Development of project wings home visits, a mental health intervention for Latino families using community-based participatory research.

PubMed

Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth

2012-11-01

As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.

Factors Affecting Intervention Fidelity of Differentiated Instruction in Kindergarten

ERIC Educational Resources Information Center

Dijkstra, Elma M.; Walraven, Amber; Mooij, Ton; Kirschner, Paul A.

2017-01-01

This paper reports on the findings in the first phase of a design-based research project as part of a large-scale intervention study in Dutch kindergartens. The project aims at enhancing differentiated instruction and evaluating its effects on children's development, in particular high-ability children. This study investigates relevant…

Influence of standing positions and beam projections on effective dose and eye lens dose of anaesthetists in interventional procedures.

PubMed

Kong, Y; Struelens, L; Vanhavere, F; Vargas, C S; Schoonjans, W; Zhuo, W H

2015-02-01

More and more anaesthetists are getting involved in interventional radiology procedures and so it is important to know the radiation dose and to optimise protection for anaesthetists. In this study, based on Monte Carlo simulations and field measurements, both the whole-body doses and eye lens dose of anaesthetists were studied. The results showed that the radiation exposure to anaesthetists not only depends on their workload, but also largely varies with their standing positions and beam projections during interventional procedures. The simulation results showed that the effective dose to anaesthetists may vary with their standing positions and beam projections to more than a factor of 10, and the eye lens dose may vary with the standing positions and beam projections to more than a factor of 200. In general, a close position to the bed and the left lateral (LLAT) beam projection will bring a high exposure to anaesthetists. Good correlations between the eye lens dose and the doses at the neck, chest and waist over the apron were observed from the field measurements. The results indicate that adequate arrangements of anaesthesia device or other monitoring equipment in the fluoroscopy rooms are useful measures to reduce the radiation exposure to anaesthetists, and anaesthetists should be aware that they will receive the highest doses under left lateral beam projection. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Study of Child Variance, Volume 2: Interventions; Conceptual Project in Emotional Disturbance.

ERIC Educational Resources Information Center

Rhodes, William C.; Tracy, Michael L.

Presented in the second volume of a series emanating from a conceptual project on emotional disturbance are six papers on general aspects of interventions as well as biophysical, behavioral, psychodynamic, environmental, and counter theoretical interventions. In an "Overview of Interventions", W. Rhodes discusses a framework for viewing…

Project power: Adapting an evidence-based HIV/STI prevention intervention for incarcerated women.

PubMed

Fasula, Amy M; Fogel, Catherine I; Gelaude, Deborah; Carry, Monique; Gaiter, Juarlyn; Parker, Sharon

2013-06-01

Incarcerated women are a critical population for targeted HIV/STI prevention programming; however, there is a dearth of evidence-based, genderspecific behavioral interventions for this population. Systematically adapting existing evidence-based interventions (EBIs) can help fill this gap. We illustrate the adaptation of the HIV/STI prevention EBI, Project Safe, for use among incarcerated women and delivery in prisons. Project POWER, the final adapted intervention, was developed using formative research with prison staff and administration, incarcerated and previously incarcerated women, and input of community advisory boards. Intervention delivery adaptations included: shorter, more frequent intervention sessions; booster sessions prior to and just after release; facilitator experience in prisons and counseling; and new videos. Intervention content adaptations addressed issues of empowerment, substance use, gender and power inequity in relationships, interpersonal violence, mental health, reentry, and social support. This illustration of the adaption process provides information to inform additional efforts to adapt EBIs for this underserved population.

The health Oriented pedagogical project (HOPP) - a controlled longitudinal school-based physical activity intervention program.

PubMed

Fredriksen, Per Morten; Hjelle, Ole Petter; Mamen, Asgeir; Meza, Trine J; Westerberg, Ane C

2017-04-28

The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance. HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 ) as of June 20 th - 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.

Individual, employment and psychosocial factors influencing walking to work: Implications for intervention design

PubMed Central

Esliger, Dale W.; Taylor, Ian M.; Sherar, Lauren B.

2017-01-01

Background Promoting walking for the journey to and from work (commuter walking) is a potential strategy for increasing physical activity. Understanding the factors influencing commuter walking is important for identifying target groups and designing effective interventions. This study aimed to examine individual, employment-related and psychosocial factors associated with commuter walking and to discuss the implications for targeting and future design of interventions. Methods 1,544 employees completed a baseline survey as part of the ‘Walking Works’ intervention project (33.4% male; 36.3% aged <30 years). Multivariate logistic regression was used to examine the associations of individual (age, ethnic group, educational qualifications, number of children <16 and car ownership), employment-related (distance lived from work, free car parking at work, working hours, working pattern and occupation) and psychosocial factors (perceived behavioural control, intention, social norms and social support from work colleagues) with commuter walking. Results Almost half of respondents (n = 587, 49%) were classified as commuter walkers. Those who were aged <30 years, did not have a car, had no free car parking at work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking were more likely to be commuter walkers. Those who perceived they lived too far away from work to walk, thought walking was less convenient than using a car for commuting, did not have time to walk, needed a car for work or had always travelled the same way were less likely to be commuter walkers. Conclusions A number of individual, employment-related and psychosocial factors were associated with commuter walking. Target groups for interventions to promote walking to and from work may include those in older age groups and those who own or have access to a car. Multi-level interventions targeting individual level behaviour

Individual, employment and psychosocial factors influencing walking to work: Implications for intervention design.

PubMed

Adams, Emma J; Esliger, Dale W; Taylor, Ian M; Sherar, Lauren B

2017-01-01

Promoting walking for the journey to and from work (commuter walking) is a potential strategy for increasing physical activity. Understanding the factors influencing commuter walking is important for identifying target groups and designing effective interventions. This study aimed to examine individual, employment-related and psychosocial factors associated with commuter walking and to discuss the implications for targeting and future design of interventions. 1,544 employees completed a baseline survey as part of the 'Walking Works' intervention project (33.4% male; 36.3% aged <30 years). Multivariate logistic regression was used to examine the associations of individual (age, ethnic group, educational qualifications, number of children <16 and car ownership), employment-related (distance lived from work, free car parking at work, working hours, working pattern and occupation) and psychosocial factors (perceived behavioural control, intention, social norms and social support from work colleagues) with commuter walking. Almost half of respondents (n = 587, 49%) were classified as commuter walkers. Those who were aged <30 years, did not have a car, had no free car parking at work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking were more likely to be commuter walkers. Those who perceived they lived too far away from work to walk, thought walking was less convenient than using a car for commuting, did not have time to walk, needed a car for work or had always travelled the same way were less likely to be commuter walkers. A number of individual, employment-related and psychosocial factors were associated with commuter walking. Target groups for interventions to promote walking to and from work may include those in older age groups and those who own or have access to a car. Multi-level interventions targeting individual level behaviour change, social support within the

DSN human factors project

NASA Technical Reports Server (NTRS)

Chafin, R. L.; Martin, T. H.

1980-01-01

The project plan was to hold focus groups to identify the factors influencing the ease of use characteristics of software and to bond the problem. A questionnaire survey was conducted to evaluate those factors which were more appropriately measured with that method. The performance oriented factors were analyzed and relationships hypothesized. The hypotheses were put to test in the experimental phase of the project. In summary, the initial analysis indicates that there is an initial performance effect favoring computer controlled dialogue but the advantage fades fast as operators become experienced. The user documentation style is seen to have a significant effect on performance. The menu and prompt command formats are preferred by inexperienced operators. The short form mnemonic is least favored. There is no clear best command format but the short form mnemonic is clearly the worst.

Factors influencing workplace health promotion intervention: a qualitative systematic review.

PubMed

Rojatz, Daniela; Merchant, Almas; Nitsch, Martina

2017-10-01

Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Contextual Factors Impacting a Pain Management Intervention.

PubMed

Alaloul, Fawwaz; Williams, Kimberly; Myers, John; Jones, Kayla Dlauren; Sullivan, Katelyn; Logsdon, M Cynthia

2017-09-01

To determine if findings from our preliminary study related to patient and nursing satisfaction with a pain management intervention could be replicated in a changed environment, and if contextual factors could impact the effectiveness of a pain management intervention on patient satisfaction with nursing staff's management of pain. A prospective, experimental design was used with six monthly assessments before, during, and after the intervention. Data were collected from 540 patients admitted to eight medical surgical and progressive care units and nurses that worked in these units at an academic health sciences center in the southern United States, from March to July 2015. The script-based, pain management communication intervention included three specific tactics: script-based communication, use of white boards, and hourly rounding. The Hospital Consumer Assessment of Healthcare Providers and Systems survey was used to assess two items: "pain is well controlled" and "staff did everything they could to help with pain." Contextual factors focused on the practice setting. Both scores for "pain is well controlled" (β = .028, p = 0.651) and scores for "staff did everything they could to help with pain" (β = .057,p = .385) did not change initially but then increased significantly and were sustained over time. Nurses had high levels of satisfaction with the intervention (M = 7.9, SD = 2.1) and compliance with the intervention (M = 8.0, SD = 1.9), and had little difficulty in implementing the intervention (M = 8.3, SD = 1.4). In terms of contextual factors, the number of beds on the unit and the number of patients being discharged negatively impacted scores for "pain is well controlled" and "staff did everything they could to help with pain." Hospital length of stay positively impacted scores for "pain is well controlled" by staff. Despite challenging contextual variables, the study extended the findings of an early preliminary study in showing the effectiveness of

[The Impact of Risk Factors and Effective Factors on Success in Crisis Intervention for Children and Adolescents].

PubMed

Wisiol, Florian; Juen, Barbara; Unterrainer, Christine

2017-05-01

The Impact of Risk Factors and Effective Factors on Success in Crisis Intervention for Children and Adolescents This article focuses on the evaluation of (inpatient) crisis interventions for children and adolescents, who can be admitted into the residential area of the KIZ for up to eight weeks in order to provide acute protection against massive violence, neglect or family conflicts in emergency situations. How successful the crisis intervention is or can be depends on various factors that have been worked out in this study. Various factors have an impact on success in crisis intervention; above all the participation, a good relationship and/or cooperation with the Counselors in the Crisis Intervention Center contribute to a great success. Restoring their own possibilities for action after a massive crisis, the strengthening of self-efficacy in crisis intervention must be considered critically. The young clients see little change here. The crisis intervention must therefore not only focus on its most important function, protection and security, but also on the strengthening of self-esteem and a positive sense of coherence as part of the crisis intervention.

Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study.

PubMed

Andersén, Åsa; Ståhl, Christian; Anderzén, Ingrid; Kristiansson, Per; Larsson, Kjerstin

2017-10-10

The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual's ability to work. The aim of this study was to investigate clients' experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

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

ERIC Educational Resources Information Center

McDaid, Janet L.

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

From Project to Program: Tupange's Experience with Scaling Up Family Planning Interventions in Urban Kenya.

PubMed

Keyonzo, Nelson; Nyachae, Paul; Kagwe, Peter; Kilonzo, Margaret; Mumba, Feddis; Owino, Kenneth; Kichamu, George; Kigen, Bartilol; Fajans, Peter; Ghiron, Laura; Simmons, Ruth

2015-05-01

This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya. Copyright © 2015. Published by Elsevier Ltd.

Factors related to risky sexual behaviors and effective STI/HIV and pregnancy intervention programs for African American adolescents.

PubMed

Lee, Young Me; Cintron, Adanisse; Kocher, Surinder

2014-01-01

The purpose of this integrative literature review study was to investigate factors related to risky sexual behaviors among African American adolescents, to evaluate which of the factors are common across successful and effective STI/HIV and pregnancy intervention programs, and finally, to propose suggestions for future intervention programs for African American adolescents in West Englewood, Chicago. An integrative literature review was conducted. Using CINAHL, PubMed, and ProQuest database, the following terms were searched: African American, Black, adolescents, teenagers, sexual behavior, cultural factors, pregnancy, STIs/HIV/AIDS, and intervention programs. A total of 18 articles were reviewed, findings indicated there were five major contributing factors related to risky sexual behaviors: substance use, gender roles, peer influences, parental involvement, and level of knowledge and information on sex and STIs. Six successful STI/HIV and pregnancy programs that incorporated those factors to effectively reduce risky sexual behaviors were identified. After analyzing six national intervention programs proven to be effective, the findings suggest that future prevention programs should be designed with more emphasis on avoidance or limited substance use, increased parental involvement, integration of cultural teaching components such as storytelling and history as suggested from the Aban Aya Youth Project. This study also concluded that future prevention programs should consider the length of programs be longer than 1 year, as it has been shown to be more effective than shorter programs. © 2014 Wiley Periodicals, Inc.

Validation of the European Cyberbullying Intervention Project Questionnaire for Colombian Adolescents.

PubMed

Herrera-López, Mauricio; Casas, José A; Romera, Eva M; Ortega-Ruiz, Rosario; Del Rey, Rosario

2017-02-01

Cyberbullying is the act of using unjustified aggression to harm or harass via digital devices. Currently regarded as a widespread problem, the phenomenon has attracted growing research interest in different measures of cyberbullying and the similarities and differences across countries and cultures. This article presents the Colombian validation of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) involving 3,830 high school students (M = 13.9 years old, standard deviation = 1.61; 48.9 percent male), of which 1,931 were Colombian and 1,899 Spanish. Confirmatory factor analysis (CFA), content validation, and multigroup analysis were performed with each of the sample subgroups. The optimal fits and psychometric properties obtained confirm the robustness and suitability of the assessment instrument to jointly measure cyber-aggression and cyber-victimization. The results corroborated the theoretical construct and the two-dimensional and universal nature of cyberbullying. The multigroup analysis showed that cyberbullying dynamics are similar in both countries. The comparative analyses of prevalence revealed that Colombian students are less involved in cyberbullying. The results indicate the suitability of the instrument and the advantages of using such a tool to evaluate and guide psychoeducational interventions aimed at preventing cyberbullying in countries where few studies have been performed.

Project Northland high school interventions: community action to reduce adolescent alcohol use.

PubMed

Perry, C L; Williams, C L; Komro, K A; Veblen-Mortenson, S; Forster, J L; Bernstein-Lachter, R; Pratt, L K; Dudovitz, B; Munson, K A; Farbakhsh, K; Finnegan, J; McGovern, P

2000-02-01

Project Northland is a randomized community trial initially implemented in 24 school districts and communities in northeastern Minnesota, with goals of delaying onset and reducing adolescent alcohol use using community-wide, multiyear, multiple interventions. The study targets the Class of 1998 from the 6th to 12th grades (1991-1998). The early adolescent phase of Project Northland has been completed, and reductions in the prevalence of alcohol use at the end of 8th grade were achieved. Phase II of Project Northland, targeting 11th- and 12th-grade students, uses five major strategies: (1) direct action community organizing methods to encourage citizens to reduce underage access to alcohol, (2) youth development involving high school students in youth action teams, (3) print media to support community organizing and youth action initiatives and communicate healthy norms about underage drinking (e.g., providing alcohol to minors is unacceptable), (4) parent education and involvement, and (5) a classroom-based curriculum for 11th-grade students. This article describes the background, design, implementation, and process measures of the intervention strategies for Phase II of Project Northland.

One on One Numeracy Intervention: A Pilot Project in Low SES Communities

ERIC Educational Resources Information Center

Thornton, Steve; Quinane, Mary; Galluzzo, Gina; Taylor, Debbie

2010-01-01

This paper reports on the structure and impact of a one on one numeracy intervention project conducted during 2009 with students in years 1, 4 and 8. The project was built on a Reading Recovery model, using research into how the brain learns mathematics and ideas of threshold concepts. Teachers were provided time to work individually with students…

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

PubMed

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

2006-01-01

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

Biographies for Artistic and Social Intervention: A Youth-Driven Project

ERIC Educational Resources Information Center

Carvalho, Claudia Pato

2014-01-01

This article discusses how biographical materials may be used in youth arts education projects to develop new methodologies and approaches that can stimulate artistic and social intervention in contemporary urban communities, thus changing the field of arts education policy at the community level. Through their creation of Artistic Society…

Effectiveness of an Adaptation of the Project Connect Health Systems Intervention: Youth and Clinic-Level Findings.

PubMed

Loosier, Penny S; Doll, Shelli; Lepar, Danielle; Ward, Kristin; Gamble, Ginger; Dittus, Patricia J

2016-08-01

The Project Connect Health Systems Intervention (Project Connect) uses a systematic process of collecting community and healthcare infrastructure information to craft a referral guide highlighting local healthcare providers who provide high quality sexual and reproductive healthcare. Previous self-report data on healthcare usage indicated Project Connect was successful with sexually experienced female youth, where it increased rates of human immunodeficiency virus (HIV) and sexually transmitted disease (STD) testing and receipt of contraception. This adaption of Project Connect examined its effectiveness in a new context and via collection of clinic encounter-level data. Project Connect was implemented in 3 high schools. (only 2 schools remained open throughout the entire project period). Participant recruitment and data collection occurred in 5 of 8 participating health clinics. Students completed Youth Surveys (N = 608) and a Clinic Survey (paired with medical data abstraction in 2 clinics [N = 305]). Students were more likely than nonstudents to report having reached a clinic via Project Connect. Nearly 40% of students attended a Project Connect school, with 32.7% using Project Connect to reach the clinic. Students were most likely to have been referred by a school nurse or coach. Project Connect is a low-cost, sustainable structural intervention with multiple applications within schools, either as a standalone intervention or in combination with ongoing efforts. © 2016, American School Health Association.

Toddler Research and Intervention Project Report-Year II. IMRID Behavioral Science Monograph No. 21.

ERIC Educational Resources Information Center

Bricker, Diane; Bricker, William

The report summarizes the second year of the Toddler Research and Intervention Project, which uses experimental research to devise and evaluate educational intervention techniques with approximately 28 normal or developmentally delayed children 1- to 4-years-old and their families. Described are researchers/teachers relationships, behavioral…

Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

PubMed

Jones, Eleri; Lattof, Samantha R; Coast, Ernestina

2017-08-31

The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

Analysis of Factors Influencing Building Refurbishment Project Performance

NASA Astrophysics Data System (ADS)

Ishak, Nurfadzillah; Aswad Ibrahim, Fazdliel; Azizi Azizan, Muhammad

2018-03-01

Presently, the refurbishment approach becomes favourable as it creates opportunities to incorporate sustainable value with other building improvement. In this regard, this approach needs to be implemented due to the issues on overwhelming ratio of existing building to new construction, which also can contribute to the environmental problem. Refurbishment principles imply to minimize the environmental impact and upgrading the performance of an existing building to meet new requirements. In theoretically, building project's performance has a direct bearing on related to its potential for project success. However, in refurbishment building projects, the criteria for measure are become wider because the projects are a complex and multi-dimensional which encompassing many factors which reflect to the nature of works. Therefore, this impetus could be achieve by examine the direct empirical relationship between critical success factors (CSFs) and complexity factors (CFs) during managing the project in relation to delivering success on project performance. The research findings will be expected as the basis of future research in establish appropriate framework that provides information on managing refurbishment building projects and enhancing the project management competency for a better-built environment.

Project Eban: An HIV/STD Intervention for African American Couples

PubMed Central

2010-01-01

Objective To describe the Eban HIV/STD Risk Reduction Intervention being evaluated in the NIMH Multisite HIV/STD Prevention trial for heterosexual African American couples, including the integrated theoretical framework, the structure, core elements and procedures of the intervention and how the content was shaped by culturally congruent concepts to address the needs of the study target population. Design The Eban HIV/STD Risk Reduction Intervention is designed to address multilevel individual, interpersonal and community level factors that contribute to HIV/STD transmission risk behaviors among heterosexual African American couples who are HIV serodiscordant. Methods The Eban HIV/STD Risk Reduction Intervention employs a mixed modality, couples-based approach that is based on an integrated ecological framework incorporating social cognitive theory and uses an Afro-centric paradigm that is informed by previous evidence-based couples HIV prevention interventions. For this randomized controlled trial, African American serodiscordant couples were recruited from four urban sites (Atlanta, Los Angeles, New York and Philadelphia) and were randomized to either the Eban HIV/STD Risk Reduction Intervention (treatment condition) or a Health Promotion Intervention that served as an attentional control condition. Both interventions had 4 individual couple sessions and 4 group sessions, but only the treatment condition was focused on reducing HIV/STD risk behaviors. Behavioral and biological data were collected at baseline, immediately after the intervention, and at 6 and 12 months. The theoretical framework, core elements and content of each session are described and lessons learned from this intervention trial are discussed. Results An HIV prevention intervention combining couple and group sessions can be feasibly implemented with African American HIV serodiscordant couples who remain at high risk of HIV/STD transmission. The lessons learned from the trial suggest that the

Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project.

PubMed

Muellmann, Saskia; Steenbock, Berit; De Cocker, Katrien; De Craemer, Marieke; Hayes, Catherine; O'Shea, Miriam P; Horodyska, Karolina; Bell, Justyna; Luszczynska, Aleksandra; Roos, Gun; Langøien, Lars Jørun; Rugseth, Gro; Terragni, Laura; De Bourdeaudhuij, Ilse; Brug, Johannes; Pischke, Claudia R

2017-12-06

The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland. Six interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher. Active involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured. Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies.

Factors affecting recruitment and retention of community health workers in a newborn care intervention in Bangladesh.

PubMed

Rahman, Syed Moshfiqur; Ali, Nabeel Ashraf; Jennings, Larissa; Seraji, M Habibur R; Mannan, Ishtiaq; Shah, Rasheduzzaman; Al-Mahmud, Arif Billah; Bari, Sanwarul; Hossain, Daniel; Das, Milan Krishna; Baqui, Abdullah H; El Arifeen, Shams; Winch, Peter J

2010-05-03

Well-trained and highly motivated community health workers (CHWs) are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh. Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation), and informal discussion with key project personnel. Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay. The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.

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

Spoor, Ellen; de Jonge, Jan; Hamers, Jan P H

2010-05-28

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. 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. 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.

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

The Childhood Obesity Research Demonstration project: a team approach for supporting a multisite, multisector intervention.

PubMed

Williams, Nancy; Dooyema, Carrie A; Foltz, Jennifer L; Belay, Brook; Blanck, Heidi M

2015-02-01

Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various levels of staff working with the project. By thoughtful development of the team and processes, an efficient system for supporting the multisite, multisector intervention project sites was developed. The team approach will be formally evaluated at the end of the project period.

Mediators and Treatment Factors in Intervention for Children Exposed to Interparental Violence.

PubMed

Overbeek, Mathilde M; De Schipper, J Clasien; Willemen, Agnes M; Lamers-Winkelman, Francien; Schuengel, Carlo

2017-01-01

Changes in children's emotion differentiation, coping skills, parenting stress, parental psychopathology, and parent-child interaction were explored as mediators of treatment factors in two selective preventive group interventions for children exposed to interparental violence (IPV) and their parents. One hundred thirty-four IPV-exposed children (ages 6-12 years, 52% boys) and their parents were randomized to an IPV-focused or common factors community-based group intervention and completed baseline, posttest, and follow-up assessments for posttraumatic stress (PTS). A multilevel model tested mediators that included children's ability to differentiate emotions and coping skills, parenting stress, parental psychopathology, and parent-child interactions. In both conditions, exposure to nonspecific factors, specific factors unrelated to IPV and trauma-specific intervention factors was coded from videotaped child and parent sessions. Improved parental mental health mediated the link between greater exposure to nonspecific treatment factors and decreases in PTS symptoms. In addition, an increase in emotion differentiation and a decrease in parenting stress were associated with a decrease in PTS symptoms. Greater exposure to trauma-specific factors in child sessions was associated with a small decrease in emotion differentiation, an increase in coping skills, and a decrease in PTS symptoms over time. Greater exposure to nonspecific treatment factors in child and parent sessions was associated with more positive parent-child interaction. Parental mental health appears to be an important mechanism of change that can be promoted through exposure to nonspecific factors in parent intervention. For children, the effect of greater exposure to trauma-specific factors in intervention is less clear and may not have clear benefits.

A childhood obesity prevention programme in Barcelona (POIBA Project): Study protocol of the intervention.

PubMed

Sánchez-Martínez, Francesca; Juárez, Olga; Serral, Gemma; Valmayor, Sara; Puigpinós, Rosa; Pasarín, María Isabel; Díez, Élia; Ariza, Carles

2018-02-05

Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-olds. Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children's eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent.

The Heartfile Lodhran CVD prevention project--end of project evaluation.

PubMed

Nishtar, Sania; Badar, Asma; Kamal, Mohammad Umer; Iqbal, Azhar; Bajwa, Rashid; Shah, Tauqeer; Larik, Zahid; Karim, Fazle; Mehmood, Mahmood ul Hassan; Jehangir, Haroon; Azam, Syed Iqbal; Mirza, Yasir Abbas; Khan, Shahzad Ali; Qayyum, Aamra; Aqeel, Fauzia; Bakir, Abdul; Rahim, Ejaz

2007-01-01

Mainstream preventive interventions often fail to reach poor populations with a high risk of cardiovascular diseases (CVDs) in Pakistan. A community-based CVD primary prevention project aimed at developing approaches to reduce risk factors in such populations was established by Heartfile in collaboration with the National Rural Support Program in the district of Lodhran. The project implemented a range of activities integrated with existing social and health service mechanisms during a three year intervention period 2000/01-03/04. These were targeted in 4 key settings: community health education, mass media interventions, training of health professionals and health education through Lady Health Workers. The project received support from the Department for International Development, U.K. At the community level, a pre-test-post-test quasi-experimental design was used for examining project outcomes related to the community component of the intervention. Pre and post-intervention (training) evaluations were conducted involving all health care providers in randomly selected workshops in order to determine baseline levels of knowledge and the impact of training on knowledge level. In order to assess practices of physician and non-physician health care providers patient interviews, with control comparisons were conducted at each health care facility. Significant positive changes were observed in knowledge levels at a community level in the district of intervention compared with baseline knowledge levels particularly in relation to a heart healthy diet, beneficial level of physical activity, the causes of high blood pressure and heart attack and the effects of high blood pressure and active and passive smoking on health. Significant changes in behaviors at a practice level were not shown in the district of intervention. However the project played a critical role in spurring national action for the prevention and control of non-communicable diseases and introducing

Factors influencing the suicide intervention skills of emergency medical services providers.

PubMed

Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

2017-01-01

Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. EMS: Emergency medical services; SIRI: Suicide intervention response inventory.

"Does Hope Change? Testing a Project-Based Health Intervention among Urban Students of Color"

ERIC Educational Resources Information Center

Zusevics, Kaija L.; Johnson, Sheri

2014-01-01

Hope is positively correlated with educational attainment and health. Interventions based on project-based learning (PBL) may increase youth hope. This study examined how a PBL intervention affected hope among urban students of color. Students in health classes were invited to participate. A PBL health class was implemented in four classrooms. The…

Multilevel perspectives on community intervention: an example from an Indo-US HIV prevention project in Mumbai, India.

PubMed

Schensul, Stephen L; Saggurti, Niranjan; Singh, Rajendra; Verma, Ravi K; Nastasi, Bonnie K; Mazumder, Papiya Guha

2009-06-01

This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.

Factors influencing the suicide intervention skills of emergency medical services providers

PubMed Central

Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

2017-01-01

ABSTRACT Background: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. Aims: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Method: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Results: Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers’ ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. Conclusions: In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. Abbreviations: EMS: Emergency medical services; SIRI: Suicide intervention response inventory PMID:28235388

Development of Risk Uncertainty Factors from Historical NASA Projects

NASA Technical Reports Server (NTRS)

Amer, Tahani R.

2011-01-01

NASA is a good investment of federal funds and strives to provide the best value to the nation. NASA has consistently budgeted to unrealistic cost estimates, which are evident in the cost growth in many of its programs. In this investigation, NASA has been using available uncertainty factors from the Aerospace Corporation, Air Force, and Booz Allen Hamilton to develop projects risk posture. NASA has no insight into the developmental of these factors and, as demonstrated here, this can lead to unrealistic risks in many NASA Programs and projects (P/p). The primary contribution of this project is the development of NASA missions uncertainty factors, from actual historical NASA projects, to aid cost-estimating as well as for independent reviews which provide NASA senior management with information and analysis to determine the appropriate decision regarding P/p. In general terms, this research project advances programmatic analysis for NASA projects.

Translating evidence-based interventions for implementation: Experiences from Project HEAL in African American churches.

PubMed

Holt, Cheryl L; Tagai, Erin K; Scheirer, Mary Ann; Santos, Sherie Lou Z; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie L; Wang, Min Qi; Whitehead, Tony

2014-05-31

Community-based approaches have been increasing in the effort to raise awareness and early detection for cancer and other chronic disease. However, many times, such interventions are tested in randomized trials, become evidence-based, and then fail to reach further use in the community. Project HEAL (Health through Early Awareness and Learning) is an implementation trial that aims to compare two strategies of implementing evidence-based cancer communication interventions in African American faith-based organizations. This article describes the community-engaged process of transforming three evidence-based cancer communication interventions into a coherent, branded strategy for training community health advisors with two delivery mechanisms. Peer community health advisors receive training through either a traditional classroom approach (with high technical assistance/support) or a web-based training portal (with low technical assistance/support). We describe the process, outline the intervention components, report on the pilot test, and conclude with lessons learned from each of these phases. Though the pilot phase showed feasibility, it resulted in modifications to data collection protocols and team and community member roles and expectations. Project HEAL offers a promising strategy to implement evidence-based interventions in community settings through the use of technology. There could be wider implications for chronic disease prevention and control.

Factors influencing rural and urban emergency clinicians' participation in an online knowledge exchange intervention.

PubMed

Curran, Janet A; Murphy, Andrea L; Sinclair, Douglas; McGrath, Patrick

2013-01-01

Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians' participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician's decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians' perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians? A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study. The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual

The Legacy Project Intervention to Enhance Meaningful Family Interactions: Case Examples

PubMed Central

ALLEN, REBECCA S.

2009-01-01

Manualized reminiscence and life review therapies are supported as an evidence-based, effective treatment for depression among older adults, but this therapeutic approach is usually individually administered and has rarely been applied in palliative care settings. We combined mutual reminiscence and life review with engagement in meaningful activity and examined the efficacy of this family-based dyadic intervention to decrease caregiving stress and increase family communication. Seventeen individuals living with chronic, life-limiting illnesses in the community and their family caregivers received three home visits with a master’s-level interventionist. During these sessions and through structured homework activities, the interventionist actively worked with the family to construct a personal Legacy Project, usually a scrapbook with photos, a cookbook, or audiotaped stories that celebrated the life of the ill individual. All participants in the intervention group initiated a Legacy Project and reported that Legacy activities improved family communication. Participation in Legacy creation also resulted in increased positive emotional experiences in patient and caregiver groups. These results are illustrated through careful examination of three case studies. PMID:20046967

Examining Factors of Engagement With Digital Interventions for Weight Management: Rapid Review

PubMed Central

2017-01-01

Background Digital interventions for weight management provide a unique opportunity to target daily lifestyle choices and eating behaviors over a sustained period of time. However, recent evidence has demonstrated a lack of user engagement with digital health interventions, impacting on the levels of intervention effectiveness. Thus, it is critical to identify the factors that may facilitate user engagement with digital health interventions to encourage behavior change and weight management. Objective The aim of this study was to identify and synthesize the available evidence to gain insights about users’ perspectives on factors that affect engagement with digital interventions for weight management. Methods A rapid review methodology was adopted. The search strategy was executed in the following databases: Web of Science, PsycINFO, and PubMed. Studies were eligible for inclusion if they investigated users’ engagement with a digital weight management intervention and were published from 2000 onwards. A narrative synthesis of data was performed on all included studies. Results A total of 11 studies were included in the review. The studies were qualitative, mixed-methods, or randomized controlled trials. Some of the studies explored features influencing engagement when using a Web-based digital intervention, others specifically explored engagement when accessing a mobile phone app, and some looked at engagement after text message (short message service, SMS) reminders. Factors influencing engagement with digital weight management interventions were found to be both user-related (eg, perceived health benefits) and digital intervention–related (eg, ease of use and the provision of personalized information). Conclusions The findings highlight the importance of incorporating user perspectives during the digital intervention development process to encourage engagement. The review contributes to our understanding of what facilitates user engagement and points toward

The foundation of NCVD PCI Registry: the Malaysia's first multi-centre interventional cardiology project.

PubMed

Liew, H B; Rosli, M A; Wan Azman, W A; Robaayah, Z; Sim, K H

2008-09-01

The National Cardiovascular Database for Percutaneous Coronary Intervention (NCVD PCI) Registry is the first multicentre interventional cardiology project, involving the main cardiac centres in the country. The ultimate goal of NCVD PCI is to provide a contemporary appraisal of PCI in Malaysia. This article introduces the foundation, the aims, methodology, database collection and preliminary results of the first six-month database.

Examination of the relationship between project management critical success factors and project success of oil and gas drilling projects

NASA Astrophysics Data System (ADS)

Alagba, Tonye J.

Oil and gas drilling projects are the primary means by which oil companies recover large volumes of commercially available hydrocarbons from deep reservoirs. These types of projects are complex in nature, involving management of multiple stakeholder interfaces, multidisciplinary personnel, complex contractor relationships, and turbulent environmental and market conditions, necessitating the application of proven project management best practices and critical success factors (CSFs) to achieve success. Although there is some practitioner oriented literature on project management CSFs for drilling projects, none of these is based on empirical evidence, from research. In addition, the literature has reported alarming rates of oil and gas drilling project failure, which is attributable not to technical factors, but to failure of project management. The aim of this quantitative correlational study therefore, was to discover an empirically verified list of project management CSFs, which consistent application leads to successful implementation of oil and gas drilling projects. The study collected survey data online, from a random sample of 127 oil and gas drilling personnel who were members of LinkedIn's online community "Drilling Supervisors, Managers, and Engineers". The results of the study indicated that 10 project management factors are individually related to project success of oil and gas drilling projects. These 10 CSFs are namely; Project mission, Top management support, Project schedule/plan, Client consultation, Personnel, Technical tasks, Client acceptance, Monitoring and feedback, Communication, and Troubleshooting. In addition, the study found that the relationships between the 10 CSFs and drilling project success is unaffected by participant and project demographics---role of project personnel, and project location. The significance of these findings are both practical, and theoretical. Practically, application of an empirically verified CSFs list to oil

Strategic factors for the sustainability of a health intervention at municipal level of Brazil.

PubMed

Oliveira, Sydia Rosana de Araujo; Medina, Maria Guadalupe; Figueiró, Ana Cláudia; Potvin, Louise

2017-07-27

The present study aims to describe the evolution of an intervention, using a methodology that adopts the critical event as the unit of analysis, and to identify strategic factors that facilitate the continuation of the interventions. Six critical events were identified: dispute care models for health; area of advice: dispute field; change policy; break of interorganizational relations; lack of physical structure and turnover of staff; difficulty in organizing practices in the work process. these are developed into strategic factors: enabling network of allies; meetings and educational activities/building capacity; benefits perceived by community members; mobilization of key actors; intervention's compatibility with the government's vision; restoration of interrelationship; and stability of the workforce. These strategic factors form a group of interrelated conditions that provide the strengthened linkages between elements in the intervention, supporting the hypothesis that they collaborate for the sustainability of the interventions in health. Tracking down the transformations of an intervention set by the critical events, it was verified that these factors performed a protective role at times of changes in the intervention process.

Multiple risk factor interventions for primary prevention of coronary heart disease

PubMed Central

Ebrahim, Shah; Beswick, Andrew; Burke, Margaret; Smith, George Davey

2014-01-01

Background Primary prevention programmes in many countries attempt to reduce mortality and morbidity due to coronary heart disease (CHD) through risk factor modification. It is widely believed that multiple risk factor intervention using counselling and educational methods is efficacious and cost-effective and should be expanded. Recent trials examining risk factor changes have cast considerable doubt on the effectiveness of these multiple risk factor interventions. Objectives To assess the effects of multiple risk factor intervention for reducing cardiovascular risk factors, total mortality, and mortality from CHD among adults without clinical evidence of established cardiovascular disease. Search strategy MEDLINE was searched for the original review to 1995. This was updated by searching the Cochrane Central Register of Controlled Trials on The Cochrane Library Issue 3 2001, MEDLINE(2000 to September 2001) and EMBASE (1998 to September 2001). Selection criteria Intervention studies using counselling or education to modify more than one cardiovascular risk factor in adults from general populations, occupational groups, or high risk groups. Trials of less than 6 months duration were excluded. Data collection and analysis Data were extracted by two reviewers independently. Investigators were contacted to obtain missing information. Main results A total of 39 trials were found of which ten reported clinical event data. In the ten trials with clinical event end-points, the pooled odds ratios for total and CHD mortality were 0.96 (95% confidence intervals (CI) 0.92 to 1.01) and 0.96 (95% CI 0.89 to 1.04) respectively. Net changes in systolic and diastolic blood pressure, and blood cholesterol were (weighted mean differences) −3.6 mmHg (95% CI −3.9 to −3.3 mmHg), −2.8 mmHg (95% CI −2.9 to −2.6 mmHg) and −0.07 mMol/l (95% CI −0.8 to −0.06 mMol/l) respectively. Odds of reduction in smoking prevalence was 20% (95% CI 8% to 31%). Statistical heterogeneity

Teacher Burnout Factors as Predictors of Adherence to Behavioral Intervention

ERIC Educational Resources Information Center

Gaitan, Peggy E.

2009-01-01

It is hypothesized that factors related to teacher burnout influence treatment adherence. This study examines the relation of teacher burnout to the frequency and quality of behavioral intervention implementation. A sample of 45 general and special education teachers were trained to implement the Good Behavior Game, an intervention designed to…

Selective Prevention Approaches to Build Protective Factors in Early Intervention

ERIC Educational Resources Information Center

Shapiro, Cheri J.

2014-01-01

Young children with disabilities may be at elevated risk for behavior problems as well as maltreatment. preventive approaches that can be infused into early intervention services are needed to support parents, build competencies among young children, and enhance protective factors that may temper risk. Two interventions--Stepping Stones Triple P,…

Cardiometabolic Risk Factor Response to a Lifestyle Intervention: A Randomized Trial

PubMed Central

Harrington, Deirdre M.; Champagne, Catherine M.; Broyles, Stephanie T.; Johnson, William D.; Tudor-Locke, Catrine

2015-01-01

Abstract Background: Strategies to increase adherence to national dietary and physical activity (PA) guidelines to improve the health in regions such as the Lower Mississippi Delta (LMD) of the United States are needed. Here we explore the cardiometabolic responses to an education and behavior change intervention among overweight and obese adults that adapted the 2010 Dietary Guidelines (DG), with and without a PA component. Methods: White and African American overweight and obese adults were randomized to a DG group (n=61) or a DG+PA group (n=60). Both groups received a 12-week dietary education and behavior change intervention, and the DG+PA group also received a PA education and behavior change intervention with a pedometer. Changes in individual risk factors (blood pressure, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) and a continuous cardiometabolic risk score were determined. General linear models compared mean changes between groups, adjusting for covariates. Results: No main effect of intervention group was found in completers (n=99) and those who engaged with ≥80% of the intervention (n=83) for individual risk factors or the continuous risk score. Pooling both groups, those with higher baseline risk factor values realized greater improvements in individual risk factors. Conclusions: Adapting DG did not produce any cardiometabolic benefits, even with a PA component. Although the sample was ostensibly healthy, they were all overweight to mildly obese (body mass index of 25–34.9 kg/m2) and participants with higher baseline risk factor values showed more improvements. Adherence to longer-term behavior change may elicit changes in risk profile, so this should be explored. PMID:25569324

A reanalysis of a behavioral intervention to prevent incident HIV infections: Including indirect effects in modeling outcomes of Project EXPLORE

PubMed Central

Eaton, Lisa A.; Kalichman, Seth C.; Kenny, David A.; Harel, Ofer

2013-01-01

Background Project EXPLORE -- a large-scale, behavioral intervention tested among men who have sex with men (MSM) at-risk for HIV infection --was generally deemed as ineffective in reducing HIV incidence. Using novel and more precise data analytic techniques we reanalyzed Project EXPLORE by including both direct and indirect paths of intervention effects. Methods Data from 4,296 HIV negative MSM who participated in Project EXPLORE, which included ten sessions of behavioral risk reduction counseling completed from 1999-2005, were included in the analysis. We reanalyzed the data to include parameters that estimate the overtime effects of the intervention on unprotected anal sex and the over-time effects of the intervention on HIV status mediated by unprotected anal sex simultaneously in a single model. Results We found the indirect effect of intervention on HIV infection through unprotected anal sex to be statistically significant up through 12 months post-intervention, OR=.83, 95% CI=.72-.95. Furthermore, the intervention significantly reduced unprotected anal sex up through 18 months post-intervention, OR=.79, 95% CI=.63-.99. Discussion Our results reveal effects not tested in the original model that offer new insight into the effectiveness of a behavioral intervention for reducing HIV incidence. Project EXPLORE demonstrated that when tested against an evidence-based, effective control condition can result in reductions in rates of HIV acquisition at one year follow-up. Findings highlight the critical role of addressing behavioral risk reduction counseling in HIV prevention. PMID:23245226

Understanding Proximal-Distal Economic Projections of the Benefits of Childhood Preventive Interventions

PubMed Central

Slade, Eric P.; Becker, Kimberly D.

2014-01-01

This paper discusses the steps and decisions involved in proximal-distal economic modeling, in which social, behavioral, and academic outcomes data for children may be used to inform projections of the economic consequences of interventions. Economic projections based on proximal-distal modeling techniques may be used in cost-benefit analyses when information is unavailable for certain long term outcomes data in adulthood or to build entire cost-benefit analyses. Although examples of proximal-distal economic analyses of preventive interventions exist in policy reports prepared for governmental agencies, such analyses have rarely been completed in conjunction with research trials. The modeling decisions on which these prediction models are based are often opaque to policymakers and other end-users. This paper aims to illuminate some of the key steps and considerations involved in constructing proximal-distal prediction models and to provide examples and suggestions that may help guide future proximal-distal analyses. PMID:24337979

Cost and threshold analysis of an HIV/STI/hepatitis prevention intervention for young men leaving prison: Project START.

PubMed

Johnson, A P; Macgowan, R J; Eldridge, G D; Morrow, K M; Sosman, J; Zack, B; Margolis, A

2013-10-01

The objectives of this study were to: (a) estimate the costs of providing a single-session HIV prevention intervention and a multi-session intervention, and (b) estimate the number of HIV transmissions that would need to be prevented for the intervention to be cost-saving or cost-effective (threshold analysis). Project START was evaluated with 522 young men aged 18-29 years released from eight prisons located in California, Mississippi, Rhode Island, and Wisconsin. Cost data were collected prospectively. Costs per participant were $689 for the single-session comparison intervention, and ranged from $1,823 to 1,836 for the Project START multi-session intervention. From the incremental threshold analysis, the multi-session intervention would be cost-effective if it prevented one HIV transmission for every 753 participants compared to the single-session intervention. Costs are comparable with other HIV prevention programs. Program managers can use these data to gauge costs of initiating these HIV prevention programs in correctional facilities.

Factors influencing the introduction of physical activity interventions in primary health care: a qualitative study.

PubMed

Huijg, Johanna M; van der Zouwe, Nicolette; Crone, Mathilde R; Verheijden, Marieke W; Middelkoop, Barend J C; Gebhardt, Winifred A

2015-06-01

The introduction of efficacious physical activity (PA) interventions in routine primary health care (PHC) is a complex process. Understanding factors influencing the process can enhance the development of successful introduction strategies. The aim of this qualitative study was to explore stakeholders' perceptions on factors influencing the introduction, i.e., adoption, implementation, and continuation, of PA interventions in PHC. Twenty-eight semistructured interviews were held with intervention managers, PHC advisors, intervention providers, and referring general practitioners of five PA interventions delivered in PHC. A theoretical framework on the introduction of innovations in health care was used to guide the data collection. Influencing factors were identified using thematic analysis. Stakeholders reported preconditions for the introduction of PA interventions in PHC (e.g., support, resources, and networks and collaborations), in addition to characteristics of PA interventions (e.g., compatibility, flexibility, and intervention materials) and characteristics of PHC professionals (e.g., knowledge, positive attitudes, and beliefs about capabilities) perceived to enhance the introduction process. Furthermore, they proposed strategies for the development of PA interventions (e.g., involvement of future stakeholders, full development, and refinement) and strategies to introduce PA interventions in PHC (e.g., training, assistance, and reinforcement). The majority of the influencing factors were discussed specifically in relation to one or two stages. This study presents an overview of factors that are perceived to influence the introduction of PA interventions in PHC. It underscores the importance of taking these factors into account when designing introduction strategies and of giving special attention to the distinct stages of the process.

[The effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children].

PubMed

Tak, Young-Ran; An, Ji-Yeon; Kim, Young-A; Woo, Hae-Young

2007-10-01

The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. Thirty-two participants (BMI>or=85 percentile or relative obesity>or=10) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM-intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gym-based exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits(diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.

Children and motorcycles: a systematic review of risk factors and interventions.

PubMed

Brown, Julie; Schonstein, Lisa; Ivers, Rebecca; Keay, Lisa

2018-04-01

To (i) identify person, vehicle and environmental risk factors for injury among children using motorcycles, and (ii) identify and appraise studies of interventions designed to reduce the occurrence or severity of injury among children using these vehicles. A systematic approach was used to collate data from published and grey literature globally on risk factors for motorcycles injury, and studies reporting evaluation of interventions to counter this injury. Academic data sets and public search engines (including Google and Yahoo!) were used. Websites of major conferences, organisations and networks were also searched. Finally, researchers and units working in this area were also contacted by email or phone seeking relevant research. All study types were eligible, excluding clinical case studies. The Haddon Matrix was used as a framework for synthesising the data. The review revealed that robust investigations of risk factors for injury among children using motorcycles are relatively scarce, and there are few interventional studies reporting effectiveness of countermeasures to this problem. Epidemiological literature is generally limited to discussion of human factors, and less attention has been given to vehicle and environmental factors. Furthermore, much of the literature is commentaries and descriptive studies. There has been little rigorous study of risk factors unique to children riding motorcycles. This first attempt at extensively reviewing literature related to risk factors and interventions for children and motorcycles using the Haddon Matrix as a framework clearly highlights need for more rigorous study as information is lacking in all cells of this matrix. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Skills-Based Residency Training in Alcohol Screening and Brief Intervention: Results from the Georgia-Texas "Improving Brief Intervention" Project

ERIC Educational Resources Information Center

Seale, J. Paul; Velasquez, Mary M.; Johnson, J. Aaron; Shellenberger, Sylvia; von Sternberg, Kirk; Dodrill, Carrie; Boltri, John M.; Takei, Roy; Clark, Denice; Grace, Daniel

2012-01-01

Alcohol screening and brief intervention (SBI) is recommended for all primary care patients but is underutilized. This project trained 111 residents and faculty in 8 family medicine residencies to conduct SBI and implement SBI protocols in residency clinics, then assessed changes in self-reported importance and confidence in performing SBI and…

Outcomes from a randomized controlled trial of a multi-component alcohol use preventive intervention for urban youth: project northland Chicago.

PubMed

Komro, Kelli A; Perry, Cheryl L; Veblen-Mortenson, Sara; Farbakhsh, Kian; Toomey, Traci L; Stigler, Melissa H; Jones-Webb, Rhonda; Kugler, Kari C; Pasch, Keryn E; Williams, Carolyn L

2008-04-01

The goal of this group-randomized trial was to test the effectiveness of an adapted alcohol use preventive intervention for urban, low-income and multi-ethnic settings. Sixty-one public schools in Chicago were recruited to participate, were grouped into neighborhood study units and assigned randomly to intervention or 'delayed program' control condition. The study sample (n = 5812 students) was primarily African American, Hispanic and low-income. Students, beginning in sixth grade (age 12 years), received 3 years of intervention strategies (curricula, family interventions, youth-led community service projects, community organizing). Students participated in yearly classroom-based surveys to measure their alcohol use and related risk and protective factors. Additional evaluation components included a parent survey, a community leader survey and alcohol purchase attempts. Overall, the intervention, compared with a control condition receiving 'prevention as usual', was not effective in reducing alcohol use, drug use or any hypothesized mediating variables (i.e. related risk and protective factors). There was a non-significant trend (P = 0.066) that suggested the ability to purchase alcohol by young-appearing buyers was reduced in the intervention communities compared to the control communities, but this could be due to chance. Secondary outcome analyses to assess the effects of each intervention component indicated that the home-based programs were associated with reduced alcohol, marijuana and tobacco use combined (P = 0.01), with alcohol use alone approaching statistical significance (P = 0.06). Study results indicate the importance of conducting evaluations of previously validated programs in contexts that differ from the original study sample. Also, the findings highlight the need for further research with urban, low-income adolescents from different ethnic backgrounds to identify effective methods to prevent and reduce alcohol use.

Lifestyle intervention reduces body weight and improves cardiometabolic risk factors in worksites.

PubMed

Salinardi, Taylor C; Batra, Payal; Roberts, Susan B; Urban, Lorien E; Robinson, Lisa M; Pittas, Anastassios G; Lichtenstein, Alice H; Deckersbach, Thilo; Saltzman, Edward; Das, Sai Krupa

2013-04-01

Worksites are potentially effective locations for obesity control because they provide opportunities for group intervention and social support. Studies are needed to identify effective interventions in these settings. We examined the effects of a multicomponent lifestyle intervention on weight loss and prevention of regain in 4 worksites (2 intervention and 2 control sites). Overweight and obese employees (n = 133) enrolled in this pilot worksite-randomized controlled trial with a 0-6-mo weight-loss phase and a 6-12-mo structured weight-maintenance phase. The intervention combined recommendations to consume a reduced-energy, low-glycemic load, high-fiber diet with behavioral change education. Outcome measurements included changes in body weight and cardiometabolic risk factors. The mean ± SEM weight loss was substantial in intervention participants, whereas control subjects gained weight (-8.0 ± 0.7 compared with +0.9 ± 0.5 kg, respectively; P < 0.001), and 89% of participants completed the weight-loss phase. Intervention effects were not significant at the 0.05 level but would have been at the 0.10 level (P = 0.08) in a mixed model in which the worksite nested within group was a random factor. There were also significant improvements in cardiometabolic risk factors in intervention compared with control subjects regarding fasting total cholesterol, glucose, systolic blood pressure, and diastolic blood pressure (P ≤ 0.02 for each). No significant weight regain was observed in participants who enrolled in the structured weight-maintenance program (0.5 ± 0.7 kg; P = 0.65), and overweight and obese employees in intervention worksites who were not enrolled in the weight-loss program lost weight compared with subjects in control worksites (-1.3 ± 0.5 compared with +0.7 ± 0.2 kg, respectively; P = 0.02). Worksites can be effective for achieving clinically important reductions in body weight and improved cardiometabolic risk factors. This trial was registered at

A childhood obesity prevention programme in Barcelona (POIBA Project): Study protocol of the intervention

PubMed Central

Sánchez-Martínez, Francesca; Juárez, Olga; Serral, Gemma; Valmayor, Sara; Puigpinós, Rosa; Pasarín, María Isabel; Díez, Élia; Ariza, Carles

2018-01-01

Background Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-olds. Design and methods Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children’s eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. Expected impact for public health It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent. Significance for public health Overweight and obesity are a major public health concern that predispose affected individuals to the development of chronic diseases. Of importance, obesity is more common among

Designing and implementing a socioeconomic intervention to enhance TB control: operational evidence from the CRESIPT project in Peru.

PubMed

Wingfield, Tom; Boccia, Delia; Tovar, Marco A; Huff, Doug; Montoya, Rosario; Lewis, James J; Gilman, Robert H; Evans, Carlton A

2015-08-21

Cash transfers are key interventions in the World Health Organisation's post-2015 global TB policy. However, evidence guiding TB-specific cash transfer implementation is limited. We designed, implemented and refined a novel TB-specific socioeconomic intervention that included cash transfers, which aimed to support TB prevention and cure in resource-constrained shantytowns in Lima, Peru for: the Community Randomized Evaluation of a Socioeconomic Intervention to Prevent TB (CRESIPT) project. Newly-diagnosed TB patients from study-site healthposts were eligible to receive the intervention consisting of economic and social support. Economic support was provided to patient households through cash transfers on meeting the following conditions: screening for TB in household contacts and MDR TB in patients; adhering to TB treatment and chemoprophylaxis; and engaging with CRESIPT social support (household visits and community meetings). To evaluate project acceptability, quantitative and qualitative feedback was collected using a mixed-methods approach during formative activities. Formative activities included consultations, focus group discussions and questionnaires conducted with the project team, project participants, civil society and stakeholders. Over 7 months, 135 randomly-selected patients and their 647 household contacts were recruited from 32 impoverished shantytown communities. Of 1299 potential cash transfers, 964 (74 %) were achieved, 259 (19 %) were not achieved, and 76 (7 %) were yet to be achieved. Of those achieved, 885/964 (92 %) were achieved optimally and 79/964 (8 %) sub-optimally. Key project successes were identified during 135 formative activities and included: strong multi-sectorial collaboration; generation of new evidence for TB-specific cash transfer; and the project being perceived as patient-centred and empowering. Challenges included: participant confidence being eroded through cash transfer delays, hidden account-charges and stigma; access to

Developing community-based preventive interventions in Hong Kong: a description of the first phase of the family project.

PubMed

Stewart, Sunita M; Fabrizio, Cecilia S; Hirschmann, Malia R; Lam, Tai Hing

2012-02-07

This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West. The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships). Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships. Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff. This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal additional costs for delivery by community agencies, and high

Effectiveness of an Adaptation of the Project Connect Health Systems Intervention: Youth and Clinic-Level Findings

ERIC Educational Resources Information Center

Loosier, Penny S.; Doll, Shelli; Lepar, Danielle; Ward, Kristin; Gamble, Ginger; Dittus, Patricia J.

2016-01-01

Background: The Project Connect Health Systems Intervention (Project Connect) uses a systematic process of collecting community and healthcare infrastructure information to craft a referral guide highlighting local healthcare providers who provide high quality sexual and reproductive healthcare. Previous self-report data on healthcare usage…

Aboriginal Suicidal Behaviour Research: From Risk Factors to Culturally-Sensitive Interventions

PubMed Central

Katz, Laurence Y.; Elias, Brenda; O’Neil, John; Enns, Murray; Cox, Brian J.; Belik, Shay-Lee; Sareen, Jitender

2006-01-01

Introduction There is a significant amount of research demonstrating that the rate of completed suicide among Aboriginal populations is much higher than in the general population. Unfortunately, there is a paucity of research evaluating the risk factors for completed suicide and suicidal behavior in this population. There is an even greater shortage of research on evidence-based interventions for suicidal behaviour. Method A literature review was conducted to facilitate the development of an approach to the study of this complex problem. Results An approach to developing a research program that informs each step of the process with evidence from the previous steps was developed. The study of risk factors and interventions is described. Conclusions Research into the risk factors and evidence-based interventions for Aboriginal suicidal behavior are required. A programmatic approach is described in detail in this paper. It is hoped this informed approach would systematically address this important public health issue that afflicts a significant proportion of the Canadian population. PMID:18392204

A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions.

PubMed

Owczarzak, Jill; Phillips, Sarah D; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna

2016-06-01

The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally generated solutions. In this study, we used the concept of "common factors," or broad constructs shared by most evidence-based HIV prevention interventions, to train service providers to develop their own programs. We recruited eight Ukrainian HIV prevention organizations from regions with HIV epidemics concentrated among people who inject drugs. We trained staff to identify HIV risk behaviors and determinants, construct behavior change logic models, and develop and manualize an intervention. We systematically reviewed each manual to assess intervention format and content and determine whether the program met intervention criteria as taught during training. All agencies developed programs that reflected common factors of effective behavior change HIV prevention interventions. Each agency's program targeted a unique population that reflected local HIV epidemiology. All programs incorporated diverse pedagogical strategies that focused on skill-building, goal-setting, communication, and empowerment. Agencies struggled to limit information dissemination and the overall scope and length of their programs. We conclude that training service providers to develop their own programs based on common elements of effective behavior change interventions can potentially transform existing processes of program development, implementation, and capacity building. Expanding this model will require committed training and support resources. © 2015 Society for Public Health Education.

Sandy Lake Health and Diabetes Project: A Community-Based Intervention Targeting Type 2 Diabetes and Its Risk Factors in a First Nations Community

PubMed Central

Kakekagumick, Kara E.; Naqshbandi Hayward, Mariam; Harris, Stewart B.; Saksvig, Brit; Gittelsohn, Joel; Manokeesic, Gary; Goodman, Starsky; Hanley, Anthony J.

2013-01-01

The Sandy Lake Health and Diabetes Project (SLHDP) was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM) in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the 22 year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation, and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners. PMID:24302919

Categorization of potential project cost overrun factors in construction industry

NASA Astrophysics Data System (ADS)

Karunakaran, P.; Abdullah, A. H.; Nagapan, S.; Sohu, S.; Kasvar, K. K.

2018-04-01

Cost overrun has been severely hit down the economy and reputations for many construction industry around the world. Many project management tools developed to control the budget of a project. However, the cost management is still considered poor as there are many cost overrun issues occurred in the construction industry. Thus, this paper aims to identify and cluster the potential construction project cost overrun factors according to their originating groups using the thematic approach. Basically, through literature review, all the potential factors that may cause cost overrun were screened thoroughly before they were clustered into seven (7) groups of the originating factors, namely project, contract, client, contractor, consultant, labour and external. Each potential factor was explained clearly with some examples based on the Malaysian case studies to illustrate the cost overrun scenario. These findings may aid in the future to highlight on how to mitigate the critical potential factors of cost overrun to reduce or overcome its impact on all the stakeholders involved.

Neurotrophic factor intervention restores auditory function in deafened animals

NASA Astrophysics Data System (ADS)

Shinohara, Takayuki; Bredberg, Göran; Ulfendahl, Mats; Pyykkö, Ilmari; Petri Olivius, N.; Kaksonen, Risto; Lindström, Bo; Altschuler, Richard; Miller, Josef M.

2002-02-01

A primary cause of deafness is damage of receptor cells in the inner ear. Clinically, it has been demonstrated that effective functionality can be provided by electrical stimulation of the auditory nerve, thus bypassing damaged receptor cells. However, subsequent to sensory cell loss there is a secondary degeneration of the afferent nerve fibers, resulting in reduced effectiveness of such cochlear prostheses. The effects of neurotrophic factors were tested in a guinea pig cochlear prosthesis model. After chemical deafening to mimic the clinical situation, the neurotrophic factors brain-derived neurotrophic factor and an analogue of ciliary neurotrophic factor were infused directly into the cochlea of the inner ear for 26 days by using an osmotic pump system. An electrode introduced into the cochlea was used to elicit auditory responses just as in patients implanted with cochlear prostheses. Intervention with brain-derived neurotrophic factor and the ciliary neurotrophic factor analogue not only increased the survival of auditory spiral ganglion neurons, but significantly enhanced the functional responsiveness of the auditory system as measured by using electrically evoked auditory brainstem responses. This demonstration that neurotrophin intervention enhances threshold sensitivity within the auditory system will have great clinical importance for the treatment of deaf patients with cochlear prostheses. The findings have direct implications for the enhancement of responsiveness in deafferented peripheral nerves.

A Benefit-Cost Structure for PACE I.D.: An Early Identification and Intervention Project. Management Systems Programs.

ERIC Educational Resources Information Center

Keenan, J. M.; And Others

This report attempts to assess the economic benefits and costs of the PACE (Projects to Advance Creativity in Education) Early Identification and Intervention Project. The report is structured to provide an indication of impacts generated by the Project, with some estimates of its direction and relative magnitude. The first section on impact…

Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

PubMed

Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

2016-08-01

Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

Factors associated with physical therapists' implementation of physical activity interventions in The Netherlands.

PubMed

Huijg, Johanna M; Dusseldorp, Elise; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; Middelkoop, Barend J C; Duijzer, Geerke; Crone, Mathilde R

2015-04-01

Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their implementation behaviors. The study objective was to investigate physical therapists' implementation fidelity regarding PA interventions, including completeness and quality of delivery, and influencing factors with a Theoretical Domains Framework-based questionnaire. The study was based on a cross-sectional design. A total of 268 physical therapists completed the Determinants of Implementation Behavior Questionnaire. Questions about completeness and quality of delivery were based on components and tasks of PA interventions as described by the Royal Dutch Society for Physical Therapy. Multilevel regression analyses were used to identify factors associated with completeness and quality of delivery. High implementation fidelity was found for the physical therapists, with higher scores for completeness of delivery than for quality of delivery. Physical therapists' knowledge, skills, beliefs about capabilities and consequences, positive emotions, behavioral regulation, and the automaticity of PA intervention delivery were the most important predictors of implementation fidelity. Together, the Theoretical Domains Framework accounted for 23% of the variance in both total completeness and total quality scores. The cross-sectional design precluded the determination of causal relationships. Also, the use of a self-report measure to assess implementation fidelity could have led to socially desirable responses, possibly resulting in more favorable ratings for completeness and quality. This study enhances the understanding of how physical therapists implement PA interventions and which factors influence their behaviors. Knowledge about these factors may assist in the development of strategies to

Creative reminiscence as an early intervention for depression: results of a pilot project.

PubMed

Bohlmeijer, E; Valenkamp, M; Westerhof, G; Smit, F; Cuijpers, P

2005-07-01

Reminiscence may help in resolving conflicts from the past and making up the balance of one's life. Life-review may be further enhanced by the creative expression of memories in stories, poems or drawings. In this way people are encouraged to create and discover metaphors, images and stories that symbolically represent the subjective and inner meaning of their lives. In this article, a new intervention, which combines reminiscence and creative expression aimed at early treatment of depression, is described. A pilot project showed that the intervention Searching for the meaning in life may generate small-sized effects in reducing depression. Additionally, it appears to generate effects of medium size in enhancing mastery. Several possible ways to improve the effectiveness of the intervention are described.

Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention.

PubMed

Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2012-10-01

This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.

Planning a multi-site, complex intervention for homeless people with mental illness: the relationships between the national team and local sites in Canada's At Home/Chez Soi project.

PubMed

Nelson, Geoffrey; Macnaughton, Eric; Goering, Paula; Dudley, Michael; O'Campo, Patricia; Patterson, Michelle; Piat, Myra; Prévost, Natasha; Strehlau, Verena; Vallée, Catherine

2013-06-01

This research focused on the relationships between a national team and five project sites across Canada in planning a complex, community intervention for homeless people with mental illness called At Home/Chez Soi, which is based on the Housing First model. The research addressed two questions: (a) what are the challenges in planning? and (b) what factors that helped or hindered moving project planning forward? Using qualitative methods, 149 national, provincial, and local stakeholders participated in key informant or focus group interviews. We found that planning entails not only intervention and research tasks, but also relational processes that occur within an ecology of time, local context, and values. More specifically, the relationships between the national team and the project sites can be conceptualized as a collaborative process in which national and local partners bring different agendas to the planning process and must therefore listen to, negotiate, discuss, and compromise with one another. A collaborative process that involves power-sharing and having project coordinators at each site helped to bridge the differences between these two stakeholder groups, to find common ground, and to accomplish planning tasks within a compressed time frame. While local context and culture pushed towards unique adaptations of Housing First, the principles of the Housing First model provided a foundation for a common approach across sites and interventions. The implications of the findings for future planning and research of multi-site, complex, community interventions are noted.

The Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) project: an operational assessment

PubMed Central

Rocha, C.; Montoya, R.; Zevallos, K.; Curatola, A.; Ynga, W.; Franco, J.; Fernandez, F.; Becerra, N.; Sabaduche, M.; Tovar, M. A.; Ramos, E.; Tapley, A.; Allen, N. R.; Onifade, D. A.; Acosta, C. D.; Maritz, M.; Concha, D. F.; Schumacher, S. G.; Evans, C. A.

2011-01-01

SETTING Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru. OBJECTIVE To evaluate socio-economic interventions for strengthening TB control by improving uptake of TB care and prevention services. DESIGN Barriers to TB control were characterised by interviews with TB-affected families. To reduce these barriers, a multidisciplinary team offered integrated community and household socio-economic interventions aiming to: 1) enhance uptake of TB care by education, community mobilisation and psychosocial support; and 2) reduce poverty through food and cash transfers, microcredit, microenterprise and vocational training. An interim analysis was performed after the socio-economic interventions had been provided for 2078 people in 311 households of newly diagnosed TB patients for up to 34 months. RESULTS Poverty (46% earned project had 100% recruitment, and involved 97% of TB-affected households in regular visits, 71% in community groups, 78% in psychosocial support and 77% in poverty-reduction interventions. The socio-economic interventions were associated with increases in household contact TB screening (from 82% to 96%); successful TB treatment completion (from 91% to 97%); patient human immunodeficiency virus testing (from 31% to 97%); and completion of preventive therapy (from 27% to 87%; all P < 0.0001). CONCLUSIONS Socio-economic interventions can strengthen TB control activities. PMID:21740659

The Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) project: an operational assessment.

PubMed

Rocha, C; Montoya, R; Zevallos, K; Curatola, A; Ynga, W; Franco, J; Fernandez, F; Becerra, N; Sabaduche, M; Tovar, M A; Ramos, E; Tapley, A; Allen, N R; Onifade, D A; Acosta, C D; Maritz, M; Concha, D F; Schumacher, S G; Evans, C A

2011-06-01

Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru. To evaluate socio-economic interventions for strengthening TB control by improving uptake of TB care and prevention services. Barriers to TB control were characterised by interviews with TB-affected families. To reduce these barriers, a multidisciplinary team offered integrated community and household socio-economic interventions aiming to: 1) enhance uptake of TB care by education, community mobilisation and psychosocial support; and 2) reduce poverty through food and cash transfers, microcredit, microenterprise and vocational training. An interim analysis was performed after the socio-economic interventions had been provided for 2078 people in 311 households of newly diagnosed TB patients for up to 34 months. Poverty (46% earned project had 100% recruitment, and involved 97% of TB-affected households in regular visits, 71% in community groups, 78% in psychosocial support and 77% in poverty-reduction interventions. The socio-economic interventions were associated with increases in household contact TB screening (from 82% to 96%); successful TB treatment completion (from 91% to 97%); patient human immunodeficiency virus testing (from 31% to 97%); and completion of preventive therapy (from 27% to 87%; all P < 0.0001). Socio-economic interventions can strengthen TB control activities. tuberculosis; control; microcredit; poverty;social determinants.

Assessing impact and sustainability of health, water, and sanitation interventions in Bolivia six years post-project.

PubMed

Eder, Clara; Schooley, Janine; Fullerton, Judith; Murguia, Jose

2012-07-01

To assess the impact and sustainability of health, water, and sanitation interventions in Bolivia six years post-project. A mixed-method (qualitative-quantitative) study was conducted in 14 rural intervention and control communities in Bolivia in November 2008, six years after the completion of interventions designed to improve knowledge and practices related to maternal and child health and nutrition, community water systems, and household water and sanitation facilities. The degree to which participants had sustained the community and household practices promoted by the interventions was a particular focus. Community site visits were made to evaluate the status (functional condition) and sustainability (state of maintenance and repair) of community and household water and sanitation infrastructure. Key informant interviews and focus group discussions were conducted to assess knowledge and practices, and perceptions about the value of the interventions to the community. Six years post-project, participants remained committed to sustaining the practices promoted in the interventions. The average rating for the functional condition of community water systems was 42% higher than the average rating in control communities. In addition, more than two-thirds of households continued to practice selected maternal and child health behaviors promoted by the interventions (compared to less than half of the households in the control communities). Communities that received integrated investments (development and health) seemed to sustain the practices promoted in the interventions better than communities that received assistance in only one of the two sectors. Infrastructure for community water systems and household water and sanitation facilities was better built and maintained, and selected maternal and child health behaviors practiced more frequently, in intervention communities versus control communities.

Project SuperHeart: An Evaluation of a Heart Disease Intervention Program For Children.

ERIC Educational Resources Information Center

Way, Joyce W.

1981-01-01

An effective way to prevent coronary heart disease in later life is to concentrate on preventive measures in the early years before coronary heart disease becomes established. Project SuperHeart, a heart disease intervention program for young children, includes physical fitness and classroom activities emphasizing basic nutritional habits. (JN)

Evaluation of the CSEC Community Intervention Project (CCIP) in Five U.S. Cities

ERIC Educational Resources Information Center

Ferguson, Kristin M.; Soydan, Haluk; Lee, Sei-Young; Yamanaka, Alisa; Freer, Adam S.; Xie, Bin

2009-01-01

In response to the commercial sexual exploitation of children (CSEC) within five U.S. cities, the CSEC Community Intervention Project (CCIP) was created to enhance collaboration among nongovernmental organization (NGO) representatives, law enforcement officials and prosecutors in Chicago, Atlantic City, Denver, Washington, D.C., and San Diego. A…

Developing culturally adapted lifestyle interventions for South Asian migrant populations: a qualitative study of the key success factors and main challenges.

PubMed

Terragni, L; Beune, E; Stronks, K; Davidson, E; Qureshi, S; Kumar, B; Diaz, E

2018-06-11

South Asian migrant populations have a high risk of non-communicable diseases, such as type 2 diabetes (T2D). The aim of this study is to provide in-depth insight into key success factors and challenges in developing culturally adapted lifestyle interventions to prevent T2D within South Asian migrant populations. The study has a qualitative research design. In-depth interviews, using a semi-structured interview guide, were conducted with eight researchers and project leaders from five studies of culturally adapted lifestyle interventions for South Asian migrant populations. Data were analysed using a grounded theory approach. Four main themes emerged as key factors for success: 'approaching the community in the right way', 'the intervention as a space for social relations', 'support from public authorities' and 'being reflexive and flexible'. Two themes emerged as challenges: 'struggling with time' and 'overemphasising cultural differences'. Our findings augment existing research by establishing the importance of cooperation at the organisational and institutional levels, of fostering the creation of social networks through interventions and of acknowledging the multiplicity of identities and resources among individuals of the same ethnic origin. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Juvenile myopia progression, risk factors and interventions.

PubMed

Myrowitz, Elliott H

2012-07-01

The development and progression of early onset myopia is actively being investigated. While myopia is often considered a benign condition it should be considered a public health problem for its visual, quality of life, and economic consequences. Nearly half of the visually impaired population in the world has uncorrected refractive errors, with myopia a high percent of that group. Uncorrected visual acuity should be screened for and treated in order to improve academic performance, career opportunities and socio-economic status. Genetic and environmental factors contribute to the onset and progression of myopia. Twin studies have supported genetic factors and research continues to identify myopia genetic loci. While multiple myopia genetic loci have been identified establishing myopia as a common complex disorder, there is not yet a genetic model explaining myopia progression in populations. Environmental factors include near work, education levels, urban compared to rural location, and time spent outdoors. In this field of study where there continues to be etiology controversies, there is recent agreement that children who spend more time outdoors are less likely to become myopic. Worldwide population studies, some completed and some in progress, with a common protocol are gathering both genetic and environmental cohort data of great value. There have been rapid population changes in prevalence rates supporting an environmental influence. Interventions to prevent juvenile myopia progression include pharmacologic agents, glasses and contact lenses. Pharmacological interventions over 1-2 year trials have shown benefits. Peripheral vision defocus has been found to affect the emmetropization process and may be affected by wearing glasses or contacts. Accommodation accuracy also has been implicated in myopia progression. Further research will aim to assess both the role and interaction of environmental influences and genetic factors.

Testing the Impact of The Worksite Heart Health Improvement Project on Cardiovascular Disease Risk factors Overtime.

PubMed

Doran, Kelly; Resnick, Barbara; Zhu, Shijun; Alghzawi, Hamzah

2018-02-13

We aimed to test the impact of the Worksite Heart Health Improvement Project (WHHIP) on cardiovascular risk factors among long-term care staff. The WHHIP was an 18-month cluster randomized control trial conducted in four long-term care facilities (n = 98). A significant positive delayed intervention effect for diastolic blood pressure was seen in intervention group (80.34 mm/Hg [SD = 6.10] at baseline to 73.08 mm/Hg [SD = 4.99] at 18-months; p = <.001). Whereas, a significant negative intervention effect was seen for steps with a mean increase from 5,807.18 (SD = 3,934.30) steps at baseline to 7,839.19 (SD = 3,126.09) steps at 18-months (p = .022) as well as body mass index with a mean change from 29.86 (SD = 7.38) at baseline to 26.67 (SD = 5.29) at 18-months (p = .045). (p = .045). The WHHIP demonstrated the ability to impact participants' blood pressure over time.

Lessons learnt from the Bristol Girls Dance Project cluster RCT: implications for designing and implementing after-school physical activity interventions

PubMed Central

Edwards, Mark J; May, Thomas; Kesten, Joanna M; Banfield, Kate; Bird, Emma L; Powell, Jane E; Sebire, Simon J; Jago, Russell

2016-01-01

Objective To consider implementation issues associated with the delivery of Bristol Girls Dance Project (BGDP) and to identify improvements that may aid the design of after-school physical activity (PA) interventions. Design Two-armed cluster randomised control trial. The BGDP was a 20-week school-based intervention, consisting of two 75 min after-school dance sessions per week, which aimed to support Year 7 girls to be more physically active. Setting 18 secondary schools (nine intervention, nine control) in the Greater Bristol area (as an indication of deprivation, children eligible for the pupil premium in participant schools ranged from 6.9 to 53.3%). Participants 571 Year 7 girls. This article reports on qualitative data collected from 59 girls in the intervention arm of the trial, 10 dance instructors and 9 school contacts involved in the delivering of the BGDP. Methods Data were obtained from nine focus groups with girls (one per intervention school), and interviews with dance instructors and school contacts. Focus groups sought views of girls’ motivation to participate, teaching styles and experiences of the intervention. Interviews explored views on implementation and dissemination. Framework analysis was used to analyse data. Results Qualitative data elicited three themes associated with the delivery of BGDP that affected implementation: project design, session content and project organisation. ‘Project design’ found issues associated with recruitment, timetabling and session quantity to influence the effectiveness of BGDP. ‘Session content’ found that dance instructors delivered a range of content and that girls enjoyed a variety of dance. Themes within ‘project organisation’ suggested an ‘open enrolment’ policy and greater parental involvement may facilitate better attendance. Conclusions After-school PA interventions have potential for increasing PA levels among adolescent girls. There is a need to consider the context in which

Strategies used by community-based organizations to evaluate their locally developed HIV prevention interventions: Lessons learned from the CDC's innovative interventions project.

PubMed

Painter, Thomas M; Ngalame, Paulyne M; Lucas, Basil; Lauby, Jennifer L; Herbst, Jeffrey H

2010-10-01

Community-based organizations (CBOs) play an important role in health promotion efforts and the delivery of HIV prevention interventions for at-risk minority populations. CBOs may also develop their own interventions but often lack the capacity or funds to rigorously evaluate them. The Innovative Interventions project of the Centers for Disease Control and Prevention (CDC) funded three CBOs to rigorously evaluate the efficacy of interventions they had developed and were delivering to Black women, Black men who have sex with men (MSM), and adolescent males in juvenile justice settings, respectively. The evaluation results have been reported elsewhere. This article describes operational issues that the CBOs identified as being particularly salient to their evaluations and the strategies they developed to address the issues and successfully complete their evaluations. These issues included the development of organizational capacity to conduct a rigorous outcome evaluation, difficulties with recruitment and retention of evaluation participants, and the use of process monitoring data to improve intervention delivery. The strategies described in this article can be used by CBOs when evaluating their locally developed HIV prevention interventions and may be of interest to funding agencies and researchers that collaborate with CBOs to evaluate their interventions.

Key Factors in Smoking Cessation Intervention among 15-16-Year-Olds

ERIC Educational Resources Information Center

Heikkinen, Anna Maria; Broms, Ulla; Pitkaniemi, Janne; Koskenvuo, Markku; Meurman, Jukka

2009-01-01

The authors aimed to investigate factors associated with smoking cessation among adolescents after tobacco intervention. They examined smokers (n = 127) from one birth cohort (n = 545) in the city of Kotka in Finland. These smokers were randomized in 3 intervention groups the dentist (n = 44) and the school nurse (n = 42 groups), and a control…

Using Sociotransformative Constructivism to Create Multicultural and Gender-Inclusive Classrooms: An Intervention Project for Teacher Professional Development

ERIC Educational Resources Information Center

Zozakiewicz, Cathy; Rodriguez, Alberto J.

2007-01-01

Maxima was an intervention project that focused on assisting teachers to establish more inquiry-based, gender-inclusive, and culturally relevant learning environments. The authors grounded the project by using sociotransformative constructivism as a theoretical framework to steer the implementation of three guiding concepts for professional…

Engaging stakeholder communities as body image intervention partners: The Body Project as a case example.

PubMed

Becker, Carolyn Black; Perez, Marisol; Kilpela, Lisa Smith; Diedrichs, Phillippa C; Trujillo, Eva; Stice, Eric

2017-04-01

Despite recent advances in developing evidence-based psychological interventions, substantial changes are needed in the current system of intervention delivery to impact mental health on a global scale (Kazdin & Blase, 2011). Prevention offers one avenue for reaching large populations because prevention interventions often are amenable to scaling-up strategies, such as task-shifting to lay providers, which further facilitate community stakeholder partnerships. This paper discusses the dissemination and implementation of the Body Project, an evidence-based body image prevention program, across 6 diverse stakeholder partnerships that span academic, non-profit and business sectors at national and international levels. The paper details key elements of the Body Project that facilitated partnership development, dissemination and implementation, including use of community-based participatory research methods and a blended train-the-trainer and task-shifting approach. We observed consistent themes across partnerships, including: sharing decision making with community partners, engaging of community leaders as gatekeepers, emphasizing strengths of community partners, working within the community's structure, optimizing non-traditional and/or private financial resources, placing value on cost-effectiveness and sustainability, marketing the program, and supporting flexibility and creativity in developing strategies for evolution within the community and in research. Ideally, lessons learned with the Body Project can be generalized to implementation of other body image and eating disorder prevention programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

A school-based physical activity promotion intervention in children: rationale and study protocol for the PREVIENE Project.

PubMed

Tercedor, Pablo; Villa-González, Emilio; Ávila-García, Manuel; Díaz-Piedra, Carolina; Martínez-Baena, Alejandro; Soriano-Maldonado, Alberto; Pérez-López, Isaac José; García-Rodríguez, Inmaculada; Mandic, Sandra; Palomares-Cuadros, Juan; Segura-Jiménez, Víctor; Huertas-Delgado, Francisco Javier

2017-09-26

The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions) to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. A total of 300 children (grade 3; 8-9 years of age) from six schools in Granada (Spain) will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school) or a control group (no intervention school; 50 children). Outcomes will include physical activity (measured by accelerometry), physical fitness (assessed using the ALPHA fitness battery), and anthropometry (height, weight and waist circumference). Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires), academic achievement (grades from the official school's records), and health-related quality of life (child and parental questionnaires). To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.

A Synthesis and Survey of Critical Success Factors for Computer Technology Projects

ERIC Educational Resources Information Center

Baker, Ross A.

2012-01-01

The author investigated the existence of critical success factors for computer technology projects. Current research literature and a survey of experienced project managers indicate that there are 23 critical success factors (CSFs) that correlate with project success. The survey gathered an assessment of project success and the degree to which…

A community based intervention program to enhance neighborhood cohesion: The Learning Families Project in Hong Kong.

PubMed

Shen, Chen; Wan, Alice; Kwok, Lit Tung; Pang, Sally; Wang, Xin; Stewart, Sunita M; Lam, Tai Hing; Chan, Sophia S

2017-01-01

Neighborhood cohesion, which refers to the extent of the connectedness and solidarity among residents in a community or neighborhood, is an important determinant of human health. To enhance neighborhood cohesion, the "Learning Families Project" was developed with a series of intervention programs in Kwun Tong in Hong Kong, a district with low neighborhood cohesion. This project, based on the social ecological model, provided a platform for neighbors to learn, communicate and interact with each other. This quasi-experimental study included two nearby government subsidized low rent housing estates separated by busy main roads. One served as the intervention (Tsui Ping (South) Estate) and one as the control (Shun Tin Estate) estate. The intervention included promotion, resident training and learning programs, embodied by a series of community activities such as talks, day camp, thematic activities and horticulture class. Baseline (before the programs) and follow-up (one year after the programs) surveys were conducted both in the intervention and control estate to assess the impact of the programs on neighborhood cohesion. The number of residents who completed both the baseline and follow-up surveys was 502 in the intervention estate and 476 in the control estate. Neighborhood cohesion significantly improved in the intervention group after the programs (Cohen effect size d: 0.15). Compared with the control group, the improvements in closeness of the neighborhood and trust in neighbors were significantly greater in the intervention group (Cohen effect size d: 0.13 and 0.14, respectively). This brief intervention program using a quasi-experimental study design increased neighborhood cohesion in a low rent housing estate. ClinicalTrials.gov NCT02851667.

Successful Up-Scaled Population Interventions to Reduce Risk Factors for Non-Communicable Disease in Adults: Results from the International Community Interventions for Health (CIH) Project in China, India and Mexico

PubMed Central

Dyson, Pamela A.; Anthony, Denis; Fenton, Brenda; Stevens, Denise E.; Champagne, Beatriz; Li, Li-Ming; Lv, Jun; Ramírez Hernández, Jorge; Thankappan, K. R.; Matthews, David R.

2015-01-01

Background Non-communicable disease (NCD) is increasing rapidly in low and middle-income countries (LMIC), and is associated with tobacco use, unhealthy diet and physical inactivity. There is little evidence for up-scaled interventions at the population level to reduce risk in LMIC. Methods The Community Interventions for Health (CIH) program was a population-scale community intervention study with comparator population group undertaken in communities in China, India, and Mexico, each with populations between 150,000-250,000. Culturally appropriate interventions were delivered over 18-24 months. Two independent cross-sectional surveys of a stratified sample of adults aged 18-64 years were conducted at baseline and follow-up. Results A total of 6,194 adults completed surveys at baseline, and 6,022 at follow-up. The proportion meeting physical activity recommendations decreased significantly in the control group (C) (44.1 to 30.2%), but not in the intervention group (I) (38.0 to 36.1%), p<0.001. Those eating ≥5 portions of fruit and vegetables daily decreased significantly in C (19.2 to 17.2%), but did not change in I (20.0 to 19.6%,), p=0.013. The proportion adding salt to food was unchanged in C (24.9 to 25.3%) and decreased in I (25.9 to 19.6%), p<0.001. Prevalence of obesity increased in C (8.3 to 11.2%), with no change in I (8.6 to 9.7%,) p=0.092. Concerning tobacco, for men the difference-in-difference analysis showed that the reduction in use was significantly greater in I compared to C (p=0.014) Conclusions Up-scaling known health promoting interventions designed to reduce the incidence of NCD in whole communities in LMIC is feasible, and has measurable beneficial outcomes on risk factors for NCD, namely tobacco use, diet, and physical inactivity. PMID:25875825

Racial-Ethnic Protective Factors and Mechanisms in Psychosocial Prevention and Intervention Programs for Black Youth.

PubMed

Jones, Shawn C T; Neblett, Enrique W

2016-06-01

Extending previous reviews related to cultural responsiveness in the treatment of ethnic minority youth, the current review provides a critical assessment and synthesis of both basic and applied research on the integration of three racial-ethnic protective factors (racial identity, racial socialization, Africentric worldview) in psychosocial prevention and intervention programs for Black children and adolescents. Seventeen programs meeting inclusion and exclusion criteria were evaluated for the extent to which racial-ethnic protective factors and related mechanisms were integrated, applied, and tested in such programs. A systematic assessment of these programs revealed that several prevention and intervention programs drew upon the three factors, particularly Africentric worldview. In addition, a number of studies hypothesized and assessed mechanisms, both those previously identified in conceptual literature and those that emerged from the interventions themselves. A set of recommendations encouraging the implementation of these factors into future prevention and intervention programs, examples of how clinicians can infuse these factors into psychotherapy, and areas for future research are discussed.

Exploring organisational competences in Human Factors and UX project work: managing careers, project tactics and organisational strategy.

PubMed

Furniss, Dominic; Curzon, Paul; Blandford, Ann

2018-06-01

Organisational competence in Human Factors and UX (user experience) has not been looked at before despite its relevance to project success. We define organisational competence as the collective competence of the individuals, bringing together their complementary abilities to deliver an outcome that is typically more than the sum of its parts. Twenty-two UX and Human Factors practitioners were interviewed about their project work in two contrasting domains: web design and safety-critical systems to explore organisational competences. Through doing a FRAM analysis, 29 functions and 6 main areas of competences were identified: the central project process; the process of learning about the problem; maintaining and developing client relations; staff development; evolving practices; and the management of documentation for audit and quality control. These dynamic and situated competences form a web of interactions. Managing competences is essential for project success. Implications for managing careers, project tactics and organisational strategy are discussed. Practitioner Summary: Organisational competences impact how routine and non-routine project work is performed, but these have received little attention in the literature. Six key areas of competences in Human Factors and UX project work were identified from practitioner interviews. Managing combinations of adaptive competences is important for developing careers, project tactics and organisational strategies.

Factors associated with self-care agency in patients after percutaneous coronary intervention.

PubMed

Saeidzadeh, Seyedehtanaz; Darvishpoor Kakhki, Ali; Abed Saeedi, Jila

2016-11-01

The aim of this study is to assess the factors associated with self-care agency in postpercutaneous coronary intervention patients. Patients after percutaneous coronary intervention need to perform self-care to reduce the side effects and increase the quality of life. Self-care agency is considered to be an important factor in guaranteeing self-care actions. In this descriptive study a total number of 300 postpercutaneous coronary intervention patients participated. Data were collected from the four hospitals affiliated with Shahid Beheshti University of Medical Sciences in Iran between February-May 2015. The data were gathered using demographic and basic conditioning factors questionnaire and appraisal of self-care agency scale. Data analysis was performed by anova and t-test. The mean age of the participants was 62·10 ± (8·14), which included 52·7% men and 47·3% women. Most patients (72%) had good level of self-care agency. Self-care agency had higher level in married and higher income patients. Self-care agency is influenced by economic and marital situation. Identifying factors associated with self-care agency can help healthcare professionals to consider these factors in self-care planning. © 2016 John Wiley & Sons Ltd.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project.

PubMed

Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara; Fantke, Peter; Hald, Tine; Rüegg, Simon R

2017-01-01

Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors' system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers' mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

PubMed Central

Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara; Fantke, Peter; Hald, Tine; Rüegg, Simon R.

2017-01-01

Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required. PMID:28804707

A Multicomponent Behavioral Intervention to Reduce Stroke Risk Factor Behaviors: The Stroke Health and Risk Education Cluster-Randomized Controlled Trial.

PubMed

Brown, Devin L; Conley, Kathleen M; Sánchez, Brisa N; Resnicow, Kenneth; Cowdery, Joan E; Sais, Emma; Murphy, Jillian; Skolarus, Lesli E; Lisabeth, Lynda D; Morgenstern, Lewis B

2015-10-01

The Stroke Health and Risk Education Project was a cluster-randomized, faith-based, culturally sensitive, theory-based multicomponent behavioral intervention trial to reduce key stroke risk factor behaviors in Hispanics/Latinos and European Americans. Ten Catholic churches were randomized to intervention or control group. The intervention group received a 1-year multicomponent intervention (with poor adherence) that included self-help materials, tailored newsletters, and motivational interviewing counseling calls. Multilevel modeling, accounting for clustering within subject pairs and parishes, was used to test treatment differences in the average change since baseline (ascertained at 6 and 12 months) in dietary sodium, fruit and vegetable intake, and physical activity, measured using standardized questionnaires. A priori, the trial was considered successful if any one of the 3 outcomes was significant at the 0.05/3 level. Of 801 subjects who consented, 760 completed baseline data assessments, and of these, 86% completed at least one outcome assessment. The median age was 53 years; 84% subjects were Hispanic/Latino; and 64% subjects were women. The intervention group had a greater increase in fruit and vegetable intake than the control group (0.25 cups per day [95% confidence interval: 0.08, 0.42], P=0.002), a greater decrease in sodium intake (-123.17 mg/d [-194.76, -51.59], P=0.04), but no difference in change in moderate- or greater-intensity physical activity (-27 metabolic equivalent-minutes per week [-526, 471], P=0.56). This multicomponent behavioral intervention targeting stroke risk factors in predominantly Hispanics/Latinos was effective in increasing fruit and vegetable intake, reaching its primary end point. The intervention also seemed to lower sodium intake. Church-based health promotions can be successful in primary stroke prevention efforts. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01378780. © 2015 American Heart Association, Inc.

The IAEA’s activities on radiation protection in interventional cardiology

PubMed Central

Rehani, MM

2007-01-01

The International Atomic Energy Agency (IAEA) under its mandate of developing and applying standards of radiation safety has initiated a number of activities in recent years on radiation protection in interventional cardiology. These activities are implemented through four mechanisms, namely training, providing information through the website, research projects and assistance to Member States through Technical Cooperation (TC) projects. Major international initiatives have been taken in the area of training where more than half a dozen regional training courses have been conducted for cardiologists from over 50 countries. Additionally four national training events for over 300 medical and paramedical staff members involved in interventional procedures were held. The training material is freely available on CD from the IAEA. The newly established website provides information on radiation protection issues [1]. Two coordinated research projects have just been completed where peak skin doses to patients undergoing high dose interventional procedures were studied and factors to manage patient doses were identified. The technical cooperation projects involving protection in cardiac interventional procedures have 30 countries as participants. PMID:21614275

Project FIT: A School, Community and Social Marketing Intervention Improves Healthy Eating Among Low-Income Elementary School Children.

PubMed

Alaimo, Katherine; Carlson, Joseph J; Pfeiffer, Karin A; Eisenmann, Joey C; Paek, Hye-Jin; Betz, Heather H; Thompson, Tracy; Wen, Yalu; Norman, Gregory J

2015-08-01

Project FIT was a two-year multi-component nutrition and physical activity intervention delivered in ethnically-diverse low-income elementary schools in Grand Rapids, MI. This paper reports effects on children's nutrition outcomes and process evaluation of the school component. A quasi-experimental design was utilized. 3rd, 4th and 5th-grade students (Yr 1 baseline: N = 410; Yr 2 baseline: N = 405; age range: 7.5-12.6 years) were measured in the fall and spring over the two-year intervention. Ordinal logistic, mixed effect models and generalized estimating equations were fitted, and the robust standard errors were utilized. Primary outcomes favoring the intervention students were found regarding consumption of fruits, vegetables and whole grain bread during year 2. Process evaluation revealed that implementation of most intervention components increased during year 2. Project FIT resulted in small but beneficial effects on consumption of fruits, vegetables, and whole grain bread in ethnically diverse low-income elementary school children.

"KiDS and Diabetes in Schools" project: Experience with an international educational intervention among parents and school professionals.

PubMed

Bechara, Glaucia Margonari; Castelo Branco, Fernanda; Rodrigues, Avelino Luiz; Chinnici, Daniela; Chaney, David; Calliari, Luis Eduardo P; Franco, Denise Reis

2018-06-01

Although it is known that school care is a major challenge in diabetes treatment, there is still no published international initiative. The aims of this study were to introduce an international educational intervention tool, the International Diabetes Federation (IDF) KiDS and Diabetes in Schools project (KiDS project), and to describe its impact on diabetes knowledge and behavior of caregivers and school professionals. The KiDS project was developed with the support of IDF and the International Society for Pediatric and Adolescent Diabetes and provides online free material in 10 languages, directed to caregivers and school personnel. A pilot evaluation of the KiDS intervention was performed in Brazil. An educational intervention was conducted in 5 primary schools, with 42 parents and school staff, followed by 2 individual interviews after 1 and 3 months. The results were evaluated in a qualitative study with a descriptive design based on content analysis. School staff acquired new knowledge on diabetes and its treatment. They felt more confident when helping students with diabetes and said the educational intervention promoted a positive impact on the teacher-student relationship, on the caring for health, and on school infrastructure. Family members of children with diabetes stated that the educational intervention gave them an opportunity to strengthen and update information on treatment and improve their knowledge. The KiDS project is the first international tool directed to foster a safe and supportive environment and a better understanding of diabetes in schools. In this pilot evaluation, it achieved the goal of informing and changing the behavior of parents and school staff, thus improving the care provided to children with diabetes in schools. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?

PubMed

Shaw, William S; Linton, Steven J; Pransky, Glenn

2006-12-01

To assess, from the review literature, the extent to which effective strategies for reducing work absence after acute low back pain (LBP) match empirical risk factors. From 17 recent review articles (2000-2005), disability risk factors and interventions were cross-tabulated to assess levels of relative concordance. Potentially modifiable risk factors included 23 variables describing 3 workplace and 3 personal domains. Effective interventions included 25 strategies that were personal (physical or behavioral), engineering, or administrative in nature. There was a strong risk factor concordance for workplace technical and organizational interventions, graded activity exposure, and cognitive restructuring of pain beliefs. There was less risk factor concordance for exercise, back education, and RTW coordination. Few interventions focused on relieving emotional distress or improving job dissatisfaction, two well-supported risk factors. Gaps between the epidemiological and intervention research of back disability prevention could be reduced by testing mediators of intervention effects or by stratifying outcomes according to pre-intervention risk factors.

Immunization, urbanization and slums - a systematic review of factors and interventions.

PubMed

Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra

2017-06-08

In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context

The Impact of an Ergonomics Intervention on Psychosocial Factors and Musculoskeletal Symptoms among Thai Hospital Orderlies.

PubMed

Chanchai, Withaya; Songkham, Wanpen; Ketsomporn, Pranom; Sappakitchanchai, Punnarat; Siriwong, Wattasit; Robson, Mark Gregory

2016-05-03

(1) BACKGROUND: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2) OBJECTIVE: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3) MATERIAL AND METHODS: This study took a participatory ergonomic (PE) approach with a randomized controlled trial (RCT) conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for data collection before and after the intervention program; (4) RESULTS: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%). The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5) CONCLUSIONS: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment.

The Impact of an Ergonomics Intervention on Psychosocial Factors and Musculoskeletal Symptoms among Thai Hospital Orderlies

PubMed Central

Chanchai, Withaya; Songkham, Wanpen; Ketsomporn, Pranom; Sappakitchanchai, Punnarat; Siriwong, Wattasit; Robson, Mark Gregory

2016-01-01

(1) Background: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2) Objective: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3) Material and Methods: This study took a participatory ergonomic (PE) approach with a randomized controlled trial (RCT) conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for data collection before and after the intervention program; (4) Results: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%). The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5) Conclusions: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment. PMID:27153076

Developing and Evaluating Interventions Aimed at Increasing Retention of Special Education Teachers (Teacher Support & Retention Project). Final Report.

ERIC Educational Resources Information Center

Cooley, Elizabeth

This final report describes the activities and outcomes of a 3-year federally funded project that developed and evaluated interventions aimed at increasing retention of special education teachers. The interventions developed and evaluated consisted of: (1) a series of stress management workshops aimed at preventing or alleviating teacher burnout,…

Mental health interventions among older adults: A systematic review.

PubMed

Niclasen, Janni; Lund, Lisbeth; Obel, Carsten; Larsen, Lars

2018-05-01

The aim of the present study was to conduct a systematic review to identify documented mental health promotion interventions developed and tested among population-based older adults. A systematic review based on PRISMA guidelines. The literature was searched in PsycINFO and PubMed between June and September 2016. The Effective Public Health Practice Project tool was used to assess the quality of the included study. In total 53 randomized controlled trial studies qualified for the systematic review. Across studies, three types of common conceptual themes emerged for interventions, including: 1) individual characteristics; 2) content and structure of the interventions; and 3) implementation of the interventions. No specific interventions could be recommended on the aforementioned basis. We conclude that a number of factors are of central importance for an intervention to have the desired effect. If these factors are considered, mental health can be successfully promoted among older adults.

Space Human Factors Engineering Gap Analysis Project Final Report

NASA Technical Reports Server (NTRS)

Hudy, Cynthia; Woolford, Barbara

2006-01-01

Humans perform critical functions throughout each phase of every space mission, beginning with the mission concept and continuing to post-mission analysis (Life Sciences Division, 1996). Space missions present humans with many challenges - the microgravity environment, relative isolation, and inherent dangers of the mission all present unique issues. As mission duration and distance from Earth increases, in-flight crew autonomy will increase along with increased complexity. As efforts for exploring the moon and Mars advance, there is a need for space human factors research and technology development to play a significant role in both on-orbit human-system interaction, as well as the development of mission requirements and needs before and after the mission. As part of the Space Human Factors Engineering (SHFE) Project within the Human Research Program (HRP), a six-month Gap Analysis Project (GAP) was funded to identify any human factors research gaps or knowledge needs. The overall aim of the project was to review the current state of human factors topic areas and requirements to determine what data, processes, or tools are needed to aid in the planning and development of future exploration missions, and also to prioritize proposals for future research and technology development.

Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review.

PubMed

Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

2017-10-22

The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Thematic analysis review of CM studies. We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004-December 2015 period, then updated to July 2017, with the keywords 'CM' and 'frequent use'. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir's implementation of health innovations framework was used to organise results into four broad levels of factors: (1) ,environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted

Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review

PubMed Central

Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

2017-01-01

Objective The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Design Thematic analysis review of CM studies. Methods We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004–December 2015 period, then updated to July 2017, with the keywords ‘CM’ and ‘frequent use’. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir’s implementation of health innovations framework was used to organise results into four broad levels of factors: (1) environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Results Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. Conclusions CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. PMID:29061623

Project-Method Fit: Exploring Factors That Influence Agile Method Use

ERIC Educational Resources Information Center

Young, Diana K.

2013-01-01

While the productivity and quality implications of agile software development methods (SDMs) have been demonstrated, research concerning the project contexts where their use is most appropriate has yielded less definitive results. Most experts agree that agile SDMs are not suited for all project contexts. Several project and team factors have been…

Mental health service users' experiences of an education intervention based on a European Union project: A comparison between nine European countries.

PubMed

Nieminen, Irja; Kaunonen, Marja

2018-06-19

Mental health service users (MHSUs) often face difficulties in achieving successful participation in education; however, the tools that could help them succeed are rarely investigated. This study aimed to illuminate the experiences of MHSUs in an education intervention based on a European Union (EU) project. Their experiences are compared across nine EU countries. The data were collected through individual interviews with MHSUs (n = 47) at day activity centres that provide mental health services. An inductive content analysis was used as the method of analysis. Three main categories, which include seven subcategories, are revealed by the analysis. The main categories are as follows: (i) the factors related to MHSUs' educational preparedness, (ii) the dimensions of the learning environment, and (iii) the effects of training intervention. The MHSUs' experiences with the education intervention were similar across all countries. The findings showed that this education intervention is a multidimensional process. It contains social, mental, and physical dimensions linked to a learner and learning environment. These dimensions influence the MHSUs' ability to participate in the education process. At its best, the education intervention supports the personal growth of MHSUs and prepares them for social integration. An education intervention can be a usable tool in the rehabilitation of MHSUs if the multidimensional nature of education is taken into consideration. Therefore, designing and executing education interventions requires the attendance of the MHSUs in cooperation with mental health and education professionals. Our findings suggest a tentative framework that can be used in designing and executing education for MHSUs. © 2018 Australian College of Mental Health Nurses Inc.

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

PubMed

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

2013-01-01

To evaluate the motivational effect of the Project WebHealth study procedures and intervention components on weight-related health behavior changes in male and female college students. Process evaluation. Eight universities in the United States. Project WebHealth participants (n = 653; 29% men). Participants rated motivational effects of study procedures and intervention components. Participants were grouped into outcome-based health behavior categories based on achievement of desired targets for fruit and vegetable intake, physical activity, and/or body weight. Differences in motivation from each procedure and component were analyzed by gender- and outcome-based health behavior category. Women were generally more motivated than men. Compared to those who did not meet any target health behaviors, men with improved health outcomes (68%) were significantly more motivated by the skills to fuel the body lesson, goal setting, and research snippets. Their female counterparts (63%) were significantly more motivated by the lessons on body size and eating enjoyment, and by the suggested weekly activities. Specific study procedures and components of Project WebHealth motivated study participants to improve their weight-related health behaviors, and they differed by gender. Findings support the need for gender-tailored interventions in this population. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Factors Influencing Implementation of a Preschool-Based Physical Activity Intervention

ERIC Educational Resources Information Center

Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.

2017-01-01

Examining factors that influence implementation of key program components that underlie an intervention's success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on…

Moderating Effects of Weather-Related Factors on a Physical Activity Intervention.

PubMed

Welch, Whitney A; Spring, Bonnie; Phillips, Siobhan M; Siddique, Juned

2018-05-01

The purpose of this study is to identify whether weather-related factors moderate the effect of a physical activity (PA) intervention. Participants (N=204, 77% female, mean age 33 [SD=11] years, mean BMI 28.2 [SD=7.1]) from the Make Better Choices 1 trial, enrolled April 2005 to April 2008, were randomized to one of two treatment conditions: (1) increase moderate to vigorous physical activity (MVPA) treatment group, or (2) decrease sedentary behavior control group. Participants wore an accelerometer for 5 weeks: a 2-week baseline assessment followed by a 3-week intervention. Accelerometer data were used to estimate minutes/day of MVPA. Average daily temperature, day length, and precipitation were obtained from the National Climatic Data Center and combined with the accelerometer data. Linear mixed effects models were used to determine whether these weather-related factors moderated the effect of the intervention on MVPA. Separate models were fit for season, daily average temperature, and day length. There was a significant moderating effect of season on MVPA such that the PA intervention, as compared with control, increased MVPA 10.4 minutes more in the summer than in the winter (95% CI=1.1, 19.6, p=0.029). There was a significant moderating effect of daily temperature such that every 10°F increase in temperature was associated with an additional 1.5 minutes/day increase in the difference in MVPA increase between the two intervention conditions (95% CI=0.1, 2.9, p=0.015). There was a significant moderating effect of day length such that every additional hour of daylight was associated with a 2.23-minute increase in the PA intervention's impact on increasing MVPA (95% CI=0.8, 3.7, p=0.002). Day length and temperature had a significant moderating effect on change in MVPA during a PA intervention such that the intervention was less effective on colder days and on shorter days, independently. These results suggest that strategies to overcome environmental barriers

An intervention to help community-based organizations implement an evidence-based HIV prevention intervention: the Mpowerment Project technology exchange system.

PubMed

Kegeles, Susan M; Rebchook, Gregory; Pollack, Lance; Huebner, David; Tebbetts, Scott; Hamiga, John; Sweeney, David; Zovod, Benjamin

2012-03-01

Considerable resources have been spent developing and rigorously testing HIV prevention intervention models, but such models do not impact the AIDS pandemic unless they are implemented effectively by community-based organizations (CBOs) and health departments. The Mpowerment Project (MP) is being implemented by CBOs around the U.S. It is a multilevel, evidence-based HIV prevention program for young gay/bisexual men that targets individual, interpersonal, social, and structural issues by using empowerment and community mobilization methods. This paper discusses the development of an intervention to help CBOs implement the MP called the Mpowerment Project Technology Exchange System (MPTES); CBOs' uptake, utilization and perceptions of the MPTES components; and issues that arose during technical assistance. The seven-component MPTES was provided to 49 CBOs implementing the MP that were followed longitudinally for up to two years. Except for the widely used program manual, other program materials were used early in implementing the MP and then their use declined. In contrast, once technical assistance was proactively provided, its usage remained constant over time, as did requests for technical assistance. CBOs expressed substantial positive feedback about the MPTES, but felt that it needs more focus on diversity issues, describing real world implementation approaches, and providing guidance on how to adapt the MP to diverse populations.

The study of KBP of road construction workers of highway AIDS prevention project before and after intervention.

PubMed

Liu, Dan; Dong, Si-Ping; Gao, Guang-Ming; Fan, Ming-Yu; Zhang, Zong-Jiu; Fang, Peng-Qian

2013-10-01

To get scientific basis for further health education through the research of the road construction workers' KBP before and after the interventions of highway AIDS prevention project. Multi-stage random sampling method was employeed to select workers of 8 sites from 14 sites along highway to investigate their AIDS knowledge, belief and performance (KBP) before and after highway AIDS prevention project. Over 90% of the investigated workers had ever heard about AIDS, and the non-skilled workers of lower educational level improved more after intervention. The correct answer rate of the three transmitting ways of AIDS of drivers which is the focused group of highway before and after intervention had the obvious statistical significance (P<0.05), and the other group's correct answer rates also had improved after intervention. Most people's understanding of preventing AIDS through correct use of condoms when having sex had a statistically significant difference(P<0.05) after prevention. The rates of using condoms of foremen and skilled workers when having sex with commercial sex worker/casual partner increased after intervention. The health education of HIV among the road construction workers is effective and further health education of HIV prevention should be carried out among the road construction workers to improve their knowledge and awareness of avoiding the high-risk behaviors. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

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

2004-01-01

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

Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project.

PubMed

Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M

2016-10-01

In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.

Implementation of brief alcohol interventions by nurses in primary care: do non-clinical factors influence practice?

PubMed

Lock, Catherine A; Kaner, Eileen F S

2004-06-01

In the UK, GPs and practice nurses selectively provide brief alcohol interventions to risk drinkers. GPs' provision of a brief alcohol intervention can be predicted by patient characteristics, practitioner characteristics and structural factors such as the features of the practice and how it is organized. However, much less is known about possible modifiers of nurse practice. Our aim was to investigate if patient characteristics, nurse characteristics and practice factors influence provision of a brief alcohol intervention by practice nurses in primary health care. One hundred and twenty-eight practice nurses who had implemented a brief alcohol intervention programme in a previous trial based in the North of England were requested to screen adults presenting to their surgery and follow a structured protocol to give a brief intervention (5 min of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of 5541 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires were collected after a 3-month implementation period and analysed by logistic regression analysis. Although AUDIT identified 1500 'risk' drinkers, only 926 (62%) received a brief intervention. Logistic regression modelling showed that patients' risk status as measured by AUDIT score was the most influential predictor of a brief intervention by practice nurses. However, risk drinkers who were most likely to receive a brief intervention were male. Patients' age or social class did not independently predict a brief intervention. The multilevel model was unable to identify any independent nurse characteristics that could predict a brief intervention, but indicated significant variation between nurses in their tendency to offer the intervention to patients. No structural factors were found to be positively associated with selective provision. Patient and nurse factors contributed to the selective provision of a brief intervention in primary care. If

Implementation of targeted medication adherence interventions within a community chain pharmacy practice: The Pennsylvania Project.

PubMed

Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma

2014-01-01

To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.

The Green Eating Project: web-based intervention to promote environmentally conscious eating behaviours in US university students.

PubMed

Monroe, Jessica T; Lofgren, Ingrid E; Sartini, Becky L; Greene, Geoffrey W

2015-09-01

To investigate the effectiveness of an online, interactive intervention, referred to as the Green Eating (GE) Project, to motivate university students to adopt GE behaviours. The study was quasi-experimental and integrated into courses for credit/extra credit. Courses were randomly stratified into experimental or non-treatment control. The 5-week intervention consisted of four modules based on different GE topics. Participants completed the GE survey at baseline (experimental, n 241; control, n 367) and post (experimental, n 187; control, n 304). The GE survey has been previously validated and consists of Transtheoretical Model constructs including stage of change (SOC), decisional balance (DB: Pros and Cons) and self-efficacy (SE: School and Home) as well as behaviours for GE. Modules contained basic information regarding each topic and knowledge items to assess content learning. The GE Project took place at a public university in the north-eastern USA. Participants were full-time students between the ages of 18 and 24 years. The GE Project was effective in significantly increasing GE behaviours, DB Pros, SE School and knowledge in experimental compared with control, but did not reduce DB Cons or increase SE Home. Experimental participants were also more likely to be in later SOC for GE at post testing. The GE Project was effective in increasing GE behaviours in university students. Motivating consumers towards adopting GE could assist in potentially mitigating negative consequences of the food system on the environment. Future research could tailor the intervention to participant SOC to further increase the effects or design the modules for other participants.

Interventions for improving modifiable risk factor control in the secondary prevention of stroke.

PubMed

Lager, Kate E; Mistri, Amit K; Khunti, Kamlesh; Haunton, Victoria J; Sett, Aung K; Wilson, Andrew D

2014-05-02

People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control, including patient adherence to prescribed medications, and the occurrence of secondary cardiovascular events. We searched the Cochrane Stroke Group Trials Register (April 2013), the Cochrane Effective Practice and Organisation of Care Group Trials Register (April 2013), CENTRAL (The Cochrane Library 2013, issue 3), MEDLINE (1950 to April 2013), EMBASE (1981 to April 2013) and 10 additional databases. We located further studies by searching reference lists of articles and contacting authors of included studies. We included randomised controlled trials (RCTs) that evaluated the effects of organisational or educational and behavioural interventions (compared with usual care) on modifiable risk factor control for secondary stroke prevention. Two review authors selected studies for inclusion and independently extracted data. One review author assessed the risk of bias for the included studies. We sought missing data from trialists. This review included 26 studies involving 8021 participants. Overall the studies were of reasonable quality, but one study was considered at high risk of bias. Fifteen studies evaluated predominantly organisational interventions and 11 studies evaluated educational and behavioural interventions for patients. Results were pooled where appropriate, although some clinical and methodological heterogeneity was present. The estimated effects of organisational interventions were compatible with improvements and no differences in the modifiable risk factors mean systolic blood pressure (mean difference (MD) -2.57 mmHg; 95% confidence

The value of demonstration projects for new interventions: The case of human papillomavirus vaccine introduction in low- and middle-income countries.

PubMed

Howard, N; Mounier-Jack, S; Gallagher, K E; Kabakama, S; Griffiths, U K; Feletto, M; LaMontagne, D S; Burchett, H E D; Watson-Jones, D

2016-09-01

Demonstration projects or pilots of new public health interventions aim to build learning and capacity to inform country-wide implementation. Authors examined the value of HPV vaccination demonstration projects and initial national programmes in low-income and lower-middle-income countries, including potential drawbacks and how value for national scale-up might be increased. Data from a systematic review and key informant interviews, analyzed thematically, included 55 demonstration projects and 8 national programmes implemented between 2007-2015 (89 years' experience). Initial demonstration projects quickly provided consistent lessons. Value would increase if projects were designed to inform sustainable national scale-up. Well-designed projects can test multiple delivery strategies, implementation for challenging areas and populations, and integration with national systems. Introduction of vaccines or other health interventions, particularly those involving new target groups or delivery strategies, needs flexible funding approaches to address specific questions of scalability and sustainability, including learning lessons through phased national expansion.

An Exploratory Study of Risk Factors for Implementing Service-Oriented IS Projects

NASA Astrophysics Data System (ADS)

Chang, Hsin-Lu; Lue, Chia-Pei

For IS project managers, how to implement the projects successfully is always a challenge. Further, as more and more enterprises start to develop service-oriented IS projects, it is essential to assess the sources and impacts of relevant risks. This research aimed at identifying risk factors related to service-oriented IS projects and analyzing the impact of these risk factors. Applying the SIMM (service integrated maturity model) proposed by IBM, customer service systems were selected to justify the research framework. Result showed that the risk factors influencing the adoption of service-oriented systems were insufficient technology planning, lack of expertise, ineffective project governance, and organizational misalignment, listed in the order of strength of influence. The findings of this research is expected to assist managers realize the risks and the importance of these risks that have to be noticed and controlled when making decisions on service-oriented systems adoption.

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.

A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol

PubMed Central

2013-01-01

Background Racial disparities in blood pressure control have been well documented in the United States. Research suggests that many factors contribute to this disparity, including barriers to care at patient, clinician, healthcare system, and community levels. To date, few interventions aimed at reducing hypertension disparities have addressed factors at all of these levels. This paper describes the design of Project ReD CHiP (Reducing Disparities and Controlling Hypertension in Primary Care), a multi-level system quality improvement project. By intervening on multiple levels, this project aims to reduce disparities in blood pressure control and improve guideline concordant hypertension care. Methods Using a pragmatic trial design, we are implementing three complementary multi-level interventions designed to improve blood pressure measurement, provide patient care management services and offer expanded provider education resources in six primary care clinics in Baltimore, Maryland. We are staggering the introduction of the interventions and will use Statistical Process Control (SPC) charting to determine if there are changes in outcomes at each clinic after implementation of each intervention. The main hypothesis is that each intervention will have an additive effect on improvements in guideline concordant care and reductions in hypertension disparities, but the combination of all three interventions will result in the greatest impact, followed by blood pressure measurement with care management support, blood pressure measurement with provider education, and blood pressure measurement only. This study also examines how organizational functioning and cultural competence affect the success of the interventions. Discussion As a quality improvement project, Project ReD CHiP employs a novel study design that specifically targets multi-level factors known to contribute to hypertension disparities. To facilitate its implementation and improve its sustainability, we have

Which factors affect software projects maintenance cost more?

PubMed

Dehaghani, Sayed Mehdi Hejazi; Hajrahimi, Nafiseh

2013-03-01

The software industry has had significant progress in recent years. The entire life of software includes two phases: production and maintenance. Software maintenance cost is increasingly growing and estimates showed that about 90% of software life cost is related to its maintenance phase. Extraction and considering the factors affecting the software maintenance cost help to estimate the cost and reduce it by controlling the factors. In this study, the factors affecting software maintenance cost were determined then were ranked based on their priority and after that effective ways to reduce the maintenance costs were presented. This paper is a research study. 15 software related to health care centers information systems in Isfahan University of Medical Sciences and hospitals function were studied in the years 2010 to 2011. Among Medical software maintenance team members, 40 were selected as sample. After interviews with experts in this field, factors affecting maintenance cost were determined. In order to prioritize the factors derived by AHP, at first, measurement criteria (factors found) were appointed by members of the maintenance team and eventually were prioritized with the help of EC software. Based on the results of this study, 32 factors were obtained which were classified in six groups. "Project" was ranked the most effective feature in maintenance cost with the highest priority. By taking into account some major elements like careful feasibility of IT projects, full documentation and accompany the designers in the maintenance phase good results can be achieved to reduce maintenance costs and increase longevity of the software.

Alzheimer's disease prevention: from risk factors to early intervention.

PubMed

Crous-Bou, Marta; Minguillón, Carolina; Gramunt, Nina; Molinuevo, José Luis

2017-09-12

Due to the progressive aging of the population, Alzheimer's disease (AD) is becoming a healthcare burden of epidemic proportions for which there is currently no cure. Disappointing results from clinical trials performed in mild-moderate AD dementia combined with clear epidemiological evidence on AD risk factors are contributing to the development of primary prevention initiatives. In addition, the characterization of the long asymptomatic stage of AD is allowing the development of intervention studies and secondary prevention programmes on asymptomatic at-risk individuals, before substantial irreversible neuronal dysfunction and loss have occurred, an approach that emerges as highly relevant.In this manuscript, we review current strategies for AD prevention, from primary prevention strategies based on identifying risk factors and risk reduction, to secondary prevention initiatives based on the early detection of the pathophysiological hallmarks and intervention at the preclinical stage of the disease. Firstly, we summarize the evidence on several AD risk factors, which are the rationale for the establishment of primary prevention programmes as well as revising current primary prevention strategies. Secondly, we review the development of public-private partnerships for disease prevention that aim to characterize the AD continuum as well as serving as platforms for secondary prevention trials. Finally, we summarize currently ongoing clinical trials recruiting participants with preclinical AD or a higher risk for the onset of AD-related cognitive impairment.The growing body of research on the risk factors for AD and its preclinical stage is favouring the development of AD prevention programmes that, by delaying the onset of Alzheimer's dementia for only a few years, would have a huge impact on public health.

Crisis intervention related to the use of psychoactive substances in recreational settings--evaluating the Kosmicare Project at Boom Festival.

PubMed

Carvalho, Maria Carmo; de Sousa, Mariana Pinto; Frango, Paula; Dias, Pedro; Carvalho, Joana; Rodrigues, Marta; Rodrigues, Tania

2014-01-01

Kosmicare project implements crisis intervention in situations related to the use of psychoactive substances at Boom Festival (Portugal). We present evaluation research that aims to contribute to the transformation of the project into an evidence-based intervention model. It relies on harm reduction and risk minimization principles, crisis intervention models, and Grof's psychedelic psychotherapy approach for crisis intervention in situations related to unsupervised use of psychedelics. Intervention was expected to produce knowledge about the relation between substance use and mental health impact in reducing potential risk related to the use of psychoactive substances and mental illness, as well as an impact upon target population's views of themselves, their relationship to substance use, and to life events in general. Research includes data on process and outcome indicators through a mixed methods approach, collected next to a sample of n=176 participants. Sample size varied considerably, however, among different research measures. 52% of Kosmicare visitors reported LSD use. Over 40% also presented multiple drug use. Pre-post mental state evaluation showed statistically significant difference (p<.05) confirming crisis resolution. Crisis episodes that presented no resolution were more often related with mental health outburst episodes, with psychoactive substance use or not. Visitors showed high satisfaction with intervention (n=58) and according to follow-up (n=18) this perception was stable over time. Crisis intervention was experienced as very significant. We discuss limitations and implications of evaluating natural setting based interventions, and the relation between psychoactive substance use and psychopathology. Other data on visitor's profile and vulnerability to crisis showed inconclusive.

Predictive Factors for Verbal Memory Performance Over Decades of Aging: Data from the Women's Healthy Ageing Project.

PubMed

Szoeke, Cassandra; Lehert, Philippe; Henderson, Victor W; Dennerstein, Lorraine; Desmond, Patricia; Campbell, Stephen

2016-10-01

Abnormalities in brain structure and function can occur several decades prior to the onset of cognitive decline. It is in the preceding decades that an intervention is most likely to be effective, when informed by an understanding of factors contributing to the disease prodrome. Few studies, however, have sufficient longitudinal data on relevant risks to determine the optimum targets for interventions to improve cognition in aging. In this article we examine the timing and exposure of factors contributing to verbal memory performance in later life. 387 participants from the population-based Women's Healthy Ageing Project, mean age at baseline of 49.6 years (range: 45-55 years), had complete neuropsychiatric assessments, clinical information, physical measures, and biomarkers collected at baseline, with at least three follow-up visits that included at least one cognitive reassessment. Mixed linear models were conducted to assess the significance of risk factors on later-life verbal memory. We explored the influence of early, contemporaneous, and cumulative exposures. Younger age and better education were associated with baseline memory test performance (CERAD). Over the 20 years of study follow-up, cumulative mid- to late-life physical activity had the strongest effect on better later life verbal memory (0.136 [0.058, 0.214]). The next most likely contributors to verbal memory in late life were the negative effect of cumulative hypertension (-0.033 [-0.047, -0.0.18] and the beneficial effect of HDL cholesterol (0.818 [0.042, 1.593]). Findings suggest that midlife interventions focused on physical activity, hypertension control, and achieving optimal levels of HDL cholesterol will help maintain later-life verbal memory skills. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Human Factors in Aerospace: Examples from Projects at NASA Ames

NASA Technical Reports Server (NTRS)

Edwards, Tamsyn

2017-01-01

Human factors is a critical consideration in system performance and system safety. This presentation provides examples of how human factors can be utilized in a variety of applied research projects to create system wide benefits

Factors influencing implementation of a preschool-based physical activity intervention

PubMed Central

Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.

2017-01-01

Abstract Examining factors that influence implementation of key program components that underlie an intervention’s success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on implementation levels of a component, called Move Outside (i.e., preschool classroom teachers to provide at least 40 min of outdoor recess per day), that was fundamental to the success of a preschool-based physical activity intervention. Level of implementation, defined as the percent of daily goal met for the Move Outside component, was assessed via direct observation. Items assessing preschool capacity, quality of prevention support system and teacher characteristics were selected from surveys and an environmental checklist completed by preschool directors and teachers. Preschool classroom was used as the unit of analysis (Year 1: n = 19; Year 2: n = 17). Results from Bayesian path analyses showed that the three factors were not significantly associated with level of implementation in Year 1, but preschool capacity was directly associated with level of implementation in Year 2 (β= 0.528, 95% CI: 0.134, 0.827). The current findings suggest that factors that influence level of implementation appear to differ as an intervention evolved over time. PMID:28158420

Violence against women in Pakistan: contributing factors and new interventions.

PubMed

Karmaliani, Rozina; Pasha, Aneeta; Hirani, Saima; Somani, Rozina; Hirani, Shela; Asad, Nargis; Cassum, Laila; McFarlane, Judith

2012-12-01

Pakistan ranks 125th out of 169 countries on the Gender Development Index and has high prevalence rates of Violence against Women (VAW). Contributing factors toward gender based violence at the micro, meso and macro levels include the acceptability of violence amongst both men and women, internalization of deservability, economic disempowerment, lack of formal education, joint family systems, entrenched patriarchal norms and values, and a lack of awareness of legal and other support systems. These factors have a long-lasting impact on the health of women and children. The gender disparities in the experience of women seeking health care in Pakistan are well-recognized and documented. In the past, common government policy responses to these disparities have included developing the role of community health workers (CHWs) and lady health visitors (LHVs). Despite being commendable initiatives, these too have been unsuccessful in addressing these multi-faceted disparities. Within this complex scenario, new interventions to address VAW and its impact on health in Pakistan include Group Counselling, Economic Skills Building, Health-Based Microfinance, and Family-Based models that increase male involvement, especially at the primary health care level. The purpose of this article is to outline key contributing factors to VAW, explore tested and new interventions, and highlight the opportunities that exist in implementing them.

The Behavior Education Support and Treatment (BEST) school intervention program: pilot project data examining schoolwide, targeted-school, and targeted-home approaches.

PubMed

Waschbusch, Daniel A; Pelham, William E; Massetti, Greta

2005-08-01

As part of a pilot project, four elementary schools were randomly assigned to receive one of four interventions: (a) a schoolwide intervention that incorporated universal and targeted treatment, (b) a targeted-school intervention delivered to individual students in regular and special education classrooms, (c) a targeted-home intervention delivered in home and regular classroom settings, and (d) a control condition that did not receive a designated intervention. Results showed that the behavior of disruptive children in all schools improved during the course of the year, with some evidence that interventions provided complementary effects. These findings support the continued use of behavioral interventions in elementary schools and argue for interventions that combine different methods of delivering interventions.

The role of family-related factors in the effects of the UP4FUN school-based family-focused intervention targeting screen time in 10- to 12-year-old children: the ENERGY project.

PubMed

Van Lippevelde, Wendy; Bere, Elling; Verloigne, Maïté; van Stralen, Maartje M; De Bourdeaudhuij, Ilse; Lien, Nanna; Vik, Frøydis Nordgård; Manios, Yannis; Grillenberger, Monika; Kovács, Eva; ChinAPaw, Mai J M; Brug, Johannes; Maes, Lea

2014-08-18

Screen-related behaviours are highly prevalent in schoolchildren. Considering the adverse health effects and the relation of obesity and screen time in childhood, efforts to affect screen use in children are warranted. Parents have been identified as an important influence on children's screen time and therefore should be involved in prevention programmes. The aim was to examine the mediating role of family-related factors on the effects of the school-based family-focused UP4FUN intervention aimed at screen time in 10- to 12-year-old European children (n child-parent dyads = 1940). A randomised controlled trial was conducted to test the six-week UP4FUN intervention in 10- to 12-year-old children and one of their parents in five European countries in 2011 (n child-parent dyads = 1940). Self-reported data of children were used to assess their TV and computer/game console time per day, and parents reported their physical activity, screen time and family-related factors associated with screen behaviours (availability, permissiveness, monitoring, negotiation, rules, avoiding negative role modeling, and frequency of physically active family excursions). Mediation analyses were performed using multi-level regression analyses (child-school-country). Almost all TV-specific and half of the computer-specific family-related factors were associated with children's screen time. However, the measured family-related factors did not mediate intervention effects on children's TV and computer/game console use, because the intervention was not successful in changing these family-related factors. Future screen-related interventions should aim to effectively target the home environment and parents' practices related to children's use of TV and computers to decrease children's screen time. The study is registered in the International Standard Randomised Controlled Trial Number Register (registration number: ISRCTN34562078).

Nutrition and physical activity educational intervention on CHD risk factors: a systematic review study.

PubMed

Rahmati Najarkolaei, Fatemeh; Ghaffarpasand, Eiman; Gholami Fesharaki, Mohammad; Jonaidi Jafari, Nematollah

2015-01-01

Fast growing epidemic of chronic diseases causes many health challenges over the world. Regarding reported pros and cons, the aim of the current study is to review the effect of nutrition and physical educational intervention in decreasing cardiovascular risk factors. In this review study, searching has done through the English and Persian databases. Articles with other languages, lack of important information, and score 3 or less in the JADAD standard checklist were exluded from the study. In the primary search, 194 articles have been found.Through four stages of secondary search and further evaluation, 43 articles were selected. These articles were published between 1989 to 2013. According to these findings, the majority of articles showed a positive effect of nutrition and physical activity educational interventions on cardiovascular risk factors- blood cholesterol, systolic and diastolic blood pressure, as well as smoking cigarette in high risk patients. These results, suggest the necessity of continiuting nutrition and physical educational intervention for individuals with cardiovascular risk factors.

A Psychometric Approach to Theory-Based Behavior Change Intervention Development: Example From the Colorado Meaning-Activity Project.

PubMed

Masters, Kevin S; Ross, Kaile M; Hooker, Stephanie A; Wooldridge, Jennalee L

2018-05-18

There has been a notable disconnect between theories of behavior change and behavior change interventions. Because few interventions are both explicitly and adequately theory-based, investigators cannot assess the impact of theory on intervention effectiveness. Theory-based interventions, designed to deliberately engage the theory's proposed mechanisms of change, are needed to adequately test theories. Thus, systematic approaches to theory-based intervention development are needed. This article will introduce and discuss the psychometric method of developing theory-based interventions. The psychometric approach to intervention development utilizes basic psychometric principles at each step of the intervention development process in order to build a theoretically driven intervention to, subsequently, be tested in process (mechanism) and outcome studies. Five stages of intervention development are presented as follows: (i) Choice of theory; (ii) Identification and characterization of key concepts and expected relations; (iii) Intervention construction; (iv) Initial testing and revision; and (v) Empirical testing of the intervention. Examples of this approach from the Colorado Meaning-Activity Project (COMAP) are presented. Based on self-determination theory integrated with meaning or purpose, and utilizing a motivational interviewing approach, the COMAP intervention is individually based with an initial interview followed by smart phone-delivered interventions for increasing daily activity. The psychometric approach to intervention development is one method to ensure careful consideration of theory in all steps of intervention development. This structured approach supports developing a research culture that endorses deliberate and systematic operationalization of theory into behavior change intervention from the outset of intervention development.

The Advanced Glaucoma Intervention Study (AGIS): 11. Risk factors for failure of trabeculectomy and argon laser trabeculoplasty.

PubMed

2002-10-01

To investigate the association of pre-intervention and post-intervention patient and eye characteristics with failure of argon laser trabeculoplasty (ALT) and trabeculectomy. Cohort study of participants in the Advanced Glaucoma Intervention Study. This multicenter study took place between 1988 and 2001. Between 1988 and 1992, 789 eyes of 591 patients aged 35 to 80 years with advanced glaucoma were randomized into one of two surgical treatment sequences: argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy or trabeculectomy-ALT-trabeculectomy. Upon study-defined failure (based on maximum medications, sustained intraocular pressure (IOP) elevation, visual field defect, and disk rim deterioration) of each intervention, patients were offered the subsequent intervention. Potential follow-up was 8 to 13 years. This report is based on data from 779 eyes that had at least 3 months of follow-up. The main outcome measures are failure of ALT and trabeculectomy, whether as first or second interventions. Effect size is measured by the hazard ratio (HR) and its corresponding 95% confidence interval (CI) obtained from Cox multiple regression analysis, where HR corresponds to the coefficient of change in risk associated with a unit increase in a factor. For binary factors, this corresponds to the change in risk in eyes with the factor relative to the risk in eyes without the factor. Pre-intervention factors associated with failure of ALT are younger age (HR = 0.98, CI = 0.96-0.99, P =.009) and higher IOP (1.11, 1.08-1.15, P <.001). Pre-intervention factors associated with failure of trabeculectomy are younger age (HR = 0.97, CI = 0.95-0.99, P =.005) and higher IOP (1.04, 1.01-1.06, P =.002), as well as diabetes (2.86, 1.88-4.36, P <.001) and any postoperative complication (1.99, 1.35-2.93, P <.001). Individual postoperative complications significantly associated with increased risk of failure of trabeculectomy are elevated IOP (3.4, 1.9-6.1, P <.001) and marked

Tackling psychosocial risk factors for adolescent cyberbullying: Evidence from a school-based intervention.

PubMed

Barkoukis, Vassilis; Lazuras, Lambros; Ourda, Despoina; Tsorbatzoudis, Haralambos

2016-01-01

Cyberbullying is an emerging form of bullying that takes place through contemporary information and communication technologies. Building on past research on the psychosocial risk factors for cyberbullying in this age group, the present study assessed a theory-driven, school-based preventive intervention that targeted moral disengagement, empathy and social cognitive predictors of cyberbullying. Adolescents (N = 355) aged between 16 and 18 years were randomly assigned into the intervention and the control group. Both groups completed anonymous structured questionnaires about demographics, empathy, moral disengagement and cyberbullying-related social cognitive variables (attitudes, actor prototypes, social norms, and behavioral expectations) before the intervention, post-intervention and 6 months after the intervention. The intervention included awareness-raising and interactive discussions about cyberbullying with intervention group students. Analysis of covariance (ANCOVA) showed that, after controlling for baseline measurements, there were significant differences at post-intervention measures in moral disengagement scores, and in favorability of actor prototypes. Further analysis on the specific mechanisms of moral disengagement showed that significant differences were observed in distortion of consequences and attribution of blame. The implications of the intervention are discussed, and guidelines for future school-based interventions against cyberbullying are provided. © 2015 Wiley Periodicals, Inc.

Stakeholder approach for evaluating organizational change projects.

PubMed

Peltokorpi, Antti; Alho, Antti; Kujala, Jaakko; Aitamurto, Johanna; Parvinen, Petri

2008-01-01

This paper aims to create a model for evaluating organizational change initiatives from a stakeholder resistance viewpoint. The paper presents a model to evaluate change projects and their expected benefits. Factors affecting the challenge to implement change were defined based on stakeholder theory literature. The authors test the model's practical validity for screening change initiatives to improve operating room productivity. Change initiatives can be evaluated using six factors: the effect of the planned intervention on stakeholders' actions and position; stakeholders' capability to influence the project's implementation; motivation to participate; capability to change; change complexity; and management capability. The presented model's generalizability should be explored by filtering presented factors through a larger number of historical cases operating in different healthcare contexts. The link between stakeholders, the change challenge and the outcomes of change projects needs to be empirically tested. The proposed model can be used to prioritize change projects, manage stakeholder resistance and establish a better organizational and professional competence for managing healthcare organization change projects. New insights into existing stakeholder-related understanding of change project successes are provided.

Causative factors of cost overrun in highway projects of Sindh province of Pakistan

NASA Astrophysics Data System (ADS)

Sohu, S.; Halid, A.; Nagapan, S.; Fattah, A.; Latif, I.; Ullah, K.

2017-11-01

Cost overrun is an increase of cost of project from approved budget which was signed by parties at the time of tender. Cost overrun in construction of highway projects is a common problem worldwide and construction industry of Pakistan is also facing this crucial problem of cost overrun in highway projects of Pakistan. The main objective of this research is to identify the causative factors of cost overrun in highway projects of Sindh province of Pakistan. A well designed questionnaire was developed based on 64 common factors of cost overrun from literature review. Developed questionnaire was distributed among selected 30 experts from owner/client, designer/consultant and contractor who have experience more than 20 years’ experience in highway projects. The collected data was statistical analyzed. After analysis results showed that delay process in payment by client, inadequate planning, client interference, poor contract management, delay of decision making, change of scope of project and financial problems faced by client were most causative factors of cost overrun in highway projects. This research will provide alertness to stakeholders of highway projects of Sindh province to avoid cost overrun in projects.

Cultural Factors and Family-Based HIV Prevention Intervention for Latino Youth

PubMed Central

Brown, Larry K.; Raffaelli, Marcela; Lima, Lori-Ann

2009-01-01

Latino youth are the fastest growing ethnic group in the United States and are at considerable risk for HIV and other sexually transmitted infections (STIs), given that they have an earlier onset of sexual activity and use condoms less consistently than European American adolescents. Theorists and scholars have emphasized the importance of taking culture into account in sexuality interventions with Latino adolescents, yet few culturally tailored interventions have been developed for this population. Given the emphasis on familismo and collectivism among Latinos, family-based programs are likely to be well received and could contribute to long-term maintenance of adolescent safety. In this synthesis of the relevant literature, cultural factors that have been identified as relevant to Latino sexuality are reviewed and implications for family-based intervention with Latinos are addressed. PMID:19181820

Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji.

PubMed

Waqa, Gade; Moodie, Marj; Schultz, Jimaima; Swinburn, Boyd

2013-12-01

Nearly one-half of the adult population in Fiji between the ages of 15-64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13-18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups.

High mobility, low access thwarts interventions among seasonal workers in the Greater Mekong Sub-region: lessons from the malaria containment project.

PubMed

Canavati, Sara E; Quintero, Cesia E; Lawford, Harriet L S; Yok, Sovann; Lek, Dysoley; Richards, Jack S; Whittaker, Maxine Anne

2016-08-26

During the process of malaria elimination in the Greater Mekong Sub-region, mobile and migrant populations (MMPs) have been identified as the most at-risk demographic. An important sub-group of MMPs are seasonal workers, and this paper presents an evaluation of the reach and effectiveness of interventions tailored towards this group and was carried out as part of the Containment Project from 2009-11. A mixed-methods study was conducted in Pailin Province in Western Cambodia. Three-hundred-and-four seasonal workers were surveyed using a structured questionnaire. Qualitative data were gathered through a total of eight focus group discussions and 14 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. High mobility and low access of the target population to the interventions, as well as lack of social and anthropological research that led to implementation oversights, resulted in under-exposure of seasonal workers to interventions. Consequently, their reach and impact were severely limited. Some services, particularly Mobile Malaria Workers, had the ability to significantly impact key factors, such as risky behaviours among those they did reach. Others, like Listening and Viewing Clubs and mass media campaigns, showed little impact. There is potential in two of the interventions assessed, but high mobility and inadequate exposure of seasonal workers to these interventions must be considered in the development and planning of future interventions to avoid investing in low-impact activities and ensure that all interventions perform according to their maximum potential. This will be critical in order for Cambodia to achieve its aim of malaria elimination. The lessons learned from this study can be extrapolated to other areas of health care in Cambodia and other countries in order to reduce the gap between healthcare provided to MMPs, especially seasonal workers, and to the general population.

[The CHILT I project (Children's Health Interventional Trial). A multicomponent intervention to prevent physical inactivity and overweight in primary schools].

PubMed

Graf, C; Dordel, S

2011-03-01

Child and juvenile obesity is increasing worldwide; therefore, effective preventive strategies are warranted. The stepwise project CHILT (Children's Health Interventional Trial) was initiated in 2000 and combines in its multicomponent school-based arm CHILT I health education and physical activity for primary school children to prevent physical inactivity and overweight. The effect on obesity and physical performance was studied in 12 primary schools (intervention schools, IS) compared with 5 control schools (CS). Anthropometric data were recorded. Physical performance was measured by a coordination test for children (the "Körperkoordinationstest für Kinder", KTK) and the 6-minute run. Anthropometric and motoric data of 436 children in IS (55.0% of the population) and 179 children in CS (62.8%) were available at baseline and at follow-up. No difference in the incidence of overweight was found between the IS and CS after 4 years of intervention. Remission of overweight was higher in IS (23.2% versus 19.2%), but not significant. The increase in BMI was significantly lower in IS, in which the program was regularly performed. There was an improvement in selected items of the KTK in IS. In particular, endurance performance tended to be higher at final examination. School-based preventive intervention seems to have a positive influence on physical motor skills and the remission of overweight. To optimize the effects, a consistent and quality assured implementation and the integration of the children's whole environment are warranted.

Factors associated with choice of web or print intervention materials in the healthy directions 2 study.

PubMed

Greaney, Mary L; Puleo, Elaine; Bennett, Gary G; Haines, Jess; Viswanath, K; Gillman, Matthew W; Sprunck-Harrild, Kim; Coeling, Molly; Rusinak, Donna; Emmons, Karen M

2014-02-01

Many U.S. adults have multiple behavioral risk factors, and effective, scalable interventions are needed to promote population-level health. In the health care setting, interventions are often provided in print, although accessible to nearly everyone, are brief (e.g., pamphlets), are not interactive, and can require some logistics around distribution. Web-based interventions offer more interactivity but may not be accessible to all. Healthy Directions 2 was a primary care-based cluster randomized controlled trial designed to improve five behavioral cancer risk factors among a diverse sample of adults (n = 2,440) in metropolitan Boston. Intervention materials were available via print or the web. Purpose. To (a) describe the Healthy Directions 2 study design and (b) identify baseline factors associated with whether participants opted for print or web-based materials. Hierarchical regression models corrected for clustering by physician were built to examine factors associated with choice of intervention modality. At baseline, just 4.0% of participants met all behavioral recommendations. Nearly equivalent numbers of intervention participants opted for print and web-based materials (44.6% vs. 55.4%). Participants choosing web-based materials were younger, and reported having a better financial status, better perceived health, greater computer comfort, and more frequent Internet use (p < .05) than those opting for print. In addition, Whites were more likely to pick web-based material than Black participants. Interventions addressing multiple behaviors are needed in the primary care setting, but they should be available in web and print formats as nearly equal number of participants chose each option, and there are significant differences in the population groups using each modality.

A youth-led social marketing intervention to encourage healthy lifestyles, the EYTO (European Youth Tackling Obesity) project: a cluster randomised controlled0 trial in Catalonia, Spain.

PubMed

Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Arola, Lluís; Prades-Tena, Jordi; Montagut, Marta; Moragas-Fernández, Carlota M; Solà, Rosa; Giralt, Montse

2015-07-03

The encouragement of healthy lifestyles for obesity prevention in young people is a public health priority. The European Youth Tackling Obesity (EYTO) project is a multicentric intervention project with participation from the United Kingdom, Portugal, the Czech Republic and Spain. The general aim of the EYTO project is to improve lifestyles, including nutritional habits and physical activity practice, and to prevent obesity in socioeconomically disadvantaged and vulnerable adolescents. The EYTO project works through a peer-led social marketing intervention that is designed and implemented by the adolescents of each participating country. Each country involved in the project acts independently. This paper describes the "Som la Pera" intervention Spanish study that is part of the EYTO project. In Spain, the research team performed a cluster randomised controlled intervention over 2 academic years (2013-2015) in which 2 high-schools were designated as the control group and 2 high-schools were designated as the intervention group, with a minimum of 121 schoolchildren per group. From the intervention group, 5 adolescents with leadership characteristics, called "Adolescent Challenge Creators" (ACCs), were recruited. These 5 ACCs received an initial 4 h training session about social marketing principles and healthy lifestyle theory, followed by 24 sessions (1.30 h/session) divided in two academic years to design and implement activities presented as challenges to encourage healthy lifestyles among their peers, the approximately 180-200 high-school students in the intervention group. During the design of the intervention, it was essential that the ACCs used the 8 social marketing criteria (customer orientation, behaviour, theory, insight, exchange, competition, segmentation and methods mix). The expected primary outcomes from the Spanish intervention will be as follows: increases in the consumption of fruits and vegetables and physical activity practice along with

Factors Predicting Sustainability of the Schoolwide Positive Behavior Intervention Support Model

ERIC Educational Resources Information Center

Chitiyo, Jonathan; May, Michael E.

2018-01-01

The Schoolwide Positive Behavior Intervention Support model (SWPBIS) continues to gain widespread use across schools in the United States and abroad. Despite its widespread implementation, little research has examined factors that influence its sustainability. Informed by Rogers's diffusion theory, this study examined school personnel's…

Scoping review of risk factors of and interventions for adolescent repeat pregnancies: A public health perspective.

PubMed

Govender, Desiree; Naidoo, Saloshni; Taylor, Myra

2018-06-19

Adolescent repeat pregnancy is of importance in public health because the birth of a second child to an adolescent mother compounds the adverse medical, educational, socioeconomic and parenting outcomes. Repeat pregnancy in adolescence is not only an international phenomenon but also a local concern as it also occurs in South Africa. The prevalence of adolescent repeat pregnancy in Durban, KwaZulu-Natal, was reported as 17.6% in 2013. This review aimed to gather relevant information from national and international sources to inform practice and to provide an understanding of what is known about the risk factors of and the interventions for adolescent repeat pregnancy. A scoping review was undertaken using the Arksey and O'Malley framework. An electronic search was conducted using PubMed, Medline, Science Direct, Ebscohost, Sage and Wiley Online and Google Scholar. The search identified 3032 citations. After a review of the full text articles, 26 articles met the inclusion criteria. Risk factors pertaining to adolescent repeat pregnancy are categorised according to individual factors, partner relationship factors, family factors, peer factors, and social and community factors. Interventions to reduce adolescent repeat pregnancy have been largely influenced by the ecological framework. Across studies, adolescent mothers who received medical, psychosocial, educational, and family planning support experienced lower rates of repeat pregnancy. A single 'one-size-fits-all' intervention for adolescent repeat pregnancy prevention is unlikely as different strategies were employed by the intervention programmes in this scoping review.

Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review.

PubMed

Goudet, Sophie; Griffiths, Paula; Bogin, Barry; Madise, Nyovani

2017-02-01

Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risk factors for children's malnutrition. Improved understanding of the risk factors for malnutrition in slums communities and the impact of interventions on children's health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. The search included 30 electronic bibliographic databases and relevant eligible studies published up to December 2013. The search located 1512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific, with nutritional intervention being the most dominant type. Seventy-three per cent of the interventions were assessed effective. The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.

[Evaluation of the effect of the health education intervention project "Healthy School"].

PubMed

Zivković, M; Bjegović, V; Vuković, D; Marinković, J

1998-01-01

Contemporary health-education intervention programs are increasingly used as a tool for improving health of school children [1-4]. Since 1992 a Network of 13 elementary Health Promoting Schools established in Yugoslavia (though not yet admitted to the European Network) has been operational. The Project was approved by the Ministries of Health, Education and Ecology from the very beginning, and financially supported by the Government of Serbia since 1995. The team of up to 40 health professionals, school principals and school project managers worked together for four years to change the working conditions in schools knowledge, attitudes and behaviour of school children and staff in order to improve their health [5]. The goal of this paper is to present results of health education intervention in changing of hygienic conditions in schools, as well as some of the attitudes, behaviour and knowledge of pupils and their parents. The study took place before and after the intervention--at two points in time--during 1993 and 1996. The tri-angular approach including (1) pupils, (2) schools (teachers, school environment), and (3) parents, was used. A random pretest and post-test study design with control group (12 experimental and two control schools) has been implemented. The multiphase cluster sample was employed in order to represent all of the country typical regions. Six types of especially designed questionnaires were used to provide comparable variables in the sample of pupils, their parents and teachers. Exception were 1st-graders and 4th-graders for whom information were gathered by means of a "draw-and-write" investigation technique [6]. The response rate was 88.70% before and 98.28% after intervention. Data were analyzed by descriptive and inferential statistics using SPSS/PC software. Schools are somewhat less overcrowded, much cleaner and better maintained after the four-year intervention. Toilets are in a better condition, but there is still much more to be done

Project Stride: An Equine-Assisted Intervention to Reduce Symptoms of Social Anxiety in Young Women.

PubMed

Alfonso, Sarah V; Alfonso, Lauren A; Llabre, Maria M; Fernandez, M Isabel

2015-01-01

Although there is evidence supporting the use of equine-assisted activities to treat mental disorders, its efficacy in reducing signs and symptoms of social anxiety in young women has not been examined. We developed and pilot tested Project Stride, a brief, six-session intervention combining equine-assisted activities and cognitive-behavioral strategies to reduce symptoms of social anxiety. A total of 12 women, 18-29 years of age, were randomly assigned to Project Stride or a no-treatment control. Participants completed the Liebowitz Social Anxiety Scale at baseline, immediate-post, and 6 weeks after treatment. Project Stride was highly acceptable and feasible. Compared to control participants, those in Project Stride had significantly greater reductions in social anxiety scores from baseline to immediate-post [decrease of 24.8 points; t (9) = 3.40, P = .008)] and from baseline to follow-up [decrease of 31.8 points; t (9) = 4.12, P = .003)]. These findings support conducting a full-scale efficacy trial of Project Stride. Copyright © 2015 Elsevier Inc. All rights reserved.

Influence of physician factors on the effectiveness of a continuing medical education intervention.

PubMed

Flores, Sergio; Reyes, Hortensia; Perez-Cuevas, Ricardo

2006-01-01

Continuing medical education (CME) is essential for improving the quality of care in primary health care settings. This study's objective was to determine how the characteristics of family physicians influenced the effectiveness of a multifaceted CME intervention to improve the management of acute respiratory infection (ARI) or type 2 diabetes (DM2). A secondary analysis was conducted based on data from 121 family physicians, who participated in the educational intervention study. The outcome variable was positive change in physician's performance for treatment of ARI or DM2. The exposure variable was multifaceted CME intervention. Independent variables were professional physicians and organizational characteristics. Analysis included log binomial regression modeling. Factors influencing positive change included, for ARI, participation in the CME intervention and medical director interested in that condition and for DM2, participation in the CME intervention, medical director interested in DM2, and being a teacher. Physicians' characteristics and organizational environment influence the effectiveness of educational intervention and are therefore relevant to the implementation of CME strategies.

The utility of Geographical Information Systems (GIS) in systems-oriented obesity intervention projects: The selection of comparable study sites for a quasi-experimental intervention design--TX CORD

USDA-ARS?s Scientific Manuscript database

The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in communit...

On the delay factors of the private construction projects in Medan city

NASA Astrophysics Data System (ADS)

Perwira Mulia Tarigan, A.; Subroto

2018-03-01

The delay in construction projects undertaken by contractors is impeding the economic growth of a region. Medan city which is one of the big cities in Indonesia is suffering from it. This study aims to identify the dominant factors causing delays in construction projects conducted by private contractors. The interview method with questionnaires is used to involve 20 contractors, 10 consultants, and 10 owner representatives in the study. From the 45 identified factors causing delays, the highest ranking is the change of work demand by the project owners with 71.84% importance index.

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Pre-Vocational Immersion as Risk Intervention in a Mainstream Setting: A Preliminary Evaluation of Project OASES.

ERIC Educational Resources Information Center

Morrow, Daniel Hibbs; And Others

This study evaluates a 1-year, pre-vocational intervention--Project OASES (Occupational and Academic Skills for the Employment of Students)--for at-risk middle school students in the Pittsburgh (Pennsylvania) Public School District. The study sample consisted of 502 former participants and 148 active participants (1988-1989 school year) plus…

Perception of drinking water safety and factors influencing acceptance and sustainability of a water quality intervention in rural southern India.

PubMed

Francis, Mark Rohit; Nagarajan, Guru; Sarkar, Rajiv; Mohan, Venkata Raghava; Kang, Gagandeep; Balraj, Vinohar

2015-07-30

Acceptance and long-term sustainability of water quality interventions are pivotal to realizing continued health benefits. However, there is limited research attempting to understand the factors that influence compliance to or adoption of such interventions. Eight focus group discussions with parents of young children--including compliant and not compliant households participating in an intervention study, and three key-informant interviews with village headmen were conducted between April and May 2014 to understand perceptions on the effects of unsafe water on health, household drinking water treatment practices, and the factors influencing acceptance and sustainability of an ongoing water quality intervention in a rural population of southern India. The ability to recognize health benefits from the intervention, ease of access to water distribution centers and the willingness to pay for intervention maintenance were factors facilitating acceptance and sustainability of the water quality intervention. On the other hand, faulty perceptions on water treatment, lack of knowledge about health hazards associated with drinking unsafe water, false sense of protection from locally available water, resistance to change in taste or odor of water and a lack of support from male members of the household were important factors impeding acceptance and long term use of the intervention. This study highlights the need to effectively involve communities at important stages of implementation for long term success of water quality interventions. Timely research on the factors influencing uptake of water quality interventions prior to implementation will ensure greater acceptance and sustainability of such interventions in low income settings.

Study protocol: a cluster randomised controlled trial of a school based fruit and vegetable intervention - Project Tomato.

PubMed

Kitchen, Meaghan S; Ransley, Joan K; Greenwood, Darren C; Clarke, Graham P; Conner, Mark T; Jupp, Jennifer; Cade, Janet E

2009-06-16

The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Medical Research Council Registry code G0501297.

Stop Stroke: development of an innovative intervention to improve risk factor management after stroke.

PubMed

Redfern, Judith; Rudd, Anthony D; Wolfe, Charles D A; McKevitt, Christopher

2008-08-01

Stroke survivors are at high risk of stroke recurrence yet current strategies to reduce recurrence risk are sub-optimal. The UK Medical Research Council (MRC) have proposed a framework for developing and evaluating complex interventions, such as community management of stroke secondary prevention. The Framework outlines a five-phased approach from theory through to implementation of effective interventions. This paper reports Phases I-III of the development of a novel intervention to improve risk factor management after stroke. The pre-clinical/theoretical phase entailed reviewing the literature and undertaking quantitative and qualitative studies to identify current practices and barriers to secondary prevention. In Phase I (modelling), findings were used to design an intervention with the potential to overcome barriers to effective stroke secondary prevention management. The feasibility of delivering the intervention and its acceptability were tested in the Phase II exploratory trial involving 25 stroke survivors and their general practitioners. This led to the development of the definitive risk factor management intervention. This comprises multiple components and involves using an on-going population stroke register to target patients, carers and health care professionals with tailored secondary prevention advice. Clinical, socio-demographic and service use data collected by the stroke register are transformed to provide an individualised secondary prevention package for patients, carers and health care professionals at three time points: within 10 weeks, 3 and 6 months post-stroke. The intervention is currently being evaluated in a randomised controlled trial. Further research is needed to test generalisability to other aspects of stroke management and for other chronic diseases. The MRC Framework for complex interventions provides a structured approach to guide the development of novel interventions in public health. Implications for practice in stroke

Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers

PubMed Central

2013-01-01

Background A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda empowers unmarried teenage mothers to cope with the consequences of early pregnancy and motherhood. Since 2000, 1036 unmarried teenage mothers, their parents, and community leaders participated in economic and social empowerment interventions. The present study explored the changes resulting from the TMP as well as factors that either enabled or inhibited these changes. Methods Semi-structured interviews (N = 23) were conducted with former teenage mothers , community leaders, and project implementers, and lifeline histories were obtained from former teenage mothers (N = 9). Quantitative monitoring data regarding demographic and social characteristics of teenage mother participants (N = 1036) were analysed. Results The findings suggest that, overall, the TMP seems to have contributed to the well-being of unmarried teenage mothers and to a supportive social environment. It appears that the project contributed to supportive community norms towards teenage mothers’ position and future opportunities, increased agency, improved coping with early motherhood and stigma, continued education, and increased income generation by teenage mothers. The study findings also suggest limited change in disapproving community norms regarding out-of-wedlock sex and pregnancy, late active enrolment of teenage mothers in the project (i.e., ten months after delivery of the child), and differences in the extent to which parents provided support. Conclusions It is concluded that strengths of the community-based TMP seem to be its socio-ecological approach, the participatory planning with community leaders and other stakeholders, counselling of parents and unmarried teenage mothers, and

Applying Intervention Mapping to Develop a Community-Based Intervention Aimed at Improved Psychological and Social Well-Being of Unmarried Teenage Mothers in Uganda

ERIC Educational Resources Information Center

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

2014-01-01

Out-of-wedlock pregnancy among adolescents in sub-Saharan Africa is a major concern, because of its association with health, social, psychological, economic and demographic factors. This article describes the development of the Teenage Mothers Project, a community-based intervention to improve psychological and social well-being of unmarried…

A study of the influence of protective factors as a resource to African American males in traditional batterers' interventions.

PubMed

Jones, Norma Gray

2002-01-01

The purpose of this study was to examine the relationship between protective factors and the responses of African American males in traditional batterers' interventions. African American male batterers have been viewed as responding poorly to batterers' interventions and were reported in the literature as at risk for dropout and treatment failure. This research proposed that there were culturally related protective factors that enhanced traditional interventions for African American males, increasing their potential for changing abusive behaviors. This within-group study used secondary data to examine the influence of protective factors on the responses of 268 active duty Navy African American males. They were a sub-sample of 861 males randomly assigned to one of four different interventions for batterers. The interventions included a cognitive behavioral men's group, couple's group, safety and stabilization group, and a control group. Each of their cases had been officially substantiated by the Navy for assault of their spouses. The measures for the protective factors of religion, self-esteem, and family support were drawn from the original study's self-report measurement tool. The results of the statistical analyses were found to be significant. The protective factors performed as social controls for reducing certain types of abusive behaviors. Little research has been conducted on the influence of cultural factors on batterers intervention outcome for African Americans. This study established a strong support for further research.

Project SOAR: a training program to increase school counselors' knowledge and confidence regarding suicide prevention and intervention.

PubMed

King, K A; Smith, J

2000-12-01

School counselors are often the lead individuals in school suicide prevention programs. All school counselors in Dallas, Texas, receive training through Project SOAR (Suicide, Options, Awareness, and Relief), a suicide prevention program. This study assessed Dallas school counselors' knowledge of suicidal risk factors and perceived ability to initiate appropriate steps when confronted with a suicidal student. A two-page, 44-item survey was distributed to all Dallas school counselors attending a mandatory meeting in spring 1999. A total of 186 school counselors (75%) responded. Most had been a school counselor for less than 10 years and one-half received initial SOAR training less than four years ago. The majority strongly agreed that they could recognize suicidal warning signs, assess a student's risk for suicide, and offer support to a suicidal student. In addition, most knew the intervention steps to take when a student assessed at high suicidal risk. When compared to school counselors nationwide, these counselors reported increased confidence in identifying students at suicidal risk.

Predictors of completing a primary health care diabetes prevention intervention programme in people at high risk of type 2 diabetes: Experiences of the DE-PLAN project.

PubMed

Gilis-Januszewska, Aleksandra; Lindström, Jaana; Barengo, Noël C; Tuomilehto, Jaakko; Schwarz, Peter Eh; Wójtowicz, Ewa; Piwońska-Solska, Beata; Szybiński, Zbigniew; Windak, Adam; Hubalewska-Dydejczyk, Alicja

2018-02-01

It has been shown that real-life implementation studies for the prevention of type 2 diabetes (DM2) performed in different settings and populations can be effective. However, not enough information is available on factors influencing the reach of DM2 prevention programmes. This study examines the predictors of completing an intervention programme targeted at people at high risk of DM2 in Krakow, Poland as part of the DE-PLAN project.A total of 262 middle-aged people, everyday patients of 9 general practitioners' (GP) practices, at high risk of DM2 (Finnish Diabetes Risk Score (FINDRISK) >14) agreed to participate in the lifestyle intervention to prevent DM2. Intervention consisted of 11 lifestyle counseling sessions, organized physical activity sessions followed by motivational phone calls and letters. Measurements were performed at baseline and 1 year after the initiation of the intervention.Seventy percent of the study participants enrolled completed the core curriculum (n = 184), 22% were men. When compared to noncompleters, completers had a healthier baseline diabetes risk profile (P <.05). People who completed the intervention were less frequently employed versus noncompleters (P = .037), less often had hypertension (P = .043), and more frequently consumed vegetables and fruit daily (P = .055).In multiple logistic regression model, employment reduced the likelihood of completing the intervention 2 times (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.25-0.81). Higher glucose 2 hours after glucose load and hypertension were the independent factors decreasing the chance to participate in the intervention (OR 0.79, 95% 0.69-0.92 and OR 0.52, 95% CI 0.27-0.99, respectively). Daily consumption of vegetables and fruits increased the likelihood of completing the intervention (OR 1.86, 95% 1.01-3.41).In conclusion, people with healthier behavior and risk profile are more predisposed to complete diabetes prevention interventions. Male, those

Parents' evaluation of the IDEFICS intervention: an analysis focussing on socio-economic factors, child's weight status and intervention exposure.

PubMed

Nicholls, S G; Pohlabeln, H; De Bourdeaudhuij, I; Chadjigeorgiou, C; Gwozdz, W; Hebestreit, A; Lauria, F; Lissner, L; Molnár, D; Santaliestra-Pasías, A M; Veidebaum, T; Williams, G

2015-12-01

From April 2008 to August 2010 the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) intervention aimed to encourage healthier diets, higher physical activity levels and lower stress levels among European children and their families. While the intervention was intended to improve children's health, we also wished to assess whether there were unwelcome aspects or negative side-effects. Therefore all parents of children who participated in the IDEFICS intervention were asked for their views on different aspects of the intervention. A total of 10,016 parents of children who participated in the IDEFICS survey and who were involved in the intervention were invited to complete a questionnaire on positive and negative impacts of the intervention. Responses to each of the statements were coded on a four point Likert-type scale. Demographic data were collected as part of the baseline (T0 ) and first follow-up (T1 ) surveys; intervention exposure data was also collected in the T1 follow-up survey. Anthropometric data was collected in the same surveys, and child's weight status was assessed according to Cole and Lobstein. After initial review of the univariate statistics multilevel logistic regression was conducted to analyse the influence of socio-economic factors, child's weight status and intervention exposure on parental responses. In total 4,997 responses were received. Approval rates were high, and few parents reported negative effects. Parents who reported higher levels of exposure to the intervention were more likely to approve of it and were also no more likely to notice negative aspects. Less-educated and lower income parents were more likely to report that the intervention would make a lasting positive difference, but also more likely to report that the intervention had had negative effects. Parents of overweight and obese children were more likely to report negative effects - above all, that 'the

Influence of Risk Factors for Child Disruptive Behavior on Parent Attendance at a Preventive Intervention

ERIC Educational Resources Information Center

Ryan, Sarah M.; Boxmeyer, Caroline L.; Lochman, John E.

2009-01-01

Although preventive interventions that include both parent and child components produce stronger effects on disruptive behavior than child-only interventions, engaging parents in behavioral parent training is a significant challenge. This study examined the effects of specific risk factors for child disruptive behavior on parent attendance in…

Preliminary Effectiveness of Project Impact: A Parent-Mediated Intervention for Children with Autism Spectrum Disorder Delivered in a Community Program

ERIC Educational Resources Information Center

Stadnick, Nicole A.; Stahmer, Aubyn; Brookman-Frazee, Lauren

2015-01-01

This is a pilot study of the effectiveness of Project ImPACT, a parent-mediated intervention for ASD delivered in a community program. The primary aim was to compare child and parent outcomes between the intervention group and a community comparison for 30 young children with ASD at baseline and 12 weeks. The secondary aim was to identify parent…

Effects of people-centred factors on enterprise resource planning implementation project success: empirical evidence from Sri Lanka

NASA Astrophysics Data System (ADS)

Wickramasinghe, Vathsala; Gunawardena, Vathsala

2010-08-01

Extant literature suggests people-centred factors as one of the major areas influencing enterprise resource planning (ERP) implementation project success. Yet, to date, few empirical studies attempted to validate the link between people-centred factors and ERP implementation project success. The purpose of this study is to empirically identify people-centred factors that are critical to ERP implementation projects in Sri Lanka. The study develops and empirically validates a framework for people-centred factors that influence the success of ERP implementation projects. Survey research methodology was used and collected data from 74 ERP implementation projects in Sri Lanka. The people-centred factors of 'project team competence', 'rewards' and 'communication and change' were found to predict significantly the ERP implementation project success.

Individual and School Organizational Factors that Influence Implementation of the PAX Good Behavior Game Intervention.

PubMed

Domitrovich, Celene E; Pas, Elise T; Bradshaw, Catherine P; Becker, Kimberly D; Keperling, Jennifer P; Embry, Dennis D; Ialongo, Nicholas

2015-11-01

Evidence-based interventions are being disseminated broadly in schools across the USA, but the implementation levels achieved in community settings vary considerably. The current study examined the extent to which teacher and school factors were associated with implementation dosage and quality of the PAX Good Behavior Game (PAX GBG), a universal classroom-based preventive intervention designed to improve student social-emotional competence and behavior. Specifically, dosage (i.e., number of games and duration of games) across the school year and quality (i.e., how well the game is delivered) of PAX GBG implementation across four time points in a school year were examined. Hierarchical linear modeling was used to examine the association between teacher-level factors (e.g., demographics, self-reports of personal resources, attitudes toward the intervention, and workplace perceptions) and longitudinal implementation data. We also accounted for school-level factors, including demographic characteristics of the students and ratings of the schools' organizational health. Findings indicated that only a few teacher-level factors were significantly related to variation in implementation. Teacher perceptions (e.g., fit with teaching style, emotional exhaustion) were generally related to dosage, whereas demographic factors (e.g., teachers' age) were related to quality. These findings highlight the importance of school contextual and proximal teacher factors on the implementation of classroom-based programs.

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

PubMed

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

2009-09-01

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

Suboptimal identification of patient-specific risk factors for poor wound healing can be improved by simple interventions.

PubMed

Harris, Lauren S; Luck, Joshua E; Atherton, Rachel R

2017-02-01

Poor wound healing is an important surgical complication. At-risk wounds must be identified early and monitored appropriately. Wound surveillance is frequently inadequate, leading to increased rates of surgical site infections (SSIs). Although the literature demonstrates that risk factor identification reduces SSI rates, no studies have focused on wound management at a junior level. Our study assesses documentation rates of patient-specific risk factors for poor wound healing at a large district general hospital in the UK. It critically evaluates the efficacy of interventions designed to promote surveillance of high-risk wounds. We conducted a full-cycle clinical audit examining medical records of patients undergoing elective surgery over 5 days. Interventions included education of the multidisciplinary team and addition of a Wound Healing Risk Assessment (WHRA) checklist to surgical admissions booklets. This checklist provided a simple stratification tool for at-risk wounds and recommendations for escalation. Prior to interventions, the documentation of patient-specific risk factors ranged from 0·0% to 91·7% (mean 42·6%). Following interventions, this increased to 86·4-95·5% (mean 92·5%), a statistically significant increase of 117·1% (P < 0·01). This study demonstrates that documentation of patient-specific risk factors for poor wound healing is inadequate. We have shown the benefit of introducing interventions to increase risk factor awareness. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Moderating effects of a postdisaster intervention on risk and resilience factors associated with posttraumatic stress disorder in Chinese children.

PubMed

Fu, Christine; Leoutsakos, Jeannie-Marie; Underwood, Carol

2013-12-01

This study is an evaluation of a psychosocial intervention involving child and adolescent survivors of the 2008 Sichuan China earthquake. Sociodemographics, earthquake-related risk exposure, resilience using the Connor-Davidson Resilience Scale, and posttraumatic stress disorder (PTSD) using the UCLA-PTSD Index were collected from 1,988 intervention participants and 2,132 controls. Mean resilience scores and the odds of PTSD did not vary between groups. The independent factors for risk and resilience and the dependent variable, PTSD, in the measurement models between control and intervention groups were equivalent. The structural model of risk and 2 resilience factors on PTSD was examined and found to be unequivalent between groups. In contrast to controls, risk exposure (B = −0.32, p <.001) in the intervention group was negatively associated with PTSD. Rational thinking (B = −0.48, p < .001), a resilience factor, was more negatively associated with PTSD in the intervention group. The second resilience factor explored, self-awareness, was positively associated with PTSD in both groups (B = 0.46 for controls, p < .001, and B = 0.69 for intervention, p < .001). Results highlight the need for more cross-cultural research in resilience theory to develop culturally appropriate interventions and evaluation measures.

Factors Associated with Use of Automated Smoking Cessation Interventions: Findings from the eQuit Study

ERIC Educational Resources Information Center

Balmford, James; Borland, Ron; Benda, Peter; Howard, Steve

2013-01-01

The aim was to better understand structural factors associated with uptake of automated tailored interventions for smoking cessation. In a prospective randomized controlled trial with interventions only offered, not mandated, participants were randomized based on the following: web-based expert system (QuitCoach); text messaging program (onQ);…

Affective and Social Factors in a Project-Based Writing Course

ERIC Educational Resources Information Center

Kathpalia, Sujata Surinder; Heah, Carmel

2011-01-01

Much of the work in academic writing has focused on the cognitive rather than the affective and social aspects involved in project-based writing. Emphasis in past research has been on skills and processes of writing rather than on affective factors such as motivation, attitudes, feelings or social factors involving intrapersonal and interpersonal…

Facilitators and barriers to effective scale-up of an evidence-based multilevel HIV prevention intervention.

PubMed

Kegeles, Susan M; Rebchook, Gregory; Tebbetts, Scott; Arnold, Emily

2015-04-17

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple, it is important to examine processes that occur in the translation of the EBIs into practice that affect successful implementation. The goal of this paper is to examine facilitators and barriers to effective implementation that arose among 72 community-based organizations as they moved into practice a multilevel HIV prevention intervention EBI, the Mpowerment Project, for young gay and bisexual men. CBOs that were implementing the Mpowerment Project participated in this study and were assessed at baseline, and 6-months, 1 year, and 2 years post-baseline. Semi-structured telephone interviews were conducted separately with individuals at each CBO. Study data came from 647 semi-structured interviews and extensive notes and commentaries from technical assistance providers. Framework Analysis guided the analytic process. Barriers and facilitators to implementation was the overarching thematic framework used across all the cases in our analysis. Thirteen themes emerged regarding factors that influence the successful implementation of the MP. These were organized into three overarching themes: HIV Prevention System Factors, Community Factors, and Intervention Factors. The entire HIV Prevention System, including coordinators, supervisors, executive directors, funders, and national HIV prevention policies, all influenced implementation success. Other Prevention System Factors that affected the effective translation of the EBI into practice include Knowledge About Intervention, Belief in the Efficacy of the Intervention, Desire to Change Existing Prevention Approach, Planning for Intervention Before Implementation, Accountability, Appropriateness of Individuals for Coordinator Positions, Evaluation of Intervention, and Organizational Stability. Community Factors included Geography and Sociopolitical Climate. Intervention Factors included Intervention Characteristics and

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

PubMed Central

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

2018-01-01

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

The CHOICE pilot project: Challenges of implementing a combined peer work and shared decision-making programme in an early intervention service.

PubMed

Simmons, Magenta B; Coates, Dominiek; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deborah

2017-12-12

Youth participation is central to early intervention policy and quality frameworks. There is good evidence for peer support (individuals with lived experience helping other consumers) and shared decision making (involving consumers in making decisions about their own care) in adult settings. However, youth programs are rarely tested or described in detail. This report aims to fill this gap by describing a consumer focused intervention in an early intervention service. This paper describes the development process, intervention content and implementation challenges of the Choices about Healthcare Options Informed by Client Experiences and Expectations (CHOICE) Pilot Project. This highly novel and innovative project combined both youth peer work and youth shared decision making. Eight peer workers were employed to deliver an online shared decision-making tool at a youth mental health service in New South Wales, Australia. The intervention development involved best practice principles, including international standards and elements of co-design. The implementation of the peer workforce in the service involved a number of targeted strategies designed to support this new service model. However, several implementation challenges were experienced which resulted in critical learning about how best to deliver these types of interventions. Delivering peer work and shared decision making within an early intervention service is feasible, but not without challenges. Providing adequate detail about interventions and implementation strategies fills a critical gap in the literature. Understanding optimal youth involvement strategies assists others to deliver acceptable and effective services to young people who experience mental ill health. © 2017 John Wiley & Sons Australia, Ltd.

Analyzing the effect of selected control policy measures and sociodemographic factors on alcoholic beverage consumption in Europe within the AMPHORA project: statistical methods.

PubMed

Baccini, Michela; Carreras, Giulia

2014-10-01

This paper describes the methods used to investigate variations in total alcoholic beverage consumption as related to selected control intervention policies and other socioeconomic factors (unplanned factors) within 12 European countries involved in the AMPHORA project. The analysis presented several critical points: presence of missing values, strong correlation among the unplanned factors, long-term waves or trends in both the time series of alcohol consumption and the time series of the main explanatory variables. These difficulties were addressed by implementing a multiple imputation procedure for filling in missing values, then specifying for each country a multiple regression model which accounted for time trend, policy measures and a limited set of unplanned factors, selected in advance on the basis of sociological and statistical considerations are addressed. This approach allowed estimating the "net" effect of the selected control policies on alcohol consumption, but not the association between each unplanned factor and the outcome.

The Health and Sport Engagement (HASE) Intervention and Evaluation Project: protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity.

PubMed

Mansfield, Louise; Anokye, Nana; Fox-Rushby, Julia; Kay, Tess

2015-10-26

Sport is being promoted to raise population levels of physical activity for health. National sport participation policy focuses on complex community provision tailored to diverse local users. Few quality research studies exist that examine the role of community sport interventions in raising physical activity levels and no research to date has examined the costs and cost-effectiveness of such provision. This study is a protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity, the Health and Sport Engagement (HASE) project part of the national Get Healthy Get Active programme led by Sport England. The HASE study is a collaborative partnership between local community sport deliverers and sport and public health researchers. It involves designing, delivering and evaluating community sport interventions. The aim is to engage previously inactive people in sustained sporting activity for 1×30 min a week and to examine associated health and well-being outcomes. The study uses mixed methods. Outcomes (physical activity, health, well-being costs to individuals) will be measured by a series of self-report questionnaires and attendance data and evaluated using interrupted time series analysis controlling for a range of sociodemographic factors. Resource use will be identified and measured using diaries, interviews and records and presented alongside effectiveness data as incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. A longitudinal process evaluation (focus groups, structured observations, in-depth interview methods) will examine the efficacy of the project for achieving its aim using the principles of thematic analysis. The results of this study will be disseminated through peer-reviewed publications, academic conference presentations, Sport England and national public health organisation policy conferences, and practice-based case studies

Intervention Mapping as a Participatory Approach to Developing an HIV prevention Intervention in Rural African American Communities

PubMed Central

Corbie-Smith, Giselle; Akers, Aletha; Blumenthal, Connie; Council, Barbara; Wynn, Mysha; Muhammad, Melvin; Stith, Doris

2011-01-01

Southeastern states are among the hardest hit by the HIV epidemic in this country, and racial disparities in HIV rates are high in this region. This is particularly true in our communities of interest in rural eastern North Carolina. Although most recent efforts to prevent HIV attempt to address multiple contributing factors, we have found few multilevel HIV interventions that have been developed, tailored or tested in rural communities for African Americans. We describe how Project GRACE integrated Intervention Mapping (IM) methodology with community based participatory research (CBPR) principles to develop a multi-level, multi-generational HIV prevention intervention. IM was carried out in a series of steps from review of relevant data through producing program components. Through the IM process, all collaborators agreed that we needed a family-based intervention involving youth and their caregivers. We found that the structured approach of IM can be adapted to incorporate the principles of CBPR. PMID:20528128

Factors that Impact Software Project Success in Offshore Information Technology (IT) Companies

ERIC Educational Resources Information Center

Edara, Venkatarao

2011-01-01

Information technology (IT) projects are unsuccessful at a rate of 65% to 75% per year, in spite of employing the latest technologies and training employees. Although many studies have been conducted on project successes in U.S. companies, there is a lack of research studying the impact of various factors on software project success in offshore IT…

Contractors perspective for critical factors of cost overrun in highway projects of Sindh, Pakistan

NASA Astrophysics Data System (ADS)

Sohu, Samiullah; Abdullah, Abd Halid; Nagapan, Sasitharan; Fattah, Abdul; Ullah, Kaleem; Kumar, Kanesh

2017-10-01

Construction industry of Pakistan is creating a number of opportunities in employment as well as plays a role model for economy development of the country. This construction industry has a serious issue of cost overrun in all construction projects especially in construction of highway projects. Cost overrun is a serious and critical issue in construction of highway projects which gives negative impact to construction practitioners because it is not only cross the approved budget but also approved time of the project. The main objective of this study is to find out critical factors causing cost overrun in highway projects of Sindh according to contractors' perspectives. Deep literature review was carried out and a total of 64 factors of cost overrun were identified. To achieve the objective, a questionnaire was designed and distributed among 16 selected respondents who have more than 20 years of experience in construction of highway projects. The results from analysis found that most critical factors of cost overrun in the order of importance include financial and cash flow difficulties faced by contractor, frequent changes in design, changes in price of materials, poor planning by client, change in scope of project, change in specification of materials and delay in taking decisions. This study will assist contractors to narrow down some of the critical factors that would lead to cost overrun, and therefore be prepared with the ways to mitigate these problems in construction of highway projects of Sindh province.

[RIU project: perceived changes by health agents and professionals after a health intervention in an urban area of socioeconomic disadvantage].

PubMed

Aviñó, Dory; Paredes-Carbonell, Joan J; Peiró-Pérez, Rosana; La Parra Casado, Daniel; Álvarez-Dardet, Carlos

2014-12-01

To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. Raval (Algemesí-Valencia) We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. Women acquired information about health, contraception, pregnancy and heath services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn't incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. RIU increases the capabilities of the participants, their social recognition and improves access and use of health services. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Project on Academic Striving: The Moderation of Stress in the Lives of the Students of an Urban Intermediate School. A Project to Coordinate Research and Environmental Intervention. Final Report. Executive Summary.

ERIC Educational Resources Information Center

Grannis, Joseph C.; Fahs, Mary Ellen

This document summarizes the evaluation of a project that studied social, physical, and academic stress in the lives of students in an inner-city intermediate school and developed interventions to reduce that stress. Over 242 students, most of whom were from low-income families and almost all of whom were black, participated in the project. The…

Using Bayes factors for testing hypotheses about intervention effectiveness in addictions research

PubMed Central

Dienes, Zoltan; Muirhead, Colin; West, Robert

2016-01-01

Abstract Background and Aims It has been proposed that more use should be made of Bayes factors in hypothesis testing in addiction research. Bayes factors are the ratios of the likelihood of a specified hypothesis (e.g. an intervention effect within a given range) to another hypothesis (e.g. no effect). They are particularly important for differentiating lack of strong evidence for an effect and evidence for lack of an effect. This paper reviewed randomized trials reported in Addiction between January and June 2013 to assess how far Bayes factors might improve the interpretation of the data. Methods Seventy‐five effect sizes and their standard errors were extracted from 12 trials. Seventy‐three per cent (n = 55) of these were non‐significant (i.e. P > 0.05). For each non‐significant finding a Bayes factor was calculated using a population effect derived from previous research. In sensitivity analyses, a further two Bayes factors were calculated assuming clinically meaningful and plausible ranges around this population effect. Results Twenty per cent (n = 11) of the non‐significant Bayes factors were < ⅓ and 3.6% (n = 2) were > 3. The other 76.4% (n = 42) of Bayes factors were between ⅓ and 3. Of these, 26 were in the direction of there being an effect (Bayes factor > 1 and < 3); 12 tended to favour the hypothesis of no effect (Bayes factor < 1 and > ⅓); and for four there was no evidence either way (Bayes factor = 1). In sensitivity analyses, 13.3% of Bayes Factors were < ⅓ (n = 20), 62.7% (n = 94) were between ⅓ and 3 and 24.0% (n = 36) were > 3, showing good concordance with the main results. Conclusions Use of Bayes factors when analysing data from randomized trials of interventions in addiction research can provide important information that would lead to more precise conclusions than are obtained typically using currently prevailing methods. PMID:27347846

Study protocol: a cluster randomised controlled trial of a school based fruit and vegetable intervention – Project Tomato

PubMed Central

Kitchen, Meaghan S; Ransley, Joan K; Greenwood, Darren C; Clarke, Graham P; Conner, Mark T; Jupp, Jennifer; Cade, Janet E

2009-01-01

Background The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. Method This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. Discussion A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Trial registration Medical Research Council Registry code G0501297 PMID:19531246

Project IMPACT: a report on barriers and facilitators to sustainability.

PubMed

Blasinsky, Margaret; Goldman, Howard H; Unützer, Jürgen

2006-11-01

Project IMPACT is a collaborative care intervention to assist older adults suffering from major depressive disorder or dysthymia. Qualitative research methods were used to determine the barriers and facilitators to sustaining IMPACT in a primary care setting. Strong evidence supports the program's sustainability, but considerable variation exists in continuation strategies and operationalization across sites. Sustainability depended on the organizations' support of collaborative care models, the availability of staff trained in the intervention, and funding. The intervention's success was the most important sustainability factor, as documented by outcome data and through the "real world" experience of treating patients with this intervention.

A public health framework to translate risk factors related to political violence and war into multi-level preventive interventions.

PubMed

De Jong, Joop T V M

2010-01-01

Political violence, armed conflicts and human rights violations are produced by a variety of political, economic and socio-cultural factors. Conflicts can be analyzed with an interdisciplinary approach to obtain a global understanding of the relative contribution of risk and protective factors. A public health framework was designed to address these risk factors and protective factors. The framework resulted in a matrix that combined primary, secondary and tertiary interventions with their implementation on the levels of the society-at-large, the community, and the family and individual. Subsequently, the risk and protective factors were translated into multi-sectoral, multi-modal and multi-level preventive interventions involving the economy, governance, diplomacy, the military, human rights, agriculture, health, and education. Then the interventions were slotted in their appropriate place in the matrix. The interventions can be applied in an integrative form by international agencies, governments and non-governmental organizations, and molded to meet the requirements of the historic, political-economic and socio-cultural context. The framework maps the complementary fit among the different actors while engaging themselves in preventive, rehabilitative and reconstructive interventions. The framework shows how the economic, diplomatic, political, criminal justice, human rights, military, health and rural development sectors can collaborate to promote peace or prevent the aggravation or continuation of violence. A deeper understanding of the association between risk and protective factors and the developmental pathways of generic, country-specific and culture-specific factors leading to political violence is needed.

Factors influencing physicians' choice of workplace: systematic review of drivers of attrition and policy interventions to address them.

PubMed

El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

2016-12-01

The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians' choice of workplace, and policy interventions for retaining physicians in the public sector. Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Nineteen articles met the inclusion criteria. Six major themes that affected physicians' choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. While factors affecting physicians' choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross-country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector.

Effect of Foster Care on Language Learning at Eight Years: Findings from the Bucharest Early Intervention Project

ERIC Educational Resources Information Center

Windsor, Jennifer; Moraru, Ana; Nelson, Charles A., III.; Fox, Nathan A.; Zeanah, Charles H.

2013-01-01

This study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care.…

Maintaining Perioperative Normothermia: Sustaining an Evidence-Based Practice Improvement Project.

PubMed

Levin, Rona F; Wright, Fay; Pecoraro, Kathleen; Kopec, Wendy

2016-02-01

Unintentional perioperative hypothermia has been shown to cause serious patient complications and, thus, to increase health care costs. In 2009, an evidence-based practice improvement project produced a significant decrease in unintentional perioperative hypothermia in colorectal surgical patients through monitoring of OR ambient room temperature. Project leaders engaged all interdisciplinary stakeholders in the original project, which facilitated the sustainability of the intervention method. An important aspect of sustainability is ongoing monitoring and evaluation of a new intervention method. Therefore, continued evaluation of outcomes of the protocol developed in 2009 was scheduled at specific time points after the initial small test of change with colorectal patients. This article focuses on how attention to sustainability factors during implementation of an improvement project led to the sustainability of a protocol for monitoring OR ambient room temperature with all types of surgical patients five years after the initial project. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

A community based intervention program to enhance neighborhood cohesion: The Learning Families Project in Hong Kong

PubMed Central

Wan, Alice; Kwok, Lit Tung; Pang, Sally; Wang, Xin; Stewart, Sunita M.; Lam, Tai Hing; Chan, Sophia S.

2017-01-01

Background Neighborhood cohesion, which refers to the extent of the connectedness and solidarity among residents in a community or neighborhood, is an important determinant of human health. To enhance neighborhood cohesion, the “Learning Families Project” was developed with a series of intervention programs in Kwun Tong in Hong Kong, a district with low neighborhood cohesion. This project, based on the social ecological model, provided a platform for neighbors to learn, communicate and interact with each other. Methods This quasi-experimental study included two nearby government subsidized low rent housing estates separated by busy main roads. One served as the intervention (Tsui Ping (South) Estate) and one as the control (Shun Tin Estate) estate. The intervention included promotion, resident training and learning programs, embodied by a series of community activities such as talks, day camp, thematic activities and horticulture class. Baseline (before the programs) and follow-up (one year after the programs) surveys were conducted both in the intervention and control estate to assess the impact of the programs on neighborhood cohesion. Results The number of residents who completed both the baseline and follow-up surveys was 502 in the intervention estate and 476 in the control estate. Neighborhood cohesion significantly improved in the intervention group after the programs (Cohen effect size d: 0.15). Compared with the control group, the improvements in closeness of the neighborhood and trust in neighbors were significantly greater in the intervention group (Cohen effect size d: 0.13 and 0.14, respectively). Conclusion This brief intervention program using a quasi-experimental study design increased neighborhood cohesion in a low rent housing estate. Trial registration ClinicalTrials.gov NCT02851667 PMID:28827798

Effect of a participatory ergonomics intervention on psychosocial factors at work in a randomised controlled trial.

PubMed

Haukka, Eija; Pehkonen, Irmeli; Leino-Arjas, Päivi; Viikari-Juntura, Eira; Takala, Esa-Pekka; Malmivaara, Antti; Hopsu, Leila; Mutanen, Pertti; Ketola, Ritva; Virtanen, Tuija; Holtari-Leino, Merja; Nykänen, Jaana; Stenholm, Sari; Ojajärvi, Anneli; Riihimäki, Hilkka

2010-03-01

To study the effect of a participatory ergonomics intervention on psychosocial factors among kitchen workers. A cluster randomised controlled trial. Four cities in Finland, 2002-2005. 504 workers in 119 municipal kitchens. Kitchens were randomised to intervention (n=59) and control (n=60) groups. The intervention lasted 11-14 months and was based on the workers' active participation in work analysis, planning and implementing the ergonomic changes aimed at decreasing the physical and mental workload. Mental stress, mental strenuousness of work, hurry, job satisfaction, job control, skill discretion, co-worker relationships and supervisor support. Data were collected by questionnaire at baseline, at the end of the intervention, and at a 12-month follow-up (PI(12)). At the end of the intervention, the OR of job dissatisfaction for the intervention group as compared with the control group was 3.0 (95% CI 1.1 to 8.5), of mental stress 2.3 (1.2 to 4.7) and of poor co-worker relationships 2.3 (1.0 to 5.2). At the PI(12), the OR of job dissatisfaction was 3.0 (1.2 to 7.8). Analysis of the independent and joint effects of the intervention and unconnected organisational reforms showed that adverse changes were accentuated among those with exposure to both. No favourable effects on psychosocial factors at work were found. The adverse changes were due to a joint effect of the intervention and the unconnected organisational reforms. The findings do not support the usefulness of this kind of intervention in changing unsatisfactory psychosocial working conditions.

Design of the Bottom-up Innovation project - a participatory, primary preventive, organizational level intervention on work-related stress and well-being for workers in Dutch vocational education

PubMed Central

2013-01-01

Background In the educational sector job demands have intensified, while job resources remained the same. A prolonged disbalance between demands and resources contributes to lowered vitality and heightened need for recovery, eventually resulting in burnout, sickness absence and retention problems. Until now stress management interventions in education focused mostly on strengthening the individual capacity to cope with stress, instead of altering the sources of stress at work at the organizational level. These interventions have been only partly effective in influencing burnout and well-being. Therefore, the “Bottom-up Innovation” project tests a two-phased participatory, primary preventive organizational level intervention (i.e. a participatory action approach) that targets and engages all workers in the primary process of schools. It is hypothesized that participating in the project results in increased occupational self-efficacy and organizational efficacy. The central research question: is an organization focused stress management intervention based on participatory action effective in reducing the need for recovery and enhancing vitality in school employees in comparison to business as usual? Methods/Design The study is designed as a controlled trial with mixed methods and three measurement moments: baseline (quantitative measures), six months and 18 months (quantitative and qualitative measures). At first follow-up short term effects of taking part in the needs assessment (phase 1) will be determined. At second follow-up the long term effects of taking part in the needs assessment will be determined as well as the effects of implemented tailored workplace solutions (phase 2). A process evaluation based on quantitative and qualitative data will shed light on whether, how and why the intervention (does not) work(s). Discussion “Bottom-up Innovation” is a combined effort of the educational sector, intervention providers and researchers. Results will

Design of the Bottom-up Innovation project--a participatory, primary preventive, organizational level intervention on work-related stress and well-being for workers in Dutch vocational education.

PubMed

Schelvis, Roosmarijn M C; Oude Hengel, Karen M; Wiezer, Noortje M; Blatter, Birgitte M; van Genabeek, Joost A G M; Bohlmeijer, Ernst T; van der Beek, Allard J

2013-08-15

In the educational sector job demands have intensified, while job resources remained the same. A prolonged disbalance between demands and resources contributes to lowered vitality and heightened need for recovery, eventually resulting in burnout, sickness absence and retention problems. Until now stress management interventions in education focused mostly on strengthening the individual capacity to cope with stress, instead of altering the sources of stress at work at the organizational level. These interventions have been only partly effective in influencing burnout and well-being. Therefore, the "Bottom-up Innovation" project tests a two-phased participatory, primary preventive organizational level intervention (i.e. a participatory action approach) that targets and engages all workers in the primary process of schools. It is hypothesized that participating in the project results in increased occupational self-efficacy and organizational efficacy. The central research question: is an organization focused stress management intervention based on participatory action effective in reducing the need for recovery and enhancing vitality in school employees in comparison to business as usual? The study is designed as a controlled trial with mixed methods and three measurement moments: baseline (quantitative measures), six months and 18 months (quantitative and qualitative measures). At first follow-up short term effects of taking part in the needs assessment (phase 1) will be determined. At second follow-up the long term effects of taking part in the needs assessment will be determined as well as the effects of implemented tailored workplace solutions (phase 2). A process evaluation based on quantitative and qualitative data will shed light on whether, how and why the intervention (does not) work(s). "Bottom-up Innovation" is a combined effort of the educational sector, intervention providers and researchers. Results will provide insight into (1) the relation between

Challenging logics of complex intervention trials: community perspectives of a health care improvement intervention in rural Uganda.

PubMed

Okwaro, Ferdinand M; Chandler, Clare I R; Hutchinson, Eleanor; Nabirye, Christine; Taaka, Lilian; Kayendeke, Miriam; Nayiga, Susan; Staedke, Sarah G

2015-04-01

Health systems in many African countries are failing to provide populations with access to good quality health care. Morbidity and mortality from curable diseases such as malaria remain high. The PRIME trial in Tororo, rural Uganda, designed and tested an intervention to improve care at health centres, with the aim of reducing ill-health due to malaria in surrounding communities. This paper presents the impact and context of this trial from the perspective of community members in the study area. Fieldwork was carried out for a year from the start of the intervention in June 2011, and involved informal observation and discussions as well as 13 focus group discussions with community members, 10 in-depth interviews with local stakeholders, and 162 context descriptions recorded through quarterly interviews with community members, health workers and district officials. Community members observed a small improvement in quality of care at most, but not all, intervention health centres. However, this was diluted by other shortfalls in health services beyond the scope of the intervention. Patients continued to seek care at health centres they considered inadequate as well as positioning themselves and their children to access care through other sources such as research and nongovernmental organization (NGO) projects. These findings point to challenges of designing and delivering interventions within a paradigm that requires factorial (reduced to predictable factors) problem definition with easily actionable and evaluable solutions by small-scale projects. Such requirements mean that interventions often work on the periphery of a health system rather than tackling the murky political and economic realities that shape access to care but are harder to change or evaluate with randomized controlled trials. Highly projectified settings further reduce the ability to genuinely 'control' for different health care access scenarios. We argue for a raised consciousness of how

Patterns of protective factors in an intervention for the prevention of suicide and alcohol abuse with Yup'ik Alaska Native youth.

PubMed

Henry, David; Allen, James; Fok, Carlotta Ching Ting; Rasmus, Stacy; Charles, Bill

2012-09-01

Community-based participatory research (CBPR) with American Indian and Alaska Native communities creates distinct interventions, complicating cross-setting comparisons. The objective of this study is to develop a method for quantifying intervention exposure in CBPR interventions that differ in their forms across communities, permitting multi-site evaluation. Attendance data from 195 youth from three Yup'ik communities were coded for the specific protective factor exposure of each youth, based on information from the intervention manual. The coded attendance data were then submitted to latent class analysis to obtain participation patterns. Five patterns of exposure to protective factors were obtained: Internal, External, Limits, Community/family, and Low Protection. Patterns differed significantly by community and youth age. Standardizing interventions by the functions an intervention serves (protective factors promoted) instead of their forms or components (specific activities) can assist in refining CBPR interventions and evaluating effects in culturally distinct settings.

Case Study in Ethics of Research: The Bucharest Early Intervention Project

PubMed Central

Zeanah, Charles H.; Fox, Nathan A.; Nelson, Charles A.

2014-01-01

The Bucharest Early Intervention Project is the first ever randomized controlled trial of foster care as an alternative to institutional care for young abandoned children. This paper examines ethical issues in the conceptualization and implementation of the study, which involved American investigators conducting research in another country, as well as vulnerable participants. We organize discussion of ethical questions about the study around several key issues. These include the nature and location of the vulnerable study population, the social value of conducting the study, risks and benefits of participating in the study to participants, and the post-trial obligations of the investigators. In discussing how these questions were addressed as the study was designed and after it was initiated, we describe our attempts to wed sound scientific practices with meaningful ethical protections for participants. PMID:22373763

Developing and implementing a positive behavioral reinforcement intervention in prison-based drug treatment: Project BRITE.

PubMed

Burdon, William M; St De Lore, Jef; Prendergast, Michael L

2011-09-01

Within prison settings, the reliance on punishment for controlling inappropriate or noncompliant behavior is self-evident. What is not so evident is the similarity between this reliance on punishment and the use of positive reinforcements to increase desired behaviors. However, seldom do inmates receive positive reinforcement for engaging in prosocial behaviors or, for inmates receiving drug treatment, behaviors that are consistent with or support their recovery. This study provides an overview of the development and implementation of a positive behavioral reinforcement intervention in male and female prison-based drug treatment programs. The active involvement of institutional staff, treatment staff, and inmates enrolled in the treatment programs in the development of the intervention along with the successful branding of the intervention were effective at promoting support and participation. However, these factors may also have ultimately impacted the ability of the randomized design to reliably demonstrate the effectiveness of the intervention.

Modifying pro-drug risk factors in adolescents: results from project ALERT.

PubMed

Ghosh-Dastidar, Bonnie; Longshore, Douglas L; Ellickson, Phyllis L; McCaffrey, Daniel F

2004-06-01

The objective of this study was to evaluate the impact of a revised state-of-the-art drug prevention program, Project ALERT, on risk factors for drug use in mostly rural midwestern schools and communities. Fifty-five middle schools from South Dakota were randomly assigned to treatment or control conditions. Treatment-group students received 11 lessons in Grade 7 and 3 more in Grade 8. Effects for 4276 eighth graders were assessed 18 months after baseline. Results indicate that Project ALERT had statistically significant effects on all the targeted risk factors associated with cigarette and marijuana use and more modest gains with the pro-alcohol risk factors. The program helped adolescents at low, moderate, and high risk for future use, with the effect sizes typically stronger for the low- and moderate-risk groups. Thus, school-based drug prevention programs can lower risk factors that correlate with drug use, help low- to high-risk adolescents, and be effective in diverse school environments.

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

PubMed

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

2014-08-01

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

Long-term multiple risk factor interventions in Japanese elderly diabetic patients: the Japanese Elderly Diabetes Intervention Trial--study design, baseline characteristics and effects of intervention.

PubMed

Araki, Atsushi; Iimuro, Satoshi; Sakurai, Takashi; Umegaki, Hiroyuki; Iijima, Katsuya; Nakano, Hiroshi; Oba, Kenzo; Yokono, Koichi; Sone, Hirohito; Yamada, Nobuhiro; Ako, Junya; Kozaki, Koichi; Miura, Hisayuki; Kashiwagi, Atsunori; Kikkawa, Ryuichi; Yoshimura, Yukio; Nakano, Tadasumi; Ohashi, Yasuo; Ito, Hideki

2012-04-01

To evaluate long-term, multiple risk factor intervention on physical, psychological and mental prognosis, and development of complications and cardiovascular disease in elderly type 2 diabetes patients. Our randomized, controlled, multicenter, prospective intervention trial included 1173 elderly type 2 diabetes patients who were enrolled from 39 Japanese institutions and randomized to an intensive or conservative treatment group. Glycemic control, dyslipidemia, hypertension, obesity, diabetic complications and atherosclerotic disease were measured annually. Instrumental activity of daily living, cognitive impairment, depressive symptoms and diabetes burden were assessed at baseline and 3 years. There was no significant difference in clinical or cognitive parameters at baseline between the two groups. The prevalence of low activities of daily living, depressive symptoms and cognitive impairment was 13%, 28% and 4%, respectively, and was similar in the two groups. A small, but significant difference in HbA1c between the two groups was observed at 1 year after the start of intervention (7.9% vs 8.1%, P < 0.05), although this significant difference was not observed after the second year. With the exception of coronary revascularization, there was no significant difference in fatal or non-fatal events between the two groups. Composite events were also similar in the two groups. This study showed no significant differences in fatal or non-fatal events between intensive and conventional treatment. The present study might clarify whether treatment of risk factors influences function and quality of life in elderly diabetic patients. © 2012 Japan Geriatrics Society.

Protocol for project IMPACT (improving millions hearts for provider and community transformation): a quasi-experimental evaluation of an integrated electronic health record and community health worker intervention study to improve hypertension management among South Asian patients.

PubMed

Lopez, Priscilla M; Zanowiak, Jennifer; Goldfeld, Keith; Wyka, Katarzyna; Masoud, Ahmad; Beane, Susan; Kumar, Rashi; Laughlin, Phoebe; Trinh-Shevrin, Chau; Thorpe, Lorna; Islam, Nadia

2017-12-06

The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building upon this initiative, we present the protocol and preliminary results of a research study, Project IMPACT, designed to fill this gap in knowledge. Project IMPACT is a stepped wedge quasi-experimental study designed to test the feasibility, adoption, and impact of integrating CHW-led health coaching with electronic health record (EHR)-based interventions to improve hypertension control among South Asian patients in New York City primary care practices. EHR intervention components include the training and implementation of hypertension-specific registry reports, alerts, and order sets. Fidelity to the EHR intervention is assessed by collecting the type, frequency, and utilization of intervention components for each practice. CHW intervention components consist of health coaching sessions on hypertension and related risk factors for uncontrolled hypertensive patients. The outcome, hypertension control (<140 mmHg systolic blood pressure (BP) and <90 mmHg diastolic BP), is collected at the aggregate- and individual-level for all 16 clinical practices enrolled. Project IMPACT builds upon the evidence base of the effectiveness of CHW and Million Hearts® initiatives and proposes a unique integration of provider-based EHR and community-based CHW

Cardiorespiratory fitness, cardiovascular workload and risk factors among cleaners; a cluster randomized worksite intervention.

PubMed

Korshøj, Mette; Krustrup, Peter; Jørgensen, Marie Birk; Prescott, Eva; Hansen, Åse Marie; Kristiansen, Jesper; Skotte, Jørgen Henrik; Mortensen, Ole Steen; Søgaard, Karen; Holtermann, Andreas

2012-08-13

Prevalence of cardiovascular risk factors is unevenly distributed among occupational groups. The working environment, as well as lifestyle and socioeconomic status contribute to the disparity and variation in prevalence of these risk factors. High physical work demands have been shown to increase the risk for cardiovascular disease and mortality, contrary to leisure time physical activity. High physical work demands in combination with a low cardiorespiratory fitness infer a high relative workload and an excessive risk for cardiovascular mortality. Therefore, the aim of this study is to examine whether a worksite aerobic exercise intervention will reduce the relative workload and cardiovascular risk factors by an increased cardiorespiratory fitness. A cluster-randomized controlled trial is performed to evaluate the effect of the worksite aerobic exercise intervention on cardiorespiratory fitness and cardiovascular risk factors among cleaners. Cleaners are eligible if they are employed ≥ 20 hours/week, at one of the enrolled companies. In the randomization, strata are formed according to the manager the participant reports to. The clusters will be balanced on the following criteria: Geographical work location, gender, age and seniority. Cleaners are randomized to either I) a reference group, receiving lectures concerning healthy living, or II) an intervention group, performing worksite aerobic exercise "60 min per week". Data collection will be conducted at baseline, four months and 12 months after baseline, at the worksite during working hours. The data collection will consist of a questionnaire-based interview, physiological testing of health and capacity-related measures, and objective diurnal measures of heart rate, physical activity and blood pressure. Primary outcome is cardiorespiratory fitness. Information is lacking about whether an improved cardiorespiratory fitness will affect the cardiovascular health, and additionally decrease the objectively

Methods of dietary and nutritional assessment and intervention and other methods in the Multiple Risk Factor Intervention Trial.

PubMed

Dolecek, T A; Stamler, J; Caggiula, A W; Tillotson, J L; Buzzard, I M

1997-01-01

Various dietary assessment instruments were used in the Multiple Risk Factor Intervention Trial (MRFIT), either to assist with the special intervention program or to assess trial outcomes. For the latter purpose, the 24-h recall was the main method and was selected with the understanding that the single recall collected at baseline and at most annual visits--considered by itself--would be useful mainly for assessing groups rather than individuals. Major components of the data collection and analysis system developed for the 24-h recall included central training and certification of nutritionists, a central nutrient coding system, and a food grouping system to assist interventionists in using recall data for counseling. Several additional nutritional assessment methods were used for men in the special intervention group only to assist them in attaining the dietary goals. These goals consisted chiefly of reduced intake of saturated fat and cholesterol and a modest increase in intake of polyunsaturated fat; total fat intake was also decreased, primarily for control of energy intake. Short-term success at attainment of these nutritional goals was evaluated by means of 3-d food records collected before the intervention and after the initial 10-wk intensive intervention period. The MRFIT nutrient goals, which became more vigorous at certain points in the trial, were translated into food patterns. Adherence to these food patterns was also assessed by scoring of 3-d records and by subjective evaluation by nutritionists throughout the trial. Methods of collecting other trial data are also described in this chapter.

Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

PubMed Central

El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

2016-01-01

Objectives The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians’ choice of workplace, and policy interventions for retaining physicians in the public sector. Methods Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Results Nineteen articles met the inclusion criteria. Six major themes that affected physicians’ choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. Conclusion While factors affecting physicians’ choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross–country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public

Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project.

PubMed

Skoien, Wade; Page, Katie; Parsonage, William; Ashover, Sarah; Milburn, Tanya; Cullen, Louise

2016-10-12

The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. The overwhelmingly positive response suggests that it

A projection operator method for the analysis of magnetic neutron form factors

NASA Astrophysics Data System (ADS)

Kaprzyk, S.; Van Laar, B.; Maniawski, F.

1981-03-01

A set of projection operators in matrix form has been derived on the basis of decomposition of the spin density into a series of fully symmetrized cubic harmonics. This set of projection operators allows a formulation of the Fourier analysis of magnetic form factors in a convenient way. The presented method is capable of checking the validity of various theoretical models used for spin density analysis up to now. The general formalism is worked out in explicit form for the fcc and bcc structures and deals with that part of spin density which is contained within the sphere inscribed in the Wigner-Seitz cell. This projection operator method has been tested on the magnetic form factors of nickel and iron.

Causes and remedies for the dominant risk factors in Enterprise System implementation projects: the consultants' perspective.

PubMed

Lech, Przemysław

2016-01-01

The purpose of this research was to investigate the causes of the dominant risk factors, affecting Enterprise System implementation projects and propose remedies for those risk factors from the perspective of implementation consultants. The study used a qualitative research strategy, based on e-mail interviews, semi-structured personal interviews with consultants and participant observation during implementation projects. The main contribution of this paper is that it offers viable indications of how to mitigate the dominant risk factors. These indications were grouped into the following categories: stable project scope, smooth communication supported by the project management, dedicated, competent and decision-making client team, competent and engaged consultant project manager, schedule and budget consistent with the project scope, use of methodology and procedures, enforced and enabled by the project managers, competent and dedicated consultants. A detailed description is provided for each category.

Factors Influencing Team Behaviors in Surgery: A Qualitative Study to Inform Teamwork Interventions.

PubMed

Aveling, Emma-Louise; Stone, Juliana; Sundt, Thoralf; Wright, Cameron; Gino, Francesca; Singer, Sara

2018-07-01

Surgical excellence demands teamwork. Poor team behaviors negatively affect team performance and are associated with adverse events and worse outcomes. Interventions to improve surgical teamwork focusing on frontline team members' nontechnical skills have proliferated but shown mixed results. Literature on teamwork in organizations suggests that team behaviors are also contingent on psychosocial, cultural, and organizational factors. This study examined factors influencing surgical team behaviors to inform more contextually sensitive and effective approaches to optimizing surgical teamwork. This qualitative study of cardiac surgical teams in a large United States teaching hospital included 34 semistructured interviews. Thematic network analysis was used to examine perceptions of ideal teamwork and factors influencing team behaviors in the operating room. Perceptions of ideal teamwork were largely shared, but team members held discrepant views of which team and leadership behaviors enhanced or undermined teamwork. Other factors affecting team behaviors were related to the local organizational culture, including management of staff behavior, variable case demands, and team members' technical competence, and fitness of organizational structures and processes to support teamwork. These factors affected perceptions of what constituted optimal interpersonal and team behaviors in the operating room. Team behaviors are contextually contingent and organizationally determined, and beliefs about optimal behaviors are not necessarily shared. Interventions to optimize surgical teamwork require establishing consensus regarding best practice, ability to adapt as circumstances require, and organizational commitment to addressing contextual factors that affect teams. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders.

PubMed

McLean, Siân A; Wertheim, Eleanor H; Masters, Jennifer; Paxton, Susan J

2017-07-01

This pilot study investigated the effectiveness of a social media literacy intervention for adolescent girls on risk factors for eating disorders. A quasi-experimental pre- to post-test design comparing intervention and control conditions was used. Participants were 101 adolescent girls (M age  = 13.13, SD = 0.33) who were allocated to receive three social media literacy intervention lessons (n = 64) or to receive classes as usual (n = 37). Self-report assessments of eating disorder risk factors were completed one week prior to, and one week following the intervention. Significant group by time interaction effects revealed improvements in the intervention condition relative to the control condition for body image (body esteem-weight; d = .19), disordered eating (dietary restraint; d = .26) and media literacy (realism scepticism; d = .32). The outcomes of this pilot study suggest that social media literacy is a potentially useful approach for prevention of risk for eating disorders in adolescent girls in the current social media environment of heightened vulnerability. Replication of this research with larger, randomized controlled trials, and longer follow-up is needed. © 2017 Wiley Periodicals, Inc.

Discriminant projective non-negative matrix factorization.

PubMed

Guan, Naiyang; Zhang, Xiang; Luo, Zhigang; Tao, Dacheng; Yang, Xuejun

2013-01-01

Projective non-negative matrix factorization (PNMF) projects high-dimensional non-negative examples X onto a lower-dimensional subspace spanned by a non-negative basis W and considers W(T) X as their coefficients, i.e., X≈WW(T) X. Since PNMF learns the natural parts-based representation Wof X, it has been widely used in many fields such as pattern recognition and computer vision. However, PNMF does not perform well in classification tasks because it completely ignores the label information of the dataset. This paper proposes a Discriminant PNMF method (DPNMF) to overcome this deficiency. In particular, DPNMF exploits Fisher's criterion to PNMF for utilizing the label information. Similar to PNMF, DPNMF learns a single non-negative basis matrix and needs less computational burden than NMF. In contrast to PNMF, DPNMF maximizes the distance between centers of any two classes of examples meanwhile minimizes the distance between any two examples of the same class in the lower-dimensional subspace and thus has more discriminant power. We develop a multiplicative update rule to solve DPNMF and prove its convergence. Experimental results on four popular face image datasets confirm its effectiveness comparing with the representative NMF and PNMF algorithms.

Discriminant Projective Non-Negative Matrix Factorization

PubMed Central

Guan, Naiyang; Zhang, Xiang; Luo, Zhigang; Tao, Dacheng; Yang, Xuejun

2013-01-01

Projective non-negative matrix factorization (PNMF) projects high-dimensional non-negative examples X onto a lower-dimensional subspace spanned by a non-negative basis W and considers WT X as their coefficients, i.e., X≈WWT X. Since PNMF learns the natural parts-based representation Wof X, it has been widely used in many fields such as pattern recognition and computer vision. However, PNMF does not perform well in classification tasks because it completely ignores the label information of the dataset. This paper proposes a Discriminant PNMF method (DPNMF) to overcome this deficiency. In particular, DPNMF exploits Fisher's criterion to PNMF for utilizing the label information. Similar to PNMF, DPNMF learns a single non-negative basis matrix and needs less computational burden than NMF. In contrast to PNMF, DPNMF maximizes the distance between centers of any two classes of examples meanwhile minimizes the distance between any two examples of the same class in the lower-dimensional subspace and thus has more discriminant power. We develop a multiplicative update rule to solve DPNMF and prove its convergence. Experimental results on four popular face image datasets confirm its effectiveness comparing with the representative NMF and PNMF algorithms. PMID:24376680

Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes

PubMed Central

Hammer, Leslie B.; Truxillo, Donald M.; Bodner, Todd; Rineer, Jennifer; Pytlovany, Amy C.; Richman, Amy

2015-01-01

The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based), followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety. PMID:26557703

Participation in physical play and leisure: developing a theory- and evidence-based intervention for children with motor impairments

PubMed Central

2011-01-01

Background Children with motor impairments (e.g. difficulties with motor control, muscle tone or balance) experience significant difficulties in participating in physical play and leisure. Current interventions are often poorly defined, lack explicit hypotheses about why or how they might work, and have insufficient evidence about effectiveness. This project will identify (i) the 'key ingredients' of an effective intervention to increase participation in physical play and leisure in children with motor impairments; and (ii) how these ingredients can be combined in a feasible and acceptable intervention. Methods/Design The project draws on the WHO International Classification of Functioning, Disability and Health and the UK Medical Research Council guidance for developing 'complex interventions'. There will be five steps: 1) identifying biomedical, personal and environmental factors proposed to predict children's participation in physical play and leisure; 2) developing an explicit model of the key predictors; 3) selecting intervention strategies to target the predictors, and specifying the pathways to change; 4) operationalising the strategies in a feasible and acceptable intervention; and 5) modelling the intervention processes and outcomes within single cases. Discussion The primary output from this project will be a detailed protocol for an intervention. The intervention, if subsequently found to be effective, will support children with motor difficulties to attain life-long well-being and participation in society. The project will also be an exemplar of methodology for a systematic development of non-drug interventions for children. PMID:22061203

Participation in physical play and leisure: developing a theory- and evidence-based intervention for children with motor impairments.

PubMed

Kolehmainen, Niina; Francis, Jillian J; Ramsay, Craig R; Owen, Christine; McKee, Lorna; Ketelaar, Marjolijn; Rosenbaum, Peter

2011-11-07

Children with motor impairments (e.g. difficulties with motor control, muscle tone or balance) experience significant difficulties in participating in physical play and leisure. Current interventions are often poorly defined, lack explicit hypotheses about why or how they might work, and have insufficient evidence about effectiveness. This project will identify (i) the 'key ingredients' of an effective intervention to increase participation in physical play and leisure in children with motor impairments; and (ii) how these ingredients can be combined in a feasible and acceptable intervention. The project draws on the WHO International Classification of Functioning, Disability and Health and the UK Medical Research Council guidance for developing 'complex interventions'. There will be five steps: 1) identifying biomedical, personal and environmental factors proposed to predict children's participation in physical play and leisure; 2) developing an explicit model of the key predictors; 3) selecting intervention strategies to target the predictors, and specifying the pathways to change; 4) operationalising the strategies in a feasible and acceptable intervention; and 5) modelling the intervention processes and outcomes within single cases. The primary output from this project will be a detailed protocol for an intervention. The intervention, if subsequently found to be effective, will support children with motor difficulties to attain life-long well-being and participation in society. The project will also be an exemplar of methodology for a systematic development of non-drug interventions for children.

Optimizing Benefits of Influenza Virus Vaccination during Pregnancy: Potential Behavioral Risk Factors and Interventions

PubMed Central

Christian, Lisa M.

2014-01-01

Pregnant women and infants are at high risk for complications, hospitalization, and death due to influenza. It is well-established that influenza vaccination during pregnancy reduces rates and severity of illness in women overall. Maternal vaccination also confers antibody protection to infants via both transplacental transfer and breast milk. However, as in the general population, a relatively high proportion of pregnant women and their infants do not achieve protective antibody levels against influenza virus following maternal vaccination. Behavioral factors, particularly maternal weight and stress exposure, may affect initial maternal antibody responses, maintenance of antibody levels over time (i.e., across pregnancy), as well as the efficiency of transplacental antibody transfer to the fetus. Conversely, behavioral interventions including acute exercise and stress reduction can enhance immune protection following vaccination. Such behavioral interventions are particularly appealing in pregnancy because they are safe and non-invasive. The identification of individual risk factors for poor responses to vaccines and the application of appropriate interventions represent important steps towards personalized health care. PMID:24709586

Developing and Implementing a Positive Behavioral Reinforcement Intervention in Prison-Based Drug Treatment: Project BRITE

PubMed Central

Burdon, William M.; De Lore, Jef St.; Prendergast, Michael L.

2012-01-01

Within prison settings, the reliance on punishment for controlling inappropriate or non-compliant behavior is self-evident. What is not so evident is the similarity between this reliance on punishment and the use of positive reinforcements to increase desired behaviors. However, seldom do inmates receive positive reinforcement for engaging in prosocial behaviors or, for inmates receiving drug treatment, behaviors that are consistent with or support their recovery. This study provides an overview of the development and implementation of a positive behavioral reinforcement intervention in male and female prison-based drug treatment programs. The active involvement of institutional staff, treatment staff, and inmates enrolled in the treatment programs in the development of the intervention along with the successful branding of the intervention were effective at promoting support and participation. However, these factors may also have ultimately impacted the ability of the randomized design to reliably demonstrate the effectiveness of the intervention. PMID:22185038

Factors Associated with Choice of Web or Print Intervention Materials in the Healthy Directions 2 Study

ERIC Educational Resources Information Center

Greaney, Mary L.; Puleo, Elaine; Bennett, Gary G.; Haines, Jess; Viswanath, K.; Gillman, Matthew W.; Sprunck-Harrild, Kim; Coeling, Molly; Rusinak, Donna; Emmons, Karen M.

2014-01-01

Background: Many U.S. adults have multiple behavioral risk factors, and effective, scalable interventions are needed to promote population-level health. In the health care setting, interventions are often provided in print, although accessible to nearly everyone, are brief (e.g., pamphlets), are not interactive, and can require some logistics…

Defining the Relationship Between Human Error Classes and Technology Intervention Strategies

NASA Technical Reports Server (NTRS)

Wiegmann, Douglas A.; Rantanen, Esa; Crisp, Vicki K. (Technical Monitor)

2002-01-01

One of the main factors in all aviation accidents is human error. The NASA Aviation Safety Program (AvSP), therefore, has identified several human-factors safety technologies to address this issue. Some technologies directly address human error either by attempting to reduce the occurrence of errors or by mitigating the negative consequences of errors. However, new technologies and system changes may also introduce new error opportunities or even induce different types of errors. Consequently, a thorough understanding of the relationship between error classes and technology "fixes" is crucial for the evaluation of intervention strategies outlined in the AvSP, so that resources can be effectively directed to maximize the benefit to flight safety. The purpose of the present project, therefore, was to examine the repositories of human factors data to identify the possible relationship between different error class and technology intervention strategies. The first phase of the project, which is summarized here, involved the development of prototype data structures or matrices that map errors onto "fixes" (and vice versa), with the hope of facilitating the development of standards for evaluating safety products. Possible follow-on phases of this project are also discussed. These additional efforts include a thorough and detailed review of the literature to fill in the data matrix and the construction of a complete database and standards checklists.

Nonnegative Matrix Factorization for Efficient Hyperspectral Image Projection

NASA Technical Reports Server (NTRS)

Iacchetta, Alexander S.; Fienup, James R.; Leisawitz, David T.; Bolcar, Matthew R.

2015-01-01

Hyperspectral imaging for remote sensing has prompted development of hyperspectral image projectors that can be used to characterize hyperspectral imaging cameras and techniques in the lab. One such emerging astronomical hyperspectral imaging technique is wide-field double-Fourier interferometry. NASA's current, state-of-the-art, Wide-field Imaging Interferometry Testbed (WIIT) uses a Calibrated Hyperspectral Image Projector (CHIP) to generate test scenes and provide a more complete understanding of wide-field double-Fourier interferometry. Given enough time, the CHIP is capable of projecting scenes with astronomically realistic spatial and spectral complexity. However, this would require a very lengthy data collection process. For accurate but time-efficient projection of complicated hyperspectral images with the CHIP, the field must be decomposed both spectrally and spatially in a way that provides a favorable trade-off between accurately projecting the hyperspectral image and the time required for data collection. We apply nonnegative matrix factorization (NMF) to decompose hyperspectral astronomical datacubes into eigenspectra and eigenimages that allow time-efficient projection with the CHIP. Included is a brief analysis of NMF parameters that affect accuracy, including the number of eigenspectra and eigenimages used to approximate the hyperspectral image to be projected. For the chosen field, the normalized mean squared synthesis error is under 0.01 with just 8 eigenspectra. NMF of hyperspectral astronomical fields better utilizes the CHIP's capabilities, providing time-efficient and accurate representations of astronomical scenes to be imaged with the WIIT.

Evaluating Temporal Factors in Combined Interventions of Workforce Shift and School Closure for Mitigating the Spread of Influenza

PubMed Central

Zhang, Tianyou; Fu, Xiuju; Ma, Stefan; Xiao, Gaoxi; Wong, Limsoon; Kwoh, Chee Keong; Lees, Michael; Lee, Gary Kee Khoon; Hung, Terence

2012-01-01

Background It is believed that combined interventions may be more effective than individual interventions in mitigating epidemic. However there is a lack of quantitative studies on performance of the combination of individual interventions under different temporal settings. Methodology/Principal Findings To better understand the problem, we develop an individual-based simulation model running on top of contact networks based on real-life contact data in Singapore. We model and evaluate the spread of influenza epidemic with intervention strategies of workforce shift and its combination with school closure, and examine the impacts of temporal factors, namely the trigger threshold and the duration of an intervention. By comparing simulation results for intervention scenarios with different temporal factors, we find that combined interventions do not always outperform individual interventions and are more effective only when the duration is longer than 6 weeks or school closure is triggered at the 5% threshold; combined interventions may be more effective if school closure starts first when the duration is less than 4 weeks or workforce shift starts first when the duration is longer than 4 weeks. Conclusions/Significance We therefore conclude that identifying the appropriate timing configuration is crucial for achieving optimal or near optimal performance in mitigating the spread of influenza epidemic. The results of this study are useful to policy makers in deliberating and planning individual and combined interventions. PMID:22403634

Using Bayes factors for testing hypotheses about intervention effectiveness in addictions research.

PubMed

Beard, Emma; Dienes, Zoltan; Muirhead, Colin; West, Robert

2016-12-01

It has been proposed that more use should be made of Bayes factors in hypothesis testing in addiction research. Bayes factors are the ratios of the likelihood of a specified hypothesis (e.g. an intervention effect within a given range) to another hypothesis (e.g. no effect). They are particularly important for differentiating lack of strong evidence for an effect and evidence for lack of an effect. This paper reviewed randomized trials reported in Addiction between January and June 2013 to assess how far Bayes factors might improve the interpretation of the data. Seventy-five effect sizes and their standard errors were extracted from 12 trials. Seventy-three per cent (n = 55) of these were non-significant (i.e. P > 0.05). For each non-significant finding a Bayes factor was calculated using a population effect derived from previous research. In sensitivity analyses, a further two Bayes factors were calculated assuming clinically meaningful and plausible ranges around this population effect. Twenty per cent (n = 11) of the non-significant Bayes factors were < ⅓ and 3.6% (n = 2) were > 3. The other 76.4% (n = 42) of Bayes factors were between ⅓ and 3. Of these, 26 were in the direction of there being an effect (Bayes factor > 1 and < 3); 12 tended to favour the hypothesis of no effect (Bayes factor < 1 and > ⅓); and for four there was no evidence either way (Bayes factor = 1). In sensitivity analyses, 13.3% of Bayes Factors were < ⅓ (n = 20), 62.7% (n = 94) were between ⅓ and 3 and 24.0% (n = 36) were > 3, showing good concordance with the main results. Use of Bayes factors when analysing data from randomized trials of interventions in addiction research can provide important information that would lead to more precise conclusions than are obtained typically using currently prevailing methods. © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Factors of human capital related to project success in health care work units.

PubMed

Suhonen, Marjo; Paasivaara, Leena

2011-03-01

To explore factors of human capital related to project success that employees expect from nurse managers. Human capital refers to those resources that managers working with projects possess, such as abilities, knowledge and qualities of character. The data were collected by open interviews (n=14) with nurses, public health nurses and nurse managers working in primary health care and a hospital. Data analysis was carried out using qualitative content analysis. The main factors of human capital related to project success proved to be as follows: (1) management of enthusiastic project culture, (2) management of regeneration and (3) management of emotional intelligence. Future research is needed on the kind of means nurse managers use in human capital management in projects and how they see their possibilities in managing human capital. Human capital management skills should be underlined as an important competence area when recruiting a nurse manager. The success of health care projects cannot be improved only through education or by training of nurse managers; in addition, projects need nurse managers who understand workplace spirituality and have high emotional intelligence. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

[Clinical trial with educational intervention in perimenopausal women with cardiovascular risk factor].

PubMed

Soto-Rodríguez, Anxela; García-Soidán, José Luís; de Toro-Santos, Manuel; Rodríguez-González, Manuel; Arias-Gómez, M Jesús; Pérez-Fernández, María Reyes

To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise. A randomized clinical trial. physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail. The IG obtained better scores on the mental component of quality of life one year later (p < 0.05) and showed a significant increase in physical activity (p < 0.01). GI women maintained their weight while in CG women it increased (p < 0.01). A simple educational intervention in premenopausal women with a cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Identification of factors that affect the adoption of an ergonomic intervention among Emergency Medical Service workers.

PubMed

Weiler, Monica R; Lavender, Steven A; Crawford, J Mac; Reichelt, Paul A; Conrad, Karen M; Browne, Michael W

2012-01-01

This study explored factors contributing to intervention adoption decisions among Emergency Medical Service (EMS) workers. Emergency Medical Service workers (n = 190), from six different organisations, participated in a two-month longitudinal study following the introduction of a patient transfer-board (also known as slide-board) designed to ease lateral transfers of patients to and from ambulance cots. Surveys administered at baseline, after one month and after two months sampled factors potentially influencing the EMS providers' decision process. 'Ergonomics Advantage' and 'Patient Advantage' entered into a stepwise regression model predicting 'intention to use' at the end of month one (R (2 )= 0.78). After the second month, the stepwise regression indicated only two factors were predictive of intention to use: 'Ergonomics Advantage,' and 'Endorsed by Champions' (R (2 )= 0.58). Actual use was predicted by: 'Ergonomics Advantage' and 'Previous Tool Experience.' These results relate to key concepts identified in the diffusion of innovation literature and have the potential to further ergonomics intervention adoption efforts. Practitioner Summary. This study explored factors that potentially facilitate the adoption of voluntarily used ergonomics interventions. EMS workers were provided with foldable transfer-boards (slideboards) designed to reduce the physical demands when laterally transferring patients. Factors predictive of adoption measures included perceived ergonomics advantage, the endorsement by champions, and prior tool experience.

Factors influencing organizational participation in the Clinical Nurse Leader project.

PubMed

Sherman, Rose O

2008-01-01

When the American Association of Colleges of Nursing introduced the Clinical Nurse Leader"s (CNL) pilot project in 2004, it was the first time in more than 40 years that an attempt was made to introduce a new role to the profession. This new role was designed to address many challenges related to patient care in the current health care delivery system including a need for more effective clinical problem solving, better coordination at the point of care, stronger interdisciplinary relationships, and more rapid implementation of evidenced-based practice findings at the patient-provider interface. Critics from both academic and practice settings have questioned the need and wisdom of introducing a new role to the profession at this time. The factors that led some nursing leaders in early stages of this project to be proactive and involve their organizations as early adopters of the CNL role were examined in this study. Five major factors were identified from the research to form a framework designed to explain organizational participation: organizational needs, a desire to improve patient care, an opportunity to redesign care delivery, the promotion of the professional development of nursing staff, and the potential to enhance physician-nurse relationships. The ability of academic and service partners to forge the types of relationships and promote best practices as is occurring in the CNL project may be a critical success factor in confronting the current and impending nursing shortage.

AAC and Early Intervention for Children with Cerebral Palsy: Parent Perceptions and Child Risk Factors

PubMed Central

Smith, Ashlyn L.; Hustad, Katherine C.

2015-01-01

The current study examined parent perceptions of communication, the focus of early intervention goals and strategies, and factors predicting the implementation of augmentative and alternative communication (AAC) for 26, 2-year-old children with cerebral palsy. Parents completed a communication questionnaire and provided early intervention plans detailing child speech and language goals. Results indicated that receptive language had the strongest association with parent perceptions of communication. Children who were not talking received a greater number of intervention goals, had a greater variety of goals, and had more AAC goals than children who were emerging and established talkers. Finally, expressive language had the strongest influence on AAC decisions. Results are discussed in terms of the relationship between parent perceptions and language skills, communication as an emphasis in early intervention, AAC intervention decisions, and the importance of receptive language. PMID:26401966

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature

PubMed Central

Janssen, Wouter; Johansen, Monika Alise

2018-01-01

Background eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Objective Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. Methods We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Results Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow

Systematic review of randomised controlled trials of multiple risk factor interventions for preventing coronary heart disease.

PubMed Central

Ebrahim, S.; Smith, G. D.

1997-01-01

OBJECTIVE: To assess the effectiveness of multiple risk factor intervention in reducing cardiovascular risk factors, total mortality, and mortality from coronary heart disease among adults. DESIGN: Systematic review and meta-analysis of randomised controlled trials in workforces and in primary care in which subjects were randomly allocated to more than one of six interventions (stopping smoking, exercise, dietary advice, weight control, antihypertensive drugs, and cholesterol lowering drugs) and followed up for at least six months. SUBJECTS: Adults aged 17-73 years, 903000 person years of observation were included in nine trials with clinical event outcomes and 303000 person years in five trials with risk factor outcomes alone. MAIN OUTCOME MEASURES: Changes in systolic and diastolic blood pressure, smoking rates, blood cholesterol concentrations, total mortality, and mortality from coronary heart disease. RESULTS: Net decreases in systolic and diastolic blood pressure, smoking prevalence, and blood cholesterol were 4.2 mm Hg (SE 0.19 mm Hg), 2.7 mm Hg (0.09 mm Hg), 4.2% (0.3%), and 0.14 mmol/l (0.01 mmol/l) respectively. In the nine trials with clinical event end points the pooled odds ratios for total and coronary heart disease mortality were 0.97 (95% confidence interval 0.92 to 1.02) and 0.96 (0.88 to 1.04) respectively. Statistical heterogeneity between the studies with respect to changes in mortality and risk factors was due to trials focusing on hypertensive participants and those using considerable amounts of drug treatment, with only these trials showing significant reductions in mortality. CONCLUSIONS: The pooled effects of multiple risk factor intervention on mortality were insignificant and a small, but potentially important, benefit of treatment (about a 10% reduction in mortality) may have been missed. Changes in risk factors were modest, were related to the amount of pharmacological treatment used, and in some cases may have been overestimated

Exploring experiences among adopters during the diffusion of a novel dance intervention in Sweden.

PubMed

Carlsson, Noomi; Kullberg, Agneta; Johansson, Ida-Klara; Bergman, Paula; Skagerström, Janna; Andersson, Agneta

2018-12-01

There is a demand for interventions aimed at adolescent girls with psychosomatic problems. In 2013, positive results were reported from a dance intervention programme addressing girls with internalizing problems. The research team behind the intervention immediately received requests from municipalities and county councils interested in using the intervention. From an implementation point of view it is unclear what made the intervention spread without an active plan. The aim of this study was to explore adopters' experiences about the diffusion and initiation of a public health intervention targeting adolescent girls with internalizing problems. Interviews were conducted with 12 people who were engaged in initiating the intervention in different settings. Data were analysed using conventional content analysis, yielding three categories: perceived appeal and trustworthiness, convenient information, and contextual factors. The results reflected that the participants found that there was a need for an intervention and found the dance intervention to be evidence based and not too complex to perform. Further, there was available information on the project which could easily be distributed to decision makers and others. When initiating the intervention, factors related to economy, possibility for collaboration and recruitment were of importance.

Making the Connection--Factors Influencing Implementation of Evidence Supported and Non-Evaluated Lifestyle Interventions in Healthcare: A Multiple Case Study

ERIC Educational Resources Information Center

van de Glind, Irene; Heinen, Maud; Geense, Wytske; Mesters, Ilse; Wensing, Michel; van Achterberg, Theo

2015-01-01

Many implementation barriers relate to lifestyle interventions (LIs) being developed by scientists. Exploring whether implementation of non-evaluated LIs is less complicated, might offer insight how to improve the use of effective interventions. This study aimed to identify influencing factors for implementation and compare factors between…

Young Children at Risk of Literacy Difficulties: Factors Predicting Recovery from Risk Following Phonologically Based Intervention

ERIC Educational Resources Information Center

Whiteley, Helen E.; Smith, Chris D.; Connors, Liz

2007-01-01

This longitudinal project identified young children at risk of literacy difficulties and asked why some of these children fail to benefit from phonologically based intervention. Reception class children were screened to identify a group at risk of literacy difficulties and a matched group of children not at risk. Profiles were compiled for each…

Employment Interventions for Individuals with ASD: The Relative Efficacy of Supported Employment With or Without Prior Project SEARCH Training.

PubMed

Schall, Carol M; Wehman, Paul; Brooke, Valerie; Graham, Carolyn; McDonough, Jennifer; Brooke, Alissa; Ham, Whitney; Rounds, Rachael; Lau, Stephanie; Allen, Jaclyn

2015-12-01

This paper presents findings from a retrospective observational records review study that compares the outcomes associated with implementation of supported employment (SE) with and without prior Project SEARCH with ASD Supports (PS-ASD) on wages earned, time spent in intervention, and job retention. Results suggest that SE resulted in competitive employment for 45 adults with ASD. Twenty-five individuals received prior intervention through PS-ASD while the other 20 individuals received SE only. Individuals in this sample who received PS-ASD required fewer hours of intervention. Additionally, individuals in the PS-ASD group achieved a mean higher wage and had higher retention rates than their peers who received SE only. Further research with a larger sample is needed to confirm these findings.

Systematic evaluation of implementation fidelity of complex interventions in health and social care

PubMed Central

2010-01-01

Background Evaluation of an implementation process and its fidelity can give insight into the 'black box' of interventions. However, a lack of standardized methods for studying fidelity and implementation process have been reported, which might be one reason for the fact that few prior studies in the field of health service research have systematically evaluated interventions' implementation processes. The aim of this project is to systematically evaluate implementation fidelity and possible factors influencing fidelity of complex interventions in health and social care. Methods A modified version of The Conceptual Framework for Implementation Fidelity will be used as a conceptual model for the evaluation. The modification implies two additional moderating factors: context and recruitment. A systematic evaluation process was developed. Multiple case study method is used to investigate implementation of three complex health service interventions. Each case will be investigated in depth and longitudinally, using both quantitative and qualitative methods. Discussion This study is the first attempt to empirically test The Conceptual Framework for Implementation Fidelity. The study can highlight mechanism and factors of importance when implementing complex interventions. Especially the role of the moderating factors on implementation fidelity can be clarified. Trial Registration Supported Employment, SE, among people with severe mental illness -- a randomized controlled trial: NCT00960024. PMID:20815872

Using logic models to enhance the methodological quality of primary health-care interventions: guidance from an intervention to promote nutrition care by general practitioners and practice nurses.

PubMed

Ball, Lauren; Ball, Dianne; Leveritt, Michael; Ray, Sumantra; Collins, Clare; Patterson, Elizabeth; Ambrosini, Gina; Lee, Patricia; Chaboyer, Wendy

2017-04-01

The methodological designs underpinning many primary health-care interventions are not rigorous. Logic models can be used to support intervention planning, implementation and evaluation in the primary health-care setting. Logic models provide a systematic and visual way of facilitating shared understanding of the rationale for the intervention, the planned activities, expected outcomes, evaluation strategy and required resources. This article provides guidance for primary health-care practitioners and researchers on the use of logic models for enhancing methodological rigour of interventions. The article outlines the recommended steps in developing a logic model using the 'NutriCare' intervention as an example. The 'NutriCare' intervention is based in the Australian primary health-care setting and promotes nutrition care by general practitioners and practice nurses. The recommended approach involves canvassing the views of all stakeholders who have valuable and informed opinions about the planned project. The following four targeted, iterative steps are recommended: (1) confirm situation, intervention aim and target population; (2) document expected outcomes and outputs of the intervention; (3) identify and describe assumptions, external factors and inputs; and (4) confirm intervention components. Over a period of 2 months, three primary health-care researchers and one health-services consultant led the collaborative development of the 'NutriCare' logic model. Primary health-care practitioners and researchers are encouraged to develop a logic model when planning interventions to maximise the methodological rigour of studies, confirm that data required to answer the question are captured and ensure that the intervention meets the project goals.

Late-onset neonatal sepsis, risk factors and interventions: an analysis of recurrent outbreaks of Serratia marcescens, 2006-2011.

PubMed

Samuelsson, A; Isaksson, B; Hanberger, H; Olhager, E

2014-01-01

Between 2006 and 2011, 11 patients with Serratia marcescens sepsis and 47 patients colonized due to the spread of various clones were observed. These recurrent clusters brought about interventions to reduce spread between patients. To evaluate the effect of stepwise interventions to prevent S. marcescens colonization/sepsis and to analyse risk factors for late-onset sepsis (LOS). An open retrospective observational study was performed to evaluate the interventions. A retrospective case-control study was performed to analyse the risk factors for LOS. S. marcescens sepsis and colonization decreased after the stepwise adoption of hygiene interventions. Low gestational age, low birth weight, indwelling central venous or umbilical catheter, and ventilator treatment were identified as risk factors for LOS. Compliance with basic hygiene guidelines was the only intervention monitored continuously from late 2007. Compliance increased gradually to a steady high level in early 2009. There was a decrease in S. marcescens LOS, clustering after the second quarter of 2008. After the first quarter of 2009, S. marcescens colonization decreased. It was not possible to identify the specific effects of each intervention, but it is likely that an update of the hospital's antibiotic policy affected the occurrence of S. marcescens LOS. The delayed effect of interventions on S. marcescens colonization was probably due to the time it takes for new routines to have an effect, illustrated by the gradual increase in compliance with basic hygiene guidelines. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Factors Mediating the Interactions between Adviser and Advisee during the Master's Thesis Project: A Quantitative Approach

ERIC Educational Resources Information Center

Rodrigues Jr., Jose Florencio; Lehmann, Angela Valeria Levay; Fleith, Denise De Souza

2005-01-01

Building on previous studies centred on the interaction between adviser and advisee in masters thesis projects, in which a qualitative approach was used, the present study uses factor analysis to identify the factors that determine either a successful or unsuccessful outcome for the masters thesis project. There were five factors relating to the…

Project Salud: Using community-based participatory research to culturally adapt an HIV prevention intervention in the Latino migrant worker community.

PubMed

Sánchez, Jesús; Serna, Claudia A; de La Rosa, Mario

2012-01-01

Despite the unique and challenging circumstances confronting Latino migrant worker communities in the U.S., debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Project Salud adopted a community-based participatory research model and utilized focus group methodology with 83 Latino migrant workers to explore the relevance of culturally adapting an evidence-based HIV prevention intervention to be disseminated within this population. Findings from this study indicate that, despite early reservations, Latino migrant workers wanted to participate in the cultural adaptation that would result in an intervention that was culturally relevant, respectful, responsive to their life experiences, and aligned with their needs. This study contributes to the cultural adaptation/fidelity debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance without sacrificing high fidelity to the core components that have established efficacy for evidence-based HIV prevention interventions.

Frequently observed risk factors for fall-related injuries and effective preventive interventions: a multihospital survey of nurses' perceptions.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2013-01-01

There is an urgent need to prioritize the risk factors for injurious falls and effective interventions in nursing practice. Registered nurses perceived that the most frequently observed risk factors were confusion, gait problems, Alzheimer disease, disorientation, and inability to follow safety instructions. The most effective interventions were keeping hospital bed brakes locked, keeping floor surfaces clean/dry, using appropriate footwear for patients, maintaining a call light within reach, and reducing tripping hazards.

A mixed methods study of the factors that influence whether intervention research has policy and practice impacts: perceptions of Australian researchers

PubMed Central

Newson, Robyn; King, Lesley; Rychetnik, Lucie; Bauman, Adrian E; Redman, Sally; Milat, Andrew J; Schroeder, Jacqueline; Cohen, Gillian; Chapman, Simon

2015-01-01

Objectives To investigate researchers’ perceptions about the factors that influenced the policy and practice impacts (or lack of impact) of one of their own funded intervention research studies. Design Mixed method, cross-sectional study. Setting Intervention research conducted in Australia and funded by Australia's National Health and Medical Research Council between 2003 and 2007. Participants The chief investigators from 50 funded intervention research studies were interviewed to determine if their study had achieved policy and practice impacts, how and why these impacts had (or had not) occurred and the approach to dissemination they had employed. Results We found that statistically significant intervention effects and publication of results influenced whether there were policy and practice impacts, along with factors related to the nature of the intervention itself, the researchers’ experience and connections, their dissemination and translation efforts, and the postresearch context. Conclusions This study indicates that sophisticated approaches to intervention development, dissemination actions and translational efforts are actually widespread among experienced researches, and can achieve policy and practice impacts. However, it was the links between the intervention results, further dissemination actions by researchers and a variety of postresearch contextual factors that ultimately determined whether a study had policy and practice impacts. Given the complicated interplay between the various factors, there appears to be no simple formula for determining which intervention studies should be funded in order to achieve optimal policy and practice impacts. PMID:26198428

Interventions addressing risk factors of ischaemic heart disease in sub-Saharan Africa: a systematic review

PubMed Central

Ebireri, Jennifer; Aderemi, Adewale V; Omoregbe, Nicholas; Adeloye, Davies

2016-01-01

Background Ischaemic heart disease (IHD) is currently ranked eighth among the leading causes of deaths in sub-Saharan Africa (sSA). Yet, effective population-wide preventive measures targeting risks in the region are still largely unavailable. We aimed to review population-wide and individual-level interventions addressing risk factors of IHD among adults in sSA. Methods A systematic search of MEDLINE, EMBASE, Global Health and AJOL was conducted to identify studies focusing on population-wide and individual-level interventions targeting risks of IHD among adults in sSA. We conducted a detailed synthesis of basic findings of selected studies. Results A total of 2311 studies were identified, with only 9 studies meeting our selection criteria. 3 broad interventions were identified: dietary modifications, physical activity and community-based health promotion measures on tobacco and alcohol cessation. 3 studies reported significant reduction in blood pressure (BP), and another study reported statistically significant reduction in mean total cholesterol. Other outcome measures observed ranged from mild to no reduction in BP, blood glucose, body mass index and total cholesterol, respectively. Conclusions We cannot specify with all certainty contextually feasible interventions that can be effective in modifying IHD risk factors in population groups across sSA. We recommend more research on IHD, particularly on the understanding of the burden, geared towards developing and/or strengthening preventive and treatment interventions for the disease in sSA. PMID:27381212

An individually-tailored multifactorial intervention program for older fallers in a middle-income developing country: Malaysian Falls Assessment and Intervention Trial (MyFAIT)

PubMed Central

2014-01-01

Background In line with a rapidly ageing global population, the rise in the frequency of falls will lead to increased healthcare and social care costs. This study will be one of the few randomized controlled trials evaluating a multifaceted falls intervention in a low-middle income, culturally-diverse older Asian community. The primary objective of our paper is to evaluate whether individually tailored multifactorial interventions will successfully reduce the number of falls among older adults. Methods Three hundred community-dwelling older Malaysian adults with a history of (i) two or more falls, or (ii) one injurious fall in the past 12 months will be recruited. Baseline assessment will include cardiovascular, frailty, fracture risk, psychological factors, gait and balance, activities of daily living and visual assessments. Fallers will be randomized into 2 groups: to receive tailored multifactorial interventions (intervention group); or given lifestyle advice with continued conventional care (control group). Multifactorial interventions will target 6 specific risk factors. All participants will be re-assessed after 12 months. The primary outcome measure will be fall recurrence, measured with monthly falls diaries. Secondary outcomes include falls risk factors; and psychological measures including fear of falling, and quality of life. Discussion Previous studies evaluating multifactorial interventions in falls have reported variable outcomes. Given likely cultural, personal, lifestyle and health service differences in Asian countries, it is vital that individually-tailored multifaceted interventions are evaluated in an Asian population to determine applicability of these interventions in our setting. If successful, these approaches have the potential for widespread application in geriatric healthcare services, will reduce the projected escalation of falls and fall-related injuries, and improve the quality of life of our older community. Trial registration

Culturally sensitive substance abuse intervention for Hispanic and African American adolescents: empirical examples from the Alcohol Treatment Targeting Adolescents in Need (ATTAIN) Project.

PubMed

Gil, Andrés G; Wagner, Eric F; Tubman, Jonathan G

2004-11-01

This study presents preliminary analyses examining the effects of an alcohol and other drug use (AOD) intervention with minority juvenile offenders. Furthermore, the study investigates the impact of cultural factors on baseline AOD use among Hispanic and African American youth, as well as on treatment outcome. Participants were 213 juvenile offenders referred for treatment (mean age = 15.7 years), 97 of whom have completed treatment to date. The intervention was carried out in clinics placed within the neighborhoods in which the participants resided. Intervention Alcohol Treatment Targeting Adolescents in Need (ATTAIN) is a controlled clinical trial evaluating the effectiveness of a brief motivational, cognitive behavioral intervention, guided self-change (GSC). Participants are assigned randomly to the individual format of guided self-change (I-GSC), the family involved format of guided self-Change (F-GSC), choice of one of these two, or a waiting list control condition. Only participants involved in active intervention are included in the present report. Data were collected via structured face-to-face interviews. Alcohol and marijuana use measures were collected using the Time-line Follow-back interview (TLFB). There were significant reductions in alcohol and marijuana use for all ethnic groups from baseline to post-intervention. Cultural factors (discrimination, acculturation, ethnic pride and cultural mistrust) were associated with pre-intervention levels of alcohol and marijuana use. Among Hispanics, pre-intervention level of substance use were higher among foreign-born than US-born youth. Analyses conducted with the US-born Hispanic group showed that ethnic orientation and ethnic pride were associated positively with greater reductions in alcohol use. The intervention provided through ATTAIN appears to be effective with a multi-ethnic population of juvenile delinquents. Cultural factors, such as ethnic orientation and ethnic mistrust, appear to constitute

Efficacy of Cognitive-Behavioral Interventions Targeting Personality Risk Factors for Youth Alcohol Misuse

ERIC Educational Resources Information Center

Conrod, Patricia J.; Stewart, Sherry H.; Comeau, Nancy; Maclean, A. Michael

2006-01-01

Sensation seeking, anxiety sensitivity, and hopelessness are personality risk factors for alcohol use disorders, each associated with specific risky drinking motives in adolescents. We developed a set of interventions and manuals that were designed to intervene at the level of personality risk and associated maladaptive coping strategies,…

Beneficial impact of exercise and obesity interventions on erectile function and its risk factors.

PubMed

Hannan, Johanna L; Maio, M Tina; Komolova, Marina; Adams, Michael A

2009-03-01

Erectile dysfunction (ED) is a multifaceted disease involving cardiovascular, metabolic, and hormonal factors and affects over 100 million men worldwide. ED has been shown to be a harbinger of underlying cardiovascular diseases (CVD), as there are common risk factors (aging, hypertension, obesity) and mechanistic basis. To provide an update on clinical and experimental evidence regarding the impact of lifestyle modifications, such as exercise and diet, with respect to changes in erectile function. Published evidence regarding the impact of aging, hypertension, and obesity on ED and CVD, as well as new experimental data linking obesity and diminished erectile responses. We reviewed the literature regarding common risk factors of ED and CVD, particularly involving obesity, as well as performed new analysis on the findings of other experimental studies involving diet and exercise interventions. Physical inactivity negatively impacts on erectile function, and experimental and clinical exercise interventions have been shown to improve sexual responses and overall cardiovascular health. Mediterranean-style diets and a reduction in caloric intake have been found to improve erectile function in men with the aspects of the metabolic syndrome. In addition, both clinical and experimental studies have confirmed that combining the two interventions provides additional benefit to erectile function, likely via reduced metabolic disturbances (e.g., inflammatory markers, insulin resistance), decreased visceral adipose tissue, and improvement in vascular function (e.g., increased endothelial function). Lifestyle modifications provide significant benefits to vascular health and erectile function in a population that is increasingly aged and more obese.

Exploratory Trial of a School-Based Alcohol Prevention Intervention with a Family Component

ERIC Educational Resources Information Center

Segrott, Jeremy; Rothwell, Heather; Pignatelli, Ilaria; Playle, Rebecca; Hewitt, Gillian; Huang, Chao; Murphy, Simon; Hickman, Matthew; Reed, Hayley; Moore, Laurence

2016-01-01

Purpose: Involvement of parents/carers may increase effectiveness of primary school-based alcohol-misuse prevention projects through strengthening family-based protective factors, but rates of parental engagement are typically low. This paper reports findings from an exploratory trial of a school-based prevention intervention--Kids, Adults…

TU-H-CAMPUS-IeP1-03: Comparison of Monte Carlo Simulation and Conversion Factor Based Method On Estimation of Effective Dose in Pediatric Patients Undergoing Interventional Cardiac Procedures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leung, K; Wong, M; Ng, Y

Purpose: Interventional cardiac procedures utilize frequent fluoroscopy and cineangiography, which impose considerable radiation risk to patients, especially pediatric patients. Accurate calculation of effective dose is important in order to estimate cancer risk over the rest of their lifetime. This study evaluates the difference in effective dose calculated by Monte Carlo simulation with those estimated by locally-derived conversion factors (CF-local) and by commonly quoted conversion factors from Karambatsakidou et al (CF-K). Methods: Effective dose (E),of 12 pediatric patients, age between 2.5–19 years old, who had undergone interventional cardiac procedures, were calculated using PCXMC-2.0 software. Tube spectrum, irradiation geometry, exposure parameters andmore » dose-area product (DAP) of each projection were included in the software calculation. Effective doses for each patient were also estimated by two Methods: 1) CF-local: conversion factor derived locally by generalizing results of 12 patients, multiplied by DAP of each patient gives E-local. 2) CF-K: selected factor from above-mentioned literature, multiplied by DAP of each patient gives E-K. Results: Mean of E, E-local and E-K were 16.01 mSv, 16.80 mSv and 22.25 mSv respectively. A deviation of −29.35% to +34.85% between E and E-local, while a greater deviation of −28.96% to +60.86% between E and EK were observed. E-K overestimated the effective dose for patients at age 7.5–19. Conclusion: Effective dose obtained by conversion factors is simple and quick to estimate radiation risk of pediatric patients. This study showed that estimation by CF-local may bear an error of 35% when compared with Monte Carlo calculation. If using conversion factors derived by other studies may result in an even greater error, of up to 60%, due to factors that are not catered for in the estimation, including patient size, projection angles, exposure parameters, tube filtration, etc. Users must be aware of these

Employment Interventions for Individuals with ASD: The Relative Efficacy of Supported Employment with or without Prior Project Search Training

ERIC Educational Resources Information Center

Schall, Carol M.; Wehman, Paul; Brooke, Valerie; Graham, Carolyn; McDonough, Jennifer; Brooke, Alissa; Ham, Whitney; Rounds, Rachael; Lau, Stephanie; Allen, Jaclyn

2015-01-01

This paper presents findings from a retrospective observational records review study that compares the outcomes associated with implementation of supported employment (SE) with and without prior Project SEARCH with ASD Supports (PS-ASD) on wages earned, time spent in intervention, and job retention. Results suggest that SE resulted in competitive…

One-Year Effects of Project EX in Spain: A Classroom-Based Smoking Prevention and Cessation Intervention Program

PubMed Central

Gonzálvez, María T.; Espada, José P.; Orgilés, Mireia; Soto, Daniel; Sussman, Steve

2015-01-01

Background Tobacco use prevalence rates are high among Spanish adolescents. Programming to counteract tobacco use is needed. Methods and Findings The current study provides a one-year follow-up outcome evaluation of Project EX, an eight-session classroom-based curriculum. The intervention was tested using a randomized controlled trial with 1,546 Spanish students, involving three program and three control schools. Compared to the control condition, the program condition revealed a greater reduction in nicotine dependence (p < .05) and CO ppm levels (p < .001), and lower consumption of cigarettes at last month (p = .03). Conclusions Long-term outcomes of the Project EX classroom-based program are promising for adolescent prevention and possibly cessation in Spain. PMID:26090821

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature.

PubMed

Granja, Conceição; Janssen, Wouter; Johansen, Monika Alise

2018-05-01

eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical

Perceptions of risk factors for diabetes among Norwegian-Pakistani women participating in a culturally adapted intervention.

PubMed

Råberg Kjøllesdal, Marte K; Hjellset, Victoria T; Bjørge, Benedikte; Holmboe-Ottesen, Gerd; Wandel, Margareta

2011-06-01

To explore perceptions of diabetes risk factors among Pakistani immigrant women, as part of their explanatory model of the disease, and the changes in these perceptions after a culturally adapted intervention. Intervention study, carried out in Oslo, Norway, comprising 198 women. At baseline, about 75% of the women perceived sugar to be a risk factor for diabetes, about 30% mentioned physical inactivity and stress and close to 20% mentioned overweight. Twelve per cent could not identify any risk factors. When asked about foods to include in a diet to prevent diabetes, vegetables were mentioned by 45%, while 33% did not know any foods to include. Among those attending ≥60% of the educational sessions, the proportions mentioning little physical activity (p<0.001), overweight (p=0.001) and family history (p=0.007) as risk factors increased. Furthermore, the proportions mentioning legumes (p=0.001), fish (p<0.001), fibre (p=0.035) or vegetables (p=0.015) as important in a diet to prevent diabetes increased, and the proportion not knowing any food to include was reduced to 10% (p=0.004). Except for little physical activity, similar changes in responses were not registered in the control group. There is a need for improved knowledge about diabetes prevention among Pakistani immigrant women, and a culturally adapted intervention may contribute to this.

Implementing Brief Interventions in Health Care: Lessons Learned from the Swedish Risk Drinking Project

PubMed Central

Nilsen, Per; Wåhlin, Sven; Heather, Nick

2011-01-01

The Risk Drinking Project was a national implementation endeavour in Sweden, carried out from 2004 to 2010, based on a government initiative to give alcohol issues a more prominent place in routine primary, child, maternity and occupational health care. The article describes and analyses the project. Critical factors that were important for the results are identified. The magnitude of the project contributed to its reach and impact in terms of providers’ awareness of the project goals and key messages. The timing of the project was appropriate. The increase in alcohol consumption in Sweden and diminished opportunities for primary prevention strategies since entry to the European Union in 1995 have led to increased expectations for health care providers to become more actively involved in alcohol prevention. This awareness provided favourable conditions for this project. A multifaceted approach was used in the project. Most educational courses were held in workshops and seminars to encourage learning-by-doing. Motivational interviewing was an integral aspect. The concept of risk drinking was promoted in all the activities. Subprojects were tailored to the specific conditions of each respective setting, building on the skills the providers already had to modify existing work practices. Nurses were afforded a key role in the project. PMID:22016706

Implementing brief interventions in health care: lessons learned from the Swedish Risk Drinking Project.

PubMed

Nilsen, Per; Wåhlin, Sven; Heather, Nick

2011-09-01

The Risk Drinking Project was a national implementation endeavour in Sweden, carried out from 2004 to 2010, based on a government initiative to give alcohol issues a more prominent place in routine primary, child, maternity and occupational health care. The article describes and analyses the project. Critical factors that were important for the results are identified. The magnitude of the project contributed to its reach and impact in terms of providers' awareness of the project goals and key messages. The timing of the project was appropriate. The increase in alcohol consumption in Sweden and diminished opportunities for primary prevention strategies since entry to the European Union in 1995 have led to increased expectations for health care providers to become more actively involved in alcohol prevention. This awareness provided favourable conditions for this project. A multifaceted approach was used in the project. Most educational courses were held in workshops and seminars to encourage learning-by-doing. Motivational interviewing was an integral aspect. The concept of risk drinking was promoted in all the activities. Subprojects were tailored to the specific conditions of each respective setting, building on the skills the providers already had to modify existing work practices. Nurses were afforded a key role in the project.

Challenges and opportunities for preventing depression in the workplace: a review of the evidence supporting workplace factors and interventions.

PubMed

Couser, Gregory P

2008-04-01

To explore the literature regarding prevention of depression in the workplace. Literature review of what the author believes are seminal articles highlighting workplace factors and interventions in preventing depression in the workplace. Employees can help prevent depression by building protective factors such as better coping and stress management skills. Employees may be candidates for depression screening if they have certain risk factors such as performance concerns. Organizational interventions such as improving mental health literacy and focusing on work-life balance may help prevent depression in the workplace but deserve further study. A strategy to prevent depression in the workplace can include developing individual resilience, screening high-risk individuals and reducing that risk, improving organizational literacy, and integrating workplace and health care systems to allow access to proactive quality interventions.

Stigma Reduction in Adolescents and Young Adults Newly Diagnosed with HIV: Findings from the Project ACCEPT Intervention

PubMed Central

Lemos, Diana; Hosek, Sybil G.

2014-01-01

Abstract This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106

Stigma reduction in adolescents and young adults newly diagnosed with HIV: findings from the Project ACCEPT intervention.

PubMed

Harper, Gary W; Lemos, Diana; Hosek, Sybil G

2014-10-01

This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma-personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV-as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women.

A mixed methods study of the factors that influence whether intervention research has policy and practice impacts: perceptions of Australian researchers.

PubMed

Newson, Robyn; King, Lesley; Rychetnik, Lucie; Bauman, Adrian E; Redman, Sally; Milat, Andrew J; Schroeder, Jacqueline; Cohen, Gillian; Chapman, Simon

2015-07-21

To investigate researchers' perceptions about the factors that influenced the policy and practice impacts (or lack of impact) of one of their own funded intervention research studies. Mixed method, cross-sectional study. Intervention research conducted in Australia and funded by Australia's National Health and Medical Research Council between 2003 and 2007. The chief investigators from 50 funded intervention research studies were interviewed to determine if their study had achieved policy and practice impacts, how and why these impacts had (or had not) occurred and the approach to dissemination they had employed. We found that statistically significant intervention effects and publication of results influenced whether there were policy and practice impacts, along with factors related to the nature of the intervention itself, the researchers' experience and connections, their dissemination and translation efforts, and the postresearch context. This study indicates that sophisticated approaches to intervention development, dissemination actions and translational efforts are actually widespread among experienced researches, and can achieve policy and practice impacts. However, it was the links between the intervention results, further dissemination actions by researchers and a variety of postresearch contextual factors that ultimately determined whether a study had policy and practice impacts. Given the complicated interplay between the various factors, there appears to be no simple formula for determining which intervention studies should be funded in order to achieve optimal policy and practice impacts. 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.

Effectiveness of a school-based intervention on physical activity for high school students in Brazil: the Saude na Boa project.

PubMed

de Barros, Mauro Virgílio Gomes; Nahas, Markus Vinicius; Hallal, Pedro Curi; de Farias Júnior, José Cazuza; Florindo, Alex Antônio; Honda de Barros, Simone Storino

2009-03-01

We evaluated the effectiveness of a school-based intervention on the promotion of physical activity among high school students in Brazil: the Saude na Boa project. A school-based, randomized trial was carried out in 2 Brazilian cities: Recife (northeast) and Florianopolis (south). Ten schools in each city were matched by size and location, and randomized into intervention or control groups. The intervention included environmental/organizational changes, physical activity education, and personnel training and engagement. Students age 15 to 24 years were evaluated at baseline and 9 months later (end of school year). Although similar at baseline, after the intervention, the control group reported significantly fewer d/wk accumulating 60 minutes+ moderate-to-vigorous physical activity (MVPA) in comparison with the intervention group (2.6 versus 3.3, P<.001). The prevalence of inactivity (0 days per week) rose in the control and decreased in the intervention group. The odds ratio for engaging at least once per week in physical activity associated with the intervention was 1.83 (95% CI=1.24-2.71) in the unadjusted analysis and 1.88 (95% CI=1.27-2.79) after controlling for gender. The Saude na Boa intervention was effective at reducing the prevalence of physical inactivity. The possibility of expanding the intervention to other locations should be considered.

“I am not telling. The mobile is telling”: Factors influencing the outcomes of a community health worker mHealth intervention in India

PubMed Central

Dieleman, Marjolein; Kraamwinkel, Nadine; Van Belle, Sara; Chaudoury, Murari; Broerse, Jacqueline E. W.

2018-01-01

Introduction Improving maternal health outcomes remains a priority in Low and Middle Income Countries. With the rapid proliferation of mobile health technologies, there is an increased interest in understanding how these technologies can effectively improve maternal health outcomes particularly maternal health seeking knowledge and behaviors. However, few studies present clear explanations of the program developers’ rationale (theory of change) and contextual factors that could influence program outcomes. This mixed-methods study assesses Mobile for Mothers, a community health workers (CHW) utilized maternal mHealth intervention. We present the program developers’ rationale and utilize it as a framework to guide our study that aimed to identify intervention-related and contextual factors, which influence the observed outcomes of a CHW, utilized mHealth intervention. Materials and methods Quantitative methods (a questionnaire with 740 women who received the intervention and survey of 57 CHWs who utilized the intervention) and qualitative methods (12 interviews and 4 group discussions with CHWs and 20 interviews and 5 group discussions with pregnant and lactating women and 15 interviews and 2 group discussions with men) were conducted. These were used to understand how the mHealth intervention was implemented and to gain insight into contextual factors that potentially influenced the observed intervention outcomes. Results Results were grouped following three categories: (1) perceptions and experiences of CHWs utilizing the mHealth technology; (2) CHW-related outcomes; and (3) contextual factors that influence maternal health-seeking behavior. The overall response of CHWs and community members to the intervention was positive. However, contextual factors like the relationship between the CHWs and their respective communities, the pregnant women’s decision-making power and lack of access due to financial influenced the observed outcomes. Conclusion Mobile health

Latinos and HIV/AIDS: Examining Factors Related to Disparity and Identifying Opportunities for Psychosocial Intervention Research

PubMed Central

Hendriksen, Ellen Setsuko; Collins, Erin Marie; Durán, Ron E.; Safren, Steven A.

2013-01-01

Latinos maintain an AIDS case rate more than 3 times higher than whites, a greater rate of progression to AIDS, and a higher rate of HIV/AIDS-related deaths. Three broad areas are reviewed related to these disparities: (1) relevant demographic, socioeconomic, and socio-cultural factors among Latinos; (2) drug abuse and mental health problems in Latinos relevant to HIV/AIDS outcomes; and (3) opportunities for psychosocial intervention. Latinos living with HIV are a rapidly growing group, are more severely impacted by HIV than whites, and confront unique challenges in coping with HIV/AIDS. A body of research suggests that depression, substance abuse, treatment adherence, health literacy, and access to healthcare may be fruitful targets for intervention research in this population. Though limited, the current literature suggests that psychosocial interventions that target these factors could help reduce HIV/AIDS disparities between Latinos and whites and could have important public health value. PMID:18498050

Evaluation of Child Care Subsidy Strategies: Implementation of Three Language and Literacy Interventions in Project Upgrade. OPRE 2011-4

ERIC Educational Resources Information Center

Layzer, Carolyn J.; Layzer, Jean I.; Wolf, Anne

2010-01-01

This report describes the design and implementation of the three interventions tested in Project Upgrade, one of four experiments conducted as part of the Evaluation of Child Care Subsidy Strategies. The evaluation was a multi-site, multi-year effort to determine whether and how different child care subsidy policies and procedures and quality…

Interventions addressing risk factors of ischaemic heart disease in sub-Saharan Africa: a systematic review.

PubMed

Ebireri, Jennifer; Aderemi, Adewale V; Omoregbe, Nicholas; Adeloye, Davies

2016-07-05

Ischaemic heart disease (IHD) is currently ranked eighth among the leading causes of deaths in sub-Saharan Africa (sSA). Yet, effective population-wide preventive measures targeting risks in the region are still largely unavailable. We aimed to review population-wide and individual-level interventions addressing risk factors of IHD among adults in sSA. A systematic search of MEDLINE, EMBASE, Global Health and AJOL was conducted to identify studies focusing on population-wide and individual-level interventions targeting risks of IHD among adults in sSA. We conducted a detailed synthesis of basic findings of selected studies. A total of 2311 studies were identified, with only 9 studies meeting our selection criteria. 3 broad interventions were identified: dietary modifications, physical activity and community-based health promotion measures on tobacco and alcohol cessation. 3 studies reported significant reduction in blood pressure (BP), and another study reported statistically significant reduction in mean total cholesterol. Other outcome measures observed ranged from mild to no reduction in BP, blood glucose, body mass index and total cholesterol, respectively. We cannot specify with all certainty contextually feasible interventions that can be effective in modifying IHD risk factors in population groups across sSA. We recommend more research on IHD, particularly on the understanding of the burden, geared towards developing and/or strengthening preventive and treatment interventions for the disease in sSA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Positive parenting as responsible care: Risks, protective factors, and intervention evaluation.

PubMed

Donato, Silvia; Bertoni, Anna

2017-01-01

In this themed issue of the Journal of Prevention & Intervention in the Community, the first four contributions provide knowledge on factors that can support or hinder positive parenting throughout children's lives. In particular, the first article examined the spillover of work stressors on parenting behaviors and the role of spousal support as a moderator of stress spillover. The second contribution examines the association between parents' promotion of volitional functioning and adopted children's sense of strength of family bonds and belonging to the adoptive family. The third article analyzes the negative impact of intrusive parenting on young adult children's romantic relationship quality and couple identity, and the fourth article examines parents' autonomous and controlled motivations to transmit values to their adolescent children and their associations with parents' socialization goals. Finally, the last two articles present the contents and evaluation of two parenting programs. The fifth article illustrates the development, content, and efficacy of an attachment-based intervention for parenting: the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD); the sixth article presents a qualitative evaluation of a group-based program focused on promoting parents' identity together with parenting skills: The Groups for Family Enrichment_Parent version (GFE_P).

Critical Factors for Improving Social Sustainability of Urban Renewal Projects

ERIC Educational Resources Information Center

Chan, Edwin; Lee, Grace K. L.

2008-01-01

This study reviews the sustainable urban design concept and identifies critical factors for enhancing social sustainability of urban renewal projects. Through a questionnaire survey carried out in Hong Kong, the opinions of architects, planners, property development managers, and local citizens were sought and evaluated. The results derived from…

The International Resilience Project Findings from the Research and the Effectiveness of Interventions.

ERIC Educational Resources Information Center

Grotberg, Edith H.

This article discusses the nature of resilience in children, means to measure and verify it, and attempts to promote it through education; it also describes a study of parental, teacher and caregiver efforts to promote resilience in children. The International Resilience Project examined resilience factors children and their parents use in…

[Assessment of an intervention on cardiovascular risk factors in patients with rheumatoid arthritis].

PubMed

Zacarías, Andrea; Narváez, Javier; Rodríguez Moreno, Jesús; Jordana, Montserrat; Nolla, Joan M; Gómez Vaquero, Carmen

2016-08-05

To evaluate the effectiveness of an intervention on cardiovascular risk factors (CVRF) in patients with rheumatoid arthritis. After determining their CVRF and cardiovascular risk (CVR) by modified SCORE, we gave the patients a letter for their general practitioners in which they were requested for their cooperation in controlling CVRF and where the therapeutic goal for LDL cholesterol was specified. Three months later, any therapeutic intervention was recorded as well as the results. We included 211 patients, 29% with a high CVR. There were new diagnoses of CVRF in 100 patients (47%). The general practitioner changed the treatment in 2/12 diabetes, 30/84 HBP, 74/167 with elevation of LDL cholesterol and 21/51 with hypertriglyceridemia. The percentage of patients with good control over CVRF was: a) in HBP, 25 to 73%; b) elevation of LDL cholesterol from 10 to 17%; and c) in hypertriglyceridemia, 25 to 38%. Through this intervention, a new CVRF was diagnosed in nearly half of the patients. The effectiveness of the intervention on CVRF was low. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

The Danish Centre for Strategic Research in Type 2 Diabetes (DD2) study: expected outcome from the DD2 project and two intervention studies

PubMed Central

Beck-Nielsen, Henning; Solomon, Thomas PJ; Lauridsen, Jørgen; Karstoft, Kristian; Pedersen, Bente K; Johnsen, Søren P; Nielsen, Jens Steen; Kryger, Tine Bjerregaard; Sortsø, Camilla; Vaag, Allan

2012-01-01

The overall aim of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) is to near-normalize metabolic control in newly diagnosed patients with type 2 diabetes (T2D) using an individualized treatment approach. We hypothesize that this will not only prevent complications and improve quality of life for T2D patients but also result in increased cost efficiency compared with current treatment modalities. This paper provides an overview of the expected outcomes from DD2, focusing on the two main intervention studies. The main data for the DD2 project are collected during patient enrollment and stored using the individual civil registration number. This enables subsequent linking to other national databases where supplemental data can be obtained. All data will be used for designing treatment guidelines and continuously monitoring the development of diabetic complications, thereby obtaining knowledge about predictors for the long-term outcome and identifying targets for new interventions. Further data are being collected from two intervention studies. The aim of the first intervention study is to improve T2D treatment using an individualized treatment modality optimizing medication according to individual metabolic responses and phenotypic characteristics. The aim of the second intervention study is to develop an evidence-based training protocol to be implemented as a treatment modality for T2D and used for initiating lifelong changes in physical activity levels in patients with T2D. An initial pilot study evaluating an interval-based walking protocol is ongoing, and preliminary results indicate that this protocol is an optimal “free-living” training intervention. An initial health-economic analysis will also be performed as a basis for analysis of the data collected during the project. A cost-benefit analysis of the two intervention studies will be conducted. The DD2 project is expected to lead to improved treatment modalities and increased knowledge

An exploration of factors related to dissemination of and exposure to internet-delivered behavior change interventions aimed at adults: a Delphi study approach.

PubMed

Brouwer, Wendy; Oenema, Anke; Crutzen, Rik; de Nooijer, Jascha; de Vries, Nanne K; Brug, Johannes

2008-04-16

The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure. The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention. A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD intervention and perceiving the intervention as personally relevant appeared to be important factors related to a first visit. The provision of tailored feedback

An Exploration of Factors Related to Dissemination of and Exposure to Internet-Delivered Behavior Change Interventions Aimed at Adults: A Delphi Study Approach

PubMed Central

Oenema, Anke; Crutzen, Rik; de Nooijer, Jascha; de Vries, Nanne K; Brug, Johannes

2008-01-01

Background The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure. Objective The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention. Methods A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD ≤ 1 were considered to be important. Results Of the 62 experts invited for the first round, 30 completed the questionnaire (48% response rate); 93/233 experts completed the second-round questionnaire (40% response rate), and 59/88 completed the third round (67% response rate). Being motivated to visit an Internet intervention and perceiving the intervention as personally relevant appeared to be important factors related to a first visit

Effectiveness of personalized face-to-face and telephone nursing counseling interventions for cardiovascular risk factors: a controlled clinical trial 1

PubMed Central

Vílchez Barboza, Vivian; Klijn, Tatiana Paravic; Salazar Molina, Alide; Sáez Carrillo, Katia Lorena

2016-01-01

Abstract Objective: to evaluate the effect and gender differences of an innovative intervention involving in-person and telephone nursing counseling to control cardiovascular risk factors (arterial hypertension, dyslipidemia, and overweight), improve health-related quality of life and strengthen self-efficacy and social support in persons using the municipal health centers' cardiovascular health program. Method: a randomized controlled clinical trial involving participants randomized into the intervention group who received traditional consultation plus personalized and telephone nursing counseling for 7 months (n = 53) and the control group (n = 56). The study followed the Consolidated Standards of Reporting Trials Statement. Results: women in the intervention group presented a significant increase in the physical and mental health components compared to the control group, with decreases in weight, abdominal circumference, total cholesterol, low-density lipoprotein cholesterol, and the atherogenic index. The effects attributable to the intervention in the men in the intervention group were increased physical and emotional roles and decreased systolic and diastolic pressure, waist circumference, total cholesterol, low-density lipoprotein cholesterol, atherogenic index, cardiovascular risk factor, and 10-year coronary risk. Conclusion: this intervention is an effective strategy for the control of three cardiovascular risk factors and the improvement of health-related quality of life. PMID:27508917

Integrative Review of Factors and Interventions That Influence Early Father-Infant Bonding.

PubMed

Scism, Ashley Renee; Cobb, Robin Lynn

To report on the current state of research analyzing early father-infant bonding, including influential factors and interventions, to identify gaps in the literature. CINAHL, MEDLINE, PubMed, and PsychInfo computerized databases were searched using the keywords bonding, paternal, father, infant, relationship, engrossment, and postpartum. Twenty-eight articles were compiled on the basis of key inclusion criteria. Quality measures were undertaken using specific components of SQUIRE 2.0 to ensure quality of methodology and data. Each study was carefully dissected and initially arranged in a generic annotated bibliography. This process resulted in pattern recognition and identification of three major themes. The findings of every article were compared for commonalities and differences and were synthesized into an integrated review of father-infant bonding. The synthesis revealed three themes: Father's Adjustment and Transition, Variables That Influence Father-Infant Bonding, and Interventions That Promote Father-Infant Bonding. There is an immediate need to perform studies on specific interventions aimed at the promotion of early father-infant bonding in the United States. More research is needed to better understand the timing of early father-infant bonding and how this bonding influences a provider's role, attitude, and priority for establishing successful bonding interventions for fathers. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

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

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

PubMed

Niks, Irene M W; de Jonge, Jan; Gevers, Josette M P; Houtman, Irene L D

2013-02-19

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. 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. 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.

Health diplomacy the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: Evaluating findings from Project Accept (HPTN 043)

PubMed Central

2012-01-01

Background Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of ‘global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. Methods We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Results Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of ‘youth-friendly’ services in South Africa, Zimbabwe and Tanzania), and

Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up.

PubMed

Hardcastle, Sarah J; Taylor, Adrian H; Bailey, Martin P; Harley, Robert A; Hagger, Martin S

2013-03-28

Intensive diet and physical activity interventions have been found to reduce cardiovascular disease (CVD) risk, but are resource intensive. The American Heart Association recently recommended motivational interviewing (MI) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss. However, there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk. The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary-care setting in maintaining reductions in CVD risk factors at12 months post-intervention. Primary-care patients were randomised to an intervention group that received standard exercise and nutrition information plus up to five face-to-face MI sessions, delivered by a physical activity specialist and registered dietician over a 6-month period, or to a minimal intervention comparison group that received the standard information only. Follow-up measures of behavioural (vigorous and moderate physical activity, walking, physical activity stage-of-change, fruit and vegetable intake, and dietary fat intake) and biomedical (weight, body mass index [BMI], blood pressure, cholesterol) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion. Intent-to-treat analyses revealed significant differences between groups for walking and cholesterol. Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group. Post-intervention improvements in other health-related outcomes including blood pressure, weight, and BMI were not maintained. The present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some, but not all, health-related outcomes (walking, cholesterol

Nutrient-dense, Plant-rich Dietary Intervention Effective at Reducing Cardiovascular Disease Risk Factors for Worksites: A Pilot Study.

PubMed

Sutliffe, Jay Thomas; Fuhrman, Joel Harvey; Carnot, Mary Jo; Beetham, Raena Marie; Peddy, Madison Sarah

2016-09-01

conduct interventions for health promotion and disease prevention to ameliorate chronic risk factors for disease, such as for cardiovascular disease (CVD). Likewise, nutrient-dense, plant-rich (NDPR) dietary patterns have been shown to be effective at preventing and improving chronic-disease conditions, including CVD. Objective • The study's aim was to determine the feasibility and effectiveness of an NDPR dietary intervention for worksites to lower CVD risk factors. Design • The study was a 6-wk pilot intervention using a pretest and posttest design. The intervention was conducted at the Northern Arizona University (Flagstaff, AZ, USA) and sponsored by its Employee Assistance and Wellness Department. Participants • Participants were 35 employees with body mass indexes (BMIs) >25 kg/m2 who were ready and willing to make a lifestyle change, who were not currently participating in a weight loss program, and who were not taking any medications that could increase medical risk or had weight loss as a primary side effect. The average age of participants was 42.57 y; 91.4% were female, and 80% were Caucasian. Intervention • The intervention used a dietary protocol consisting of the daily consumption of greens, beans, legumes, and a variety of other vegetables, as well as fresh or frozen whole fruits, nuts, seeds, and whole grains. Participants were encouraged to minimize the consumption of refined grains, vegetable oils, processed foods, and animal products. Outcome Measures • The study measured serum lipids, height, weight, waist and hip circumference, waist-to-hip ratio, and blood pressure. Results • Based on paired-sample t tests and Wilcoxon signed-ranks test with a maximum level of P = .05, the intervention resulted in significant changes in weight, BMI, waist and hip measurements, high-density lipoproteins, low-density lipoproteins, and estimated average glucose. Conclusions • The findings favorably revealed that an NDPR dietary intervention that was

External Validity of the New York University Caregiver Intervention: Key Caregiver Outcomes Across Multiple Demonstration Projects.

PubMed

Fauth, Elizabeth B; Jackson, Mark A; Walberg, Donna K; Lee, Nancy E; Easom, Leisa R; Alston, Gayle; Ramos, Angel; Felten, Kristen; LaRue, Asenath; Mittelman, Mary

2017-06-01

The Administration on Aging funded six New York University Caregiver Intervention (NYUCI) demonstration projects, a counseling/support intervention targeting dementia caregivers and families. Three sites (Georgia, Utah, Wisconsin) pooled data to inform external validity in nonresearch settings. This study (a) assesses collective changes over time, and (b) compares outcomes across sites on caregiver burden, depressive symptoms, satisfaction with social support, family conflict, and quality of life. Data included baseline/preintervention ( N = 294) and follow-up visits (approximately 4, 8, 12 months). Linear mixed models showed that social support satisfaction increased ( p < .05) and family conflict decreased ( p < .05; Cohen's d = 0.49 and 0.35, respectively). Marginally significant findings emerged for quality of life increases ( p = .05) and burden decreases ( p < .10). Depressive symptoms remained stable. Slopes did not differ much by site. NYUCI demonstrated external validity in nonresearch settings across diverse caregiver samples.

Effect of peer support interventions on cardiovascular disease risk factors in adults with diabetes: a systematic review and meta-analysis.

PubMed

Patil, Sonal J; Ruppar, Todd; Koopman, Richelle J; Lindbloom, Erik J; Elliott, Susan G; Mehr, David R; Conn, Vicki S

2018-03-23

Peer support by persons affected with diabetes improves peer supporter's diabetes self-management skills. Peer support interventions by individuals who have diabetes or are affected by diabetes have been shown to improve glycemic control; however, its effects on other cardiovascular disease risk factors in adults with diabetes are unknown. We aimed to estimate the effect of peer support interventions on cardiovascular disease risk factors other than glycemic control in adults with diabetes. We conducted a systematic review and meta-analysis of randomized controlled trials comparing peer support interventions to a control condition in adults affected by diabetes that measured any cardiovascular disease risk factors [Body Mass Index, smoking, diet, physical activity, cholesterol level, glucose control and blood pressure]. Quality was assessed by Cochrane's risk of bias tool. We calculated standardized mean difference effect sizes using random effects models. We retrieved 438 citations from multiple databases including OVID MEDLINE, Cochrane database and Scopus, and author searches. Of 233 abstracts reviewed, 16 articles met inclusion criteria. A random effects model in a total of 3243 participants showed a positive effect of peer support interventions on systolic BP with a pooled effect size of 2.07 mmHg (CI 0.35 mmHg to 3.79 mmHg, p = 0.02); baseline pooled systolic blood pressure was 137 mmHg. There was a non-significant effect of peer support interventions on diastolic blood pressure, cholesterol, body mass index, diet and physical activity. Cardiovascular disease risk factors other than glycemic control outcomes were secondary outcomes in most studies and baseline values were normal or mildly elevated. Only one study reported smoking outcomes. We found a small (2 mmHg) positive effect of peer support interventions on systolic blood pressure in adults with diabetes whose baseline blood pressure was on average minimally elevated. Additional studies need to

High prevalence of sedentary risk factors amongst university employees and potential health benefits of campus workplace exercise intervention.

PubMed

Alkhatib, Ahmad

2015-01-01

Sedentariness and physical inactivity are often reported within white-collar workers, including university campus employees. However, the prevalence of the associated sedentary risk factors and risk reduction intervention strategies within a university campus workplace are less known. This study investigates whether the prevalence of sedentary risk factors within university campus employees could be reduced with a campus based exercise intervention. 56 UK university employees (age = 50.7 ± 10.2, stature = 1.68.8 ± 8.6, body mass = 73.9 ± 15.1) were tested for body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and maximal cardiorespiratory capacity (V̇O2max). The prevalence was analyzed across genders and job roles. An exercise intervention followed for the sedentary employees involving walking and running for 25 min twice/week for 10 weeks at an intensity corresponding to individual's ventilatory threshold (VT). The university workplace demonstrated a prevalence of higher BMI, SBP and DBP than the recommended healthy thresholds, with gender having a significant effect. Males' BMI, SBP and DBP were higher than in females (p <  0.05) and males' V̇O2max was lower than the recommended healthy thresholds. The exercise training intervention significantly improved V̇O2max, VT and VT velocity in both genders (all p <  0.05) with both groups meeting the recommended thresholds following the intervention. University campus employees have a high prevalence of sedentary risk factors across different genders and job roles. These risks can be reduced by an exercise-based intervention administered within the campus workplace, which should be considered in university workplace policies.

The Effect of Interdisciplinary Interventions on Risk Factors for Lifestyle Disease: A Literature Review

ERIC Educational Resources Information Center

Tapsell, Linda C.; Neale, Elizabeth P.

2016-01-01

Interventions that comprise interdisciplinary collaboration including behavioral elements are effective in addressing lifestyle disease risk factors. However, it is not known how best to conduct this collaboration for sustainable change. The aim of this study was to systematically examine the evidence for the effects of interdisciplinary…

Psychosocial group rehabilitation for lonely older people: favourable processes and mediating factors of the intervention leading to alleviated loneliness.

PubMed

Savikko, Niina; Routasalo, Pirkko; Tilvis, Reijo; Pitkälä, Kaisu

2010-03-01

Loneliness among community-dwelling older people is a common problem, with serious health consequences. The favourable processes and mediating factors of a psychosocial group rehabilitation intervention in alleviating older people's loneliness were evaluated. Altogether, 117 lonely, home-dwelling individuals (aged ≥75 years) participated in a psychosocial group rehabilitation intervention. The content comprised (i) art and inspiring activities, (ii) group exercise and discussions or (iii) therapeutic writing and group therapy. The psychosocial group rehabilitation intervention was evaluated from the group leaders' diaries and by observing the groups. Experiences of loneliness and social participation were collected by postintervention questionnaires from the participants. Data were analysed using methodological triangulation. Doing things together and sharing experiences with their peers inspired lively discussions, created a feeling of togetherness and led to participants' empowerment and increased self-esteem. The intervention socially activated the participants, and their feelings of loneliness had been alleviated during the intervention. Several common favourable processes and mediating factors were identified in the psychosocial group rehabilitation intervention that led to alleviation of loneliness among older people. Relevance to clinical practice.  The psychosocial group rehabilitation intervention gives nurses an effective tool to support older people's psychosocial resources by activating them and alleviating their loneliness. © 2009 Blackwell Publishing Ltd.

Assessing children's perceptions of academic interventions: The Kids Intervention Profile.

PubMed

Eckert, Tanya L; Hier, Bridget O; Hamsho, Narmene F; Malandrino, Rigby D

2017-06-01

The psychometric properties of the Kids Intervention Profile (KIP), a rating scale designed to measure academic intervention acceptability from the perspective of students, were examined as well as the influence of background factors on students' acceptability ratings. Data were extracted from 4 randomized controlled trials investigating the effects of a performance feedback intervention on third-grade students' writing fluency (n = 228). Results indicated that the KIP contains 2 factors (General Intervention Acceptability, Skill Improvement) and has adequate internal consistency and stability across a 3-week period. There were gender differences in students' acceptability ratings, with female students rating the intervention as significantly more acceptable than males. In addition, results suggested a modest, positive relationship between students' intervention acceptability ratings and their intervention outcomes. Considerations regarding the use of the KIP, as well as limitations of the study, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Designing equitable workplace dietary interventions: perceptions of intervention deliverers.

PubMed

Smith, Sarah A; Visram, Shelina; O'Malley, Claire; Summerbell, Carolyn; Araujo-Soares, Vera; Hillier-Brown, Frances; Lake, Amelia A

2017-10-16

Workplaces are a good setting for interventions that aim to support workers in achieving a healthier diet and body weight. However, little is known about the factors that impact on the feasibility and implementation of these interventions, and how these might vary by type of workplace and type of worker. The aim of this study was to explore the views of those involved in commissioning and delivering the Better Health at Work Award, an established and evidence-based workplace health improvement programme. One-to-one semi-structured interviews were conducted with 11 individuals in North East England who had some level of responsibility for delivering workplace dietary interventions. Interviews were transcribed verbatim and analysed using thematic framework analysis. A number of factors were felt to promote the feasibility and implementation of interventions. These included interventions that were cost-neutral (to employee and employer), unstructured, involved colleagues for support, took place at lunchtimes, and were well-advertised and communicated via a variety of media. Offering incentives, not necessarily monetary, was perceived to increase recruitment rates. Factors that militate against feasibility and implementation of interventions included worksites that were large in size and remote, working patterns including shifts and working outside of normal working hours that were not conducive to workers being able to access intervention sessions, workplaces without appropriate provision for healthy food on site, and a lack of support from management. Intervention deliverers perceived that workplace dietary interventions should be equally and easily accessible (in terms of cost and timing of sessions) for all staff, regardless of their job role. Additional effort should be taken to ensure those staff working outside normal working hours, and those working off-site, can easily engage with any intervention, to avoid the risk of intervention-generated inequalities (IGIs).

A systematic literature review of engineering identity: definitions, factors, and interventions affecting development, and means of measurement

NASA Astrophysics Data System (ADS)

Morelock, John R.

2017-11-01

Studies exploring what it means to be an engineer professionally have been conducted for decades, but have boomed in recent years. This systematic literature review aims to organise extant studies on engineering identity by coding around four key variables: (a) definitions of engineering identity, (b) factors affecting engineering identity development, (c) interventions affecting engineering identity development, and (d) means of measuring identity. In doing so, this review provides strategies for future research and educational interventions to advance work related to engineering identity. Publications were selected for inclusion by screening and appraising results obtained from databases and keywords refined through a scoping study. Derived from key findings, suggestions for future research include bridging disparate strands of engineering identity literature and incorporating more varied methodological approaches. Also from key findings, suggestions for future practice involve better connecting existing definitions of engineering identity and factors known to affect identity development with identity-related interventions.

Factors Influencing Implementation of a Physical Activity Intervention in Residential Children's Homes.

PubMed

Lau, Erica Y; Saunders, Ruth P; Pate, Russell R

2016-11-01

The Environmental Intervention in Children's Homes (ENRICH) study was the first published physical activity intervention undertaken in residential children's homes (RCHs). The study revealed differences in implementation across the homes, which may be a key factor that affects program effectiveness. The purpose of this study was to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation of the ENRICH intervention. This study analyzed the ENRICH process evaluation data collected from 24 RCHs. Bayesian Path analysis was used to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation. Level of implementation across RCHs was variable, ranging from 38 to 97 % (M = 68.3, SD = 14.45). Results revealed that organizational capacity and provider characteristics had significant direct associations with level of implementation. Neither direct nor indirect associations between quality of prevention support system and level of implementation reached statistical significance. Conducting formative assessments on organizational capacity and provider characteristics and incorporating such information in implementation planning may increase the likelihood of achieving higher levels of implementation in future studies.

Social and cultural factors affecting uptake of interventions for malaria in pregnancy in Africa: a systematic review of the qualitative research.

PubMed

Pell, Christopher; Straus, Lianne; Andrew, Erin V W; Meñaca, Arantza; Pool, Robert

2011-01-01

Malaria during pregnancy (MiP) results in adverse birth outcomes and poor maternal health. MiP-related morbidity and mortality is most pronounced in sub-Saharan Africa, where recommended MiP interventions include intermittent preventive treatment, insecticide-treated bednets and appropriate case management. Besides their clinical efficacy, the effectiveness of these interventions depends on the attitudes and behaviours of pregnant women and the wider community, which are shaped by social and cultural factors. Although these factors have been studied largely using quantitative methods, qualitative research also offers important insights. This article provides a comprehensive overview of qualitative research on social and cultural factors relevant to uptake of MiP interventions in sub-Saharan Africa. A systematic search strategy was employed: literature searches were undertaken in several databases (OVID SP, IS Web of Knowledge, MiP Consortium library). MiP-related original research, on social/cultural factors relevant to MiP interventions, in Africa, with findings derived from qualitative methods was included. Non-English language articles were excluded. A meta-ethnographic approach was taken to analysing and synthesizing findings. Thirty-seven studies were identified. Fourteen concentrated on MiP. Others focused on malaria treatment and prevention, antenatal care (ANC), anaemia during pregnancy or reproductive loss. Themes identified included concepts of malaria and risk in pregnancy, attitudes towards interventions, structural factors affecting delivery and uptake, and perceptions of ANC. Although malaria risk is associated with pregnancy, women's vulnerability is often considered less disease-specific and MiP interpreted in locally defined categories. Furthermore, local discourses and health workers' ideas and comments influence concerns about MiP interventions. Understandings of ANC, health worker-client interactions, household decision-making, gender relations

Social and Cultural Factors Affecting Uptake of Interventions for Malaria in Pregnancy in Africa: A Systematic Review of the Qualitative Research

PubMed Central

Pell, Christopher; Straus, Lianne; Andrew, Erin V. W.; Meñaca, Arantza; Pool, Robert

2011-01-01

Background Malaria during pregnancy (MiP) results in adverse birth outcomes and poor maternal health. MiP-related morbidity and mortality is most pronounced in sub-Saharan Africa, where recommended MiP interventions include intermittent preventive treatment, insecticide-treated bednets and appropriate case management. Besides their clinical efficacy, the effectiveness of these interventions depends on the attitudes and behaviours of pregnant women and the wider community, which are shaped by social and cultural factors. Although these factors have been studied largely using quantitative methods, qualitative research also offers important insights. This article provides a comprehensive overview of qualitative research on social and cultural factors relevant to uptake of MiP interventions in sub-Saharan Africa. Methods and Findings A systematic search strategy was employed: literature searches were undertaken in several databases (OVID SP, IS Web of Knowledge, MiP Consortium library). MiP-related original research, on social/cultural factors relevant to MiP interventions, in Africa, with findings derived from qualitative methods was included. Non-English language articles were excluded. A meta-ethnographic approach was taken to analysing and synthesizing findings. Thirty-seven studies were identified. Fourteen concentrated on MiP. Others focused on malaria treatment and prevention, antenatal care (ANC), anaemia during pregnancy or reproductive loss. Themes identified included concepts of malaria and risk in pregnancy, attitudes towards interventions, structural factors affecting delivery and uptake, and perceptions of ANC. Conclusions Although malaria risk is associated with pregnancy, women's vulnerability is often considered less disease-specific and MiP interpreted in locally defined categories. Furthermore, local discourses and health workers' ideas and comments influence concerns about MiP interventions. Understandings of ANC, health worker-client interactions

Exploring factors affecting owners' trust of contractors in construction projects: a case of China.

PubMed

Tai, Shuangliang; Sun, Chengshuang; Zhang, Shoujian

2016-01-01

It has been found that a low level of trust among members of a construction project team leads to poor performance in China. Many researchers have described the challenges, consequently advocating partnering as an attractive approach for more valuable cooperation. Because substantial investments have been poured into construction projects since the year 2000, trust research will improve the performance of construction projects and will be meaningful to the Chinese construction industry. The purpose of this paper is to investigate the attributes affecting owners' trust of contractors, to understand the potential properties of these factors, and to rank the factors in order of importance. Twenty-four attributes are identified from a literature review. Supported by qualitative reviews, a questionnaire is conducted to obtain relevant data, and 168 valid responses are obtained for data analysis. Principal component analysis (PCA) is employed to find the factor structure of the identified trust attributes. By the method of PCA, the attributes are extracted into eight factors, including interaction history, information sharing and communication, contract and institution, relation-specific investment, reputation, integrity, competence, and opportunistic behaviour. The value and originality of this paper are embodied in using PCA to understand the various attribute groupings and to illuminate trust impact factors in the Chinese context. When they understand the critical factors affecting trust better, owners and contractors can devise more appropriate strategies to improve performance.

Projecting the Long-Term Impact of School- or Community-Based Mass-Treatment Interventions for Control of Schistosoma Infection

PubMed Central

Wang, Xiaoxia; Gurarie, David; Mungai, Peter L.; Muchiri, Eric M.; Kitron, Uriel; King, Charles H.

2012-01-01

Background Schistosomiasis remains a significant health burden in many areas of the world. Morbidity control, focused on limiting infection intensity through periodic delivery of anti-schistosomal medicines, is the thrust of current World Health Organization guidelines (2006) for reduction of Schistosoma-related disease. A new appreciation of the lifetime impact of repeated Schistosoma infection has directed attention toward strategies for greater suppression of parasite infection per se, with the goal of transmission interruption. Variations in drug schedules involving increased population coverage and/or treatment frequency are now undergoing field trials. However, their relative effectiveness in long-term infection suppression is presently unknown. Methodology/Principal Findings Our study used available field data to calibrate advanced network models of village-level Schistosoma transmission to project outcomes of six different community- or school age-based programs, as compared to the impact of current 2006 W.H.O. recommended control strategies. We then scored the number of years each of 10 typical villages would remain below 10% infection prevalence (a practicable level associated with minimal prevalence of disease). All strategies that included four annual treatments effectively reduced community prevalence to less than 10%, while programs having yearly gaps (‘holidays’) failed to reach this objective in half of the communities. Effective post-program suppression of infection prevalence persisted in half of the 10 villages for 7–10 years, whereas in five high-risk villages, program effects on prevalence lasted zero to four years only. Conclusions/Significance At typical levels of treatment adherence (60 to 70%), current WHO recommendations will likely not achieve effective suppression of Schistosoma prevalence unless implemented for ≥6 years. Following more aggressive 4 year annual intervention, some communities may be able to continue without

Barriers to and enablers of evidence-based practice in perinatal care in the SEA-ORCHID project.

PubMed

Turner, Tari; Short, Jacki

2013-08-01

The South-East Asia Optimising Reproductive and Child Health in Developing Countries (SEA-ORCHID) project aimed to improve health outcomes for mothers and babies in nine hospitals in South-East Asia by supporting evidence-based perinatal health care. In this research, we aimed to identify and explore the factors that may have acted as barriers to or enablers of evidence-based practice change at each of the hospitals. During the final 6 months of the intervention phase of the project, semi-structured, face-to-face interviews were undertaken with 179 nurses, midwives and doctors from the maternal and neonatal departments at each of the nine participating South-East Asian hospitals. The interviews identified several factors that participants believed had a substantial impact on the effectiveness of the SEA-ORCHID intervention. These included knowledge, skills, hierarchy, multidisciplinarity and leadership, beliefs about consequences, resources, and the nature of the behaviours. The success of the SEA-ORCHID intervention in improving practice may reflect the extent to which tailored strategies were effective in overcoming these barriers. Effective interventions to align practice with evidence rely on identifying and addressing barriers to practice change. The barriers identified in this study may be useful for those designing similar clinical practice improvement projects, as well as for continued efforts to improve practice in the SEA-ORCHID hospitals. © 2011 John Wiley & Sons Ltd.

Factors Affecting Readiness for Low Vision Interventions in Older Adults.

PubMed

Mohler, Amanda Jean; Neufeld, Peggy; Perlmutter, Monica S

2015-01-01

We sought to identify factors that facilitate and inhibit readiness for low vision interventions in people with vision loss, conceptualized as readiness for change in the way they perform daily activities. We conducted 10 semistructured interviews with older adults with low vision and analyzed the results using grounded theory concepts. Themes involving factors that facilitated change included desire to maintain or regain independence, positive attitude, and presence of formal social support. Themes related to barriers to change included limited knowledge of options and activity not a priority. Themes that acted as both barriers and facilitators were informal social support and community resources. This study provides insight into readiness to make changes in behavior and environment in older adults with vision loss. Study findings can help occupational therapy practitioners practice client-centered care more effectively and promote safe and satisfying daily living activity performance in this population. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Matryoshka Project: lessons learned about early intervention in psychosis programme development.

PubMed

Cheng, Chiachen; Dewa, Carolyn S; Goering, Paula

2011-02-01

This part of the Matryoshka project sought to understand the processes with which early intervention in psychosis (EIP) programmes were implemented and developed. The goals were to understand the key influences of programme implementation in the context of rapid EIP service growth and lack of specific provincial guidelines. Sampling was purposive and data were collected with semi-structured interviews. Five Matryoshka Project programmes were successfully contacted. All interviews were conducted by phone, recorded and transcribed verbatim. Emerging themes were analysed iteratively and discussed among authors. Key themes were validated with participants. The new EIP services were significantly influenced by the provincial EIP network, advocacy groups and clinical mentors. EIP programme decision makers often relied on each other for guidance. Although the research evidence assisted programme decision makers to develop an effective EIP model for their region, implementation was often shaped by funding constraints. Programmes adapted their EIP models according to funding and local service characteristics. The lack of specific guidelines may have allowed innovation; programme creativity and diversity is consistent with EIP values. Despite the challenges related to geography and staffing, programmes experienced important successes such as partnerships across sectors, quality clinical service and the ability to engage hard-to-serve clientele. Although important, research evidence played only a secondary role. Relationships among providers and services, coupled with the dedication of front-line staff, were more critical to knowledge exchange than written documents alone. These findings stress the importance of researcher-front-line relationships to the adoption of evidence-informed practice. © 2011 Blackwell Publishing Asia Pty Ltd.

Mediating Factors of a School-Based Multi-Component Smoking Prevention Intervention: The LdP Cluster Randomized Controlled Trial

ERIC Educational Resources Information Center

Carreras, G.; Bosi, S.; Angelini, P.; Gorini, G.

2016-01-01

The aim of this study was to investigate factors mediating the effects of Luoghi di Prevenzione (LdP) smoking prevention intervention based on social competence and social influence approaches, and characterized by peer-led school-based interventions, out-of-school workshops, school lessons, and by enforcing the school anti-smoking policy.…

Increasing the treatment of hypertension through primary intervention

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fair, M.D.

1994-12-31

South Carolina is one of the leading states in stroke mortality. Hypertension is one of the major risk factors that lead to strokes. Unfortunately, many people who are hypertensive do not treat their disease properly due to lack of medical education. The specific objectives of this project are to access geographic areas to determine the level of medical representation available; to identify areas of medical needs based on race, income and health status; and, to structure an intervention plan to target areas that are in the highest hypertension at-risk category. The methods used are to identify medical coverage by geographicmore » areas. Health in poor areas is identified and mapped. Implementation of intervention strategies is prioritized based on areas of need.« less

Factors that may impede the weight loss response to exercise-based interventions.

PubMed

Boutcher, S H; Dunn, S L

2009-11-01

The results of exercise programmes designed to reduce body fat are disappointing. However, the reporting of weight loss as mean values disguises those individuals who do lose significant amounts of fat. Why some participants produce significant exercise-induced fat loss whereas others lose little or increase fat stores is likely to be an outcome of a range of behavioural (e.g. sleep deprivation, caloric intake), inherited (e.g. muscle fibre type, gender) and physiological (e.g. hyperinsulinaemia, hypothyroidism) factors. The following review highlights possible factors involved in weight loss and discusses how individual differences may determine the extent of weight loss after an exercise intervention. Finally, implications for the treatment and prevention of obesity are discussed.

Cash transfer and microfinance interventions for tuberculosis control: review of the impact evidence and policy implications.

PubMed

Boccia, D; Hargreaves, J; Lönnroth, K; Jaramillo, E; Weiss, J; Uplekar, M; Porter, J D H; Evans, C A

2011-06-01

To quantify the impact of cash transfer and microfinance interventions on a selected list of tuberculosis (TB) risk factors and assess their potential role in supporting TB control. Published and unpublished references identified from clinical and social electronic databases, grey literature and web sites. Eligible interventions had to be conducted in middle- or low-income countries and document an impact evaluation on any of the following outcomes: 1) TB or other respiratory infections; 2) household socio-economic position; and 3) factors mediating the association between low household socio-economic position and TB, including inadequate health-seeking behaviours, food insecurity and biological TB risk factors such as human immunodeficiency virus (HIV) and adult malnutrition. Interventions targeting special populations were excluded. Fifteen cash transfer schemes (four unconditional and 11 conditional) and seven microfinance programmes met the eligibility criteria. No intervention addressed TB or any other respiratory infection. Of 11 cash transfer and four microfinance interventions, respectively seven and four reported a positive impact on indicators of economic well-being. A positive impact on household food security was documented in respectively eight of nine and three of five cash transfer and microfinance interventions. Improved health care access was documented respectively in 10 of 12 cash transfer and four of five microfinance interventions. The only intervention evaluating impact on HIV incidence was a microfinance project that found no effect. No cash transfer or microfinance interventions had an impact on adult malnutrition. Cash transfer and microfinance interventions can positively impact TB risk factors. Evaluation studies are urgently needed to assess the impact of these social protection interventions on actual TB indicators.

The Baade-Wesselink projection factor of the δ-Scuti stars AI Vel and β Cas

NASA Astrophysics Data System (ADS)

Guiglion, G.; Nardetto, N.; Domiciano de Souza, A.; Mathias, P.; Mourard, D.; Poretti, E.

2012-12-01

The Baade-Wesselink method of distance determination is based on the oscillations of pulsating stars. After determining the angular diameter and the linear radius variations, the distance is derived by a simple ratio. The linear radius variation is measured by integrating the pulsation velocity (hereafter V_{puls}) over one pulsating cycle. However, from observations we have only access to the radial velocity (V_{rad}) because of the projection along the line-of-sight. The projection factor, used to convert the radial velocity into the pulsation velocity, is defined by: p = V_{puls} / V_{rad}. We aim to derive the projection factor for two δ-Scuti stars, the high amplitude pulsator AI Vel and the fast rotator β Cas. The geometric component of the projection factor is derived using a limb-darkening model of the intensity distribution of AI Vel, and a fast rotator model for β Cas. Then, by comparing the radial velocity curves of several spectral lines forming at different levels in the atmosphere, we derive directly the velocity gradient (in a part of the atmosphere of the star) using SOPHIE/OHP data for β Cas and HARPS/ESO data for AI Vel, which is used to derive a dynamical projection factor for both stars. We find p = 1.44 ± 0.05 for AI Vel and p = 1.41 ± 0.25 for β Cas. By comparing Cepheids and δ-Scuti stars, these results bring valuable insights into the dynamical structure of pulsating star atmospheres.

Ergonomics intervention in an Iranian television manufacturing industry.

PubMed

Motamedzade, M; Mohseni, M; Golmohammadi, R; Mahjoob, H

2011-01-01

The primary goal of this study was to use the Strain Index (SI) to assess the risk of developing upper extremity musculoskeletal disorders in a television (TV) manufacturing industry and evaluate the effectiveness of an educational intervention. The project was designed and implemented in two stages. In first stage, the SI score was calculated and the Nordic Musculoskeletal Questionnaire (NMQ) was completed. Following this, hazardous jobs were identified and existing risk factors in these jobs were studied. Based on these data, an educational intervention was designed and implemented. In the second stage, three months after implementing the interventions, the SI score was re-calculated and the Nordic Musculoskeletal Questionnaire (NMQ) completed again. 80 assembly workers of an Iranian TV manufacturing industry were randomly selected using simple random sampling approach. The results showed that the SI score had a good correlation with the symptoms of musculoskeletal disorders. It was also observed that the difference between prevalence of signs and symptoms of musculoskeletal disorders, before and after intervention, was significantly reduced. A well conducted implementation of an interventional program with total participation of all stakeholders can lead to a decrease in musculoskeletal disorders.

Investigation on the Factors Influencing Construction Time and Cost Overrun for High-Rise Building Projects In Penang

NASA Astrophysics Data System (ADS)

Nor Haslinda, A.; Xian, T. Wei; Norfarahayu, K.; Muhamad Hanafi, R.; Fikri, H. Muhammad

2018-04-01

Time and cost overruns have become one prominent issue for most construction projects around the world. Project costing and timeframe extension had been causing a lot of wastage and loss of opportunity for many parties involved. Therefore, this research was carried out to investigate the factors influencing time and cost overruns for high-rise construction projects in Penang, Malaysia. A set of questionnaires survey was distributed to the project managers who had been or currently involved in the high-rise building projects in Penang to get their input and perceptions for each factor identified as well as its frequency of occurrence. In order to rank all the factors gathered, the mean index of the most distinguishing factors and its frequency of occurrence were multiplied to get the severity index. The results revealed that for time overrun, the most predominant causes were due to design changes, inadequate planning and scheduling and poor labor productivity. Meanwhile, the predominant causes of cost overrun were poor pre-construction budget and material cost planning, inaccurate quantity take-off and materials cost increased by inflation. The significance of establishing the issues related to time and cost overruns for the high-rise building construction project is to provide a greater insight and understanding on the causes of delays, particularly among the main project players: contractors, client, and consultants.

Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project.

PubMed

Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita

2014-01-01

It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and "vulnerability index", a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4-3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2-4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2-3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0-2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community involvement, in order to strengthen the structural response to HIV

Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project

PubMed Central

Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita

2014-01-01

Background It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4–3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2–4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2–3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0–2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community

Risk factors for early failure after peripheral endovascular intervention: application of a reliability engineering approach.

PubMed

Meltzer, Andrew J; Graham, Ashley; Connolly, Peter H; Karwowski, John K; Bush, Harry L; Frazier, Peter I; Schneider, Darren B

2013-01-01

We apply an innovative and novel analytic approach, based on reliability engineering (RE) principles frequently used to characterize the behavior of manufactured products, to examine outcomes after peripheral endovascular intervention. We hypothesized that this would allow for improved prediction of outcome after peripheral endovascular intervention, specifically with regard to identification of risk factors for early failure. Patients undergoing infrainguinal endovascular intervention for chronic lower-extremity ischemia from 2005 to 2010 were identified in a prospectively maintained database. The primary outcome of failure was defined as patency loss detected by duplex ultrasonography, with or without clinical failure. Analysis included univariate and multivariate Cox regression models, as well as RE-based analysis including product life-cycle models and Weibull failure plots. Early failures were distinguished using the RE principle of "basic rating life," and multivariate models identified independent risk factors for early failure. From 2005 to 2010, 434 primary endovascular peripheral interventions were performed for claudication (51.8%), rest pain (16.8%), or tissue loss (31.3%). Fifty-five percent of patients were aged ≥75 years; 57% were men. Failure was noted after 159 (36.6%) interventions during a mean follow-up of 18 months (range, 0-71 months). Using multivariate (Cox) regression analysis, rest pain and tissue loss were independent predictors of patency loss, with hazard ratios of 2.5 (95% confidence interval, 1.6-4.1; P < 0.001) and 3.2 (95% confidence interval, 2.0-5.2, P < 0.001), respectively. The distribution of failure times for both claudication and critical limb ischemia fit distinct Weibull plots, with different characteristics: interventions for claudication demonstrated an increasing failure rate (β = 1.22, θ = 13.46, mean time to failure = 12.603 months, index of fit = 0.99037, R(2) = 0.98084), whereas interventions for critical limb

Factors Associated with Passing School District Capital Project Referenda in Wisconsin, 2011-2016

ERIC Educational Resources Information Center

Hoh, Thomas John

2017-01-01

Wisconsin school district superintendents faced with the need to fund capital improvement projects through a school finance bond referendum need support. Information regarding the factors related to a successful referendum in Wisconsin is limited. This mixed methods study examined the factors associated with successful bond referenda in Wisconsin…

[Intervention with rumba and nutrition education to modify cardiovascular risk factors in adults with metabolic syndrome].

PubMed

Pérez-Idárraga, Alexandra; Valencia Gómez, Katerine; Gallo Villegas, Jaime; Arenas Sosa, Mónica; Quintero Velásquez, Mario A

2015-01-01

Evaluate the effect of an intervention with rumba dance and nutrition education on the cardiovascular risk factors in a group of people with metabolic syndrome in a rural area of Colombia. Controlled, randomized clinical trial that included 59 people between 30 and 60 years of age with metabolic syndrome. The intervention group (n = 30) participated in a 12-week exercise program of aerobic rumba (60 minutes, 3 days per week) and muscle-strengthening work (30 minutes, twice a week). Each week the group also received two hours of nutrition education. The control group (n = 29) continued with conventional care. An assessment was made of the effect on the cardiovascular risk factors (physiological, metabolic, anthropometric, and nutritional) in the intervention group. The intervention group showed a reduction in systolic blood pressure (-10.0 mmHg; CI95%: -14.3 to -5.6, P < 0.001), diastolic blood pressure (-4.8 mmHg; CI95%: -8.4 to -1.1, P < 0.05) and overall cardiovascular risk at 10 years (-1.5%; CI95%: -2.7 to -0.3, P < 0.05). Furthermore, there was an increase in peak oxygen con-sumption (1.7 ml O2∙kg-1∙min-1; CI95%: 0.1 to 3.3, P < 0.05) and muscular strength (P < 0.001). Positive changes were also observed in body composition, caloric intake, and consumption of macro and micronutrients (P < 0.05). No differences were detected between metabolic variables in the two groups or in inflammatory markers (P < 0.05). An exercise program with rumba and muscular strengthening, combined with nutrition education, favorably modifies cardiovascular risk factors in people with metabolic syndrome.

Developing adaptive interventions for adolescent substance use treatment settings: protocol of an observational, mixed-methods project.

PubMed

Grant, Sean; Agniel, Denis; Almirall, Daniel; Burkhart, Q; Hunter, Sarah B; McCaffrey, Daniel F; Pedersen, Eric R; Ramchand, Rajeev; Griffin, Beth Ann

2017-12-19

Over 1.6 million adolescents in the United States meet criteria for substance use disorders (SUDs). While there are promising treatments for SUDs, adolescents respond to these treatments differentially in part based on the setting in which treatments are delivered. One way to address such individualized response to treatment is through the development of adaptive interventions (AIs): sequences of decision rules for altering treatment based on an individual's needs. This protocol describes a project with the overarching goal of beginning the development of AIs that provide recommendations for altering the setting of an adolescent's substance use treatment. This project has three discrete aims: (1) explore the views of various stakeholders (parents, providers, policymakers, and researchers) on deciding the setting of substance use treatment for an adolescent based on individualized need, (2) generate hypotheses concerning candidate AIs, and (3) compare the relative effectiveness among candidate AIs and non-adaptive interventions commonly used in everyday practice. This project uses a mixed-methods approach. First, we will conduct an iterative stakeholder engagement process, using RAND's ExpertLens online system, to assess the importance of considering specific individual needs and clinical outcomes when deciding the setting for an adolescent's substance use treatment. Second, we will use results from the stakeholder engagement process to analyze an observational longitudinal data set of 15,656 adolescents in substance use treatment, supported by the Substance Abuse and Mental Health Services Administration, using the Global Appraisal of Individual Needs questionnaire. We will utilize methods based on Q-learning regression to generate hypotheses about candidate AIs. Third, we will use robust statistical methods that aim to appropriately handle casemix adjustment on a large number of covariates (marginal structural modeling and inverse probability of treatment weights

Methods for the cultural adaptation of a diabetes lifestyle intervention for Latinas: an illustrative project.

PubMed

Osuna, Diego; Barrera, Manuel; Strycker, Lisa A; Toobert, Deborah J; Glasgow, Russell E; Geno, Cristy R; Almeida, Fabio; Perdomo, Malena; King, Diane; Doty, Alyssa Tinley

2011-05-01

Because Latinas experience a high prevalence of type 2 diabetes and its complications, there is an urgent need to reach them with interventions that promote healthful lifestyles. This article illustrates a sequential approach that took an effective multiple-risk-factor behavior-change program and adapted it for Latinas with type 2 diabetes. Adaptation stages include (a) information gathering from literature and focus groups, (b) preliminary adaptation design, and (c) preliminary adaptation test. In this third stage, a pilot study finds that participants were highly satisfied with the intervention and showed improvement across diverse outcomes. Key implications for applications include the importance of a model for guiding cultural adaptations, and the value of procedures for obtaining continuous feedback from staff and participants during the preliminary adaptation test.

Monte Carlo investigation of backscatter factors for skin dose determination in interventional neuroradiology procedures

NASA Astrophysics Data System (ADS)

Omar, Artur; Benmakhlouf, Hamza; Marteinsdottir, Maria; Bujila, Robert; Nowik, Patrik; Andreo, Pedro

2014-03-01

Complex interventional and diagnostic x-ray angiographic (XA) procedures may yield patient skin doses exceeding the threshold for radiation induced skin injuries. Skin dose is conventionally determined by converting the incident air kerma free-in-air into entrance surface air kerma, a process that requires the use of backscatter factors. Subsequently, the entrance surface air kerma is converted into skin kerma using mass energy-absorption coefficient ratios tissue-to-air, which for the photon energies used in XA is identical to the skin dose. The purpose of this work was to investigate how the cranial bone affects backscatter factors for the dosimetry of interventional neuroradiology procedures. The PENELOPE Monte Carlo system was used to calculate backscatter factors at the entrance surface of a spherical and a cubic water phantom that includes a cranial bone layer. The simulations were performed for different clinical x-ray spectra, field sizes, and thicknesses of the bone layer. The results show a reduction of up to 15% when a cranial bone layer is included in the simulations, compared with conventional backscatter factors calculated for a homogeneous water phantom. The reduction increases for thicker bone layers, softer incident beam qualities, and larger field sizes, indicating that, due to the increased photoelectric crosssection of cranial bone compared to water, the bone layer acts primarily as an absorber of low-energy photons. For neurointerventional radiology procedures, backscatter factors calculated at the entrance surface of a water phantom containing a cranial bone layer increase the accuracy of the skin dose determination.

Sleep Duration and Diabetes Risk in American Indian and Alaska Native Participants of a Lifestyle Intervention Project.

PubMed

Nuyujukian, Daniel S; Beals, Janette; Huang, Haixiao; Johnson, Ann; Bullock, Ann; Manson, Spero M; Jiang, Luohua

2016-11-01

We examine the association between self-reported sleep duration and diabetes incidence in a national sample of American Indians/ Alaska Natives (AI/ANs) with prediabetes. Data were derived from the Special Diabetes Program for Indians Diabetes Prevention demonstration project. This longitudinal analysis included 1,899 participants with prediabetes recruited between January 1, 2006 and July 31, 2009 who reported sleep duration and completed all 16 classes of the lifestyle intervention consisting of diet, exercise, and behavior modification sessions to promote weight loss. Three years of follow-up data were included to fit Cox regression models to compute hazard ratios (HRs) for diabetes incidence across sleep duration categories. The crude diabetes incidence rate was 4.6 per 100 person-years among short sleepers (≤ 6 h per night) compared to 3.2 among those sleeping 7 h and 3.3 among those sleeping 8 h or more. After adjustment for age and sex, short sleep (≤ 6 h vs. others) was associated with increased diabetes risk (HR 1.55 [95% confidence interval 1.11-2.17]); risk remained significantly elevated after controlling for socioeconomic characteristics, health behaviors, and health status. When adjusting for body mass index and percent weight loss, the short sleep-diabetes relationship was attenuated (HR 1.32 [95% confidence interval 0.92-1.89]). No significant long sleep-diabetes association was found. Further, short sleepers lost significantly less weight than others (3.7% vs. 4.3%, P = 0.003). Short sleep duration, but not long duration, was significantly associated with increased diabetes risk and less weight loss among AI/ANs in a lifestyle intervention. Further exploration of the complex factors underlying short sleep duration is warranted. © 2016 Associated Professional Sleep Societies, LLC.

Gender Differences in Risk Factors for Adolescent Binge Drinking and Implications for Intervention and Prevention

PubMed Central

Dir, Allyson L.; Bell, Richard L.; Adams, Zachary W.; Hulvershorn, Leslie A.

2017-01-01

Alcohol use, particularly binge drinking (BD), is a major public health concern among adolescents. Recent national data show that the gender gap in alcohol use is lessening, and BD among girls is rising. Considering the increase in BD among adolescent girls, as well as females’ increased risk of experiencing more severe biopsychosocial negative effects and consequences from BD, the current review sought to examine gender differences in risk factors for BD. The review highlights gender differences in (1) developmental-related neurobiological vulnerability to BD, (2) psychiatric comorbidity and risk phenotypes for BD, and (3) social-related risk factors for BD among adolescents, as well as considerations for BD prevention and intervention. Most of the information gleaned thus far has come from preclinical research. However, it is expected that, with recent advances in clinical imaging technology, neurobiological effects observed in lower mammals will be confirmed in humans and vice versa. A synthesis of the literature highlights that males and females experience unique neurobiological paths of development, and although there is debate regarding the specific nature of these differences, literature suggests that these differences in turn influence gender differences in psychiatric comorbidity and risk for BD. For one, girls are more susceptible to stress, depression, and other internalizing behaviors and, in turn, these symptoms contribute to their risk for BD. On the other hand, males, given gender differences across the lifespan as well as gender differences in development, are driven by an externalizing phenotype for risk of BD, in part, due to unique paths of neurobiological development that occur across adolescence. With respect to social domains, although social and peer influences are important for both adolescent males and females, there are gender differences. For example, girls may be more sensitive to pressure from peers to fit in and impress others, while

Gender Differences in Risk Factors for Adolescent Binge Drinking and Implications for Intervention and Prevention.

PubMed

Dir, Allyson L; Bell, Richard L; Adams, Zachary W; Hulvershorn, Leslie A

2017-01-01

Alcohol use, particularly binge drinking (BD), is a major public health concern among adolescents. Recent national data show that the gender gap in alcohol use is lessening, and BD among girls is rising. Considering the increase in BD among adolescent girls, as well as females' increased risk of experiencing more severe biopsychosocial negative effects and consequences from BD, the current review sought to examine gender differences in risk factors for BD. The review highlights gender differences in (1) developmental-related neurobiological vulnerability to BD, (2) psychiatric comorbidity and risk phenotypes for BD, and (3) social-related risk factors for BD among adolescents, as well as considerations for BD prevention and intervention. Most of the information gleaned thus far has come from preclinical research. However, it is expected that, with recent advances in clinical imaging technology, neurobiological effects observed in lower mammals will be confirmed in humans and vice versa . A synthesis of the literature highlights that males and females experience unique neurobiological paths of development, and although there is debate regarding the specific nature of these differences, literature suggests that these differences in turn influence gender differences in psychiatric comorbidity and risk for BD. For one, girls are more susceptible to stress, depression, and other internalizing behaviors and, in turn, these symptoms contribute to their risk for BD. On the other hand, males, given gender differences across the lifespan as well as gender differences in development, are driven by an externalizing phenotype for risk of BD, in part, due to unique paths of neurobiological development that occur across adolescence. With respect to social domains, although social and peer influences are important for both adolescent males and females, there are gender differences. For example, girls may be more sensitive to pressure from peers to fit in and impress others, while

IQ at age 12 following a history of institutional care: Findings from the Bucharest Early Intervention Project

PubMed Central

Almas, Alisa N.; Degnan, Kathryn A.; Nelson, Charles A.; Zeanah, Charles H.; Fox, Nathan A.

2016-01-01

Young children removed from institutions and placed into foster care or adoptive homes have been shown to experience significant gains in IQ relative to children who remain in institutions. Less is known about the long-term impact of severe early deprivation on development in late childhood. Data are presented from a follow-up of children at 12 years of age in the Bucharest Early Intervention Project, a randomized clinical trial of foster care for institutionally reared children. One hundred and seven of the original 136 children in the study were tested with the WISC IV. Results revealed continued benefit from the intervention through age 12, with 12-year-old children placed in foster care scoring significantly higher on full scale IQ compared to their peers who received prolonged institutional care. Longitudinal IQ data revealed two IQ profiles from early to late childhood. Attachment security emerged as a significant predictor of a profile of stable, typical IQ scores over time. We demonstrate the continued importance of foster care intervention and the negative effects of severe, early psychosocial deprivation on IQ into late childhood. PMID:27709994

IQ at age 12 following a history of institutional care: Findings from the Bucharest Early Intervention Project.

PubMed

Almas, Alisa N; Degnan, Kathryn A; Nelson, Charles A; Zeanah, Charles H; Fox, Nathan A

2016-11-01

Young children removed from institutions and placed into foster care or adoptive homes have been shown to experience significant gains in IQ relative to children who remain in institutions. Less is known about the long-term impact of severe early deprivation on development in late childhood. Data are presented from a follow-up of children at 12 years of age in the Bucharest Early Intervention Project, a randomized clinical trial of foster care for institutionally reared children. Of the original 136 children in the study, 107 were tested with the Wechsler Intelligence Scale for Children-IV. Results revealed continued benefit from the intervention through age 12, with 12-year-old children placed in foster care scoring significantly higher on full-scale IQ compared to their peers who received prolonged institutional care. Longitudinal IQ data revealed 2 IQ profiles from early to late childhood. Attachment security emerged as a significant predictor of a profile of stable, typical IQ scores over time. We demonstrate the continued importance of foster care intervention and the negative effects of severe, early psychosocial deprivation on IQ into late childhood. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Projecting the impact of a nationwide school plain water access intervention on childhood obesity: a cost-benefit analysis.

PubMed

An, R; Xue, H; Wang, L; Wang, Y

2017-09-22

This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide. A decision model was constructed to simulate two events under Markov chain processes - placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved. Based on the decision model, the estimated incremental cost of the school-based water access intervention is $18 per student, and the corresponding incremental benefit is $192, resulting in a net benefit of $174 per student. Subgroup analysis estimates the net benefit per student to be $199 and $149 among boys and girls, respectively. Nationwide adoption of the intervention would prevent 0.57 million cases of childhood overweight, resulting in a lifetime cost saving totalling $13.1 billion. The estimated total cost saved per dollar spent was $14.5. The New York school-based water access intervention, if adopted nationwide, may have a considerably favourable benefit-cost portfolio. © 2017 World Obesity Federation.

The utility of Geographical Information Systems (GIS) in systems-oriented obesity intervention projects: the selection of comparable study sites for a quasi-experimental intervention design--TX CORD.

PubMed

Oluyomi, Abiodun O; Byars, Allison; Byrd-Williams, Courtney; Sharma, Shreela V; Durand, Casey; Hoelscher, Deanna M; Butte, Nancy F; Kelder, Steven H

2015-02-01

The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in community-level intervention studies, TX CORD uses a quasi-experimental design. Comparable intervention and comparison study sites are needed to address internal validity bias. TX CORD was designed to be implemented in low-income, ethnically diverse communities in Austin and Houston, Texas. A three-stage Geographical Information System (GIS) methodology was used to establish and ascertain the comparability of the intervention and comparison study sites. Census tract (stage 1) and school (stage 2) data were used to identify spatially exclusive geographic areas that were comparable. In stage 3, study sites were compared on demographic characteristics, socioeconomic status (SES), food assets, and physical activity (PA) assets. Student's t-test was used to examine significant differences between the selected sites. The methodology that was used resulted in the selection of catchment areas with demographic and socioeconomic characteristics that fit the target population: ethnically diverse population; lower-median household income; and lower home ownership rates. Additionally, the intervention and comparison sites were statistically comparable on demographic and SES variables, as well as food assets and PA assets. This GIS approach can provide researchers, program evaluators, and policy makers with useful tools for both research and practice. Area-level information that allows for robust understanding of communities can enhance analytical procedures in community health research and offer significant contributions in terms of community assessment and engagement.

Optimizing care in osteoporosis: The Canadian quality circle project

PubMed Central

Ioannidis, George; Thabane, Lehana; Gafni, Amiram; Hodsman, Anthony; Kvern, Brent; Johnstone, Dan; Plumley, Nathalie; Salach, Lena; Jiwa, Famida; Adachi, Jonathan D; Papaioannou, Alexandra

2008-01-01

Background While the Osteoporosis Canada 2002 Canadian guidelines provided evidence based strategies in preventing, diagnosing, and managing this condition, publication and distribution of guidelines have not, in and of themselves, been shown to alter physicians clinical approaches. We hypothesize that primary care physicians enrolled in the Quality Circle project would change their patient management of osteoporosis in terms of awareness of osteoporosis risk factors and bone mineral density testing in accordance with the guidelines. Methods The project consisted of five Quality Circle phases that included: 1) Training & Baseline Data Collection, 2) First Educational Intervention & First Follow-Up Data Collection 3) First Strategy Implementation Session, 4) Final Educational Intervention & Final Follow-up Data Collection, and 5) Final Strategy Implementation Session. A total of 340 circle members formed 34 quality circles and participated in the study. The generalized estimating equations approach was used to model physician awareness of risk factors for osteoporosis and appropriate utilization of bone mineral density testing pre and post educational intervention (first year of the study). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Results After the 1st year of the study, physicians' certainty of their patients' risk factor status increased. Certainty varied from an OR of 1.4 (95% CI: 1.1, 1.8) for prior vertebral fracture status to 6.3 (95% CI: 2.3, 17.9) for prior hip fracture status. Furthermore, bone mineral density testing increased in high risk as compared with low risk patients (OR: 1.4; 95% CI: 1.2, 1.7). Conclusion Quality Circle methodology was successful in increasing both physicians' awareness of osteoporosis risk factors and appropriate bone mineral density testing in accordance with the 2002 Canadian guidelines. PMID:18828906

Modifiable Risk Factors and Interventions for Childhood Obesity Prevention within the First 1,000 Days.

PubMed

Dattilo, Anne M

2017-01-01

Worldwide, the prevalence of childhood obesity has increased, amounting to 42 million overweight or obese children, and there is increasing evidence that the origins are within the first 1,000 days: the period of conception through 2 years. Antecedents of early childhood obesity are multifactorial, and associations of varying strength have been documented for genetic/epigenetic, biologic, dietary, environmental, social, and behavioral influences. Modifiable factors in pregnancy and early infancy associated with childhood obesity include maternal overweight/obesity, maternal smoking, gestational weight gain, infant and young child feeding, caregiver responsive feeding practices, as well as sleep duration, and physical activity. Promising obesity prevention interventions include those beginning during the first 1,000 days, using a multicomponent approach, with roots in nutrition education theories or behavior change communication that can continue over time. However, the limited number of completed interventions to date (within pediatric clinics or in home-based or community settings) may not be scalable to the magnitude needed for sustainable obesity prevention. Scale-up interventions that can be maintained for the durations needed, addressing infant and young child feeding and other modifiable risk factors associated with childhood obesity are needed. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.

Reduction in overweight and obesity from a 3-year community-based intervention in Australia: the 'It's Your Move!' project.

PubMed

Millar, L; Kremer, P; de Silva-Sanigorski, A; McCabe, M P; Mavoa, H; Moodie, M; Utter, J; Bell, C; Malakellis, M; Mathews, L; Roberts, G; Robertson, N; Swinburn, B A

2011-11-01

'It's Your Move!' was a 3-year intervention study implemented in secondary schools in Australia as part of the Pacific Obesity Prevention In Communities Project. This paper reports the outcome results of anthropometric indices and relevant obesity-related behaviours. The interventions focused on building the capacity of families, schools and communities to promote healthy eating and physical activity. Baseline response rates and follow-up rates were 53% and 69% respectively for the intervention group (n=5 schools) and 47% and 66% respectively for the comparison group (n=7 schools). Statistically significant relative reductions in the intervention versus comparison group were observed: weight (-0.74 kg, P < 0.04), and standardized body mass index (-0.07, P<0.03), and non-significant reductions in prevalence of overweight and obesity (0.75 odds ratio, P=0.12) and body mass index (-0.22, P=0.06). Obesity-related behavioural variables showed mixed results with no pattern of positive intervention outcomes. In conclusion, this is the first study to show that long-term, community-based interventions using a capacity-building approach can prevent unhealthy weight gain in adolescents. Obesity prevention efforts in this important transitional stage of life can be successful and these findings need to be translated to scale for a national effort to reverse the epidemic in children and adolescents. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

A Comprehensive Lifestyle Peer Group-Based Intervention on Cardiovascular Risk Factors: The Randomized Controlled Fifty-Fifty Program.

PubMed

Gómez-Pardo, Emilia; Fernández-Alvira, Juan Miguel; Vilanova, Marta; Haro, Domingo; Martínez, Ramona; Carvajal, Isabel; Carral, Vanesa; Rodríguez, Carla; de Miguel, Mercedes; Bodega, Patricia; Santos-Beneit, Gloria; Peñalvo, Jose Luis; Marina, Iñaki; Pérez-Farinós, Napoleón; Dal Re, Marian; Villar, Carmen; Robledo, Teresa; Vedanthan, Rajesh; Bansilal, Sameer; Fuster, Valentin

2016-02-09

Cardiovascular diseases stem from modifiable risk factors. Peer support is a proven strategy for many chronic illnesses. Randomized trials assessing the efficacy of this strategy for global cardiovascular risk factor modification are lacking. This study assessed the hypothesis that a peer group strategy would help improve healthy behaviors in individuals with cardiovascular risk factors. A total of 543 adults 25 to 50 years of age with at least 1 risk factor were recruited; risk factors included hypertension (20%), overweight (82%), smoking (31%), and physical inactivity (81%). Subjects were randomized 1:1 to a peer group-based intervention group (IG) or a self-management control group (CG) for 12 months. Peer-elected leaders moderated monthly meetings involving role-play, brainstorming, and activities to address emotions, diet, and exercise. The primary outcome was mean change in a composite score related to blood pressure, exercise, weight, alimentation, and tobacco (Fuster-BEWAT score, 0 to 15). Multilevel models with municipality as a cluster variable were applied to assess differences between groups. Participants' mean age was 42 ± 6 years, 71% were female, and they had a mean baseline Fuster-BEWAT score of 8.42 ± 2.35. After 1 year, the mean scores were significantly higher in the IG (n = 277) than in the CG (n = 266) (IG mean score: 8.84; 95% confidence interval (CI): 8.37 to 9.32; CG mean score: 8.17; 95% CI: 7.55 to 8.79; p = 0.02). The increase in the overall score was significantly larger in the IG compared with the CG (difference: 0.75; 95% CI: 0.32 to 1.18; p = 0.02). The mean improvement in the individual components was uniformly greater in the IG, with a significant difference for the tobacco component. The peer group intervention had beneficial effects on cardiovascular risk factors, with significant improvements in the overall score and specifically on tobacco cessation. A follow-up assessment will be performed 1 year after the final assessment

Factors Associated with Effective Nutrition Interventions for Pregnant Indigenous Women: A Systematic Review.

PubMed

Ashman, Amy M; Brown, Leanne J; Collins, Clare E; Rollo, Megan E; Rae, Kym M

2017-08-01

Indigenous people continue to experience health disparities relative to non-Indigenous populations. Interventions to improve nutrition during pregnancy in these groups may improve health outcomes for mothers and their infants. The effectiveness of existing nutrition intervention programs has not been reviewed previously. The objective was to identify interventions targeting improving nutrition-related outcomes for pregnant Indigenous women residing in Organisation for Economic Co-operation and Development countries, and to identify positive factors contributing to successful programs. Thirteen electronic databases were searched up until October 2015. Key words identified studies intervening to improve nutrition-related outcomes for pregnant Indigenous women. Two reviewers assessed articles for inclusion and study quality and extracted data. Only studies published in English were included. Data were summarized narratively. Abstracts and titles were screened (n=2,566) and 315 full texts were reviewed for eligibility. This review included 27 articles from 20 intervention programs from Australia, Canada, and the United States. The most prevalent measurable outcomes were birth weight (n=9) and breastfeeding initiation/duration (n=11). Programs with statistically significant results for these outcomes employed the following nutrition activities: individual counseling/education (n=8); delivery by senior Indigenous woman (n=2), peer counselor (n=3), or other Indigenous health worker (n=4); community-wide interventions (n=2); media campaigns (n=2); delivery by non-Indigenous health professional (n=3); and home visits (n=3). Heterogeneity of included studies made it challenging to make firm recommendations regarding program success. Authors of included studies recommended community consultation be included when designing studies and working with communities at all stages of the research process. Individualized counseling/education can contribute to successful program

The Fort McMurray Demonstration Project in Social Marketing: no demonstrable effect on already falling injury rates following intensive community and workplace intervention.

PubMed

Guidotti, Tee L; Deb, Pooja; Bertera, Robert; Ford, Lynda

2009-10-01

The Fort McMurray Demonstration Project in Social Marketing attempted to achieve mutually reinforcing effects from thematically coordinated educational and awareness efforts in the community as a whole and in the workplace and the inclusion of occupational safety within the framework of a community health promotion project. The study community was Fort McMurray, a small, industrial city in northern Alberta. The Mistahiai Health Region, several hundred kilometers to the west and also dominated by one city, Grande Prairie, served as the reference community. The intervention was based on media and events staged at public events, with supporting educational activities in schools and the community. It relied heavily on community-based partners and volunteers. Data on healthcare utilization of selected preventable injuries were obtained from Alberta Health for the time period 1990-1996 for the Regional Health Authorities of Northern Lights, where the only large population centre is Fort McMurray, and Mistahia. Age-adjusted aggregate injury rates were analyzed for evidence of an effect of the intervention. Severity was measured by proxy, using the number of diagnostic claims submitted for reimbursement for medical services in a given year. The communities differed in age-specific injury rates, with Fort McMurray showing higher rates for residents aged less than 55. Young adults and older adolescents showed higher levels of severity. Injury rates fell substantially and at similar rates in both communities over the five-year period. However, in both communities injury rates were already falling before the intervention in Fort McMurray began and continued to fall at about the same rate, slowing toward the end of the period. No evidence was found for an effect of the Project or for acceleration of the reduction in injury frequency in the intervention area. Over the period, fewer medical services were delivered in office settings and more in emergency rooms, in both

Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.

PubMed

Johnston, Maximilian J; Arora, Sonal; King, Dominic; Darzi, Ara

2018-01-01

This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards. Twenty-seven junior and senior surgeons completed validated questionnaires assessing supervision, escalation of care, and safety culture pre and post-intervention along with interviews to further explore the impact of the intervention. Patient outcomes pre and postintervention were also analyzed. Questionnaires revealed significant improvements in supervision postintervention (senior median pre 5 vs post 7, P = 0.002 and junior 4 vs 6, P = 0.039) and senior surgeon approachability (junior 5 vs 6, P = 0.047). Both groups agreed that they would feel safer as a patient in their hospital postintervention (senior 3 vs 4.5, P = 0.021 and junior 3 vs 4, P = 0.034). The interviews confirmed that the safety culture of the department had improved. There were no differences in inpatient mortality, cardiac arrest, reoperation, or readmission rates pre and postintervention. Improving supervision and introducing clear protocols can improve safety culture on the surgical ward. Future work should evaluate the effect these measures have on patient outcomes in multiple institutions.

Innovative interventions for disordered eating: evaluating dissonance-based and yoga interventions.

PubMed

Mitchell, Karen S; Mazzeo, Suzanne E; Rausch, Sarah M; Cooke, Kathryn L

2007-03-01

Eating-disordered behavior is prevalent among college women. Few interventions have successfully reduced risk factors for these behaviors, however. The most promising interventions are both selective and interactive. This study compared two newer types of interventions that meet these criteria: cognitive dissonance and yoga programs. This study advertised programs for women who were dissatisfied with their bodies. Participants (N = 93) were randomly assigned to dissonance, yoga, or control groups. Hierarchical regression analyses revealed that there were no significant post-intervention differences between the yoga and control groups. Dissonance group participants had significantly lower scores than the scores of both other groups on measures of disordered eating, drive for thinness, body dissatisfaction, alexithymia, and anxiety. These findings have important implications for interventions on college campuses. In particular, dissonance interventions appear to be an efficient and inexpensive approach to reducing eating disorder risk factors. Additional research regarding the value of yoga interventions is needed. 2006 by Wiley Periodicals, Inc.

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

PubMed

Wang, Zhiyun; Wang, Jianping; Maercker, Andreas

2016-09-09

Insight into user adherence to Web-based intervention programs and into its relationship to intervention effect is needed. The objective of this study was to examine use of a Web-based self-help intervention program, the Chinese version of My Trauma Recovery (CMTR), among Chinese traumatized individuals, and to investigate the relationship between program use and user characteristics before the intervention and change in outcomes after the intervention and at 3-months' follow-up. The sample consisted of 56 urban survivors of different trauma types and 90 rural survivors of the 2008 Sichuan earthquake, who used the CMTR in 1 month on their own or guided by volunteers in a counseling center. Predictors were demographics (sex, age, highest education, marital status, and annual family income), health problems (trauma duration, posttraumatic symptoms, and depression), psychological factors (coping self-efficacy), and social factors (social functioning impairment and social support). Program use was assessed by general program usage (eg, number of visiting days) and program adherence (eg, webpages completed in modules). Outcome measures were the Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy scale (CSE), Crisis Support Scale (CSS), and Social Functioning Impairment questionnaire (SFI) adopted from the CMTR. (1) Program use: rural participants had a larger total number of visiting days (F1,144=40.50, P<.001) and visited more program modules in 1 month (χ(2)3=73.67, P<.001) than urban participants. (2) Predictors and program use: total number of visiting days was correlated with CSS at pretest (r=.22, P=.009), and total number of completed webpages was associated with SFI at pretest (r=.19, P=.02). Number of webpages completed in modules was correlated with all demographic, disease severity, psychological, and social factors at pretest. (3) Program use and outcomes change: in general, use of the triggers and self

Reducing Falls After Electroconvulsive Therapy: A Quality Improvement Project.

PubMed

Brown, Allana Marie

2017-07-01

Falls after electroconvulsive therapy (ECT) in patients 60 and older have been long recognized as a major clinical care issue across many mental health care settings. The evidence base for fall prevention strategies after receiving ECT is sparse. The risk factors for falls after ECT are vast and complex in nature, especially considering existing comorbid medical conditions. The dearth of research in guiding practitioners on fall reduction interventions for this patient population illuminates a gap in mental health care quality and safety. The purpose of the current nurse-led quality improvement project was to reduce falls in patients undergoing ECT by enhancing safety measures through education and a post-ECT treatment protocol. The project did not prove to be as efficacious as anticipated as measured by fall rate outcomes. Several factors that may account for the project's findings are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 20-29.]. Copyright 2017, SLACK Incorporated.

The use of process mapping in healthcare quality improvement projects.

PubMed

Antonacci, Grazia; Reed, Julie E; Lennox, Laura; Barlow, James

2018-05-01

Introduction Process mapping provides insight into systems and processes in which improvement interventions are introduced and is seen as useful in healthcare quality improvement projects. There is little empirical evidence on the use of process mapping in healthcare practice. This study advances understanding of the benefits and success factors of process mapping within quality improvement projects. Methods Eight quality improvement projects were purposively selected from different healthcare settings within the UK's National Health Service. Data were gathered from multiple data-sources, including interviews exploring participants' experience of using process mapping in their projects and perceptions of benefits and challenges related to its use. These were analysed using inductive analysis. Results Eight key benefits related to process mapping use were reported by participants (gathering a shared understanding of the reality; identifying improvement opportunities; engaging stakeholders in the project; defining project's objectives; monitoring project progress; learning; increased empathy; simplicity of the method) and five factors related to successful process mapping exercises (simple and appropriate visual representation, information gathered from multiple stakeholders, facilitator's experience and soft skills, basic training, iterative use of process mapping throughout the project). Conclusions Findings highlight benefits and versatility of process mapping and provide practical suggestions to improve its use in practice.

Randomised Controlled Trial of Parent Groups for Child Antisocial Behaviour Targeting Multiple Risk Factors: The SPOKES Project

ERIC Educational Resources Information Center

Scott, Stephen; Sylva, Kathy; Doolan, Moira; Price, Jenny; Jacobs, Brian; Crook, Carolyn; Landau, Sabine

2010-01-01

Background: There is a pressing need for cost-effective population-based interventions to tackle early-onset antisocial behaviour. As this is determined by many factors, it would seem logical to devise interventions that address several influences while using an efficient means of delivery. The aim of this trial was to change four risk factors…

People Awakening: Collaborative Research to Develop Cultural Strategies for Prevention in Community Intervention

PubMed Central

Allen, James; Mohatt, Gerald V.; Beehler, Sarah; Rowe, Hillary L.

2014-01-01

The consequences of alcohol use disorder (AUD) and suicide create immense health disparities among Alaska Native people. The People Awakening project is a long-term collaboration between Alaska Native (AN) communities and university researchers seeking to foster health equity through development of positive solutions to these disparities. These efforts initiated a research relationship that identified individual, family, and community protective factors from AUD and suicide. AN co-researchers next expressed interest in translating these findings into intervention. This led to development of a strengths-based community intervention that is the focus of the special issue. The intervention builds these protective factors to prevent AUD and suicide risk within AN youth, and their families and communities. This review provides a critical examination of existing literature and a brief history of work leading to the intervention research. These work efforts portray a shared commitment of university researchers and community members to function as co-researchers, and to conduct research in accord with local Yup’ik cultural values. This imperative allowed the team to navigate several tensions we locate in a convergence of historical and contemporary ecological contextual factors inherent in AN tribal communities with countervailing constraints imposed by Western science. PMID:24903819

Rejuvenating harm reduction projects for injection drug users: Ukraine's nationwide introduction of peer-driven interventions.

PubMed

Smyrnov, Pavlo; Broadhead, Robert S; Datsenko, Oleksandra; Matiyash, Oksana

2012-03-01

A peer-driven intervention (PDI) for injecting drug users (IDUs) was implemented in five Ukrainian city-sites to test-pilot its effectiveness in rejuvenating harm reduction (HR) projects that had become moribund. A PDI relies on drug users in a unique way to educate their peers in the community and recruit them for HIV prevention services. The goal of the PDI was to recruit in six month 500 IDUs who had never been respondents before to each of the five HR projects, especially stimulant- and women-injectors, and IDUs<25 years of age. We standardized the PDI's structure and operations across all five sites. All five PDIs were started in May 2007 using a carefully selected handful of "seed" IDU-recruiters who were trained to educate three peers who had never received HR services. We also accessed the database of all five projects and analysed the new respondents they recruited six-months prior to the start-up of the PDIs with the new recruits generated by the PDIs. Whilst the HR projects in the five city-sites recruited 72 new respondents on average during the six months prior to the PDIs' start-up, the PDIs recruited 455 new respondents on average in each city during their six months of operation, indicating that the PDI was 6.3 times more powerful as a recruitment mechanism. Compared to traditional outreach the PDIs resulted in significant increases in the recruitment of women- and young-injectors, and IDUs who injected a more diverse variety of drugs. The PDI can have a rejuvenating effect when added to HR projects that had become stagnate over time, resulting in an increase in the number and diversity of new IDU-respondents. Copyright © 2012 Elsevier B.V. All rights reserved.

Hospital cultural competency as a systematic organizational intervention: Key findings from the national center for healthcare leadership diversity demonstration project.

PubMed

Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne

Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective

Factors affecting pain relief in response to physical exercise interventions among healthcare workers.

PubMed

Jakobsen, M D; Sundstrup, E; Brandt, M; Andersen, L L

2017-12-01

The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effects of Risk Factor-Targeted Lifestyle Counselling Intervention on working-age stroke patients' adherence to lifestyle change.

PubMed

Oikarinen, Anne; Engblom, Janne; Kääriäinen, Maria; Kyngäs, Helvi

2017-09-01

Since a history of stroke or transient ischaemic attack is a major risk factor for a recurrent event, lifestyle counselling during the hospital phase is an essential component of treatment and may increase the probability of lifestyle change. To study the effect of risk factor-targeted lifestyle counselling intervention on working-age stroke patients' adherence to lifestyle changes. A quasi-experimental, nonequivalent control group pretest-post-test design. Stroke patients in an acute neurological unit were divided into a control group (n = 75) receiving standard counselling and an experimental group (n = 75) receiving risk factor-targeted counselling. Lifestyle data and clinical outcomes were collected at hospital between January 2010 and October 2011, while data on adherence to lifestyle changes 3, 6, and 12 months after discharge. The baseline lifestyle habits did not differ significantly other than in alcohol behaviour. Both groups increased their intake, but the intervention group to a lesser degree. However, the experimental group significantly lost their weight for the first 3 and 6 months; at 3 months reduction in cigarette consumption and at 6 months significant increases in smoking cessation were also achieved. All improved some of their lifestyle habits. Intervention was associated with support from nurses as well as from family and friends. Adherence scores were higher in the experimental group. Some short-term advantages in lifestyle habits due to the intervention were noted. Participants in both groups improved some of their lifestyle habits. © 2016 Nordic College of Caring Science.

14. Implementation, execution, and completion of projects.

PubMed

2014-05-01

Once an intervention has been selected for implementation, it becomes a project. Implementation of a project is a complex process and requires completion of a host of tasks. The implementation process has been deconstructed into its components so that it can be analysed and evaluated. A prerequisite for implementation is an operational plan. The tasks that require completion include: (1) reassessing current status and verifying the needs; (2) activating the operational plan; (3) setting-up and operating an administrative structure; (4) identifying, acquiring, and organising resources (including human resources); (5) assigning roles and responsibilities; (6) educating and training personnel (including mission-specific); (7) briefing staff; (8) preparing/readying resources for transport; (9) assuring project self-sufficiency; (10) arranging for personal necessities; (11) ensuring the safety of personnel and the security of equipment and supplies; (12) insuring personnel; (13) coordinating with other projects/actors; (14) coordinating with other BSF systems (role of the coordination and control centre); (15) communicating with community leaders; (16) initiating the use of standardised progress reports; (17) deploying personnel, equipment, and supplies; (18) initiating the intervention(s); (19) executing the intervention(s); (20) reporting start of interventions; (21) completing the project; and (22) completing and submitting a formal report. This deconstruction is essential in order to study the process and identify critical points of success and failure. It also is recognised that many interventions consist of many components (subfunctions), each of which may be considered a production process.

Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model.

PubMed

Frye, Victoria; Paige, Mark Q; Gordon, Steven; Matthews, David; Musgrave, Geneva; Kornegay, Mark; Greene, Emily; Phelan, Jo C; Koblin, Beryl A; Taylor-Akutagawa, Vaughn

2017-08-01

HIV/AIDS stigma and homophobia are associated with significant negative health and social outcomes among people living with HIV/AIDS (PLWHA) and those at risk of infection. Interventions to decrease HIV stigma have focused on providing information and education, changing attitudes and values, and increasing contact with people living with HIV/AIDS (PLWHA), activities that act to reduce stereotyped beliefs and prejudice, as well as acts of discrimination. Most anti-homophobia interventions have focused on bullying reduction and have been implemented at the secondary and post-secondary education levels. Few interventions address HIV stigma and homophobia and operate at the community level. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a community-level, multi-component anti-HIV/AIDS stigma and homophobia intervention designed to reduce HIV stigma and homophobia thus increasing access to HIV prevention and treatment access. The theory-based intervention included three primary components: workshops and trainings with local residents, businesses and community-based organizations (CBO); space-based events at a CBO-partner drop-in storefront and "pop-up" street-based events and outreach; and a bus shelter ad campaign. This paper describes the intervention design process, resultant intervention and the study team's experiences working with the community. We conclude that CHHANGE was feasible and acceptable to the community. Promoting the labeling of gay and/or HIV-related "space" as a non-stigmatized, community resource, as well as providing opportunities for residents to have contact with targeted groups and to understand how HIV stigma and homophobia relate to HIV/AIDS prevalence in their neighborhood may be crucial components of successful anti-stigma and discrimination programming. Copyright © 2017. Published by Elsevier Ltd.

The Utility of Geographical Information Systems (GIS) in Systems-Oriented Obesity Intervention Projects: The Selection of Comparable Study Sites for a Quasi-Experimental Intervention Design—TX CORD

PubMed Central

Byars, Allison; Byrd-Williams, Courtney; Sharma, Shreela V.; Durand, Casey; Hoelscher, Deanna M.; Butte, Nancy F.; Kelder, Steven H.

2015-01-01

Abstract Background: The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in community-level intervention studies, TX CORD uses a quasi-experimental design. Comparable intervention and comparison study sites are needed to address internal validity bias. Methods: TX CORD was designed to be implemented in low-income, ethnically diverse communities in Austin and Houston, Texas. A three-stage Geographical Information System (GIS) methodology was used to establish and ascertain the comparability of the intervention and comparison study sites. Census tract (stage 1) and school (stage 2) data were used to identify spatially exclusive geographic areas that were comparable. In stage 3, study sites were compared on demographic characteristics, socioeconomic status (SES), food assets, and physical activity (PA) assets. Student's t-test was used to examine significant differences between the selected sites. Results: The methodology that was used resulted in the selection of catchment areas with demographic and socioeconomic characteristics that fit the target population: ethnically diverse population; lower-median household income; and lower home ownership rates. Additionally, the intervention and comparison sites were statistically comparable on demographic and SES variables, as well as food assets and PA assets. Conclusions: This GIS approach can provide researchers, program evaluators, and policy makers with useful tools for both research and practice. Area-level information that allows for robust understanding of communities can enhance analytical procedures in community health research and offer significant contributions in terms of community assessment and engagement. PMID:25587670

A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project.

PubMed

Herrman, Helen; Humphreys, Cathy; Halperin, Stephen; Monson, Katherine; Harvey, Carol; Mihalopoulos, Cathrine; Cotton, Susan; Mitchell, Penelope; Glynn, Tony; Magnus, Anne; Murray, Lenice; Szwarc, Josef; Davis, Elise; Havighurst, Sophie; McGorry, Patrick; Tyano, Sam; Kaplan, Ida; Rice, Simon; Moeller-Saxone, Kristen

2016-12-07

Out-of-home care (OoHC) refers to young people removed from their families by the state because of abuse, neglect or other adversities. Many of the young people experience poor mental health and social function before, during and after leaving care. Rigorously evaluated interventions are urgently required. This publication describes the protocol for the Ripple project and notes early findings from a controlled trial demonstrating the feasibility of the work. The Ripple project is implementing and evaluating a complex mental health intervention that aims to strengthen the therapeutic capacities of carers and case managers of young people (12-17 years) in OoHC. The study is conducted in partnership with mental health, substance abuse and social services in Melbourne, with young people as participants. It has three parts: 1. Needs assessment and implementation of a complex mental health intervention; 2. A 3-year controlled trial of the mental health, social and economic outcomes; and 3. Nested process evaluation of the intervention. Early findings characterising the young people, their carers and case managers and implementing the intervention are available. The trial Wave 1 includes interviews with 176 young people, 52% of those eligible in the study population, 104 carers and 79 case managers. Implementing and researching an affordable service system intervention appears feasible and likely to be applicable in other places and countries. Success of the intervention will potentially contribute to reducing mental ill-health among these young people, including suicide attempts, self-harm and substance abuse, as well as reducing homelessness, social isolation and contact with the criminal justice system. Australian New Zealand Clinical Trials Registry ACTRN12615000501549 . Retrospectively registered 19 May 2015.

To be seen, confirmed and involved - a ten year follow-up of perceived health and cardiovascular risk factors in a Swedish community intervention programme

PubMed Central

Emmelin, Maria; Weinehall, Lars; Stenlund, Hans; Wall, Stig; Dahlgren, Lars

2007-01-01

Background Public health interventions are directed towards social systems and it is difficult to foresee all consequences. While targeted outcomes may be positively influenced, interventions may at worst be counterproductive. To include self-reported health in an evaluation is one way of addressing possible side-effects. This study is based on a 10 year follow-up of a cardiovascular community intervention programme in northern Sweden. Methods Both quantitative and qualitative approaches were used to address the interaction between changes in self-rated health and risk factor load. Qualitative interviews contributed to an analysis of how the outcome was influenced by health related norms and attitudes. Results Most people maintained a low risk factor load and a positive perception of health. However, more people improved than deteriorated their situation regarding both perceived health and risk factor load. "Ideal types" of attitude sets towards the programme, generated from the interviews, helped to interpret an observed polarisation for men and the lower educated. Conclusion Our observation of a socially and gender differentiated intervention effect suggests a need to test new intervention strategies. Future community interventions may benefit from targeting more directly those who in combination with high risk factor load perceive their health as bad and to make all participants feel seen, confirmed and involved. PMID:17672911

The Coronary Health Improvement Projects Impact on Lowering Eating, Sleep, Stress, and Depressive Disorders

ERIC Educational Resources Information Center

Merrill, Ray M.; Aldana, Stephen G.; Greenlaw, Roger L.; Diehl, Hans A.

2008-01-01

Background: The Coronary Health Improvement Project (CHIP) is designed to lower cardiovascular risk factors among a group of generally healthy individuals through health education. Purpose: This study will evaluate the efficacy of the CHIP intervention at improving eating, sleep, stress, and depressive disorders. Methods: A health education…

A mixed methods study of individual and organizational factors that affect implementation of interventions for children with autism in public schools.

PubMed

Locke, Jill; Beidas, Rinad S; Marcus, Steven; Stahmer, Aubyn; Aarons, Gregory A; Lyon, Aaron R; Cannuscio, Carolyn; Barg, Frances; Dorsey, Shannon; Mandell, David S

2016-10-10

The significant lifelong impairments associated with autism spectrum disorder (ASD), combined with the growing number of children diagnosed with ASD, have created urgency in improving school-based quality of care. Although many interventions have shown efficacy in university-based research, few have been effectively implemented and sustained in schools, the primary setting in which children with ASD receive services. Individual- and organizational-level factors have been shown to predict the implementation of evidence-based interventions (EBIs) for the prevention and treatment of other mental disorders in schools, and may be potential targets for implementation strategies in the successful use of autism EBIs in schools. The purpose of this study is to examine the individual- and organizational-level factors associated with the implementation of EBIs for children with ASD in public schools. We will apply the Domitrovich and colleagues (2008) framework that examines the influence of contextual factors (i.e., individual- and organizational-level factors) on intervention implementation in schools. We utilize mixed methods to quantitatively test whether the factors identified in the Domitrovich and colleagues (2008) framework are associated with the implementation of autism EBIs, and use qualitative methods to provide a more comprehensive understanding of the factors associated with successful implementation and sustainment of these interventions with the goal of tailoring implementation strategies. The results of this study will provide an in-depth understanding of individual- and organizational-level factors that influence the successful implementation of EBIs for children with ASD in public schools. These data will inform potential implementation targets and tailoring of strategies that will help schools overcome barriers to implementation and ultimately improve the services and outcomes for children with ASD.

Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review

PubMed Central

Kok, Maryse C; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline EW; Kane, Sumit S; Ormel, Hermen; Tijm, Mandy M; de Koning, Korrie AM

2015-01-01

Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design related factors influencing performance of CHWs. We systematically searched six databases for quantitative and qualitative studies that included CHWs working in promotional, preventive or curative primary health services in LMICs. One hundred and forty studies met the inclusion criteria, were quality assessed and double read to extract data relevant to the design of CHW programmes. A preliminary framework containing factors influencing CHW performance and characteristics of CHW performance (such as motivation and competencies) guided the literature search and review. A mix of financial and non-financial incentives, predictable for the CHWs, was found to be an effective strategy to enhance performance, especially of those CHWs with multiple tasks. Performance-based financial incentives sometimes resulted in neglect of unpaid tasks. Intervention designs which involved frequent supervision and continuous training led to better CHW performance in certain settings. Supervision and training were often mentioned as facilitating factors, but few studies tested which approach worked best or how these were best implemented. Embedment of CHWs in community and health systems was found to diminish workload and increase CHW credibility. Clearly defined CHW roles and introduction of clear processes for communication among different levels of the health system could strengthen CHW performance. When designing community-based health programmes, factors that increased CHW performance in comparable settings should be taken into account. Additional intervention research to develop a better evidence base for the most effective training and supervision mechanisms and qualitative research to

Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review.

PubMed

Kok, Maryse C; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; Kane, Sumit S; Ormel, Hermen; Tijm, Mandy M; de Koning, Korrie A M

2015-11-01

Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design related factors influencing performance of CHWs. We systematically searched six databases for quantitative and qualitative studies that included CHWs working in promotional, preventive or curative primary health services in LMICs. One hundred and forty studies met the inclusion criteria, were quality assessed and double read to extract data relevant to the design of CHW programmes. A preliminary framework containing factors influencing CHW performance and characteristics of CHW performance (such as motivation and competencies) guided the literature search and review.A mix of financial and non-financial incentives, predictable for the CHWs, was found to be an effective strategy to enhance performance, especially of those CHWs with multiple tasks. Performance-based financial incentives sometimes resulted in neglect of unpaid tasks. Intervention designs which involved frequent supervision and continuous training led to better CHW performance in certain settings. Supervision and training were often mentioned as facilitating factors, but few studies tested which approach worked best or how these were best implemented. Embedment of CHWs in community and health systems was found to diminish workload and increase CHW credibility. Clearly defined CHW roles and introduction of clear processes for communication among different levels of the health system could strengthen CHW performance.When designing community-based health programmes, factors that increased CHW performance in comparable settings should be taken into account. Additional intervention research to develop a better evidence base for the most effective training and supervision mechanisms and qualitative research to inform

Patterns in coverage of maternal, newborn, and child health interventions: projections of neonatal and under-5 mortality to 2035.

PubMed

Walker, Neff; Yenokyan, Gayane; Friberg, Ingrid K; Bryce, Jennifer

2013-09-21

Urgent calls have been made for improved understanding of changes in coverage of maternal, newborn, and child health interventions, and their country-level determinants. We examined historical trends in coverage of interventions with proven effectiveness, and used them to project rates of child and neonatal mortality in 2035 in 74 Countdown to 2015 priority countries. We investigated coverage of all interventions for which evidence was available to suggest effective reductions in maternal and child mortality, for which indicators have been defined, and data have been obtained through household surveys. We reanalysed coverage data from 312 nationally-representative household surveys done between 1990 and 2011 in 69 countries, including 58 Countdown countries. We developed logistic Loess regression models for patterns of coverage change for each intervention, and used k-means cluster analysis to divide interventions into three groups with different historical patterns of coverage change. Within each intervention group, we examined performance of each country in achieving coverage gains. We constructed models that included baseline coverage, region, gross domestic product, conflict, and governance to examine country-specific annual percentage coverage change for each group of indicators. We used the Lives Saved Tool (LiST) to predict mortality rates of children younger than 5 years (henceforth, under 5) and in the neonatal period in 2035 for Countdown countries if trends in coverage continue unchanged (historical trends scenario) and if each country accelerates intervention coverage to the highest level achieved by a Countdown country with similar baseline coverage level (best performer scenario). Odds of coverage of three interventions (antimalarial treatment, skilled attendant at birth, and use of improved sanitation facilities) have decreased since 1990, with a mean annual decrease of 5·5% (SD 2·7%). Odds of coverage of four interventions--all related to the

Unpacking the Black Box of the Chicago School Readiness Project Intervention: The Mediating Roles of Teacher-Child Relationship Quality and Self-Regulation

ERIC Educational Resources Information Center

Jones, Stephanie M.; Bub, Kristen L.; Raver, C. Cybele

2013-01-01

Research Findings: This study examines the theory of change of the Chicago School Readiness Project (CSRP), testing a sequence of theory-derived mediating mechanisms that include the quality of teacher-child relationships and children's self-regulation. The CSRP is a multicomponent teacher and classroom-focused intervention, and its…

Evaluating the Social Validity of Project "TEAM": A Problem-Solving Intervention to Teach Transition Age Youth with Developmental Disabilities to Resolve Environmental Barriers

ERIC Educational Resources Information Center

Kramer, Jessica M.; Hwang, I-Ting; Helfrich, Christine A.; Samuel, Preethy S.; Carrellas, Ann

2018-01-01

Project "TEAM" teaches transition-age youth with developmental disabilities (DD) to identify physical and social environmental barriers and supports, generate solutions to barriers, and request modifications to increase participation. Establishing the social validity of this environment focused intervention with youth and their parents…

Maternal hormonal interventions as a risk factor for Autism Spectrum Disorder: an epidemiological assessment from India.

PubMed

Mamidala, Madhu Poornima; Polinedi, Anupama; Kumar, P T V Praveen; Rajesh, N; Vallamkonda, Omsai Ramesh; Udani, Vrajesh; Singhal, Nidhi; Rajesh, Vidya

2013-12-01

Globalization and women empowerment have led to stressful life among Indian women. This stress impairs women's hormonal makeup and menstrual cycle, leading to infertility. National Family Health Survey-3 (NFHS-3) reports a decline in fertility status in India, indicating a rise in various infertility treatments involving hormonal interventions. No studies are available from India on the risk association link between maternal hormonal treatments and ASD. Hence, this study explores the association of maternal hormonal interventions with risk for ASD. Parents of 942 children (471 ASD and 471 controls) across 9 cities in India participated in the questionnaire-based study. The questionnaire was pilot tested and validated for its content and reliability as a psychometric instrument. Data collection was done at 70 centres through direct interaction with parents and with the help of trained staff. Statistical analysis of data was carried out using SAS 9.1.3. Out of the 471 ASD cases analysed, 58 mothers had undergone hormonal interventions (12.3 percent) while there were only 22 mothers among controls who underwent hormonal interventions (4.6 percent). According to logistic regression analysis maternal hormonal intervention (OR=2.24) was a significant risk factor for ASD.

Modifying Pro-Drug Risk Factors in Adolescents: Results from Project ALERT

ERIC Educational Resources Information Center

Ghosh-Dastidar, Bonnie; Longshore, Douglas L.; Ellickson, Phyllis L.; McCaffrey, Daniel F.

2004-01-01

The objective of this study was to evaluate the impact of a revised state-of-the-art drug prevention program, Project ALERT, on risk factors for drug use in mostly rural midwestern schools and communities. Fifty-five middle schools from South Dakota were randomly assigned to treatment or control conditions. Treatment-group students received 11…

Project Northland: outcomes of a communitywide alcohol use prevention program during early adolescence.

PubMed Central

Perry, C L; Williams, C L; Veblen-Mortenson, S; Toomey, T L; Komro, K A; Anstine, P S; McGovern, P G; Finnegan, J R; Forster, J L; Wagenaar, A C; Wolfson, M

1996-01-01

OBJECTIVES. Project Northland is an efficacy trial with the goal of preventing or reducing alcohol use among young adolescents by using a multilevel, communitywide approach. METHODS. Conducted in 24 school districts and adjacent communities in northeastern Minnesota since 1991, the intervention targets the class of 1998 (sixth-grade students in 1991) and has been implemented for 3 school years (1991 to 1994). The intervention consists of social-behavioral curricula in schools, peer leadership, parental involvement/education, and communitywide task force activities. Annual surveys of the class of 1998 measure alcohol use, tobacco use, and psychosocial factors. RESULTS. At the end of 3 years, students in the intervention school districts report less onset and prevalence of alcohol use than students in the reference districts. The differences were particularly notable among those who were nonusers at baseline. CONCLUSIONS. The results of Project Northland suggest that multilevel, targeted prevention programs for young adolescents are effective in reducing alcohol use. PMID:8669519

Evaluating the Effectiveness of First Grade Literacy Interventions: Reading Recovery and Leveled Literacy Intervention

ERIC Educational Resources Information Center

Miller, Heidi Thomson

2014-01-01

This is a quantitative research project utilizing secondary data. Reading Recovery and Leveled Literacy Intervention are two early literacy interventions based on a whole language and phonetic approach to reading instruction. For the purposes of this study, the end-of-first-grade benchmark is a Developmental Reading Assessment (DRA) 18 and the…

Relationship of Social Network to Protective Factors in Suicide and Alcohol Use Disorder Intervention for Rural Yup’ik Alaska Native Youth

PubMed Central

Philip, Jacques; Ford, Tara; Henry, David; Rasmus, Stacy; Allen, James

2015-01-01

Suicide and alcohol use disorders are significant Alaska Native health disparities, yet there is limited understanding of protection and no studies of social network factors in protection in this or other populations. The Qungasvik intervention enhances protective factors from suicide and alcohol use disorders through activities grounded in Yup’ik cultural practices and values. Identification of social network factors associated with protection within the cultural context of these tight, close knit, and high density rural Yup’ik Alaska Native communities in southwest Alaska can help identify effective prevention strategies for suicide and alcohol use disorder risk. Using data from ego-centered social network and protective factors from suicide and alcohol use disorders surveys with 50 Yup’ik adolescents, we provide descriptive data on structural and network composition variables, identify key network variables that explain major proportions of the variance in a four principal component structure of these network variables, and demonstrate the utility of these key network variables as predictors of family and community protective factors from suicide and alcohol use disorder risk. Connections to adults and connections to elders, but not peer connections, emerged as predictors of family and community level protection, suggesting these network factors as important intervention targets for intervention. PMID:27110094

['Third day intervention': an analysis of the factors associated with following the recommendations on the prescribing of antibiotics].

PubMed

García-San Miguel, Lucía; Cobo, Javier; Martínez, José Antonio; Arnau, Josep Maria; Murillas, Javier; Peña, Carmen; Segura, Ferran; Gurguí, Montserrat; Gálvez, Juan; Giménez, Montserrat; Gudiol, Francesc

2014-12-01

Stewardship programs on the use of antibiotics usually include interventions based on non-compulsory recommendations for the prescribers. Factors related to the adherence to expert recommendations, and the implementation of these programmes in daily practice, are of interest. A randomized, controlled, multicentre intervention study was performed in 32 hospitalization units. Antibiotic prescriptions were evaluated by an infectious disease specialist on the third day. We describe the implementation of the intervention, the factors associated with adherence to recommendations, and the impact of the intervention. A total of 3,192 interventions were carried out. Information sources used to prepare the recommendations varied significantly between centres. A modification was recommended in 65% of cases: withdrawal (47%), change in administration route (26%), change of drugs or number of antibiotics (27%), and change in dose (5%). Simplification of treatment accounted for 75% of all recommendations. Adherence was 68%, with significant differences between hospitals, and higher when the recommendations consisted of a dose adjustment or change of route, during the first intervention period, and also when recommendations were personally commented on, in addition to writing a note in the clinical chart. We did not find any reduction in antibiotic consumption or variation in the incidence of resistant pathogens. An important proportion of antibiotic prescriptions may be susceptible to improvement, most of them towards simplification. The adherence to the intervention was high, but significant variations at different centres were observed, depending on the type of recommendation, and the study period. Those recommendations that were personally commented on were more followed more than those only written. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Using an intervention mapping approach for planning, implementing and assessing a community-led project towards malaria elimination in the Eastern Province of Rwanda.

PubMed

Ingabire, Chantal Marie; Hakizimana, Emmanuel; Kateera, Fredrick; Rulisa, Alexis; Van Den Borne, Bart; Nieuwold, Ingmar; Muvunyi, Claude; Koenraadt, Constantianus J M; Van Vugt, Michele; Mutesa, Leon; Alaii, Jane

2016-12-16

Active community participation in malaria control is key to achieving malaria pre-elimination in Rwanda. This paper describes development, implementation and evaluation of a community-based malaria elimination project in Ruhuha sector, Bugesera district, Eastern province of Rwanda. Guided by an intervention mapping approach, a needs assessment was conducted using household and entomological surveys and focus group interviews. Data related to behavioural, epidemiological, entomological and economical aspects were collected. Desired behavioural and environmental outcomes were identified concurrently with behavioural and environmental determinants. Theoretical methods and their practical applications were enumerated to guide programme development and implementation. An operational plan including the scope and sequence as well as programme materials was developed. Two project components were subsequently implemented following community trainings: (1) community malaria action teams (CMATs) were initiated in mid-2014 as platforms to deliver malaria preventive messages at village level, and (2) a mosquito larval source control programme using biological substances was deployed for a duration of 6 months, implemented from January to July 2015. Process and outcome evaluation has been conducted for both programme components to inform future scale up. The project highlighted malaria patterns in the area and underpinned behavioural and environmental factors contributing to malaria transmission. Active involvement of the community in collaboration with CMATs contributed to health literacy, particularly increasing ability to make knowledgeable decisions in regards to malaria prevention and control. A follow up survey conducted six months following the establishment of CMATs reported a reduction of presumed malaria cases at the end of 2014. The changes were related to an increase in the acceptance and use of available preventive measures, such as indoor residual spraying and

Determining organisation-specific factors for developing health interventions in companies by a Delphi procedure: Organisational Mapping.

PubMed

van Scheppingen, Arjella R; ten Have, Kristin C J M; Zwetsloot, Gerard J I M; Kok, Gerjo; van Mechelen, Willem

2015-12-01

Companies, seen as social communities, are major health promotion contexts. However, health promotion in the work setting is often less successful than intended. An optimal adjustment to the organisational context is required. Knowledge of which organisation-specific factors are relevant to health promotion is scarce. A Delphi procedure is used to identify these factors. The aim is to contribute to more effective workplace health promotion. The identified factors are described and embedded into a practical methodology (Intervention Mapping). A systematic use of these factors (called 'Organisational Mapping') is likely to contribute to more effective health promotion in the work setting. © The Author(s) 2014.

Ideal cardiovascular health in childhood-Longitudinal associations with cardiac structure and function: The Special Turku Coronary Risk Factor Intervention Project (STRIP) and the Cardiovascular Risk in Young Finns Study (YFS).

PubMed

Laitinen, Tomi T; Ruohonen, Saku; Juonala, Markus; Magnussen, Costan G; Mikkilä, Vera; Mikola, Hanna; Hutri-Kähönen, Nina; Laitinen, Tomi; Tossavainen, Päivi; Jokinen, Eero; Niinikoski, Harri; Jula, Antti; Viikari, Jorma S A; Rönnemaa, Tapani; Raitakari, Olli T; Pahkala, Katja

2017-03-01

Ideal cardiovascular health (CVH), defined by the American Heart Association, is associated with incident cardiovascular disease in adults. However, association of the ideal CVH in childhood with current and future cardiac structure and function has not been studied. The sample comprised 827 children participating in the longitudinal Special Turku Coronary Risk Factor Intervention Project (STRIP) and The Cardiovascular Risk in Young Finns Study (YFS). In STRIP, complete data on the seven ideal CVH metrics and left ventricular (LV) mass measured with echocardiography were available at the age of 15 (n=321), 17 (n=309) and 19 (n=283) years. In YFS, the cohort comprised children aged 12-18years (n=506) with complete ideal CVH metrics data from childhood and 25years later in adulthood, and echocardiography performed in adulthood. In STRIP, ideal CVH score was inversely associated with LV mass during childhood (P=0.036). In YFS, childhood ideal CVH score was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume in adulthood (all P<0.01). In addition, improvement of the ideal CVH score between childhood and adulthood was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume (all P≤0.03). Childhood ideal CVH score has a long-lasting effect on cardiac structure and function, and the association is evident already in childhood. Our findings support targeting the ideal CVH metrics as part of primordial prevention of cardiovascular diseases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Evaluation of a workplace brief intervention for excessive alcohol consumption: the workscreen project.

PubMed

Richmond, R; Kehoe, L; Heather, N; Wodak, A

2000-01-01

The workplace provides a useful setting for early identification and intervention with individuals who have unhealthy lifestyles. The objective was to evaluate the effects of a workplace-based lifestyle intervention (Workscreen) to reduce excessive drinking. There were eight Australia Post networks randomly allocated to experimental and control conditions, comprising 67 worksites and 1206 employees. The experimental condition involved a broad spectrum lifestyle campaign, incorporating support from management, employee awareness of health, and brief interventions for high-risk behaviors, including excessive alcohol use. Focus groups identified relevant cultural factors. Changes in workplace culture and employee behavior were assessed 10 months after baseline. Males and females were analyzed separately. Over half of APOST employees participated at each screening point. In the experimental condition 61% of employees overall and 58% of those identified as excessive drinkers in Phase 1 responded to the lifestyle campaign by attending health assessments. Analyses focusing on the organization as a whole did not reveal significant reductions in excessive alcohol consumption among men or women. However, a significant reduction in number of drinks was observed in the experimental condition among women for whom completion of baseline and follow-up could be confirmed (P < 0.001). The present study indicates that a workplace-based lifestyle campaign can assist self-selected employees in reducing their alcohol consumption. There was a moderately high level of participation among those identified as drinking excessively, which supports our approach of embedding a low-intensity alcohol program within the context of a broader health promotion campaign. Copyright 2000 American Health Foundation and Academic Press.

Effectiveness of psychosocial intervention enhancing resilience among war-affected children and the moderating role of family factors.

PubMed

Diab, Marwan; Peltonen, Kirsi; Qouta, Samir R; Palosaari, Esa; Punamäki, Raija-Leena

2015-02-01

The study examines, first, the effectiveness of a psychosocial intervention based on Teaching Recovery Techniques (TRT) to increase resiliency among Palestinian children, exposed to a major trauma of war. Second, it analyses the role of family factors (maternal attachment and family atmosphere) as moderating the intervention impacts on resilience. School classes in Gaza were randomized into intervention (N=242) and control (N=240) groups. The percentage of girls (49.4%) and boys (50.6%) were equal, and the child age was 10-13 years in both groups. Children reported positive indicators of their mental health (prosocial behaviour and psychosocial well-being) at baseline (T1), post-intervention (T2) and at a six-month follow-up (T3). At T1 they accounted their exposure to war trauma. Mothers reported about their willingness to serve as an attachment figure, and the child reported about the family atmosphere. Resilience was conceptualized as a presence of positive indications of mental health despite trauma exposure. Against our hypothesis, the intervention did not increase the level of resilience statistically significantly, nor was the effect of the intervention moderated by maternal attachment responses or family atmosphere. Copyright © 2014 Elsevier Ltd. All rights reserved.

Development of the Oxford Hills Healthy Moms Project using a social marketing process: a community-based physical activity and nutrition intervention for low-socioeconomic-status mothers in a rural area in Maine.

PubMed

Dharod, Jigna M; Drewette-Card, Rebecca; Crawford, David

2011-03-01

A physical activity and nutrition community intervention called the Oxford Hills Healthy Moms (OHHM) Project was developed using a multifaceted social marketing process, including review of state surveillance results, key informant interviews, and a survey and focus group discussions with low-socioeconomic-status (low-SES) mothers. This formative work was used to make key decisions on the selection of the intervention region, segmentation of the audience, and design of intervention strategies addressing multiple levels of the socioecological model. The OHHM Project aims to increase fruit and vegetable consumption and physical activity levels among low-SES mothers in the Oxford Hills region of Maine. The OHHM Project includes five components: (a) physical activity buddy program, (b) cooking club with education, (c) fruit and vegetable discount buying club with education, (d) increased access to produce vendors, and (e) increased access to places for physical activity.

Project Connect Online: User and visitor experiences of an Internet-based intervention for women with breast cancer

PubMed Central

Harris, Lauren N.; Cleary, Elizabeth H.; Stanton, Annette L.

2015-01-01

Objective This study's purpose was to characterize the experience of breast cancer patients randomly assigned to the intervention arm of Project Connect Online (PCO), a randomized controlled trial of an Internet-based intervention, and to examine relationships between website use variables and psychosocial outcomes. Methods In the larger PCO trial, breast cancer patients (N = 88) were randomly assigned to an intervention or a waiting-list control. This report pertains to the 46 women in the intervention arm, a three-hour workshop for creation of personal websites with a blog function to communicate with their interpersonal network and chronicle their experience. Participants completed assessments at one and six months. Visitors to the websites (N = 66) completed an online questionnaire. Results Reactions to website use were positive, although lack of time was a barrier for some. Women with advanced cancer were more likely to use their websites. Women found the websites useful for telling the story of their experience and expressing emotions. Positive word use was associated with heightened positive mood at six months; negative word use was associated with improved depressive symptoms. Visitors were most commonly female friends of participants who valued the websites as a way to connect emotionally with participants and receive information about their health. Conclusions Specific aspects of patients' blogs predicted improvements in psychosocial functioning. Personal websites can help women with breast cancer construct a narrative of their experience, express emotions, and receive the social support they need, particularly from friends and extended family. PMID:25521661

Project connect online: user and visitor experiences of an Internet-based intervention for women with breast cancer.

PubMed

Harris, Lauren N; Cleary, Elizabeth H; Stanton, Annette L

2015-09-01

This study's purpose was to characterize the experience of patients with breast cancer randomly assigned to the intervention arm of Project Connect Online (PCO), a randomized controlled trial of an Internet-based intervention, and to examine relationships between website use variables and psychosocial outcomes. In the larger PCO trial, patients with breast cancer (n = 88) were randomly assigned to an intervention or a waiting-list control. This report pertains to the 46 women in the intervention arm, a 3-h workshop for creation of personal websites with a blog function to communicate with their interpersonal network and chronicle their breast cancer experience. Participants completed assessments at 1 and 6 months. Visitors to the websites (n = 66) completed an online questionnaire. Reactions to website use were positive, although lack of time was a barrier for some. Women with advanced cancer were more likely to use their websites. Women found the websites useful for telling the story of their experience and expressing emotions. Positive word use was associated with heightened positive mood at 6 months; negative word use was associated with improved depressive symptoms. Visitors were most commonly female friends of participants who valued the websites as a way to connect emotionally with participants and receive information about their health. Specific aspects of patients' blogs predicted improvements in psychosocial functioning. Personal websites can help women with breast cancer construct a narrative of their experience, express emotions, and receive the social support they need, particularly from friends and extended family. Copyright © 2014 John Wiley & Sons, Ltd.

Applying the results based management framework to the CERCA multi-component project in adolescent sexual and reproductive health: a retrospective analysis.

PubMed

Cordova-Pozo, Kathya; Hoopes, Andrea J; Cordova, Freddy; Vega, Bernardo; Segura, Zoyla; Hagens, Arnold

2018-02-08

Adolescent sexual and reproductive health (SRH), problems such as unplanned pregnancies are complex and multifactorial, thus requiring multifaceted prevention interventions. Evaluating the impact of such interventions is important to ensure efficiency, effectiveness and accountability for project funders and community members. In this study, we propose Results Based Management (RBM) as a framework for project management, using the Community Embedded Reproductive Health Care for Adolescents (CERCA) as a case study for RBM. The CERCA Project (2010-2014) tested interventions to reduce adolescent pregnancy in three Latin American countries, Bolivia, Ecuador and Nicaragua. Activities were designed to increase adolescent SRH behaviors in four domains: communication with parents, partners and peers; access to SRH information; access to SRH services; and use of contraception. When the project ended, the outcome evaluation showed limited impact with concerns about accuracy of monitoring and attrition of participants. We reviewed and analyzed a series of CERCA documents and related data sources. Key findings from these documents were organized within an RBM framework (planning, monitoring, and impact evaluation) to understand how CERCA methodology and performance might have reaped improved results. Strengths and weaknesses were identified in all three elements of the RBM framework. In Planning, the proposed Theory of Change (ToC) differed from that which was carried out in the intervention package. Each country implemented a different intervention package without articulated assumptions on how the activities of intervention would bring about change. In Monitoring, the project oversight was mainly based on administrative and financial requirements rather than monitoring fidelity and quality of intervention activities. In Impact Evaluation, the original CERCA evaluation assessed intervention effects among adolescents, without identifying success and failure factors related to

Mediating Effects of Home-Related Factors on Fat Intake from Snacks in a School-Based Nutrition Intervention among Adolescents

ERIC Educational Resources Information Center

Van Lippevelde, Wendy; van Stralen, Maartje; Verloigne, Maite; De Bourdeaudhuij, Ilse; Deforche, Benedicte; Brug, Johannes; Maes, Lea; Haerens, Leen

2012-01-01

The purpose of the present study was to investigate if the effects of the parental component of a school-based intervention on dietary fat intake from snacking were mediated by changes in home-related factors. A random sample of 10 schools with 2232 pupils aged 11-15 years was randomly assigned to one of two intervention groups [one with (n =…

Efficacy of a Group-Based Multimedia HIV Prevention Intervention for Drug-Involved Women under Community Supervision: Project WORTH

PubMed Central

El-Bassel, Nabila; Gilbert, Louisa; Goddard-Eckrich, Dawn; Chang, Mingway; Wu, Elwin; Hunt, Tim; Epperson, Matt; Shaw, Stacey A.; Rowe, Jessica; Almonte, Maria; Witte, Susan

2014-01-01

Importance This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. Objective We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. Design, Setting, Participants, and Intervention We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. Main Outcomes and Measures Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. Results Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02–0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57–0.90). Conclusion and Relevance The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may

The Mental Health, Substance Use, and Delinquency among Truant Youths in a Brief Intervention Project: A Longitudinal Study

PubMed Central

Dembo, Richard; Briones-Robinson, Rhissa; Barrett, Kimberly; Winters, Ken C.; Schmeidler, James; Ungaro, Rocio; Karas, Lora M.; Belenko, Steven; Gulledge, Laura

2011-01-01

The relationship between substance use, mental health disorders, and delinquency among youth is well documented. What has received far less attention from researchers is the relationship between these issues among truant youth, in spite of studies that document truants are a population at-risk for negative outcomes. The present study bridges this gap by (1) examining psychosocial functioning and delinquency among truants, and (2) assessing the efficacy of a Brief Intervention (BI) in reducing delinquent behavior over time. To meet these objectives, data were collected from 183 truant youth enrolled in an ongoing NIDA-funded BI project. Informed by a developmental damage perspective, a structural equation model was formulated and estimated. Interim results provide overall support for the model, and suggest the BI may be a promising, innovative intervention for truant youth. Service delivery implications and directions for future analyses are discussed. PMID:23914129

Project on Academic Striving: The Moderation of Stress in the Lives of the Students of an Urban Intermediate School. A Project To Coordinate Research and Environmental Intervention. Final Report to the William T. Grant Foundation. Volume One [and] Volume Two.

ERIC Educational Resources Information Center

Grannis, Joseph C.; Fahs, Mary Ellen

This report evaluates a project that studied social, physical, and academic stress in the lives of students in an inner-city intermediate school and developed interventions to reduce that stress. Over 242 students, most of whom were from low-income families and almost all of whom were black, participated in the project. The following findings are…

Using biological factors to individualize interventions for youth with conduct problems: Current state and ethical issues.

PubMed

Glenn, Andrea L

2018-04-16

A growing body of evidence suggests that biological factors such as genes, hormone levels, brain structure, and brain functioning influence the development and trajectory of conduct problems in youth. In addition, biological factors affect how individuals respond to the environment, including how individuals respond to programs designed to prevent or treat conduct problems. Programs designed to reduce behavior problems in youth would have the greatest impact if they were targeted toward youth who need it the most (e.g., who are mostly likely to demonstrate persistent behavior problems) as well as youth who may benefit the most from the program. Biological information may improve our ability to make decisions about which type or level of intervention is best for a particular child, thus maximizing overall effectiveness, but it also raises a number of ethical concerns. These include the idea that we may be providing fewer services to some youth based on biological factors, and that information about biological risk could potentially lead to discrimination or labeling. In this article, I discuss the risks and benefits of using biological information to individualize interventions for youth with conduct problems. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis.