Hardin, Thomas L

2002-09-01

This research tested the effects of a long-term psychosocial nursing intervention designed to decrease mental distress in adolescents following a catastrophic event. Advanced Practice Psychiatric Nurses conducted the Catastrophic Stress Intervention (CSI) in two South Carolina high schools for three years following Hurricane Hugo. The CSI consisted of nine protocols designed to decrease adolescents' mental distress by increasing their understanding of stress and by enhancing their self-efficacy and social support. Adolescents (N = 1030) were randomized to intervention or control groups and completed one baseline and five postintervention measures of mental distress, self-efficacy, and social support. The hypothesis was that intervention adolescents would have less mental distress than control adolescents. The research also addressed the particular time points at which differences between intervention and control adolescents might be shown. Repeated measures multivariate analysis of variance, with exposure to the hurricane, self-efficacy, and social support as control variables, showed that intervention adolescents reported less mental distress than control adolescents at 12, 18, and 24 months but that this difference dissipated by 30 and 36 months. Implications for the CSI and timing of interventions with adolescents after a catastrophic event are discussed.

A systematic review of evidence for end-of-life communication interventions: Who do they target, how are they structured and do they work?

PubMed

Walczak, Adam; Butow, Phyllis N; Bu, Stella; Clayton, Josephine M

2016-01-01

To identify and synthesise evidence for interventions targeting end-of-life communication. Database, reference list and author searches were conducted to identify evaluations of end-of-life communication-focussed interventions. Data were extracted, synthesised and QUALSYST quality analyses were performed. Forty-five studies met inclusion criteria. Interventions targeted patients (n=6), caregivers (n=3), healthcare professionals (HCPs n=24) and multiple stakeholders (n=12). Interventions took various forms including communication skills training, education, advance care planning and structured practice changes. Substantial heterogeneity in study designs, outcomes, settings and measures was apparent and study quality was variable. A substantial number of end-of-life communication interventions have been evaluated. Interventions have particularly targeted HCPs in cancer settings, though patient, caregiver and multi-focal interventions have also been evaluated. While some interventions were efficacious in well-designed RCTs, most evidence was from less robust studies. While additional interventions targeting patients and caregivers are needed, multi-focal interventions may more effectively remove barriers to end-of-life communication. Despite the limitations evident in the existing literature, healthcare professionals may still derive useful insights into effective approaches to end-of-life communication if appropriate caution is exercised. However, additional RCTs, implementation studies and cost-benefit analyses are required to bolster arguments for implementing and resourcing communication interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Designing a theory-informed, contextually appropriate intervention strategy to improve delivery of paediatric services in Kenyan hospitals.

PubMed

English, Mike

2013-03-28

District hospital services in Kenya and many low-income countries should deliver proven, effective interventions that could substantially reduce child and newborn mortality. However such services are often of poor quality. Researchers have therefore been challenged to identify intervention strategies that go beyond addressing knowledge, skill, or resource inadequacies to support health systems to deliver better services at scale. An effort to develop a system-oriented intervention tailored to local needs and context and drawing on theory is described. An intervention was designed to improve district hospital services for children based on four main strategies: a reflective process to distill root causes for the observed problems with service delivery; developing a set of possible intervention approaches to address these problems; a search of literature for theory that provided the most appropriate basis for intervention design; and repeatedly moving backwards and forwards between identified causes, proposed interventions, identified theory, and knowledge of the existing context to develop an overarching intervention that seemed feasible and likely to be acceptable and potentially sustainable. In addition to human and resource constraints key problems included failures of relevant professionals to take responsibility for or ownership of the challenge of pediatric service delivery; inadequately prepared, poorly supported leaders of service units (mid-level managers) who are often professionally and geographically isolated and an almost complete lack of useful information for routinely monitoring or understanding service delivery practice or outcomes. A system-oriented intervention recognizing the pivotal role of leaders of service units but addressing the outer and inner setting of hospitals was designed to help shape and support an appropriate role for these professionals. It aims to foster a sense of ownership while providing the necessary understanding, knowledge, and skills for mid-level managers to work effectively with senior managers and frontline staff to improve services. The intervention will include development of an information system, feedback mechanisms, and discussion fora that promote positive change. The vehicle for such an intervention is a collaborative network partnering government and national professional associations. This case is presented to promote discussion on approaches to developing context appropriate interventions particularly in international health.

Food Choice Architecture: An Intervention in a Secondary School and its Impact on Students’ Plant-based Food Choices

PubMed Central

Ensaff, Hannah; Homer, Matt; Sahota, Pinki; Braybrook, Debbie; Coan, Susan; McLeod, Helen

2015-01-01

With growing evidence for the positive health outcomes associated with a plant-based diet, the study’s purpose was to examine the potential of shifting adolescents’ food choices towards plant-based foods. Using a real world setting of a school canteen, a set of small changes to the choice architecture was designed and deployed in a secondary school in Yorkshire, England. Focussing on designated food items (whole fruit, fruit salad, vegetarian daily specials, and sandwiches containing salad) the changes were implemented for six weeks. Data collected on students’ food choice (218,796 transactions) enabled students’ (980 students) selections to be examined. Students’ food choice was compared for three periods: baseline (29 weeks); intervention (six weeks); and post-intervention (three weeks). Selection of designated food items significantly increased during the intervention and post-intervention periods, compared to baseline (baseline, 1.4%; intervention 3.0%; post-intervention, 2.2%) χ2(2) = 68.1, p < 0.001. Logistic regression modelling also revealed the independent effect of the intervention, with students 2.5 times as likely (p < 0.001) to select the designated food items during the intervention period, compared to baseline. The study’s results point to the influence of choice architecture within secondary school settings, and its potential role in improving adolescents’ daily food choices. PMID:26043039

An Innovative School-Based Intervention to Promote Healthy Lifestyles

ERIC Educational Resources Information Center

Piana, Natalia; Ranucci, Claudia; Buratta, Livia; Foglia, Elena; Fabi, Marta; Novelli, Francesca; Casucci, Simone; Reginato, Elisa; Pippi, Roberto; Aiello, Cristina; Leonardi, Alessia; Romani, Giannermete; De Feo, Pierpaolo; Mazzeschi, Claudia

2017-01-01

Objective: To describe an innovative school-based intervention to promote healthy lifestyles. To evaluate its effects on children's food habits and to highlight the key components which contribute most to the beneficial effects obtained from children's, teachers' and parents' perspectives. Design: An educational tool to improve personal awareness,…

Analysis of Complex Intervention Effects in Time-Series Experiments.

ERIC Educational Resources Information Center

Bower, Cathleen

An iterative least squares procedure for analyzing the effect of various kinds of intervention in time-series data is described. There are numerous applications of this design in economics, education, and psychology, although until recently, no appropriate analysis techniques had been developed to deal with the model adequately. This paper…

Parenting Interventions Implementation Science: How Delivery Format Impacts the Parenting Wisely Program

ERIC Educational Resources Information Center

Cotter, Katie L.; Bacallao, Martica; Smokowski, Paul R.; Robertson, Caroline I. B.

2013-01-01

Objectives: This study examines the implementation and effectiveness of Parenting Wisely, an Internet-based parenting skills intervention. The study assesses whether parents benefit from Parenting Wisely participation and whether the delivery format influences program effectiveness. Method: This study uses a quasi-experimental design.…

Effects of Fluency Instruction on Selection-Based and Topography-Based Comprehension Measures

ERIC Educational Resources Information Center

Barnes, Clarissa S.; Rehfeldt, Ruth Anne

2013-01-01

A multiple probe across participants design was used to assess the effects of an intervention package on reading fluency and section-based and topography-based comprehension tasks. Participants were three adolescents diagnosed with high functioning pervasive developmental disorders. The intervention package consisted of listen passage preview,…

Single-Site, Results-Level Evaluation of Quality Awareness Training.

ERIC Educational Resources Information Center

Murray, Brian; Raffaele, Gary C.

1997-01-01

An interrupted time-series design pooling 6 12-year series evaluated the long-term effects of a quality training intervention in a factory. Training positively affected quality of goods and dollar utility. Production process was an important contextual factor in assessing the effect size of the intervention. (SK)

Effectiveness of Motivational Interviewing Interventions for Adolescent Substance Use Behavior Change: A Meta-Analytic Review

ERIC Educational Resources Information Center

Jensen, Chad D.; Cushing, Christopher C.; Aylward, Brandon S.; Craig, James T.; Sorell, Danielle M.; Steele, Ric G.

2011-01-01

Objective: This study was designed to quantitatively evaluate the effectiveness of motivational interviewing (MI) interventions for adolescent substance use behavior change. Method: Literature searches of electronic databases were undertaken in addition to manual reference searches of identified review articles. Databases searched include…

Evaluating the effect of integrated microfinance and health interventions: an updated review of the evidence.

PubMed

Lorenzetti, Lara M J; Leatherman, Sheila; Flax, Valerie L

2017-06-01

Solutions delivered within firm sectoral boundaries are inadequate in achieving income security and better health for poor populations. Integrated microfinance and health interventions leverage networks of women to promote financial inclusion, build livelihoods, and safeguard against high cost illnesses. Our understanding of the effect of integrated interventions has been limited by variability in intervention, outcome, design, and methodological rigour. This systematic review synthesises the literature through 2015 to understand the effect of integrated microfinance and health programs. We searched PubMed, Scopus, Embase, EconLit, and Global Health databases and sourced bibliographies, identifying 964 articles exclusive of duplicates. Title, abstract, and full text review yielded 35 articles. Articles evaluated the effect of intentionally integrated microfinance and health programs on client outcomes. We rated the quality of evidence for each article. Most interventions combined microfinance with health education, which demonstrated positive effects on health knowledge and behaviours, though not health status. Among programs that integrated microfinance with other health components ( i.e. health micro-insurance, linkages to health providers, and access to health products), results were generally positive but mixed due to the smaller number and quality of studies. Interventions combining multiple health components in a given study demonstrated positive effects, though it was unclear which component was driving the effect. Most articles (57%) were moderate in quality. Integrated microfinance and health education programs were effective, though longer intervention periods are necessary to measure more complex pathways to health status. The effect of microfinance combined with other health components was less clear. Stronger randomized research designs with multiple study arms are required to improve evidence and disentangle the effects of multiple component microfinance and health interventions. Few studies attempted to understand changes in economic outcomes, limiting our understanding of the relationship between health and income effects. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

PubMed Central

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

2017-01-01

Background Cancer-related fatigue (CrF) is the most common and disruptive symptom experienced by cancer survivors. We aimed to develop a theory-based, interactive Web-based intervention designed to facilitate self-management and enhance coping with CrF following cancer treatment. Objective The aim of our study was to outline the rationale, decision-making processes, methods, and findings which led to the development of a Web-based intervention to be tested in a feasibility trial. This paper outlines the process and method of development of the intervention. Methods An extensive review of the literature and qualitative research was conducted to establish a therapeutic approach for this intervention, based on theory. The psychological principles used in the development process are outlined, and we also clarify hypothesized causal mechanisms. We describe decision-making processes involved in the development of the content of the intervention, input from the target patient group and stakeholders, the design of the website features, and the initial user testing of the website. Results The cocreation of the intervention with the experts and service users allowed the design team to ensure that an acceptable intervention was developed. This evidence-based Web-based program is the first intervention of its kind based on self-regulation model theory, with the primary aim of targeting the representations of fatigue and enhancing self-management of CrF, specifically. Conclusions This research sought to integrate psychological theory, existing evidence of effective interventions, empirically derived principles of Web design, and the views of potential users into the systematic planning and design of the intervention of an easy-to-use website for cancer survivors. PMID:28676465

Online interventions for social marketing health behavior change campaigns: a meta-analysis of psychological architectures and adherence factors.

PubMed

Cugelman, Brian; Thelwall, Mike; Dawes, Phil

2011-02-14

Researchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage their weight. Motivations to develop eHealth interventions may be driven by the Internet's reach, interactivity, cost-effectiveness, and studies that show online interventions work. However, when designing online interventions suitable for public campaigns, there are few evidence-based guidelines, taxonomies are difficult to apply, many studies lack impact data, and prior meta-analyses are not applicable to large-scale public campaigns targeting voluntary behavioral change. This meta-analysis assessed online intervention design features in order to inform the development of online campaigns, such as those employed by social marketers, that seek to encourage voluntary health behavior change. A further objective was to increase understanding of the relationships between intervention adherence, study adherence, and behavioral outcomes. Drawing on systematic review methods, a combination of 84 query terms were used in 5 bibliographic databases with additional gray literature searches. This resulted in 1271 abstracts and papers; 31 met the inclusion criteria. In total, 29 papers describing 30 interventions were included in the primary meta-analysis, with the 2 additional studies qualifying for the adherence analysis. Using a random effects model, the first analysis estimated the overall effect size, including groupings by control conditions and time factors. The second analysis assessed the impacts of psychological design features that were coded with taxonomies from evidence-based behavioral medicine, persuasive technology, and other behavioral influence fields. These separate systems were integrated into a coding framework model called the communication-based influence components model. Finally, the third analysis assessed the relationships between intervention adherence and behavioral outcomes. The overall impact of online interventions across all studies was small but statistically significant (standardized mean difference effect size d=0.19, 95% confidence interval [CI]=0.11-0.28, P<.001, number of interventions k=30). The largest impact with a moderate level of efficacy was exerted from online interventions when compared with waitlists and placebos (d=0.28, 95% CI=0.17-0.39, P<.001, k=18), followed by comparison with lower-tech online interventions (d=0.16, 95% CI=0.00-0.32, P=.04, k=8); no significant difference was found when compared with sophisticated print interventions (d=-0.11, 95% CI=-0.34 to 0.12, P=.35, k=4), though online interventions offer a small effect with the advantage of lower costs and larger reach. Time proved to be a critical factor, with shorter interventions generally achieving larger impacts and greater adherence. For psychological design, most interventions drew from the transtheoretical approach and were goal orientated, deploying numerous influence components aimed at showing users the consequences of their behavior, assisting them in reaching goals, and providing normative pressure. Inconclusive results suggest a relationship between the number of influence components and intervention efficacy. Despite one contradictory correlation, the evidence suggests that study adherence, intervention adherence, and behavioral outcomes are correlated. These findings demonstrate that online interventions have the capacity to influence voluntary behaviors, such as those routinely targeted by social marketing campaigns. Given the high reach and low cost of online technologies, the stage may be set for increased public health campaigns that blend interpersonal online systems with mass-media outreach. Such a combination of approaches could help individuals achieve personal goals that, at an individual level, help citizens improve the quality of their lives and at a state level, contribute to healthier societies.

Inducing a health-promoting change process within an organization: the effectiveness of a large-scale intervention on social capital, openness, and autonomous motivation toward health.

PubMed

van Scheppingen, Arjella R; de Vroome, Ernest M M; Ten Have, Kristin C J M; Bos, Ellen H; Zwetsloot, Gerard I J M; van Mechelen, W

2014-11-01

To examine the effectiveness of an organizational large-scale intervention applied to induce a health-promoting organizational change process. A quasi-experimental, "as-treated" design was used. Regression analyses on data of employees of a Dutch dairy company (n = 324) were used to examine the effects on bonding social capital, openness, and autonomous motivation toward health and on employees' lifestyle, health, vitality, and sustainable employability. Also, the sensitivity of the intervention components was examined. Intervention effects were found for bonding social capital, openness toward health, smoking, healthy eating, and sustainable employability. The effects were primarily attributable to the intervention's dialogue component. The change process initiated by the large-scale intervention contributed to a social climate in the workplace that promoted health and ownership toward health. The study confirms the relevance of collective change processes for health promotion.

Evaluating Public Health Interventions: 3. The Two-Stage Design for Confounding Bias Reduction-Having Your Cake and Eating It Two.

PubMed

Spiegelman, Donna; Rivera-Rodriguez, Claudia L; Haneuse, Sebastien

2016-07-01

In public health evaluations, confounding bias in the estimate of the intervention effect will typically threaten the validity of the findings. It is a common misperception that the only way to avoid this bias is to measure detailed, high-quality data on potential confounders for every intervention participant, but this strategy for adjusting for confounding bias is often infeasible. Rather than ignoring confounding altogether, the two-phase design and analysis-in which detailed high-quality confounding data are obtained among a small subsample-can be considered. We describe the two-stage design and analysis approach, and illustrate its use in the evaluation of an intervention conducted in Dar es Salaam, Tanzania, of an enhanced community health worker program to improve antenatal care uptake.

Treatment of pregnancy-related pelvic girdle and/or low back pain after delivery design of a randomized clinical trial within a comprehensive prognostic cohort study [ISRCTN08477490

PubMed Central

Bastiaenen, Caroline HG; de Bie, Rob A; Wolters, Pieter MJC; Vlaeyen, Johan WS; Bastiaanssen, Janneke M; Klabbers, Aldegonda BA; Heuts, Annie; van den Brandt, Piet A; Essed, Gerard GM

2004-01-01

Background Pregnancy-related pelvic girdle and/or low back pain is a controversial syndrome because insight in etiology and prognosis is lacking. The controversy relates to factors eliciting pain and some prognostic factors such as the interpretation of pain at the symphysis. Recent research about treatment strategies also reflects those various opinions, in fact suggesting there is professional uncertainty about the optimal approach. Currently, physiotherapists often prescribe a pain-contingent treatment regime of relative rest and avoiding several day-to-day activities. Additionally, treatment more often includes an exercise program to guide rectification of the muscle imbalance and alignment of the pelvic girdle. Effectiveness of those interventions is not proven and the majority of the studies are methodologically flawed. Investigators draw particular attention to biomedical factors but there is growing evidence that important prognostic issues such as biopsychosocial factors appear to be even more important as point of action in a treatment program. Methods/design This pragmatic randomized controlled trial is designed to evaluate the effectiveness of a tailor-made treatment program with respect to biopsychosocial factors in primary care. The effect of the experimental intervention and usual care are evaluated as they are applied in primary health care. The trial is embedded in a cohort study that is designed as a longitudinal, prospective study, which studies prevalence, etiology, severity and prognosis during pregnancy until one year after delivery. The present paper focuses on choices regarding recruitment procedures, in-/exclusion criteria and the development of a well-timed intervention. Discussion This section briefly discusses the actions taken to minimize bias in the design, the proper time-window for the experimental intervention and the contrast between the experimental intervention and usual care. PMID:15619331

Adult asthma disease management: an analysis of studies, approaches, outcomes, and methods.

PubMed

Maciejewski, Matthew L; Chen, Shih-Yin; Au, David H

2009-07-01

Disease management has been implemented for patients with asthma in various ways. We describe the approaches to and components of adult asthma disease-management interventions, examine the outcomes evaluated, and assess the quality of published studies. We searched the MEDLINE, EMBASE, CINAHL, PsychInfo, and Cochrane databases for studies published in 1986 through 2008, on adult asthma management. With the studies that met our inclusion criteria, we examined the clinical, process, medication, economic, and patient-reported outcomes reported, and the study designs, provider collaboration during the studies, and statistical methods. Twenty-nine articles describing 27 studies satisfied our inclusion criteria. There was great variation in the content, extent of collaboration between physician and non-physician providers responsible for intervention delivery, and outcomes examined across the 27 studies. Because of limitations in the design of 22 of the 27 studies, the differences in outcomes assessed, and the lack of rigorous statistical adjustment, we could not draw definitive conclusions about the effectiveness or cost-effectiveness of the asthma disease-management programs or which approach was most effective. Few well-designed studies with rigorous evaluations have been conducted to evaluate disease-management interventions for adults with asthma. Current evidence is insufficient to recommend any particular intervention.

Effectiveness of Interventions for Breast Cancer Screening in African American Women: A Meta-Analysis.

PubMed

Copeland, Valire Carr; Kim, Yoo Jung; Eack, Shaun M

2017-11-21

The purpose of this study was to report the results of a meta-analysis conducted on the effects of clinical trials in breast cancer screening for African American women between 1997 and 2017. Articles published in English and in the United States, between January 1997 and March 2017, were eligible for inclusion if they (1) conducted psychosocial, behavioral, or educational interventions designed to increase screening mammography rates in predominantly African American women of all ages; (2) utilized a randomized, controlled trial (RCT) design; and (3) reported quantitative screening rates following the intervention. Randomized clinical trials on breast cancer screening in African American women, published between January 1997 and March 2017, were selected from database searches. Data collected included effect size of screening versus comparison interventions, intervention characteristics, and a number of study characteristics to explore potential moderators. Search results yielded 327 articles, of which 14 met inclusion criteria and were included in analyses. Findings indicated that screening interventions for African American women were significantly more likely to result in mammography than control (OR = 1.56 [95 percent CI = 1.27-1.93], p < .0001). Although no patient or study characteristics significantly moderated screening efficacy, the most effective interventions were those specifically tailored to meet the perceived risk of African American women. Screening interventions are at least minimally effective for promoting mammography among African American women, but research in this area is limited to a small number of studies. More research is needed to enhance the efficacy of existing interventions and reduce the high morbidity and mortality rate of this underserved population. © Health Research and Educational Trust.

Preventive interventions among children exposed to trauma of armed conflict: a literature review.

PubMed

Peltonen, Kirsi; Punamäki, Raija-Leena

2010-01-01

Increasing research is available on the preconditions for child mental health and optimal development in traumatic conditions, whereas less is known how to translate the findings into effective interventions to help traumatized children. This literature review analyses the effectiveness of psychosocial preventive interventions and treatments and their theoretical bases among children traumatized in the context of armed conflicts (war, military violence, terrorism and refugee). The first aim is to evaluate the effectiveness of preventive interventions in preventing emotional distress and impairment and promoting optimal emotional-cognitive and social development. The second task is to analyze the nature of the underlying mechanisms for the success of preventive interventions, and the theoretical premises of the choice of intervention techniques, procedures and tools. We found 16 relevant published studies, but an examination of them revealed that only four of them had experimental designs strong enough that they could be included in the meta-analysis. While the subjective reports of the researchers suggested that systematic preventive interventions were effective in decreasing PTSD and depressive symptoms among children traumatized due to armed conflict, the more objective results of the meta-analysis and the weaknesses in designs uncovered during the meta-analysis undermine such a conclusion. Additionally, a majority of the reported preventive interventions focused only on children's biased cognitive processes and negative emotions, while only a few aimed at influencing multiple domains of child development and improving developmental functioning on emotional, social and psychophysiological levels. It is concluded that substantial additional work needs to be done in developing effective preventive interventions and treatments for children traumatized by exposure to war and violence. (c) 2009 Wiley-Liss, Inc.

Self-management intervention to improve self-care and quality of life in heart failure patients.

PubMed

Tung, Heng-Hsin; Lin, Chun-Yu; Chen, Kuei-Ying; Chang, Chien-Jung; Lin, Yu-Ping; Chou, Cheng-Hui

2013-01-01

Self-management intervention is a good method to improve self-care ability, as such, to promote quality of life. However, the research focused on self-management intervention in heart failure patients in Taiwan is very limited. Therefore, the purposes of this study were to test the effectiveness of self-management intervention in patients with heart failure in Taiwan and examine the relationship between self-care ability and quality of life. A quasi-experimental design was used in this study with convenience sampling. Of the 82 subjects participating in this study, 40 of them chose to join the experimental (self-management intervention plus usual care) and 42 of them chose to join control (usual care) group. Three questionnaires were used to collect the data, which were the demographic questionnaire, the self-care questionnaire (Self-Care of HF Index V 6), and the quality of life questionnaire (Minnesota Living with Heart Failure Questionnaire). To examine the effectiveness of the intervention, self-care ability and quality of life were measured, using a pretest, 1- and 2-month follow-up assessment. Generalized estimation equations (GEE) were used to compare changes over time among groups for outcomes to ensure the effectiveness of the intervention. This study confirmed the effectiveness of the self-management intervention. The clinical provider should increase the awareness of the importance of self-management skills and self-care ability especially for heart failure patients. The designated disease-specific self-management patient book and individualize intervention should be dispensing and implementing. © 2012 Wiley Periodicals, Inc.

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…

Promoting an Inclusive Image of Scientists among Students: Towards Research Evidence-Based Practice

ERIC Educational Resources Information Center

Cakmakci, Gultekin; Tosun, Ozge; Turgut, Sebnem; Orenler, Sefika; Sengul, Kubra; Top, Gokce

2011-01-01

This study aims at investigating the effects of a teaching intervention, the design of which is informed by evidence from educational theories and research data, on students' images of scientists. A quasi-experimental design with a non-equivalent pre-test-post-test control group (CG) was used to compare the outcomes of the intervention. The…

Experimental Intervention Studies on Word Problem Solving and Math Disabilities: A Selective Analysis of the Literature

ERIC Educational Resources Information Center

Zheng, Xinhua; Flynn, Lindsay J.; Swanson, H. Lee

2013-01-01

This article provides a quantitative synthesis of the published literature on word problem solving intervention studies for children with math disabilities (MD). Seven group and eight single-subject design studies met inclusion criteria. Mean effect sizes ("ES"s) for solution accuracy for group design studies were 0.95 (SE = 0.19) for…

Using Narrated Literacy-Based Behavioural Interventions to Decrease Episodes of Physical Aggression in Elementary Students with Disabilities

ERIC Educational Resources Information Center

Anderson, Shelley; Bucholz, Jessica L.; Hazelkorn, Michael; Cooper, Margaret A.

2016-01-01

This study was designed to examine the effects of literacy-based behavioural interventions (Bucholz et al., 2008) to decrease acts of physical aggression with kindergarten and first grade students. The study used a multiple baseline design across three participants. The results showed a decrease in acts of physical aggression by students with…

One-Year Outcomes from the CASAWORKS for Families Intervention for Substance-Abusing Women on Welfare

ERIC Educational Resources Information Center

Mclellan, A. Thomas; Gutman, Marjorie; Lynch, Kevin; Mckay, James R.; Ketterlinus, Robert; Morgenstern, Jon; Woolis, Diana

2003-01-01

Aim: To evaluate the effectiveness of a multiservice intervention designed to move substance-abusing women on welfare to sobriety and self-sufficiency by addressing their substance abuse, domestic violence, employment, and basic needs. Design: A field evaluation with repeated measures at 6 and 12 months on an intent-to-treat sample of 529 women…

Advancing Scientific Reasoning in Upper Elementary Classrooms: Direct Instruction Versus Task Structuring

NASA Astrophysics Data System (ADS)

Lazonder, Ard W.; Wiskerke-Drost, Sjanou

2015-02-01

Several studies found that direct instruction and task structuring can effectively promote children's ability to design unconfounded experiments. The present study examined whether the impact of these interventions extends to other scientific reasoning skills by comparing the inquiry activities of 55 fifth-graders randomly assigned to one of three conditions. Children in the control condition investigated a four-variable inquiry task without additional support. Performance of this task in the direct instruction condition was preceded by a short training in experimental design, whereas children in the task structuring condition, who did not receive the introductory training, were given a version of the task that addressed the four variables one at a time. Analysis of children's experimentation behavior confirmed that direct instruction and task structuring are equally effective and superior to unguided inquiry. Both interventions also evoked more determinate predictions and valid inferences. These findings demonstrate that the effect of short-term interventions designed to promote unconfounded experimentation extends beyond the control of variables.

Improved self-confidence was a mechanism of action in two geriatric trials evaluating physical interventions.

PubMed

Peduzzi, Peter; Guo, Zhenchao; Marottoli, Richard A; Gill, Thomas M; Araujo, Katy; Allore, Heather G

2007-01-01

To evaluate the mechanisms of action in two successful geriatric clinical trials that tested multicomponent physical conditioning programs and to determine whether the pathways for overall benefit were through improvement in physical ability and/or self-confidence. PREHAB and DRIVER were conducted by the Yale Pepper Center. PREHAB participants received an individualized program that focused on the impairments present (standardly tailored design); DRIVER participants received the entire intervention (global design). PREHAB enrolled 188 community-living persons, aged 75 years or older, who were physically frail but ambulatory; DRIVER enrolled 178 drivers aged 70 years or older with physical impairments associated with poor driving performance. The primary outcome for PREHAB was a disability score and for DRIVER it was a driving score; potential mediators were measures of physical ability and self-confidence. In PREHAB, pathways for the intervention were established through improvement in physical ability and self-confidence. In DRIVER, there was some evidence for a pathway through improved driving self-confidence but not through physical ability; however, the intervention effect was largely unexplained. Multicomponent physical interventions may operate through psychological mechanisms, and these mechanisms should be anticipated in trial designs so that the component effects can be suitably evaluated.

Attributional intervention for depression in two people with multiple sclerosis (MS): single case design.

PubMed

Wain, Helen; Kneebone, Ian I; Cropley, Mark

2011-01-01

Depression is common in those with MS. The hopelessness theory of depression, emphasizing the role of attributional style, is supported in this population. Cognitive behaviour therapy (CBT) that can affect attributional style can reduce depression in people who have MS. The present study aimed to consider whether changing attributional style would reduce depression in two people with MS, thereby supporting the importance of this component of CBT with this population. Two female participants with MS were offered a 5-session intervention designed to alter attributional style. The study followed an ABA design. Attributional style and depressive symptoms were the principal measures considered. Negative life events and MS related stresses were also monitored. The intervention appeared effective for one of the participants, with predicted changes in attributional style and sizeable reductions in depressive symptoms from pre- to post-treatment that were sustained at 3-month follow-up. Improvement was still evident at 6 months, although with some reduction of effect. The intervention was less successful for the other participant who declined further treatment after three sessions. Some support for the hopelessness theory of depression was found, indicating its relevance to CBT interventions for those who have MS and depression.

A Scholar-Practitioner Perspective to Promoting Minority Success in STEM

ERIC Educational Resources Information Center

Covington, Megan; Chavis, Terry; Perry, April

2017-01-01

Purpose: The purpose of this conceptual paper is to present the existing research on already effective programmatic efforts designed to increase diversity in STEM fields and to subsequently encourage researchers and practitioners to more intentionally build upon and design effective interventions around this issue. Design/methodology/approach:…

Effect Size Calculations and Single Subject Designs

ERIC Educational Resources Information Center

Olive, Melissa L.; Smith, Benjamin W.

2005-01-01

This study compared visual analyses with five alternative methods for assessing the magnitude of effect with single subject designs. Each method was successful in detecting intervention effect. When rank ordered, each method was consistent in identifying the participants with the largest effect. We recommend the use of the standard mean difference…

Design of a trial-based economic evaluation on the cost-effectiveness of employability interventions among work disabled employees or employees at risk of work disability: The CASE-study

PubMed Central

2012-01-01

Background In the Netherlands, absenteeism and reduced productivity due to work disability lead to high yearly costs reaching almost 5% of the gross national product. To reduce the economic burden of sick leave and reduced productivity, different employability interventions for work-disabled employees or employees at risk of work disability have been developed. Within this study, called 'CASE-study' (Cost-effectiveness Analysis of Sustainable Employability), five different employability interventions directed at work disabled employees with divergent health complaints will be analysed on their effectiveness and cost-effectiveness. This paper describes a consistent and transparent methodological design to do so. Methods/design Per employability intervention 142 participants are needed whereof approximately 66 participants receiving the intervention will be compared with 66 participants receiving usual care. Based on the intervention-specific characteristics, a randomized control trial or a quasi-experiment with match-criteria will be conducted. Notwithstanding the study design, eligible participants will be employees aged 18 to 63, working at least 12 h per week, and at risk of work disability, or already work-disabled due to medical restrictions. The primary outcome will be the duration of sick leave. Secondary outcomes are health status and quality of life. Outcomes will be assessed at baseline and then 6, 12 and 18 months later. Economic costs will consist of healthcare costs and cost of lost production due to work disability, and will be evaluated from a societal perspective. Discussion The CASE-study is the first to conduct economic evaluations of multiple different employability interventions based on a similar methodological framework. The cost-effectiveness results for every employability intervention will be published in 2014, but the methods, strengths and weaknesses of the study protocol are discussed in this paper. To contribute to treatment options in occupational health practice and enable the development of guidelines on how to conduct economic evaluation better suited to this field; this paper provides an important first step. Trial registration Four trials involved in the CASE-study are registered with the Netherlands Trial Registry: Care for Work (NTR2886), Health and Motion (NTR3111), Guidance to Excel in Return to Work (NTR3151), Care for Companies/Second Care (NTR3136). PMID:22257557

A systematic review of the evidence regarding efficacy of obesity prevention interventions among adults.

PubMed

Lemmens, V E P P; Oenema, A; Klepp, K I; Henriksen, H B; Brug, J

2008-09-01

In the past, interventions aimed at reducing obesity have mainly targeted at weight loss treatment in obese adults, with limited long-term effects. With the increasing number of people being obese and being at risk for obesity, there has been a shift in focus towards prevention of obesity. We conducted a systematic review of the peer-reviewed literature on the efficacy of obesity prevention interventions in adults in order to identify effective interventions and intervention elements. Pubmed, OVID, and Web of Science databases were searched from January 1996 to June 2006. Interventions aimed at primary prevention of weight gain among adults achieved by focusing on dietary intake, physical activity or the combination of both were included. The outcome measure had to be difference in change in body mass index or body weight between the intervention and the control groups. Nine studies were included, five long-term studies (at least 1 year) and four short-term (3 months to 1 year). Seven studies evaluated an intervention that focused on a combination of diet and physical activity to prevent weight gain, one on diet only and one on physical activity only. One dietary intervention (long-term), and three combined dietary and physical activity interventions (one long-term and two short-term) produced significantly positive results at end of follow-up. The two long-term, effective interventions consisted of intensive and long-term intervention implementation, including groups sessions designed to promote behavioural changes. The current evidence of efficacy of obesity prevention interventions is based on a very small number of studies. Some studies showed a positive impact on body mass index or weight status, but there was too much heterogeneity in terms of study design, theoretical underpinning and target population to draw firm conclusions about which intervention approaches are more effective than others. More research is urgently needed to extend the body of evidence.

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

PubMed Central

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

2016-01-01

Background Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. Objective The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Methods Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. Results The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Conclusions Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible. PMID:27489143

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

PubMed

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

2016-08-03

Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible.

The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing: the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress.

PubMed

Lappalainen, Raimo; Sairanen, Essi; Järvelä, Elina; Rantala, Sanni; Korpela, Riitta; Puttonen, Sampsa; Kujala, Urho M; Myllymäki, Tero; Peuhkuri, Katri; Mattila, Elina; Kaipainen, Kirsikka; Ahtinen, Aino; Karhunen, Leila; Pihlajamäki, Jussi; Järnefelt, Heli; Laitinen, Jaana; Kutinlahti, Eija; Saarelma, Osmo; Ermes, Miikka; Kolehmainen, Marjukka

2014-04-04

Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes. 339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-to-face group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations. This study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value-based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions. Current Clinical Trials NCT01738256, Registered 17 August, 2012.

Investigating variations in implementation fidelity of an organizational-level occupational health intervention.

PubMed

Augustsson, Hanna; von Thiele Schwarz, Ulrica; Stenfors-Hayes, Terese; Hasson, Henna

2015-06-01

The workplace has been suggested as an important arena for health promotion, but little is known about how the organizational setting influences the implementation of interventions. The aims of this study are to evaluate implementation fidelity in an organizational-level occupational health intervention and to investigate possible explanations for variations in fidelity between intervention units. The intervention consisted of an integration of health promotion, occupational health and safety, and a system for continuous improvements (Kaizen) and was conducted in a quasi-experimental design at a Swedish hospital. Implementation fidelity was evaluated with the Conceptual Framework for Implementation Fidelity and implementation factors used to investigate variations in fidelity with the Framework for Evaluating Organizational-level Interventions. A multi-method approach including interviews, Kaizen notes, and questionnaires was applied. Implementation fidelity differed between units even though the intervention was introduced and supported in the same way. Important differences in all elements proposed in the model for evaluating organizational-level interventions, i.e., context, intervention, and mental models, were found to explain the differences in fidelity. Implementation strategies may need to be adapted depending on the local context. Implementation fidelity, as well as pre-intervention implementation elements, is likely to affect the implementation success and needs to be assessed in intervention research. The high variation in fidelity across the units indicates the need for adjustments to the type of designs used to assess the effects of interventions. Thus, rather than using designs that aim to control variation, it may be necessary to use those that aim at exploring and explaining variation, such as adapted study designs.

Design and implementation of a physical activity intervention to enhance children's use of the built environment (the CUBE study).

PubMed

Oreskovic, Nicolas M; Goodman, Elizabeth; Park, Elyse R; Robinson, Alyssa I; Winickoff, Jonathan P

2015-01-01

Adequate physical activity promotes physical and mental health and decreases obesity risk. However, most adolescents do not attain recommended physical activity levels and effective interventions are lacking. Physical activity trials rarely incorporate built environment use patterns. This paper describes the design and rationale of the Children's Use of the Built Environment (CUBE) Study, an office-based intervention designed to teach youth how to use their surrounding built environment to increase physical activity. CUBE is a 6-month intervention trial among 60 overweight and obese 10-16 year old adolescents from a community health center in Massachusetts. The study began in the winter of 2013. Patients are sequentially assigned to either the intervention or control group. Baseline physical activity by accelerometry and location by GPS, along with measured height, weight, and blood pressure are collected. Control subjects receive standard of care lifestyle counseling. Intervention subjects receive tailored recommendations on how to increase their physical activity based on their accelerometer and GPS data. Data collections are repeated at end-of-treatment, and again 3 months later. The findings from this study should help guide future efforts to design interventions aimed at increasing adolescent physical activity as well as to inform design professionals and government officials charged with creating outdoor spaces where adolescents spend time. Copyright © 2014 Elsevier Inc. All rights reserved.

Bridging research and practice: community-researcher partnerships for replicating effective interventions.

PubMed

Rotheram-Borus, M J; Rebchook, G M; Kelly, J A; Adams, J; Neumann, M S

2000-01-01

Long-term collaborations among researchers, staff and volunteers in community-based agencies, staff in institutional settings, and health advocates present challenges. Each group has different missions, procedures, attributes, and rewards. This article reviews areas of potential conflict and suggests strategies for coping with these challenges. During the replication of five effective HIV prevention interventions, strategies for maintaining mutually beneficial collaborations included selecting agencies with infrastructures that could support research-based interventions; obtaining letters of understanding that clarified roles, responsibilities, and time frames; and setting training schedules with opportunities for observing, practicing, becoming invested in, and repeatedly implementing the intervention. The process of implementing interventions highlighted educating funders of research and public health services about (a) the costs of disseminating interventions, (b) the need for innovation to new modalities and theories for delivering effective interventions, and (c) adopting strategies of marketing research and quality engineering when designing interventions.

Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial - Cell Phone Intervention for You (CITY).

PubMed

Batch, Bryan C; Tyson, Crystal; Bagwell, Jacqueline; Corsino, Leonor; Intille, Stephen; Lin, Pao-Hwa; Lazenka, Tony; Bennett, Gary; Bosworth, Hayden B; Voils, Corrine; Grambow, Steven; Sutton, Aziza; Bordogna, Rachel; Pangborn, Matthew; Schwager, Jenifer; Pilewski, Kate; Caccia, Carla; Burroughs, Jasmine; Svetkey, Laura P

2014-03-01

The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population. To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to 3) a usual care, advice-only control condition. A total of 365 community-dwelling overweight/obese adults aged 18-35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 24 [corrected] months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014. If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. ClinicalTrial.gov: NCT01092364. Published by Elsevier Inc.

Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial – Cell phone Intervention for You (CITY)

PubMed Central

Batch, Bryan C.; Tyson, Crystal; Bagwell, Jacqueline; Corsino, Leonor; Intille, Stephen; Lin, Pao-Hwa; Lazenka, Tony; Bennett, Gary; Bosworth, Hayden B.; Voils, Corrine; Grambow, Steven; Sutton, Aziza; Bordogna, Rachel; Pangborn, Matthew; Schwager, Jenifer; Pilewski, Kate; Caccia, Carla; Burroughs, Jasmine; Svetkey, Laura P.

2014-01-01

Background The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population. Purpose To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to; 3) a usual care, advice-only control condition. Methods A total of 365 community-dwelling overweight/obese adults aged 18–35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 12 months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014. Conclusions If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. PMID:24462568

Improving Urban African Americans’ Blood Pressure Control through Multi-level Interventions in the Achieving Blood Pressure Control Together (ACT) Study: A Randomized Clinical Trial

PubMed Central

Ephraim, Patti L.; Hill-Briggs, Felicia; Roter, Debra; Bone, Lee; Wolff, Jennifer; Lewis-Boyer, LaPricia; Levine, David; Aboumatar, Hanan; Cooper, Lisa A; Fitzpatrick, Stephanie; Gudzune, Kimberly; Albert, Michael; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary; Fagan, Peter; Ramamurthi, Hema; Ameling, Jessica; Charlston, Jeanne; Sam, Tanyka; Carson, Kathryn A.; Wang, Nae-Yuh; Crews, Deidra; Greer, Raquel; Sneed, Valerie; Flynn, Sarah J.; DePasquale, Nicole; Boulware, L. Ebony

2014-01-01

Background Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients’ management of a variety of chronic illnesses. However, studies of multilevel interventions designed specifically to improve urban African American patients’ blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. Methods/Design We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients’ improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients’ blood pressure control at 12 months. Discussion Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients’ hypertension control. PMID:24956323

SWITCH: rationale, design, and implementation of a community, school, and family-based intervention to modify behaviors related to childhood obesity

PubMed Central

Eisenmann, Joey C; Gentile, Douglas A; Welk, Gregory J; Callahan, Randi; Strickland, Sarah; Walsh, Monica; Walsh, David A

2008-01-01

Background Although several previous projects have attempted to address the issue of child obesity through school-based interventions, the overall effectiveness of school-based programs on health-related outcomes in youth has been poor. Thus, it has been suggested that multi-level interventions that aim to influence healthy lifestyle behaviors at the community, school and family levels may prove more successful in the prevention of childhood obesity. Methods/Design This paper describes the rationale, design, and implementation of a community-, school-, and family-based intervention aimed at modifying key behaviors (physical activity, screen time (Internet, television, video games), and nutrition) related to childhood obesity among third through fifth graders in two mid-western cities. The intervention involves a randomized study of 10 schools (5 intervention and 5 control schools). The intervention is being conducted during the duration of the academic year – approximately 9 months – and includes baseline and post-intervention measurements of physical activity, dietary intake, screen time and body composition. Discussion We hope this report will be useful to researchers, public health professionals, and school administrators and health professionals (nurses and physical/health educators) seeking to develop similar prevention programs. It is obvious that more collaborative, inter-disciplinary, multi-level work is needed before a proven, effective intervention package to modify behaviors related to childhood obesity can be generally recommended. It is our hope that SWITCH is a step in that direction. Trial Registration ClinicalTrials.gov NCT00685555 PMID:18588706

Can a costly intervention be cost-effective?: An analysis of violence prevention.

PubMed

Foster, E Michael; Jones, Damon

2006-11-01

To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations.

Benefits and challenges of using the cohort multiple randomised controlled trial design for testing an intervention for depression.

PubMed

Viksveen, Petter; Relton, Clare; Nicholl, Jon

2017-07-06

Trials which test the effectiveness of interventions compared with the status quo frequently encounter challenges. The cohort multiple randomised controlled trial (cmRCT) design is an innovative approach to the design and conduct of pragmatic trials which seeks to address some of these challenges. In this article, we report our experiences with the first completed randomised controlled trial (RCT) using the cmRCT design. This trial-the Depression in South Yorkshire (DEPSY) trial-involved comparison of treatment as usual (TAU) with TAU plus the offer of an intervention for people with self-reported long-term moderate to severe depression. In the trial, we used an existing large population-based cohort: the Yorkshire Health Study. We discuss our experiences with recruitment, attrition, crossover, data analysis, generalisability of results, and cost. The main challenges in using the cmRCT design were the high crossover to the control group and the lower questionnaire response rate among patients who refused the offer of treatment. However, the design did help facilitate efficient and complete recruitment of the trial population as well as analysable data that were generalisable to the population of interest. Attrition rates were also smaller than those reported in other depression trials. This first completed full trial using the cmRCT design testing an intervention for self-reported depression was associated with a number of important benefits. Further research is required to compare the acceptability and cost effectiveness of standard pragmatic RCT design with the cmRCT design. ISRCTN registry: ISRCTN02484593 . Registered on 7 Jan 2013.

Evaluating psycho-educational interventions for informal carers of patients receiving cancer care or palliative care: strengths and limitations of different study designs.

PubMed

Schildmann, Eva K; Higginson, Irene J

2011-06-01

Despite evidence of negative psychological sequelae and unmet needs, there are few evaluated interventions for informal caregivers in cancer and palliative care. The aim of this article is to debate the strengths and limitations of randomized controlled trials (RCTs) and other designs that can be used to evaluate the effectiveness of these interventions. Psycho-educational interventions are used as example for this debate article, as a number of studies of various designs evaluating this type of intervention have been published. Systematic searching in Medline and the bibliography of a relevant systematic review identified five RCTs, one pre-test/post-test study with a control group and six one-group pre-test/post-test studies of psycho-educational interventions for caregivers. The methodological strengths and weaknesses were assessed. RCTs are seen as the gold standard, but can have important limitations in the context of carer intervention research, including biased recruitment and low generalizability, problems with blinding and attrition. Pre-test/post-test studies with a control group may be more feasible and more generalizable. Their crucial limitation is selection bias. Before-after studies are compromised by additional specific biases and therefore are the weakest of all discussed designs. After analysing the strengths and weaknesses of the mentioned study designs, this paper presents strategies to address the limitations of RCTs evaluating psycho-educational interventions for carers in cancer or palliative care. © The Author(s) 2011

Interventions designed to prevent adverse programming outcomes resulting from exposure to maternal obesity during development

PubMed Central

Nathanielsz, PW; Ford, SP; Long, NM; Vega, CC; Reyes-Castro, LA; Zambrano, E

2013-01-01

Maternal obesity is a global epidemic affecting the developed and developing world. Human and animal studies indicate that maternal obesity programs development predisposing offspring to later-life chronic diseases. Several mechanisms act together to produce these adverse health problems. There is a need for effective interventions that prevent these outcomes and guide management in human pregnancy. We report here dietary and exercise intervention studies in both altricial and precocial species, rats and sheep, designed to prevent adverse offspring outcomes. Both interventions present exciting opportunities to at least in part prevent adverse metabolic and other outcomes in mother and offspring. PMID:24147928

Factors affecting acceptability of an email-based intervention to increase fruit and vegetable consumption.

PubMed

Kothe, Emily J; Mullan, Barbara A

2014-09-30

Fresh Facts is a 30-day email-delivered intervention designed to increase the fruit and vegetable consumption of Australian young adults. This study investigated the extent to which the program was acceptable to members of the target audience and examined the relationships between participant and intervention characteristics, attrition, effectiveness, and acceptability ratings. Young adults were randomised to two levels of message frequency: high-frequency (n = 102), low-frequency (n = 173). Individuals in the high-frequency group received daily emails while individuals in the low-frequency group received an email every 3 days. Individuals in the high-frequency group were more likely to indicate that they received too many emails than individuals in the low-frequency group. No other differences in acceptability were observed. Baseline beliefs about fruit and vegetables were an important predictor of intervention acceptability. In turn, acceptability was associated with a number of indicators of intervention success, including change in fruit and vegetable consumption. The findings highlight the importance of considering the relationship between these intervention and participant factors and acceptability in intervention design and evaluation. Results support the ongoing use of email-based interventions to target fruit and vegetable consumption within young adults. However, the relationships between beliefs about fruit and vegetable consumption and acceptability suggest that this intervention may be differentially effective depending on individual's existing beliefs about fruit and vegetable consumption. As such, there is a pressing need to consider these factors in future research in order to minimize attrition and maximize intervention effectiveness when interventions are implemented outside of a research context.

CHALLENGES AND INNOVATIONS IN A COMMUNITY-BASED PARTICIPATORY RANDOMIZED CONTROLLED TRIAL

PubMed Central

Goodkind, Jessica R.; Amer, Suha; Christian, Charlisa; Hess, Julia Meredith; Bybee, Deborah; Isakson, Brian; Baca, Brandon; Ndaysenga, Martin; Greene, R. Neil; Shantzek, Cece

2016-01-01

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants’ intervention experiences, and their feasibility and acceptability. In the current mixed methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African and Iraqi refugee adults and engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013-2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, post-intervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs. PMID:27179291

Increasing adolescents' depth of understanding of cross-curriculum words: an intervention study.

PubMed

Spencer, Sarah; Clegg, Judy; Lowe, Hilary; Stackhouse, Joy

2017-09-01

There is some evidence that vocabulary intervention is effective for children, although further research is needed to confirm the impact of intervention within contexts of social disadvantage. Very little is known about the effectiveness of interventions to increase adolescent knowledge of cross-curriculum words. To evaluate the effectiveness of an intervention programme designed to develop adolescents' knowledge of cross-curriculum words. Participants were 35 adolescents aged between 12 and 14 years who were at risk of educational underachievement with low scores on a range of assessments. Participants received a 10-week intervention programme in small groups, targeting 10 cross-curriculum words (e.g., 'summarize'). This was evaluated using a bespoke outcome measure (the Word Knowledge Profile). The study involved an AABA design, with a repeated baseline, delayed intervention cohort and blind assessment. Intervention included both semantic and phonological information about the target words and involved the adolescents using the words in multiple contexts. Results were promising and participants' knowledge of the targeted words significantly increased following intervention. Progress was demonstrated on the Word Knowledge Profile on the item requiring participants to define the word (for the summer intervention group only). This increase in depth of knowledge was seen on taught words but not on matched non-taught words. Cross-curriculum words are not consistently understood by adolescents at risk of low educational attainment within a low socio-economic context. A 10-week intervention programme resulted in some increases to the depth of knowledge of targeted cross-curriculum words. © 2017 Royal College of Speech and Language Therapists.

Reducing Youth Access to Alcohol: Findings from a Community-Based Randomized Trial*

PubMed Central

Flewelling, Robert L.; Grube, Joel W.; Paschall, M.J.; Biglan, Anthony; Kraft, Anne; Black, Carol; Hanley, Sean; Ringwalt, Christopher; Wiesen, Chris; Ruscoe, Jeff

2012-01-01

Underage drinking continues to be an important public health problem and a challenge to the substance abuse prevention field. Community-based interventions designed to more rigorously control underage access to alcohol through retailer education and greater enforcement of underage drinking laws have been advocated as potentially effective strategies to help address this problem, but studies designed to evaluate such interventions are sparse. To address this issue we conducted a randomized trial involving 36 communities to test the combined effectiveness of five interrelated intervention components designed to reduce underage access to alcohol. The intervention was found to be effective in reducing the likelihood that retail clerks would sell alcohol to underage-looking buyers, but did not reduce underage drinking or the perceived availability of alcohol among high school students. Post hoc analyses, however, revealed significant associations between the level of underage drinking law enforcement in the intervention communities and reductions in both 30-day use of alcohol and binge drinking. The findings highlight the difficulty in reducing youth drinking even when efforts to curtail retail access are successful. Study findings also suggest that high intensity implementation of underage drinking law enforcement can reduce underage drinking. Any such effects of enhanced enforcement on underage drinking appear to be more directly attributable to an increase in perceived likelihood of enforcement and the resultant perceived inconveniences and/or sanctions to potential drinkers, than to a reduction in access to alcohol per se. PMID:22688848

Reducing youth access to alcohol: findings from a community-based randomized trial.

PubMed

Flewelling, Robert L; Grube, Joel W; Paschall, M J; Biglan, Anthony; Kraft, Anne; Black, Carol; Hanley, Sean M; Ringwalt, Christopher; Wiesen, Chris; Ruscoe, Jeff

2013-03-01

Underage drinking continues to be an important public health problem and a challenge to the substance abuse prevention field. Community-based interventions designed to more rigorously control underage access to alcohol through retailer education and greater enforcement of underage drinking laws have been advocated as potentially effective strategies to help address this problem, but studies designed to evaluate such interventions are sparse. To address this issue we conducted a randomized trial involving 36 communities to test the combined effectiveness of five interrelated intervention components designed to reduce underage access to alcohol. The intervention was found to be effective in reducing the likelihood that retail clerks would sell alcohol to underage-looking buyers, but did not reduce underage drinking or the perceived availability of alcohol among high school students. Post hoc analyses, however, revealed significant associations between the level of underage drinking law enforcement in the intervention communities and reductions in both 30-day use of alcohol and binge drinking. The findings highlight the difficulty in reducing youth drinking even when efforts to curtail retail access are successful. Study findings also suggest that high intensity implementation of underage drinking law enforcement can reduce underage drinking. Any such effects of enhanced enforcement on underage drinking appear to be more directly attributable to an increase in perceived likelihood of enforcement and the resultant perceived inconveniences and/or sanctions to potential drinkers, than to a reduction in access to alcohol per se.

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS

PubMed Central

Collins, Linda M.; Kugler, Kari C.; Gwadz, Marya Viorst

2015-01-01

To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally. PMID:26238037

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS.

PubMed

Collins, Linda M; Kugler, Kari C; Gwadz, Marya Viorst

2016-01-01

To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally.

Alcohol assessment & feedback by e-mail for university student hazardous and harmful drinkers: study protocol for the AMADEUS-2 randomised controlled trial.

PubMed

McCambridge, Jim; Bendtsen, Marcus; Karlsson, Nadine; White, Ian R; Bendtsen, Preben

2013-10-10

Alcohol is responsible for a large and growing proportion of the global burden of disease, as well as being the cause of social problems. Brief interventions are one component of comprehensive policy measures necessary to reduce these harms. Brief interventions increasingly take advantage of the Internet to reach large numbers of high risk groups such as students. The research literature on the efficacy and effectiveness of online interventions is developing rapidly. Although many studies show benefits in the form of reduced consumption, other intervention studies show no effects, for reasons that are unclear. Sweden became the first country in the world to implement a national system in which all university students are offered a brief online intervention via an e-mail. This randomized controlled trial (RCT) aims to evaluate the effectiveness of this national system comprising a brief online intervention among university students who are hazardous and harmful drinkers. This study employs a conventional RCT design in which screening to determine eligibility precedes random allocation to immediate or delayed access to online intervention. The online intervention evaluated comprises three main components; assessment, normative feedback and advice on reducing drinking. Screening is confined to a single question in order to minimise assessment reactivity and to prevent contamination. Outcomes will be evaluated after 2 months, with total weekly alcohol consumption being the primary outcome measure. Invitations to participate are provided by e-mail to approximately 55,000 students in 9 Swedish universities. This RCT evaluates routine service provision in Swedish universities via a delay in offer of intervention to the control group. It evaluates effects in the key population for whom this intervention has been designed. Study findings will inform the further development of the national service provision. ISRCTN02335307.

Effect of motor control training on muscle size and football games missed from injury.

PubMed

Hides, Julie A; Stanton, Warren R; Mendis, M Dilani; Gildea, Jan; Sexton, Margot J

2012-06-01

This panel-randomized intervention trial was designed to examine the effect of a motor control training program for elite Australian Football League players with and without low back pain (LBP). The outcome measures included cross-sectional area (CSA) and symmetry of multifidus, quadratus lumborum, and psoas muscles and the change in CSA of the trunk in response to an abdominal drawing-in task. These measures of muscle size and function were performed using magnetic resonance imaging. Availability of players for competition games was used to assess the effect of the intervention on the occurrence of injuries. The motor control program involved performance of voluntary contractions of the multifidus and transversus abdominis muscles while receiving feedback from ultrasound imaging. Because all players were to receive the intervention, the trial was delivered as a stepped-wedge design with three treatment arms (a 15-wk intervention, a 8-wk intervention, and a waitlist control who received a 7-wk intervention toward the end of the playing season). Players participated in a Pilates program when they were not receiving the intervention. The intervention program was associated with an increase in multifidus muscle size relative to results in the control group. The program was also associated with an improved ability to draw-in the abdominal wall. Intervention was commensurate with an increase in availability for games and a high level of perceived benefit. The motor control program delivered to elite footballers was effective, with demonstrated changes in the size and control of the targeted muscles. In this study, footballers who received the intervention early in the season missed fewer games because of injury than those who received it late in the playing season.

Teaching kids to cope: a preventive mental health nursing strategy for adolescents.

PubMed

Puskar, K R; Lamb, J; Tusaie-Mumford, K

1997-01-01

The theoretical base, implementation, and effectiveness of Teaching Kids to Cope (TKC). To inform clinicians about the benefits and uses of TKC, a 10-week psychoeducational group intervention designed to enhance the coping repertoire of adolescents. Authors' clinical experience. Following the TKC intervention, students demonstrated less depressive symptomatology and improved coping behaviors. Further research is needed to test the intervention on a larger group and to determine its effectiveness.

Screening and brief interventions for hazardous alcohol use in accident and emergency departments: a randomised controlled trial protocol

PubMed Central

Coulton, Simon; Perryman, Katherine; Bland, Martin; Cassidy, Paul; Crawford, Mike; Deluca, Paolo; Drummond, Colin; Gilvarry, Eilish; Godfrey, Christine; Heather, Nick; Kaner, Eileen; Myles, Judy; Newbury-Birch, Dorothy; Oyefeso, Adenekan; Parrott, Steve; Phillips, Tom; Shenker, Don; Shepherd, Jonathan

2009-01-01

Background There is a wealth of evidence regarding the detrimental impact of excessive alcohol consumption on the physical, psychological and social health of the population. There also exists a substantial evidence base for the efficacy of brief interventions aimed at reducing alcohol consumption across a range of healthcare settings. Primary research conducted in emergency departments has reinforced the current evidence regarding the potential effectiveness and cost-effectiveness. Within this body of evidence there is marked variation in the intensity of brief intervention delivered, from very minimal interventions to more intensive behavioural or lifestyle counselling approaches. Further the majority of primary research has been conducted in single centre and there is little evidence of the wider issues of generalisability and implementation of brief interventions across emergency departments. Methods/design The study design is a prospective pragmatic factorial cluster randomised controlled trial. Individual Emergency Departments (ED) (n = 9) are randomised with equal probability to a combination of screening tool (M-SASQ vs FAST vs SIPS-PAT) and an intervention (Minimal intervention vs Brief advice vs Brief lifestyle counselling). The primary hypothesis is that brief lifestyle counselling delivered by an Alcohol Health Worker (AHW) is more effective than Brief Advice or a minimal intervention delivered by ED staff. Secondary hypotheses address whether short screening instruments are more acceptable and as efficient as longer screening instruments and the cost-effectiveness of screening and brief interventions in ED. Individual participants will be followed up at 6 and 12 months after consent. The primary outcome measure is performance using a gold-standard screening test (AUDIT). Secondary outcomes include; quantity and frequency of alcohol consumed, alcohol-related problems, motivation to change, health related quality of life and service utilisation. Discussion This paper presents a protocol for a large multi-centre pragmatic factorial cluster randomised trial to evaluate the effectiveness and cost-effectiveness of screening and brief interventions for hazardous alcohol users attending emergency departments. Trial Registration ISRCTN 93681536 PMID:19575791

Planning for Long-Term Follow-Up: Strategies Learned from Longitudinal Studies.

PubMed

Hill, Karl G; Woodward, Danielle; Woelfel, Tiffany; Hawkins, J David; Green, Sara

2016-10-01

Preventive interventions are often designed and tested with the immediate program period in mind, and little thought that the intervention sample might be followed up for years or even decades beyond the initial trial. However, depending on the type of intervention and the nature of the outcomes, long-term follow-up may well be appropriate. The advantages of long-term follow-up of preventive interventions are discussed and include the capacity to examine program effects across multiple later life outcomes, the ability to examine the etiological processes involved in the development of the outcomes of interest, and the ability to provide more concrete estimates of the relative benefits and costs of an intervention. In addition, researchers have identified potential methodological risks of long-term follow-up such as inflation of type 1 error through post hoc selection of outcomes, selection bias, and problems stemming from attrition over time. The present paper presents a set of seven recommendations for the design or evaluation of studies for potential long-term follow-up organized under four areas: Intervention Logic Model, Developmental Theory and Measurement Issues; Design for Retention; Dealing with Missing Data; and Unique Considerations for Intervention Studies. These recommendations include conceptual considerations in the design of a study, pragmatic concerns in the design and implementation of the data collection for long-term follow-up, as well as criteria to be considered for the evaluation of an existing intervention for potential for long-term follow-up. Concrete examples from existing intervention studies that have been followed up over the long term are provided.

Planning for Long-Term Follow-up: Strategies Learned from Longitudinal Studies

PubMed Central

Hill, Karl G.; Woodward, Danielle; Woelfel, Tiffany; Hawkins, J. David; Green, Sara

2017-01-01

Preventive interventions are often designed and tested with the immediate program period in mind, and little thought that the intervention sample might be followed up for years, or even decades beyond the initial trial. However, depending on the type of intervention and the nature of the outcomes, long-term follow-up may well be appropriate. The advantages of long-term follow-up of preventive interventions are discussed, and include the capacity to examine program effects across multiple later life outcomes, the ability to examine the etiological processes involved in the development of the outcomes of interest and the ability to provide more concrete estimates of the relative benefits and costs of an intervention. In addition, researchers have identified potential methodological risks of long-term follow-up such as inflation of type 1 error through post-hoc selection of outcomes, selection bias and problems stemming from attrition over time. The present paper presents a set of seven recommendations for the design or evaluation of studies for potential long-term follow-up organized under four areas: Intervention Logic Model, Developmental Theory and Measurement Issues; Design for Retention; Dealing with Missing Data; and Unique Considerations for Intervention Studies. These recommendations include conceptual considerations in the design of a study, pragmatic concerns in the design and implementation of the data collection for long-term follow-up, as well as criteria to be considered for the evaluation of an existing intervention for potential for long-term follow-up. Concrete examples from existing intervention studies that have been followed up over the long-term are provided. PMID:26453453

Estimating regression to the mean and true effects of an intervention in a four-wave panel study.

PubMed

Gmel, Gerhard; Wicki, Matthias; Rehm, Jürgen; Heeb, Jean-Luc

2008-01-01

First, to analyse whether a taxation-related decrease in spirit prices had a similar effect on spirit consumption for low-, medium- and high-level drinkers. Secondly, as the relationship between baseline values and post-intervention changes is confounded with regression to the mean (RTM) effects, to apply different approaches for estimating the RTM effect and true change. Consumption of spirits and total alcohol consumption were analysed in a four-wave panel study (one pre-intervention and three post-intervention measurements) of 889 alcohol consumers sampled from the general population of Switzerland. Two correlational methods, one method quantitatively estimating the RTM effect and one growth curve approach based on hierarchical linear models (HLM), were used to estimate RTM effects among low-, medium- and high-level drinkers. Adjusted for RTM effects, high-level drinkers increased consumption more than lighter drinkers in the short term, but this was not a persisting effect. Changes in taxation affected mainly light and moderate drinkers in the long term. All methods concurred that RTM effects were present to a considerable degree, and methods quantifying the RTM effect or adjusting for it yielded similar estimates. Intervention studies have to consider RTM effects both in the study design and in the evaluation methods. Observed changes can be adjusted for RTM effects and true change can be estimated. The recommended method, particularly if the aim is to estimate change not only for the sample as a whole, but for groups of drinkers with different baseline consumption levels, is growth curve modelling. If reliability of measurement instruments cannot be increased, the incorporation of more than one pre-intervention measurement point may be a valuable adjustment of the study design.

Behavioral intervention for problem behavior in children with fragile X syndrome.

PubMed

Moskowitz, Lauren J; Carr, Edward G; Durand, V Mark

2011-11-01

Parents and professionals typically report problem behavior as a significant concern for children with fragile X syndrome. In the present study, the authors explored whether behaviorally based interventions would result in a reduction in problem behavior and an improvement in quality of life for 3 children with fragile X syndrome and their families. A multiple baseline design was used to demonstrate intervention effects for specific high-priority contexts (i.e., bedtime, running errands, and toileting). A multicomponent intervention plan was developed to teach the parents and child to effectively cope with the particular context. After intervention, there were substantial improvements in problem behavior and family quality of life within the given contexts. Results of this study demonstrated the effectiveness of behavioral intervention for children with fragile X syndrome.

Comparison of Two Theory-Based, Fully Automated Telephone Interventions Designed to Maintain Dietary Change in Healthy Adults: Study Protocol of a Three-Arm Randomized Controlled Trial

PubMed Central

Quintiliani, Lisa M; Turner-McGrievy, Gabrielle M; Migneault, Jeffrey P; Heeren, Timothy; Friedman, Robert H

2014-01-01

Background Health behavior change interventions have focused on obtaining short-term intervention effects; few studies have evaluated mid-term and long-term outcomes, and even fewer have evaluated interventions that are designed to maintain and enhance initial intervention effects. Moreover, behavior theory has not been developed for maintenance or applied to maintenance intervention design to the degree that it has for behavior change initiation. Objective The objective of this paper is to describe a study that compared two theory-based interventions (social cognitive theory [SCT] vs goal systems theory [GST]) designed to maintain previously achieved improvements in fruit and vegetable (F&V) consumption. Methods The interventions used tailored, interactive conversations delivered by a fully automated telephony system (Telephone-Linked Care [TLC]) over a 6-month period. TLC maintenance intervention based on SCT used a skills-based approach to build self-efficacy. It assessed confidence in and barriers to eating F&V, provided feedback on how to overcome barriers, plan ahead, and set goals. The TLC maintenance intervention based on GST used a cognitive-based approach. Conversations trained participants in goal management to help them integrate their newly acquired dietary behavior into their hierarchical system of goals. Content included goal facilitation, conflict, shielding, and redundancy, and reflection on personal goals and priorities. To evaluate and compare the two approaches, a sample of adults whose F&V consumption was below public health goal levels were recruited from a large urban area to participate in a fully automated telephony intervention (TLC-EAT) for 3-6 months. Participants who increase their daily intake of F&V by ≥1 serving/day will be eligible for the three-arm randomized controlled trial. A sample of 405 participants will be randomized to one of three arms: (1) an assessment-only control, (2) TLC-SCT, and (3) TLC-GST. The maintenance interventions are 6 months. All 405 participants who qualify for the trial will complete surveys administered by blinded interviewers at baseline (randomization), 6, 12, 18, and 24 months. Results Data analysis is not yet complete, but we hypothesize that (1) TLC-GST > TLC-SCT > control at all follow-up time points for F&V consumption, and (2) intervention effects will be mediated by the theoretical constructs (eg, self-efficacy, goal pursuit, conflict, shielding, and facilitation). Conclusions This study used a novel study design to initiate and then promote the maintenance of dietary behavior change through the use of an evidence-based fully automated telephony intervention. After the first 6 months (the acquisition phase), we will examine whether two telephony interventions built using different underlying behavioral theories were more successful than an assessment-only control group in helping participants maintain their newly acquired health behavior change. Trial Registration Clinicaltrials.gov NCT00148525; http://clinicaltrials.gov/ct2/show/NCT00148525 (Archived by Webcite at http://www.webcitation.org/6TiRriJOs). PMID:25387065

Relative Risk Reduction as a Metric to Standardize Effect Size for Public Heath Interventions for Translational Research: Methods and Applications

PubMed Central

Mirzazadeh, A; Malekinejad, M; Kahn, JG

2018-01-01

Objective Heterogeneity of effect measures in intervention studies undermines the use of evidence to inform policy. Our objective was to develop a comprehensive algorithm to convert all types of effect measures to one standard metric, relative risk reduction (RRR). Study Design and Setting This work was conducted to facilitate synthesis of published intervention effects for our epidemic modeling of the health impact of HIV Testing and Counseling (HTC). We designed and implemented an algorithm to transform varied effect measures to RRR, representing the proportionate reduction in undesirable outcomes. Results Our extraction of 55 HTC studies identified 473 effect measures representing unique combinations of intervention-outcome-population characteristics, using five outcome metrics: pre-post proportion (70.6%), odds ratio (14.0%), mean difference (10.2%), risk ratio (4.4%), and RRR (0.9%). Outcomes were expressed as both desirable (29.5%, e.g., consistent condom use) and undesirable (70.5% e.g., inconsistent condom use). Using four examples, we demonstrate our algorithm for converting varied effect measures to RRR, and provide the conceptual basis for advantages of RRR over other metrics. Conclusion Our review of the literature suggests that RRR, an easily understood and useful metric to convey risk reduction associated with an intervention, is underutilized by original and review studies. PMID:25726522