Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework

PubMed Central

2012-01-01

Background There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a Series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research. Methods The intervention was developed considering three main components: theory, evidence, and practical issues. We used a four-step approach, consisting of guiding questions, to direct the choice of the most appropriate components of an implementation intervention: Who needs to do what, differently? Using a theoretical framework, which barriers and enablers need to be addressed? Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? And how can behaviour change be measured and understood? Results A complex implementation intervention was designed that aimed to improve acute low back pain management in primary care. We used the TDF to identify the barriers and enablers to the uptake of evidence into practice and to guide the choice of intervention components. These components were then combined into a cohesive intervention. The intervention was delivered via two facilitated interactive small group workshops. We also produced a DVD to distribute to all participants in the intervention group. We chose outcome measures in order to assess the mediating mechanisms of behaviour change. Conclusions We have illustrated a four-step systematic method for developing an intervention designed to change clinical practice based on a theoretical framework. The method of development provides a systematic framework that could be used by others developing complex implementation interventions. While this framework should be iteratively adjusted and refined to suit other contexts and settings, we believe that the four-step process should be maintained as the primary framework to guide researchers through a comprehensive intervention development process. PMID:22531013

A magnetic resonance image-guided breast needle intervention robot system: overview and design considerations.

PubMed

Park, Samuel Byeongjun; Kim, Jung-Gun; Lim, Ki-Woong; Yoon, Chae-Hyun; Kim, Dong-Jun; Kang, Han-Sung; Jo, Yung-Ho

2017-08-01

We developed an image-guided intervention robot system that can be operated in a magnetic resonance (MR) imaging gantry. The system incorporates a bendable needle intervention robot for breast cancer patients that overcomes the space limitations of the MR gantry. Most breast coil designs for breast MR imaging have side openings to allow manual localization. However, for many intervention procedures, the patient must be removed from the gantry. A robotic manipulation system with integrated image guidance software was developed. Our robotic manipulator was designed to be slim, so as to fit between the patient's side and the MR gantry wall. Only non-magnetic materials were used, and an electromagnetic shield was employed for cables and circuits. The image guidance software was built using open source libraries. In situ feasibility tests were performed in a 3-T MR system. One target point in the breast phantom was chosen by the clinician for each experiment, and our robot moved the needle close to the target point. Without image-guided feedback control, the needle end could not hit the target point (distance = 5 mm) in the first experiment. Using our robotic system, the needle hits the target lesion of the breast phantom at a distance of 2.3 mm from the same target point using image-guided feedback. The second experiment was performed using other target points, and the distance between the final needle end point and the target point was 0.8 mm. We successfully developed an MR-guided needle intervention robot for breast cancer patients. Further research will allow the expansion of these interventions.

How to write a surgical clinical research protocol: literature review and practical guide.

PubMed

Rosenthal, Rachel; Schäfer, Juliane; Briel, Matthias; Bucher, Heiner C; Oertli, Daniel; Dell-Kuster, Salome

2014-02-01

The study protocol is the core document of every clinical research project. Clinical research in studies involving surgical interventions presents some specific challenges, which need to be accounted for and described in the study protocol. The aim of this review is to provide a practical guide for developing a clinical study protocol for surgical interventions with a focus on methodologic issues. On the basis of an in-depth literature search of methodologic literature and on some cardinal published surgical trials and observational studies, the authors provides a 10-step guide for developing a clinical study protocol in surgery. This practical guide outlines key methodologic issues important when planning an ethically and scientifically sound research project involving surgical interventions, with the ultimate goal of providing high-level evidence relevant for health care decision making in surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Extended use of the GuideLiner in complex coronary interventions.

PubMed

Chan, Pak Hei; Alegria-Barrero, Eduardo; Foin, Nicholas; Paulo, Manuel; Lindsay, Alistair C; Viceconte, Nicola; Di Mario, Carlo

2015-07-01

Challenging coronary anatomies including chronic total occlusions (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries pose difficulties in coronary interventions. The GuideLiner is a monorail catheter originally developed to facilitate delivery of stents to target lesions in tortuous vessels. We conducted a study on the feasibility and safety of utilising this catheter in a wider array of complex coronary interventions. Consecutive patients undergoing coronary or peripheral interventions where a GuideLiner was used were recruited into this study. Patient demographics, lesion and vessel characteristics, procedural details and outcomes were prospectively entered into our database and analysed. From September 2009 to October 2011, 54 consecutive patients underwent coronary intervention in our institution using a GuideLiner; 21 out of 54 coronary applications were motivated by the need to increase support to cross CTOs, predominantly of the RCA. Anomalous or angulated take-off of the treatment vessels (31%), previously deployed proximal stents (15%), heavy proximal calcification (9%) and tortuosity (7%) accounted for the remaining reasons. One patient had successful renal denervation with the aid of a GuideLiner catheter. Procedural success was 98% in our series with no device-related periprocedural complications such as ostial dissection or myocardial necrosis. The use of a GuideLiner facilitates the approach to complex coronary interventions including chronic total occlusion and saphenous vein graft intervention by providing greater back-up support and easier engagement of coronary ostia.

Public health program planning logic model for community engaged type 2 diabetes management and prevention.

PubMed

West, Joseph F

2014-02-01

Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using the Medical Research Council framework for development and evaluation of complex interventions in a low resource setting to develop a theory-based treatment support intervention delivered via SMS text message to improve blood pressure control.

PubMed

Bobrow, Kirsten; Farmer, Andrew; Cishe, Nomazizi; Nwagi, Ntobeko; Namane, Mosedi; Brennan, Thomas P; Springer, David; Tarassenko, Lionel; Levitt, Naomi

2018-01-23

Several frameworks now exist to guide intervention development but there remains only limited evidence of their application to health interventions based around use of mobile phones or devices, particularly in a low-resource setting. We aimed to describe our experience of using the Medical Research Council (MRC) Framework on complex interventions to develop and evaluate an adherence support intervention for high blood pressure delivered by SMS text message. We further aimed to describe the developed intervention in line with reporting guidelines for a structured and systematic description. We used a non-sequential and flexible approach guided by the 2008 MRC Framework for the development and evaluation of complex interventions. We reviewed published literature and established a multi-disciplinary expert group to guide the development process. We selected health psychology theory and behaviour change techniques that have been shown to be important in adherence and persistence with chronic medications. Semi-structured interviews and focus groups with various stakeholders identified ways in which treatment adherence could be supported and also identified key features of well-regarded messages: polite tone, credible information, contextualised, and endorsed by identifiable member of primary care facility staff. Direct and indirect user testing enabled us to refine the intervention including refining use of language and testing of interactive components. Our experience shows that using a formal intervention development process is feasible in a low-resource multi-lingual setting. The process enabled us to pre-test assumptions about the intervention and the evaluation process, allowing the improvement of both. Describing how a multi-component intervention was developed including standardised descriptions of content aimed to support behaviour change will enable comparison with other similar interventions and support development of new interventions. Even in low-resource settings, funders and policy-makers should provide researchers with time and resources for intervention development work and encourage evaluation of the entire design and testing process. The trial of the intervention is registered with South African National Clinical Trials Register number (SANCTR DOH-27-1212-386; 28/12/2012); Pan Africa Trial Register (PACTR201411000724141; 14/12/2013); ClinicalTrials.gov ( NCT02019823 ; 24/12/2013).

Development of a theory-guided pan-European computer-assisted safer sex intervention.

PubMed

Nöstlinger, Christiana; Borms, Ruth; Dec-Pietrowska, Joanna; Dias, Sonia; Rojas, Daniela; Platteau, Tom; Vanden Berghe, Wim; Kok, Gerjo

2016-12-01

HIV is a growing public health problem in Europe, with men-having-sex-with-men and migrants from endemic regions as the most affected key populations. More evidence on effective behavioral interventions to reduce sexual risk is needed. This article describes the systematic development of a theory-guided computer-assisted safer sex intervention, aiming at supporting people living with HIV in sexual risk reduction. We applied the Intervention Mapping (IM) protocol to develop this counseling intervention in the framework of a European multicenter study. We conducted a needs assessment guided by the information-motivation-behavioral (IMB) skills model, formulated change objectives and selected theory-based methods and practical strategies, i.e. interactive computer-assisted modules as supporting tools for provider-delivered counseling. Theoretical foundations were the IMB skills model, social cognitive theory and the transtheoretical model, complemented by dual process models of affective decision making to account for the specifics of sexual behavior. The counseling approach for delivering three individual sessions was tailored to participants' needs and contexts, adopting elements of motivational interviewing and cognitive-behavioral therapy. We implemented and evaluated the intervention using a randomized controlled trial combined with a process evaluation. IM provided a useful framework for developing a coherent intervention for heterogeneous target groups, which was feasible and effective across the culturally diverse settings. This article responds to the need for transparent descriptions of the development and content of evidence-based behavior change interventions as potential pillars of effective combination prevention strategies. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Culturally Based Intervention Development: The Case of Latino Families Dealing with Schizophrenia

ERIC Educational Resources Information Center

Barrio, Concepcion; Yamada, Ann-Marie

2010-01-01

Objectives: This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method: Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this…

Using intervention mapping to develop a breast and cervical cancer screening program for Hispanic farmworkers: Cultivando La Salud.

PubMed

Fernández, Maria E; Gonzales, Alicia; Tortolero-Luna, Guillermo; Partida, Sylvia; Bartholomew, L Kay

2005-10-01

This article describes the development of the Cultivando La Salud program, an intervention to increase breast and cervical cancer screening for Hispanic farmworker women. Processes and findings of intervention mapping (IM), a planning process for development of theory and evidence-informed program are discussed. The six IM steps are presented: needs assessment, preparation of planning matrices, election of theoretic methods and practical strategies, program design, implementation planning, and evaluation. The article also describes how qualitative and quantitative findings informed intervention development. IM helped ensure that theory and evidence guided (a) the identification of behavioral and environmental factors related to a target health problem and (b) the selection of the most appropriate methods and strategies to address the identified determinants. IM also guided the development of program materials and implementation by lay health workers. Also reported are findings of the pilot study and effectiveness trial.

Application of Intervention Mapping to the Development of a Complex Physical Therapist Intervention.

PubMed

Jones, Taryn M; Dear, Blake F; Hush, Julia M; Titov, Nickolai; Dean, Catherine M

2016-12-01

Physical therapist interventions, such as those designed to change physical activity behavior, are often complex and multifaceted. In order to facilitate rigorous evaluation and implementation of these complex interventions into clinical practice, the development process must be comprehensive, systematic, and transparent, with a sound theoretical basis. Intervention Mapping is designed to guide an iterative and problem-focused approach to the development of complex interventions. The purpose of this case report is to demonstrate the application of an Intervention Mapping approach to the development of a complex physical therapist intervention, a remote self-management program aimed at increasing physical activity after acquired brain injury. Intervention Mapping consists of 6 steps to guide the development of complex interventions: (1) needs assessment; (2) identification of outcomes, performance objectives, and change objectives; (3) selection of theory-based intervention methods and practical applications; (4) organization of methods and applications into an intervention program; (5) creation of an implementation plan; and (6) generation of an evaluation plan. The rationale and detailed description of this process are presented using an example of the development of a novel and complex physical therapist intervention, myMoves-a program designed to help individuals with an acquired brain injury to change their physical activity behavior. The Intervention Mapping framework may be useful in the development of complex physical therapist interventions, ensuring the development is comprehensive, systematic, and thorough, with a sound theoretical basis. This process facilitates translation into clinical practice and allows for greater confidence and transparency when the program efficacy is investigated. © 2016 American Physical Therapy Association.

Using the Intervention Mapping and Behavioral Intervention Technology Frameworks: Development of an mHealth Intervention for Physical Activity and Sedentary Behavior Change.

PubMed

Direito, Artur; Walsh, Deirdre; Hinbarji, Moohamad; Albatal, Rami; Tooley, Mark; Whittaker, Robyn; Maddison, Ralph

2018-06-01

Few interventions to promote physical activity (PA) adapt dynamically to changes in individuals' behavior. Interventions targeting determinants of behavior are linked with increased effectiveness and should reflect changes in behavior over time. This article describes the application of two frameworks to assist the development of an adaptive evidence-based smartphone-delivered intervention aimed at influencing PA and sedentary behaviors (SB). Intervention mapping was used to identify the determinants influencing uptake of PA and optimal behavior change techniques (BCTs). Behavioral intervention technology was used to translate and operationalize the BCTs and its modes of delivery. The intervention was based on the integrated behavior change model, focused on nine determinants, consisted of 33 BCTs, and included three main components: (1) automated capture of daily PA and SB via an existing smartphone application, (2) classification of the individual into an activity profile according to their PA and SB, and (3) behavior change content delivery in a dynamic fashion via a proof-of-concept application. This article illustrates how two complementary frameworks can be used to guide the development of a mobile health behavior change program. This approach can guide the development of future mHealth programs.

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

PubMed Central

Robinson, Thomas N; King, Abby C

2016-01-01

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

Post-fall decision tree development and implementation.

PubMed

Gordon, Bonita M; Wnek, Theresa Frissora; Glorius, Nancy; Hasdorff, Carmen; Shiverski, Joyce; Ginn, Janet

2010-01-01

Care and evaluation after a patient's fall require a number of steps to ensure that appropriate care is given and injury is minimized. Astute and appropriate assessment skills with strategic interventions and communication can minimize the harm from a fall. Post-Fall Decision Guidelines were developed to guide care and treatment and to identify potential complications after a patient has fallen. This systematic approach mobilizes the steps of communication, using the Situation-Background-Assessment-Recommendation (SBAR) format, and guides assessment interventions.

Country planning for health interventions under development: lessons from the malaria vaccine decision-making framework and implications for other new interventions

PubMed Central

Brooks, Alan; Ba-Nguz, Antoinette

2012-01-01

Traditionally it has taken years or decades for new public health interventions targeting diseases found in developing countries to be accessible to those most in need. One reason for the delay has been insufficient anticipation of the eventual processes and evidence required for decision making by countries. This paper describes research into the anticipated processes and data needed to inform decision making on malaria vaccines, the most advanced of which is still in phase 3 trials. From 2006 to 2008, a series of country consultations in Africa led to the development of a guide to assist countries in preparing their malaria vaccine decision-making frameworks. The guide builds upon the World Health Organization’s Vaccine Introduction Guidelines. It identifies the processes and data for decisions, when they would be needed relative to the development timelines of the intervention, and where they will come from. Policy development will be supported by data (e.g. malaria disease burden; roles of other malaria interventions; malaria vaccine impact; economic and financial issues; malaria vaccine efficacy, quality and safety) as will implementation decisions (e.g. programmatic issues and socio-cultural environment). This generic guide can now be applied to any future malaria vaccine. The paper discusses the opportunities and challenges to early planning for country decision-making—from the potential for timely, evidence-informed decisions to the risks of over-promising around an intervention still under development. Careful and well-structured planning by countries is an important way to ensure that new interventions do not remain unused for years or decades after they become available. PMID:22513733

Development of the Intervention Materials for the HomeStyles Obesity Prevention Program for Parents of Preschoolers

PubMed Central

Martin-Biggers, Jennifer; Spaccarotella, Kim; Delaney, Colleen; Koenings, Mallory; Alleman, Gayle; Hongu, Nobuko; Worobey, John; Byrd-Bredbenner, Carol

2015-01-01

Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles) with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith’s Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251) and content (n = 261) occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial. PMID:26266419

[Three-dimensional 3D modeling: First applications in radioanatomy and interventional radiology under CT guidance].

PubMed

Aubry, S; Pousse, A; Sarliève, P; Laborie, L; Delabrousse, E; Kastler, B

2006-11-01

To model vertebrae in 3D to improve radioanatomic knowledge of the spine with the vascular and nerve environment and simulate CT-guided interventions. Vertebra acquisitions were made with multidetector CT. We developed segmentation software and specific viewer software using the Delphi programming environment. This segmentation software makes it possible to model 3D high-resolution segments of vertebrae and their environment from multidetector CT acquisitions. Then the specific viewer software provides multiplanar reconstructions of the CT volume and the possibility to select different 3D objects of interest. This software package improves radiologists' radioanatomic knowledge through a new 3D anatomy presentation. Furthermore, the possibility of inserting virtual 3D objects in the volume can simulate CT-guided intervention. The first volumetric radioanatomic software has been born. Furthermore, it simulates CT-guided intervention and consequently has the potential to facilitate learning interventions using CT guidance.

Endoscopic Ultrasound-Guided Management of Pancreatic Fluid Collections: Update and Review of the Literature

PubMed Central

Alali, Ali; Mosko, Jeffrey; May, Gary; Teshima, Christopher

2017-01-01

Severe acute pancreatitis is often complicated by the development of pancreatic fluid collections (PFCs), which may be associated with significant morbidity and mortality. It is crucial to accurately classify these collections as a pseudocyst or walled-off necrosis (WON) given significant differences in outcomes and management. Interventions for PFCs have increasingly shifted to less invasive strategies, with endoscopic ultrasound (EUS)-guided methods being shown to be safer and equally effective as more invasive surgical techniques. In recent years, many new developments have improved the safety and efficacy of EUS-guided interventions, such as the introduction of lumen-apposing metal stents (LAMS), direct endoscopic necrosectomy (DEN) and multiple other adjunctive techniques. Despite these developments, treatment of PFCs, and infected WON in particular, continues to be associated with significant morbidity and mortality. In this article, we discuss the EUS-guided management of PFCs while reviewing the latest developments and controversies in the field. We end by summarizing our own approach to managing PFCs. PMID:28391671

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application.

PubMed

Barkhausen, Jörg; Kahn, Thomas; Krombach, Gabriele A; Kuhl, Christiane K; Lotz, Joachim; Maintz, David; Ricke, Jens; Schönberg, Stefan O; Vogl, Thomas J; Wacker, Frank K

2017-07-01

Background  MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function. Method  The current status of interventional MRI for the clinical routine was analyzed. Results  The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Conclusion  Interventional MRI has been established in the clinical routine for a variety of indications. Broader application can be expected in the clinical routine in the future owing to the multiple advantages compared to other techniques. Key points   · Due to the significant technical effort, MR-guided interventions are only recommended in the long term for regions in which MRI either facilitates or greatly improves the intervention.. · Breast biopsy of otherwise undetectable target lesions has long been established in the clinical routine. Prostate biopsy is currently being introduced in the clinical routine for similar reasons. Other methods such as MR-guided focused ultrasound for the treatment of uterine fibroids or tumor ablation of metastases represent alternative methods and are offered in many places.. · Endovascular MR-guided interventions offer advantages for a number of indications and have already been clinically established for the treatment of children with congenital heart defects and for atrial ablation at individual centers. Greater application can be expected in the future.. Citation format · Barkhausen J, Kahn T, Krombach GA et al. White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application. Fortschr Röntgenstr 2017; 189: 611 - 623. © Georg Thieme Verlag KG Stuttgart · New York.

Teaching Paraprofessionals to Implement Function-Based Interventions

ERIC Educational Resources Information Center

Walker, Virginia L.; Snell, Martha E.

2017-01-01

The purpose of this study was to evaluate the effects of workshops and coaching on paraprofessional implementation of function-based interventions. The results of indirect and direct functional behavior assessment guided the development of intervention strategies for three students with autism and intellectual disability. Following intervention,…

Value of MR contrast media in image-guided body interventions.

PubMed

Saeed, Maythem; Wilson, Mark

2012-01-28

In the past few years, there have been multiple advances in magnetic resonance (MR) instrumentation, in vivo devices, real-time imaging sequences and interventional procedures with new therapies. More recently, interventionists have started to use minimally invasive image-guided procedures and local therapies, which reduce the pain from conventional surgery and increase drug effectiveness, respectively. Local therapy also reduces the systemic dose and eliminates the toxic side effects of some drugs to other organs. The success of MR-guided procedures depends on visualization of the targets in 3D and precise deployment of ablation catheters, local therapies and devices. MR contrast media provide a wealth of tissue contrast and allows 3D and 4D image acquisitions. After the development of fast imaging sequences, the clinical applications of MR contrast media have been substantially expanded to include pre- during- and post-interventions. Prior to intervention, MR contrast media have the potential to localize and delineate pathologic tissues of vital organs, such as the brain, heart, breast, kidney, prostate, liver and uterus. They also offer other options such as labeling therapeutic agents or cells. During intervention, these agents have the capability to map blood vessels and enhance the contrast between the endovascular guidewire/catheters/devices, blood and tissues as well as direct therapies to the target. Furthermore, labeling therapeutic agents or cells aids in visualizing their delivery sites and tracking their tissue distribution. After intervention, MR contrast media have been used for assessing the efficacy of ablation and therapies. It should be noted that most image-guided procedures are under preclinical research and development. It can be concluded that MR contrast media have great value in preclinical and some clinical interventional procedures. Future applications of MR contrast media in image-guided procedures depend on their safety, tolerability, tissue specificity and effectiveness in demonstrating success of the interventions and therapies.

Implementing and evaluating early intervention for children with autism: Where are the gaps and what should we do?

PubMed

Vivanti, Giacomo; Kasari, Connie; Green, Jonathan; Mandell, David; Maye, Melissa; Hudry, Kristelle

2018-01-01

Despite recent advances, the evidence base supporting early intervention for young children with autism spectrum disorder (ASD) remains relatively sparse. The International Society for Autism Research (INSAR) recently sponsored a Special Interest Group (SIG) on Implementing and Evaluating Community-Based Early Intervention. Across three meetings, in 2015, 2016, and 2017, conveners of this SIG engaged >200 members to identify knowledge gaps and research priorities for moving the field forward. Here, we summarize the perspectives that emerged from group discussion at the SIG meetings as represented by scholars working actively in the field. Despite encouraging progress, critical gaps and research priorities were identified across all the stages of intervention development and testing from conceptualization to community implementation. Key issues include the need for (a) formal theories to guide early intervention development, evaluation, and implementation; and alignment of intervention goals with scientific knowledge and societal changes that have occurred in the decades since interventions were originally developed; (b) increased focus on feasibility of treatment procedures and alignment with stakeholder values during pilot evaluations; (c) use of research designs that allow for comparisons of different interventions and formats, analyses of active ingredients of treatment, and identification of moderators and mediators of outcome; (d) use of community-partnered participatory research to guide adaptation of intervention models to community settings; (e) inclusion of constructs related to implementation processes and outcomes in treatment trials and; (f) an iterative approach to the progression of knowledge from intervention development to implementation. Autism Res 2018, 11: 16-23. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. In this article, we summarize the themes discussed at the INSAR Special Interest Group (SIG) on Implementing and Evaluating Community-Based Early Intervention. Priorities for moving the field forward identified in the SIG included the need for (a) formal theories to guide the development and evaluation of interventions, (b) pilot evaluations that investigate feasibility and acceptability of interventions, (c) methodologies that allow us to determine for whom different interventions bring most benefit and why this is so, (d) strategies to include community members and other stakeholders in the process of developing and evaluating interventions, and (e) understanding of factors that make interventions more likely to be adopted and successfully implemented in the real world. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Development of a Post-Intensive Care Unit Storytelling Intervention for Surrogates Involved in Decisions to Limit Life-Sustaining Treatment

PubMed Central

Schenker, Yael; Dew, Mary Amanda; Reynolds, Charles F.; Arnold, Robert M.; Tiver, Greer A.; Barnato, Amber E.

2014-01-01

Objectives Surrogates involved in decisions to limit life-sustaining treatment for a loved one in the intensive care unit (ICU) are at increased risk for adverse psychological outcomes lasting months to years after the ICU experience. Post-ICU interventions to reduce surrogate distress have not been developed. We sought to 1) describe a conceptual framework underlying the beneficial mental health effects of storytelling and 2) present formative work developing a storytelling intervention to reduce distress for recently bereaved surrogates. Methods An interdisciplinary team conceived the idea for a storytelling intervention based upon evidence from narrative theory that storytelling reduces distress from traumatic events through emotional disclosure, cognitive processing, and social connections. We developed an initial storytelling guide based upon this theory and the clinical perspectives of team members. We then conducted a case series with recently bereaved surrogates to iteratively test and modify the guide. Results The storytelling guide covered three key domains of the surrogate's experience of the patient's illness and death: antecedents, ICU experience, and aftermath. The facilitator focused on parts of the story that appeared to generate strong emotions and used non-judgmental statements to attend to these emotions. Between September 2012 and May 2013 we identified 28 eligible surrogates from 1 medical ICU and consented 20 for medical record review and recontact; 10 became eligible of whom 6 consented and completed the storytelling intervention. The single-session storytelling intervention lasted 40-92 minutes. All storytelling participants endorsed the intervention as acceptable, and 5 of 6 reported that it was helpful. Significance of Results Surrogate storytelling is an innovative and acceptable post-ICU intervention for recently bereaved surrogates and should be evaluated further. PMID:24524736

Development of a post-intensive care unit storytelling intervention for surrogates involved in decisions to limit life-sustaining treatment.

PubMed

Schenker, Yael; Dew, Mary Amanda; Reynolds, Charles F; Arnold, Robert M; Tiver, Greer A; Barnato, Amber E

2015-06-01

Surrogates involved in decisions to limit life-sustaining treatment for a loved one in the intensive care unit (ICU) are at increased risk for adverse psychological outcomes that can last for months to years after the ICU experience. Post-ICU interventions to reduce surrogate distress have not yet been developed. We sought to (1) describe a conceptual framework underlying the beneficial mental health effects of storytelling, and (2) present formative work developing a storytelling intervention to reduce distress for recently bereaved surrogates. An interdisciplinary team conceived the idea for a storytelling intervention based on evidence from narrative theory that storytelling reduces distress from traumatic events through emotional disclosure, cognitive processing, and social connection. We developed an initial storytelling guide based on this theory and the clinical perspectives of team members. We then conducted a case series with recently bereaved surrogates to iteratively test and modify the guide. The storytelling guide covered three key domains of the surrogate's experience of the patient's illness and death: antecedents, ICU experience, and aftermath. The facilitator focused on the parts of a story that appeared to generate strong emotions and used nonjudgmental statements to attend to these emotions. Between September 2012 and May 2013, we identified 28 eligible surrogates from a medical ICU and consented 20 for medical record review and recontact; 10 became eligible, of whom 6 consented and completed the storytelling intervention. The single-session storytelling intervention lasted from 40 to 92 minutes. All storytelling participants endorsed the intervention as acceptable, and five of six reported it as helpful. Surrogate storytelling is an innovative and acceptable post-ICU intervention for recently bereaved surrogates and should be evaluated further.

MO-DE-202-03: Image-Guided Surgery and Interventions in the Advanced Multimodality Image-Guided Operating (AMIGO) Suite

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

Kapur, T.

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guidedmore » neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.« less

Teenagers and Their Babies: A Perinatal Home Visitor's Guide

ERIC Educational Resources Information Center

Cardone, Ida; Gilkerson, Linda; Wechsler, Nick

2008-01-01

"Teenagers and Their Babies" is a self-study and preparation guide for paraprofessional home-based visitors to engage expectant and new parents in an exploration of their baby's development and their expectations for parenthood. The guide includes service interventions--strategies, techniques, and activities--for home visitors and doulas to use…

3D ultrasound imaging in image-guided intervention.

PubMed

Fenster, Aaron; Bax, Jeff; Neshat, Hamid; Cool, Derek; Kakani, Nirmal; Romagnoli, Cesare

2014-01-01

Ultrasound imaging is used extensively in diagnosis and image-guidance for interventions of human diseases. However, conventional 2D ultrasound suffers from limitations since it can only provide 2D images of 3-dimensional structures in the body. Thus, measurement of organ size is variable, and guidance of interventions is limited, as the physician is required to mentally reconstruct the 3-dimensional anatomy using 2D views. Over the past 20 years, a number of 3-dimensional ultrasound imaging approaches have been developed. We have developed an approach that is based on a mechanical mechanism to move any conventional ultrasound transducer while 2D images are collected rapidly and reconstructed into a 3D image. In this presentation, 3D ultrasound imaging approaches will be described for use in image-guided interventions.

Discerning the Future of Early Childhood Intervention.

ERIC Educational Resources Information Center

Zigler, Edward; Berman, Winnie

1983-01-01

Examines the recent history of early childhood intervention efforts; discusses principles that guided the formation of intervention programs in the 1960s and 1970s; describes the Head Start program and lessons learned from its development; considers issues in evaluating intervention programs; and presents suggestions for future directions in early…

Effects of a Digital Intervention on the Development of Algebraic Expertise

ERIC Educational Resources Information Center

Bokhove, Christian; Drijvers, Paul

2012-01-01

In this article we report on the effects of a digital intervention on the development of algebraic expertise of 17-18 year old students in the Netherlands. The question to be answered was whether the intervention would be effective and what factors influenced the outcome. With notions of formative assessment and symbol sense as guiding theoretical…

Intervention mapping as a guide for the development of a diabetes peer support intervention in rural Alabama.

PubMed

Cherrington, Andrea; Martin, Michelle Y; Hayes, Michaela; Halanych, Jewell H; Wright, Mary Annette; Appel, Susan J; Andreae, Susan J; Safford, Monika

2012-01-01

Peer support is a promising strategy for the reduction of diabetes-related health disparities; however, few studies describe the development of such strategies in enough detail to allow for replication. The objective of this article is to describe the development of a 1-year peer support intervention to improve diabetes self-management among African American adults with diabetes in Alabama's Black Belt. We used principles of intervention mapping, including literature review, interviews with key informants, and a discussion group with community health workers, to guide intervention development. Qualitative data were combined with behavioral constructs and principles of diabetes self-management to create a peer support intervention to be delivered by trained peer advisors. Feedback from a 1-month pilot was used to modify the training and intervention. The resulting intervention includes a 2-day training for peer advisors, who were each paired with 3 to 6 clients. A one-on-one in-person needs assessment begins an intensive intervention phase conducted via telephone for 8 to 12 weeks, followed by a maintenance phase of at least once monthly contacts for the remainder of the intervention period. A peer support network and process measures collected monthly throughout the study supplement formal data collection points at baseline, 6 months, and 12 months. Intervention mapping provided a useful framework for the development of culturally relevant diabetes peer support intervention for African Americans living in Alabama's Black Belt. The process described could be implemented by others in public health to develop or adapt programs suitable for their particular community or context.

An Alternative Methodological Approach for Cost-Effectiveness Analysis and Decision Making in Genomic Medicine.

PubMed

Fragoulakis, Vasilios; Mitropoulou, Christina; van Schaik, Ron H; Maniadakis, Nikolaos; Patrinos, George P

2016-05-01

Genomic Medicine aims to improve therapeutic interventions and diagnostics, the quality of life of patients, but also to rationalize healthcare costs. To reach this goal, careful assessment and identification of evidence gaps for public health genomics priorities are required so that a more efficient healthcare environment is created. Here, we propose a public health genomics-driven approach to adjust the classical healthcare decision making process with an alternative methodological approach of cost-effectiveness analysis, which is particularly helpful for genomic medicine interventions. By combining classical cost-effectiveness analysis with budget constraints, social preferences, and patient ethics, we demonstrate the application of this model, the Genome Economics Model (GEM), based on a previously reported genome-guided intervention from a developing country environment. The model and the attendant rationale provide a practical guide by which all major healthcare stakeholders could ensure the sustainability of funding for genome-guided interventions, their adoption and coverage by health insurance funds, and prioritization of Genomic Medicine research, development, and innovation, given the restriction of budgets, particularly in developing countries and low-income healthcare settings in developed countries. The implications of the GEM for the policy makers interested in Genomic Medicine and new health technology and innovation assessment are also discussed.

Navigation concepts for MR image-guided interventions.

PubMed

Moche, Michael; Trampel, Robert; Kahn, Thomas; Busse, Harald

2008-02-01

The ongoing development of powerful magnetic resonance imaging techniques also allows for advanced possibilities to guide and control minimally invasive interventions. Various navigation concepts have been described for practically all regions of the body. The specific advantages and limitations of these concepts largely depend on the magnet design of the MR scanner and the interventional environment. Open MR scanners involve minimal patient transfer, which improves the interventional workflow and reduces the need for coregistration, ie, the mapping of spatial coordinates between imaging and intervention position. Most diagnostic scanners, in contrast, do not allow the physician to guide his instrument inside the magnet and, consequently, the patient needs to be moved out of the bore. Although adequate coregistration and navigation concepts for closed-bore scanners are technically more challenging, many developments are driven by the well-known capabilities of high-field systems and their better economic value. Advanced concepts such as multimodal overlays, augmented reality displays, and robotic assistance devices are still in their infancy but might propel the use of intraoperative navigation. The goal of this work is to give an update on MRI-based navigation and related techniques and to briefly discuss the clinical experience and limitations of some selected systems. (Copyright) 2008 Wiley-Liss, Inc.

Magnetic resonance-guided prostate interventions.

PubMed

Haker, Steven J; Mulkern, Robert V; Roebuck, Joseph R; Barnes, Agnieska Szot; Dimaio, Simon; Hata, Nobuhiko; Tempany, Clare M C

2005-10-01

We review our experience using an open 0.5-T magnetic resonance (MR) interventional unit to guide procedures in the prostate. This system allows access to the patient and real-time MR imaging simultaneously and has made it possible to perform prostate biopsy and brachytherapy under MR guidance. We review MR imaging of the prostate and its use in targeted therapy, and describe our use of image processing methods such as image registration to further facilitate precise targeting. We describe current developments with a robot assist system being developed to aid radioactive seed placement.

Study guides: effective tools to improve self-directed learning skills of medical students.

PubMed

Khabaz Mafinejad, Mahboobeh; Aghili, Rokhsareh; Emami, Zahra; Malek, Mojtaba; Baradaran, Hamidreza; Taghavinia, Mansoureh; Khamseh, Mohammad E

2014-01-01

In medicine, there is a rapid development of a knowledge base. Medical professionals need to sustain and advance their competence to practice in response to these varieties. So, there is increased interest in self-directed learning methods. Study guides can make a major contribution to self-directed learning. This study was carried out to evaluate the effect of study guides on improving self-learning skills of medical students in the Iran University of Medical Sciences (IUMS). In this quasi-experimental study, 46 medical students were randomly assigned into two groups; the intervention group and the control group. Both groups participated in a diagnostic test at the beginning of the course (pre-test). The same test was taken at the end of the course (post-test). The intervention group was provided with study guides on thyroid disorders and diabetes. Meanwhile, they continued their routine clinical training. The control group was only involved in the conventional training program. Students in the intervention group were also asked to complete a designed questionnaire in regard to their attitude toward the study guides. At enrollment, there was no statistically significant difference between the two groups. The mean scores of the pre-test for the control group and the intervention group were 6.18 and 6.13 respectively (P=0.9). In the post-test, the mean score of the students in the intervention group was considerably higher: 9.25 vs. 12 (P=0.002). The students in the intervention group found the study guides useful. The study guides were potentially effective in motivating self-learning in this group of medical students and had a remarkable effect on their final score.

Children with Severe Cerebral Palsy: An Educational Guide. Guides for Special Education No. 7.

ERIC Educational Resources Information Center

Rye, Henning, Ed.; Skjorten, Miriam Donath, Ed.

The guide, intended to help teachers, parents, and community workers throughout the world develop educational services for children with severe cerebral palsy, is published in English, French, Spanish, Arabic, and Chinese. The 11 practitioner-contributed chapters stress specific intervention techniques based on the practitioners' own experiences…

Improving Early Reading and Literacy: A Guide for Developing Research-Based Programs.

ERIC Educational Resources Information Center

St. John, Edward P.; Bardzell, Jeffrey S.

This guide is designed to help school communities make good choices about early literacy intervention. The guide distinguishes between "reading" (a process of learning to decode and comprehend texts) and a broader concept of "literacy" that includes understanding of the value of language and reading (emergent literacy), the…

Interventions. Organizing Systems To Support Competent Social Behavior in Children and Youth.

ERIC Educational Resources Information Center

Carter, Susanne

This guide describes classroom and school interventions intended to meet the needs of students with emotional/behavioral disabilities and those at risk for developing these disabilities. The first section presents "Classroom Interventions," a compilation of 77 interventions which may be used in regular or self-contained classrooms. A brief…

Problems and possible solutions for interventions among children and adolescents

USDA-ARS?s Scientific Manuscript database

This chapter provides an overview of childhood obesity causes and a discussion about the efficacy of potential preventive interventions. Interventions for obesity prevention generally have had no or limited effects with no obvious patterns in findings to guide program development. This chapter assum...

Virtual coach technology for supporting self-care.

PubMed

Ding, Dan; Liu, Hsin-Yi; Cooper, Rosemarie; Cooper, Rory A; Smailagic, Asim; Siewiorek, Dan

2010-02-01

"Virtual Coach" refers to a coaching program or device aiming to guide users through tasks for the purpose of prompting positive behavior or assisting with learning new skills. This article reviews virtual coach interventions with the purpose of guiding rehabilitation professionals to comprehend more effectively the essential components of such interventions, the underlying technologies and their integration, and example applications. A design space of virtual coach interventions including self-monitoring, context awareness, interface modality, and coaching strategies were identified and discussed to address when, how, and what coaching messages to deliver in an automated and intelligent way. Example applications that address various health-related issues also are provided to illustrate how a virtual coach intervention is developed and evaluated. Finally, the article provides some insight into addressing key challenges and opportunities in designing and implementing virtual coach interventions. It is expected that more virtual coach interventions will be developed in the field of rehabilitation to support self-care and prevent secondary conditions in individuals with disabilities.

Mapping barriers and intervention activities to behaviour change theory for Mobilization of Vulnerable Elders in Ontario (MOVE ON), a multi-site implementation intervention in acute care hospitals.

PubMed

Moore, Julia E; Mascarenhas, Alekhya; Marquez, Christine; Almaawiy, Ummukulthum; Chan, Wai-Hin; D'Souza, Jennifer; Liu, Barbara; Straus, Sharon E

2014-10-30

As evidence-informed implementation interventions spread, they need to be tailored to address the unique needs of each setting, and this process should be well documented to facilitate replication. To facilitate the spread of the Mobilization of Vulnerable Elders in Ontario (MOVE ON) intervention, the aim of the current study is to develop a mapping guide that links identified barriers and intervention activities to behaviour change theory. Focus groups were conducted with front line health-care professionals to identify perceived barriers to implementation of an early mobilization intervention targeted to hospitalized older adults. Participating units then used or adapted intervention activities from an existing menu or developed new activities to facilitate early mobilization. A thematic analysis was performed on the focus group data, emphasizing concepts related to barriers to behaviour change. A behaviour change theory, the 'capability, opportunity, motivation-behaviour (COM-B) system', was used as a taxonomy to map the identified barriers to their root causes. We also mapped the behaviour constructs and intervention activities to overcome these. A total of 46 focus groups were conducted across 26 hospital inpatient units in Ontario, Canada, with 261 participants. The barriers were conceptualized at three levels: health-care provider (HCP), patient, and unit. Commonly mentioned barriers were time constraints and workload (HCP), patient clinical acuity and their perceived 'sick role' (patient), and lack of proper equipment and human resources (unit level). Thirty intervention activities to facilitate early mobilization of older adults were implemented across hospitals; examples of unit-developed intervention activities include the 'mobility clock' communication tool and the use of staff champions. A mapping guide was created with barriers and intervention activities matched though the lens of the COM-B system. We used a systematic approach to develop a guide, which maps barriers, intervention activities, and behaviour change constructs in order to tailor an implementation intervention to the local context. This approach allows implementers to identify potential strategies to overcome local-level barriers and to document adaptations.

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

PubMed

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

2013-08-01

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

Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach.

PubMed

Abbey, Mercy; Bartholomew, L Kay; Chinbuah, Margaret A; Gyapong, Margaret; Gyapong, John O; van den Borne, Bart

2017-01-25

This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development. The intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively. Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%. We were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.

A Guide to the Kentucky System of Interventions

ERIC Educational Resources Information Center

Kentucky Department of Education, 2012

2012-01-01

The Kentucky System of Interventions (KSI) framework emphasizes optimizing instruction through targeted accelerated learning, development of teacher expertise and responsiveness to the needs of all learners. This approach to Response to Intervention (RtI) provides the structures needed for closing achievement gaps, ensuring readiness to learn and…

Radiation exposure of the radiologist's eye lens during CT-guided interventions.

PubMed

Heusch, Philipp; Kröpil, Patric; Buchbender, Christian; Aissa, Joel; Lanzman, Rotem S; Heusner, Till A; Ewen, Klaus; Antoch, Gerald; Fürst, Günther

2014-02-01

In the past decade the number of computed tomography (CT)-guided procedures performed by interventional radiologists have increased, leading to a significantly higher radiation exposure of the interventionalist's eye lens. Because of growing concern that there is a stochastic effect for the development of lens opacification, eye lens dose reduction for operators and patients should be of maximal interest. To determine the interventionalist's equivalent eye lens dose during CT-guided interventions and to relate the results to the maximum of the recommended equivalent dose limit. During 89 CT-guided interventions (e.g. biopsies, drainage procedures, etc.) measurements of eye lens' radiation doses were obtained from a dedicated dosimeter system for scattered radiation. The sensor of the personal dosimeter system was clipped onto the side of the lead glasses which was located nearest to the CT gantry. After the procedure, radiation dose (µSv), dose rate (µSv/min) and the total exposure time (s) were recorded. For all 89 interventions, the median total exposure lens dose was 3.3 µSv (range, 0.03-218.9 µSv) for a median exposure time of 26.2 s (range, 1.1-94.0 s). The median dose rate was 13.9 µSv/min (range, 1.1-335.5 µSv/min). Estimating 50-200 CT-guided interventions per year performed by one interventionalist, the median dose of the eye lens of the interventional radiologist does not exceed the maximum of the ICRP-recommended equivalent eye lens dose limit of 20 mSv per year.

Designing and Undertaking a Health Economics Study of Digital Health Interventions.

PubMed

McNamee, Paul; Murray, Elizabeth; Kelly, Michael P; Bojke, Laura; Chilcott, Jim; Fischer, Alastair; West, Robert; Yardley, Lucy

2016-11-01

This paper introduces and discusses key issues in the economic evaluation of digital health interventions. The purpose is to stimulate debate so that existing economic techniques may be refined or new methods developed. The paper does not seek to provide definitive guidance on appropriate methods of economic analysis for digital health interventions. This paper describes existing guides and analytic frameworks that have been suggested for the economic evaluation of healthcare interventions. Using selected examples of digital health interventions, it assesses how well existing guides and frameworks align to digital health interventions. It shows that digital health interventions may be best characterized as complex interventions in complex systems. Key features of complexity relate to intervention complexity, outcome complexity, and causal pathway complexity, with much of this driven by iterative intervention development over time and uncertainty regarding likely reach of the interventions among the relevant population. These characteristics imply that more-complex methods of economic evaluation are likely to be better able to capture fully the impact of the intervention on costs and benefits over the appropriate time horizon. This complexity includes wider measurement of costs and benefits, and a modeling framework that is able to capture dynamic interactions among the intervention, the population of interest, and the environment. The authors recommend that future research should develop and apply more-flexible modeling techniques to allow better prediction of the interdependency between interventions and important environmental influences. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Men's experience of a guided self-help intervention for hot flushes associated with prostate cancer treatment.

PubMed

Grunfeld, E A; Hunter, M S; Yousaf, O

2017-04-01

Up to 80% of men who receive androgen deprivation therapy report hot flushes and for many these are associated with reduced quality of life. However it is recognised that there are a number of barriers to men's engagement with support to manage symptoms and improve quality of life. This qualitative study was embedded within a larger randomised controlled trial (MANCAN) of a guided self-help cognitive behavioural intervention to manage hot flushes resulting among men receiving androgen deprivation therapy. The study aimed to explore the engagement and experiences with the guided self-help intervention. Twenty men recruited from the treatment arm of the MANCAN trial participated in a semi-structured interview exploring acceptability of the intervention, factors affecting engagement and perceived usefulness of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a Framework approach. Over two thirds of respondents (69%) reported reading the intervention booklet in full and over 90% reporting practising the relaxation CD at least once a week. Analysis of the interviews identified three super-ordinate themes and these related to changes in hot flush symptomatology (learned to cope with hot flushes in new ways), the skills that participants had derived from the intervention (promoting relaxation and reducing stressors), and to a broader usefulness of the intervention (broader impact of the intervention and skills). The present study identified positive engagement with a guided self-help intervention and that men applied the skills developed through the intervention to help them undertake general lifestyle changes. Psycho-educational interventions (e.g. cognitive behaviour therapy, relaxation, and positive lifestyle elements) offer the potential to be both effective and well received by male cancer survivors.

Approaches to creating and controlling motion in MRI.

PubMed

Fischer, Gregory S; Cole, Gregory; Su, Hao

2011-01-01

Magnetic Resonance Imaging (MRI) can provide three dimensional (3D) imaging with excellent resolution and sensitivity making it ideal for guiding and monitoring interventions. The development of MRI-compatible interventional devices is complicated by factors including: the high magnetic field strength, the requirement that such devices should not degrade image quality, and the confined physical space of the scanner bore. Numerous MRI guided actuated devices have been developed or are currently being developed utilizing piezoelectric actuators as their primary means of mechanical energy generation to enable better interventional procedure performance. While piezoelectric actuators are highly desirable for MRI guided actuation for their precision, high holding force, and non-magnetic operation they are often found to cause image degradation on a large enough to scale to render live imaging unusable. This paper describes a newly developed piezoelectric actuator driver and control system designed to drive a variety of both harmonic and non-harmonic motors that has been demonstrated to be capable of operating both harmonic and non-harmonic piezoelectric actuators with less than 5% SNR loss under closed loop control. The proposed system device allows for a single controller to control any supported actuator and feedback sensor without any physical hardware changes.

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

PubMed Central

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

2016-01-01

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

Effective Literacy and English Language Instruction for English Learners in the Elementary Grades. IES Practice Guide. NCEE 2007-4011

ERIC Educational Resources Information Center

Gersten, Russell; Baker, Scott K.; Shanahan, Timothy; Linan-Thompson, Sylvia; Collins, Penny; Scarcella, Robin

2007-01-01

This Practice Guide is the first in a series of the Institute of Education Sciences (IES) guides in education that are developed by a panel of experts. The guides are intended to bring the best available evidence and expertise to bear on the types of systemic challenges that cannot currently be addressed by single intervention or programs. This…

Operation and force analysis of the guide wire in a minimally invasive vascular interventional surgery robot system

NASA Astrophysics Data System (ADS)

Yang, Xue; Wang, Hongbo; Sun, Li; Yu, Hongnian

2015-03-01

To develop a robot system for minimally invasive surgery is significant, however the existing minimally invasive surgery robots are not applicable in practical operations, due to their limited functioning and weaker perception. A novel wire feeder is proposed for minimally invasive vascular interventional surgery. It is used for assisting surgeons in delivering a guide wire, balloon and stenting into a specific lesion location. By contrasting those existing wire feeders, the motion methods for delivering and rotating the guide wire in blood vessel are described, and their mechanical realization is presented. A new resistant force detecting method is given in details. The change of the resistance force can help the operator feel the block or embolism existing in front of the guide wire. The driving torque for rotating the guide wire is developed at different positions. Using the CT reconstruction image and extracted vessel paths, the path equation of the blood vessel is obtained. Combining the shapes of the guide wire outside the blood vessel, the whole bending equation of the guide wire is obtained. That is a risk criterion in the delivering process. This process can make operations safer and man-machine interaction more reliable. A novel surgery robot for feeding guide wire is designed, and a risk criterion for the system is given.

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

PubMed

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

2016-12-16

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

A user-centered model for designing consumer mobile health (mHealth) applications (apps).

PubMed

Schnall, Rebecca; Rojas, Marlene; Bakken, Suzanne; Brown, William; Carballo-Dieguez, Alex; Carry, Monique; Gelaude, Deborah; Mosley, Jocelyn Patterson; Travers, Jasmine

2016-04-01

Mobile technologies are a useful platform for the delivery of health behavior interventions. Yet little work has been done to create a rigorous and standardized process for the design of mobile health (mHealth) apps. This project sought to explore the use of the Information Systems Research (ISR) framework as guide for the design of mHealth apps. Our work was guided by the ISR framework which is comprised of 3 cycles: Relevance, Rigor and Design. In the Relevance cycle, we conducted 5 focus groups with 33 targeted end-users. In the Rigor cycle, we performed a review to identify technology-based interventions for meeting the health prevention needs of our target population. In the Design Cycle, we employed usability evaluation methods to iteratively develop and refine mock-ups for a mHealth app. Through an iterative process, we identified barriers and facilitators to the use of mHealth technology for HIV prevention for high-risk MSM, developed 'use cases' and identified relevant functional content and features for inclusion in a design document to guide future app development. Findings from our work support the use of the ISR framework as a guide for designing future mHealth apps. Results from this work provide detailed descriptions of the user-centered design and system development and have heuristic value for those venturing into the area of technology-based intervention work. Findings from this study support the use of the ISR framework as a guide for future mHealth app development. Use of the ISR framework is a potentially useful approach for the design of a mobile app that incorporates end-users' design preferences. Copyright © 2016 Elsevier Inc. All rights reserved.

Fiber Optic Force Sensors for MRI-Guided Interventions and Rehabilitation: A Review

PubMed Central

Iordachita, Iulian I.; Tokuda, Junichi; Hata, Nobuhiko; Liu, Xuan; Seifabadi, Reza; Xu, Sheng; Wood, Bradford; Fischer, Gregory S.

2017-01-01

Magnetic Resonance Imaging (MRI) provides both anatomical imaging with excellent soft tissue contrast and functional MRI imaging (fMRI) of physiological parameters. The last two decades have witnessed the manifestation of increased interest in MRI-guided minimally invasive intervention procedures and fMRI for rehabilitation and neuroscience research. Accompanying the aspiration to utilize MRI to provide imaging feedback during interventions and brain activity for neuroscience study, there is an accumulated effort to utilize force sensors compatible with the MRI environment to meet the growing demand of these procedures, with the goal of enhanced interventional safety and accuracy, improved efficacy and rehabilitation outcome. This paper summarizes the fundamental principles, the state of the art development and challenges of fiber optic force sensors for MRI-guided interventions and rehabilitation. It provides an overview of MRI-compatible fiber optic force sensors based on different sensing principles, including light intensity modulation, wavelength modulation, and phase modulation. Extensive design prototypes are reviewed to illustrate the detailed implementation of these principles. Advantages and disadvantages of the sensor designs are compared and analyzed. A perspective on the future development of fiber optic sensors is also presented which may have additional broad clinical applications. Future surgical interventions or rehabilitation will rely on intelligent force sensors to provide situational awareness to augment or complement human perception in these procedures. PMID:28652857

MO-DE-202-00: Image-Guided Interventions: Advances in Intraoperative Imaging, Guidance, and An Emerging Role for Medical Physics in Surgery

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

NONE

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guidedmore » neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.« less

MO-DE-202-04: Multimodality Image-Guided Surgery and Intervention: For the Rest of Us

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

Shekhar, R.

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guidedmore » neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.« less

Feasibility of Intraoperative Nerve Monitoring in Preventing Thermal Damage to the “Nerve at Risk” During Image-Guided Ablation of Tumors

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

Marshall, Richard H., E-mail: rmars1@lsuhsc.edu; Avila, Edward K., E-mail: avilae@mskcc.org; Solomon, Stephen B., E-mail: solomons@mskcc.org

PurposeTo assess feasibility of intraoperative neurophysiologic monitoring (IONM) during image-guided, percutaneous thermal ablation of tumors.Materials and MethodsFrom February 2009 to October 2013, a retrospective review of all image-guided percutaneous thermal ablation interventions using IONM was performed and data was compiled using electronic medical records and imaging studies.ResultsTwelve patients were treated in 13 ablation interventions. In 4 patients, real-time feedback from the monitoring neurologist was used to adjust applicator placement and ablation settings. IONM was technically feasible in all procedures and there were no complications related to monitoring or ablation. All nerves at risk remained intact and of the 11 patientsmore » who could be followed, none developed new nerve deficit up to a minimum of 2 months after ablation.ConclusionIONM is safe and feasible for use during image-guided thermal ablation of tumors in the vicinity of nerves. Outcomes in this study demonstrate its potential utility in image-guided ablation interventions.« less

Using Intervention Mapping to develop the Parents as Agents of Change (PAC©) intervention for managing pediatric obesity.

PubMed

Ball, Geoff D C; Mushquash, Aislin R; Keaschuk, Rachel A; Ambler, Kathryn A; Newton, Amanda S

2017-01-13

Pediatric obesity has become increasingly prevalent over recent decades. In view of the psychosocial and physical health risks, and the high likelihood that children with obesity will grow to become adults with obesity, there is a clear need to develop evidence-based interventions that can be delivered in the health care system to optimize the health and well-being of children with obesity and their families. The aim of this paper is to describe the development, implementation, and planned evaluation of a parent-based weight management intervention designed for parents of 8-12 year olds with obesity. The principles of Intervention Mapping (IM) were used to develop an intervention called Parents as Agents of Change (PAC © ). From 2006 to 2009, an environmental scan plus qualitative (individual interviews with parents and children), quantitative (medical record reviews), and literature review data were collected to gain broad insight into family factors related to pediatric obesity and its management. Theoretical frameworks and empirical evidence guided curriculum development, which was founded primarily on the tenets of family systems theory and cognitive behavioral theory. PAC was developed as a manualized, 16-session, group-based, health care professional-led intervention for parents to address individual, family, and environmental factors related to the management of pediatric obesity. The intervention was refined based on feedback from local and international experts, and has been implemented successfully in a multi-disciplinary weight management centre in a children's hospital. IM provided a practical framework to guide the systematic development of a pediatric weight management intervention for parents of children with obesity. This logical, step-by-step process blends theory and practice and is broadly applicable in the context of obesity management intervention development and evaluation. Following intervention development, the PAC intervention was evaluated within a randomized clinical trial. Trial registration NCT01267097; clinicaltrials.gov.

Designing and delivering facilitated storytelling interventions for chronic disease self-management: a scoping review.

PubMed

Gucciardi, Enza; Jean-Pierre, Nicole; Karam, Grace; Sidani, Souraya

2016-07-11

Little is known about how to develop and deliver storytelling as an intervention to support those managing chronic illnesses. This scoping review aims to describe the core elements of storytelling interventions in order to help facilitate its implementation. A scoping review was conducted in seven databases for articles published up to May 2014 to identify interventions that describe in detail how storytelling was used to support people in disease self-management interventions. Ten articles met all inclusion criteria. Core elements consistently observed across the storytelling interventions were: reflection and interactive meaning-making of experiences; principles of informality and spontaneity; non-directional and non-hierarchical facilitation; development of group norms and conduct to create a community among participants; and both an individual and collective role for participants. Differences were also observed across interventions, such as: the conceptual frameworks that directed the design of the intervention; the type and training of facilitators; intervention duration; and how session topics were selected and stories delivered. Furthermore, evaluation of the intervention and outcome assessment varied greatly across studies. The use of storytelling can be a novel intervention to enhance chronic disease self-management. The core elements identified in the review inform the development of the intervention to be more patient-centred by guiding participants to take ownership of and lead the intervention, which differs significantly from traditional support groups. Storytelling has the potential to provide patients with a more active role in their health care by identifying their specific needs as well as gaps in knowledge and skills, while allowing them to form strong bonds with peers who share similar disease-related experiences. However, measures of impact differed across interventions given the variation in chronic conditions. Our findings can guide future development and implementations of storytelling interventions.

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

PubMed

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

2016-06-23

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

Data to action: using formative research to develop intervention programs to increase physical activity in adolescent girls.

PubMed

Young, Deborah Rohm; Johnson, Carolyn C; Steckler, Allan; Gittelsohn, Joel; Saunders, Ruth P; Saksvig, Brit I; Ribisl, Kurt M; Lytle, Leslie A; McKenzie, Thomas L

2006-02-01

Formative research is used to inform intervention development, but the processes of transmitting results to intervention planners and incorporating information into intervention designs are not well documented. The authors describe how formative research results from the Trial of Activity for Adolescent Girls (TAAG) were transferred to planners to guide intervention development. Methods included providing oral and written reports, prioritizing recommendations, and cross-checking recommendations with intervention objectives and implementation strategies. Formative work influenced the intervention in many ways. For example, results indicated that middle schools offered only coeducational physical education and health education classes, so the TAAG intervention was designed to be appropriate for both sexes, and intervention strategies were developed to directly address girls' stated preferences (e.g., enjoyable activities, opportunity to socialize) and barriers (e.g., lack of skills, fear of injury) for physical activity. The challenges of using formative research for intervention development are discussed.

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

ERIC Educational Resources Information Center

Devaney, Barbara; And Others

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

Bridging Mental Health and Education in Urban Elementary Schools: Participatory Research to Inform Intervention Development

ERIC Educational Resources Information Center

Cappella, Elise; Jackson, Daisy R.; Bilal, Caroline; Hamre, Bridget K.; Soule, Carles

2011-01-01

Guided by participatory research and implementation science, we conducted a two-phase study to contextualize a school mental health intervention for its implementation settings. Drawing from research and existing programs, we created a teacher consultation and coaching intervention delivered by indigenous school and community mental health…

Rapid guiding catheter swapping for management of rupture during percutaneous venoplasty for idiopathic occlusion of superior vena cava.

PubMed

Pandit, Bhagya Narayan; Chaturvedi, Vivek; Parakh, Neeraj; Gade, Sandeep; Trehan, Vijay

2015-04-01

Treatment for superior vena cava syndrome (SVCS) by percutaneous interventions has become established as a definitive therapy. However, there is a significant risk of rupture during SVC intervention. We describe an uncommon case that developed SVC rupture during percutaneous intervention for idiopathic SVCS. This was managed successfully with pericardiocentesis and rapid implantation of covered stent in SVC by rapid guiding catheter swapping technique. This, however, led to inadvertent obstruction of left innominate vein which was successfully treated by kissing balloon inflation. At 18-month follow-up, he is asymptomatic with a well apposed patent stent-graft in the SVC.

The role of analogy-guided learning experiences in enhancing students' clinical decision-making skills.

PubMed

Edelen, Bonnie Gilbert; Bell, Alexandra Alice

2011-08-01

The purpose of this study was to address the need for effective educational interventions to promote students' clinical decision making (CDM) within clinical practice environments. Researchers used a quasi-experimental, non-equivalent groups, posttest-only design to assess differences in CDM ability between intervention group students who participated in analogy-guided learning activities and control group students who participated in traditional activities. For the intervention, analogy-guided learning activities were incorporated into weekly group discussions, reflective journal writing, and questioning with clinical faculty. The researcher-designed Assessment of Clinical Decision Making Rubric was used to assess indicators of CDM ability in all students' reflective journal entries. Results indicated that the intervention group demonstrated significantly higher levels of CDM ability in their journals compared with the control group (ES(sm) = 0.52). Recommendations provide nurse educators with strategies to maximize students' development of CDM ability, better preparing students for the demands they face when they enter the profession. Copyright 2011, SLACK Incorporated.

Development of Active Catheter,Active Guide Wire and Micro Sensor Systems

PubMed Central

Haga, Y.; Mineta, T.; Totsu, K.; Makishi, W.; Esashi, M.

2001-01-01

Summary Active catheters and active guide wires which move like a snake have been developed for catheter-based minimally invasive diagnosis and therapy. Communication and control IC chips in the active catheter reduce the number of lead wires for control. The active catheter can be not only bent but also torsioned and extended. An ultra minature fiber-optic pressure sensor; a forward-looking ultrasonic probe and a magnetic position and orientation sensor have been developed for catheters and guide wires. These moving mechanisms and several sensors which are fitted near the tip of the catheter and the guide wire will provide detailed information near the tip and enable delicate and effective catheter intervention. PMID:20663389

Development of a cervical cancer educational program for Chinese women using intervention mapping.

PubMed

Hou, Su-I; Fernandez, Maria E; Parcel, Guy S

2004-01-01

This article describes the development of a program to increase Pap screening behavior among women in Taiwan. Intervention mapping, an innovative process of intervention design, guided the development of this program. The development process included a needs assessment identifying factors influencing Pap screening behavior relevant to Chinese women. The program used methods such as information transmission, modeling, persuasion, and facilitation. Strategies included direct mail communication, role-model stories and testimonials, and a telephone-counseling component. The delineation of specific plans for implementation and evaluation are also described.

Obesity Prevention from Conception: A Workshop to Guide the Development of a Pan-Canadian Trial Targeting the Gestational Period

PubMed Central

Adamo, Kristi B; Shen, Garry X; Mottola, Michelle; Nascimento, Simony; Jean-Philippe, Sonia; Ferraro, Zachary M; Nerenberg, Kara; Smith, Graeme; Chari, Radha; Gaudet, Laura; Piccinini-Vallis, Helena; McDonald, Sarah; Atkinson, Stephanie; Godbout, Ariane; Robitaille, Julie; Davidge, Sandra T; Gruslin, Andrée; Prud’homme, Denis; Stacey, Dawn; Rossiter, Melissa; Goldfield, Gary S; Dodd, Jodie

2014-01-01

This report summarizes a meeting, Obesity Prevention from Conception, held in Ottawa in 2012. This planning workshop was funded by the Canadian Institutes of Health Research (CIHR) to bring together researchers with expertise in the area of maternal obesity (OB) and weight gain in pregnancy and pregnancy-related disease to attend a one-day workshop and symposium to discuss the development of a cross-Canada lifestyle intervention trial for targeting pregnant women. This future intervention will aim to reduce downstream OB in children through encouraging appropriate weight gain during the mother’s pregnancy. The workshop served to (i) inform the development of a lifestyle intervention for women with a high pre-pregnancy body mass index (BMI), (ii) identify site investigators across Canada, and (iii) guide the development of a grant proposal focusing on the health of mom and baby. A brief summary of the presentations as well as the focus groups is presented for use in planning future research.

Interventions designed to prevent adverse programming outcomes resulting from exposure to maternal obesity during development

PubMed Central

Nathanielsz, PW; Ford, SP; Long, NM; Vega, CC; Reyes-Castro, LA; Zambrano, E

2013-01-01

Maternal obesity is a global epidemic affecting the developed and developing world. Human and animal studies indicate that maternal obesity programs development predisposing offspring to later-life chronic diseases. Several mechanisms act together to produce these adverse health problems. There is a need for effective interventions that prevent these outcomes and guide management in human pregnancy. We report here dietary and exercise intervention studies in both altricial and precocial species, rats and sheep, designed to prevent adverse offspring outcomes. Both interventions present exciting opportunities to at least in part prevent adverse metabolic and other outcomes in mother and offspring. PMID:24147928

Data to Action

PubMed Central

Rohm Young, Deborah; Johnson, Carolyn C.; Steckler, Allan; Gittelsohn, Joel; Saunders, Ruth P.; Saksvig, Brit I.; Ribisl, Kurt M.; Lytle, Leslie A.; McKenzie, Thomas L.

2008-01-01

Formative research is used to inform intervention development, but the processes of transmitting results to intervention planners and incorporating information into intervention designs are not well documented. The authors describe how formative research results from the Trial of Activity for Adolescent Girls (TAAG) were transferred to planners to guide intervention development. Methods included providing oral and written reports, prioritizing recommendations, and cross-checking recommendations with intervention objectives and implementation strategies. Formative work influenced the intervention in many ways. For example, results indicated that middle schools offered only coeducational physical education and health education classes, so the TAAG intervention was designed to be appropriate for both sexes, and intervention strategies were developed to directly address girls’ stated preferences (e.g., enjoyable activities, opportunity to socialize) and barriers (e.g., lack of skills, fear of injury) for physical activity. The challenges of using formative research for intervention development are discussed. PMID:16397162

Using Theory to Guide Practice in Children's Pedestrian Safety Education

ERIC Educational Resources Information Center

Cross, Donna; Hall, Margaret; Howat, Peter

2003-01-01

Few pedestrian injury prevention programs appear to articulate the theory upon which their design and evaluation are based. This article describes how theory was used to plan, develop, implement, and evaluate the educational component of a comprehensive child pedestrian intervention. Organizational and planning theories were used to guide the…

Steroids. A Resource Guide.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of School Health Education and Services.

This guide provides information on steroid use as well as prevention and intervention strategies. It is intended to serve as a supplement to drug abuse education and prevention programs in elementary and secondary schools and as the basis for local curriculum development and instructional activities. The following topics are covered: (1) history…

MO-DE-202-01: Image-Guided Focused Ultrasound Surgery and Therapy

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

Farahani, K.

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guidedmore » neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.« less

MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery

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

Siewerdsen, J.

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guidedmore » neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.« less

Understanding the Impact of Interventions to Prevent Antimicrobial Resistant Infections in the Long-Term Care Facility: A Review and Practical Guide to Mathematical Modeling.

PubMed

Rosello, Alicia; Horner, Carolyne; Hopkins, Susan; Hayward, Andrew C; Deeny, Sarah R

2017-02-01

OBJECTIVES (1) To systematically search for all dynamic mathematical models of infectious disease transmission in long-term care facilities (LTCFs); (2) to critically evaluate models of interventions against antimicrobial resistance (AMR) in this setting; and (3) to develop a checklist for hospital epidemiologists and policy makers by which to distinguish good quality models of AMR in LTCFs. METHODS The CINAHL, EMBASE, Global Health, MEDLINE, and Scopus databases were systematically searched for studies of dynamic mathematical models set in LTCFs. Models of interventions targeting methicillin-resistant Staphylococcus aureus in LTCFs were critically assessed. Using this analysis, we developed a checklist for good quality mathematical models of AMR in LTCFs. RESULTS AND DISCUSSION Overall, 18 papers described mathematical models that characterized the spread of infectious diseases in LTCFs, but no models of AMR in gram-negative bacteria in this setting were described. Future models of AMR in LTCFs require a more robust methodology (ie, formal model fitting to data and validation), greater transparency regarding model assumptions, setting-specific data, realistic and current setting-specific parameters, and inclusion of movement dynamics between LTCFs and hospitals. CONCLUSIONS Mathematical models of AMR in gram-negative bacteria in the LTCF setting, where these bacteria are increasingly becoming prevalent, are needed to help guide infection prevention and control. Improvements are required to develop outputs of sufficient quality to help guide interventions and policy in the future. We suggest a checklist of criteria to be used as a practical guide to determine whether a model is robust enough to test policy. Infect Control Hosp Epidemiol 2017;38:216-225.

Design and development of C-arm based cone-beam CT for image-guided interventions: initial results

NASA Astrophysics Data System (ADS)

Chen, Guang-Hong; Zambelli, Joseph; Nett, Brian E.; Supanich, Mark; Riddell, Cyril; Belanger, Barry; Mistretta, Charles A.

2006-03-01

X-ray cone-beam computed tomography (CBCT) is of importance in image-guided intervention (IGI) and image-guided radiation therapy (IGRT). In this paper, we present a cone-beam CT data acquisition system using a GE INNOVA 4100 (GE Healthcare Technologies, Waukesha, Wisconsin) clinical system. This new cone-beam data acquisition mode was developed for research purposes without interfering with any clinical function of the system. It provides us a basic imaging pipeline for more advanced cone-beam data acquisition methods. It also provides us a platform to study and overcome the limiting factors such as cone-beam artifacts and limiting low contrast resolution in current C-arm based cone-beam CT systems. A geometrical calibration method was developed to experimentally determine parameters of the scanning geometry to correct the image reconstruction for geometric non-idealities. Extensive phantom studies and some small animal studies have been conducted to evaluate the performance of our cone-beam CT data acquisition system.

Building health behavior models to guide the development of just-in-time adaptive interventions: A pragmatic framework

PubMed Central

Nahum-Shani, Inbal; Hekler, Eric B.; Spruijt-Metz, Donna

2016-01-01

Advances in wireless devices and mobile technology offer many opportunities for delivering just-in-time adaptive interventions (JITAIs)--suites of interventions that adapt over time to an individual’s changing status and circumstances with the goal to address the individual’s need for support, whenever this need arises. A major challenge confronting behavioral scientists aiming to develop a JITAI concerns the selection and integration of existing empirical, theoretical and practical evidence into a scientific model that can inform the construction of a JITAI and help identify scientific gaps. The purpose of this paper is to establish a pragmatic framework that can be used to organize existing evidence into a useful model for JITAI construction. This framework involves clarifying the conceptual purpose of a JITAI, namely the provision of just-in-time support via adaptation, as well as describing the components of a JITAI and articulating a list of concrete questions to guide the establishment of a useful model for JITAI construction. The proposed framework includes an organizing scheme for translating the relatively static scientific models underlying many health behavior interventions into a more dynamic model that better incorporates the element of time. This framework will help to guide the next generation of empirical work to support the creation of effective JITAIs. PMID:26651462

Appropriate Use Criteria for Fluoroscopically Guided Diagnostic and Therapeutic Sacroiliac Interventions: Results from the Spine Intervention Society Convened Multispecialty Collaborative.

PubMed

MacVicar, John; Kreiner, D Scott; Duszynski, Belinda; Kennedy, David J

2017-11-01

To provide an overview of a multisociety effort to formulate appropriate use criteria for image-guided injections and radiofrequency procedures in the diagnosis and treatment of sacroiliac joint and posterior sacroiliac complex pain. The Spine Intervention Society convened a multisociety effort to guide physicians and define for payers the appropriate use of image-guided injections and radiofrequency procedures. An evidence panel was established to write systematic reviews, define key terms and assumptions, and develop clinical scenarios to be addressed. The rating panel considered the evidence presented in the systematic reviews, carefully reviewed the definitions and assumptions, and rated the clinical scenarios. Final median ratings, in combination with the level of agreement, determined the final ratings for the appropriate use of sacroiliac injections and radiofrequency neurotomy. More than 10,000 scenarios were addressed in the appropriate use criteria and are housed within five modules in the portal, available on the Spine Intervention Society website: Module 1: Clinical Indications and Imaging; Module 2: Anticoagulants; Module 3: Timing of Injections; Module 4: Number of Injections; and Module 5: Lateral Branch Radiofrequency Neurotomy. Within several of these modules, several issues of interest are identified and discussed. Physicians and payers can access the appropriate use criteria portal on the Spine Intervention Society's website and select specific clinical indications for a particular patient in order to learn more about the appropriateness of the intervention(s) under consideration. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The expert's guide to mealtime interventions - A Delphi method survey.

PubMed

Conchin, Simone; Carey, Sharon

2017-09-27

Prevalence of malnutrition and a myriad of barriers to adequate oral diet in hospitalised patients warrants further investment to improve the patient mealtime experience. The aim of this study was to explore barriers and enablers to implementing effective mealtime interventions and develop a process framework to guide clinicians and researchers in the area. Potential experts in the area of hospital mealtime intervention were identified as having published in this field of work within the Australasian setting. Further information was sought by email and telephone communication on professional background; research experience; interest; and capacity to participate. Recruited participants were surveyed using a modified Delphi method to establish opinion and experience in the area of mealtime interventions. Results were collated and content was coded using a thematic analysis approach by the primary researcher and two additional reviewers. Thirty-two Australian authors in the area of mealtime interventions within the hospital environment were identified from publication. Twenty-one participants were able to be contacted and nineteen of these consented to enrol in the study. Participants included those from a dietetic (n = 14), nursing (n = 4) and medical (n = 1) background. Participants were deemed to have expert knowledge if they had significant involvement in the published research and demonstrated a deep level of understanding of hospital mealtime interventions. All participants provided key insights into barriers to oral intake in the hospital environment and suggestions for interventions to address these barriers. From the survey, an eight step framework to guide mealtime interventions was developed. Hospital mealtime interventions are complex processes. Interventions should be implemented after careful consideration of the local context and baseline data; and tailored to address barriers. Roles and responsibilities for nutrition care should be clear and consistent. Implementation planning is recommended to ensure that an ongoing process is in place to engage executive support and staff involvement, foster project team resilience and ensure sustainability of interventions. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

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

PubMed

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

2016-07-26

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

Development of a Trans-disciplinary Intervention Module for Adolescent Girls on Self-awareness.

PubMed

John, Jasmine Mary; Navneetham, Janardhan; Nagendra, H R

2017-08-01

Mental health promotion among adolescents has been a key area of intervention for professionals working with children and adolescents. The opinions of experts in the field of mental health have taken to frame a trans-disciplinary intervention for adolescent girls on self awareness. To discuss the development and validation of a structured intervention by combining the knowledge from different disciplines in helping adolescents enhancing self awareness. Both qualitative and quantitative methodologies were followed for the development and validation of the module. First phase of the development of intervention module was the framing of intervention module after conducting in-depth interviews with experts in both mental health and yoga fields. Six experts each from mental health and yoga field were chosen for interview through convenient sampling. Validated interview guides were used for the process. The framed intervention module was given to six mental health experts and six yoga experts for content validation. The experts rated the usefulness of the intervention on a scale 0-4 (4=extremely helpful). The themes derived in the interviews were importance of self awareness, autonomy of self, physical level of self understanding, self regulation of emotions and self monitoring. The interviews were consolidated to frame the intervention module consisting of eight sessions having two parts in each session. Part one of each session is activities and interactions on mental health and part two is guided instructions for body focused meditation. Sessions were finalized with rating and suggestions from the experts. The final version of the module was pilot tested and had found to have enhanced self awareness among adolescent girls. Integration of multiple disciplines brought in novel perspectives in intervention.

Culturally Based Intervention Development: The Case of Latino Families Dealing With Schizophrenia

PubMed Central

Barrio, Concepción; Yamada, Ann-Marie

2011-01-01

Objectives This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this multifamily group 16-session intervention with 59 Latino families in a randomized control trial. Data were collected on family- and client-level outcomes, and poststudy focus groups were conducted with intervention participants. Results Preliminary evidence indicates that the intervention is effective by increasing illness knowledge and reducing family burden. Conclusions This work can provide a model for how to integrate cultural factors into psychosocial services and enhance interventions in real-world settings for culturally diverse populations. PMID:22121328

Laws of Life: A Literacy-Based Intervention for Social-Emotional and Character Development and Resilience

ERIC Educational Resources Information Center

Elias, Maurice

2008-01-01

Laws of Life is a literacy-based intervention that allows students to identify and articulate the principles by which they live their lives. In the urban context, such an intervention is vital for reclaiming children's interest in writing and helping them to more intentionally guide their lives and their futures according to positive core values.…

Directed Consultation, the SEALS Model, and Teachers' Classroom Management

ERIC Educational Resources Information Center

Motoca, Luci M.; Farmer, Thomas W.; Hamm, Jill V.; Byun, Soo-yong; Lee, David L.; Brooks, Debbie S.; Rucker, Nkecha; Moohr, Michele M.

2014-01-01

Directed consultation is presented as a professional development framework to guide and support teachers in the implementation of evidence-based interventions that involve contextual and process-oriented approaches designed to be incorporated into daily classroom management. This approach consists of four components: pre-intervention observations…

Effectiveness of the Mississippi communities for healthy living (MCHL) nutrition intervention

USDA-ARS?s Scientific Manuscript database

The objective of our study was to determine the effectiveness of two nutrition interventions targeting women's social/civic organizations in the Lower Mississippi Delta. Diffusion of Innovation theory and the RE-AIM structured framework for program development and evaluation guided the 6-month MCHL ...

Resource Guide: Selected Early Childhood/Early Intervention Training Materials. 9th Edition. Systems Change in Personnel Preparation.

ERIC Educational Resources Information Center

Catlett, Camille, Ed.; Winton, Pamela J., Ed.

This resource guide identifies and describes early childhood education teaching, training, and staff development materials that meet three basic criteria: good, readily available, and inexpensive. It is designed to provide educators, trainers, supervisors, and other personnel preparation decision makers with resources for designing quality…

Resource Guide: Selected Early Childhood/Early Intervention Training Materials. 10th Edition.

ERIC Educational Resources Information Center

Catlett, Camille, Comp.; Winton, Pamela J., Comp.

The purpose of this resource guide is to identify and describe teaching, training, and staff development materials that meet three basic criteria: they are good, they are readily available, and they are inexpensive. These resources may assist educators, trainers, supervisors, and other personnel preparation decisionmakers in designing quality…

Measurement in the Service of Mathematics Education Research: The Case of Cognitively Guided Instruction

ERIC Educational Resources Information Center

Helding, Brandon Alan

2010-01-01

The purpose of this dissertation is to demonstrate one iterate of a process for developing a measurement instrument for student knowledge within educational interventions. Student mathematical knowledge is framed within Cognitively Guided Instruction (CGI) and its tenets. That is, the construct underlying the measurement instrument corresponded…

Linking theory with qualitative research through study of stroke caregiving families.

PubMed

Pierce, Linda L; Steiner, Victoria; Cervantez Thompson, Teresa L; Friedemann, Marie-Luise

2014-01-01

This theoretical article outlines the deliberate process of applying a qualitative data analysis method rooted in Friedemann's Framework of Systemic Organization through the study of a web-based education and support intervention for stroke caregiving families. Directed by Friedemann's framework, the analytic method involved developing, refining, and using a coding rubric to explore interactive patterns between caregivers and care recipients from this 3-month feasibility study using this education and support intervention. Specifically, data were gathered from the intervention's web-based discussion component between caregivers and the nurse specialist, as well as from telephone caregiver interviews. A theoretical framework guided the process of developing and refining this coding rubric for the purpose of organizing data; but, more importantly, guided the investigators' thought processes, allowing them to extract rich information from the data set, as well as synthesize this information to generate a broad understanding of the caring situation. © 2013 Association of Rehabilitation Nurses.

Theory-and evidence-based development and process evaluation of the Move More for Life program: a tailored-print intervention designed to promote physical activity among post-treatment breast cancer survivors

PubMed Central

2013-01-01

Objective Several physical activity interventions have been effective in improving the health outcomes of breast cancer survivors. However, few interventions have provided detailed descriptions regarding how such interventions work. To develop evidence-based practice in this field, detailed descriptions of intervention development and delivery is needed. This paper aims to (1) describe the theory-and evidence-based development of the Move More for Life program, a physical activity program for breast cancer survivors; and (2) serve as an exemplar for theory-based applied research. Method The program-planning model outlined by Kreuter and colleagues was used to develop the computer-tailored intervention. Results The tailoring guide developed by Kreuter and colleagues served as a useful program planning tool in terms of integrating theory and evidence-based best practice into intervention strategies. Overall, participants rated the intervention positively, with the majority reporting that the tailored materials caught their attention, were personally relevant to them, and were useful for helping them to change their behaviour. However, there was considerable room for improvement. Conclusion The Move More for Life program is an example of a theory-based, low-cost and potentially sustainable strategy to physical activity promotion and may stand as an exemplar for Social Cognitive Theory-based applied research. By providing a detailed description of the development of the Move More for Life program, a critical evaluation of the working mechanisms of the intervention is possible, and will guide researchers in the replication or adaption and re-application of the specified techniques. This has potential implications for researchers examining physical activity promotion among cancer survivors and for researchers exploring distance-based physical activity promotion techniques among other populations. Trial registrations Australian New Zealand Clinical Trials Registry (ANZCTR) identifier: ACTRN12611001061921. PMID:24192320

Organizational culture change in U.S. hospitals: a mixed methods longitudinal intervention study.

PubMed

Curry, Leslie A; Linnander, Erika L; Brewster, Amanda L; Ting, Henry; Krumholz, Harlan M; Bradley, Elizabeth H

2015-03-07

Improving outcomes for patients with acute myocardial infarction (AMI) is a priority for hospital leadership, clinicians, and policymakers. Evidence suggests links between hospital organizational culture and hospital performance; however, few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with AMI. We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL). This manuscript describes the methodology of LSL, a 2-year intervention study using a concurrent mixed methods design, guided by open systems theory and the Assess, Innovate, Develop, Engage, Devolve (AIDED) model of diffusion, implemented in 10 U.S. hospitals and their peer hospital networks. The intervention has three primary components: 1) annual convenings of the ten intervention hospitals; 2) semiannual workshops with guiding coalitions at each hospital; and 3) continuous remote support across all intervention hospitals through a web-based platform. Primary outcomes include 1) shifts in key dimensions of hospital organizational culture associated with lower mortality rates for patients with AMI; 2) use of targeted evidence-based practices associated with lower mortality rates for patients with AMI; and 3) in-hospital AMI mortality. Quantitative data include annual surveys of guiding coalition members in the intervention hospitals and peer network hospitals. Qualitative data include in-person, in-depth interviews with all guiding coalition members and selective observations of key interactions in care for patients with AMI, collected at three time points. Data integration will identify patterns and major themes in change processes across all intervention hospitals over time. LSL is novel in its use of a longitudinal mixed methods approach in a diverse sample of hospitals, its focus on objective outcome measures of mortality, and its examination of changes not only in the intervention hospitals but also in their peer hospital networks over time. This paper adds to the methodological literature for the study of complex interventions to promote hospital organizational culture change.

Image-guided thoracic surgery in the hybrid operation room.

PubMed

Ujiie, Hideki; Effat, Andrew; Yasufuku, Kazuhiro

2017-01-01

There has been an increase in the use of image-guided technology to facilitate minimally invasive therapy. The next generation of minimally invasive therapy is focused on advancement and translation of novel image-guided technologies in therapeutic interventions, including surgery, interventional pulmonology, radiation therapy, and interventional laser therapy. To establish the efficacy of different minimally invasive therapies, we have developed a hybrid operating room, known as the guided therapeutics operating room (GTx OR) at the Toronto General Hospital. The GTx OR is equipped with multi-modality image-guidance systems, which features a dual source-dual energy computed tomography (CT) scanner, a robotic cone-beam CT (CBCT)/fluoroscopy, high-performance endobronchial ultrasound system, endoscopic surgery system, near-infrared (NIR) fluorescence imaging system, and navigation tracking systems. The novel multimodality image-guidance systems allow physicians to quickly, and accurately image patients while they are on the operating table. This yield improved outcomes since physicians are able to use image guidance during their procedures, and carry out innovative multi-modality therapeutics. Multiple preclinical translational studies pertaining to innovative minimally invasive technology is being developed in our guided therapeutics laboratory (GTx Lab). The GTx Lab is equipped with similar technology, and multimodality image-guidance systems as the GTx OR, and acts as an appropriate platform for translation of research into human clinical trials. Through the GTx Lab, we are able to perform basic research, such as the development of image-guided technologies, preclinical model testing, as well as preclinical imaging, and then translate that research into the GTx OR. This OR allows for the utilization of new technologies in cancer therapy, including molecular imaging, and other innovative imaging modalities, and therefore enables a better quality of life for patients, both during and after the procedure. In this article, we describe capabilities of the GTx systems, and discuss the first-in-human technologies used, and evaluated in GTx OR.

Wisconsin Response to Intervention: A Guiding Document

ERIC Educational Resources Information Center

Wisconsin Department of Public Instruction, 2010

2010-01-01

To assist Wisconsin education leaders with planning for Response to Intervention (RtI), the Wisconsin Department of Public Instruction (DPI), in partnership with Wisconsin education stakeholders, has developed this informational brief. This brief is intended to provide guidance for implementation of RtI and should not be read as administrative…

TIPS: Trends for Inclusive Pediatric Services.

ERIC Educational Resources Information Center

Connecticut Univ. Health Center, Farmington.

This guide was developed as part of a project to provide practicing physicians with training to enhance their understanding of and involvement with early intervention and the special education system in Connecticut. The introductory section notes that best practices in both primary medical care and early intervention promote care that is family…

Developing Reading Comprehension among Students with Mild Intellectual Disabilities: An Intervention Study

ERIC Educational Resources Information Center

Lundberg, Ingvar; Reichenberg, Monica

2013-01-01

The present study demonstrated that students with mild intellectual disabilities are capable of constructing meaning from written text by guided social interaction. Participants were 40 adolescents in special schools divided into two intervention conditions: reciprocal teaching (RT) and inference teaching (IT). In RT the students practiced four…

Tier 2 Intervention for At-Risk First-Grade Students within a Response-to-Intervention Model of Support

ERIC Educational Resources Information Center

Bryant, Diane Pedrotty

2014-01-01

Clarke et al. (2014) provide a persuasive case for the role of a theory-of-change model to guide the nature of curriculum development work embodying both a theoretical and empirical knowledge foundation. They illuminate the components of their model, which were used to design and test the efficacy of a Tier 2 intervention for students who met…

Guided Imagery as a Treatment Option for Fatigue

PubMed Central

Menzies, Victoria; Jallo, Nancy

2013-01-01

Purpose Fatigue is one of the most common complaints experienced among the general population. Because fatigue is recognized as a biobehavioral occurrence, a biobehavioral intervention such as guided imagery may be effective in reducing self-reported fatigue. Therefore, the purpose of this study was to explore the research literature related to the use of guided imagery as a nonpharmacological mind-body intervention for the symptom of fatigue. Method The electronic databases MEDLINE, CINAHL, PsychInfo, Psychology and Behavioral Sciences Collection and the Cochrane Library were searched from January 1980 to June 2010. Findings Of 24 articles retrieved, eight met the inclusion criteria and were included in this systematic literature review. Findings were inconsistent regarding the effectiveness of guided imagery on fatigue. Studies varied in study length, duration of the applied guided imagery intervention, dosage, and whether the images were targeted to the purpose of the intervention. Implications Guided imagery is a simple, economic intervention with the potential to effectively treat fatigue, thus further research is warranted using systematic, well-designed methodologies Standardizing guided imagery interventions according to total duration of exposure and targeted imagery in a variety of different populations adequately powered to detect changes will contribute to and strengthen nursing’s symptom-management armamentarium. PMID:21772047

A Community-based Participatory Research Approach to the Development of a Peer Navigator Health Promotion Intervention for People with Spinal Cord Injury

PubMed Central

Newman, Susan D.; Gillenwater, Gwen; Toatley, Sherwood; Rodgers, Marka D.; Todd, Nathan; Epperly, Diane; Andrews, Jeannette O.

2014-01-01

Background Recent trends indicate research targeting outcomes of importance to people with disabilities, such as spinal cord injury (SCI), may be best informed by those individuals; however, there are very few published rehabilitation intervention studies that include people with disabilities in the research process in a role beyond study participant. Objective To describe a community-based participatory research (CBPR) approach to the development and pilot testing of an intervention using community-based Peer Navigators with SCI to provide health education to individuals with SCI, with the goal of reducing preventable secondary conditions and rehospitalizations, and improving community participation. Methods A CBPR framework guides the research partnership between academic researchers and a community-based team of individuals who either have SCI or provide SCI-related services. Using this framework, the processes of our research partnership supporting the current study are described including: partnership formation, problem identification, intervention development, and pilot testing of the intervention. Challenges associated with CBPR are identified. Results Using CBPR, the SCI Peer Navigator intervention addresses the partnership’s priority issues identified in the formative studies. Utilization of the framework and integration of CBPR principles into all phases of research have promoted sustainability of the partnership. Recognition of and proactive planning for challenges that are commonly encountered in CBPR, such as sharing power and limited resources, has helped sustain our partnership. Conclusions The CBPR framework provides a guide for inclusion of individuals with SCI as research partners in the development, implementation, and evaluation of interventions intended to improve outcomes after SCI. PMID:25224988

[Clinical use of interventional MR imaging].

PubMed

Kahn, Thomas; Schulz, Thomas; Moche, Michael; Prothmann, Sascha; Schneider, Jens-Peter

2003-01-01

The integration of diagnostic and therapeutic procedures by MRI is based on the combination of excellent morphologic and functional imaging. The spectrum of MR-guided interventions includes biopsies, thermal ablation procedures, vascular applications, and intraoperative MRI. In all these applications, different scientific groups have obtained convincing results in basic developments as well as in clinical use. Interventional MRI (iMRI) is expected to attain an important role in interventional radiology, minimal invasive therapy, and monitoring of surgical procedures.

Interest Matters: The Importance of Promoting Interest in Education.

PubMed

Harackiewicz, Judith M; Smith, Jessi L; Priniski, Stacy J

2016-10-01

Interest is a powerful motivational process that energizes learning, guides academic and career trajectories, and is essential to academic success. Interest is both a psychological state of attention and affect toward a particular object or topic, and an enduring predisposition to reengage over time. Integrating these two definitions, the four-phase model of interest development guides interventions that promote interest and capitalize on existing interests. Four interest-enhancing interventions seem useful: attention-getting settings, contexts evoking prior individual interest, problem-based learning, and enhancing utility value. Promoting interest can contribute to a more engaged, motivated, learning experience for students.

Building health behavior models to guide the development of just-in-time adaptive interventions: A pragmatic framework.

PubMed

Nahum-Shani, Inbal; Hekler, Eric B; Spruijt-Metz, Donna

2015-12-01

Advances in wireless devices and mobile technology offer many opportunities for delivering just-in-time adaptive interventions (JITAIs)-suites of interventions that adapt over time to an individual's changing status and circumstances with the goal to address the individual's need for support, whenever this need arises. A major challenge confronting behavioral scientists aiming to develop a JITAI concerns the selection and integration of existing empirical, theoretical and practical evidence into a scientific model that can inform the construction of a JITAI and help identify scientific gaps. The purpose of this paper is to establish a pragmatic framework that can be used to organize existing evidence into a useful model for JITAI construction. This framework involves clarifying the conceptual purpose of a JITAI, namely, the provision of just-in-time support via adaptation, as well as describing the components of a JITAI and articulating a list of concrete questions to guide the establishment of a useful model for JITAI construction. The proposed framework includes an organizing scheme for translating the relatively static scientific models underlying many health behavior interventions into a more dynamic model that better incorporates the element of time. This framework will help to guide the next generation of empirical work to support the creation of effective JITAIs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

In Their Own Words: Using First-Year Student Research Journals to Guide Information Literacy Instruction

ERIC Educational Resources Information Center

Insua, Glenda M.; Lantz, Catherine; Armstrong, Annie

2018-01-01

This action research study explores first-year students' conceptions of the research process, with a focus on which aspects students find most challenging and how this information can guide stakeholders in developing curricular or service-based interventions. To gather student reflections on the research process, researchers assigned and collected…

A framework for designing hand hygiene educational interventions in schools.

PubMed

Appiah-Brempong, Emmanuel; Harris, Muriel J; Newton, Samuel; Gulis, Gabriel

2018-03-01

Hygiene education appears to be the commonest school-based intervention for preventing infectious diseases, especially in the developing world. Nevertheless, there remains a gap in literature regarding a school-specific theory-based framework for designing a hand hygiene educational intervention in schools. We sought to suggest a framework underpinned by psychosocial theories towards bridging this knowledge gap. Furthermore, we sought to propound a more comprehensive definition of hand hygiene which could guide the conceptualisation of hand hygiene interventions in varied settings. Literature search was guided by a standardized tool and literature was retrieved on the basis of a predetermined inclusion criteria. Databases consulted include PubMed, ERIC, and EBSCO host (Medline, CINAHL, PsycINFO, etc.). Evidence bordering on a theoretical framework to aid the design of school-based hand hygiene educational interventions is summarized narratively. School-based hand hygiene educational interventions seeking to positively influence behavioural outcomes could consider enhancing psychosocial variables including behavioural capacity, attitudes and subjective norms (normative beliefs and motivation to comply). A framework underpinned by formalized psychosocial theories has relevance and could enhance the design of hand hygiene educational interventions, especially in schools.

Dissemination of an Electronic Manual to Build Capacity for Implementing Farmers' Markets with Community Health Centers.

PubMed

Guest, M Aaron; Freedman, Darcy; Alia, Kassandra A; Brandt, Heather M; Friedman, Daniela B

2015-10-01

Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to access the free manual. During the 6-month dissemination period, 271 individuals downloaded the manual. Findings highlighted the value of translating community-based participatory research into user-friendly manuals to guide future intervention development and dissemination approaches, and demonstrate the need to include capacity building opportunities to support translation and adoption of interventions. © 2015 Wiley Periodicals, Inc.

Dissemination of an Electronic Manual to Build Capacity for Implementing Farmers’ Markets with Community Health Centers

PubMed Central

Guest, M. Aaron; Alia, Kassandra A.; Brandt, Heather M.; Friedman, Daniela B.

2015-01-01

Abstract Community–university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, “Building Farmacies,” describes an approach for developing capacity and sustaining a community health center–based farmers’ market that emerged through a community–university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce‐only farmers’ market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web‐based survey to access the free manual. During the 6‐month dissemination period, 271 individuals downloaded the manual. Findings highlighted the value of translating community‐based participatory research into user‐friendly manuals to guide future intervention development and dissemination approaches, and demonstrate the need to include capacity building opportunities to support translation and adoption of interventions. PMID:26296392

Validation of antimicrobial interventions for small and very small processors: a how-to guide to develop and conduct validations

USDA-ARS?s Scientific Manuscript database

It is increasingly important to assure that antimicrobial interventions applied on/into foods to control pathogenic microorganisms are functioning properly and achieving the desired goal of preventing, reducing and/or eliminating microbial hazards associated with a defined food product. This approac...

Developing Theory to Guide Building Practitioners' Capacity to Implement Evidence-Based Interventions

ERIC Educational Resources Information Center

Leeman, Jennifer; Calancie, Larissa; Kegler, Michelle C.; Escoffery, Cam T.; Herrmann, Alison K.; Thatcher, Esther; Hartman, Marieke A.; Fernandez, Maria E.

2017-01-01

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and…

Reflective Practice: Using Focus Groups to Determine Family Priorities and Guide Social Pragmatic Program Development

ERIC Educational Resources Information Center

Theadore, Geraldine; Laurent, Amy; Kovarsky, Dana; Weiss, Amy L.

2011-01-01

Reflective practice requires that professionals carefully examine and integrate multiple sources of information when designing intervention and evaluating its effectiveness. This article describes the use of focus group discussion as a form of qualitative research for understanding parents' perspectives of a university-based intervention program…

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…

Guided Interventions for Prostate Cancer Using 3D-Transurethral Ultrasound and MRI Fusion

DTIC Science & Technology

2015-10-01

AWARD NUMBER: W81XWH-14-1-0461 TITLE: Guided Interventions for Prostate Cancer Using 3D-Transurethral Ultrasound and MRI Fusion PRINCIPAL...Sep 2014 - 28 Sep 2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Guided Interventions for Prostate Cancer Using 3D- Transurethral Ultrasound and...Magnetic Resonance- Ultrasound (MR-US) fusion allows for specific targeting of the tumors in real-time during clinical interventions, outside of an MR

Development of a Guided Internet-based Psycho-education Intervention Using Cognitive Behavioral Therapy and Self-Management for Individuals with Chronic Pain.

PubMed

Perry, Jennifer; VanDenKerkhof, Elizabeth G; Wilson, Rosemary; Tripp, Dean A

2017-04-01

Evidence-based chronic pain treatment includes nonpharmacologic therapies. When addressing barriers to treatment, there is a need to deliver these therapies in a way that is accessible to all individuals who may benefit. To develop a guided Internet-based intervention for individuals with chronic pain, program content and sequence of evidence-based treatments for chronic pain, traditionally delivered via in-person sessions, were identified to be adapted for Internet delivery. With consideration to historical barriers to treatment, and through use of a concept map, therapeutic components and educational material were situated, in an ordered sequence, into six modules. An Internet-based chronic pain intervention was constructed to improve access to evidence-based chronic pain therapies. Research using this intervention, in the form of a pilot study for intervention refinement, was conducted, and a large-scale study to assess effectiveness is necessary prior to implementation. As clients may face barriers to multimodal treatment for chronic pain, nurses could introduce components of education, cognitive behavioral therapy and self-management to clients and prepare them for the "work" of managing chronic pain, through use of this Internet-based intervention. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Mixed reality ultrasound guidance system: a case study in system development and a cautionary tale.

PubMed

Ameri, Golafsoun; Baxter, John S H; Bainbridge, Daniel; Peters, Terry M; Chen, Elvis C S

2018-04-01

Real-time ultrasound has become a crucial aspect of several image-guided interventions. One of the main constraints of such an approach is the difficulty in interpretability of the limited field of view of the image, a problem that has recently been addressed using mixed reality, such as augmented reality and augmented virtuality. The growing popularity and maturity of mixed reality has led to a series of informal guidelines to direct development of new systems and to facilitate regulatory approval. However, the goals of mixed reality image guidance systems and the guidelines for their development have not been thoroughly discussed. The purpose of this paper is to identify and critically examine development guidelines in the context of a mixed reality ultrasound guidance system through a case study. A mixed reality ultrasound guidance system tailored to central line insertions was developed in close collaboration with an expert user. This system outperformed ultrasound-only guidance in a novice user study and has obtained clearance for clinical use in humans. A phantom study with 25 experienced physicians was carried out to compare the performance of the mixed reality ultrasound system against conventional ultrasound-only guidance. Despite the previous promising results, there was no statistically significant difference between the two systems. Guidelines for developing mixed reality image guidance systems cannot be applied indiscriminately. Each design decision, no matter how well justified, should be the subject of scientific and technical investigation. Iterative and small-scale evaluation can readily unearth issues and previously unknown or implicit system requirements. We recommend a wary eye in development of mixed reality ultrasound image guidance systems emphasizing small-scale iterative evaluation alongside system development. Ultimately, we recommend that the image-guided intervention community furthers and deepens this discussion into best practices in developing image-guided interventions.

Intervention Mapping to develop a Social Cognitive Theory-based intervention for chronic pain tailored to individuals with HIV.

PubMed

Merlin, Jessica S; Young, Sarah R; Johnson, Mallory O; Saag, Michael; Demonte, William; Kerns, Robert; Bair, Matthew J; Kertesz, Stefan; Turan, Janet M; Kilgore, Meredith; Clay, Olivio J; Pekmezi, Dorothy; Davies, Susan

2018-06-01

Chronic pain is an important comorbidity among individuals with HIV. Behavioral interventions are widely regarded as evidence-based, efficacious non-pharmacologic interventions for chronic pain in the general population. An accepted principle in behavioral science is that theory-based, systematically-developed behavioral interventions tailored to the unique needs of a target population are most likely to be efficacious. Our aim was to use Intervention Mapping to systematically develop a Social Cognitive Theory (SCT)-based intervention for chronic pain tailored to individuals with HIV that will improve pain intensity and pain-related functional impairment. Our Intervention Mapping process was informed by qualitative inquiry of 24 patients and seven providers in an HIV primary care clinic. The resulting intervention includes group and one-on-one sessions and peer and staff interventionists. We also developed a conceptual framework that integrates our qualitative findings with SCT-based theoretical constructs. Using this conceptual framework as a guide, our future work will investigate the intervention's impact on chronic pain outcomes, as well as our hypothesized proximal mediators of the intervention's effect.

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study.

PubMed

Apolinário-Hagen, Jennifer; Harrer, Mathias; Kählke, Fanny; Fritsche, Lara; Salewski, Christel; Ebert, David Daniel

2018-05-15

Internet interventions have been proposed to improve the accessibility and use of evidence-based psychological treatments. However, little is known about attitudes toward such treatments, which can be an important barrier to their use. This study aimed to (1) determine attitudes toward guided internet interventions, (2) assess its acceptability compared with other internet-based formats, and (3) explore predictors of acceptance. A convenience-sample Web-based survey (N=646) assessed attitudes toward guided internet therapies (ie, perceived usefulness and helpfulness, and advantage relative to face-to-face therapy), preferences for delivery modes (ie, e-preference: guided internet interventions, unguided internet interventions, or videoconferencing psychotherapy), and potential predictors of attitudes and preferences: sociodemographics, help-seeking-related variables, attachment style, and perceived stress. Although most participants perceived internet interventions as useful or helpful (426/646, 65.9%), a few indicated their advantage relative to face-to-face therapy (56/646, 8.7%). Most participants preferred guided internet interventions (252/646, 39.0%) over videoconferencing psychotherapy (147/646, 22.8%), unguided internet interventions (124/646, 19.2%), and not using internet interventions (121/646, 18.8%; missing data: 1/646, 0.2%). Attachment avoidance and stress were related to e-preference (all P<.05). Moreover, preference for therapist-guided internet interventions was higher for individuals who were aware of internet-based treatment (χ 2 6 =12.8; P=.046). Participants assessed therapist-guided internet interventions as helpful, but not equivalent to face-to-face therapies. The vast majority (523/646, 81.0%) of the participants were potentially willing to use internet-based approaches. In lieu of providing patients with only one specific low-intensity treatment, implementation concepts should offer several options, including guided internet interventions, but not limited to them. Conversely, our results also indicate that efforts should focus on increasing public knowledge about internet interventions, including information about their effectiveness, to promote acceptance and uptake. ©Jennifer Apolinário-Hagen, Mathias Harrer, Fanny Kählke, Lara Fritsche, Christel Salewski, David Daniel Ebert. Originally published in JMIR Mental Health (http://mental.jmir.org), 15.05.2018.

Hybrid Approach for Biliary Interventions Employing MRI-Guided Bile Duct Puncture with Near-Real-Time Imaging

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

Wybranski, Christian, E-mail: Christian.Wybranski@uk-koeln.de; Pech, Maciej; Lux, Anke

ObjectiveTo assess the feasibility of a hybrid approach employing MRI-guided bile duct (BD) puncture for subsequent fluoroscopy-guided biliary interventions in patients with non-dilated (≤3 mm) or dilated BD (≥3 mm) but unfavorable conditions for ultrasonography (US)-guided BD puncture.MethodsA total of 23 hybrid interventions were performed in 21 patients. Visualization of BD and puncture needles (PN) in the interventional MR images was rated on a 5-point Likert scale by two radiologists. Technical success, planning time, BD puncture time and positioning adjustments of the PN as well as technical success of the biliary intervention and complication rate were recorded.ResultsVisualization even of third-order non-dilated BDmore » and PN was rated excellent by both radiologists with good to excellent interrater agreement. MRI-guided BD puncture was successful in all cases. Planning and BD puncture times were 1:36 ± 2.13 (0:16–11:07) min. and 3:58 ± 2:35 (1:11–9:32) min. Positioning adjustments of the PN was necessary in two patients. Repeated capsular puncture was not necessary in any case. All biliary interventions were completed successfully without major complications.ConclusionA hybrid approach which employs MRI-guided BD puncture for subsequent fluoroscopy-guided biliary intervention is feasible in clinical routine and yields high technical success in patients with non-dilated BD and/or unfavorable conditions for US-guided puncture. Excellent visualization of BD and PN in near-real-time interventional MRI allows successful cannulation of the BD.« less

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

PubMed

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

2012-06-28

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

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

PubMed Central

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

2012-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-05-01

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

Adherence predictors in an Internet-based Intervention program for depression.

PubMed

Castro, Adoración; López-Del-Hoyo, Yolanda; Peake, Christian; Mayoral, Fermín; Botella, Cristina; García-Campayo, Javier; Baños, Rosa María; Nogueira-Arjona, Raquel; Roca, Miquel; Gili, Margalida

2018-05-01

Internet-delivered psychotherapy has been demonstrated to be effective in the treatment of depression. Nevertheless, the study of the adherence in this type of the treatment reported divergent results. The main objective of this study is to analyze predictors of adherence in a primary care Internet-based intervention for depression in Spain. A multi-center, three arm, parallel, randomized controlled trial was conducted with 194 depressive patients, who were allocated in self-guided or supported-guided intervention. Sociodemographic and clinical characteristics were gathered using a case report form. The Mini international neuropsychiatric interview diagnoses major depression. Beck Depression Inventory was used to assess depression severity. The visual analogic scale assesses the respondent's self-rated health and Short Form Health Survey was used to measure the health-related quality of life. Age results a predictor variable for both intervention groups (with and without therapist support). Perceived health is a negative predictor of adherence for the self-guided intervention when change in depression severity was included in the model. Change in depression severity results a predictor of adherence in the support-guided intervention. Our findings demonstrate that in our sample, there are differences in sociodemographic and clinical variables between active and dropout participants and we provide adherence predictors in each intervention condition of this Internet-based program for depression (self-guided and support-guided). It is important to point that further research in this area is essential to improve tailored interventions and to know specific patients groups can benefit from these interventions.

Pilot Study of a Parent Guided Website Access Package for Early Intervention Decision-Making for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Carlon, Sarah; Carter, Mark; Stephenson, Jennifer

2017-01-01

A pilot study of the effectiveness of guided access to websites that provide information on intervention options for children with autism spectrum disorder (ASD) was conducted with 12 parents of preschool aged children with ASD. Guided access to reliable websites that included information about the effcacy of interventions for ASD (Raising…

Development of a behaviour change intervention: a case study on the practical application of theory.

PubMed

Porcheret, Mark; Main, Chris; Croft, Peter; McKinley, Robert; Hassell, Andrew; Dziedzic, Krysia

2014-04-03

Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised 'context-bound communication skills training.' Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. A stepped approach to the development of a behaviour change intervention, with the utilisation of theoretical frameworks to identify determinants of change matched with behaviour change techniques, has enabled a systematic and theory-driven development of an intervention designed to enhance consultations by GPs for patients with OA. The success of the behaviour change intervention in practice will be evaluated in the context of the MOSAICS trial as a whole, and will inform understanding of practice level and patient outcomes in the trial.

The Boost study: design of a school- and community-based randomised trial to promote fruit and vegetable consumption among teenagers

PubMed Central

2012-01-01

Background The aim of the Boost study was to produce a persistent increase in fruit and vegetable consumption among 13-year-olds. This paper describes the development, implementation and evaluation of a school-and community-based, multi-component intervention guided by theory, evidence, and best practice. Methods/design We used the Intervention Mapping protocol to guide the development of the intervention. Programme activities combined environmental and educational strategies and focused on increasing access to fruit and vegetables in three settings: School: Daily provision of free fruit and vegetables; a pleasant eating environment; classroom curricular activities; individually computer tailored messages; one-day-workshop for teachers. Families: school meeting; guided child-parent activities; newsletters. Local community: guided visits in grocery stores and local area as part of classroom curriculum; information sheets to sports-and youth clubs. The Boost study employed a cluster-randomised controlled study design and applied simple two-stage cluster sampling: A random sample of 10 municipalities followed by a random sample of 4 schools within each municipality (N = 40 schools). Schools were randomised into a total of 20 intervention-and 20 control schools. We included all year 7 pupils except those from school classes with special needs. Timeline: Baseline survey: August 2010. Delivery of intervention: September 2010-May 2011. First follow-up survey: May/June 2011. Second follow-up survey: May/June 2012. Primary outcome measures: Daily mean intake of fruit and vegetables and habitual fruit and vegetable intake measured by validated 24-hour recall-and food frequency questionnaires. Secondary outcome measures: determinants of fruit and vegetable intake, positive side-effects and unintended adverse effects. Implementation was monitored by thorough process evaluation. Discussion The baseline data file included 2,156 adolescents (95%). There was baseline equivalence between intervention-and control groups for sociodemographics, primary outcomes, and availability at home, school and sports-and youth clubs. Significantly larger proportions of pupils in the control group had parents born in Denmark. The study will provide insights into effective strategies to increase fruit and vegetable intake among teenagers. The study will gain knowledge on implementation processes, intervention effects in population subgroups with low intake, and opportunities for including local communities in interventions. Trial registration Current Controlled Trials ISRCTN11666034. PMID:22413782

A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems.

PubMed

Atkins, Lou; Francis, Jill; Islam, Rafat; O'Connor, Denise; Patey, Andrea; Ivers, Noah; Foy, Robbie; Duncan, Eilidh M; Colquhoun, Heather; Grimshaw, Jeremy M; Lawton, Rebecca; Michie, Susan

2017-06-21

Implementing new practices requires changes in the behaviour of relevant actors, and this is facilitated by understanding of the determinants of current and desired behaviours. The Theoretical Domains Framework (TDF) was developed by a collaboration of behavioural scientists and implementation researchers who identified theories relevant to implementation and grouped constructs from these theories into domains. The collaboration aimed to provide a comprehensive, theory-informed approach to identify determinants of behaviour. The first version was published in 2005, and a subsequent version following a validation exercise was published in 2012. This guide offers practical guidance for those who wish to apply the TDF to assess implementation problems and support intervention design. It presents a brief rationale for using a theoretical approach to investigate and address implementation problems, summarises the TDF and its development, and describes how to apply the TDF to achieve implementation objectives. Examples from the implementation research literature are presented to illustrate relevant methods and practical considerations. Researchers from Canada, the UK and Australia attended a 3-day meeting in December 2012 to build an international collaboration among researchers and decision-makers interested in the advancing use of the TDF. The participants were experienced in using the TDF to assess implementation problems, design interventions, and/or understand change processes. This guide is an output of the meeting and also draws on the authors' collective experience. Examples from the implementation research literature judged by authors to be representative of specific applications of the TDF are included in this guide. We explain and illustrate methods, with a focus on qualitative approaches, for selecting and specifying target behaviours key to implementation, selecting the study design, deciding the sampling strategy, developing study materials, collecting and analysing data, and reporting findings of TDF-based studies. Areas for development include methods for triangulating data, e.g. from interviews, questionnaires and observation and methods for designing interventions based on TDF-based problem analysis. We offer this guide to the implementation community to assist in the application of the TDF to achieve implementation objectives. Benefits of using the TDF include the provision of a theoretical basis for implementation studies, good coverage of potential reasons for slow diffusion of evidence into practice and a method for progressing from theory-based investigation to intervention.

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

PubMed

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

2015-01-01

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

Navigation with Electromagnetic Tracking for Interventional Radiology Procedures

PubMed Central

Wood, Bradford J.; Zhang, Hui; Durrani, Amir; Glossop, Neil; Ranjan, Sohan; Lindisch, David; Levy, Eliott; Banovac, Filip; Borgert, Joern; Krueger, Sascha; Kruecker, Jochen; Viswanathan, Anand; Cleary, Kevin

2008-01-01

PURPOSE To assess the feasibility of the use of preprocedural imaging for guide wire, catheter, and needle navigation with electromagnetic tracking in phantom and animal models. MATERIALS AND METHODS An image-guided intervention software system was developed based on open-source software components. Catheters, needles, and guide wires were constructed with small position and orientation sensors in the tips. A tetrahedral-shaped weak electromagnetic field generator was placed in proximity to an abdominal vascular phantom or three pigs on the angiography table. Preprocedural computed tomographic (CT) images of the phantom or pig were loaded into custom-developed tracking, registration, navigation, and rendering software. Devices were manipulated within the phantom or pig with guidance from the previously acquired CT scan and simultaneous real-time angiography. Navigation within positron emission tomography (PET) and magnetic resonance (MR) volumetric datasets was also performed. External and endovascular fiducials were used for registration in the phantom, and registration error and tracking error were estimated. RESULTS The CT scan position of the devices within phantoms and pigs was accurately determined during angiography and biopsy procedures, with manageable error for some applications. Preprocedural CT depicted the anatomy in the region of the devices with real-time position updating and minimal registration error and tracking error (<5 mm). PET can also be used with this system to guide percutaneous biopsies to the most metabolically active region of a tumor. CONCLUSIONS Previously acquired CT, MR, or PET data can be accurately codisplayed during procedures with reconstructed imaging based on the position and orientation of catheters, guide wires, or needles. Multimodality interventions are feasible by allowing the real-time updated display of previously acquired functional or morphologic imaging during angiography, biopsy, and ablation. PMID:15802449

Development and feasibility study of very brief interventions for physical activity in primary care.

PubMed

Pears, Sally; Morton, Katie; Bijker, Maaike; Sutton, Stephen; Hardeman, Wendy

2015-04-08

There is increasing interest in brief and very brief behaviour change interventions for physical activity as they are potentially scalable to the population level. However, few very brief interventions (VBIs) have been published, and evidence is lacking about their feasibility, acceptability and which 'active ingredients' (behaviour change techniques) would maximise their effectiveness. The aim of this research was to identify and develop promising VBIs for physical activity and test their feasibility and acceptability in the context of preventive health checks in primary care. The process included two stages, guided by four criteria: effectiveness, feasibility, acceptability, and cost. In Stage 1, we used an iterative approach informed by systematic reviews, a scoping review of BCTs, team discussion, stakeholder consultation, a qualitative study, and cost estimation to guide the development of promising VBIs. In Stage 2, a feasibility study assessed the feasibility and acceptability of the short-listed VBIs, using tape-recordings and interviews with practitioners (n = 4) and patients (n = 68), to decide which VBIs merited further evaluation in a pilot trial. Four VBIs were short-listed: Motivational intervention; Action Planning intervention; Pedometer intervention; and Physical Activity Diary intervention. All were deliverable in around five minutes and were feasible and acceptable to participants and practitioners. Based on the results of interviews with practitioners and patients, techniques from the VBIs were combined into three new VBIs for further evaluation in a pilot trial. Using a two-stage approach, in which we considered the practicability of VBIs (acceptability, feasibility and cost) alongside potential efficacy from the outset, we developed a short-list of four promising VBIs for physical activity and demonstrated that they were acceptable and feasible as part of a preventive health check in primary care. Current Controlled Trials ISRCTN02863077. Registered 5 October 2012.

Designing a Clinical Framework to Guide Gross Motor Intervention Decisions for Infants and Young Children with Hypotonia

ERIC Educational Resources Information Center

Darrah, Johanna; O'Donnell, Maureen; Lam, Joyce; Story, Maureen; Wickenheiser, Diane; Xu, Kaishou; Jin, Xiaokun

2013-01-01

Clinical practice frameworks are a valuable component of clinical education, promoting informed clinical decision making based on the best available evidence and/or clinical experience. They encourage standardized intervention approaches and evaluation of practice. Based on an international project to support the development of an enhanced service…

Social Ecological Approaches to Individuals and Their Contexts: Twenty Years of "Health Education & Behavior" Health Promotion Interventions

ERIC Educational Resources Information Center

Golden, Shelley D.; Earp, Jo Anne L.

2012-01-01

Social ecological models that describe the interactive characteristics of individuals and environments that underlie health outcomes have long been recommended to guide public health practice. The extent to which such recommendations have been applied in health promotion interventions, however, is unclear. The authors developed a coding system to…

Traditional foods and practices of Spanish-speaking latina mothers influence the home food environment: Implications for future interventions

USDA-ARS?s Scientific Manuscript database

The goal of this study was to obtain in-depth information from low income, Spanish-speaking Latino families with young children to guide the development of culturally appropriate nutrition interventions. Focus groups were used to assess parent’s knowledge about healthful eating, the home food enviro...

[Interventional radiology and radiation therapy].

PubMed

Hadjiev, Janaki

2015-04-26

The revolutionary role of modern cross-sectional imaging, the improved target definition in CT/MRI image guided brachytherapy, the precise topography for applicator and anatomy contribute to a better knowledge and management of tumors and critical organs. Further developments and functional imaging is expected to lead to a broad use of patient tailored therapy in the field of interventional radiation oncology.

The Uses of Force on Spaceship Earth: Revolution and Intervention in the '70's. A Study Guide.

ERIC Educational Resources Information Center

Rivera, Charles R.; And Others

The relationship between internal revolution and subsequent intervention by a foreign power is examined in this guide book for senior high students. Why nations pursue a policy of military intervention and what other alternatives are available are two major questions investigated. Intervention and non-intervention are both determined policies that…

Development of Intervention Materials for Individuals With Limited English Proficiency

PubMed Central

Tu, Shin-Ping; Yip, Mei-Po; Chun, Alan; Choe, John; Bastani, Roshan; Taylor, Vicky

2013-01-01

Background According to recent US census data, 52 million people reported speaking a language other than English at home, and almost 45% of this population reported limited English proficiency (LEP). Colorectal cancer (CRC) ranks among the top 3 most common cancers for several Asian ethnic groups, yet screening remains underutilized by Asian Americans. Objectives This article describes the development of culturally and linguistically appropriate intervention materials for individuals with LEP. We discuss lessons learned from this research and implications for the translation of research into practice. Methods The Health Behavior Framework served as the conceptual model for this study, and qualitative findings guided the development of our intervention materials (a video and pamphlet). To recommend Western preventive behaviors, the research team bridged the gap between Western and Chinese values and beliefs by devoting particular attention to: (1) the target population's sociocul-tural values and health beliefs; and (2) unique linguistic features of the Chinese language. Results Key lessons learned from this study include the importance of: (1) a conceptual framework to guide intervention development; (2) incorporating sociocultural values and health beliefs into the intervention; (3) addressing and capitalizing on complex linguistics issues; (4) using qualitative methodology in cross-cultural research; and (5) contributions from a multicultural and multilingual research team. Other lessons relate to the translation of research findings into practice. We surmise that lessons learned from this study may be pertinent to the promotion of CRC screening among other patient groups with LEP and applicable to additional cancer screening tests. PMID:18725834

Issues and Challenges in the Design of Culturally Adapted Evidence-Based Interventions

PubMed Central

Castro, Felipe González; Barrera, Manuel; Holleran Steiker, Lori K.

2014-01-01

This article examines issues and challenges in the design of cultural adaptations that are developed from an original evidence-based intervention (EBI). Recently emerging multistep frameworks or stage models are examined, as these can systematically guide the development of culturally adapted EBIs. Critical issues are also presented regarding whether and how such adaptations may be conducted, and empirical evidence is presented regarding the effectiveness of such cultural adaptations. Recent evidence suggests that these cultural adaptations are effective when applied with certain subcultural groups, although they are less effective when applied with other subcultural groups. Generally, current evidence regarding the effectiveness of cultural adaptations is promising but mixed. Further research is needed to obtain more definitive conclusions regarding the efficacy and effectiveness of culturally adapted EBIs. Directions for future research and recommendations are presented to guide the development of a new generation of culturally adapted EBIs. PMID:20192800

Thinking about internal states, a qualitative investigation into metacognitions in women with eating disorders

PubMed Central

2013-01-01

Background There is a need for qualitative research to help develop case conceptualisations to guide the development of Metacognitive Therapy interventions for Eating Disorders. Method A qualitative study informed by grounded theory methodology was conducted involving open-ended interviews with 27 women aged 18–55 years, who were seeking or receiving treatment for a diagnosed ED. Results The categories identified in this study appeared to be consistent with a metacognitive model including constructs of a Cognitive Attentional Syndrome and metacognitive beliefs. These categories appear to be transdiagnostic, and the interaction between the categories is proposed to explain the maintenance of EDs. Conclusions The transdiagnostic model proposed may be useful to guide the development of future metacognitive therapy interventions for EDs with the hope that this will lead to improved outcomes for individuals with EDs. PMID:24999403

Development and testing of two lifestyle interventions for persons with chronic mild-to-moderate traumatic brain injury: Acceptability and feasibility.

PubMed

Bay, Esther; Ribbens-Grimm, Christine; Chan, Roxane R

2016-05-01

This clinical methods discursive highlights the development, piloting, and evaluation of two group interventions designed for persons who experienced chronic traumatic brain injury (TBI). Intervention science for this population is limited and lacking in rigor. Our innovative approach to customize existing interventions and develop parallel delivery methods guided by Allostatic Load theory is presented and preliminary results described. Overall, parallel group interventions delivered by trained leaders with mental health expertise were acceptable and feasible for persons who reported being depressed, stressed, and symptomatic. They reported being satisfied with the overall programs and mostly satisfied with the individual classes. Attendance was over the anticipated 70% expected rate and changes in daily living habits were reported by participants. These two group interventions show promise in helping persons to self manage their chronic stress and symptomatology. Copyright © 2015 Elsevier Inc. All rights reserved.

Ultrasound-guided Interventions for Core and Hip Injuries in Athletes.

PubMed

McCarthy, Eoghan; Hegazi, Tarek M; Zoga, Adam C; Morrison, William B; Meyers, William C; Poor, Alex E; Nevalainen, Mika T; Roedl, Johannes B

2016-09-01

Trauma and the mechanical strain of high-energy activity predispose athletes to pelvic injuries. Magnetic resonance imaging remains the primary modality for diagnosing these conditions, but ultrasonography-guided interventions are important in the management of core muscle, hip, and other pelvic conditions. This article reviews ultrasonography-guided interventions for injuries at the core, including the pelvis and hips. It reviews common injuries, procedure optimization, medication preparation, clinical evidence behind injections, tenotomy, and platelet-rich plasma. These interventions are especially important in athletes, because ultrasonography-guided procedures are often undertaken early in the treatment process, paralleling conservative rehabilitation to facilitate a faster return to play. Copyright © 2016 Elsevier Inc. All rights reserved.

Economic Development Planning for Single Parents. Curriculum Materials for Vocational Teachers of Adolescents and Single Parents. Special Emphasis on Meeting the Needs of the Teen Parent.

ERIC Educational Resources Information Center

Simpson, Kawanna J.; And Others

This guide is intended for use in school-based intervention programs intended to help single parents (particularly teenagers who are expecting or already have a child) master basic money management and consumer skills. The guide is divided into sections dealing with the following topics: interpersonal relationships, value clarification,…

PREVIEW Behavior Modification Intervention Toolbox (PREMIT): A Study Protocol for a Psychological Element of a Multicenter Project.

PubMed

Kahlert, Daniela; Unyi-Reicherz, Annelie; Stratton, Gareth; Meinert Larsen, Thomas; Fogelholm, Mikael; Raben, Anne; Schlicht, Wolfgang

2016-01-01

Losing excess body weight and preventing weight regain by changing lifestyle is a challenging but promising task to prevent the incidence of type-2 diabetes. To be successful, it is necessary to use evidence-based and theory-driven interventions, which also contribute to the science of behavior modification by providing a deeper understanding of successful intervention components. To develop a physical activity and dietary behavior modification intervention toolbox (PREMIT) that fulfills current requirements of being theory-driven and evidence-based, comprehensively described and feasible to evaluate. PREMIT is part of an intervention trial, which aims to prevent the onset of type-2 diabetes in pre-diabetics in eight clinical centers across the world by guiding them in changing their physical activity and dietary behavior through a group counseling approach. The program development took five progressive steps, in line with the Public Health Action Cycle: (1) Summing-up the intervention goal(s), target group and the setting, (2) uncovering the generative psychological mechanisms, (3) identifying behavior change techniques and tools, (4) preparing for evaluation and (5) implementing the intervention and assuring quality. PREMIT is based on a trans-theoretical approach referring to valid behavior modification theories, models and approaches. A major "product" of PREMIT is a matrix, constructed for use by onsite-instructors. The matrix includes objectives, tasks and activities ordered by periods. PREMIT is constructed to help instructors guide participants' behavior change. To ensure high fidelity and adherence of program-implementation across the eight intervention centers standardized operational procedures were defined and "train-the-trainer" workshops were held. In summary PREMIT is a theory-driven, evidence-based program carefully developed to change physical activity and dietary behaviors in pre-diabetic people.

PREVIEW Behavior Modification Intervention Toolbox (PREMIT): A Study Protocol for a Psychological Element of a Multicenter Project

PubMed Central

Kahlert, Daniela; Unyi-Reicherz, Annelie; Stratton, Gareth; Meinert Larsen, Thomas; Fogelholm, Mikael; Raben, Anne; Schlicht, Wolfgang

2016-01-01

Background: Losing excess body weight and preventing weight regain by changing lifestyle is a challenging but promising task to prevent the incidence of type-2 diabetes. To be successful, it is necessary to use evidence-based and theory-driven interventions, which also contribute to the science of behavior modification by providing a deeper understanding of successful intervention components. Objective: To develop a physical activity and dietary behavior modification intervention toolbox (PREMIT) that fulfills current requirements of being theory-driven and evidence-based, comprehensively described and feasible to evaluate. PREMIT is part of an intervention trial, which aims to prevent the onset of type-2 diabetes in pre-diabetics in eight clinical centers across the world by guiding them in changing their physical activity and dietary behavior through a group counseling approach. Methods: The program development took five progressive steps, in line with the Public Health Action Cycle: (1) Summing-up the intervention goal(s), target group and the setting, (2) uncovering the generative psychological mechanisms, (3) identifying behavior change techniques and tools, (4) preparing for evaluation and (5) implementing the intervention and assuring quality. Results: PREMIT is based on a trans-theoretical approach referring to valid behavior modification theories, models and approaches. A major “product” of PREMIT is a matrix, constructed for use by onsite-instructors. The matrix includes objectives, tasks and activities ordered by periods. PREMIT is constructed to help instructors guide participants' behavior change. To ensure high fidelity and adherence of program-implementation across the eight intervention centers standardized operational procedures were defined and “train-the-trainer” workshops were held. In summary PREMIT is a theory-driven, evidence-based program carefully developed to change physical activity and dietary behaviors in pre-diabetic people. PMID:27559319

Guided, internet-based, rumination-focused cognitive behavioural therapy (i-RFCBT) versus a no-intervention control to prevent depression in high-ruminating young adults, along with an adjunct assessment of the feasibility of unguided i-RFCBT, in the REducing Stress and Preventing Depression trial (RESPOND): study protocol for a phase III randomised controlled trial.

PubMed

Cook, Lorna; Watkins, Edward

2016-01-04

Depression is a global health challenge. Prevention is highlighted as a priority to reduce its prevalence. Although effective preventive interventions exist, the efficacy and coverage can be improved. One proposed means to increase efficacy is by using interventions to target specific risk factors, such as rumination. Rumination-focused CBT (RFCBT) was developed to specifically target depressive rumination and reduces acute depressive symptoms and relapse for patients with residual depression in a randomised controlled trial. Preliminary findings from a Dutch randomised prevention trial in 251 high-risk 15- to 22-year-old subjects selected with elevated worry and rumination found that both supported internet-RFBCT and group-delivered RFCBT equally reduced depressive symptoms and the onset of depressive cases over a period of 1 year, relative to the no-intervention control. A phase III randomised controlled trial following the Medical Research Council (MRC) Complex Interventions Framework will extend a Dutch trial to the United Kingdom, with the addition of diagnostic interviews, primarily to test whether guided internet-RFCBT reduces the onset of depression relative to a no-intervention control. High-risk young adults (aged 18 to 24 years), selected with elevated worry/rumination and recruited through university and internet advertisement, will be randomised to receive either guided internet-RFCBT, supported by clinical psychologists or mental health paraprofessionals, or a no-intervention control. As an adjunct arm, participants are also randomised to unguided internet-RFCBT self-help to provide an initial test of the feasibility and effect size of this intervention. While participants are also randomised to unguided internet-RFCBT, the trial was designed and powered as a phase III trial comparing guided internet-RFCBT versus a no-intervention control. In the comparison between these two arms, the primary outcomes are as follows: a) onset of major depressive episode over a 12-month period, assessed with a Structured Clinical Interview for Diagnosis at 3 months (post-intervention), 6 months and 15 months after randomisation. The following secondary outcomes will be recorded: the incidence of generalized anxiety disorder, symptoms of depression and anxiety, and levels of worry and rumination, measured at baseline and at the same follow-up intervals. In relation to the pilot investigation of unguided internet-RFCBT (the adjunct intervention arm), we will assess the feasibility and acceptability of the data-collection procedures, levels of attrition, effect size and acceptability of the unguided internet-RFCBT intervention. Widespread implementation is necessary for effective prevention, suggesting that the internet may be a valuable mode of delivery. Previous research suggests that guided internet-RFCBT reduces incidence rates relative to controls. We are also interested in developing and evaluating an unguided version to potentially increase the availability and reduce the costs. Current Controlled Trials ISRCTN12683436 . Date of registration: 27 October 2014.

MR-guided endovascular interventions: a comprehensive review on techniques and applications.

PubMed

Kos, Sebastian; Huegli, Rolf; Bongartz, Georg M; Jacob, Augustinus L; Bilecen, Deniz

2008-04-01

The magnetic resonance (MR) guidance of endovascular interventions is probably one of the greatest challenges of clinical MR research. MR angiography is not only an imaging tool for the vasculature but can also simultaneously depict high tissue contrast, including the differentiation of the vascular wall and perivascular tissues, as well as vascular function. Several hurdles had to be overcome to allow MR guidance for endovascular interventions. MR hardware and sequence design had to be developed to achieve acceptable patient access and to allow real-time or near real-time imaging. The development of interventional devices, both applicable and safe for MR imaging (MRI), was also mandatory. The subject of this review is to summarize the latest developments in real-time MRI hardware, MRI, visualization tools, interventional devices, endovascular tracking techniques, actual applications and safety issues.

Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach.

PubMed

Band, Rebecca; Bradbury, Katherine; Morton, Katherine; May, Carl; Michie, Susan; Mair, Frances S; Murray, Elizabeth; McManus, Richard J; Little, Paul; Yardley, Lucy

2017-02-23

This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Person-Based Approach to intervention development emphasises the use of qualitative research to ensure that the intervention is acceptable, persuasive, engaging and easy to implement. Our intervention planning process comprised two parallel, integrated work streams, which combined theory-, evidence- and person-based elements. The first work stream involved collating evidence from a mixed methods feasibility study, a systematic review and a synthesis of qualitative research. This evidence was analysed to identify likely barriers and facilitators to uptake and implementation as well as design features that should be incorporated in the HOME BP intervention. The second work stream used three complementary approaches to theoretical modelling: developing brief guiding principles for intervention design, causal modelling to map behaviour change techniques in the intervention onto the Behaviour Change Wheel and Normalisation Process Theory frameworks, and developing a logic model. The different elements of our integrated approach to intervention planning yielded important, complementary insights into how to design the intervention to maximise acceptability and ease of implementation by both patients and health professionals. From the primary and secondary evidence, we identified key barriers to overcome (such as patient and health professional concerns about side effects of escalating medication) and effective intervention ingredients (such as providing in-person support for making healthy behaviour changes). Our guiding principles highlighted unique design features that could address these issues (such as online reassurance and procedures for managing concerns). Causal modelling ensured that all relevant behavioural determinants had been addressed, and provided a complete description of the intervention. Our logic model linked the hypothesised mechanisms of action of our intervention to existing psychological theory. Our integrated approach to intervention development, combining theory-, evidence- and person-based approaches, increased the clarity, comprehensiveness and confidence of our theoretical modelling and enabled us to ground our intervention in an in-depth understanding of the barriers and facilitators most relevant to this specific intervention and user population.

Endovascular brain intervention and mapping in a dog experimental model using magnetically-guided micro-catheter technology.

PubMed

Kara, Tomas; Leinveber, Pavel; Vlasin, Michal; Jurak, Pavel; Novak, Miroslav; Novak, Zdenek; Chrastina, Jan; Czechowicz, Krzysztof; Belehrad, Milos; Asirvatham, Samuel J

2014-06-01

Despite the substantial progress that has been achieved in interventional cardiology and cardiac electrophysiology, endovascular intervention for the diagnosis and treatment of central nervous system (CNS) disorders such as stroke, epilepsy and CNS malignancy is still limited, particularly due to highly tortuous nature of the cerebral arterial and venous system. Existing interventional devices and techniques enable only limited and complicated access especially into intra-cerebral vessels. The aim of this study was to develop a micro-catheter magnetically-guided technology specifically designed for endovascular intervention and mapping in deep CNS vascular structures. Mapping of electrical brain activity was performed via the venous system on an animal dog model with the support of the NIOBE II system. A novel micro-catheter specially designed for endovascular interventions in the CNS, with the support of the NIOBE II technology, was able to reach safely deep intra-cerebral venous structures and map the electrical activity there. Such structures are not currently accessible using standard catheters. This is the first study demonstrating successful use of a new micro-catheter in combination with NIOBE II technology for endovascular intervention in the brain.

A Systematic Review of the Impact of Multi-Strategy Nutrition Education Programs on Health and Nutrition of Adolescents.

PubMed

Meiklejohn, Sarah; Ryan, Lisa; Palermo, Claire

2016-10-01

To update evidence on the impact of multi-strategy nutrition education interventions on adolescents' health and nutrition outcomes and behaviors. Systematic review of randomized controlled studies of multi-strategy interventions encompassing nutrition education published from 2000 to 2014 guided by the Preferred Reported Items for Systematic Reviews and Meta-analyses statement. Secondary schools in developed countries. Adolescents aged 10-18 years. Anthropometric and dietary intake. Systematic search of 7,009 unduplicated articles and review of 11 studies (13 articles) meeting inclusion criteria using qualitative comparison. Four studies reported significant changes in anthropometric measures and 9 showed significant changes in dietary intake. Type of nutrition education varied. Components of the interventions that showed statistically significant changes in anthropometric and dietary intake included facilitation of the programs by school staff and teachers, parental involvement, and using theoretical models to guide the intervention's development. Changes in canteens, food supply, and vending machines were associated with significant changes in dietary intake. Multi-strategy interventions can have significant impacts on nutrition of adolescents when the nutrition education is theoretically based and facilitated by school staff in conjunction with parents and families, and includes changes to the school food environment. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Interventional articular and para-articular knee procedures

PubMed Central

Lalam, Radhesh K; Winn, Naomi

2016-01-01

The knee is a common area of the body to undergo interventional procedures. This article discusses image-guided interventional issues specific to the knee area. The soft tissues in and around the knee are frequently affected by sport-related injuries and often need image-guided intervention. This article details the specific technical issues related to intervention in these soft tissues, including the iliotibial tract, fat pads, patellar tendon and other tendons, bursae and the meniscus. Most often, simple procedures such as injection and aspiration are performed without image guidance. Rarely image-guided diagnostic arthrography and therapeutic joint injections are necessary. The technique, indications and diagnostic considerations for arthrography are discussed in this article. Primary bone and soft-tissue tumours may involve the knee and adjacent soft tissues. Image-guided biopsies are frequently necessary for these lesions; this article details the technical issues related to image-guided biopsy around the knee. A number of newer ablation treatments are now available, including cryoablation, high-frequency ultrasound and microwave ablation. Radiofrequency ablation, however, still remains the most commonly employed ablation technique. The indications, technical and therapeutic considerations related to the application of this technique around the knee are discussed here. Finally, we briefly discuss some newer, but as of yet, unproven image-guided interventions for osteochondral lesions and Brodie's abscess. PMID:26682669

Development of the "Recovery from Eating Disorders for Life" Food Guide (REAL Food Guide) - a food pyramid for adults with an eating disorder.

PubMed

Hart, Susan; Marnane, Claire; McMaster, Caitlin; Thomas, Angela

2018-01-01

There is limited evidence to inform nutrition and dietetic interventions for individuals with eating disorders even though it is recommended as an essential part of multidisciplinary management. There is minimal guidance, an absence of standardised nutrition educational material, and no research on how best to educate patients on healthy eating and how to achieve nutrition adequacy. Therefore the REAL Food Guide was developed. The REAL Food Guide is a pyramid with four layers and key nutrition messages beside each layer that was conceived to address gaps in nutrition education and intervention for individuals with eating disorders. Written and verbal consumer feedback was obtained from consumers receiving treatment regarding the acceptability and usefulness of the REAL Food Guide. A unique database was developed to reflect the types of foods and realistic portion sizes that patients are likely to select. This database was used for nutrition modelling to assess the nutrition adequacy of three meal patterns (meat containing, vegetarian and semi-vegan) for both weight maintenance and weight regain. Each meal pattern was compared to the Nutrient Reference Values for Australia and New Zealand. Nutritional analysis demonstrated nutritional adequacy of meal patterns for energy, macronutrients and most micronutrients when the recommended number of serves from the REAL Food Guide were assessed. All meal patterns were adequate in micronutrients except for the semi-vegan meal pattern that was inadequate in vitamin D. Feedback from individuals with eating disorders demonstrates the nutrition education tool was acceptable to them as they felt it was more helpful for their recovery than general nutrition guidelines. The REAL Food Guide is a comprehensive and user-friendly guide that clinicians can use to educate patients about components of a balanced and healthy diet. The guide can educate all eating disorder clinicians, including those who are new to the field, about the basics of nutrition. Clinicians using the guide can be confident that, if followed, patient's energy and nutritional requirements will be met and important nutrition education messages are reinforced, that are tailored to the beliefs and concerns of individuals with eating disorders.

Internet interventions for depression: new developments.

PubMed

Schröder, Johanna; Berger, Thomas; Westermann, Stefan; Klein, Jan Philipp; Moritz, Steffen

2016-06-01

A wide range of Internet interventions, mostly grounded in methods of cognitive behavioral therapy, have been developed and tested for several mental disorders. The evidence to date shows that these interventions are effective in reducing symptoms of depression. Metaanalyses report small-to-medium effect sizes when Internet interventions are delivered as stand-alone self-help interventions (d=0.25-0.36), and medium-to-large effect sizes when delivered as therapist-guided interventions (d=0.58-0.78), both compared with usual care. Only a minority of people suffering from depression receive adequate treatment, and Internet interventions might help bridge the large treatment gap. This review summarizes the current body of evidence and highlights pros and cons of Internet interventions. It also outlines how they could be implemented in mental health care systems and points out unresolved questions, as well as future directions, in this research field.

Internet interventions for depression: new developments

PubMed Central

Schröder, Johanna; Berger, Thomas; Westermann, Stefan; Klein, Jan Philipp; Moritz, Steffen

2016-01-01

A wide range of Internet interventions, mostly grounded in methods of cognitive behavioral therapy, have been developed and tested for several mental disorders. The evidence to date shows that these interventions are effective in reducing symptoms of depression. Metaanalyses report small-to-medium effect sizes when Internet interventions are delivered as stand-alone self-help interventions (d=0.25-0.36), and medium-to-large effect sizes when delivered as therapist-guided interventions (d=0.58-0.78), both compared with usual care. Only a minority of people suffering from depression receive adequate treatment, and Internet interventions might help bridge the large treatment gap. This review summarizes the current body of evidence and highlights pros and cons of Internet interventions. It also outlines how they could be implemented in mental health care systems and points out unresolved questions, as well as future directions, in this research field. PMID:27489460

American Medical Society for Sports Medicine (AMSSM) position statement: interventional musculoskeletal ultrasound in sports medicine.

PubMed

Finnoff, Jonathan T; Hall, Mederic M; Adams, Erik; Berkoff, David; Concoff, Andrew L; Dexter, William; Smith, Jay

2015-02-01

The use of diagnostic and interventional ultrasound has significantly increased over the past decade. A majority of the increased utilisation is by non-radiologists. In sports medicine, ultrasound is often used to guide interventions such as aspirations, diagnostic or therapeutic injections, tenotomies, releases and hydrodissections. Critically review the literature related to the accuracy, efficacy and cost-effectiveness of ultrasound-guided injections (USGIs) in major, intermediate and small joints; and soft tissues. Systematic review of the literature. USGIs are more accurate than landmark-guided injections (LMGIs; strength of recommendation taxonomy (SORT) Evidence Rating=A). USGIs are more efficacious than LMGIs (SORT Evidence Rating=B). USGIs are more cost-effective than LMGIs (SORT Evidence Rating=B). Ultrasound guidance is required to perform many new procedures (SORT Evidence Rating=C). The findings of this position statement indicate there is strong evidence that USGIs are more accurate than LMGI, moderate evidence that they are more efficacious and preliminary evidence that they are more cost-effective. Furthermore, ultrasound-guided (USG) is required to perform many new, advanced procedures and will likely enable the development of innovative USG surgical techniques in the future. 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.

Game playbooks: tools to guide multidisciplinary teams in developing videogame-based behavior change interventions.

PubMed

Duncan, Lindsay R; Hieftje, Kimberly D; Culyba, Sabrina; Fiellin, Lynn E

2014-03-01

As mobile technologies and videogaming platforms are becoming increasingly prevalent in the realm of health and healthcare, so are the opportunities to use these resources to conduct behavioral interventions. The creation and empirical testing of game style interventions, however, is challenged by the requisite collaboration of multidisciplinary teams, including researchers and game developers who have different cultures, terminologies, and standards of evidence. Thus, traditional intervention development tools such as logic models and intervention manuals may need to be augmented by creating what we have termed "Game Playbooks" which are intervention guidebooks that are created by, understood by, and acceptable to all members of the multidisciplinary game development team. The purpose of this paper is to describe the importance and content of a Game Playbook created to aide in the development of a videogame intervention designed specifically for health behavior change in young teens as well as the process for creating such a tool. We draw on the experience of our research and game design team to describe the critical components of the Game Playbook and the necessity of creating such a tool.

Improving health promotion through central rating of interventions: the need for Responsive Guidance.

PubMed

Kok, Maarten Olivier; Bal, Roland; Roelofs, Caspar David; Schuit, Albertine Jantine

2017-11-23

In several countries, attempts are made to improve health promotion by centrally rating the effectiveness of health promotion interventions. The Dutch Effectiveness Rating System (ERS) for health promotion interventions is an improvement-oriented approach in which multi-disciplinary expert committees rate available health promotion interventions as 'theoretically sound', 'probably effective' or 'proven effective'. The aim of this study is to explore the functioning of the ERS and the perspective of researchers, policy-makers and practitioners regarding its contribution to improvement. We interviewed 53 selected key informants from research, policy and practice in the Netherlands and observed the assessment of 12 interventions. Between 2008 and 2012, a total of 94 interventions were submitted to the ERS, of which 23 were rejected, 58 were rated as 'theoretically sound', 10 were rated as 'probably effective' and 3 were rated as 'proven effective'. According to participants, the ERS was intended to facilitate both the improvement of available interventions and the improvement of health promotion in practice. While participants expected that describing and rating interventions promoted learning and enhanced the transferability of interventions, they were concerned that the ERS approach was not suitable for guiding intervention development and improving health promotion in practice. The expert committees that assessed the interventions struggled with a lack of norms for the relevance of effects and questions about how effects should be studied and rated. Health promotion practitioners were concerned that the ERS neglected the local adaptation of interventions and did not encourage the improvement of aspects like applicability and costs. Policy-makers and practitioners were worried that the lack of proven effectiveness legitimised cutbacks rather than learning and advancing health promotion. While measuring and centrally rating the effectiveness of interventions can be beneficial, the evidence based-inspired ERS approach is too limited to guide both intervention development and the improvement of health promotion in practice. To better contribute to improving health promotion, a more reflexive and responsive guidance approach is required, namely one which stimulates the improvement of different intervention aspects, provides targeted recommendations to practitioners and provides feedback to those who develop and rate interventions.

Intervention Tailoring for Chinese American Women: Comparing the Effects of Two Videos on Knowledge, Attitudes and Intentions to Obtain a Mammogram

ERIC Educational Resources Information Center

Wang, Judy Huei-yu; Schwartz, Marc D.; Luta, George; Maxwell, Annette E.; Mandelblatt, Jeanne S.

2012-01-01

This study utilized data from an ongoing randomized controlled trial to compare a culturally tailored video promoting positive attitudes toward mammography among Chinese immigrant women to a linguistically appropriate generic video and print media. Intervention development was guided by the Health Belief Model. Five hundred and ninety-two…

Planning for the Future: A Model for Using the Principles of Transition to Guide the Development of Behavior Intervention Plans

ERIC Educational Resources Information Center

Mueller, Tracy Gershwin; Bassett, Diane S.; Brewer, Robin D.

2012-01-01

The Individuals with Disabilities Education Act (IDEA) mandates the implementation of a behavior intervention plan based on a functional behavioral assessment when a student's behavior necessitates disciplinary actions. However, IDEA does not provide any clear guidelines as to what the plans should contain nor how they can address behaviors that…

Development of a Procedural Guide to Implement Response to Intervention (RtI) with High-Ability Learners

ERIC Educational Resources Information Center

Robertson, Stephanie; Pfeiffer, Steven

2016-01-01

In recent years, a focus on individual student needs has set the stage for tailoring educational interventions to address issues of students who are not working up to educational proficiency standards outlined in the No Child Left Behind (NCLB) legislation. This new pedagogical model may provide a unique opportunity to meet the needs of…

Translational Neuroscience as a Tool for Intervention Development in the Context of High-Adversity Families

PubMed Central

Fisher, Philip A.

2017-01-01

The use of theory-driven models to develop and evaluate family-based intervention programs has a long history in psychology. Some of the first evidence-based parenting programs to address child problem behavior, developed in the 1970s, were grounded in causal models derived from longitudinal developmental research. The same translational strategies can also be applied to designing programs that leverage emerging scientific knowledge about the effects of early adverse experiences on neurobiological systems to reduce risk and promote well-being. By specifying not only behavioral targets but also affected underlying neural systems, interventions can become more precise and efficient. This chapter describes the development of a program of research focusing on an intervention for young children in foster care. The intervention emerged from social learning theory research and employs a translational neuroscience approach. The conceptual model guiding the research, which incorporates behavioral domains as well as stress-regulatory neural systems, is described. Finally, future directions for translational neuroscience in family-based intervention research are considered. PMID:27589501

The development of healthy tennis clubs in the Netherlands.

PubMed

Pluim, Babette M; Earland, Jane; Pluim, Nicole E

2014-06-01

To explore the factors that facilitate or hinder the development of healthy tennis clubs in the Netherlands and to identify suitable interventions that would help clubs to reach 'healthy club' status. A maximum variation, purposive sampling strategy was used to identify and recruit board members (n=16) from 10 Dutch tennis clubs. Data were collected using in-depth interviews based on an interview guide. The interviews explored what steps the clubs had taken to create a healthy tennis club, and what the respondents perceived to be the barriers to reaching healthy club status. The data were analysed using thematic content analysis. An ecological model was used to frame the interpretation of the themes and guide the development of the interventions. Four emerging themes were identified: provision of healthy foods, injury prevention and health services, social health and safety around the club. The main facilitators were found to be support from club management, having appropriate policies in place and having appointed officers. The main barriers were identified as a lack of policy templates, inadequate knowledge of coaches on injury prevention and injury management and fragmented access to relevant information. Guided by an ecological model, this study demonstrates the many factors that influence tennis clubs and the individual members of a healthy tennis club. Using this model, a multilevel intervention framework has been created that could be used by the Royal Netherlands Lawn Tennis Association to increase the number of healthy tennis clubs in the Netherlands.

The GUIDES checklist: development of a tool to improve the successful use of guideline-based computerised clinical decision support.

PubMed

Van de Velde, Stijn; Kunnamo, Ilkka; Roshanov, Pavel; Kortteisto, Tiina; Aertgeerts, Bert; Vandvik, Per Olav; Flottorp, Signe

2018-06-25

Computerised decision support (CDS) based on trustworthy clinical guidelines is a key component of a learning healthcare system. Research shows that the effectiveness of CDS is mixed. Multifaceted context, system, recommendation and implementation factors may potentially affect the success of CDS interventions. This paper describes the development of a checklist that is intended to support professionals to implement CDS successfully. We developed the checklist through an iterative process that involved a systematic review of evidence and frameworks, a synthesis of the success factors identified in the review, feedback from an international expert panel that evaluated the checklist in relation to a list of desirable framework attributes, consultations with patients and healthcare consumers and pilot testing of the checklist. We screened 5347 papers and selected 71 papers with relevant information on success factors for guideline-based CDS. From the selected papers, we developed a 16-factor checklist that is divided in four domains, i.e. the CDS context, content, system and implementation domains. The panel of experts evaluated the checklist positively as an instrument that could support people implementing guideline-based CDS across a wide range of settings globally. Patients and healthcare consumers identified guideline-based CDS as an important quality improvement intervention and perceived the GUIDES checklist as a suitable and useful strategy. The GUIDES checklist can support professionals in considering the factors that affect the success of CDS interventions. It may facilitate a deeper and more accurate understanding of the factors shaping CDS effectiveness. Relying on a structured approach may prevent that important factors are missed.

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

PubMed

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

2017-01-01

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

Preclinical Feasibility of a Technology Framework for MRI-guided Iliac Angioplasty

PubMed Central

Rube, Martin A.; Fernandez-Gutierrez, Fabiola; Cox, Benjamin F.; Holbrook, Andrew B.; Houston, J. Graeme; White, Richard D.; McLeod, Helen; Fatahi, Mahsa; Melzer, Andreas

2015-01-01

Purpose Interventional MRI has significant potential for image guidance of iliac angioplasty and related vascular procedures. A technology framework with in-room image display, control, communication and MRI-guided intervention techniques was designed and tested for its potential to provide safe, fast and efficient MRI-guided angioplasty of the iliac arteries. Methods A 1.5T MRI scanner was adapted for interactive imaging during endovascular procedures using new or modified interventional devices such as guidewires and catheters. A perfused vascular phantom was used for testing. Pre-, intra- and post-procedural visualization and measurement of vascular morphology and flow was implemented. A detailed analysis of X-Ray fluoroscopic angiography workflow was conducted and applied. Two interventional radiologists and one physician in training performed 39 procedures. All procedures were timed and analyzed. Results MRI-guided iliac angioplasty procedures were successfully performed with progressive adaptation of techniques and workflow. The workflow, setup and protocol enabled a reduction in table time for a dedicated MRI-guided procedure to 6 min 33 s with a mean procedure time of 9 min 2 s, comparable to the mean procedure time of 8 min 42 s for the standard X-Ray guided procedure. Conclusions MRI-guided iliac vascular interventions were found to be feasible and practical using this framework and optimized workflow. In particular the real-time flow analysis was found to be helpful for pre- and post-interventional assessments. Design optimization of the catheters and in vivo experiments are required before clinical evaluation. PMID:25102933

A Systematic Review Exploring the Social Cognitive Theory of Self-Regulation as a Framework for Chronic Health Condition Interventions

PubMed Central

Tougas, Michelle E.; Hayden, Jill A.; McGrath, Patrick J.; Huguet, Anna; Rozario, Sharlene

2015-01-01

Background Theory is often recommended as a framework for guiding hypothesized mechanisms of treatment effect. However, there is limited guidance about how to use theory in intervention development. Methods We conducted a systematic review to provide an exemplar review evaluating the extent to which use of theory is identified and incorporated within existing interventions. We searched electronic databases PubMed, PsycINFO, CENTRAL, and EMBASE from inception to May 2014. We searched clinicaltrials.gov for registered protocols, reference lists of relevant systematic reviews and included studies, and conducted a citation search in Web of Science. We included peer-reviewed publications of interventions that referenced the social cognitive theory of self-regulation as a framework for interventions to manage chronic health conditions. Two reviewers independently assessed articles for eligibility. We contacted all authors of included studies for information detailing intervention content. We describe how often theory mechanisms were addressed by interventions, and report intervention characteristics used to address theory. Results Of 202 articles that reported using the social cognitive theory of self-regulation, 52% failed to incorporate self-monitoring, a main theory component, and were therefore excluded. We included 35 interventions that adequately used the theory framework. Intervention characteristics were often poorly reported in peer-reviewed publications, 21 of 35 interventions incorporated characteristics that addressed each of the main theory components. Each intervention addressed, on average, six of eight self-monitoring mechanisms, two of five self-judgement mechanisms, and one of three self-evaluation mechanisms. The self-monitoring mechanisms ‘Feedback’ and ‘Consistency’ were addressed by all interventions, whereas the self-evaluation mechanisms ‘Self-incentives’ and ‘External rewards’ were addressed by six and four interventions, respectively. The present review establishes that systematic review is a feasible method of identifying use of theory as a conceptual framework for existing interventions. We identified the social cognitive theory of self-regulation as a feasible framework to guide intervention development for chronic health conditions. PMID:26252889

A rehabilitation intervention to promote physical recovery following intensive care: a detailed description of construct development, rationale and content together with proposed taxonomy to capture processes in a randomised controlled trial.

PubMed

Ramsay, Pam; Salisbury, Lisa G; Merriweather, Judith L; Huby, Guro; Rattray, Janice E; Hull, Alastair M; Brett, Stephen J; Mackenzie, Simon J; Murray, Gordon D; Forbes, John F; Walsh, Timothy Simon

2014-01-29

Increasing numbers of patients are surviving critical illness, but survival may be associated with a constellation of physical and psychological sequelae that can cause ongoing disability and reduced health-related quality of life. Limited evidence currently exists to guide the optimum structure, timing, and content of rehabilitation programmes. There is a need to both develop and evaluate interventions to support and expedite recovery during the post-ICU discharge period. This paper describes the construct development for a complex rehabilitation intervention intended to promote physical recovery following critical illness. The intervention is currently being evaluated in a randomised trial (ISRCTN09412438; funder Chief Scientists Office, Scotland). The intervention was developed using the Medical Research Council (MRC) framework for developing complex healthcare interventions. We ensured representation from a wide variety of stakeholders including content experts from multiple specialties, methodologists, and patient representation. The intervention construct was initially based on literature review, local observational and audit work, qualitative studies with ICU survivors, and brainstorming activities. Iterative refinement was aided by the publication of a National Institute for Health and Care Excellence guideline (No. 83), publicly available patient stories (Healthtalkonline), a stakeholder event in collaboration with the James Lind Alliance, and local piloting. Modelling and further work involved a feasibility trial and development of a novel generic rehabilitation assistant (GRA) role. Several rounds of external peer review during successive funding applications also contributed to development. The final construct for the complex intervention involved a dedicated GRA trained to pre-defined competencies across multiple rehabilitation domains (physiotherapy, dietetics, occupational therapy, and speech/language therapy), with specific training in post-critical illness issues. The intervention was from ICU discharge to 3 months post-discharge, including inpatient and post-hospital discharge elements. Clear strategies to provide information to patients/families were included. A detailed taxonomy was developed to define and describe the processes undertaken, and capture them during the trial. The detailed process measure description, together with a range of patient, health service, and economic outcomes were successfully mapped on to the modified CONSORT recommendations for reporting non-pharmacologic trial interventions. The MRC complex intervention framework was an effective guide to developing a novel post-ICU rehabilitation intervention. Combining a clearly defined new healthcare role with a detailed taxonomy of process and activity enabled the intervention to be clearly described for the purpose of trial delivery and reporting. These data will be useful when interpreting the results of the randomised trial, will increase internal and external trial validity, and help others implement the intervention if the intervention proves clinically and cost effective.

A rehabilitation intervention to promote physical recovery following intensive care: a detailed description of construct development, rationale and content together with proposed taxonomy to capture processes in a randomised controlled trial

PubMed Central

2014-01-01

Background Increasing numbers of patients are surviving critical illness, but survival may be associated with a constellation of physical and psychological sequelae that can cause ongoing disability and reduced health-related quality of life. Limited evidence currently exists to guide the optimum structure, timing, and content of rehabilitation programmes. There is a need to both develop and evaluate interventions to support and expedite recovery during the post-ICU discharge period. This paper describes the construct development for a complex rehabilitation intervention intended to promote physical recovery following critical illness. The intervention is currently being evaluated in a randomised trial (ISRCTN09412438; funder Chief Scientists Office, Scotland). Methods The intervention was developed using the Medical Research Council (MRC) framework for developing complex healthcare interventions. We ensured representation from a wide variety of stakeholders including content experts from multiple specialties, methodologists, and patient representation. The intervention construct was initially based on literature review, local observational and audit work, qualitative studies with ICU survivors, and brainstorming activities. Iterative refinement was aided by the publication of a National Institute for Health and Care Excellence guideline (No. 83), publicly available patient stories (Healthtalkonline), a stakeholder event in collaboration with the James Lind Alliance, and local piloting. Modelling and further work involved a feasibility trial and development of a novel generic rehabilitation assistant (GRA) role. Several rounds of external peer review during successive funding applications also contributed to development. Results The final construct for the complex intervention involved a dedicated GRA trained to pre-defined competencies across multiple rehabilitation domains (physiotherapy, dietetics, occupational therapy, and speech/language therapy), with specific training in post-critical illness issues. The intervention was from ICU discharge to 3 months post-discharge, including inpatient and post-hospital discharge elements. Clear strategies to provide information to patients/families were included. A detailed taxonomy was developed to define and describe the processes undertaken, and capture them during the trial. The detailed process measure description, together with a range of patient, health service, and economic outcomes were successfully mapped on to the modified CONSORT recommendations for reporting non-pharmacologic trial interventions. Conclusions The MRC complex intervention framework was an effective guide to developing a novel post-ICU rehabilitation intervention. Combining a clearly defined new healthcare role with a detailed taxonomy of process and activity enabled the intervention to be clearly described for the purpose of trial delivery and reporting. These data will be useful when interpreting the results of the randomised trial, will increase internal and external trial validity, and help others implement the intervention if the intervention proves clinically and cost effective. PMID:24476530

Using theory to develop an exercise intervention for patients post stroke.

PubMed

Shaughnessy, Marianne; Resnick, Barbara M

2009-01-01

Stroke remains a leading cause of disability for older adults. While is it well established in the literature that exercise programs can have significant benefit, many stroke survivors do not receive specific recommendations for exercise or lack the motivation to continue exercising following discharge from rehabilitation. This article describes an exercise intervention developed for subacute stroke survivors that utilizes the self-efficacy theory framework. The rationale for selection of this theoretical framework and specific examples of interventions linked to components of the model are provided. The article describes the motivational/educational program and the sequential follow-up designed to prepare stroke survivors to increase exercise behavior. Theoretical frameworks are useful tools for guiding and organizing research investigations from literature review through development and implementation of the intervention to interpretation of findings.

Image-guided elbow interventions: a literature review of interventional treatment options

PubMed Central

Sorani, Alan

2016-01-01

Over the years, a wide range of image-guided interventional therapies have been used in treating different elbow pathologies, many of which are predominantly based on anecdotal and low-level study findings. This article critically assesses the existing literature and discusses the efficacy of the most commonly utilized interventional procedures for elbow pathology. PMID:26206415

The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention.

PubMed

Michelson, Kelly N; Frader, Joel; Sorce, Lauren; Clayman, Marla L; Persell, Stephen D; Fragen, Patricia; Ciolino, Jody D; Campbell, Laura C; Arenson, Melanie; Aniciete, Danica Y; Brown, Melanie L; Ali, Farah N; White, Douglas

2016-12-01

Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention.

Guided Internet-based versus face-to-face clinical care in the management of tinnitus: study protocol for a multi-centre randomised controlled trial.

PubMed

Beukes, Eldré W; Baguley, David M; Allen, Peter M; Manchaiah, Vinaya; Andersson, Gerhard

2017-04-21

Innovative strategies are required to improve access to evidence-based tinnitus interventions. A guided Internet-based cognitive behavioural therapy (iCBT) intervention for tinnitus was therefore developed for a U.K. Initial clinical trials indicated efficacy of iCBT at reducing tinnitus severity and associated comorbidities such as insomnia and depression. The aim of this phase III randomised controlled trial is to compare this new iCBT intervention with an established intervention, namely face-to-face clinical care for tinnitus. This will be a multi-centre study undertaken across three hospitals in the East of England. The design is a randomised, two-arm, parallel-group, non-inferiority trial with a 2-month follow-up. The experimental group will receive the guided iCBT intervention, whereas the active control group will receive the usual face-to-face clinical care. An independent researcher will randomly assign participants, using a computer-generated randomisation schedule, after stratification for tinnitus severity. There will be 46 participants in each group. The primary assessment measure will be the Tinnitus Functional Index. Data analysis will establish whether non-inferiority is achieved using a pre-defined non-inferiority margin. This protocol outlines phase III of a clinical trial comparing a new iCBT with established face-to-face care for tinnitus. If guided iCBT for tinnitus proves to be as effective as the usual tinnitus care, it may be a viable additional management route for individuals with tinnitus. This could increase access to evidence-based effective tinnitus care and reduce the pressures on existing health care systems. ClinicalTrials.gov identifier: NCT02665975 . Registered on 22 January 2016.

eHealth and mHealth interventions in the treatment of fatigued cancer survivors: A systematic review and meta-analysis.

PubMed

Seiler, Annina; Klaas, Vanessa; Tröster, Gerhard; Fagundes, Christopher P

2017-09-01

To (1) evaluate existing eHealth/mHealth interventions developed to help manage cancer-related fatigue (CRF); and (2) summarize the best available evidence on their effectiveness. A comprehensive literature search of PubMed, MEDLINE, EMBASE, and the Cochrane Library up to November 2016 was conducted. Study outcomes were extracted, tabulated, and summarized. Random effects meta-analyses were conducted for the primary outcome (fatigue), and the secondary outcomes quality of life and depression, yielding pooled effect sizes (r), and 95% confidence intervals (CI). For eHealth interventions, our search of published papers identified 9 completed studies and 6 protocols for funded projects underway. No studies were identified for mHealth interventions that met our inclusion criteria. A meta-analysis of the 9 completed eHealth studies revealed a statistically significant beneficial effect of eHealth interventions on CRF (r = .27, 95% CI [.1109 - .4218], P < 0.01). Therapist-guided eHealth interventions were more efficacious then self-guided interventions (r = .58, 95% CI: [.3136 - .5985, P < 0.001). Small to moderate therapeutic effects were also observed for HRQoL (r = .17, 95% CI [.0384 - .3085], P < 0.05) and depression (r = .24, 95% CI [.1431 - .3334], P < 0.001). eHealth interventions appear to be effective for managing fatigue in cancer survivors with CRF. Continuous development of eHealth interventions for the treatment of CRF in cancer survivors and their testing in long-term, large-scale efficacy outcome studies is encouraged. The degree to which mHealth interventions can change CRF in cancer survivors need to be assessed systematically and empirically. Copyright © 2017 John Wiley & Sons, Ltd.

Image fusion and navigation platforms for percutaneous image-guided interventions.

PubMed

Rajagopal, Manoj; Venkatesan, Aradhana M

2016-04-01

Image-guided interventional procedures, particularly image guided biopsy and ablation, serve an important role in the care of the oncology patient. The need for tumor genomic and proteomic profiling, early tumor response assessment and confirmation of early recurrence are common scenarios that may necessitate successful biopsies of targets, including those that are small, anatomically unfavorable or inconspicuous. As image-guided ablation is increasingly incorporated into interventional oncology practice, similar obstacles are posed for the ablation of technically challenging tumor targets. Navigation tools, including image fusion and device tracking, can enable abdominal interventionalists to more accurately target challenging biopsy and ablation targets. Image fusion technologies enable multimodality fusion and real-time co-displays of US, CT, MRI, and PET/CT data, with navigational technologies including electromagnetic tracking, robotic, cone beam CT, optical, and laser guidance of interventional devices. Image fusion and navigational platform technology is reviewed in this article, including the results of studies implementing their use for interventional procedures. Pre-clinical and clinical experiences to date suggest these technologies have the potential to reduce procedure risk, time, and radiation dose to both the patient and the operator, with a valuable role to play for complex image-guided interventions.

Stand More AT Work (SMArT Work): using the behaviour change wheel to develop an intervention to reduce sitting time in the workplace.

PubMed

Munir, Fehmidah; Biddle, Stuart J H; Davies, Melanie J; Dunstan, David; Esliger, David; Gray, Laura J; Jackson, Ben R; O'Connell, Sophie E; Yates, Tom; Edwardson, Charlotte L

2018-03-06

Sitting (sedentary behaviour) is widespread among desk-based office workers and a high level of sedentary behaviour is a risk factor for poor health. Reducing workplace sitting time is therefore an important prevention strategy. Interventions are more likely to be effective if they are theory and evidence-based. The Behaviour Change Wheel (BCW) provides a framework for intervention development. This article describes the development of the Stand More AT Work (SMArT Work) intervention, which aims to reduce sitting time among National Health Service (NHS) office-based workers in Leicester, UK. We followed the BCW guide and used the Capability, Opportunity and Motivation Behaviour (COM-B) model to conduct focus group discussions with 39 NHS office workers. With these data we used the taxonomy of Behaviour Change Techniques (BCTv1) to identify the most appropriate strategies for facilitating behaviour change in our intervention. To identify the best method for participants to self-monitor their sitting time, a sub-group of participants (n = 31) tested a number of electronic self-monitoring devices. From our BCW steps and the BCT-Taxonomy we identified 10 behaviour change strategies addressing environmental (e.g. provision of height adjustable desks,), organisational (e.g. senior management support, seminar), and individual level (e.g. face-to-face coaching session) barriers. The Darma cushion scored the highest for practicality and acceptability for self-monitoring sitting. The BCW guide, COM-B model and BCT-Taxonomy can be applied successfully in the context of designing a workplace intervention for reducing sitting time through standing and moving more. The intervention was developed in collaboration with office workers (a participatory approach) to ensure relevance for them and their work situation. The effectiveness of this intervention is currently being evaluated in a randomised controlled trial. ISRCTN10967042 . Registered on 2 February 2015.

Evaluation of the clinical benefit of an electromagnetic navigation system for CT-guided interventional radiology procedures in the thoraco-abdominal region compared with conventional CT guidance (CTNAV II): study protocol for a randomised controlled trial.

PubMed

Rouchy, R C; Moreau-Gaudry, A; Chipon, E; Aubry, S; Pazart, L; Lapuyade, B; Durand, M; Hajjam, M; Pottier, S; Renard, B; Logier, R; Orry, X; Cherifi, A; Quehen, E; Kervio, G; Favelle, O; Patat, F; De Kerviler, E; Hughes, C; Medici, M; Ghelfi, J; Mounier, A; Bricault, I

2017-07-06

Interventional radiology includes a range of minimally invasive image-guided diagnostic and therapeutic procedures that have become routine clinical practice. Each procedure involves a percutaneous needle insertion, often guided using computed tomography (CT) because of its availability and usability. However, procedures remain complicated, in particular when an obstacle must be avoided, meaning that an oblique trajectory is required. Navigation systems track the operator's instruments, meaning the position and progression of the instruments are visualised in real time on the patient's images. A novel electromagnetic navigation system for CT-guided interventional procedures (IMACTIS-CT®) has been developed, and a previous clinical trial demonstrated improved needle placement accuracy in navigation-assisted procedures. In the present trial, we are evaluating the clinical benefit of the navigation system during the needle insertion step of CT-guided procedures in the thoraco-abdominal region. This study is designed as an open, multicentre, prospective, randomised, controlled interventional clinical trial and is structured as a standard two-arm, parallel-design, individually randomised trial. A maximum of 500 patients will be enrolled. In the experimental arm (navigation system), the procedures are carried out using navigation assistance, and in the active comparator arm (CT), the procedures are carried out with conventional CT guidance. The randomisation is stratified by centre and by the expected difficulty of the procedure. The primary outcome of the trial is a combined criterion to assess the safety (number of serious adverse events), efficacy (number of targets reached) and performance (number of control scans acquired) of navigation-assisted, CT-guided procedures as evaluated by a blinded radiologist and confirmed by an expert committee in case of discordance. The secondary outcomes are (1) the duration of the procedure, (2) the satisfaction of the operator and (3) the irradiation dose delivered, with (4) subgroup analysis according to the expected difficulty of the procedure, as well as an evaluation of (5) the usability of the device. This trial addresses the lack of published high-level evidence studies in which navigation-assisted CT-guided interventional procedures are evaluated. This trial is important because it addresses the problems associated with conventional CT guidance and is particularly relevant because the number of interventional radiology procedures carried out in routine clinical practice is increasing. ClinicalTrials.gov identifier: NCT01896219 . Registered on 5 July 2013.

Handbook of Consultation: An Intervention for Advocacy and Outreach.

ERIC Educational Resources Information Center

Kurpius, DeWayne J., Ed.; Brown, Duane, Ed.

This handbook is one of four handbooks developed for preservice and inservice counselor preparation and professional development. It was developed as a practical guide for practicing professionals and as a textbook or supplementary material for use in courses or workshops on consultation. It consists of six chapters. "Introduction to Consultation:…

Using formative evaluation in an implementation project to increase vaccination rates in high-risk veterans: QUERI Series

PubMed Central

Wallace, Carolyn M; Legro, Marcia W

2008-01-01

Background Implementation of research into practice in health care systems is a challenging and often unsuccessful endeavor. The United States Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) research teams include formative evaluations (FE) in their action-oriented VA implementation projects to identify critical information about the processes of implementation that can guide adjustments to project activities, in order to better meet project goals. This article describes the development and use of FE in an action-oriented implementation research project. Methods This two-year action-oriented implementation research project was conducted at 23 VA Spinal Cord Injury (SCI) Centers, and targeted patients, staff and the system of care, such as administration and information technology. Data for FE were collected by electronic and paper surveys, semi-structured and open-ended interviews, notes during conference calls, and exchange of e-mail messages. Specific questions were developed for each intervention (designed to improve vaccination rates for influenza in veterans with spinal cord injury and disorder); informants were selected for their knowledge of interventions and their use in SCI Centers. Results Data from FE were compiled separately for each intervention to describe barriers to progress and guide adjustments to implementation activities. These data addressed the processes of implementing the interventions, problem-solving activities and the status of interventions at SCI Centers. Conclusion Formative evaluations provided the project team with a broad view of the processes of implementing multi-targeted interventions as well as the evolving status of the related best practice. Using FE was useful, although the challenges of conducting FE for non-field researchers should be addressed. Work is needed to develop methods for conducting FE across multiple sites, as well as acknowledging variations in local contexts that affect implementation of interventions. PMID:18430201

A Changing Landscape for Vitamin A Programs: Implications for Optimal Intervention Packages, Program Monitoring, and Safety.

PubMed

Klemm, Rolf D W; Palmer, Amanda C; Greig, Alison; Engle-Stone, Reina; Dalmiya, Nita

2016-06-01

Vitamin A deficiency (VAD) remains a widespread public health problem in the developing world, despite changes in under-5 mortality rates, morbidity patterns, and intervention options. This article considers the implications of a changing epidemiologic and programmatic landscape for vitamin A (VA) programs. We review progress to prevent VAD and its health consequences, assess gaps in VA status and intervention coverage data, and assess data needed to guide decisions regarding the optimal mix, targeting, and dose of VA interventions to maximize benefit and minimize risk. Vitamin A supplementation programs have contributed to the reduction in under-5 mortality rates, but alone, do not address the underlying problem of inadequate dietary VA intakes and VAD among preschool-aged children in the developing world. A combination of VA interventions (eg, supplementation, fortified foods, multiple micronutrient powders, and lipid-based nutrient supplements) will be required to achieve VA adequacy in most settings. Current efforts to measure the coverage of multiple VA interventions, as well as whether and how much VA children are receiving, are few and fragmented. Where intervention overlap exists, further effort is needed to monitor VA intakes, ensuring that targeted groups are consuming adequate amounts but not exceeding the tolerable upper intake level. Vitamin A status data will also be critical for navigating the changing landscape of VA programs. Data from these monitoring efforts will help to guide decisions on the optimal mix, targeting, and exposure to VA interventions to maximize public health benefit while minimizing any potential risk. © The Author(s) 2016.

New concepts and materials for the manufacturing of MR-compatible guide wires.

PubMed

Brecher, Christian; Emonts, Michael; Brack, Alexander; Wasiak, Christian; Schütte, Adrian; Krämer, Nils; Bruhn, Robin

2014-04-01

This paper shows the development of a new magnetic resonance imaging (MRI)-compatible guide wire made from fiber-reinforced plastics. The basic material of the developed guide wire is manufactured using a specially developed micro-pullwinding technology, which allows the adjustment of tensile, bending, and torsional stiffness independent from each other. Additionally, the micro-pullwinding technology provides the possibility to vary the stiffness along the length of the guide wire in a continuous process. With the possibilities of this technology, the mechanical properties of the guide wire were precisely adjusted for the intended usage in MRI-guided interventions. The performance of the guide wire regarding the mechanical properties was investigated. It could be shown, that the mechanical properties could be changed independently from each other by varying the process parameters. Especially, the torsional stiffness could be significantly improved with only a minor influence on bending and tensile properties. The precise influence of the variation of the winding angle on the mechanical and geometrical properties has to be further investigated. The usability of the guide wire as well as its visibility in MRI was investigated by radiologists. With the micro-pullwinding technology, a continuous manufacturing technique for highly stressable, MRI-safe profiles is available and can be the trigger for a new class of medical devices.

Developing Internet-Based Health Interventions: A Guide for Public Health Researchers and Practitioners

PubMed Central

Ecklund, Alexandra M; Hunt, Shanda L; Nelson, Toben F; Toomey, Traci L

2015-01-01

Background Researchers and practitioners interested in developing online health interventions most often rely on Web-based and print resources to guide them through the process of online intervention development. Although useful for understanding many aspects of best practices for website development, missing from these resources are concrete examples of experiences in online intervention development for health apps from the perspective of those conducting online health interventions. Objective This study aims to serve as a series of case studies in the development of online health interventions to provide insights for researchers and practitioners who are considering technology-based interventional or programmatic approaches. Methods A convenience sample of six study coordinators and five principal investigators at a large, US-based land grant university were interviewed about the process of developing online interventions in the areas of alcohol policy, adolescent health, medication adherence, and human immunodeficiency virus prevention in transgender persons and in men who have sex with men. Participants were asked questions that broadly addressed each of the four phases of the User-Centered Design Process Map from the US Department of Health and Human Services' Research-Based Web Design & Usability Guidelines. Interviews were audio recorded and transcribed. Qualitative codes were developed using line-by-line open coding for all transcripts, and all transcripts were coded independently by at least 2 authors. Differences among coders were resolved with discussion. Results We identified the following seven themes: (1) hire a strong (or at least the right) research team, (2) take time to plan before beginning the design process, (3) recognize that vendors and researchers have differing values, objectives, and language, (4) develop a detailed contract, (5) document all decisions and development activities, (6) use a content management system, and (7) allow extra time for testing and debugging your intervention. Each of these areas is discussed in detail, with supporting quotations from principal investigators and study coordinators. Conclusions The values held by members of each participating organization involved in the development of the online intervention or program, as well as the objectives that are trying to be met with the website, must be considered. These defined values and objectives should prompt an open and explicit discussion about the scope of work, budget, and other needs from the perspectives of each organization. Because of the complexity of developing online interventions, researchers and practitioners should become familiar with the process and how it may differ from the development and implementation of in-person interventions or programs. To assist with this, the intervention team should consider expanding the team to include experts in computer science or learning technologies, as well as taking advantage of institutional resources that will be needed for successful completion of the project. Finally, we describe the tradeoff between funds available for online intervention or program development and the complexity of the project. PMID:25650702

Developing Internet-based health interventions: a guide for public health researchers and practitioners.

PubMed

Horvath, Keith J; Ecklund, Alexandra M; Hunt, Shanda L; Nelson, Toben F; Toomey, Traci L

2015-01-23

Researchers and practitioners interested in developing online health interventions most often rely on Web-based and print resources to guide them through the process of online intervention development. Although useful for understanding many aspects of best practices for website development, missing from these resources are concrete examples of experiences in online intervention development for health apps from the perspective of those conducting online health interventions. This study aims to serve as a series of case studies in the development of online health interventions to provide insights for researchers and practitioners who are considering technology-based interventional or programmatic approaches. A convenience sample of six study coordinators and five principal investigators at a large, US-based land grant university were interviewed about the process of developing online interventions in the areas of alcohol policy, adolescent health, medication adherence, and human immunodeficiency virus prevention in transgender persons and in men who have sex with men. Participants were asked questions that broadly addressed each of the four phases of the User-Centered Design Process Map from the US Department of Health and Human Services' Research-Based Web Design & Usability Guidelines. Interviews were audio recorded and transcribed. Qualitative codes were developed using line-by-line open coding for all transcripts, and all transcripts were coded independently by at least 2 authors. Differences among coders were resolved with discussion. We identified the following seven themes: (1) hire a strong (or at least the right) research team, (2) take time to plan before beginning the design process, (3) recognize that vendors and researchers have differing values, objectives, and language, (4) develop a detailed contract, (5) document all decisions and development activities, (6) use a content management system, and (7) allow extra time for testing and debugging your intervention. Each of these areas is discussed in detail, with supporting quotations from principal investigators and study coordinators. The values held by members of each participating organization involved in the development of the online intervention or program, as well as the objectives that are trying to be met with the website, must be considered. These defined values and objectives should prompt an open and explicit discussion about the scope of work, budget, and other needs from the perspectives of each organization. Because of the complexity of developing online interventions, researchers and practitioners should become familiar with the process and how it may differ from the development and implementation of in-person interventions or programs. To assist with this, the intervention team should consider expanding the team to include experts in computer science or learning technologies, as well as taking advantage of institutional resources that will be needed for successful completion of the project. Finally, we describe the tradeoff between funds available for online intervention or program development and the complexity of the project.

From Qualitative Work to Intervention Development in Pediatric Oncology Palliative Care Research

PubMed Central

Gilmer, Mary Jo; Friedman, Debra L.; Given, Barbara; Hendricks-Ferguson, Verna L.; Hinds, Pamela S.

2013-01-01

Qualitative methods can be particularly useful approaches to use with individuals who are experiencing a rare disease and thus who comprise a small sample (such as children with cancer) and are at points in care that few experience (such as end of life). This data-based methods article describes how findings from a qualitative study were used to guide and shape a pediatric oncology palliative care intervention. Qualitative data can lay a strong foundation for subsequent pilot intervention work by facilitating the development of an underlying study conceptualization, providing recruitment feasibility estimates, helping establish clinically meaningful inclusion criteria, establishing staff acceptability of a research intervention, and providing support for face validity of newly developed interventions. These benefits of preliminary qualitative research are described in the context of this study on legacy-making, which involves reports of children (7-12 years of age) living with advanced cancer and of their parent caregivers. PMID:23632900

Development of a behaviour change intervention: a case study on the practical application of theory

PubMed Central

2014-01-01

Background Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. Methods The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. Results The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised ‘context-bound communication skills training.’ Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. Conclusions A stepped approach to the development of a behaviour change intervention, with the utilisation of theoretical frameworks to identify determinants of change matched with behaviour change techniques, has enabled a systematic and theory-driven development of an intervention designed to enhance consultations by GPs for patients with OA. The success of the behaviour change intervention in practice will be evaluated in the context of the MOSAICS trial as a whole, and will inform understanding of practice level and patient outcomes in the trial. PMID:24708880

Using the Medical Research Council framework for the development and evaluation of complex interventions in a theory-based infant feeding intervention to prevent childhood obesity: the baby milk intervention and trial.

PubMed

Lakshman, Rajalakshmi; Griffin, Simon; Hardeman, Wendy; Schiff, Annie; Kinmonth, Ann Louise; Ong, Ken K

2014-01-01

We describe our experience of using the Medical Research Council framework on complex interventions to guide the development and evaluation of an intervention to prevent obesity by modifying infant feeding behaviours. We reviewed the epidemiological evidence on early life risk factors for obesity and interventions to prevent obesity in this age group. The review suggested prevention of excess weight gain in bottle-fed babies and appropriate weaning as intervention targets; hence we undertook systematic reviews to further our understanding of these behaviours. We chose theory and behaviour change techniques that demonstrated evidence of effectiveness in altering dietary behaviours. We subsequently developed intervention materials and evaluation tools and conducted qualitative studies with mothers (intervention recipients) and healthcare professionals (intervention deliverers) to refine them. We developed a questionnaire to assess maternal attitudes and feeding practices to understand the mechanism of any intervention effects. In addition to informing development of our specific intervention and evaluation materials, use of the Medical Research Council framework has helped to build a generalisable evidence base for early life nutritional interventions. However, the process is resource intensive and prolonged, and this should be taken into account by public health research funders. This trial is registered with ISRTCN: 20814693 Baby Milk Trial.

Interdisciplinary Graduate Program: Rural Early Intervention Specialists for Low Incidence Disabilities (REIS/LID). Final Grant Performance Report [and] REIS/LID Student Guide.

ERIC Educational Resources Information Center

Maine Univ., Orono. Center for Community Inclusion.

This final report describes accomplishments and activities of a 3-year federally funded project of the University of Maine to develop and deliver a graduate Master's degree program in early intervention for infants and young children with low incidence disabilities. A curriculum was designed to prepare professionals to provide culturally relevant,…

Designing Interventions for Preschool Learning and Behavior Problems. The Jossey-Bass Social and Behavioral Science Series and the Jossey-Bass Education Series.

ERIC Educational Resources Information Center

Barnett, David W.; Carey, Karen T.

This book aims to help in developing interventions for preschool children with learning and behavior problems, guided by a scientist-practitioner model that integrates research and deals effectively with the realities of practice. The book emphasizes a theory of psychosocial change rather than developmental theories. The book is written for…

Searching for solutions to alcohol and other drug abuse during pregnancy: ethics, values, and constitutional principles.

PubMed

Andrews, A B; Patterson, E G

1995-01-01

Recent efforts to develop legal mechanisms to detect prenatal substance abuse and force pregnant women into drug-free conditions have precipitated ethical struggles for social workers. This article reviews relevant social work values and ethical issues, particularly the need to balance obligations to promote client self-determination, privacy, and access to chosen services with professional values that support coercive intervention to aid vulnerable people and to protect life. The constitutional principles that most affect coercive interventions--due process and equal protection--are reviewed. Recommendations are offered to guide ethical and legal social work for case interventions and policy development.

Fostering First Graders' Reasoning Strategies with Basic Sums: The Value of Guided Instruction

ERIC Educational Resources Information Center

Purpura, David J.; Baroody, Arthur J.; Eiland, Michael D.; Reid, Erin E.

2016-01-01

An intervention experiment served to evaluate the efficacy of highly guided discovery learning of relations underlying add-1 and doubles combination families and to compare the impact of such instruction with minimally guided instruction. After a pretest, 78 first graders were randomly assigned to one of three intervention conditions: highly…

Early Childhood Practitioner Judgments of the Social Validity of Performance Checklists and Parent Practice Guides

ERIC Educational Resources Information Center

Dunst, Carl J.

2017-01-01

Findings from three field tests evaluations of early childhood intervention practitioner performance checklists and three parent practice guides are reported. Forty-two practitioners from three early childhood intervention programs reviewed the checklists and practice guides and made (1) social validity judgments of both products, (2) judgments of…

Storybridging: Four Steps for Constructing Effective Health Narratives

ERIC Educational Resources Information Center

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2017-01-01

Objective: To develop a practical step-by-step approach to constructing narrative health interventions in response to the mixed results and wide diversity of narratives used in health-related narrative persuasion research. Method: Development work was guided by essential narrative characteristics as well as principles enshrined in the Health…

Early Care in Children with Neurodevelopmental Disorders

ERIC Educational Resources Information Center

Ponce-Meza, Jacqueline

2017-01-01

The article analyzes the importance of early care in child development, guiding a neuropsychological perspective of development. The early care model seeks to refer to the set of interventions aimed at children and their work in conjunction with a multidisciplinary team. It presents recommendations for the implementation of programs that allow…

Nurse's Pocket Guide: Nursing Diagnoses with Interventions M Doenges M Moorbouse Nurse's Pocket Guide: Nursing Diagnoses with Interventions F A Davis 548pp £12.00 0-8036-2666-5 [Formula: see text].

PubMed

1991-07-31

My first thought when I began to read the Nurse's Pocket Guide: Nursing Diagnoses with Interventions was 'at last, a nursing dictionary instead of the usual medical dictionary for nurses!' Unfortunately, it did not live up to my expectations. The book starts out with a good idea but, like so many others, fails to communicate it effectively and simply.

Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the “Active Ingredients” of an Effective Program Using Intervention Mapping

PubMed Central

Mesters, Ilse; Gijsbers, Barbara; Bartholomew, L. Kay

2018-01-01

Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development. PMID:29616209

Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the "Active Ingredients" of an Effective Program Using Intervention Mapping.

PubMed

Mesters, Ilse; Gijsbers, Barbara; Bartholomew, L Kay

2018-01-01

Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development.

Effect of Information and Telephone-Guided Access to Community Support for People with Chronic Kidney Disease: Randomised Controlled Trial

PubMed Central

Blakeman, Tom; Blickem, Christian; Kennedy, Anne; Reeves, David; Bower, Peter; Gaffney, Hannah; Gardner, Caroline; Lee, Victoria; Jariwala, Praksha; Dawson, Shoba; Mossabir, Rahena; Brooks, Helen; Richardson, Gerry; Spackman, Eldon; Vassilev, Ivaylo; Chew-Graham, Carolyn; Rogers, Anne

2014-01-01

Background Implementation of self-management support in traditional primary care settings has proved difficult, encouraging the development of alternative models which actively link to community resources. Chronic kidney disease (CKD) is a common condition usually diagnosed in the presence of other co-morbidities. This trial aimed to determine the effectiveness of an intervention to provide information and telephone-guided access to community support versus usual care for patients with stage 3 CKD. Methods and Findings In a pragmatic, two-arm, patient level randomised controlled trial 436 patients with a diagnosis of stage 3 CKD were recruited from 24 general practices in Greater Manchester. Patients were randomised to intervention (215) or usual care (221). Primary outcome measures were health related quality of life (EQ-5D health questionnaire), blood pressure control, and positive and active engagement in life (heiQ) at 6 months. At 6 months, mean health related quality of life was significantly higher for the intervention group (adjusted mean difference = 0.05; 95% CI = 0.01, 0.08) and blood pressure was controlled for a significantly greater proportion of patients in the intervention group (adjusted odds-ratio = 1.85; 95% CI = 1.25, 2.72). Patients did not differ significantly in positive and active engagement in life. The intervention group reported a reduction in costs compared with control. Conclusions An intervention to provide tailored information and telephone-guided access to community resources was associated with modest but significant improvements in health related quality of life and better maintenance of blood pressure control for patients with stage 3 CKD compared with usual care. However, further research is required to identify the mechanisms of action of the intervention. Trial Registration Controlled-Trials.com ISRCTN45433299 PMID:25330169

Adaptation of an HIV Medication Adherence Intervention for Adolescents and Young Adults

PubMed Central

Thurston, Idia B.; Bogart, Laura M.; Wachman, Madeline; Closson, Elizabeth F.; Skeer, Margie R.; Mimiaga, Matthew J.

2014-01-01

Rising rates of human immunodeficiency virus (HIV) infection among adolescents and young adults underscore the importance of interventions for this population. While the morbidity and mortality of HIV has greatly decreased over the years, maintaining high rates of adherence is necessary to receive optimal medication effects. Few studies have developed interventions for adolescents and young adults and none have specifically been developed for sexual minority (lesbian, gay, and bisexual; LGB) youth. Guided by an evidence-based adult intervention and adolescent qualitative interviews, we developed a multicomponent, technology-enhanced, customizable adherence intervention for adolescents and young adults for use in a clinical setting. The two cases presented in this paper illustrate the use of the five-session positive strategies to enhance problem solving (Positive STEPS) intervention, based on cognitive-behavioral techniques and motivational interviewing. We present a perinatally infected heterosexual woman and a behaviorally infected gay man to demonstrate the unique challenges faced by these youth and showcase how the intervention can be customized. Future directions include varying the number of intervention sessions based on mode of HIV infection and incorporating booster sessions. PMID:25452680

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development.

PubMed

Joseph, Rodney P; Keller, Colleen; Affuso, Olivia; Ainsworth, Barbara E

2017-06-01

African-American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e., 57 % are obese, 49 % have cardiovascular disease). The marked health disparities among African-American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring physical activity programs to address the sociocultural norms, values, beliefs, and behaviors of African-American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African-American women and to present a conceptual framework to guide intervention development. Development of the framework was based on our previous physical activity research with African-American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African-American culture, and key determinants of physical activity engagement among African-American women. Three key concepts are discussed in the conceptual framework: (1) Developmental milestones and life stage transitions of African-American women; (2) Historical, social, and cultural influences associated with physical activity engagement; and (3) Intervention delivery strategies. Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African-American women.

Designing Culturally Relevant Physical Activity Programs for African American Women: A Framework for Intervention Development

PubMed Central

Keller, Colleen; Affuso, Oliva; Ainsworth, Barbara E.

2016-01-01

Background African American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e. 57% are obese, 49% have cardiovascular disease) The marked health disparities among African American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring PA programs to address the sociocultural norms, values, beliefs, and behaviors of African American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African American women and to present a conceptual framework to guide intervention development. Methods Development of the framework was based on our previous physical activity research with African American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African American culture, and key determinants of physical activity engagement among African American women. Results Three key concepts are discussed in the conceptual framework: 1) Developmental milestones and life stage transitions of African American women, 2) Historical, social and cultural influences associated with physical activity engagement, and 3) Intervention delivery strategies. Discussion Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African American women. PMID:27178447

Choosing between responsive-design websites versus mobile apps for your mobile behavioral intervention: presenting four case studies.

PubMed

Turner-McGrievy, Gabrielle M; Hales, Sarah B; Schoffman, Danielle E; Valafar, Homay; Brazendale, Keith; Weaver, R Glenn; Beets, Michael W; Wirth, Michael D; Shivappa, Nitin; Mandes, Trisha; Hébert, James R; Wilcox, Sara; Hester, Andrew; McGrievy, Matthew J

2017-06-01

Both mobile apps and responsive-design websites (web apps) can be used to deliver mobile health (mHealth) interventions, but it can be difficult to discern which to use in research. The goal of this paper is to present four case studies from behavioral interventions that developed either a mobile app or a web app for research and present an information table to help researchers determine which mobile option would work best for them. Four behavioral intervention case studies (two developed a mobile app, and two developed a web app) presented include time, cost, and expertise. Considerations for adopting a mobile app or a web app-such as time, cost, access to programmers, data collection, security needs, and intervention components- are presented. Future studies will likely integrate both mobile app and web app modalities. The considerations presented here can help guide researchers on which platforms to choose prior to starting an mHealth intervention.

Managing crises through organisational development: a conceptual framework.

PubMed

Lalonde, Carole

2011-04-01

This paper presents a synthesis of the guiding principles in crisis management in accordance with the four configurational imperatives (strategy, structure, leadership and environment) defined by Miller (1987) and outlines interventions in organisational development (OD) that may contribute to their achievement. The aim is to build a conceptual framework at the intersection of these two fields that could help to strengthen the resilient capabilities of individuals, organisations and communities to face crises. This incursion into the field of OD--to generate more efficient configurations of practices in crisis management--seems particularly fruitful considering the system-wide application of OD, based on open-systems theory (Burke, 2008). Various interventions proposed by OD in terms of human processes, structural designs and human resource management, as well as strategy, may help leaders, members of organisations and civil society apply effectively, and in a more sustainable way, the crisis management guiding principles defined by researchers. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Duplex-guided percutaneous transluminal angioplasty in iliac arterial occlusive disease.

PubMed

Krasznai, A G; Sigterman, T A; Welten, R J; Heijboer, R; Sikkink, C J J M; van de Akker, L H J M; Bouwman, L H

2013-11-01

Chronic renal insufficiency (CRI) is a growing global problem. PTA can be performed without nephrotoxic contrast, utilizing Doppler-ultrasound (Duplex) guidance. Duplex-guided infra-inguinal interventions and access-related interventions have been reported. Duplex-guided iliac interventions have not been performed to any extent because of the anatomic location. In our study we evaluated the safety and efficacy of Duplex-guided percutaneous transluminal angioplasty (DuPTA) in iliac arteries. From June 2012 until February 2013, 31 patients (35 iliac lesions), underwent DuPTA. Indications ranged from Rutherford 3 to 5. Preoperative evaluation included Ankle Brachial Index (ABI), Duplex and MRA. Procedural success was defined as crossing the lesion with a guidewire and dilating or stenting the lesion. Clinical success was defined as 50% reduction in peak systolic velocity (PSV) or clinical improvement. PSV was evaluated after PTA, then at 2 weeks. Clinical results were assessed 2 weeks after the procedure. Procedural success was achieved in 94% of patients (33/35), all of whom also had clinical success. Post-procedural PSV reduction showed an average improvement of 63% (431 cm/s to 153 cm/s). Mean preoperative ABI was 0.72 and improved to 0.88 postoperatively. PTA using Duplex-guidance in significant iliac stenosis is a safe method with major advantages in patients at high risk for developing contrast-induced nephropathy. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.

PubMed

Narouze, Samer N; Provenzano, David; Peng, Philip; Eichenberger, Urs; Lee, Sang Chul; Nicholls, Barry; Moriggl, Bernhard

2012-01-01

The use of ultrasound in pain medicine for interventional axial, nonaxial, and musculoskeletal pain procedures is rapidly evolving and growing. Because of the lack of specialty-specific guidelines for ultrasonography in pain medicine, an international collaborative effort consisting of members of the Special Interest Group on Ultrasonography in Pain Medicine from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies developed the following recommendations for education and training in ultrasound-guided interventional pain procedures. The purpose of these recommendations is to define the required skills for performing ultrasound-guided pain procedures, the processes for appropriate education, and training and quality improvement. Training algorithms are outlined for practice- and fellowship-based pathways. The previously published American Society of Regional Anesthesia and Pain Medicine and European Society of Regional Anaesthesia and Pain Therapy education and teaching recommendations for ultrasound-guided regional anesthesia served as a foundation for the pain medicine recommendations. Although the decision to grant ultrasound privileges occurs at the institutional level, the committee recommends that the training guidelines outlined in this document serve as the foundation for educational training and the advancement of the practice of ultrasonography in pain medicine.

Guide Catheter Extension Device Is Effective in Renal Angioplasty for Severely Calcified Lesions.

PubMed

Sugimoto, Takeshi; Nomura, Tetsuya; Hori, Yusuke; Yoshioka, Kenichi; Kubota, Hiroshi; Miyawaki, Daisuke; Urata, Ryota; Kikai, Masakazu; Keira, Natsuya; Tatsumi, Tetsuya

2017-05-23

BACKGROUND The GuideLiner catheter extension device is a monorail-type "Child" support catheter that facilitates coaxial alignment with the guide catheter and provides an appropriate back-up force. This device has been developed in the field of coronary intervention, and now is becoming widely applied in the field of endovascular treatment. However, there has been no report on the effectiveness of the guide catheter extension device in percutaneous transluminal renal angioplasty (PTRA). CASE REPORT We encountered a case of atherosclerotic subtotal occlusion at the ostium of the left renal artery. Due to the severely calcified orifice and weaker back-up force provided by a JR4 guide catheter, we could not pass any guidewires through the target lesion. Therefore, we introduced a guide catheter extension device, the GuideLiner catheter, through the guide catheter and achieved good guidewire maneuverability. We finally deployed 2 balloon-expandable stents and successfully performed all PTRA procedures. CONCLUSIONS The guide catheter extension device can be effective in PTRA for severely calcified subtotal occlusion.

Pure versus guided mirror exposure to reduce body dissatisfaction: a preliminary study with university women.

PubMed

Moreno-Domínguez, Silvia; Rodríguez-Ruiz, Sonia; Fernández-Santaella, M Carmen; Jansen, Anita; Tuschen-Caffier, Brunna

2012-03-01

While effectiveness of mirror exposure to reduce body dissatisfaction has been demonstrated, the exposure was almost always combined with other interventions. The aim of the study was to evaluate the effectiveness of a pure mirror exposure intervention compared with a guided mirror exposure (participants are guided to describe their body shape in a non-evaluative manner) and an imagery exposure intervention (participants are guided to describe their body through mental representation). Thirty-one women with high body dissatisfaction received five sessions of treatment under one of the three conditions. All interventions reduced body dissatisfaction, but only the mirror exposures successfully reduced the frequency of negative thoughts and feelings of ugliness. Pure mirror exposure was more effective than guided exposure for reducing body discomfort within and between sessions. Pure mirror exposure, based on the traditional extinction paradigm, led to strong emotional activation followed by a fast decrease in emotional reactivity. Copyright © 2011 Elsevier Ltd. All rights reserved.

Guiding principles and clinical applications for speech-language pathology practice in early intervention.

PubMed

Paul, Diane; Roth, Froma P

2011-07-01

This article describes guiding principles in early intervention (EI) and demonstrates how speech-language pathologists (SLPs) can apply these principles to best serve infants and toddlers with communication and related problems and their families. Four principles guide the implementation of speech-language pathology services. EI services are services that are (a) family centered and culturally and linguistically responsive; (b) developmentally supportive, promoting children's participation in their natural environments; (c) comprehensive, coordinated, and team based; and (d) based on the highest quality evidence available. Actual clinical scenarios are presented to illustrate each principle. The four principles provide a framework for the wide range of roles and responsibilities assumed by SLPs in EI: (a) screening/evaluation/assessment, (b) goal setting and intervention, (c) consultation with and education for team members, (d) service coordination, (e) transition planning, and (f) advocacy. It is critical that families of infants and toddlers who are at risk for, or who have been diagnosed with, communication disorders receive all necessary services and supports. EI services should be tailored to the individual and the changing needs, preferences, and priorities of each family. The earlier services are provided, the more likely is the child's chance to develop effective communication.

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

PubMed

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

2016-01-01

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

Information without Implementation: A Practical Example for Developing a Best Practice Education Control Group.

PubMed

Balderson, Benjamin H; McCurry, Susan M; Vitiello, Michael V; Shortreed, Susan M; Rybarczyk, Bruce D; Keefe, Francis J; Korff, Michael Von

2016-01-01

This article considers methodology for developing an education-only control group and proposes a simple approach to designing rigorous and well-accepted control groups. This approach is demonstrated in a large randomized trial. The Lifestyles trial (n = 367) compared three group interventions: (a) cognitive-behavioral treatment (CBT) for osteoarthritis pain, (b) CBT for osteoarthritis pain and insomnia, and (c) education-only control (EOC). EOC emulated the interventions excluding hypothesized treatment components and controlling for nonspecific treatment effects. Results showed this approach resulted in a control group that was highly credible and acceptable to patients. This approach can be an effective and practical guide for developing high-quality control groups in trials of behavioral interventions.

Gathering time-series data for evaluating behavior-change campaigns in developing countries: reactivity of diaries and interviews.

PubMed

Tobias, Robert; Inauen, Jennifer

2010-10-01

Gathering time-series data of behaviors and psychological variables is important to understand, guide, and evaluate behavior-change campaigns and other change processes. However, repeated measurement can affect the phenomena investigated, particularly frequent face-to-face interviews, which are often the only option in developing countries. This article presents three intervention control studies to investigate this issue. Daily diaries in Cuba did not affect behavior or attitudes for persons with intervention but reduced attitudes for persons without intervention. Reactivity of face-to-face interviews in Bolivia was negligible if applied weekly, but strong if applied twice per week. The article concludes with recommendations for gathering time-series data in developing countries.

The Use of Guided Imagery as an Intervention in Addressing Nonsuicidal Self-Injury

ERIC Educational Resources Information Center

Kress, Victoria E.; Adamson, Nicole; DeMarco, Carrie; Paylo, Matthew J.; Zoldan, Chelsey A.

2013-01-01

This article presents guided imagery as an intervention that can be used to address clients' nonsuicidal self-injurious behaviors. Guided imagery is a behavioral therapy technique that involves the use of positive thoughts or images to regulate negative emotional experiences, and it can be used to prevent and manage impulses to self-injure.…

Magnetic resonance-compatible robotic and mechatronics systems for image-guided interventions and rehabilitation: a review study.

PubMed

Tsekos, Nikolaos V; Khanicheh, Azadeh; Christoforou, Eftychios; Mavroidis, Constantinos

2007-01-01

The continuous technological progress of magnetic resonance imaging (MRI), as well as its widespread clinical use as a highly sensitive tool in diagnostics and advanced brain research, has brought a high demand for the development of magnetic resonance (MR)-compatible robotic/mechatronic systems. Revolutionary robots guided by real-time three-dimensional (3-D)-MRI allow reliable and precise minimally invasive interventions with relatively short recovery times. Dedicated robotic interfaces used in conjunction with fMRI allow neuroscientists to investigate the brain mechanisms of manipulation and motor learning, as well as to improve rehabilitation therapies. This paper gives an overview of the motivation, advantages, technical challenges, and existing prototypes for MR-compatible robotic/mechatronic devices.

[Interventional Radiology for Intra-Abdominal Abscess after Gastrectomy].

PubMed

Matsuura, Norihiro; Fujitani, Kazumasa; Kawada, Junji; Nishikawa, Kazuhiro; Nakatsuka, Rie; Miyazaki, Susumu; Danno, Katsuki; Motoori, Masaaki; Kubota, Masaru; Matsuda, Chu; Yoshida, Hiroshi; Iwase, Kazuhiro; Tanaka, Yasuhiro

2015-11-01

Approximately 20% of patients develop some complications after gastrectomy. These complications should be treated appropriately to achieve a positive outcome. The records of 6 patients with postoperative intra-abdominal abscesses treated with interventional radiology (IVR) were analyzed. The cause of abscess was anastomotic leakage in 4 patients and contaminated surgery after gastric perforation in 2 patients. Intra-abdominal abscesses were detected on postoperative day 12 (median), and an IVR-guided drainage tube was inserted with a median interval of 1 day. The drainage tube was kept in place for 26 days (median), and patients were discharged 6.5 days (median) after drainage tube removal. No patients were converted to open surgery. Early IVR-guided drainage was essential and effective for intra-abdominal abscess treatment after gastrectomy.

Towards interruption of schistosomiasis transmission in sub-Saharan Africa: developing an appropriate environmental surveillance framework to guide and to support 'end game' interventions.

PubMed

Stothard, J Russell; Campbell, Suzy J; Osei-Atweneboana, Mike Y; Durant, Timothy; Stanton, Michelle C; Biritwum, Nana-Kwadwo; Rollinson, David; Ombede, Dieudonné R Eloundou; Tchuem-Tchuenté, Louis-Albert

2017-01-14

Schistosomiasis is a waterborne parasitic disease in sub-Saharan Africa, particularly common in rural populations living in impoverished conditions. With the scale-up of preventive chemotherapy, national campaigns will transition from morbidity- to transmission-focused interventions thus formal investigation of actual or expected declines in environmental transmission is needed as 'end game' scenarios arise. Surprisingly, there are no international or national guidelines to do so in sub-Saharan Africa. Our article therefore provides an introduction to key practicalities and pitfalls in the development of an appropriate environmental surveillance framework. In this context, we discuss how strategies need to be adapted and tailored to the local level to better guide and support future interventions through this transition. As detection of egg-patent infection in people becomes rare, careful sampling of schistosome larvae in freshwater and in aquatic snails with robust species-specific DNA assays will be required. Appropriate metrics, derived from observed prevalence(s) as compared with predetermined thresholds, could each provide a clearer insight into contamination- and exposure-related dynamics. Application could be twofold, first to certify areas currently free from schistosomiasis transmission or second to red-flag recalcitrant locations where extra effort or alternative interventions are needed.

The Guide to Community Preventive Services and Disability Inclusion.

PubMed

Hinton, Cynthia F; Kraus, Lewis E; Richards, T Anne; Fox, Michael H; Campbell, Vincent A

2017-12-01

Approximately 40 million people in the U.S. identify as having a serious disability, and people with disabilities experience many health disparities compared with the general population. The Guide to Community Preventive Services (The Community Guide) identifies evidence-based programs and policies recommended by the Community Preventive Services Task Force (Task Force) to promote health and prevent disease. The Community Guide was assessed to answer the questions: are Community Guide public health intervention recommendations applicable to people with disabilities, and are adaptations required? An assessment of 91 recommendations from The Community Guide was conducted for 15 health topics by qualitative analysis involving three data approaches: an integrative literature review (years 1980-2011), key informant interviews, and focus group discussion during 2011. Twenty-six recommended interventions would not need any adaptation to be of benefit to people with disabilities. Forty-one recommended interventions could benefit from adaptations in communication and technology; 33 could benefit from training adaptations; 31 from physical accessibility adaptations; and 16 could benefit from other adaptations, such as written policy changes and creation of peer support networks. Thirty-eight recommended interventions could benefit from one or more adaptations to enhance disability inclusion. As public health and healthcare systems implement Task Force recommendations, identifying and addressing barriers to full participation for people with disabilities is important so that interventions reach the entire population. With appropriate adaptations, implementation of recommendations from The Community Guide could be successfully expanded to address the needs of people with disabilities. Published by Elsevier Inc.

Development of a chronic disease management program for stroke survivors using intervention mapping: The Stroke Coach

PubMed Central

Sakakibara, Brodie M.; Lear, Scott A.; Barr, Susan I.; Benavente, Oscar; Goldsmith, Charlie H.; Silverberg, Noah D.; Yao, Jennifer; Eng, Janice J.

2018-01-01

Objective To describe the systematic development of the Stroke Coach, a theory- and evidence-based intervention to improve control of lifestyle behaviour risk factors in stroke patients. Design Intervention development. Setting Community. Participants Individuals who have had a stroke. Intervention We used Intervention Mapping to guide the development of the Stroke Coach. Intervention Mapping is a systematic process used for intervention development and comprised of steps that progress from the integration of theory and evidence to the organization of realistic strategies to facilitate the development of a practical intervention supported by empirical evidence. Social Cognitive Theory was the underlying premise for behaviour change, while Control Theory methods were directed towards sustaining the changes to ensure long-term health benefits. Practical evidence-based strategies were linked to behavioural determinants to improve stroke risk factor control. Main outcome measures Not applicable. Results The Stroke Coach is a patient-centred, community-based, telehealth intervention to promote healthy lifestyles after stroke. Over six months, participants receive seven 30 to 60 minute telephone sessions with a lifestyle coach who provides education, facilitates motivation for lifestyle modification, and empowers participants to self-management their stroke risk factors. Participants also receive a self-management manual and a self-monitoring kit. Conclusion Through the use of Intervention Mapping we developed a theoretically sound and evidence-grounded intervention to improve risk factor control in stroke patients. If empirical evaluation of the Stroke Coach produces positive results, the next step will be to develop an implementation intervention to ensure successful uptake and delivery of the program in community and outpatient settings. PMID:28219685

A randomized controlled pilot study feasibility of a tablet-based guided audio-visual relaxation intervention for reducing stress and pain in adults with sickle cell disease.

PubMed

Ezenwa, Miriam O; Yao, Yingwei; Engeland, Christopher G; Molokie, Robert E; Wang, Zaijie Jim; Suarez, Marie L; Wilkie, Diana J

2016-06-01

To test feasibility of a guided audio-visual relaxation intervention protocol for reducing stress and pain in adults with sickle cell disease. Sickle cell pain is inadequately controlled using opioids, necessitating further intervention such as guided relaxation to reduce stress and pain. Attention-control, randomized clinical feasibility pilot study with repeated measures. Randomized to guided relaxation or control groups, all patients recruited between 2013-2014 during clinical visits, completed stress and pain measures via a Galaxy Internet-enabled Android tablet at the Baseline visit (pre/post intervention), 2-week posttest visit and also daily at home between the two visits. Experimental group patients were asked to use a guided relaxation intervention at the Baseline visit and at least once daily for 2 weeks. Control group patients engaged in a recorded sickle cell discussion at the Baseline visit. Data were analysed using linear regression with bootstrapping. At baseline, 27/28 of consented patients completed the study protocol. Group comparison showed that guided relaxation significantly reduced current stress and pain. At the 2-week posttest, 24/27 of patients completed the study, all of whom reported liking the study. Patients completed tablet-based measures on 71% of study days (69% in control group, 72% in experiment group). At the 2-week posttest, the experimental group had significantly lower composite pain index scores, but the two groups did not differ significantly on stress intensity. This study protocol appears feasible. The tablet-based guided relaxation intervention shows promise for reducing sickle cell pain and warrants a larger efficacy trial. The ClinicalTrials.gov Identifier is: NCT02501447. © 2016 John Wiley & Sons Ltd.

Workflow and intervention times of MR-guided focused ultrasound - Predicting the impact of new techniques.

PubMed

Loeve, Arjo J; Al-Issawi, Jumana; Fernandez-Gutiérrez, Fabiola; Langø, Thomas; Strehlow, Jan; Haase, Sabrina; Matzko, Matthias; Napoli, Alessandro; Melzer, Andreas; Dankelman, Jenny

2016-04-01

Magnetic resonance guided focused ultrasound surgery (MRgFUS) has become an attractive, non-invasive treatment for benign and malignant tumours, and offers specific benefits for poorly accessible locations in the liver. However, the presence of the ribcage and the occurrence of liver motion due to respiration limit the applicability MRgFUS. Several techniques are being developed to address these issues or to decrease treatment times in other ways. However, the potential benefit of such improvements has not been quantified. In this research, the detailed workflow of current MRgFUS procedures was determined qualitatively and quantitatively by using observation studies on uterine MRgFUS interventions, and the bottlenecks in MRgFUS were identified. A validated simulation model based on discrete events simulation was developed to quantitatively predict the effect of new technological developments on the intervention duration of MRgFUS on the liver. During the observation studies, the duration and occurrence frequencies of all actions and decisions in the MRgFUS workflow were registered, as were the occurrence frequencies of motion detections and intervention halts. The observation results show that current MRgFUS uterine interventions take on average 213min. Organ motion was detected on average 2.9 times per intervention, of which on average 1.0 actually caused a need for rework. Nevertheless, these motion occurrences and the actions required to continue after their detection consumed on average 11% and up to 29% of the total intervention duration. The simulation results suggest that, depending on the motion occurrence frequency, the addition of new technology to automate currently manual MRgFUS tasks and motion compensation could potentially reduce the intervention durations by 98.4% (from 256h 5min to 4h 4min) in the case of 90% motion occurrence, and with 24% (from 5h 19min to 4h 2min) in the case of no motion. In conclusion, new tools were developed to predict how intervention durations will be affected by future workflow changes and by the introduction of new technology. Copyright © 2016 Elsevier Inc. All rights reserved.

Enhancing the Effectiveness of Smoking Treatment Research: Conceptual Bases and Progress

PubMed Central

Baker, Timothy B.; Collins, Linda M.; Mermelstein, Robin; Piper, Megan E.; Schlam, Tanya R.; Cook, Jessica W.; Bolt, Daniel M.; Smith, Stevens S.; Jorenby, Douglas E.; Fraser, David; Loh, Wei-Yin; Theobald, Wendy E.; Fiore, Michael C.

2015-01-01

Background and aims A chronic care strategy could potentially enhance the reach and effectiveness of smoking treatment by providing effective interventions for all smokers, including those who are initially unwilling to quit. This paper describes the conceptual bases of a National Cancer Institute-funded research program designed to develop an optimized, comprehensive, chronic care smoking treatment. Methods This research is grounded in three methodological approaches: 1) the Phase-Based Model, which guides the selection of intervention components to be experimentally evaluated for the different phases of smoking treatment (motivation, preparation, cessation, and maintenance); 2) the Multiphase Optimization Strategy (MOST), which guides the screening of intervention components via efficient experimental designs and, ultimately, the assembly of promising components into an optimized treatment package; and 3) pragmatic research methods, such as electronic health record recruitment, that facilitate the efficient translation of research findings into clinical practice. Using this foundation and working in primary care clinics, we conducted three factorial experiments (reported in three accompanying articles) to screen 15 motivation, preparation, cessation, and maintenance phase intervention components for possible inclusion in a chronic care smoking treatment program. Results This research identified intervention components with relatively strong evidence of effectiveness at particular phases of smoking treatment and it demonstrated the efficiency of the MOST approach in terms both of the number of intervention components tested and of the richness of the information yielded. Conclusions A new, synthesized research approach efficiently evaluates multiple intervention components to identify promising components for every phase of smoking treatment. Many intervention components interact with one another, supporting the use of factorial experiments in smoking treatment development. PMID:26581974

Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia).

PubMed

Beauchamp, Alison; Batterham, Roy W; Dodson, Sarity; Astbury, Brad; Elsworth, Gerald R; McPhee, Crystal; Jacobson, Jeanine; Buchbinder, Rachelle; Osborne, Richard H

2017-03-03

The need for healthcare strengthening to enhance equity is critical, requiring systematic approaches that focus on those experiencing lesser access and outcomes. This project developed and tested the Ophelia (OPtimising HEalth LIteracy and Access) approach for co-design of interventions to improve health literacy and equity of access. Eight principles guided this development: Outcomes focused; Equity driven, Needs diagnosis, Co-design, Driven by local wisdom, Sustainable, Responsive and Systematically applied. We report the application of the Ophelia process where proof-of-concept was defined as successful application of the principles. Nine sites were briefed on the aims of the project around health literacy, co-design and quality improvement. The sites were rural/metropolitan, small/large hospitals, community health centres or municipalities. Each site identified their own priorities for improvement; collected health literacy data using the Health Literacy Questionnaire (HLQ) within the identified priority groups; engaged staff in co-design workshops to generate ideas for improvement; developed program-logic models; and implemented their projects using Plan-Do-Study-Act (PDSA) cycles. Evaluation included assessment of impacts on organisations, practitioners and service users, and whether the principles were applied. Sites undertook co-design workshops involving discussion of service user needs informed by HLQ (n = 813) and interview data. Sites generated between 21 and 78 intervention ideas and then planned their selected interventions through program-logic models. Sites successfully implemented interventions and refined them progressively with PDSA cycles. Interventions generally involved one of four pathways: development of clinician skills and resources for health literacy, engagement of community volunteers to disseminate health promotion messages, direct impact on consumers' health literacy, and redesign of existing services. Evidence of application of the principles was found in all sites. The Ophelia approach guided identification of health literacy issues at each participating site and the development and implementation of locally appropriate solutions. The eight principles provided a framework that allowed flexible application of the Ophelia approach and generation of a diverse set of interventions. Changes were observed at organisational, staff, and community member levels. The Ophelia approach can be used to generate health service improvements that enhance health outcomes and address inequity of access to healthcare.

Designing for Clinical Change: Creating an Intervention to Implement New Statin Guidelines in a Primary Care Clinic.

PubMed

DeJonckheere, Melissa; Robinson, Claire H; Evans, Lindsey; Lowery, Julie; Youles, Bradley; Tremblay, Adam; Kelley, Caitlin; Sussman, Jeremy B

2018-04-24

Recent clinical practice guidelines from major national organizations, including a joint United States Department of Veterans Affairs (VA) and Department of Defense (DoD) committee, have substantially changed recommendations for the use of the cholesterol-lowering statin medications after years of relative stability. Because statin medications are among the most commonly prescribed treatments in the United States, any change in their use may have significant implications for patients and providers alike. Prior research has shown that effective implementation interventions should be both user centered and specifically chosen to address identified barriers. The objectives of this study were to identify potential determinants of provider uptake of the new statin guidelines and to use that information to tailor a coordinated and streamlined local quality improvement intervention focused on prescribing appropriate statins. We employed user-centered design principles to guide the development and testing of a multicomponent guideline implementation intervention to improve statin prescribing. This paper describes the intervention development process whereby semistructured qualitative interviews with providers were conducted to (1) illuminate the knowledge, attitudes, and behaviors of providers and (2) elicit feedback on intervention prototypes developed to align with and support the use of the VA/DoD guidelines. Our aim was to use this information to design a local quality improvement intervention focused on statin prescribing that was tailored to the needs of primary care providers at our facility. Cabana's Clinical Practice Guidelines Framework for Improvement and Nielsen's Usability Heuristics were used to guide the analysis of data obtained in the intervention development process. Semistructured qualitative interviews were conducted with 15 primary care Patient Aligned Care Team professionals (13 physicians and 2 clinical pharmacists) at a single VA medical center. Findings highlight that providers were generally comfortable with the paradigm shift to risk-based guidelines but less clear on the need for the VA/DoD guidelines in specific. Providers preferred a clinical decision support tool that helped them calculate patient risk and guide their care without limiting autonomy. They were less comfortable with risk communication and performance measurement systems that do not account for shared decision making. When possible, we incorporated their recommendations into the intervention. By combining qualitative methods and user-centered design principles, we could inform the design of a multicomponent guideline implementation intervention to better address the needs and preferences of providers, including clear and direct language, logical decision prompts with an option to dismiss a clinical decision support tool, and logical ordering of feedback information. Additionally, this process allowed us to identify future design considerations for quality improvement interventions. ©Melissa DeJonckheere, Claire H Robinson, Lindsey Evans, Julie Lowery, Bradley Youles, Adam Tremblay, Caitlin Kelley, Jeremy B Sussman. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 24.04.2018.

Nursing Empowerment, Workplace Environment, and Job Satisfaction in Nurses Employed in an Academic Health Science Center.

PubMed

Kretzschmer, Shari; Walker, Mandi; Myers, John; Vogt, Krista; Massouda, Jessica; Gottbrath, Deidra; Pritchett, Melissa; Stikes, Reetta; Logsdon, M Cynthia

The aim of this study was to test predictors of nursing empowerment and job satisfaction in nurses. Nursing professional development leaders and Magnet® coordinators need foundational data on which to build interventions that will support and empower nurses on the journey toward American Nurses Credentialing Center Magnet® designation. Secondary data analysis methods were used. Overall, nurses perceived that they had moderate empowerment and were satisfied with their jobs. Study results support predicted relationships and can be used to guide interventions for, and development of, nurses.

A Talent for Tinkering: Developing Talents in Children from Low-Income Households through Engineering Curriculum

ERIC Educational Resources Information Center

Robinson, Ann; Adelson, Jill L.; Kidd, Kristy A.; Cunningham, Christine M.

2018-01-01

Guided by the theoretical framework of curriculum as a platform for talent development, this quasi-experimental field study investigated an intervention focused on engineering curriculum and curriculum based on a biography of a scientist through a comparative design implemented in low-income schools. Student outcome measures included science…

A Primer for the Design of Practice Manuals: Four Stages of Development

ERIC Educational Resources Information Center

Galinsky, Maeda J.; Fraser, Mark W.; Day, Steven H.; Richman, Jack M.

2013-01-01

Treatment manuals are increasingly being used to guide interventions with individuals, families, groups, organizations, and communities. However, little is known about best practices in designing manuals. We describe a process that provides for the development of manuals and specifies the means by which manuals can be adapted for practice…

Youth Suicide: A Prevention, Intervention, and Postvention Guide for Public Schools.

ERIC Educational Resources Information Center

Texas Education Agency, Austin.

Part of the purpose of public schooling is to help children develop into productive adults who responsibly participate in a democratic community. The prevention of suicide is critical to the accomplishment of this purpose. Suicide prevention includes the development of policies and procedures that address enhancing school climate, developing…

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

ERIC Educational Resources Information Center

Arulmani, G.

2011-01-01

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

Day Care and Intervention Programs for Infants.

ERIC Educational Resources Information Center

Haith, Marshall M.

This guide represents an attempt to organize the available literature on day care programs currently in operation or in the proposal stage for infants under two years of age. Special emphases are placed on program goals for psychological development in the first two years, the curricula which have been developed to accomplish these goals, and the…

The Role of Peer Guided Play for Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Papacek, Amy M.

2015-01-01

Childhood play has a well-established role in the development of social and cognitive skills that may have important implications for intervention with children with autism spectrum disorder (ASD). Yet, social and language skills of children with ASD are developmentally different from those of typically developing children, although these…

"I need to hear from women who have 'been there'": Developing a woman-focused intervention for drug use and partner violence in the emergency department.

PubMed

Choo, Esther; Guthrie, K Morrow; Mello, Michael; Wetle, Terrie F; Ranney, Megan; Tapé, Chantal; Zlotnick, Caron

2016-04-01

Addressing violence and linking women to community services in parallel with drug change goals is critical for women with coexisting intimate partner violence (IPV) and substance use disorders (SUD). Our objective was to develop a Web-based intervention to address violence and drug use among women patients in the ED. The intervention was developed in a five-step process: 1) Initial intervention development based on selected theoretical frameworks; 2) In-depth interviews with the target population; 3) Intervention adaptation, with iterative feedback from further interviews; 4) Beta testing and review by an advisory committee of domestic violence advocates; 5) Acceptability and feasibility testing in a small open trial. Themes supported the selection of MI and empowerment models but also guided major adaptations to the intervention, including the introduction of videos and a more robust booster phone call. Participants in the open trial reported high scores for satisfaction, usability, and consistency with essential elements of motivational interviewing. This qualitative work with our target population of women in the ED with SUD experiencing IPV underscored the importance of connection to peers and empathetic human contact. We developed an acceptable and feasible intervention distinct from prior ED-based brief interventions for substance-using populations.

Using Intervention Mapping to Develop Health Education Components to Increase Colorectal Cancer Screening in Puerto Rico.

PubMed

Serra, Yolanda A; Colón-López, Vivian; Savas, Lara S; Vernon, Sally W; Fernández-Espada, Natalie; Vélez, Camille; Ayala, Alelí; Fernández, María E

2017-01-01

Colorectal cancer (CRC) is a leading cause of cancer-related mortality in Puerto Rico (PR). Although largely preventable through screening and treatment of precancerous polyps, CRC screening rates in PR remain low while CRC incidence and mortality continue to increase. We used intervention mapping (IM), a systematic framework using theory and evidence to plan a health promotion intervention to increase colorectal cancer screening (CRCS) among Puerto Rican adults 50 years and older who are patients of Federally Qualified Health Centers (FQHCs) in PR. To inform the development of a logic model of the problem during the needs assessment phase, we determined the CRC incidence and mortality rates in PR using recent data from the PR Cancer Registry, conducted a literature review to better understand behavioral and environmental factors influencing CRC among Hispanics in general and in Puerto Ricans, and collected new data. We conducted seven focus groups to identify community needs and resources, specific sub-behaviors related to CRCS (performance objectives) and the determinants of CRCS. We then developed matrices of change objectives that would guide the content, behavioral change method selection, and the practical applications that would be included in the program. We selected two overarching methods: entertainment education and behavioral journalism and developed practical applications, materials, and messages containing several other methods including modeling, persuasion, information, and tailoring. We developed and pretested a Tailored Interactive Multimedia Intervention, newsletter, an action plan, and supplemental print materials for patients. We also developed a patient mediated provider prompt to increase provider recommendation and improve patient provider communication. The use of IM for systematic planning produced a detailed coherent plan for the CRCS educational intervention. Guided by IM processes, steps, and tasks, we used community level information, existing literature, theory, and new data to develop health education materials that were well received by the priority population and will likely increase CRCS among FQHC patients in PR.

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

PubMed

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

2015-10-01

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

Effect of a newly-devised nutritional guide based on self-efficacy for patients with type 2 diabetes in Japan over 2 years: 1-year intervention and 1-year follow-up studies.

PubMed

Yamamoto, Takuya; Moyama, Shota; Yano, Hideki

2017-03-01

We devised a new system called "Educational Guidance" (E-Guide) for nutritional education based on self-efficacy. The present study aimed to examine the effects of E-Guide use on glycemic control among patients with type 2 diabetes. We carried out an interventional and observational study that included 74 patients with type 2 diabetes. The extent of glycemic control in the 39 patients who received guidance through the E-Guide (E-Guide group) was compared with that of 35 patients who received conventional nutritional guidance (control group). We carried out a 1-year follow-up survey (subanalysis) based on the electronic health records of 18 patients from the E-guide group and 19 patients from the control group. These patients continued treatment at Hikone Municipal Hospital, Hikone, Shiga, Japan. Changes in glycated hemoglobin levels, body mass index and medication dose were examined from time of enrollment to the end of the 1-year intervention, and during the 1-year follow-up. Decreases in glycated hemoglobin levels were more pronounced in the E-Guide group than in the control group during the intervention period (P < 0.05). The levels further decreased during the follow-up period (P < 0.01). In the E-Guide group, body mass index decreased significantly throughout the follow-up period (P < 0.001). Additionally, increased medication doses were significantly less common in the E-Guide group than in the control group (P < 0.01). Intervention based on our "E-Guide" is more useful and powerful than the conventional methods for glycemic control and self-care behavior among patients with type 2 diabetes in Japan. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Growing: Birth to Three. Piecing It All Together.

ERIC Educational Resources Information Center

Doan-Sampon, Mary Anne; And Others

This guide is one part of a set of materials designed to support an ecological intervention system for families and their special needs children between birth and three. The system is constructed on four premises: (1) intervention is guided by the family; (2) parent-child interactions are the heart of early intervention; (3) family rituals, daily…

Safety of pediatric percutaneous liver biopsy performed by interventional radiologists.

PubMed

Potter, Carol; Hogan, Mark J; Henry-Kendjorsky, Katherine; Balint, Jane; Barnard, John A

2011-08-01

National data suggest that pediatric percutaneous liver biopsy is increasingly being performed by interventional radiologists rather than pediatric gastroenterologists. The objective of the present report is to describe the safety and effectiveness of percutaneous liver biopsy performed by interventional radiologists in a large cohort of children and to compare the results with the existing literature on biopsies performed by pediatric gastroenterologists. The medical records of 249 children undergoing ultrasound-guided percutaneous liver biopsy by interventional radiologists were reviewed for adverse events and success of obtaining tissue. Two hundred ninety-four biopsies were reviewed. There were no deaths. There were 2 instances of a 2-g or greater drop in hemoglobin following biopsy, neither of which was associated with clinical signs of hemorrhage. A small, asymptomatic pneumothorax quickly resolved without treatment. One patient developed Klebsiella sepsis 48  hours after biopsy. In all but 1 case, an adequate sample size was obtained. This low incidence of adverse events compares favorably with existing published reports of morbidity and mortality following percutaneous liver biopsy performed by pediatric gastroenterologists. Ultrasound-guided percutaneous liver biopsy performed by experienced pediatric interventional radiologists in a children's hospital setting is as safe and effective as biopsy performed by pediatric gastroenterologists.

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research

PubMed Central

Carter-Harris, Lisa; Davis, Lorie L.; Rawl, Susan M.

2017-01-01

Purpose To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. Methods Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. Results Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. Conclusion This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development. PMID:28304262

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research.

PubMed

Carter-Harris, Lisa; Davis, Lorie L; Rawl, Susan M

2016-11-01

To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development.

Promoting community practitioners' use of evidence-based approaches to increase breast cancer screening.

PubMed

Leeman, Jennifer; Moore, Alexis; Teal, Randall; Barrett, Nadine; Leighton, Ashely; Steckler, Allan

2013-07-01

Many women do not get mammography screenings at the intervals recommended for early detection and treatment of breast cancer. The Guide to Community Preventive Services (Community Guide) recommends a range of evidence-based strategies to improve mammography rates. However, nurses and others working in community-based settings make only limited use of these strategies. We report on a dissemination intervention that partnered the University of North Carolina with the Susan G. Komen Triangle Affiliate to disseminate Community Guide breast cancer screening strategies to community organizations. The intervention was guided by social marketing and diffusion of innovation theory and was designed to provide evidence and support via Komen's existing relationships with grantee organizations. The present study reports the findings from a formative evaluation of the intervention, which included a content analysis of 46 grant applications pre- and post intervention and focus groups with 20 grant recipients. © 2013 Wiley Periodicals, Inc.

Health is Power: an ecological, theory-based health intervention for women of color.

PubMed

Lee, Rebecca E; Medina, Ashley V; Mama, Scherezade K; Reese-Smith, Jacqueline Y; O'Connor, Daniel P; Brosnan, Marcella; Cubbin, Catherine; McMillan, Tracy; Estabrooks, Paul A

2011-11-01

Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. This manuscript describes the rationale, design and methodology of Health Is Power (HIP), a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity and improve dietary habits in African American and Hispanic or Latina women in Houston and Austin, Texas. The intervention development was guided by group dynamics principles anchored within an ecologic model. Women participated in three health assessments and a six month face to face intervention that included evidence-based behavioral methods - integrated into strategies to promote group cohesion - framed to account for environmental factors contributing to health disparities. Women participated in team building activities, environmental mapping exercises, and supervised walks or taste tests. Neighborhood contextual and environmental measures are described to test ecologic factors that may contribute to behavioral maintenance. Theoretically guided interventions that account for multiple levels of influence in behavior initiation and maintenance stand to improve health outcomes in vulnerable populations. Copyright © 2011 Elsevier Inc. All rights reserved.

Health Is Power: an Ecological Theory-based Health Intervention for Women of Color

PubMed Central

Lee, Rebecca E.; Medina, Ashley V.; Mama, Scherezade K.; Reese-Smith, Jacqueline Y.; O’Connor, Daniel P.; Brosnan, Marcella; Cubbin, Catherine; McMillan, Tracy; Estabrooks, Paul A.

2011-01-01

Objective Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. This manuscript describes the rationale, design and methodology of Health Is Power (HIP), a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity and improve dietary habits in African American and Hispanic or Latina women in Houston and Austin, Texas. Methods The intervention development was guided by group dynamics principles anchored within an ecologic model. Results Women participated in three health assessments and a six month face to face intervention that included evidence-based behavioral methods—integrated into strategies to promote group cohesion—framed to account for environmental factors contributing to health disparities. Women participated in team building activities, environmental mapping exercises, and supervised walks or taste tests. Conclusions Neighborhood contextual and environmental measures are described to test ecologic factors that may contribute to behavioral maintenance. Theoretically guided interventions that account for multiple levels of influence in behavior initiation and maintenance stand to improve health outcomes in vulnerable populations. PMID:21782975

Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials

PubMed Central

Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

2015-01-01

Objectives Total knee replacement can be a successful operation for pain relief. However, 10–34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. Setting We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Participants Adult patients receiving total knee replacement. Interventions Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Primary and secondary outcome measures Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. Results No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Conclusions Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. PMID:25967998

A Systematic Review of CPAP Adherence Across Age Groups: Clinical and Empiric Insights for Developing CPAP Adherence Interventions

PubMed Central

Sawyer, A.M.; Gooneratne, N.; Marcus, C.L.; Ofer, D.; Richards, K.C.; Weaver, T.E.

2011-01-01

Continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA) but adherence to the treatment limits its overall effectiveness across all age groups of patients. Factors that influence adherence to CPAP include disease and patient characteristics, treatment titration procedures, technological device factors and side effects, and psychological and social factors. These influential factors have guided the development of interventions to promote CPAP adherence. Various intervention strategies have been described and include educational, technological, psychosocial, pharmacological, and multi-dimensional approaches. Though evidence to date has led to innovative strategies that address adherence in CPAP-treated children, adults, and older adults, significant opportunities exist to develop and test interventions that are clinically applicable, specific to subgroups of patients likely to demonstrate poor adherence, and address the multifactorial nature of CPAP adherence. The translation of CPAP adherence promotion interventions to clinical practice is imperative to improve health and functional outcomes in all persons with CPAP-treated OSA. PMID:21652236

CT-guided robotically-assisted infiltration of foot and ankle joints.

PubMed

Wiewiorski, Martin; Valderrabano, Victor; Kretzschmar, Martin; Rasch, Helmut; Markus, Tanja; Dziergwa, Severine; Kos, Sebastian; Bilecen, Deniz; Jacob, Augustinus Ludwig

2009-01-01

It was our aim to describe a CT-guided robotically-assisted infiltration technique for diagnostic injections in foot and ankle orthopaedics. CT-guided mechatronically-assisted joint infiltration was performed on 16 patients referred to the orthopaedic department for diagnostic foot and ankle assessment. All interventions were performed using an INNOMOTION-assistance device on a multislice CT scanner in an image-guided therapy suite. Successful infiltration was defined as CT localization of contrast media in the target joint. Additionally, pre- and post-interventional VAS pain scores were assessed. All injections (16/16 joints) were technically successful. Contrast media deposit was documented in all targeted joints. Significant relief of pain was noted by all 16 patients (p<0.01). CT-guided robotically-assisted intervention is an exact, reliable and safe application method for diagnostic infiltration of midfoot and hindfoot joints. The high accuracy and feasibility in a clinical environment make it a viable alternative to the commonly used fluoroscopic-guided procedures.

A cluster randomized theory-guided oral hygiene trial in adolescents-A latent growth model.

PubMed

Aleksejūnienė, J; Brukienė, V

2018-05-01

(i) To test whether theory-guided interventions are more effective than conventional dental instruction (CDI) for changing oral hygiene in adolescents and (ii) to examine whether such interventions equally benefit both genders and different socio-economic (SES) groups. A total of 244 adolescents were recruited from three schools, and cluster randomization allocated adolescents to one of the three types of interventions: two were theory-based interventions (Precaution Adoption Process Model or Authoritative Parenting Model) and CDI served as an active control. Oral hygiene levels % (OH) were assessed at baseline, after 3 months and after 12 months. A complete data set was available for 166 adolescents (the total follow-up rate: 69%). There were no significant differences in baseline OH between those who participated throughout the study and those who dropped out. Bivariate and multivariate analyses showed that theory-guided interventions produced significant improvements in oral hygiene and that there were no significant gender or socio-economic differences. Theory-guided interventions produced more positive changes in OH than CDI, and these changes did not differ between gender and SES groups. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Research into Theory into Practice: An Overview of Family Based Interventions for Child Antisocial Behavior Developed at the Oregon Social Learning Center

PubMed Central

Fisher, Philip A.; Gilliam, Kathryn S.

2017-01-01

Although many psychotherapeutic approaches exist for treating troubled children and their families, not all have been evaluated to be effective through research. Moreover, among those that have been determined to be “evidence-based,” few have followed as coherent and rigorous a path of rigorous scientific investigation as the interventions that have been developed at the Oregon Social Learning Center. As such, these interventions serve as a model of “research to theory to practice” that may not only be employed to support families with children in need of treatment, but may also guide other programs of treatment development. This is the story of how this work has unfolded over the past four decades. PMID:29225459

An Evaluation of a Train-the-Trainer Workshop for Social Service Workers to Develop Community-Based Family Interventions.

PubMed

Lai, Agnes Y; Stewart, Sunita M; Mui, Moses W; Wan, Alice; Yew, Carol; Lam, Tai Hing; Chan, Sophia S

2017-01-01

Evaluation studies on train-the-trainer workshops (TTTs) to develop family well-being interventions are limited in the literature. The Logic Model offers a framework to place some important concepts and tools of intervention science in the hands of frontline service providers. This paper reports on the evaluation of a TTT for a large community-based program to enhance family well-being in Hong Kong. The 2-day TTT introduced positive psychology themes (relevant to the programs that the trainees would deliver) and the Logic Model (which provides a framework to guide intervention development and evaluation) for social service workers to guide their community-based family interventions. The effectiveness of the TTT was examined by self-administered questionnaires that assessed trainees' changes in learning (perceived knowledge, self-efficacy, attitude, and intention), trainees' reactions to training content, knowledge sharing, and benefits to their service organizations before and after the training and then 6 months and 1 year later. Missing data were replaced by baseline values in an intention-to-treat analysis. Focus group interviews were conducted approximately 6 months after training. Fifty-six trainees (79% women) joined the TTT. Forty-four and 31 trainees completed the 6-month and 1-year questionnaires, respectively. The trainees indicated that the workshop was informative and well organized. The TTT-enhanced trainees' perceived knowledge, self-efficacy, and attitudes toward the application of the Logic Model and positive psychology constructs in program design. These changes were present with small to large effect size that persisted to the 1 year follow-up. The skills learned were used to develop 31 family interventions that were delivered to about 1,000 families. Qualitative feedback supported the quantitative results. This TTT offers a practical example of academic-community partnerships that promote capacity among community social service workers. Goals included sharing basic tools of intervention development and evaluation, and the TTT offered, therefore, the potential of learning skills that extended beyond the lifetime of a single program. The research protocol was registered at the National Institutes of Health (identifier number: NCT01796275).

Using an intervention mapping approach to develop a discharge protocol for intensive care patients.

PubMed

van Mol, Margo; Nijkamp, Marjan; Markham, Christine; Ista, Erwin

2017-12-19

Admission into an intensive care unit (ICU) may result in long-term physical, cognitive, and emotional consequences for patients and their relatives. The care of the critically ill patient does not end upon ICU discharge; therefore, integrated and ongoing care during and after transition to the follow-up ward is pivotal. This study described the development of an intervention that responds to this need. Intervention Mapping (IM), a six-step theory- and evidence-based approach, was used to guide intervention development. The first step, a problem analysis, comprised a literature review, six semi-structured telephone interviews with former ICU-patients and their relatives, and seven qualitative roundtable meetings for all eligible nurses (i.e., 135 specialized and 105 general ward nurses). Performance and change objectives were formulated in step two. In step three, theory-based methods and practical applications were selected and directed at the desired behaviors and the identified barriers. Step four designed a revised discharge protocol taking into account existing interventions. Adoption, implementation and evaluation of the new discharge protocol (IM steps five and six) are in progress and were not included in this study. Four former ICU patients and two relatives underlined the importance of the need for effective discharge information and supportive written material. They also reported a lack of knowledge regarding the consequences of ICU admission. 42 ICU and 19 general ward nurses identified benefits and barriers regarding discharge procedures using three vignettes framed by literature. Some discrepancies were found. For example, ICU nurses were skeptical about the impact of writing a lay summary despite extensive evidence of the known benefits for the patients. ICU nurses anticipated having insufficient skills, not knowing the patient well enough, and fearing legal consequences of their writings. The intervention was designed to target the knowledge, attitudes, self-efficacy, and perceived social influence. Building upon IM steps one to three, a concept discharge protocol was developed that is relevant and feasible within current daily practice. Intervention mapping provided a comprehensive framework to improve ICU discharge by guiding the development process of a theory- and empirically-based discharge protocol that is robust and useful in practice.

[Image guided and robotic treatment--the advance of cybernetics in clinical medicine].

PubMed

Fosse, E; Elle, O J; Samset, E; Johansen, M; Røtnes, J S; Tønnessen, T I; Edwin, B

2000-01-10

The introduction of advanced technology in hospitals has changed the treatment practice towards more image guided and minimal invasive procedures. Modern computer and communication technology opens up for robot aided and pre-programmed intervention. Several robotic systems are in clinical use today both in microsurgery and in major cardiac and orthopedic operations. As this trend develops, professions which are new in this context such as physicists, mathematicians and cybernetic engineers will be increasingly important in the treatment of patients.

Conceptual Model of Research to Reduce Stigma Related to Mental Disorders in Adolescents

PubMed Central

Pinto-Foltz, Melissa D.; Logsdon, M. Cynthia

2010-01-01

Purpose: To explicate an initial conceptual model that is amenable to testing and guiding anti-stigma interventions with adolescents. Design/Sources Used: Multidisciplinary research and theoretical articles were reviewed. . Conclusions: The conceptual model may guide anti-stigma interventions, and undergo testing and refinement in the future to reflect scientific advances in stigma reduction among adolescents. Use of a conceptual model enhances empirical evaluation of anti-stigma interventions yielding a casual explanation for the intervention effects and enhances clinical applicability of interventions across settings. PMID:19916813

Reducing social inequities in health through settings-related interventions -- a conceptual framework.

PubMed

Shareck, Martine; Frohlich, Katherine L; Poland, Blake

2013-06-01

The creation of supportive environments for health is a basic action principle of health promotion, and equity is a core value. A settings approach offers an opportunity to bridge these two, with its focus on the interplay between individual, environmental and social determinants of health. We conducted a scoping review of the literature on theoretical bases and practical applications of the settings approach. Interventions targeting social inequities in health through action on various settings were analyzed to establish what is done in health equity research and action as it relates to settings. Four elements emerged as central to an equity-focused settings approach: a focus on social determinants of health, addressing the needs of marginalized groups, effecting change in a setting's structure, and involving stakeholders. Each came with related challenges. To offer potential solutions to these challenges we developed a conceptual framework that integrates theoretical and methodological approaches, along with six core guiding principles, into a 'settings praxis'. Reducing social inequities in health through the creation of supportive environments requires the application of the settings approach in an innovative way. The proposed conceptual framework can serve as a guide to do so, and help develop, implement and evaluate equity-focused settings-related interventions.

Metabolomics: Insulin Resistance and Type 2 Diabetes Mellitus

USDA-ARS?s Scientific Manuscript database

Type 2 diabetes mellitus (T2DM) develops over many years, providing an opportunity to consider early prognostic tools that guide interventions to thwart disease. Advancements in analytical chemistry enable quantitation of hundreds of metabolites in biofluids and tissues (metabolomics), providing in...

Recommendations and Guidance for Practice in Youth Tobacco Cessation

ERIC Educational Resources Information Center

Milton, Micah H.; Maule, Catherine O.; Backinger, Cathy L.; Gregory, Dena M.

2003-01-01

Objectives: To summarize recommendations from Youth Tobacco Cessation: A Guide for Making Informed Decisions for careful consideration, selection, implementation, and evaluation of youth cessation interventions. Methods: Recommendations were developed from an evidence review and consensus from a multidisciplinary advisory panel. Results:…

Development of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries.

PubMed

McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; López Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; Makleff, Shelly; Vandewiele, Marieka; Standaert, Sarah; Free, Caroline

2018-05-02

Unintended pregnancies can result in poorer health outcomes for women, children and families. Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions. There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours. This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan, Bolivia and Palestine, where unmet need for contraception is high among this group. Guided by Intervention Mapping, the following steps contributed to the development of the interventions: (1) needs assessment; (2) specifying behavioural change to result from the intervention; (3) selecting behaviour change methods to include in the intervention; (4) producing and refining the intervention content. The results of the needs assessment produced similar interventions across the countries. The interventions consist of short daily messages delivered over 4 months (delivered by text messaging in Palestine and mobile phone application instant messages in Bolivia and Tajikistan). The messages provide information about contraception, target attitudes that are barriers to contraceptive uptake and support young people in feeling that they can influence their reproductive health. The interventions each contain the same ten behaviour change methods, adapted for delivery by mobile phone. The development resulted in a well-specified, theory-based intervention, tailored to each country. It is feasible to develop an intervention delivered by mobile phone for young people in resource-limited settings.

An MRI-Compatible Robotic System With Hybrid Tracking for MRI-Guided Prostate Intervention

PubMed Central

Krieger, Axel; Iordachita, Iulian I.; Guion, Peter; Singh, Anurag K.; Kaushal, Aradhana; Ménard, Cynthia; Pinto, Peter A.; Camphausen, Kevin; Fichtinger, Gabor

2012-01-01

This paper reports the development, evaluation, and first clinical trials of the access to the prostate tissue (APT) II system—a scanner independent system for magnetic resonance imaging (MRI)-guided transrectal prostate interventions. The system utilizes novel manipulator mechanics employing a steerable needle channel and a novel six degree-of-freedom hybrid tracking method, comprising passive fiducial tracking for initial registration and subsequent incremental motion measurements. Targeting accuracy of the system in prostate phantom experiments and two clinical human-subject procedures is shown to compare favorably with existing systems using passive and active tracking methods. The portable design of the APT II system, using only standard MRI image sequences and minimal custom scanner interfacing, allows the system to be easily used on different MRI scanners. PMID:22009867

Biomarker-based risk prediction in the community.

PubMed

AbouEzzeddine, Omar F; McKie, Paul M; Scott, Christopher G; Rodeheffer, Richard J; Chen, Horng H; Michael Felker, G; Jaffe, Allan S; Burnett, John C; Redfield, Margaret M

2016-11-01

Guided by predictive characteristics of cardiovascular biomarkers, we explored the clinical implications of a simulated biomarker-guided heart failure (HF) and major adverse cardiovascular events (MACE) prevention strategy in the community. In a community cohort (n = 1824), the predictive characteristics for HF and MACE of galectin-3 (Gal-3), ST2, high-sensitivity cardiac troponin I (hscTnI), high-sensitivity C-reactive protein (hsCRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) were established. We performed number needed to screen (NNS) and treat (NNT) with the intervention analyses according to biomarker screening strategy and intervention efficacy in persons with at least one cardiovascular risk factor. In the entire cohort, for both HF and MACE, the predictive characteristics of NT-proBNP and hscTnI were superior to other biomarkers; alone, in a multimarker model, and adjusting for clinical risk factors. An NT-proBNP-guided preventative intervention with an intervention effect size (4-year hazard ratio for intervention in biomarker positive cohort) of ≤0.7 would reduce the global burden of HF by ≥20% and MACE by ≥15%. From this simulation, the NNS to prevent one HF event or MACE in 4 years would be ≤100 with a NNT to prevent one HF event of ≤20 and one MACE of ≤10. The predictive characteristics of NT-proBNP and hscTnI for HF or MACE in the community are superior to other biomarkers. Biomarker-guided preventative interventions with reasonable efficacy would compare favourably to established preventative interventions. This data provides a framework for biomarker selection which may inform design of biomarker-guided preventative intervention trials. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

A Primer for Developing Measures of Science Content Knowledge for Small-Scale Research and Instructional Use

ERIC Educational Resources Information Center

Bass, Kristin M.; Drits-Esser, Dina; Stark, Louisa A.

2016-01-01

The credibility of conclusions made about the effectiveness of educational interventions depends greatly on the quality of the assessments used to measure learning gains. This essay, intended for faculty involved in small-scale projects, courses, or educational research, provides a step-by-step guide to the process of developing, scoring, and…

Becoming Partners with Children: From Play to Conversation. A Developmental Guide for Professionals and Parents.

ERIC Educational Resources Information Center

MacDonald, James D.

Focusing on the preconversational child who has yet to develop a stable or generalized habit of spontaneous conversation, this book presents ECO (Ecological Communication Model), a new intervention model for social and communicative development of developmentally delayed children. The model is based on two perspectives: the literature on the…

The Impact of a Three-Year Teacher Professional Development Course on Quality of Teaching: Strengths and Limitations of the Dynamic Approach

ERIC Educational Resources Information Center

Kyriakides, L.; Christoforidou, M.; Panayiotou, A.; Creemers, B. P. M.

2017-01-01

The dynamic approach (DA) suggests that professional development should be differentiated to meet teachers' individual needs while engaging participants into systematic and guided critical reflection. Previous experimental studies demonstrated that one-year interventions based on the DA have a positive impact on teacher effectiveness. The study…

TAKING IT TO THE PEWS: A CBPR-GUIDED HIV AWARENESS AND SCREENING PROJECT WITH BLACK CHURCHES

PubMed Central

Berkley-Patton, Jannette; Bowe-Thompson, Carole; Bradley-Ewing, Andrea; Hawes, Starlyn; Moore, Erin; Williams, Eric; Martinez, David; Goggin, Kathy

2014-01-01

Utilizing a community-based participatory research (CBPR) approach is a potentially effective strategy for exploring the development, implementation, and evaluation of HIV interventions in African American churches. This CBPR-guided study describes a church-based HIV awareness and screening intervention (Taking It to the Pews [TIPS]) that fully involved African American church leaders in all phases of the research project. Findings from the implementation and evaluation phases indicated that church leaders delivered TIPS Tool Kit activities on an ongoing basis (about twice a month) over a 9-month period. TIPS church members were highly exposed to TIPS activities (e.g., 91% reported receiving HIV educational brochures, 84% heard a sermon about HIV). Most (87%) believed that the church should talk about HIV, and 77% believed that the church should offer HIV screening. These findings suggest that implementing an HIV intervention in Black church settings is achievable, particularly when a CBPR approach is used. PMID:20528130

Development of a Barbershop-Based HIV/STI Risk Reduction Intervention for Young Heterosexual African American Men.

PubMed

Jemmott, Loretta Sweet; Jemmott, John B; Lanier, Yzette; Thompson, Ciarra; Baker, Jillian Lucas

2016-08-12

Young, heterosexual African American men ages 18 to 24 years continue to be at high risk for HIV and other sexually transmitted infections. However, few interventions have been designed to meet the needs of this "forgotten" population. The article describes the systematic development of a theory-based, culturally-tailored, gender-specific, barbershop-based HIV risk reduction intervention for heterosexual African American men ages 18 to 24. The process included developing a community advisory board, selecting a guiding theoretical framework, incorporating community-based participatory research principles, and conducting formative research with African American males, barbers, and barbershop owners. The result was Shape Up: Barbers Building Better Brothers, a 2-day, HIV risk reduction intervention focused on increasing HIV knowledge and condom use and reducing the number of sexual partners. Intervention sessions were facilitated by barbers who used iPads to deliver the content. As a high-risk population, this intervention has great public health significance for the health of African American men and their sexual partners. © 2016 Society for Public Health Education.

State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

PubMed Central

Kim, Hyung Tae; Kim, Sae Young; Byun, Gyung Jo; Shin, Byung Chul; Lee, Jin Young; Choi, Eun Joo; Choi, Jong Bum; Hong, Ji Hee; Choi, Seung Won

2017-01-01

Background Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management. PMID:29123624

Cost-effectiveness analysis of personalized antiplatelet therapy in patients with acute coronary syndrome.

PubMed

Jiang, Minghuan; You, Joyce Hs

2016-05-01

This study aimed to compare the clinical and economic outcomes of pharmacogenetic-guided (PG-guided) and platelet reactivity testing-guided antiplatelet therapy for patients with acute coronary syndrome undergoing percutaneous coronary intervention. A decision-analytic model was simulated including four antiplatelet strategies: universal clopidogrel 75 mg daily, universal alternative P2Y12 inhibitor (prasugrel or ticagrelor), PG-guided therapy, and platelet reactivity testing-guided therapy. PG-guided therapy was the preferred option with lowest cost (US$75,208) and highest quality-adjusted life years gained (7.6249 quality-adjusted life years). The base-case results were robust in sensitivity analysis. PG-guided antiplatelet therapy showed the highest probability to be preferred antiplatelet strategy for acute coronary syndrome patients with percutaneous coronary intervention.

The Reading Club: A Guide to a Literacy Intervention Program for Reluctant Readers in Spanish and English

ERIC Educational Resources Information Center

Henn-Reinke, Kathryn

2004-01-01

As a result of recent federal legislation, school districts are being required to have all students reading at grade level by the year 2012. Such an exceedingly lofty goal cannot be achieved without powerful intervention programs. Here is a guide for districts and schools that outlines an intervention program for students in grades 1-3 who…

A Novel, Self-Guided, Home-Based Intervention to Improve Condom Use among Young Men Who Have Sex with Men

ERIC Educational Resources Information Center

Emetu, Roberta E.; Marshall, Alexandra; Sanders, Stephanie A.; Yarber, William L.; Milhausen, Robin R.; Crosby, Richard A.; Graham, Cynthia A.

2014-01-01

Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a…

Attitudes on first aid for paediatric burns: Pilot survey of a developed city state.

PubMed

Kua Phek Hui, Jade; Allen, John Carson; Mok, Wan Loong James

2016-06-01

Burn-related injuries are prevalent worldwide. Caregiver first aid can mitigate the devastating effects of paediatric burn injuries. Our aim was to assess knowledge of paediatric burns first aid among caregivers and determine whether knowledge levels can be raised following a short educational intervention. Over a 13-week period we surveyed 274 caregivers at the children's emergency department of KK Women's and Children's Hospital. The questionnaire assessed caregiver demographics and knowledge of burn first aid pre-intervention. There was an educational interlude during which the moderator educated the caregiver using a simple pictorial guide. The survey resumed thereafter and the post-intervention questions were completed. Of the 274 surveys conducted, 272 complete responses were obtained. We found a substantial and statistically significant increase in knowledge of caregivers immediately following the intervention. Two statistically significant predictors of adequate post-interventional scores were the caregivers' highest educational level and their total score in the pre-interventional assessment. Caregivers who scored well in the post-intervention questionnaire relied on school (p=0.013) and the Internet (p=0.130) as sources of information on burns first aid. Caregivers without prior personal experience with burns tended to fare better in the post-interventional survey. Our study shows it is possible to correct knowledge gaps in the immediate period through a simple pictorial guide. Our study also identified a structure for a focused national educational campaign. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Automatic management system for dose parameters in interventional radiology and cardiology.

PubMed

Ten, J I; Fernandez, J M; Vaño, E

2011-09-01

The purpose of this work was to develop an automatic management system to archive and analyse the major study parameters and patient doses for fluoroscopy guided procedures performed in cardiology and interventional radiology systems. The X-ray systems used for this trial have the capability to export at the end of the procedure and via e-mail the technical parameters of the study and the patient dose values. An application was developed to query and retrieve from a mail server, all study reports sent by the imaging modality and store them on a Microsoft SQL Server data base. The results from 3538 interventional study reports generated by 7 interventional systems were processed. In the case of some technical parameters and patient doses, alarms were added to receive malfunction alerts so as to immediately take appropriate corrective actions.

The construct of resilience: Implications for interventions and social policies

PubMed Central

LUTHAR, SUNIYA S.; CICCHETTI, DANTE

2007-01-01

The focus of this article is on the interface between research on resilience—a construct representing positive adaptation despite adversity —and the applications of this work to the development of interventions and social policies. Salient defining features of research on resilience are delineated, as are various advantages, limitations, and precautions linked with the application of the resilience framework to developing interventions. For future applied efforts within this tradition, a series of guiding principles are presented along with exemplars of existing programs based on the resilience paradigm. The article concludes with discussions of directions for future work in this area, with emphases on an enhanced interface between science and practice, and a broadened scope of resilience-based interventions in terms of the types of populations, and the types of adjustment domains, that are encompassed. PMID:11202047

A networked modular hardware and software system for MRI-guided robotic prostate interventions

NASA Astrophysics Data System (ADS)

Su, Hao; Shang, Weijian; Harrington, Kevin; Camilo, Alex; Cole, Gregory; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare; Fischer, Gregory S.

2012-02-01

Magnetic resonance imaging (MRI) provides high resolution multi-parametric imaging, large soft tissue contrast, and interactive image updates making it an ideal modality for diagnosing prostate cancer and guiding surgical tools. Despite a substantial armamentarium of apparatuses and systems has been developed to assist surgical diagnosis and therapy for MRI-guided procedures over last decade, the unified method to develop high fidelity robotic systems in terms of accuracy, dynamic performance, size, robustness and modularity, to work inside close-bore MRI scanner still remains a challenge. In this work, we develop and evaluate an integrated modular hardware and software system to support the surgical workflow of intra-operative MRI, with percutaneous prostate intervention as an illustrative case. Specifically, the distinct apparatuses and methods include: 1) a robot controller system for precision closed loop control of piezoelectric motors, 2) a robot control interface software that connects the 3D Slicer navigation software and the robot controller to exchange robot commands and coordinates using the OpenIGTLink open network communication protocol, and 3) MRI scan plane alignment to the planned path and imaging of the needle as it is inserted into the target location. A preliminary experiment with ex-vivo phantom validates the system workflow, MRI-compatibility and shows that the robotic system has a better than 0.01mm positioning accuracy.

A qualitative study to inform the development of a video game for adolescent HIV prevention.

PubMed

Hieftje, Kimberly; Rosenthal, Marjorie S; Camenga, Deepa R; Edelman, E Jennifer; Fiellin, Lynn E

2012-08-10

To inform the development of an interactive video game focused on behavior change to reduce risk and promote HIV prevention in young minority adolescents. We used qualitative methods guided by community-partnered research principles to conduct and analyze 16 individual interviews and six focus groups with 10-15 year old boys and girls (36 unique participants) at a neighborhood-based non-profit organization serving youth from low-resource neighborhoods. We identified three recurring themes. Adolescents report protective factors and facilitators to engaging in risk behaviors including: 1) their personal ability to balance the tension between individuation and group membership; 2) the presence of stable mentor figures in their life; and 3) the neighborhood in which they live. By conducting a qualitative study guided by community-partnered research principles, we identified themes from our target audience that could be translated into a video game-based intervention, including the storyline and character development. These methods may increase the intervention's efficacy at promoting HIV prevention by making them more tailored and relevant to a specific population.

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

PubMed

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

2017-06-01

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

Designing an Agent-Based Model for Childhood Obesity Interventions: A Case Study of ChildObesity180.

PubMed

Hennessy, Erin; Ornstein, Joseph T; Economos, Christina D; Herzog, Julia Bloom; Lynskey, Vanessa; Coffield, Edward; Hammond, Ross A

2016-01-07

Complex systems modeling can provide useful insights when designing and anticipating the impact of public health interventions. We developed an agent-based, or individual-based, computation model (ABM) to aid in evaluating and refining implementation of behavior change interventions designed to increase physical activity and healthy eating and reduce unnecessary weight gain among school-aged children. The potential benefits of applying an ABM approach include estimating outcomes despite data gaps, anticipating impact among different populations or scenarios, and exploring how to expand or modify an intervention. The practical challenges inherent in implementing such an approach include data resources, data availability, and the skills and knowledge of ABM among the public health obesity intervention community. The aim of this article was to provide a step-by-step guide on how to develop an ABM to evaluate multifaceted interventions on childhood obesity prevention in multiple settings. We used data from 2 obesity prevention initiatives and public-use resources. The details and goals of the interventions, overview of the model design process, and generalizability of this approach for future interventions is discussed.

Open-source image registration for MRI-TRUS fusion-guided prostate interventions.

PubMed

Fedorov, Andriy; Khallaghi, Siavash; Sánchez, C Antonio; Lasso, Andras; Fels, Sidney; Tuncali, Kemal; Sugar, Emily Neubauer; Kapur, Tina; Zhang, Chenxi; Wells, William; Nguyen, Paul L; Abolmaesumi, Purang; Tempany, Clare

2015-06-01

We propose two software tools for non-rigid registration of MRI and transrectal ultrasound (TRUS) images of the prostate. Our ultimate goal is to develop an open-source solution to support MRI-TRUS fusion image guidance of prostate interventions, such as targeted biopsy for prostate cancer detection and focal therapy. It is widely hypothesized that image registration is an essential component in such systems. The two non-rigid registration methods are: (1) a deformable registration of the prostate segmentation distance maps with B-spline regularization and (2) a finite element-based deformable registration of the segmentation surfaces in the presence of partial data. We evaluate the methods retrospectively using clinical patient image data collected during standard clinical procedures. Computation time and Target Registration Error (TRE) calculated at the expert-identified anatomical landmarks were used as quantitative measures for the evaluation. The presented image registration tools were capable of completing deformable registration computation within 5 min. Average TRE was approximately 3 mm for both methods, which is comparable with the slice thickness in our MRI data. Both tools are available under nonrestrictive open-source license. We release open-source tools that may be used for registration during MRI-TRUS-guided prostate interventions. Our tools implement novel registration approaches and produce acceptable registration results. We believe these tools will lower the barriers in development and deployment of interventional research solutions and facilitate comparison with similar tools.

Using Behavioural Insights to Promote Food Waste Recycling in Urban Households-Evidence From a Longitudinal Field Experiment.

PubMed

Linder, Noah; Lindahl, Therese; Borgström, Sara

2018-01-01

Promoting pro-environmental behaviour amongst urban dwellers is one of today's greatest sustainability challenges. The aim of this study is to test whether an information intervention, designed based on theories from environmental psychology and behavioural economics, can be effective in promoting recycling of food waste in an urban area. To this end we developed and evaluated an information leaflet, mainly guided by insights from nudging and community-based social marketing. The effect of the intervention was estimated through a natural field experiment in Hökarängen, a suburb of Stockholm city, Sweden, and was evaluated using a difference-in-difference analysis. The results indicate a statistically significant increase in food waste recycled compared to a control group in the research area. The data analysed was on the weight of food waste collected from sorting stations in the research area, and the collection period stretched for almost 2 years, allowing us to study the short- and long term effects of the intervention. Although the immediate positive effect of the leaflet seems to have attenuated over time, results show that there was a significant difference between the control and the treatment group, even 8 months after the leaflet was distributed. Insights from this study can be used to guide development of similar pro-environmental behaviour interventions for other urban areas in Sweden and abroad, improving chances of reaching environmental policy goals.

Reconceptualizing Working Memory in Educational Research

ERIC Educational Resources Information Center

Fenesi, Barbara; Sana, Faria; Kim, Joseph A.; Shore, David I.

2015-01-01

In recent years, research from cognitive science has provided a solid theoretical framework to develop evidence-based interventions in education. In particular, research into reading, writing, language, mathematics and multimedia learning has been guided by the application of Baddeley's multicomponent model of working memory. However, an…

Development of a Chronic Disease Management Program for Stroke Survivors Using Intervention Mapping: The Stroke Coach.

PubMed

Sakakibara, Brodie M; Lear, Scott A; Barr, Susan I; Benavente, Oscar; Goldsmith, Charlie H; Silverberg, Noah D; Yao, Jennifer; Eng, Janice J

2017-06-01

To describe the systematic development of the Stroke Coach, a theory- and evidence-based intervention to improve control of lifestyle behavior risk factors in patients with stroke. Intervention development. Community. Individuals who have had a stroke. We used intervention mapping to guide the development of the Stroke Coach. Intervention mapping is a systematic process used for intervention development and composed of steps that progress from the integration of theory and evidence to the organization of realistic strategies to facilitate the development of a practical intervention supported by empirical evidence. Social cognitive theory was the underlying premise for behavior change, whereas control theory methods were directed toward sustaining the changes to ensure long-term health benefits. Practical evidence-based strategies were linked to behavioral determinants to improve stroke risk factor control. Not applicable. The Stroke Coach is a patient-centered, community-based, telehealth intervention to promote healthy lifestyles after stroke. Over 6 months, participants receive seven 30- to 60-minute telephone sessions with a lifestyle coach who provides education, facilitates motivation for lifestyle modification, and empowers participants to self-management their stroke risk factors. Participants also receive a self-management manual and a self-monitoring kit. Through the use of intervention mapping, we developed a theoretically sound and evidence-grounded intervention to improve risk factor control in patients with stroke. If empirical evaluation of the Stroke Coach produces positive results, the next step will be to develop an implementation intervention to ensure successful uptake and delivery of the program in community and outpatient settings. Copyright © 2017 American Congress of Rehabilitation Medicine. All rights reserved.

A serious game for learning ultrasound-guided needle placement skills.

PubMed

Chan, Wing-Yin; Qin, Jing; Chui, Yim-Pan; Heng, Pheng-Ann

2012-11-01

Ultrasound-guided needle placement is a key step in a lot of radiological intervention procedures such as biopsy, local anesthesia and fluid drainage. To help training future intervention radiologists, we develop a serious game to teach the skills involved. We introduce novel techniques for realistic simulation and integrate game elements for active and effective learning. This game is designed in the context of needle placement training based on the some essential characteristics of serious games. Training scenarios are interactively generated via a block-based construction scheme. A novel example-based texture synthesis technique is proposed to simulate corresponding ultrasound images. Game levels are defined based on the difficulties of the generated scenarios. Interactive recommendation of desirable insertion paths is provided during the training as an adaptation mechanism. We also develop a fast physics-based approach to reproduce the shadowing effect of needles in ultrasound images. Game elements such as time-attack tasks, hints and performance evaluation tools are also integrated in our system. Extensive experiments are performed to validate its feasibility for training.

Development of an intervention program to increase effective behaviours by patients and clinicians in psychiatric services: Intervention Mapping study.

PubMed

Koekkoek, Bauke; van Meijel, Berno; Schene, Aart; Hutschemaekers, Giel

2010-10-25

Health clinicians perceive certain patients as 'difficult' across all settings, including mental health care. In this area, patients with non-psychotic disorders that become long-term care users may be perceived as obstructing their own recovery or seeking secondary gain. This negative perception of patients results in ineffective responses and low-quality care by health clinicians. Using the concept of illness behaviour, this paper describes the development, implementation, and planned evaluation of a structured intervention aimed at prevention and management of ineffective behaviours by long-term non-psychotic patients and their treating clinicians. The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the intervention. Qualitative (individual and group interviews), quantitative (survey), and mixed methods (Delphi-procedure) research was used to gain a broad perspective of the problem. Empirical findings, theoretical models, and existing evidence were combined to construct a program tailored to the needs of the target groups. A structured program to increase effective illness behaviour in long-term non-psychotic patients and effective professional behaviour in their treating clinicians was developed, consisting of three subsequent stages and four substantial components, that is described in detail. Implementation took place and evaluation of the intervention is being carried out. Intervention Mapping proved to be a suitable method to develop a structured intervention for a multi-faceted problem in mental health care.

Pancreatic pseudocyst drainage performed with a new prototype forward-viewing linear echoendoscope.

PubMed

Fernández de Castro, Cristina; Cañete, Ángel; Sanz de Villalobos, Eduardo; Ferreiro, Reyes; Albillos Martínez, Agustín; Vázquez Sequeiros, Enrique

2016-10-01

Interventional endoscopy is a field that continues to grow rapidly. A novel prototype forward-viewing echoendoscope (FV-EUS) has been recently developed in an attempt to overcome some of the limitations of conventional curved linear-array echoendoscopes (OV-EUS). We present a case of a successful endoscopic ultrasound-guided drainage of a pancreatic pseudocyst using a forward-viewing echoendoscope. Although the utilization use of this newly developed echoendoscope has not yet become widespread, its unique characteristics can help to easily perform routine therapeutic procedures and contribute to the expansion of interventional endoscopic utrasoundultrasound.

Endoscopic ultrasound-guided biliary drainage

PubMed Central

Chavalitdhamrong, Disaya; Draganov, Peter V

2012-01-01

Endoscopic ultrasound (EUS)-guided biliary drainage has emerged as a minimally invasive alternative to percutaneous and surgical interventions for patients with biliary obstruction who had failed endoscopic retrograde cholangiopancreatography (ERCP). EUS-guided biliary drainage has become feasible due to the development of large channel curvilinear therapeutic echo-endoscopes and the use of real-time ultrasound and fluoroscopy imaging in addition to standard ERCP devices and techniques. EUS-guided biliary drainage is an attractive option because of its minimally invasive, single step procedure which provides internal biliary decompression. Multiple investigators have reported high success and low complication rates. Unfortunately, high quality prospective data are still lacking. We provide detailed review of the use of EUS for biliary drainage from the perspective of practicing endoscopists with specific focus on the technical aspects of the procedure. PMID:22363114

Tailoring implementation strategies for evidence-based recommendations using computerised clinical decision support systems: protocol for the development of the GUIDES tools.

PubMed

Van de Velde, Stijn; Roshanov, Pavel; Kortteisto, Tiina; Kunnamo, Ilkka; Aertgeerts, Bert; Vandvik, Per Olav; Flottorp, Signe

2016-03-05

A computerised clinical decision support system (CCDSS) is a technology that uses patient-specific data to provide relevant medical knowledge at the point of care. It is considered to be an important quality improvement intervention, and the implementation of CCDSS is growing substantially. However, the significant investments do not consistently result in value for money due to content, context, system and implementation issues. The Guideline Implementation with Decision Support (GUIDES) project aims to improve the impact of CCDSS through optimised implementation based on high-quality evidence-based recommendations. To achieve this, we will develop tools that address the factors that determine successful CCDSS implementation. We will develop the GUIDES tools in four steps, using the methods and results of the Tailored Implementation for Chronic Diseases (TICD) project as a starting point: (1) a review of research evidence and frameworks on the determinants of implementing recommendations using CCDSS; (2) a synthesis of a comprehensive framework for the identified determinants; (3) the development of tools for use of the framework and (4) pilot testing the utility of the tools through the development of a tailored CCDSS intervention in Norway, Belgium and Finland. We selected the conservative management of knee osteoarthritis as a prototype condition for the pilot. During the process, the authors will collaborate with an international expert group to provide input and feedback on the tools. This project will provide guidance and tools on methods of identifying implementation determinants and selecting strategies to implement evidence-based recommendations through CCDSS. We will make the GUIDES tools available to CCDSS developers, implementers, researchers, funders, clinicians, managers, educators, and policymakers internationally. The tools and recommendations will be generic, which makes them scalable to a large spectrum of conditions. Ultimately, the better implementation of CCDSS may lead to better-informed decisions and improved care and patient outcomes for a wide range of conditions. PROSPERO, CRD42016033738.

Hard and soft nanoparticles for image-guided surgery in nanomedicine

NASA Astrophysics Data System (ADS)

Locatelli, Erica; Monaco, Ilaria; Comes Franchini, Mauro

2015-08-01

The use of hard and/or soft nanoparticles for therapy, collectively called nanomedicine, has great potential in the battle against cancer. Major research efforts are underway in this area leading to development of new drug delivery approaches and imaging techniques. Despite this progress, the vast majority of patients who are affected by cancer today sadly still need surgical intervention, especially in the case of solid tumors. An important perspective for researchers is therefore to provide even more powerful tools to the surgeon for pre- and post-operative approaches. In this context, image-guided surgery, in combination with nanotechnology, opens a new strategy to win this battle. In this perspective, we will analyze and discuss the recent progress with nanoparticles of both metallic and biomaterial composition, and their use to develop powerful systems to be applied in image-guided surgery.

[CT-guided intervention by means of a laser marking and targeting aid].

PubMed

Klöppel, R; Wilke, W; Weisse, T; Steinecke, R

1997-08-01

The present study evaluates the use of a laser guidance system for CT-guided intervention. 94 cases of diagnostic biopsies and lumbar sympathectomies (54 cases with laser guidance system and 40 without) were compared. Using the laser guidance system, the number of control scans decreased by 30 to 50%, and necessary corrections of needle location were reduced by a maximum of 30%. The average target deviation of the needle decreased to less than 5 mm in 50% of cases. The laser guidance system is strongly recommended in CT-guided interventions for quality assurance and higher efficiency. The advantage is especially marked if the target area is small.

Tribal recommendations for designing culturally appropriate technology-based sexual health interventions targeting Native youth in the Pacific Northwest.

PubMed

Craig Rushing, Stephanie; Stephens, David

2012-01-01

Media technologies, including the Internet, cell phones, and video games, offer new avenues to reach Native youth on sensitive health topics. Project Red Talon, a sexually transmitted disease (STD)/HIV prevention project that serves the 43 federally recognized tribes in Oregon, Washington, and Idaho, used community-based participatory research methods in partnership with the Northwest tribes to review existing technology-based interventions and generate recommendations for designing interventions that reflect the culture, needs, and organizational capacities of participating tribes and Native youth. These findings are now being used to guide the development of technology-based health interventions targeting American Indian/Alaska Native teens and young adults.

A Guide for Educators to Move beyond Conventional School Playgrounds: The RE-AIM Evaluation of the Lunchtime Enjoyment Activity and Play (LEAP) Intervention

ERIC Educational Resources Information Center

Hyndman, Brendon P; Benson, Amanda C.; Telford, Amanda

2014-01-01

Despite an increase in the provision of effective school-based interventions in recent times, there is an absence of literature for teachers focusing on the translation of promising interventions into real-world practice. The aim of this research was to provide a social-ecological guide for teachers of the external validity of implementing the…

Successful percutaneous coronary intervention with GuideLiner® catheter for subtotal occlusive lesion in the right coronary artery with anomalous origin from the left sinus of Valsalva: a case report.

PubMed

Shirota, Ayumi; Nomura, Tetsuya; Kubota, Hiroshi; Taminishi, Shunta; Urata, Ryota; Sugimoto, Takeshi; Higuchi, Yusuke; Kato, Taku; Keira, Natsuya; Tatsumi, Tetsuya

2015-07-28

Because of the unusual anatomy of an anomalous origin of the right coronary artery from the left sinus of Valsalva, selective cannulation of the guiding catheter in percutaneous coronary intervention for these cases is always challenging. A 58-year-old Japanese man was admitted to our hospital complaining of worsening exertional chest pain. He was suspected of having unstable angina pectoris and underwent cardiac catheterization. We found a subtotal occlusive lesion in the mid-portion of his right coronary artery that originated from the left sinus of Valsalva. On the previous percutaneous coronary intervention, we failed to cannulate the guiding catheter to the anomalous orifice of the right coronary artery. Therefore, we decided to use the GuideLiner catheter for stable back-up support from the beginning. A 6Fr GuideLiner catheter was introduced into the right coronary artery by anchoring it coaxially with a semi-compliant balloon catheter. And we successfully deployed two drug-eluting stents by crossing over the posterior-descending artery. Final angiography demonstrated favorable dilatation of the target lesion, and native blood flow in the right coronary artery was completely recovered. GuideLiner is a monorail-type "child" support catheter that facilitates coaxial guiding catheter engagement and an appropriate back-up force, achieving successful device delivery to target lesions in this kind of complex percutaneous coronary intervention.

Principles for Designing Intervention in Mathematics

ERIC Educational Resources Information Center

National Center on Intensive Intervention, 2016

2016-01-01

The purpose of this guide is to provide brief explanations of practices that can be implemented when working with students in need of intensive intervention in mathematics. Special education instructors, math interventionists, and others working with students who struggle with mathematics may find this guide helpful. Specific topics covered…

Do multiple micronutrient interventions improve child health, growth, and development?

PubMed

Ramakrishnan, Usha; Goldenberg, Tamar; Allen, Lindsay H

2011-11-01

Micronutrient deficiencies are common and often co-occur in many developing countries. Several studies have examined the benefits of providing multiple micronutrient (MMN) interventions during pregnancy and childhood, but the implications for programs remain unclear. The key objective of this review is to summarize what is known about the efficacy of MMN interventions during early childhood on functional outcomes, namely, child health, survival, growth, and development, to guide policy and identify gaps for future research. We identified review articles including meta-analyses and intervention studies that evaluated the benefits of MMN interventions (3 or more micronutrients) in children (<5 y of age) using Pubmed and EMBASE. Several controlled trials (n = 45) and meta-analyses (n = 6) have evaluated the effects of MMN interventions primarily for child morbidity, anemia, and growth. Two studies found no effects on child mortality. The findings for respiratory illness and diarrhea are mixed, although suggestive of benefit when provided as fortified foods. There is evidence from several controlled trials (>25) and 2 meta-analyses that MMN interventions improve hemoglobin concentrations and reduce anemia, but the effects were small compared to providing only iron or iron with folic acid. Two recent meta-analyses and several intervention trials also indicated that MMN interventions improve linear growth compared to providing a placebo or single nutrients. Much less is known about the effects on MMN interventions during early childhood on motor and mental development. In summary, MMN interventions may result in improved outcomes for children in settings where micronutrient deficiencies are widespread.

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

PubMed Central

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

2016-01-01

Background The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory—the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). Methods We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. Results We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. Conclusion The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa. PMID:27560352

GuideLiner™ as guide catheter extension for the unreachable mammary bypass graft.

PubMed

Vishnevsky, Alec; Savage, Michael P; Fischman, David L

2018-03-09

Percutaneous coronary intervention (PCI) of mammary artery bypass grafts through a trans-radial (TR) approach can present unique challenges, including coaxial vessel engagement of the guiding catheter, adequate visualization of the target lesion, sufficient backup support for equipment delivery, and the ability to reach very distal lesions. The GuideLiner catheter, a rapid exchange monorail mother-in-daughter system, facilitates successful interventions in such challenging anatomy. We present a case of a patient undergoing PCI of a right internal mammary artery (RIMA) graft via TR access in whom the graft could not be engaged with any guiding catheter. Using a balloon tracking technique over a guidewire, a GuideLiner was placed as an extension of the guiding catheter and facilitated TR-PCI by overcoming technical challenges associated with difficult anatomy. © 2018 Wiley Periodicals, Inc.

Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors.

PubMed

Schumacher, Lauren; Armaou, Maria; Rolf, Pauline; Sadhra, Steven; Sutton, Andrew John; Zarkar, Anjali; Grunfeld, Elizabeth A

2017-10-04

Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work. As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis. Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention. The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process. Current Controlled Trials ISRCTN56342476 . Retrospectively registered 14 October 2015.

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

PubMed

Hulscher, M E J L; Prins, J M

2017-11-01

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

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

PubMed Central

2014-01-01

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

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

PubMed

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

2012-12-14

Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity. In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the "black box" of Web-based intervention development and to support future Web-based intervention development. The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables. The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk-reduction behavior of patients with cardiovascular risk factors. The Intervention Mapping protocol provided a systematic method for developing the intervention and each intervention design choice was carefully thought-out and justified. Although it was not a rapid or an easy method for developing an intervention, the protocol guided and directed the development process. The application of evidence-based behavior change methods used in our intervention offers insight regarding how an intervention may change intention and health behavior. The Web-based intervention appeared feasible and was implemented. Further research will test the effectiveness of the PIB2 intervention. Dutch Trial Register, Trial ID: ECP-92.

Pre-K Mathematics. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2007

2007-01-01

"Pre-K Mathematics" is a supplemental curriculum designed to develop informal mathematical knowledge and skills in preschool children. Mathematical content is organized into seven units. Specific mathematical concepts and skills from each unit are taught in the classroom through teacher-guided, small-group activities with concrete…

The Socialization Community.

ERIC Educational Resources Information Center

Lippitt, Ronald O.

This paper develops a conceptual framework as a guide for research analysis and the designing of experimental interventions aimed at the improvement of the socialization process of the community. Socialization agents are the parents, older and like-age peers, formal education agencies, churches, leisure time child and youth serving agencies, legal…

Translating global recommendations on HIV and infant feeding to the local context: the development of culturally sensitive counselling tools in the Kilimanjaro Region, Tanzania.

PubMed

Leshabari, Sebalda C; Koniz-Booher, Peggy; Astrøm, Anne N; de Paoli, Marina M; Moland, Karen M

2006-10-03

This paper describes the process used to develop an integrated set of culturally sensitive, evidence-based counselling tools (job aids) by using qualitative participatory research. The aim of the intervention was to contribute to improving infant feeding counselling services for HIV positive women in the Kilimanjaro Region of Tanzania. Formative research using a combination of qualitative methods preceded the development of the intervention and mapped existing practices, perceptions and attitudes towards HIV and infant feeding (HIV/IF) among mothers, counsellors and community members. Intervention Mapping (IM) protocol guided the development of the overall intervention strategy. Theories of behaviour change, a review of the international HIV/IF guidelines and formative research findings contributed to the definition of performance and learning objectives. Key communication messages and colourful graphic illustrations related to infant feeding in the context of HIV were then developed and/or adapted from existing generic materials. Draft materials were field tested with intended audiences and subjected to stakeholder technical review. An integrated set of infant feeding counselling tools, referred to as 'job aids', was developed and included brochures on feeding methods that were found to be socially and culturally acceptable, a Question and Answer Guide for counsellors, a counselling card on the risk of transmission of HIV, and an infant feeding toolbox for demonstration. Each brochure describes the steps to ensure safer infant feeding using simple language and images based on local ideas and resources. The brochures are meant to serve as both a reference material during infant feeding counselling in the ongoing prevention of mother to child transmission (pMTCT) of HIV programme and as take home material for the mother. The study underscores the importance of formative research and a systematic theory based approach to developing an intervention aimed at improving counselling and changing customary feeding practices. The identification of perceived barriers and facilitators for change contributed to developing the key counselling messages and graphics, reflecting the socio-economic reality, cultural beliefs and norms of mothers and their significant others.

Translating global recommendations on HIV and infant feeding to the local context: the development of culturally sensitive counselling tools in the Kilimanjaro Region, Tanzania

PubMed Central

Leshabari, Sebalda C; Koniz-Booher, Peggy; Åstrøm, Anne N; de Paoli, Marina M; Moland, Karen M

2006-01-01

Background This paper describes the process used to develop an integrated set of culturally sensitive, evidence-based counselling tools (job aids) by using qualitative participatory research. The aim of the intervention was to contribute to improving infant feeding counselling services for HIV positive women in the Kilimanjaro Region of Tanzania. Methods Formative research using a combination of qualitative methods preceded the development of the intervention and mapped existing practices, perceptions and attitudes towards HIV and infant feeding (HIV/IF) among mothers, counsellors and community members. Intervention Mapping (IM) protocol guided the development of the overall intervention strategy. Theories of behaviour change, a review of the international HIV/IF guidelines and formative research findings contributed to the definition of performance and learning objectives. Key communication messages and colourful graphic illustrations related to infant feeding in the context of HIV were then developed and/or adapted from existing generic materials. Draft materials were field tested with intended audiences and subjected to stakeholder technical review. Results An integrated set of infant feeding counselling tools, referred to as 'job aids', was developed and included brochures on feeding methods that were found to be socially and culturally acceptable, a Question and Answer Guide for counsellors, a counselling card on the risk of transmission of HIV, and an infant feeding toolbox for demonstration. Each brochure describes the steps to ensure safer infant feeding using simple language and images based on local ideas and resources. The brochures are meant to serve as both a reference material during infant feeding counselling in the ongoing prevention of mother to child transmission (pMTCT) of HIV programme and as take home material for the mother. Conclusion The study underscores the importance of formative research and a systematic theory based approach to developing an intervention aimed at improving counselling and changing customary feeding practices. The identification of perceived barriers and facilitators for change contributed to developing the key counselling messages and graphics, reflecting the socio-economic reality, cultural beliefs and norms of mothers and their significant others. PMID:17018140

Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community

PubMed Central

Baquero, Barbara; Ashida, Sato; Daniel-Ulloa, Jason; Laroche, Helena H.; Haines, Heidi; Bucklin, Rebecca; Maldonado, Adriana; Coronado Garcia, Mayra; Berto, Sandy; Sewell, Dan; Janz, Kathleen; Gates, Claudia; Parker, Edith A.

2018-01-01

Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity. PMID:29734709

Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community.

PubMed

Baquero, Barbara; Kava, Christine M; Ashida, Sato; Daniel-Ulloa, Jason; Laroche, Helena H; Haines, Heidi; Bucklin, Rebecca; Maldonado, Adriana; Coronado Garcia, Mayra; Berto, Sandy; Sewell, Dan; Novak, Nicole; Janz, Kathleen; Gates, Claudia; Parker, Edith A

2018-05-04

Background : Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods : The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results : We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions : This study will assess the effectiveness and impact of a community-wide intervention to support physical activity.

Guided goal setting: effectiveness in a dietary and physical activity intervention with low-income adolescents.

PubMed

Shilts, Mical Kay; Horowitz, Marcel; Townsend, Marilyn S

2009-01-01

Determining the effectiveness of the guided goal setting strategy on changing adolescents' dietary and physical activity self-efficacy and behaviors. Adolescents were individually assigned to treatment (intervention with guided goal setting) or control conditions (intervention without guided goal setting) with data collected before and after the education intervention. Urban middle school in a low-income community in Central California. Ethnically diverse middle school students (n = 94, 55% male) who were participants of a USDA nutrition education program. Driven by the Social Cognitive Theory, the intervention targeted dietary and physical activity behaviors of adolescents. Dietary self-efficacy and behavior; physical activity self-efficacy and behavior; goal effort and spontaneous goal setting. ANCOVA and path analysis were performed using the full sample and a sub-sample informed by Locke's recommendations (accounting for goal effort and spontaneous goal setting). No significant differences were found between groups using the full sample. Using the sub-sample, greater gains in dietary behavior (p < .05), physical activity behavior (p < .05), and physical activity self-efficacy (p < .05) were made by treatment participants compared to control participants. Change in physical activity behaviors was mediated by self-efficacy. Accounting for goal effort and spontaneous goal setting, this study provides some evidence that the use of guided goal setting with adolescents may be a viable strategy to promote dietary and physical activity behavior change.

With Little Research out There It's a Matter of Learning What Works in Teaching Students with Deafness and Autism

ERIC Educational Resources Information Center

Bradley, Lee Ann; Krakowski, Brandi; Thiessen, Ann

2008-01-01

The development of language and literacy is the foundation for all other learning. This statement is the guiding philosophy at the Iowa School for the Deaf (ISD). Teachers at ISD believe that intensive, highly structured early intervention and education work best to support cognitive and communication development in their students. However, little…

A Comparison of Functional Behavior Assessment Methodologies with Young Children: Descriptive Methods and Functional Analysis

ERIC Educational Resources Information Center

Alter, Peter J.; Conroy, Maureen A.; Mancil, G. Rich; Haydon, Todd

2008-01-01

The use of functional behavior assessment (FBA) to guide the development of behavior intervention plans continues to increase since they were first mandated in IDEA (Individuals with Disabilities Education Act Amendments of 1997, 20 U.S.C. Section 1400 et seq, 1997). A variety of indirect and direct instruments have been developed to facilitate…

Guide Catheter Extension Device Is Effective in Renal Angioplasty for Severely Calcified Lesions

PubMed Central

Sugimoto, Takeshi; Nomura, Tetsuya; Hori, Yusuke; Yoshioka, Kenichi; Kubota, Hiroshi; Miyawaki, Daisuke; Urata, Ryota; Kikai, Masakazu; Keira, Natsuya; Tatsumi, Tetsuya

2017-01-01

Patient: Male, 69 Final Diagnosis: Atherosclerotic renal artery stenosis Symptoms: None Medication: — Clinical Procedure: — Specialty: Radiology Objective: Unusual setting of medical care Background: The GuideLiner catheter extension device is a monorail-type “Child” support catheter that facilitates coaxial alignment with the guide catheter and provides an appropriate back-up force. This device has been developed in the field of coronary intervention, and now is becoming widely applied in the field of endovascular treatment. However, there has been no report on the effectiveness of the guide catheter extension device in percutaneous transluminal renal angioplasty (PTRA). Case Report: We encountered a case of atherosclerotic subtotal occlusion at the ostium of the left renal artery. Due to the severely calcified orifice and weaker back-up force provided by a JR4 guide catheter, we could not pass any guide-wires through the target lesion. Therefore, we introduced a guide catheter extension device, the GuideLiner catheter, through the guide catheter and achieved good guidewire maneuverability. We finally deployed 2 balloon-expandable stents and successfully performed all PTRA procedures. Conclusions: The guide catheter extension device can be effective in PTRA for severely calcified subtotal occlusion. PMID:28533503

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

PubMed

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

2014-05-06

Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms before sick leave via the Internet could be beneficial and cost saving. In this study, we developed and tested the effectiveness of a Web-based guided self-help course for employees with depressive symptoms. We report on the posttreatment effectiveness of the intervention. This study is a two-arm randomized controlled trial comparing a Web-based guided self-help course to care as usual (CAU). We recruited employees from 6 different companies via the companies' intranet and posters. The main inclusion criterion was elevated depressive symptoms as measured by a score of ≥16 on the Center for Epidemiological Studies Depression scale (CES-D). The intervention (Happy@Work) was based on problem-solving treatment and cognitive therapy and consisted of 6 weekly lessons. Participants were asked to submit their weekly assignment via the website after completion. They subsequently received feedback from a coach via the website. Self-report questionnaires on depressive symptoms (CES-D; primary outcome), anxiety measured by the Hospital Anxiety and Depression Scale (HADS), burnout measured by the Maslach Burnout Inventory (MBI), and work performance measured by the Health and Work Performance Questionnaire (HPQ; secondary outcomes) were completed at baseline and at posttreatment. A total of 231 employees were randomized to either the intervention group (n=116) or CAU (n=115).The posttreatment assessment was completed by 171 (74.0%) participants. Both the intervention and the CAU group showed significant improvements in the primary outcome of depressive symptoms, but no differences between the conditions was found (d=0.16, 95% CI -0.10 to 0.41, P=.29). Significant but small effects in favor of the intervention group were found for anxiety symptoms (d=0.16, 95% CI -0.09 to 0.42, P=.04) and exhaustion (d=0.17, 95% CI -0.09 to 0.43, P=.02). This study showed that a Web-based guided self-help course for employees with depressive symptoms was not more effective in reducing depressive symptoms among employees than CAU. Large improvements in depressive symptoms in the CAU group were unforeseen and potential explanations are discussed.

Activity matters: a web-based resource to enable people with multiple sclerosis to become more active.

PubMed

Casey, Blathin; Coote, Susan; Byrne, Molly

2018-03-27

Increasing physical activity (PA) through exercise is associated with improvements in many of the symptoms associated with multiple sclerosis (MS) such as fatigue, strength, balance, and mobility. Despite this, people with MS remain largely inactive. Interventions that are grounded in theory and that aim to change PA behavior need to be developed. The purpose of this study was to describe the development process of a web-based resource, namely, "Activity Matters," to enable people with MS to become more active. Development of the "Activity Matters" online intervention was guided by the UK's Medical Research Council (MRC) framework for the development and evaluation of complex interventions and the behavior change wheel (BCW). Seven sources of data were used to inform the process and were mapped on to both the MRC and BCW frameworks. The intervention is theoretically based, and constructs including knowledge, memory, attention and decision processes, skills, social influences, environmental context and resources, beliefs about capabilities, beliefs about consequences, goals, and emotions were recognized as important. "Activity Matters" is the first MS PA intervention to be developed using the theoretical approach outlined by the BCW and MRC complex interventions frameworks. The next phase of this work is to test the usability, acceptability, and preliminary effectiveness of "Activity Matters" among people with MS.

Development, Theoretical Framework, and Outcome Evaluation from Implementation of a Parent and Teacher-Delivered Adolescent Intervention on Adolescent Vaccination

PubMed Central

Gargano, Lisa M.; Herbert, Natasha L.; Painter, Julia E.; Sales, Jessica M.; Vogt, Tara M.; Morfaw, Christopher; Jones, LaDawna M.; Murray, Dennis; DiClemente, Ralph J.; Hughes, James M.

2017-01-01

The Advisory Committee on Immunization Practices recommended immunization schedule for adolescents includes three vaccines (Tdap, HPV, and MCV4) and annual influenza vaccination. Given the increasing number of recommended vaccines for adolescents and health and economic costs associated with non-vaccination, it is imperative that effective strategies for increasing vaccination rates among adolescents be developed. This article describes the development, theoretical framework, and initial first-year evaluation of an intervention designed to promote vaccine acceptance among a middle- and high-school based sample of adolescents and their parents in eastern Georgia. Adolescents, parents, and teachers were active participants in the development of the intervention. The intervention, which consisted of a brochure for parents and a teacher-delivered curriculum for adolescents, was guided by constructs from the Health Belief Model and Theory of Reasoned Action. Evaluation results indicated that our intervention development methods were successful in creating a brochure that met cultural relevance and literacy needs of parents. We also demonstrated an increase in student knowledge of and attitudes toward vaccines. To our knowledge, this study is the first to extensively engage middle- and high-school students, parents, and teachers in the design and implementation of key theory-based educational components of a school-based, teacher-delivered adolescent vaccination intervention. PMID:24440920

Preschool Multi-Tier Prevention-Intervention Model for Language and Early Literacy (Pre-3T): Development Summary and Implementation Guide. CYFS Working Paper No. 2014-3

ERIC Educational Resources Information Center

Clarke, Brandy L.; Knoche, Lisa L.; Abbott, Mary I.; Sheridan, Susan M.; Carta, Judith J.; Sjuts, Tara S.

2014-01-01

The primary objective of this development study was to develop and pilot a three-tiered prevention model (universal, targeted, individualized) in early education for children at risk of reading difficulties. The aims of this study were to: (1) Define and develop a Pre-3T model to address the early literacy and language needs of young children in…

Developing a framework to guide the de-adoption of low-value clinical practices in acute care medicine: a study protocol.

PubMed

Parsons Leigh, Jeanna; Niven, Daniel J; Boyd, Jamie M; Stelfox, Henry T

2017-01-19

Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process. The proposed project is a multi-stage mixed methods study to develop a framework to guide the de-adoption of low-value clinical practices in acute care medicine that will be tested in a representative sample of acute care settings in Alberta, Canada. Specifically, we will: 1) conduct a systematic review of the de-adoption literature to identify published barriers and facilitators to the de-adoption of low-value clinical practices in acute care medicine and any associated interventions proposed (Phase one); 2) conduct focus groups with acute care stakeholders to identify important themes not published in the literature and obtain a comprehensive appreciation of stakeholder perspectives (Phase two); 3) extend the generalizability of focus group findings by conducting individual stakeholder surveys with a representative sample of acute care providers throughout the province to determine which barriers and facilitators identified in Phases one and two are most relevant in their clinical setting (Phase three). Identified barriers and facilitators will be catalogued and integrated with targeted interventions in a framework to guide the process of de-adoption in each of four targeted areas of acute care medicine (Emergency Medicine, Cardiovascular Health and Stroke, Surgery and Critical Care Medicine). Analyses will be descriptive using a combination of qualitative and quantitative analyses. There is a growing body of literature suggesting that the de-adoption of ineffective or harmful practices from patient care is integral to the delivery of high quality care and healthcare sustainability. The framework developed in this study will map barriers and facilitators to de-adoption to the most appropriate interventions, allowing stakeholders to effectively initiate, execute and sustain this process in an evidence-based manner.

An Approach for Preoperative Planning and Performance of MR-guided Interventions Demonstrated With a Manual Manipulator in a 1.5T MRI Scanner

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

Seimenis, Ioannis; Tsekos, Nikolaos V.; Keroglou, Christoforos

2012-04-15

Purpose: The aim of this work was to develop and test a general methodology for the planning and performance of robot-assisted, MR-guided interventions. This methodology also includes the employment of software tools with appropriately tailored routines to effectively exploit the capabilities of MRI and address the relevant spatial limitations. Methods: The described methodology consists of: (1) patient-customized feasibility study that focuses on the geometric limitations imposed by the gantry, the robotic hardware, and interventional tools, as well as the patient; (2) stereotactic preoperative planning for initial positioning of the manipulator and alignment of its end-effector with a selected target; andmore » (3) real-time, intraoperative tool tracking and monitoring of the actual intervention execution. Testing was performed inside a standard 1.5T MRI scanner in which the MR-compatible manipulator is deployed to provide the required access. Results: A volunteer imaging study demonstrates the application of the feasibility stage. A phantom study on needle targeting is also presented, demonstrating the applicability and effectiveness of the proposed preoperative and intraoperative stages of the methodology. For this purpose, a manually actuated, MR-compatible robotic manipulation system was used to accurately acquire a prescribed target through alternative approaching paths. Conclusions: The methodology presented and experimentally examined allows the effective performance of MR-guided interventions. It is suitable for, but not restricted to, needle-targeting applications assisted by a robotic manipulation system, which can be deployed inside a cylindrical scanner to provide the required access to the patient facilitating real-time guidance and monitoring.« less

Reducing medical students' stigmatization of people with chronic mental illness: a field intervention at the "living museum" state hospital art studio.

PubMed

Cutler, Janis L; Harding, Kelli J; Hutner, Lucy A; Cortland, Clarissa; Graham, Mark J

2012-05-01

The authors designed an intervention to reduce beginning medical students' stigmatization of people with chronic mental illness (CMI). Pre-clinical medical students visited a state psychiatric facility's "Living Museum," a combination patient art studio/display space, as the intervention. During the visit, students interacted with artist-guides who showed their work and discussed their experiences creating art. Students completed a self-assessment survey developed to measure attitudes and feelings toward people with CMI after half of the class visited the Living Museum, constituting a Visit/No-Visit cross-sectional comparison. Students who visited the Living Museum (N=64), as compared with those who did not visit (N=110), endorsed more positive attitudes toward people with CMI. Among the students who visited, however, those who reported having spoken individually with a patient-artist (N=44), paradoxically, indicated less-positive feelings toward people with CMI. An intervention in which pre-clinical medical students visited patient-artist guides in an art-studio setting generally improved students' attitudes toward people with CMI. Thus, nontraditional psychiatric settings offer a valuable adjunct to more traditional clinical settings to reduce stigma when introducing medical students to the field of psychiatry.

Endurance with partnership: a preliminary conceptual framework for couples undergoing in vitro fertilisation treatment.

PubMed

Ying, Liying; Wu, Lai Har; Wu, Xiangli; Shu, Jing; Loke, Alice Yuen

2018-04-01

Infertility affects both women and men in the physical, emotional, existential, and interpersonal realms. When couples seek in vitro fertilisation (IVF) treatment, they further suffer from the difficulties of the treatment and the uncertainty of its outcome. The aim of this study was to develop a preliminary conceptual framework for couples undergoing IVF treatment to give health professionals a better understanding of the experiences of such couples, and to guide the development of an intervention. The process of identifying frameworks adopted in intervention studies confirmed that there is no established framework for infertile couples undergoing IVF treatment. A skeletal framework identified from previous studies provides an internal structure for the proposed framework for couples undergoing IVF treatment, filled out with concepts drawn from a concept analysis and a qualitative study, knitting the structure together. This preliminary framework is the Endurance with Partnership Conceptual Framework (P-EPCF). It consists of four domains: the impacts of infertility and stressors, dyadic mediators, dyadic moderators and dyadic outcomes. According to the P-EPCF, the impacts of infertility and IVF treatment can be mediated by the couples' partnership and dyadic coping. Improvements in the psychological well-being and marital functioning of IVF couples can then be expected. The P-EPCF would be potentially valuable in guiding the development of a complex, couple-based intervention, which could focus on enhancing the partnership of couples and their coping strategies.

Formative research to develop a lifestyle application (app) for African American breast cancer survivors

PubMed Central

Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Fontenot, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin

2016-01-01

Background There is a proliferation of lifestyle-oriented mobile technologies; however, few have targeted users. Through intervention mapping, investigators and community partners completed Steps 1–3 (needs assessment, formulation of change objectives, and selection of theory-based methods) of a process to develop a mobile cancer prevention application (app) for cancer prevention. The aim of this qualitative study was to complete Step 4 (intervention development) by eliciting input from African American (AA) breast cancer survivors (BCSs) to guide app development. Methods Four focus group discussions (n=60) and three individual semi-structured interviews (n=36) were conducted with AA BCSs (40–72 years of age) to assess barriers and strategies for lifestyle change. All focus groups and interviews were recorded and transcribed verbatim. Data were analyzed with NVivo qualitative data analysis software version 10, allowing categories, themes, and patterns to emerge. Results Three categories and related themes emerged from the analysis: 1) perceptions about modifiable risk factors; 2) strategies related to adherence to cancer prevention guidelines; and 3) app components to address barriers to adherence. Participant perceptions, strategies, and recommended components guided development of the app. Conclusions For development of a mobile cancer prevention app, these findings will assist investigators in targeting features that are usable, acceptable, and accessible for AA BCSs. PMID:27583307

A framework for the evaluation of new interventional procedures.

PubMed

Lourenco, Tania; Grant, Adrian M; Burr, Jennifer M; Vale, Luke

2012-03-01

The introduction of new interventional procedures is less regulated than for other health technologies such as pharmaceuticals. Decisions are often taken on evidence of efficacy and short-term safety from small-scale usually observational studies. This reflects the particular challenges of evaluating interventional procedures - the extra facets of skill and training and the difficulty defining a 'new' technology. Currently, there is no framework to evaluate new interventional procedures before they become available in clinical practice as opposed to new pharmaceuticals. This paper proposes a framework to guide the evaluation of a new interventional procedure. A framework was developed consisting of a four-stage progressive evaluation for a new interventional procedure: Stage 1: Development; Stage 2: Efficacy and short-term safety; Stage 3: Effectiveness and cost-effectiveness; and Stage 4: Implementation. The framework also suggests the types of studies or data collection methods that can be used to satisfy each stage. This paper makes a first step on a framework for generating evidence on new interventional procedures. The difficulties and limitations of applying such a framework are discussed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Narrative Means to Preventative Ends: A Narrative Engagement Framework for Designing Prevention Interventions

PubMed Central

Miller-Day, Michelle; Hecht, Michael L.

2013-01-01

This paper describes a Narrative Engagement Framework (NEF) for guiding communication-based prevention efforts. This framework suggests that personal narratives have distinctive capabilities in prevention. The paper discusses the concept of narrative, links narrative to prevention, and discusses the central role of youth in developing narrative interventions. As illustration, the authors describe how the NEF is applied in the keepin’ it REAL adolescent drug prevention curriculum, pose theoretical directions, and offer suggestions for future work in prevention communication. PMID:23980613

Gaps and Pathways Project: driving pathways by diagnosis sheets.

PubMed

Touchinsky, Susan; Chew, Felicia; Davis, Elin Schold

2014-04-01

This paper describes the development and use of information sheets for occupational therapy practitioners to use as guides for evaluation and intervention planning to address their client's driving and community mobility needs. Called Driving Pathways by Diagnosis Sheets, the information assists therapists with direction to connect impairment to driving risk and incorporate intervention to client goals and priorities related to driving and community mobility. An example of one of the sheets for the diagnosis of arthritis is highlighted and implications for use are discussed.

Resource Guide: Selected Early Childhood/Early Intervention Training Materials. 8th Edition.

ERIC Educational Resources Information Center

Catlett, Camille, Comp.; Winton, Pamela J., Comp.

This resource guide is intended to identify both primary and supplementary resources for designing preservice and inservice training on early intervention programs for children with disabilities. The instructional materials are described and listed in three sections. The first section provides annotated descriptions of instructional materials in…

Accelerated Reader/Reading Renaissance. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2007

2007-01-01

The Accelerated Reader/Reading Renaissance program (now called Accelerated Reader Best Classroom Practices) is a guided reading intervention in which teachers direct student reading of text. It involves two components. Reading Renaissance, the first component, is a set of recommended principles on guided reading (or teachers' direction of…

Community Health Environment Scan Survey (CHESS): a novel tool that captures the impact of the built environment on lifestyle factors.

PubMed

Wong, Fiona; Stevens, Denise; O'Connor-Duffany, Kathleen; Siegel, Karen; Gao, Yue

2011-03-07

Novel efforts and accompanying tools are needed to tackle the global burden of chronic disease. This paper presents an approach to describe the environments in which people live, work, and play. Community Health Environment Scan Survey (CHESS) is an empirical assessment tool that measures the availability and accessibility, of healthy lifestyle options lifestyle options. CHESS reveals existing community assets as well as opportunities for change, shaping community intervention planning efforts by focusing on community-relevant opportunities to address the three key risk factors for chronic disease (i.e. unhealthy diet, physical inactivity, and tobacco use). The CHESS tool was developed following a review of existing auditing tools and in consultation with experts. It is based on the social-ecological model and is adaptable to diverse settings in developed and developing countries throughout the world. For illustrative purposes, baseline results from the Community Interventions for Health (CIH) Mexico site are used, where the CHESS tool assessed 583 food stores and 168 restaurants. Comparisons between individual-level survey data from schools and community-level CHESS data are made to demonstrate the utility of the tool in strategically guiding intervention activities. The environments where people live, work, and play are key factors in determining their diet, levels of physical activity, and tobacco use. CHESS is the first tool of its kind that systematically and simultaneously examines how built environments encourage/discourage healthy eating, physical activity, and tobacco use. CHESS can help to design community interventions to prevent chronic disease and guide healthy urban planning. © 2011 Fiona Wong et al.

Supportive accountability: a model for providing human support to enhance adherence to eHealth interventions.

PubMed

Mohr, David C; Cuijpers, Pim; Lehman, Kenneth

2011-03-10

The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.

PET/CT-guided interventions: Indications, advantages, disadvantages and the state of the art.

PubMed

Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Koch, Guillaume; Tsoumakidou, Georgia; Caudrelier, Jean; Addeo, Pietro; Bachellier, Philippe; Namer, Izzie Jacques; Gangi, Afshin

2018-02-01

Positron emission tomography/computed tomography (PET/CT) represents an emerging imaging guidance modality that has been applied to successfully guide percutaneous procedures such as biopsies and tumour ablations. The aim of the present narrative review is to report the indications, advantages and disadvantages of PET/CT-guided procedures in the field of interventional oncology and to briefly describe the experience gained with this new emerging technique while performing biopsies and tumor ablations.

Development of Young Adults Eating and Active for Health (YEAH) internet-based intervention via a community-based participatory research model.

PubMed

Kattelmann, Kendra K; White, Adrienne A; Greene, Geoffrey W; Byrd-Bredbenner, Carol; Hoerr, Sharon L; Horacek, Tanya M; Kidd, Tandalayo; Colby, Sarah; Phillips, Beatrice W; Koenings, Mallory M; Brown, Onikia N; Olfert, Melissa; Shelnutt, Karla P; Morrell, Jesse Stabile

2014-01-01

To develop a tailored, theory-based, Web-delivered intervention to prevent excessive weight gain in young adults using a Community-Based Participatory Research model. Investigators from 14 universities developed the intervention and supporting administrative portal using the 4 phases of the PRECEDE model. Steering committees were composed of the target audience (aged 19-24 years) and key health/wellness personnel were formed at each institution and provided information during each phase that was used to guide development of the intervention, Project YEAH (Young Adults Eating and Active for Health). Piloting results were used to refine the curriculum and identify and avoid barriers to delivery. Qualitative and quantitative data collected at each phase informed Project YEAH development. In Phase 1, factors of highest priority to young adults were identified. In Phase 2, environmental supports for healthful lifestyles were elucidated. In Phase 3, behavior and environmental changes considered important and changeable were identified. In Phase 4, the 10-week, theory-based, stage-tailored, interactive-learning intervention with a 10-month reinforcement period was developed. Applying the PRECEDE model with fidelity during development of Project YEAH resulted in an intervention that pilot participants found relevant and useful, gained attention, instilled confidence in the ability to apply the information, and provided a sense of satisfaction. Copyright © 2014. Published by Elsevier Inc.

Pressure pain sensitivity as a marker for stress and pressure pain sensitivity-guided stress management in women with primary breast cancer.

PubMed

Axelsson, Christen K; Ballegaard, Søren; Karpatschof, Benny; Schousen, Peer

2014-08-01

To validate (1) Pressure Pain Sensitivity (PPS) as a marker for stress and (2) a PPS-guided intervention in women with primary Breast Cancer (BC). (1) A total of 58 women with BC were examined before and after 6 months of intervention. A control group of 165 women office employees was divided in a High Stress Group (HSG, n = 37) and a Low Stress Group (LSG, n = 128) to evaluate the association between PPS, questionnaire-related Quality of Life (QOL) and self-evaluated stress. (2) A PPS-guided stress management program (n = 40) was compared to a Psychosocial Group Intervention (PGI, n = 91) and no treatment (n = 86) with respect to a European Organization for Research and Treatment of Cancer (EORTC) questionnaire measured QOL. (1) Resting PPS and changes in PPS during the intervention period correlated significantly to EORTC and Short Form 36 (SF 36) main scores: (all p < 0.05). Between BC, HSG and LSG there was a significant and positive correlation with respect to PPS, SF 36 main scores, depression, and clinical stress scores (all p < 0.05). However, the BC group scored significantly lower than both HSG and LSG (both p < 0.05) with respect to self-evaluated stress. (2) The PPS-guided intervention group improved EORTC main score, pain and nausea, when compared to the control groups (all p < 0.05). PPS was positively associated with QOL, which was in contrast to self-evaluated stress. PPS-guided intervention improved QOL in women with breast cancer.

Selection and Evaluation of Media for Behavioral Health Interventions Employing Critical Media Analysis.

PubMed

Wilson, Patrick A; Cherenack, Emily M; Jadwin-Cakmak, Laura; Harper, Gary W

2018-01-01

Although a growing number of psychosocial health promotion interventions use the critical analysis of media to facilitate behavior change, no specific guidelines exist to assist researchers and practitioners in the selection and evaluation of culturally relevant media stimuli for intervention development. Mobilizing Our Voices for Empowerment is a critical consciousness-based health enhancement intervention for HIV-positive Black young gay/bisexual men that employs the critical analysis of popular media. In the process of developing and testing this intervention, feedback on media stimuli was collected from youth advisory board members (n = 8), focus group participants (n = 19), intervention participants (n = 40), and intervention facilitators (n = 6). A thematic analysis of qualitative data resulted in the identification of four key attributes of media stimuli and participants' responses to media stimuli that are important to consider when selecting and evaluating media stimuli for use in behavioral health interventions employing the critical analysis of media: comprehension, relevance, emotionality, and action. These four attributes are defined and presented as a framework for evaluating media, and adaptable tools are provided based on this framework to guide researchers and practitioners in the selection and evaluation of media for similar interventions.

Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools: study protocol for a cluster randomized controlled trial.

PubMed

Huang, Keng-Yen; Nakigudde, Janet; Calzada, Esther; Boivin, Michael J; Ogedegbe, Gbenga; Brotman, Laurie Miller

2014-12-01

Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students. The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions. The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings. This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.

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

PubMed

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

2005-01-01

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

A qualitative study exploring the views, attitudes and beliefs of patients and health professionals towards exercise intervention for people who are surgically treated for lung cancer.

PubMed

Crandall, K; Maguire, R; Campbell, A; Kearney, N

2018-03-01

Surgical removal remains the best curative option for patients diagnosed with early-stage lung cancer. However, it is also associated with significant morbidity and reduced quality of life. Interventions to improve patient outcomes are required. This study aimed to explore the views, attitudes and beliefs of key stakeholders on exercise intervention for people who are surgically treated for lung cancer to inform the development of future interventions. Focus groups and individual interviews were carried out at two Scottish sites. The study was guided by the Health Action Process Approach behaviour change model. A total of 23 (12 patients and 11 health professionals) participated in the study. The data analysis resulted in three main themes: attitudes and beliefs, external factors and intervention design. The results highlighted certain key elements that should be included in an exercise intervention, such as the need for supervised sessions, an element of individualisation and the perceived social benefits of exercising with others. This study emphasises the importance of including key stakeholders in the development of complex interventions such as exercise and provides important information for the development of future exercise intervention trials for people who are surgically treated for lung cancer. © 2018 John Wiley & Sons Ltd.

Developing a Risk Model to Target High-risk Preventive Interventions for Sexual Assault Victimization among Female U.S. Army Soldiers

PubMed Central

Street, Amy E.; Rosellini, Anthony J.; Ursano, Robert J.; Heeringa, Steven G.; Hill, Eric D.; Monahan, John; Naifeh, James A.; Petukhova, Maria V.; Reis, Ben Y.; Sampson, Nancy A.; Bliese, Paul D.; Stein, Murray B.; Zaslavsky, Alan M.; Kessler, Ronald C.

2016-01-01

Sexual violence victimization is a significant problem among female U.S. military personnel. Preventive interventions for high-risk individuals might reduce prevalence, but would require accurate targeting. We attempted to develop a targeting model for female Regular U.S. Army soldiers based on theoretically-guided predictors abstracted from administrative data records. As administrative reports of sexual assault victimization are known to be incomplete, parallel machine learning models were developed to predict administratively-recorded (in the population) and self-reported (in a representative survey) victimization. Capture-recapture methods were used to combine predictions across models. Key predictors included low status, crime involvement, and treated mental disorders. Area under the Receiver Operating Characteristic curve was .83−.88. 33.7-63.2% of victimizations occurred among soldiers in the highest-risk ventile (5%). This high concentration of risk suggests that the models could be useful in targeting preventive interventions, although final determination would require careful weighing of intervention costs, effectiveness, and competing risks. PMID:28154788

Development of a program logic model and evaluation plan for a participatory ergonomics intervention in construction.

PubMed

Jaegers, Lisa; Dale, Ann Marie; Weaver, Nancy; Buchholz, Bryan; Welch, Laura; Evanoff, Bradley

2014-03-01

Intervention studies in participatory ergonomics (PE) are often difficult to interpret due to limited descriptions of program planning and evaluation. In an ongoing PE program with floor layers, we developed a logic model to describe our program plan, and process and summative evaluations designed to describe the efficacy of the program. The logic model was a useful tool for describing the program elements and subsequent modifications. The process evaluation measured how well the program was delivered as intended, and revealed the need for program modifications. The summative evaluation provided early measures of the efficacy of the program as delivered. Inadequate information on program delivery may lead to erroneous conclusions about intervention efficacy due to Type III error. A logic model guided the delivery and evaluation of our intervention and provides useful information to aid interpretation of results. © 2013 Wiley Periodicals, Inc.

Development of a Program Logic Model and Evaluation Plan for a Participatory Ergonomics Intervention in Construction

PubMed Central

Jaegers, Lisa; Dale, Ann Marie; Weaver, Nancy; Buchholz, Bryan; Welch, Laura; Evanoff, Bradley

2013-01-01

Background Intervention studies in participatory ergonomics (PE) are often difficult to interpret due to limited descriptions of program planning and evaluation. Methods In an ongoing PE program with floor layers, we developed a logic model to describe our program plan, and process and summative evaluations designed to describe the efficacy of the program. Results The logic model was a useful tool for describing the program elements and subsequent modifications. The process evaluation measured how well the program was delivered as intended, and revealed the need for program modifications. The summative evaluation provided early measures of the efficacy of the program as delivered. Conclusions Inadequate information on program delivery may lead to erroneous conclusions about intervention efficacy due to Type III error. A logic model guided the delivery and evaluation of our intervention and provides useful information to aid interpretation of results. PMID:24006097

Storytelling/narrative theory to address health communication with minority populations.

PubMed

Lee, Haeok; Fawcett, Jacqueline; DeMarco, Rosanna

2016-05-01

To explain the development and application of storytelling/narrative theory in health disparities intervention research as a way to promote health communication and behavior change among racial, ethnic, and minority populations. The proposed storytelling theory helps explain that storytelling affects changes in attitude and health behavior of the viewer through realism, identification, and transportation. The proposed storytelling/narrative theory can be a guide to develop culturally grounded narrative interventions that have the ability to connect with hard-to-reach populations. Narrative communication is context-dependent because it derives meaning from the surrounding situation and provides situation-based stories that are a pathway to processing story content. Although storytelling is grounded in nursing practice and education, it is underutilized in nursing interventional research. Future efforts are needed to extend theory-based narrative intervention studies designed to change attitude and behaviors that will reduce health disparities among minorities. Copyright © 2015 Elsevier Inc. All rights reserved.

A behavior change model for internet interventions.

PubMed

Ritterband, Lee M; Thorndike, Frances P; Cox, Daniel J; Kovatchev, Boris P; Gonder-Frederick, Linda A

2009-08-01

The Internet has become a major component to health care and has important implications for the future of the health care system. One of the most notable aspects of the Web is its ability to provide efficient, interactive, and tailored content to the user. Given the wide reach and extensive capabilities of the Internet, researchers in behavioral medicine have been using it to develop and deliver interactive and comprehensive treatment programs with the ultimate goal of impacting patient behavior and reducing unwanted symptoms. To date, however, many of these interventions have not been grounded in theory or developed from behavior change models, and no overarching model to explain behavior change in Internet interventions has yet been published. The purpose of this article is to propose a model to help guide future Internet intervention development and predict and explain behavior changes and symptom improvement produced by Internet interventions. The model purports that effective Internet interventions produce (and maintain) behavior change and symptom improvement via nine nonlinear steps: the user, influenced by environmental factors, affects website use and adherence, which is influenced by support and website characteristics. Website use leads to behavior change and symptom improvement through various mechanisms of change. The improvements are sustained via treatment maintenance. By grounding Internet intervention research within a scientific framework, developers can plan feasible, informed, and testable Internet interventions, and this form of treatment will become more firmly established.

Assessment of an Intervention Curriculum Unit in Intergroup Education.

ERIC Educational Resources Information Center

Glick, Irvin David; Meinke, Dean L.

While materials for teaching for intergroup understandings in the form of books, curriculum guides, and articles are widely available for direct implementation into ongoing curricula, the actual development and implementation of this type of material into school programs has usually been reserved for specifically designated national dates.…

School Counselors Role in College Readiness for Students with Disabilities

ERIC Educational Resources Information Center

Temple, Michell; Roy, Jon; Gonder, Ty; Whisenhunt, Julia

2015-01-01

This article discusses the importance of the professional school counselors' participation in the development of self-determination skills students with disabilities need to transition from high school to college. An intervention is proposed to guide high school counselors' involvement. Strategies to promote college readiness through the…

Developing Clinically Practicable Biomarkers for Autism Spectrum Disorder

ERIC Educational Resources Information Center

McPartland, James C.

2017-01-01

Despite significant advances in understanding the biological bases of autism spectrum disorder (ASD), the field remains primarily reliant on observational and parent report measures of behavior to guide clinical practice, conduct research, and evaluate intervention outcomes. There is a critical need for objective measures to more sensitively and…

Medications for School-Age Children: Effects on Learning and Behavior.

ERIC Educational Resources Information Center

Brown, Ronald T.; Sawyer, Michael G.

Use of medications that target specific behaviors affecting learning and social development has been the most extensively studied form of intervention available to children with behavioral and learning problems. Drawing from extensive research literature spanning the past 30 years, this guide for psychologists and other professionals who work with…

The Logic of the Theoretical and Practical Products of Design Research

ERIC Educational Resources Information Center

Easterday, Matthew W.; Rees Lewis, Daniel G.; Gerber, Elizabeth M.

2016-01-01

Design research (DR) promises to simultaneously solve practical problems of education and develop theory to guide future interventions. However, educational DR remains paradigmatically underdeveloped, making it difficult to train new researchers, to agree upon what makes a theoretical contribution, and to promise clear outputs to funders--all of…

Parent Voices Guide Smoking Intervention Development

ERIC Educational Resources Information Center

Johnston, Robyn; Hearn, Lydia; Cross, Donna; Thomas, Laura T.; Bell, Sharon

2015-01-01

Purpose: While parents' influence on their children's smoking behaviour is widely recognised, little is known about parents of four to eight year olds' attitudes and beliefs around smoking cessation and how they communicate with their children about smoking. The purpose of this paper is to explore parents' perceptions of quitting smoking and their…

Enhancing Inter-Firm Networks and Interorganizational Strategies. Research in Management Consulting Series.

ERIC Educational Resources Information Center

Buono, Anthony F., Ed.

This book contain papers 13 papers on enhancing inter-firm networks, including by intervening in mergers and acquisitions and developing strategic alliances and partnerships. The following papers are included: "Introduction" (Anthony F. Buono); "Making Mergers and Acquisitions Work: A Guide to Consulting Interventions" (Mitchell Lee Marks);…

Classroom Technology Use and Middle School Mathematics Students' Self-Efficacy

ERIC Educational Resources Information Center

King, Jeriann Cline

2014-01-01

Educators face decisions when incorporating an expanding array of technological resources in mathematics education and interventions. Guided by Bandura's theory of self-efficacy, which holds that self-efficacy augments personal accomplishments, this quantitative study explored the relationship of Web 2.0 technology use and the development of…

Level System Use in Special Education: Classroom Intervention with Prima Facie Appeal.

ERIC Educational Resources Information Center

Smith, Stephen W.; Farrell, Daniel T.

1993-01-01

This article chronicles the development of level systems designed for students with significant behavior problems, to foster student improvement through self-management and positive reinforcement. The article examines assumptions underlying level systems' concepts and components and offers recommendations to guide future research into the design…

Positive Youth Development and Nutrition: Interdisciplinary Strategies to Enhance Student Outcomes

ERIC Educational Resources Information Center

Edwards, Oliver W.; Cheeley, Taylor

2016-01-01

Educational policies require the use of data and progress monitoring frameworks to guide instruction and intervention in schools. As a result, different problem-solving models such as multitiered systems of supports (MTSS) have emerged that use these frameworks to improve student outcomes. However, problem-focused models emphasize negative…

Counseling for Diversity. A Guide for School Counselors and Related Professionals.

ERIC Educational Resources Information Center

Lee, Courtland C., Ed.

This book provides practicing school counselors and their colleagues in related professions with direction for developing, implementing, and evaluating counseling programs for culturally diverse student groups. It also serves as a useful methods textbook for counselor training. Intervention strategies and counseling techniques are presented in the…

Development of a coping intervention to improve traumatic stress and HIV care engagement among South African women with sexual trauma histories.

PubMed

Sikkema, Kathleen J; Choi, Karmel W; Robertson, Corne; Knettel, Brandon A; Ciya, Nonceba; Knippler, Elizabeth T; Watt, Melissa H; Joska, John A

2018-06-01

This paper describes the development and preliminary trial run of ImpACT (Improving AIDS Care after Trauma), a brief coping intervention to address traumatic stress and HIV care engagement among South African women with sexual trauma histories. We engaged in an iterative process to culturally adapt a cognitive-behavioral intervention for delivery within a South African primary care clinic. This process involved three phases: (a) preliminary intervention development, drawing on content from a prior evidence-based intervention; (b) contextual adaptation of the curriculum through formative data collection using a multi-method qualitative approach; and (c) pre-testing of trauma screening procedures and a subsequent trial run of the intervention. Feedback from key informant interviews and patient in-depth interviews guided the refinement of session content and adaptation of key intervention elements, including culturally relevant visuals, metaphors, and interactive exercises. The trial run curriculum consisted of four individual sessions and two group sessions. Strong session attendance during the trial run supported the feasibility of ImpACT. Participants responded positively to the logistics of the intervention delivery and the majority of session content. Trial run feedback helped to further refine intervention content and delivery towards a pilot randomized clinical trial to assess the feasibility and potential efficacy of this intervention. Copyright © 2018 Elsevier Ltd. All rights reserved.

Restoring Body Image After Cancer (ReBIC): Results of a Randomized Controlled Trial.

PubMed

Esplen, Mary Jane; Wong, Jiahui; Warner, Ellen; Toner, Brenda

2018-03-10

Purpose This study aimed to test a group psychosocial intervention focused on improving disturbances of body image (BI), sexual functioning, and quality of life in breast cancer (BC) survivors. Methods A prospective, randomized controlled trial was conducted to assess the efficacy of an 8-week group intervention in women after BC treatment. The manual-based intervention combined two powerful ingredients: expressive guided-imagery exercises integrated within a model of group-therapy principles. The intervention facilitates exploration of identity, the development of new self-schemas, and personal growth. In addition, the intervention included an educational component on the social and cultural factors affecting women's self-esteem and BI. The control condition included standard care plus educational reading materials. One hundred ninety-four BC survivors who had expressed concerns about negative BI and/or difficulties with sexual functioning participated in the study; 131 were randomly assigned to the intervention, and 63 were assigned to the control condition. Participants were followed for 1 year. Results Women in the intervention group reported significantly less concern/distress about body appearance ( P < .01), decreased body stigma ( P < .01), and lower level of BC-related concerns ( P < .01), compared with women in the control group. BC-related quality of life was also better in the intervention group compared with the control group at the 1-year follow-up ( P < .01). There was no statistically significant group difference in sexual functioning. Conclusion Restoring Body Image After Cancer (ReBIC), a group intervention using guided imagery within a group-therapy approach, is an effective method for addressing BI-related concerns and quality of life post-BC. The manual-based intervention can be easily adapted to both cancer centers and primary care settings.

Interventional magnetic resonance imaging-guided cell transplantation into the brain with radially branched deployment.

PubMed

Silvestrini, Matthew T; Yin, Dali; Martin, Alastair J; Coppes, Valerie G; Mann, Preeti; Larson, Paul S; Starr, Philip A; Zeng, Xianmin; Gupta, Nalin; Panter, S S; Desai, Tejal A; Lim, Daniel A

2015-01-01

Intracerebral cell transplantation is being pursued as a treatment for many neurological diseases, and effective cell delivery is critical for clinical success. To facilitate intracerebral cell transplantation at the scale and complexity of the human brain, we developed a platform technology that enables radially branched deployment (RBD) of cells to multiple target locations at variable radial distances and depths along the initial brain penetration tract with real-time interventional magnetic resonance image (iMRI) guidance. iMRI-guided RBD functioned as an "add-on" to standard neurosurgical and imaging workflows, and procedures were performed in a commonly available clinical MRI scanner. Multiple deposits of super paramagnetic iron oxide beads were safely delivered to the striatum of live swine, and distribution to the entire putamen was achieved via a single cannula insertion in human cadaveric heads. Human embryonic stem cell-derived dopaminergic neurons were biocompatible with the iMRI-guided RBD platform and successfully delivered with iMRI guidance into the swine striatum. Thus, iMRI-guided RBD overcomes some of the technical limitations inherent to the use of straight cannulas and standard stereotactic targeting. This platform technology could have a major impact on the clinical translation of a wide range of cell therapeutics for the treatment of many neurological diseases.

The Empowerment of Low-Income Parents Engaged in a Childhood Obesity Intervention

PubMed Central

Jurkowski, Janine M.; Lawson, Hal A.; Green Mills, Lisa L.; Wilner, Paul G.; Davison, Kirsten K.

2017-01-01

Parents influence children’s obesity risk factors but are infrequently targeted for interventions. This study targeting low-income parents integrated a community-based participatory research approach with the Family Ecological Model and Empowerment Theory to develop a childhood obesity intervention. This article (1) examines pre- to postintervention changes in parents’ empowerment; (2) determines the effects of intervention dose on empowerment, and (3) determines whether changes in parent empowerment mediate previous changes identified in food-, physical activity–, and screen-related parenting. The pre-post quasi-experimental design evaluation demonstrated positive changes in parent empowerment and empowerment predicted improvement in parenting practices. The integrated model applied in this study provides a means to enhance intervention relevance and guide translation to other childhood obesity and health disparities studies. PMID:24569157

Achieving an optimal allocation of resources for animal health surveillance, intervention and disease mitigation.

PubMed

Hasler, B; Delabouglise, A; Babo Martins, S

2017-04-01

The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.

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

PubMed Central

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

2016-01-01

Background Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. Objective The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Methods Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. Results The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Conclusions Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible. PMID:27489143

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

PubMed

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

2016-08-03

Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible.

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 acceptability to participants.

Do guided internet-based interventions result in clinically relevant changes for patients with depression? An individual participant data meta-analysis.

PubMed

Karyotaki, Eirini; Ebert, David Daniel; Donkin, Liesje; Riper, Heleen; Twisk, Jos; Burger, Simone; Rozental, Alexander; Lange, Alfred; Williams, Alishia D; Zarski, Anna Carlotta; Geraedts, Anna; van Straten, Annemieke; Kleiboer, Annet; Meyer, Björn; Ünlü Ince, Burçin B; Buntrock, Claudia; Lehr, Dirk; Snoek, Frank J; Andrews, Gavin; Andersson, Gerhard; Choi, Isabella; Ruwaard, Jeroen; Klein, Jan Philipp; Newby, Jill M; Schröder, Johanna; Laferton, Johannes A C; Van Bastelaar, Kim; Imamura, Kotaro; Vernmark, Kristofer; Boß, Leif; Sheeber, Lisa B; Kivi, Marie; Berking, Matthias; Titov, Nickolai; Carlbring, Per; Johansson, Robert; Kenter, Robin; Perini, Sarah; Moritz, Steffen; Nobis, Stephanie; Berger, Thomas; Kaldo, Viktor; Forsell, Yvonne; Lindefors, Nils; Kraepelien, Martin; Björkelund, Cecilia; Kawakami, Norito; Cuijpers, Pim

2018-06-19

Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients' groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving internet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments. Copyright © 2018. Published by Elsevier Ltd.

Intervention Planning Using a Laser Navigation System for CT-Guided Interventions: A Phantom and Patient Study

PubMed Central

Lee, Clara; Bolck, Jan; Naguib, Nagy N.N.; Schulz, Boris; Eichler, Katrin; Aschenbach, Rene; Wichmann, Julian L.; Vogl, Thomas. J.; Zangos, Stephan

2015-01-01

Objective To investigate the accuracy, efficiency and radiation dose of a novel laser navigation system (LNS) compared to those of free-handed punctures on computed tomography (CT). Materials and Methods Sixty punctures were performed using a phantom body to compare accuracy, timely effort, and radiation dose of the conventional free-handed procedure to those of the LNS-guided method. An additional 20 LNS-guided interventions were performed on another phantom to confirm accuracy. Ten patients subsequently underwent LNS-guided punctures. Results The phantom 1-LNS group showed a target point accuracy of 4.0 ± 2.7 mm (freehand, 6.3 ± 3.6 mm; p = 0.008), entrance point accuracy of 0.8 ± 0.6 mm (freehand, 6.1 ± 4.7 mm), needle angulation accuracy of 1.3 ± 0.9° (freehand, 3.4 ± 3.1°; p < 0.001), intervention time of 7.03 ± 5.18 minutes (freehand, 8.38 ± 4.09 minutes; p = 0.006), and 4.2 ± 3.6 CT images (freehand, 7.9 ± 5.1; p < 0.001). These results show significant improvement in 60 punctures compared to freehand. The phantom 2-LNS group showed a target point accuracy of 3.6 ± 2.5 mm, entrance point accuracy of 1.4 ± 2.0 mm, needle angulation accuracy of 1.0 ± 1.2°, intervention time of 1.44 ± 0.22 minutes, and 3.4 ± 1.7 CT images. The LNS group achieved target point accuracy of 5.0 ± 1.2 mm, entrance point accuracy of 2.0 ± 1.5 mm, needle angulation accuracy of 1.5 ± 0.3°, intervention time of 12.08 ± 3.07 minutes, and used 5.7 ± 1.6 CT-images for the first experience with patients. Conclusion Laser navigation system improved accuracy, duration of intervention, and radiation dose of CT-guided interventions. PMID:26175571

Knowing so much, yet knowing so little: a scoping review of interventions that address the stigma of mental illness in the Canadian context.

PubMed

Guruge, Sepali; Wang, Arthur Ze Yu; Jayasuriya-Illesinghe, Vathsala; Sidani, Souraya

2017-06-01

Stigma can have detrimental effects on the health and wellbeing of individuals living with a mental illness. This scoping review describes the nature, range, and extent of intervention research aimed at reducing public and self-stigma of mental illness in the Canadian context. The review was guided by Arksey and O'Malley's framework. A search of databases and relevant websites identified 35 primary studies. Most studies used quantitative research methods and included predominantly youth or middle-aged adults, women, and white Canadian-born people. Guided by different conceptualizations of stigma, direct or indirect contact, education, and advocacy-focused interventions, aimed to provide information, and/or develop skills to address self and public stigma. Most studies evaluated interventions' effectiveness short-term. Of the few studies that followed-up participants long-term, some were able to reduce stigmatizing attitudes post-intervention, however, these targeted only specific groups such as students or health care professionals. Lack of diversity among the samples, and limited evidence of long-term effectiveness of interventions, were some of the studies' limitations. What is currently known about interventions aimed at reducing the stigma of mental illness in the Canadian context is not informed by research among vulnerable groups, such as people living with a mental illness, older adults, immigrants, and people of diverse ethnic backgrounds. Interventions that are informed by clear conceptualizations of stigma and rigorously evaluated in a range of ethno-cultural groups would create a knowledge base that is useful for policy-makers, community leaders, and agencies serving various ethnic communities in Canada.

Automated laser guidance of neuronal growth cones using a spatial light modulator.

PubMed

Carnegie, David J; Cizmár, Tomás; Baumgartl, Jörg; Gunn-Moore, Frank J; Dholakia, Kishan

2009-11-01

The growth cone of a developing neuron can be guided using a focused infra-red (IR) laser beam [1]. In previous setups this process has required a significant amount of user intervention to adjust continuously the laser beam to guide the growing neuron. Previously, a system using an acousto-optical deflector (AOD) has been developed to steer the beam [2]. However, to enhance the controllability of this system, here we demonstrate the use of a computer controlled spatial light modulator (SLM) to steer and manipulate the shape of a laser beam for use in guided neuronal growth. This new experimental setup paves the way to enable a comprehensive investigation into beam shaping effects on neuronal growth and we show neuronal growth initiated by a Bessel light mode. This is a robust platform to explore the biochemistry of this novel phenomenon. (c) 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

Theory-based evaluation of a comprehensive Latino education initiative: an interactive evaluation approach.

PubMed

Nesman, Teresa M; Batsche, Catherine; Hernandez, Mario

2007-08-01

Latino student access to higher education has received significant national attention in recent years. This article describes a theory-based evaluation approach used with ENLACE of Hillsborough, a 5-year project funded by the W.K. Kellogg Foundation for the purpose of increasing Latino student graduation from high school and college. Theory-based evaluation guided planning, implementation as well as evaluation through the process of developing consensus on the Latino population of focus, adoption of culturally appropriate principles and values to guide the project, and identification of strategies to reach, engage, and impact outcomes for Latino students and their families. The approach included interactive development of logic models that focused the scope of interventions and guided evaluation designs for addressing three stages of the initiative. Challenges and opportunities created by the approach are discussed, as well as ways in which the initiative impacted Latino students and collaborating educational institutions.

Practice-Based Evidence in Community Guide Systematic Reviews.

PubMed

Vaidya, Namita; Thota, Anilkrishna B; Proia, Krista K; Jamieson, Sara; Mercer, Shawna L; Elder, Randy W; Yoon, Paula; Kaufmann, Rachel; Zaza, Stephanie

2017-03-01

To assess the relative contributions and quality of practice-based evidence (PBE) and research-based evidence (RBE) in The Guide to Community Preventive Services (The Community Guide). We developed operational definitions for PBE and RBE in which the main distinguishing feature was whether allocation of participants to intervention and comparison conditions was under the control of researchers (RBE) or not (PBE). We conceptualized a continuum between RBE and PBE. We then categorized 3656 studies in 202 reviews completed since The Community Guide began in 1996. Fifty-four percent of studies were PBE and 46% RBE. Community-based and policy reviews had more PBE. Health care system and programmatic reviews had more RBE. The majority of both PBE and RBE studies were of high quality according to Community Guide scoring methods. The inclusion of substantial PBE in Community Guide reviews suggests that evidence of adequate rigor to inform practice is being produced. This should increase stakeholders' confidence that The Community Guide provides recommendations with real-world relevance. Limitations in some PBE studies suggest a need for strengthening practice-relevant designs and external validity reporting standards.

Design, delivery, and evaluation of early interventions for children exposed to acute trauma

PubMed Central

Kassam-Adams, Nancy

2014-01-01

Background Exposure to acute, potentially traumatic events is an unfortunately common experience for children and adolescents. Posttraumatic stress (PTS) responses following acute trauma can have an ongoing impact on child development and well-being. Early intervention to prevent or reduce PTS responses holds promise but requires careful development and empirical evaluation. Objectives The aims of this review paper are to present a framework for thinking about the design, delivery, and evaluation of early interventions for children who have been exposed to acute trauma; highlight targets for early intervention; and describe next steps for research and practice. Results and conclusions Proposed early intervention methods must (1) have a firm theoretical grounding that guides the design of intervention components; (2) be practical for delivery in peri-trauma or early post-trauma contexts, which may require creative models that go outside of traditional means of providing services to children; and (3) be ready for evaluation of both outcomes and mechanisms of action. This paper describes three potential targets for early intervention—maladaptive trauma-related appraisals, excessive early avoidance, and social/interpersonal processes—for which there is theory and evidence suggesting an etiological role in the development or persistence of PTS symptoms in children. PMID:25018860

Development of an Internet-Administered Cognitive Behavior Therapy Program (ENGAGE) for Parents of Children Previously Treated for Cancer: Participatory Action Research Approach.

PubMed

Wikman, Anna; Kukkola, Laura; Börjesson, Helene; Cernvall, Martin; Woodford, Joanne; Grönqvist, Helena; von Essen, Louise

2018-04-18

Parenting a child through cancer is a distressing experience, and a subgroup of parents report negative long-term psychological consequences years after treatment completion. However, there is a lack of evidence-based psychological interventions for parents who experience distress in relation to a child's cancer disease after end of treatment. One aim of this study was to develop an internet-administered, cognitive behavior therapy-based, psychological, guided, self-help intervention (ENGAGE) for parents of children previously treated for cancer. Another aim was to identify acceptable procedures for future feasibility and efficacy studies testing and evaluating the intervention. Participatory action research methodology was used. The study included face-to-face workshops and related Web-based exercises. A total of 6 parents (4 mothers, 2 fathers) of children previously treated for cancer were involved as parent research partners. Moreover, 2 clinical psychologists were involved as expert research partners. Research partners and research group members worked collaboratively throughout the study. Data were analyzed iteratively using written summaries of the workshops and Web-based exercises parallel to data collection. A 10-week, internet-administered, cognitive behavior therapy-based, psychological, guided, self-help intervention (ENGAGE) was developed in collaboration with parent research partners and expert research partners. The content of the intervention, mode and frequency of e-therapist support, and the individualized approach for feedback were modified based on the research partner input. Shared solutions were reached regarding the type and timing of support from an e-therapist (eg, initial video or telephone call, multiple methods of e-therapist contact), duration and timing of intervention (eg, 10 weeks, 30-min assessments), and the removal of unnecessary support functions (eg, removal of chat and forum functions). Preferences for study procedures in future studies testing and evaluating the intervention were discussed; consensus was not reached for all aspects. To the best of our knowledge, this study is the first use of a participatory action research approach to develop a psychological intervention for parents of children previously treated for cancer and to identify acceptable study procedures. Involvement of parents with lived experience was vital in the development of a potentially relevant and acceptable intervention for this population. ©Anna Wikman, Laura Kukkola, Helene Börjesson, Martin Cernvall, Joanne Woodford, Helena Grönqvist, Louise von Essen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.04.2018.

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

PubMed

Beaulieu, Dominique; Godin, Gaston

2012-08-01

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

Improving Early Reading: A Resource Guide for Elementary Schools.

ERIC Educational Resources Information Center

St. John, Edward P.; Loescher, Siri Ann

Indiana's Early Intervention Grant Program (EIGP) provides funding for Reading Recovery and other early interventions focused on improvement in early reading programs (Grades 1-5). This resource guide provides information that schools in Indiana can use to plan for proposals for EIGP and other grant programs, such as comprehensive school reform…

Therapeutic aspects of endoscopic ultrasound

NASA Astrophysics Data System (ADS)

Woodward, Timothy A.

1999-06-01

Endoscopic ultrasound (EUS) is a technology that had been used primarily as a passive imaging modality. Recent advances have enabled us to move beyond the use of EUS solely as a staging tool to an interventional device. Current studies suggest that interventional applications of EUS will allow for minimally invasive assessment and therapies in a cost-effective manner. Endoscopic ultrasound with fine needle aspiration (EUS-FNA) has been demonstrated to be a technically feasible, relatively safe method of obtaining cytologic specimens. The clinical utility of EUS- FNA appears to be greatest in the diagnosis and staging of pancreatic cancer and in the nodal staging of gastrointestinal and pulmonary malignancies. In addition, EUS-FNA has demonstrated utility in the sampling pleural and ascitic fluid not generally appreciated or assessable to standard interventions. Interventional applications of EUS include EUS-guided pseudocyst drainage, EUS-guided injection of botulinum toxin in the treatment of achalasia, and EUS- guided celiac plexus neurolysis in the treatment of pancreatic cancer pain. Finally, EUS-guided fine-needle installation is being evaluated, in conjunction with recent bimolecular treatment modalities, as a delivery system in the treatment of certain gastrointestinal tumors.

Patient-specific 3D printing simulation to guide complex coronary intervention.

PubMed

Oliveira-Santos, Manuel; Oliveira Santos, Eduardo; Marinho, Ana Vera; Leite, Luís; Guardado, Jorge; Matos, Vítor; Pego, Guilherme Mariano; Marques, João Silva

2018-05-07

The field of three-dimensional printing applied to patient-specific simulation is evolving as a tool to enhance intervention results. We report the first case of a fully simulated percutaneous coronary intervention in a three-dimensional patient-specific model to guide treatment. An 85-year-old female presented with symptomatic in-stent restenosis in the ostial circumflex and was scheduled for percutaneous coronary intervention. Considering the complexity of the anatomy, patient setting and intervention technique, we elected to replicate the coronary anatomy using a three-dimensional model. In this way, we simulated the intervention procedure beforehand in the catheterization laboratory using standard materials. The procedure was guided by optical coherence tomography, with pre-dilatation of the lesion, implantation of a single drug-eluting stent in the ostial circumflex and kissing balloon inflation to the left anterior descending artery and circumflex. Procedural steps were replicated in the real patient's treatment, with remarkable parallelism in angiographic outcome and luminal gain at intracoronary imaging. In this proof-of-concept report, we show that patient-specific simulation is feasible to guide the treatment strategy of complex coronary artery disease. It enables the surgical team to plan and practice the procedure beforehand, and possibly predict complications and gain confidence. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Empirically Based Strategies for Preventing Juvenile Delinquency.

PubMed

Pardini, Dustin

2016-04-01

Juvenile crime is a serious public health problem that results in significant emotional and financial costs for victims and society. Using etiologic models as a guide, multiple interventions have been developed to target risk factors thought to perpetuate the emergence and persistence of delinquent behavior. Evidence suggests that the most effective interventions tend to have well-defined treatment protocols, focus on therapeutic approaches as opposed to external control techniques, and use multimodal cognitive-behavioral treatment strategies. Moving forward, there is a need to develop effective policies and procedures that promote the widespread adoption of evidence-based delinquency prevention practices across multiple settings. Copyright © 2016 Elsevier Inc. All rights reserved.

PACS for surgery and interventional radiology: features of a Therapy Imaging and Model Management System (TIMMS).

PubMed

Lemke, Heinz U; Berliner, Leonard

2011-05-01

Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the "image-centric world view" of the classical PACS technology is complemented by an IT "model-centric world view". Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve the therapeutic disciplines by enabling modelling technology to be based on standards. Copyright © 2011. Published by Elsevier Ireland Ltd.

Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia.

PubMed

Morony, Suzanne; Weir, Kristie; Duncan, Gregory; Biggs, Janice; Nutbeam, Don; Mccaffery, Kirsten J

2018-03-07

Telehealth professionals require advanced communication skills, in part to compensate for lack of visual cues. Teach-Back is a best practice communication technique that has been recommended but not previously evaluated for consumer telehealth. We aimed to implement Teach-Back at a national maternal and child health telephone helpline. We describe the intervention and report telenurse experiences learning to use Teach-Back. We identified barriers (time, knowledge, skills, beliefs) and enablers (self-reflection) to using Teach-Back, and developed a novel training program to address these, guided by the Theoretical Domains Framework. We engaged maternal and child health telenurses to participate in a "communication skills" study. The intervention had two key components: guided self-reflection and a Teach-Back skills workshop. For the duration of the 7-week study nurses completed brief online surveys following each call, reflecting on both the effectiveness of their communication and perceived caller understanding. At the end of each shift they reflected on what worked well. Teach-Back knowledge, skills, and beliefs were addressed in a 2-h workshop using videos, discussion, and role play. We explored nurses' experiences of the intervention in focus groups and interviews; and analysed transcripts and comments from the self-reflection surveys using the Framework method. This study forms part of a larger evaluation conducted in 2016. In total 16 nurses participated: 15 were trained in Teach-Back, and 13 participated in focus groups or interviews. All engaged with both self-reflection and Teach-Back, although to differing extents. Those who reported acquiring Teach-Back skills easily limited themselves to one or two Teach-Back phrases. Nurses reported that actively self-reflecting (including on what they did well) was useful both for developing Teach-Back skills and analysing effectiveness of the techniques. Most wanted more opportunity to learn how their colleagues manage Teach-Back in different situations, and more visual reminders to use Teach-Back. Our theory-informed intervention successfully enabled nurses to use Teach-Back. Guided self-reflection is a low-resource method aligned with nurse professional identity that can facilitate Teach-Back skills learning, and could also be applied to other advanced communication skills for telehealth. Listening to multiple workplace-specific examples of Teach-Back is recommended for future training. ACTRN12616000623493 Registered 15 May 2016. Retrospectively registered.

Behavioral and Nondirective Guided Self-Help for Parents of Children with Externalizing Behavior: Mediating Mechanisms in a Head-To-Head Comparison.

PubMed

Katzmann, Josepha; Hautmann, Christopher; Greimel, Lisa; Imort, Stephanie; Pinior, Julia; Scholz, Kristin; Döpfner, Manfred

2017-05-01

Parent training (PT) delivered as a guided self-help intervention may be a cost- and time-effective intervention in the treatment of children with externalizing disorders. In face-to-face PT, parenting strategies have repeatedly been identified as mediating mechanisms for the decrease of children's problem behavior. Few studies have examined possible mediating effects in guided self-help interventions for parents. The present study aimed to investigate possible mediating variables of a behaviorally oriented guided self-help program for parents of children with externalizing problems compared to a nondirective intervention in a clinical sample. A sample of 110 parents of children with externalizing disorders (80 % boys) were randomized to either a behaviorally oriented or a nondirective guided self-help program. Four putative mediating variables were examined simultaneously in a multiple mediation model using structural equation modelling. The outcomes were child symptoms of ADHD and ODD as well as child externalizing problems, assessed at posttreatment. Analyses showed a significant indirect effect for dysfunctional parental attributions in favor of the group receiving the behavioral program, and significant effects of the behavioral program on positive and negative parenting and parental self-efficacy, compared to the nondirective intervention. Our results indicate that a decrease of dysfunctional parental attributions leads to a decrease of child externalizing problems when parents take part in a behaviorally oriented guided self-help program. However, none of the putative mediating variables could explain the decrease in child externalizing behavior problems in the nondirective group. A change in dysfunctional parental attributions should be considered as a possible mediator in the context of PT.

Using Behavioural Insights to Promote Food Waste Recycling in Urban Households—Evidence From a Longitudinal Field Experiment

PubMed Central

Linder, Noah; Lindahl, Therese; Borgström, Sara

2018-01-01

Promoting pro-environmental behaviour amongst urban dwellers is one of today's greatest sustainability challenges. The aim of this study is to test whether an information intervention, designed based on theories from environmental psychology and behavioural economics, can be effective in promoting recycling of food waste in an urban area. To this end we developed and evaluated an information leaflet, mainly guided by insights from nudging and community-based social marketing. The effect of the intervention was estimated through a natural field experiment in Hökarängen, a suburb of Stockholm city, Sweden, and was evaluated using a difference-in-difference analysis. The results indicate a statistically significant increase in food waste recycled compared to a control group in the research area. The data analysed was on the weight of food waste collected from sorting stations in the research area, and the collection period stretched for almost 2 years, allowing us to study the short- and long term effects of the intervention. Although the immediate positive effect of the leaflet seems to have attenuated over time, results show that there was a significant difference between the control and the treatment group, even 8 months after the leaflet was distributed. Insights from this study can be used to guide development of similar pro-environmental behaviour interventions for other urban areas in Sweden and abroad, improving chances of reaching environmental policy goals. PMID:29623056

Electromagnetic tracking for abdominal interventions in computer aided surgery

PubMed Central

Zhang, Hui; Banovac, Filip; Lin, Ralph; Glossop, Neil; Wood, Bradford J.; Lindisch, David; Levy, Elliot; Cleary, Kevin

2014-01-01

Electromagnetic tracking has great potential for assisting physicians in precision placement of instruments during minimally invasive interventions in the abdomen, since electromagnetic tracking is not limited by the line-of-sight restrictions of optical tracking. A new generation of electromagnetic tracking has recently become available, with sensors small enough to be included in the tips of instruments. To fully exploit the potential of this technology, our research group has been developing a computer aided, image-guided system that uses electromagnetic tracking for visualization of the internal anatomy during abdominal interventions. As registration is a critical component in developing an accurate image-guided system, we present three registration techniques: 1) enhanced paired-point registration (time-stamp match registration and dynamic registration); 2) orientation-based registration; and 3) needle shape-based registration. Respiration compensation is another important issue, particularly in the abdomen, where respiratory motion can make precise targeting difficult. To address this problem, we propose reference tracking and affine transformation methods. Finally, we present our prototype navigation system, which integrates the registration, segmentation, path-planning and navigation functions to provide real-time image guidance in the clinical environment. The methods presented here have been tested with a respiratory phantom specially designed by our group and in swine animal studies under approved protocols. Based on these tests, we conclude that our system can provide quick and accurate localization of tracked instruments in abdominal interventions, and that it offers a user friendly display for the physician. PMID:16829506

Autism and Equine-Assisted Interventions: A Systematic Mapping Review.

PubMed

McDaniel Peters, B Caitlin; Wood, Wendy

2017-10-01

This systematic mapping review mapped current knowledge of equine-assisted interventions for people with autism to help guide future practice and research. Thirty-three studies including children and adolescents with autism, 3 of which confirmed diagnoses, were reviewed. Five types of equine-assisted activities were identified across 25 studies, with reported improvements in behavior, social interaction, and communication. Four types of equine-assisted therapies were identified across 8 studies, with reported improvements in motor control and self-care. Different approaches to therapeutic riding and hippotherapy, the most studied interventions, were evident. While this literature reflected early scientific development, it offered broad proof of concept that equine-assisted interventions can benefit children and adolescents with autism. Promising outcomes support continued investigation focused on standardization, appropriateness, and efficacy.

Musculoskeletal ultrasound for interventional physiatry.

PubMed

De Muynck, M; Parlevliet, T; De Cock, K; Vanden Bossche, L; Vanderstraeten, G; Özçakar, L

2012-12-01

More and more physiatrists are interested in learning how to use musculoskeletal ultrasonography in their clinical practice. The possibility of high resolution, dynamic, comparative and repeatable imaging makes it an important diagnostic tool for soft tissue pathology. There is also growing interest to use sonography for guiding interventions such as aspirations and infiltrations. In daily practice these are often done blindly or palpation-guided. To improve the accuracy of interventions, fluoroscopy or computed tomography were traditionally used for guidance. Since sonography is non-ionizing, readily available and relatively low cost, it has become the first choice to guide many musculoskeletal interventions. Ultrasound allows real-time imaging of target and needle as well as surrounding vulnerable structures such as vessels and nerves. Many different techniques are proposed in the literature. Interventions under ultrasound guidance have been proven to be more accurate than unguided ones. Further studies are required to prove better clinical results and fewer complications. Infection is the most dreaded complication. This review wants to highlight technical aspects of ultrasound guidance of interventions and give a survey of different interventions that have been introduced, with emphasis on applications in Physical Medicine and Rehabilitation. Results and complications are discussed. Finally training requirements and modalities are presented.

Bereaved mothers' and fathers' perceptions of a legacy intervention for parents of infants in the NICU.

PubMed

Akard, T F; Duffy, M; Hord, A; Randall, A; Sanders, A; Adelstein, K; Anani, U E; Gilmer, M J

2018-01-01

Legacy-making, actions or behaviors aimed at being remembered, may be one strategy to enhance coping and improve grief outcomes for bereaved parents and siblings. While legacy interventions have been developed and tested in pediatric and adult populations, legacy activities specific to bereaved parents in the neonatal intensive care unit remain unexplored. This study explored bereaved parents' perceptions of a digital storytelling legacy-making intervention for parents after the death of an infant. Six bereaved mothers and fathers participated in a focus group interview three to 12 months after the death of an infant in the NICU. A semi-structured interview guide with open-ended questions was used to obtain parent self-reports. Qualitative content analysis identified emerging themes. Four major themes emerged regarding participants' perceptions of a legacy intervention: (a) parents' willingness to participate in a legacy intervention, (b) parents' suggestions for a feasible intervention, (c) parents' suggestions for an acceptable intervention, and (d) parents' perceived benefits of legacy-making. Participants reported that a legacy-making intervention via digital storytelling would be feasible, acceptable, and beneficial for NICU parents. Study results support the need and desire for legacy-making services to be developed and offered in the NICU.

Outcomes of percutaneous coronary intervention in intermediate coronary artery disease: fractional flow reserve-guided versus intravascular ultrasound-guided.

PubMed

Nam, Chang-Wook; Yoon, Hyuck-Jun; Cho, Yun-Kyeong; Park, Hyoung-Seob; Kim, Hyungseop; Hur, Seung-Ho; Kim, Yoon-Nyun; Chung, In-Sung; Koo, Bon-Kwon; Tahk, Seung-Jae; Fearon, William F; Kim, Kwon-Bae

2010-08-01

This study sought to evaluate the long-term clinical outcomes of a fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) strategy compared with intravascular ultrasound (IVUS)-guided PCI for intermediate coronary lesions. Both FFR- and IVUS-guided PCI strategies have been reported to be safe and effective in intermediate coronary lesions. The study included 167 consecutive patients, with intermediate coronary lesions evaluated by FFR or IVUS (FFR-guided, 83 lesions vs. IVUS-guided, 94 lesions). Cutoff value of FFR in FFR-guided PCI was 0.80, whereas that for minimal lumen cross sectional area in IVUS-guided PCI was 4.0 mm(2). The primary outcome was defined as a composite of major adverse cardiac events including death, myocardial infarction, and ischemia-driven target vessel revascularization at 1 year after the index procedure. Baseline percent diameter stenosis and lesion length were similar in both groups (51 +/- 8% and 24 +/- 12 mm in the FFR group vs. 52 +/- 8% and 24 +/- 13 mm in the IVUS group, respectively). However, the IVUS-guided group underwent revascularization therapy significantly more often (91.5% vs. 33.7%, p < 0.001). No significant difference was found in major adverse cardiac event rates between the 2 groups (3.6% in FFR-guided PCI vs. 3.2% in IVUS-guided PCI). Independent predictors for performing intervention were guiding device: FFR versus IVUS (relative risk [RR]: 0.02); left anterior descending coronary artery versus non-left anterior descending coronary artery disease (RR: 5.60); and multi- versus single-vessel disease (RR: 3.28). Both FFR- and IVUS-guided PCI strategy for intermediate coronary artery disease were associated with favorable outcomes. The FFR-guided PCI reduces the need for revascularization of many of these lesions. Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Using the intervention mapping protocol to reduce European preschoolers' sedentary behavior, an application to the ToyBox-Study.

PubMed

De Decker, Ellen; De Craemer, Marieke; De Bourdeaudhuij, Ilse; Verbestel, Vera; Duvinage, Kristin; Iotova, Violeta; Grammatikaki, Evangelia; Wildgruber, Andreas; Mouratidou, Theodora; Manios, Yannis; Cardon, Greet

2014-02-19

High levels of sedentary behavior are often measured in preschoolers, but only a few interventions have been developed to counteract this. Furthermore, detailed descriptions of interventions in preschoolers targeting different forms of sedentary behavior could not be located in the literature. The aim of the present paper was to describe the different steps of the Intervention Mapping Protocol used towards the development of an intervention component of the ToyBox-study focusing on decreasing preschoolers' sedentary behavior. The ToyBox-study focuses on the prevention of overweight in 4- to 6-year-old children by implementing a multi-component kindergarten-based intervention with family involvement in six different European countries. Applying the Intervention Mapping Protocol, six different steps were systematically completed for the structured planning and development of the intervention. A literature search and results from focus groups with parents/caregivers and kindergarten teachers were used as a guide during the development of the intervention and the intervention materials. The application of the different steps in the Intervention Mapping Protocol resulted in the creation of matrices of change objectives, followed by the selection of practical applications for five different intervention tools that could be used at the individual level of the preschool child, at the interpersonal level (i.e., parents/caregivers) and at the organizational level (i.e., kindergarten teachers). No cultural differences regarding preschoolers' sedentary behavior were identified between the participating countries during the focus groups, so cultural and local adaptations of the intervention materials were not necessary to improve the adoption and implementation of the intervention. A systematic and evidence-based approach was used for the development of this kindergarten-based family-involved intervention targeting preschoolers, with the inclusion of parental involvement. The application of the Intervention Mapping Protocol may lead to the development of more effective interventions. The detailed intervention matrices that were developed as part of the ToyBox-study can be used by other researchers as an aid in order to avoid repetitive work for the design of similar interventions.

Using the intervention mapping protocol to reduce European preschoolers’ sedentary behavior, an application to the ToyBox-Study

PubMed Central

2014-01-01

Background High levels of sedentary behavior are often measured in preschoolers, but only a few interventions have been developed to counteract this. Furthermore, detailed descriptions of interventions in preschoolers targeting different forms of sedentary behavior could not be located in the literature. The aim of the present paper was to describe the different steps of the Intervention Mapping Protocol used towards the development of an intervention component of the ToyBox-study focusing on decreasing preschoolers’ sedentary behavior. The ToyBox-study focuses on the prevention of overweight in 4- to 6-year-old children by implementing a multi-component kindergarten-based intervention with family involvement in six different European countries. Methods Applying the Intervention Mapping Protocol, six different steps were systematically completed for the structured planning and development of the intervention. A literature search and results from focus groups with parents/caregivers and kindergarten teachers were used as a guide during the development of the intervention and the intervention materials. Results The application of the different steps in the Intervention Mapping Protocol resulted in the creation of matrices of change objectives, followed by the selection of practical applications for five different intervention tools that could be used at the individual level of the preschool child, at the interpersonal level (i.e., parents/caregivers) and at the organizational level (i.e., kindergarten teachers). No cultural differences regarding preschoolers’ sedentary behavior were identified between the participating countries during the focus groups, so cultural and local adaptations of the intervention materials were not necessary to improve the adoption and implementation of the intervention. Conclusions A systematic and evidence-based approach was used for the development of this kindergarten-based family-involved intervention targeting preschoolers, with the inclusion of parental involvement. The application of the Intervention Mapping Protocol may lead to the development of more effective interventions. The detailed intervention matrices that were developed as part of the ToyBox-study can be used by other researchers as an aid in order to avoid repetitive work for the design of similar interventions. PMID:24552138

Use of Evidence in the Implementation of Social Programs: A Qualitative Study from Chile.

PubMed

Flores, Rodrigo; Naranjo, Carola; Hein, Andreas

2016-01-01

Through this qualitative, empirical study the authors aim to explore and describe the sources of knowledge that are used to guide intervention practice by social workers in Chile. Particular attention was paid to factors that may facilitate or hinder the use of research-based evidence to guide social interventions design, implementation, and outcome evaluation. In order to explore these issues, 25 semi-structured interviews with social workers from Chilean social service non-profit organizations were conducted. The main findings suggest that social workers do not use research-based evidence to support their social interventions due to various personal organizational constraints (e.g., lack of time, lack of access to resources for disseminating evidence, lack of English command). In addition, no evaluation processes of social programs which will support evidence-based effectiveness could be found. One key barrier to support use of evidence and evidence production may be related to the fact that most non-governmental organizations maintain a hierarchical and vertical relationship with state agencies (program design, oversight, and funding) for social program development.

Costing behavioral interventions: a practical guide to enhance translation.

PubMed

Ritzwoller, Debra P; Sukhanova, Anna; Gaglio, Bridget; Glasgow, Russell E

2009-04-01

Cost and cost effectiveness of behavioral interventions are critical parts of dissemination and implementation into non-academic settings. Due to the lack of indicative data and policy makers' increasing demands for both program effectiveness and efficiency, cost analyses can serve as valuable tools in the evaluation process. To stimulate and promote broader use of practical techniques that can be used to efficiently estimate the implementation costs of behavioral interventions, we propose a set of analytic steps that can be employed across a broad range of interventions. Intervention costs must be distinguished from research, development, and recruitment costs. The inclusion of sensitivity analyses is recommended to understand the implications of implementation of the intervention into different settings using different intervention resources. To illustrate these procedures, we use data from a smoking reduction practical clinical trial to describe the techniques and methods used to estimate and evaluate the costs associated with the intervention. Estimated intervention costs per participant were $419, with a range of $276 to $703, depending on the number of participants.

Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

PubMed

Besharati, Fereshteh; Karimi-Shahanjarini, Akram; Hazavehei, Seyed Mohammad Mehdi; Bashirian, Saeid; Bagheri, Fahimeh; Faradmal, Javad

2017-08-27

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (P<0.001). Conclusions: IM is a useful process in the design of a theory-based intervention addressing CRC screening among Iranian population. Creative Commons Attribution License

Perspectives in ultrasound-guided musculoskeletal interventions

PubMed Central

Daftary, Aditya Ravindra; Karnik, Alpana Sudhir

2015-01-01

Ultrasonography (USG) is a safe, easily available, and cost-effective modality, which has the additional advantage of being real time for imaging and image-guided interventions of the musculoskeletal system. Musculoskeletal interventions are gaining popularity in sports and rehabilitation for rapid healing of muscle and tendon injuries in professional athletes, healing of chronic tendinopathies, aspiration of joint effusions, periarticular bursae and ganglia, and perineural injections in acute and chronic pain syndromes. This article aims to provide an overview of the spectrum of musculoskeletal interventions that can be done under USG guidance both for diagnostic and therapeutic purposes. PMID:26288519

Effectiveness of an intervention to increase construction workers' use of hearing protection.

PubMed

Lusk, S L; Hong, O S; Ronis, D L; Eakin, B L; Kerr, M J; Early, M R

1999-09-01

In this project we tested the effectiveness of a theory-based intervention (video, pamphlets, and guided practice session) to increase the use of hearing protection devices (HPDs) among Midwestern construction workers and a national group of plumber/pipefitter trainers. Posttest measures were collected 10-12 months following this intervention. Pender's Health Promotion Model (1987) provided the conceptual basis for development of the training program. A total of 837 high-noise-exposed workers were included in the analysis: 652 regional Midwestern construction workers and 185 national plumber/pipefitter trainers. Effectiveness of the intervention was determined through the sequence of analyses recommended by Braver and Braver (1988) for the Solomon Four-Group Design. Analysis of variance and covariance of postintervention use and intention to use HPDs and a meta-analytic test were done. These analyses indicated that the intervention significantly increased use of HPDs but had no effect on intention to use HPDs in the future. Pretesting had no effect on use. Actual or potential applications of this research include guidance in the development of successful theory-based interventions to increase use of HPDs.

The Effect of a State Department of Education Teacher Mentor Initiative on Science Achievement

NASA Astrophysics Data System (ADS)

Pruitt, Stephen L.; Wallace, Carolyn S.

2012-06-01

This study investigated the effectiveness of a southern state's department of education program to improve science achievement through embedded professional development of science teachers in the lowest performing schools. The Science Mentor Program provided content and inquiry-based coaching by teacher leaders to science teachers in their own classrooms. The study analyzed the mean scale scores for the science portion of the state's high school graduation test for the years 2004 through 2007 to determine whether schools receiving the intervention scored significantly higher than comparison schools receiving no intervention. The results showed that all schools achieved significant improvement of scale scores between 2004 and 2007, but there were no significant performance differences between intervention and comparison schools, nor were there any significant differences between various subgroups in intervention and comparison schools. However, one subgroup, economically disadvantaged (ED) students, from high-level intervention schools closed the achievement gap with ED students from no-intervention schools across the period of the study. The study provides important information to guide future research on and design of large-scale professional development programs to foster inquiry-based science.

Field tests of a participatory ergonomics toolkit for Total Worker Health

PubMed Central

Kernan, Laura; Plaku-Alakbarova, Bora; Robertson, Michelle; Warren, Nicholas; Henning, Robert

2018-01-01

Growing interest in Total Worker Health® (TWH) programs to advance worker safety, health and well-being motivated development of a toolkit to guide their implementation. Iterative design of a program toolkit occurred in which participatory ergonomics (PE) served as the primary basis to plan integrated TWH interventions in four diverse organizations. The toolkit provided start-up guides for committee formation and training, and a structured PE process for generating integrated TWH interventions. Process data from program facilitators and participants throughout program implementation were used for iterative toolkit design. Program success depended on organizational commitment to regular design team meetings with a trained facilitator, the availability of subject matter experts on ergonomics and health to support the design process, and retraining whenever committee turnover occurred. A two committee structure (employee Design Team, management Steering Committee) provided advantages over a single, multilevel committee structure, and enhanced the planning, communication, and team-work skills of participants. PMID:28166897

Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology.

PubMed

Räber, Lorenz; Mintz, Gary S; Koskinas, Konstantinos C; Johnson, Thomas W; Holm, Niels R; Onuma, Yoshinubo; Radu, Maria D; Joner, Michael; Yu, Bo; Jia, Haibo; Menevau, Nicolas; de la Torre Hernandez, Jose M; Escaned, Javier; Hill, Jonathan; Prati, Francesco; Colombo, Antonio; di Mario, Carlo; Regar, Evelyn; Capodanno, Davide; Wijns, William; Byrne, Robert A; Guagliumi, Giulio

2018-05-22

This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior to PCI for optimizing stent sizing (stent length and diameter) and planning the procedural strategy is discussed. Regarding post-implantation imaging, the consensus group recommends key parameters that characterize an optimal PCI result and provides cut-offs to guide corrective measures and optimize the stenting result. Moreover, routine performance of intracoronary imaging in patients with stent failure (restenosis or stent thrombosis) is recommended. Finally, strengths and limitations of IVUS and OCT for guiding PCI and assessing stent failures and areas that warrant further research are critically discussed.

Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial.

PubMed

Calner, T; Nordin, C; Eriksson, M K; Nyberg, L; Gard, G; Michaelson, P

2017-07-01

Web-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life. We included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life. There were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables. This trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain. The comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations. © 2017 European Pain Federation - EFIC®.

Application of the Intervention Mapping protocol to develop Keys, a family child care home intervention to prevent early childhood obesity.

PubMed

Mann, Courtney M; Ward, Dianne S; Vaughn, Amber; Benjamin Neelon, Sara E; Long Vidal, Lenita J; Omar, Sakinah; Namenek Brouwer, Rebecca J; Østbye, Truls

2015-12-10

Many families rely on child care outside the home, making these settings important influences on child development. Nearly 1.5 million children in the U.S. spend time in family child care homes (FCCHs), where providers care for children in their own residences. There is some evidence that children in FCCHs are heavier than those cared for in centers. However, few interventions have targeted FCCHs for obesity prevention. This paper will describe the application of the Intervention Mapping (IM) framework to the development of a childhood obesity prevention intervention for FCCHs Following the IM protocol, six steps were completed in the planning and development of an intervention targeting FCCHs: needs assessment, formulation of change objectives matrices, selection of theory-based methods and strategies, creation of intervention components and materials, adoption and implementation planning, and evaluation planning Application of the IM process resulted in the creation of the Keys to Healthy Family Child Care Homes program (Keys), which includes three modules: Healthy You, Healthy Home, and Healthy Business. Delivery of each module includes a workshop, educational binder and tool-kit resources, and four coaching contacts. Social Cognitive Theory and Self-Determination Theory helped guide development of change objective matrices, selection of behavior change strategies, and identification of outcome measures. The Keys program is currently being evaluated through a cluster-randomized controlled trial The IM process, while time-consuming, enabled rigorous and systematic development of intervention components that are directly tied to behavior change theory and may increase the potential for behavior change within the FCCHs.

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

PubMed Central

2012-01-01

Background Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity. Objective In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the “black box” of Web-based intervention development and to support future Web-based intervention development. Methods The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables. Results The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk-reduction behavior of patients with cardiovascular risk factors. Conclusions The Intervention Mapping protocol provided a systematic method for developing the intervention and each intervention design choice was carefully thought-out and justified. Although it was not a rapid or an easy method for developing an intervention, the protocol guided and directed the development process. The application of evidence-based behavior change methods used in our intervention offers insight regarding how an intervention may change intention and health behavior. The Web-based intervention appeared feasible and was implemented. Further research will test the effectiveness of the PIB2 intervention. Trial Registration Dutch Trial Register, Trial ID: ECP-92 PMID:23612470

Your blues ain't like mine: considering integrative antiracism in HIV prevention research with black men who have sex with men in Canada and the United States.

PubMed

Nelson, LaRon E; Walker, Ja'Nina J; DuBois, Steve N; Giwa, Sulaimon

2014-12-01

Evidence-based interventions have been developed and used to prevent HIV infections among black men who have sex with men (MSM) in Canada and the United States; however, the degree to which interventions address racism and other interlocking oppressions that influence HIV vulnerability is not well known. We utilize integrative antiracism to guide a review of HIV prevention intervention studies with black MSM and to determine how racism and religious oppression are addressed in the current intervention evidence base. We searched CINAHL, PsychInfo, MEDLINE and the CDC compendium of evidence-based HIV prevention interventions and identified seventeen interventions. Three interventions targeted black MSM, yet only one intervention addressed racism, religious oppression, cultural assets and religious assets. Most interventions' samples included low numbers of black MSM. More research is needed on interventions that address racism and religious oppression on HIV vulnerability among black MSM. Future research should focus on explicating mechanisms by which multiple oppressions impact HIV vulnerability. We recommend the development and integration of social justice tools for nursing practice that aid in addressing the impacts of racism and other oppressions on HIV vulnerability of black MSM. © 2014 John Wiley & Sons Ltd.

Development of a theory-based intervention to increase prescription of inspiratory muscle training by health professionals in the management of people with chronic obstructive pulmonary disease.

PubMed

Simms, Alanna M; Li, Linda C; Reid, W Darlene

2011-01-01

The purpose of this paper is twofold: (1) to provide an overview of the literature on barriers to evidence-based practice (EBP) and the effectiveness of implementation interventions in health care; and (2) to outline the development of an implementation intervention for improving the prescription of inspiratory muscle training (IMT) by physical therapists and other health professionals for people with chronic obstructive pulmonary disease (COPD). Individuals, organizations, and the research itself present barriers to EBP in physical therapy. Despite the evidence supporting the use of IMT, this treatment continues to be under-used in managing COPD. Current health services research shows that traditional information-based approaches to implementation, such as didactic lectures, do not adequately address the challenges health professionals face when trying to make changes in practice. We propose the development of a theory-based intervention to improve health professionals' use of IMT in the management of COPD. It is postulated that a behavioural intervention, based on the theory of planned behaviour (TPB), may be more effective than an information-based strategy in increasing the prescription of IMT by health professionals. TPB may be used to understand the antecedents of health professionals' behaviour and to guide the development of implementation interventions. Further research is needed to evaluate the effectiveness of this proposed intervention in the management of people with COPD.

A Call to Digital Health Practitioners: New Guidelines Can Help Improve the Quality of Digital Health Evidence

PubMed Central

Agarwal, Smisha; Lefevre, Amnesty E

2017-01-01

Background Despite the rapid proliferation of health interventions that employ digital tools, the evidence on the effectiveness of such approaches remains insufficient and of variable quality. To address gaps in the comprehensiveness and quality of reporting on the effectiveness of digital programs, the mHealth Technical Evidence Review Group (mTERG), convened by the World Health Organization, proposed the mHealth Evidence Reporting and Assessment (mERA) checklist to address existing gaps in the comprehensiveness and quality of reporting on the effectiveness of digital health programs. Objective We present an overview of the mERA checklist and encourage researchers working in the digital health space to use the mERA checklist for reporting their research. Methods The development of the mERA checklist consisted of convening an expert group to recommend an appropriate approach, convening a global expert review panel for checklist development, and pilot-testing the checklist. Results The mERA checklist consists of 16 core mHealth items that define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features). Additionally, a 29-item methodology checklist guides authors on reporting critical aspects of the research methodology employed in the study. We recommend that the core mERA checklist is used in conjunction with an appropriate study-design specific checklist. Conclusions The mERA checklist aims to assist authors in reporting on digital health research, guide reviewers and policymakers in synthesizing evidence, and guide journal editors in assessing the completeness in reporting on digital health studies. An increase in transparent and rigorous reporting can help identify gaps in the conduct of research and understand the effects of digital health interventions as a field of inquiry. PMID:28986340

Multimode C-arm fluoroscopy, tomosynthesis, and cone-beam CT for image-guided interventions: from proof of principle to patient protocols

NASA Astrophysics Data System (ADS)

Siewerdsen, J. H.; Daly, M. J.; Bachar, G.; Moseley, D. J.; Bootsma, G.; Brock, K. K.; Ansell, S.; Wilson, G. A.; Chhabra, S.; Jaffray, D. A.; Irish, J. C.

2007-03-01

High-performance intraoperative imaging is essential to an ever-expanding scope of therapeutic procedures ranging from tumor surgery to interventional radiology. The need for precise visualization of bony and soft-tissue structures with minimal obstruction to the therapy setup presents challenges and opportunities in the development of novel imaging technologies specifically for image-guided procedures. Over the past ~5 years, a mobile C-arm has been modified in collaboration with Siemens Medical Solutions for 3D imaging. Based upon a Siemens PowerMobil, the device includes: a flat-panel detector (Varian PaxScan 4030CB); a motorized orbit; a system for geometric calibration; integration with real-time tracking and navigation (NDI Polaris); and a computer control system for multi-mode fluoroscopy, tomosynthesis, and cone-beam CT. Investigation of 3D imaging performance (noise-equivalent quanta), image quality (human observer studies), and image artifacts (scatter, truncation, and cone-beam artifacts) has driven the development of imaging techniques appropriate to a host of image-guided interventions. Multi-mode functionality presents a valuable spectrum of acquisition techniques: i.) fluoroscopy for real-time 2D guidance; ii.) limited-angle tomosynthesis for fast 3D imaging (e.g., ~10 sec acquisition of coronal slices containing the surgical target); and iii.) fully 3D cone-beam CT (e.g., ~30-60 sec acquisition providing bony and soft-tissue visualization across the field of view). Phantom and cadaver studies clearly indicate the potential for improved surgical performance - up to a factor of 2 increase in challenging surgical target excisions. The C-arm system is currently being deployed in patient protocols ranging from brachytherapy to chest, breast, spine, and head and neck surgery.

An intervention fidelity framework for technology-based behavioral interventions.

PubMed

Devito Dabbs, Annette; Song, Mi-Kyung; Hawkins, Robert; Aubrecht, Jill; Kovach, Karen; Terhorst, Lauren; Connolly, Mary; McNulty, Mary; Callan, Judith

2011-01-01

Despite the proliferation of health technologies, descriptions of the unique considerations and practical guidance for evaluating the intervention fidelity of technology-based behavioral interventions are lacking. The aims of this study were to (a) discuss how technology-based behavioral interventions challenge conventions about how intervention fidelity is conceptualized and evaluated, (b) propose an intervention fidelity framework that may be more appropriate for technology-based behavioral interventions, and (c) present a plan for operationalizing each concept in the framework using the intervention fidelity monitoring plan for Pocket PATH (Personal Assistant for Tracking Health), a mobile health technology designed to promote self-care behaviors after lung transplantation, as an exemplar. The literature related to intervention fidelity and technology acceptance was used to identify the issues that are unique to the fidelity of technology-based behavioral interventions and thus important to include in a proposed intervention fidelity framework. An intervention fidelity monitoring plan for technology-based behavioral interventions was developed as an example. The intervention fidelity monitoring plan was deemed feasible and practical to implement and showed utility in operationalizing the concepts such as assessing interventionists' delivery and participants' acceptance of the technology-based behavioral intervention. The framework has the potential to guide the development of implementation fidelity monitoring tools for other technology-based behavioral interventions. Further application and testing of this framework will allow for a better understanding of the role that technology acceptance plays in the adoption and enactment of the behaviors that technology-based behavioral interventions are intended to promote.

Relaxation and Guided Imagery: A School-Based Intervention for Children with Asthma.

ERIC Educational Resources Information Center

Peck, Heather L.; Bray, Melissa A.; Kehle, Thomas J.

2003-01-01

This investigation analyzed the effect of relaxation and guided imagery on lung function and anxiety by employing a multiple baseline design across four middle school students with asthma. With the introduction of the intervention, it was found that lung function improved and anxiety decreased in all students. (Contains 63 references, 1 table, and…

2000 RSNA annual oration in diagnostic radiology: The future of interventional radiology.

PubMed

Becker, G J

2001-08-01

Origins in imaging, procedural emphasis, and dependence on innovation characterize interventional radiology, which will continue as the field of image-guided minimally invasive therapies. A steady supply of innovators will be needed. Current workforce shortages demand that this problem be addressed and in an ongoing fashion. Interventional radiology's major identity problem will require multiple corrective measures, including a name change. Diagnostic radiologists must fully embrace the concept of the dedicated interventionalist. Interspecialty turf battles will continue, especially with cardiologists and vascular surgeons. To advance the discipline, interventional radiologists must remain involved in cutting-edge therapies such as endograft repair of aortic aneurysms and carotid stent placement. As the population ages, interventionalists will experience a shift toward a greater emphasis on cancer treatment. Political agendas and public pressure will improve access to care and result in managed health care reforms. Academic centers will continue to witness a decline in time and resources available to pursue academic missions. The public outcry for accountability will result in systems changes aimed at reducing errors and process changes in the way physicians are trained, certified, and monitored. Evidence-based medicine will be the watchword of this century. Interventional radiology will maintain its role through development of methods for delivery of genes, gene products, and drugs to specific target sites; control of angiogenesis and other biologic processes; and noninvasive image-guided delivery of various forms of energy for ablation.

Counselor-Mediated Contracts in Self-Management for Students in the New Start Program.

ERIC Educational Resources Information Center

Santa Rita, Emilio D., Jr.

In an effort to help students on academic suspension achieve full academic status and succeed in college, New York's Bronx Community College developed the New Start program, a portfolio-based intervention strategy utilizing personal success contracts. Students participating in the program complete guided self-assessments, identify problem areas,…

Sex Is Like Jelly Beans: Educating Students on the Risks of Oral Sex

ERIC Educational Resources Information Center

Moore, Erin; Harris, Terrance

2014-01-01

This study provides a description of an innovative workshop that educated college students about the risks of unprotected sexual behavior, particularly oral sex, and methods of risk reduction using a metaphor of "sharing and eating jelly beans." Intervention development was guided by the Information-Motivation-Behavioral Skills model.…

A Path Analysis of a Randomized "Promotora de Salud" Cardiovascular Disease-Prevention Trial among At-Risk Hispanic Adults

ERIC Educational Resources Information Center

de Heer, Hendrik Dirk; Balcazar, Hector G.; Castro, Felipe; Schulz, Leslie

2012-01-01

This study assessed effectiveness of an educational community intervention taught by "promotoras de salud" in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of…

Kids Learn from the Inside Out: How To Enhance the Human Matrix.

ERIC Educational Resources Information Center

Randolph, Shirley L.; And Others

Noting that humans develop according to a genetically encoded timeline and that departure from the timeline limits human potential, this book provides an illustrated practical guide to intervention to help children's bodies work as they should, to nurture children along their developmental timeline, to help children learn "from the inside…

School-Based Health Promotion Intervention: Parent and School Staff Perspectives

ERIC Educational Resources Information Center

Patino-Fernandez, Anna M.; Hernandez, Jennifer; Villa, Manuela; Delamater, Alan

2013-01-01

Background: The prevalence of childhood obesity is high, particularly among minority youth. The objective of this article was to evaluate parent and school staff perspectives of childhood health and weight qualitatively to guide the development of a school-based obesity prevention program for minority youth. Methods: Hispanic parents (N?=?9) of…

Initial Understandings of Fraction Concepts Evidenced by Students with Mathematics Learning Disabilities and Difficulties: A Framework

ERIC Educational Resources Information Center

Hunt, Jessica H.; Welch-Ptak, Jasmine J.; Silva, Juanita M.

2016-01-01

Documenting how students with learning disabilities (LD) initially conceive of fractional quantities, and how their understandings may align with or differ from students with mathematics difficulties, is necessary to guide development of assessments and interventions that attach to unique ways of thinking or inherent difficulties these students…

Sources of Cigarettes among Adolescent Smokers: Free or Purchased?

ERIC Educational Resources Information Center

Jansen, Paul; Toomey, Traci L.; Nelson, Toben F.; Fabian, Lindsey E. A.; Lenk, Kathleen M.; Forster, Jean L.

2011-01-01

Few studies have described youth cigarette sources in terms of whether the cigarettes were free or purchased. Understanding the different ways youth obtain tobacco can guide development of interventions to more effectively reduce youth smoking. Purpose: To determine the propensity for youth to purchase cigarettes versus obtain cigarettes for free,…

The Early Intervention Readiness Program (EIRP): A Post-ASD Diagnosis Family Support Program

ERIC Educational Resources Information Center

Tolmie, Rhiannon S.; Bruck, Susan; Kerslake, Rachel

2017-01-01

A child's diagnosis with autism spectrum disorder (ASD) can be an extremely stressful time for families. Researchers suggest that the period immediately following ASD diagnosis is a key time for professionals to guide families by providing appropriate information about support options. This article describes a family support program, developed by…

Instructed Pragmatics at a Glance: Where Instructional Studies Were, Are, and Should Be Going

ERIC Educational Resources Information Center

Taguchi, Naoko

2015-01-01

This paper brings together the research and developments of instructed pragmatics over the past three decades by reporting the synthesis findings of instructional intervention studies in interlanguage pragmatics. Two questions have guided this investigation: (1) is instruction effective in learning pragmatics?; and (2) what methods are most…

Nutrition: Intervention Guidance for Service Providers and Families. Connecticut Birth to Three System, Service Guideline 6.

ERIC Educational Resources Information Center

Connecticut Birth to Three System, Hartford.

This guide was developed to assist families and service providers in Connecticut with nutrition services for infants and toddlers with disabilities. Individual sections provide information about the following topics: laws and regulations related to nutrition services; eligibility for the Connecticut Birth to Three System and nutrition; nutrition…

Developing Controls from Within through Service Learning

ERIC Educational Resources Information Center

Schneider-Munoz, Andrew J.

2009-01-01

The developmental impact of national service is a newer intervention for youth. Policy influences the ability of the society to guide youth and structure their time with positive and productive activities. Built on the idea that helping one another can prepare and teach youth to regulate healthy emotions and behavior, the classic theories of Erik…

Online Learning Tools for Middle School Science: Lessons Learned from a Design-Based Research Project

ERIC Educational Resources Information Center

Terrazas-Arellanes, Fatima E.; Knox, Carolyn; Strycker, Lisa A.; Walden, Emily D.

2017-01-01

This article reports on how design-based research methodology was used to guide a line of intervention research that developed, implemented, revised, and evaluated online learning science curricula for middle school students, including general education students and English language learners (primarily of Hispanic origin). The iterative,…

The Colorado Autism Manual for Teachers, Service-Providers and Parents.

ERIC Educational Resources Information Center

Colorado State Dept. of Education, Denver.

This manual provides information on autism to enable Colorado parents and educators to recognize early symptoms in children and to provide for early intervention. Section 1 of the manual provides an introduction to the Colorado Autism Task Force, lists participants in the task force, explains the guiding principles for development of educational…

Advanced Endoscopic Navigation: Surgical Big Data, Methodology, and Applications.

PubMed

Luo, Xiongbiao; Mori, Kensaku; Peters, Terry M

2018-06-04

Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions. Nevertheless, it remains challenging to realize the next generation of context-aware navigated endoscopy. This review presents a broad survey of various aspects of endoscopic navigation, particularly with respect to the development of endoscopic navigation techniques. First, we investigate big data with multimodal information involved in endoscopic navigation. Next, we focus on numerous methodologies used for endoscopic navigation. We then review different endoscopic procedures in clinical applications. Finally, we discuss novel techniques and promising directions for the development of endoscopic navigation.

Development, theoretical framework, and evaluation of a parent and teacher-delivered intervention on adolescent vaccination.

PubMed

Gargano, Lisa M; Herbert, Natasha L; Painter, Julia E; Sales, Jessica M; Vogt, Tara M; Morfaw, Christopher; Jones, LaDawna M; Murray, Dennis; DiClemente, Ralph J; Hughes, James M

2014-07-01

The Advisory Committee on Immunization Practices recommended immunization schedule for adolescents includes three vaccines (tetanus, diphtheria, and acellular pertussis [Tdap]; human papillomavirus [HPV] vaccine; and meningococcal conjugate vaccine [MCV4]) and an annual influenza vaccination. Given the increasing number of recommended vaccines for adolescents and health and economic costs associated with nonvaccination, it is imperative that effective strategies for increasing vaccination rates among adolescents are developed. This article describes the development, theoretical framework, and initial first-year evaluation of an intervention designed to promote vaccine acceptance among a middle and high school-based sample of adolescents and their parents in eastern Georgia. Adolescents, parents, and teachers were active participants in the development of the intervention. The intervention, which consisted of a brochure for parents and a teacher-delivered curriculum for adolescents, was guided by constructs from the health belief model and theory of reasoned action. Evaluation results indicated that our intervention development methods were successful in creating a brochure that met cultural relevance and the literacy needs of parents. We also demonstrated an increase in student knowledge of and positive attitudes toward vaccines. To our knowledge, this study is the first to extensively engage middle and high school students, parents, and teachers in the design and implementation of key theory-based educational components of a school-based, teacher-delivered adolescent vaccination intervention. © 2014 Society for Public Health Education.

Community-based Interventions to Prevent Skin Cancer: Two Community Guide Systematic Reviews

PubMed Central

Sandhu, Paramjit K.; Elder, Randy; Patel, Mona; Saraiya, Mona; Holman, Dawn M.; Perna, Frank; Smith, Robert A.; Buller, David; Sinclair, Craig; Reeder, Anthony; Makin, Jen; McNoe, Bronwen; Glanz, Karen

2016-01-01

Context Skin cancer is a preventable and commonly diagnosed cancer in the U.S. Excessive ultraviolet radiation exposure is a known cause of skin cancer. This article presents updated results of two types of interventions evaluated in a previously published Community Guide systematic review: multicomponent community-wide (MCCW) interventions and mass media (MM) interventions when used alone. Evidence acquisition Studies assessing MCCW and MM interventions to prevent skin cancer by reducing ultraviolet radiation exposure were evaluated using Community Guide systematic review methods. Relevant studies published between 1966 and 2013 were included and analyzed for this review. Evidence synthesis Seven studies evaluating the effectiveness of MCCW interventions showed a median increase in sunscreen use of 10.8 percentage points (interquartile interval=7.3, 23.2); a small decrease in ultraviolet radiation exposure; a decrease in indoor tanning device use of 4.0 percentage points (95% CI=2.5, 5.5); and mixed results for other protective behaviors. Four studies evaluating the effectiveness of MM interventions found that they generally led to improved ultraviolet protection behaviors among children and adults. Conclusions The available evidence showed that MCCW interventions are effective in reducing ultraviolet radiation exposure by increasing sunscreen use. There was, however, insufficient evidence to determine the effectiveness of MM interventions alone in reducing ultraviolet radiation exposure, indicating a continuing need for more research in this field to improve assessment of effectiveness. PMID:27647053

A Primer for Developing Measures of Science Content Knowledge for Small-Scale Research and Instructional Use

PubMed Central

Bass, Kristin M.; Drits-Esser, Dina; Stark, Louisa A.

2016-01-01

The credibility of conclusions made about the effectiveness of educational interventions depends greatly on the quality of the assessments used to measure learning gains. This essay, intended for faculty involved in small-scale projects, courses, or educational research, provides a step-by-step guide to the process of developing, scoring, and validating high-quality content knowledge assessments. We illustrate our discussion with examples from our assessments of high school students’ understanding of concepts in cell biology and epigenetics. Throughout, we emphasize the iterative nature of the development process, the importance of creating instruments aligned to the learning goals of an intervention or curricula, and the importance of collaborating with other content and measurement specialists along the way. PMID:27055776

How Could Nurse Researchers Apply Theory to Generate Knowledge More Efficiently?

PubMed

Lor, Maichou; Backonja, Uba; Lauver, Diane R

2017-09-01

Reports of nursing research often do not provide adequate information about whether, and how, researchers applied theory when conducting their studies. Unfortunately, the lack of adequate application and explication of theory in research impedes development of knowledge to guide nursing practice. To clarify and exemplify how to apply theory in research. First we describe how researchers can apply theory in phases of research. Then we share examples of how three research teams applied one theory to these phases of research in three different studies of preventive behaviors. Nurse researchers can review and refine ways in which they apply theory in guiding research and writing publications. Scholars can appreciate how one theory can guide researchers in building knowledge about a given condition such as preventive behaviors. Clinicians and researchers can collaborate to apply and examine the usefulness of theory. If nurses had improved understanding of theory-guided research, they could better assess, select, and apply theory-guided interventions in their practices. © 2017 Sigma Theta Tau International.

Magnetic navigation in ultrasound-guided interventional radiology procedures.

PubMed

Xu, H-X; Lu, M-D; Liu, L-N; Guo, L-H

2012-05-01

To evaluate the usefulness of magnetic navigation in ultrasound (US)-guided interventional procedures. Thirty-seven patients who were scheduled for US-guided interventional procedures (20 liver cancer ablation procedures and 17 other procedures) were included. Magnetic navigation with three-dimensional (3D) computed tomography (CT), magnetic resonance imaging (MRI), 3D US, and position-marking magnetic navigation were used for guidance. The influence on clinical outcome was also evaluated. Magnetic navigation facilitated applicator placement in 15 of 20 ablation procedures for liver cancer in which multiple ablations were performed; enhanced guidance in two small liver cancers invisible on conventional US but visible at CT or MRI; and depicted the residual viable tumour after transcatheter arterial chemoembolization for liver cancer in one procedure. In four of 17 other interventional procedures, position-marking magnetic navigation increased the visualization of the needle tip. Magnetic navigation was beneficial in 11 (55%) of 20 ablation procedures; increased confidence but did not change management in five (25%); added some information but did not change management in two (10%); and made no change in two (10%). In the other 17 interventional procedures, the corresponding numbers were 1 (5.9%), 2 (11.7%), 7 (41.2%), and 7 (41.2%), respectively (p=0.002). Magnetic navigation in US-guided interventional procedure provides solutions in some difficult cases in which conventional US guidance is not suitable. It is especially useful in complicated interventional procedures such as ablation for liver cancer. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial.

PubMed

Wenham, Aniela; Atkin, Karl; Woodman, Julia; Ballard, Kathleen; MacPherson, Hugh

2018-05-01

A large randomised controlled trial found that the provision of either Alexander Technique lessons or acupuncture, for those with chronic neck pain, resulted in significantly increased self-efficacy when compared with usual care alone. In turn, enhanced self-efficacy was associated with significant reductions in neck pain at 6 and 12 months. In this analysis we explore the perspectives of participants within the trial, with the aim of gaining a better understanding of how these interventions had an impact. We used a longitudinal qualitative approach; in-depth interviews, informed by a topic guide, were conducted with a sample of the trial population. Participants were interviewed twice: at around six months (n = 30) and twelve months (n = 26) after trial entry. Analysis was guided by the principles of grounded theory, and key themes were developed. Five key themes emerged: pre-trial experiences of biomedical treatment against which subsequent interventions were compared; emergence of tangible benefits from the interventions; factors that contributed to the observed benefits, notably growing self-care and self-efficacy; a developing sense of embodiment as an integral part of the transformative process; and contribution of these factors to sustaining benefits over the longer term. In-depth interviews revealed a rich array of experiences. They gave insight into the positive impact of the interventions on development of self-care, self-efficacy and embodiment. These findings complement the quantitative trial data, providing a more nuanced understanding of the factors that underpin the previously quantified improvement in self-efficacy and its association with longer-term reductions in pain. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ultrasound-Guided Treatment of Peripheral Nerve Pathology.

PubMed

Dettori, Nathan; Choudur, Hema; Chhabra, Avneesh

2018-07-01

High-resolution ultrasound serves as a fast, accessible, reliable, and radiation-free tool for anatomical and dynamic evaluation of various peripheral nerves. It can be used not only to identify and diagnose peripheral nerve and perineural pathology accurately but also to guide various nerve and perineural interventions. We describe the normal and pathologic appearances of peripheral nerves, the pathologies commonly affecting the individual peripheral nerves, and the current ultrasound-guided peripheral nerve interventions and techniques. Future directions are also highlighted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community.

PubMed

Cheng, Mei; Cheng, Shu-Ling; Zhang, Qing; Jiang, He; Cong, Ji-Yan; Zang, Xiao-Ying; Zhao, Yue

2014-08-01

To explore the effect of continuous nursing intervention guided by chronotherapeutics so as to provide the easy, noninvasive, effective and acceptable intervention for older hypertensive patients in the community. Many researchers studied the effect of administration at different times on blood pressure control and circadian rhythm. However, the individual administrative time was set ambiguously in previous studies. A semi-experimental study. In the study, 90 eligible patients were recruited and separated into three groups randomly, which were the control group, intervention group A (behaviour and chronotherapy intervention) and intervention group B (behaviour intervention). At 6 and 12 months after the study, the intervention groups were measured 24-hour ambulatory blood pressure monitoring. There were significant differences in ambulatory blood pressure monitoring parameters of the two intervention groups at different measurement times, and there were interaction between measurement time and different groups. The number of patients with dipper increased and reverse dipper decreased in group A as the intervention applied. There were statistical differences between two groups. The number of patients with morning surge in group A decreased more, and there were statistical differences between two groups at six months after the intervention. The behaviour and chronotherapy intervention based on the patients' ambulatory blood pressure monitoring can control casual blood pressure much better and last longer, which can also improve patients' indexes of ambulatory blood pressure monitoring better than behaviour intervention only. The behaviour and chronotherapy intervention can increase patients' nocturnal blood pressure drop, increase the number of patients with dipper and decrease reverse dipper, and improve blood pressure surge in the morning. Nurses can use continuous nursing intervention guided by chronotherapeutics to help improve hypertension of older patients better in the community. © 2014 John Wiley & Sons Ltd.

The new United Nations approach to sustainable development post-2015: Findings from four overviews of systematic reviews on interventions for sustainable development and health.

PubMed

Galvão, Luiz A C; Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Câmara, Volney Magalhães; Luiz, Ronir Raggio; Becerra-Posada, Francisco

2016-03-01

Objective To identify reported interventions that facilitate sustainable development and have had a positive impact on health in four areas: sustainable food production; sustainable energy use; sustainable jobs ("decent work"); and prevention of toxic exposure to chemicals. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted of at least 14 databases and 8 websites for each of the four overviews, using pre-defined protocols, including clear inclusion criteria. To qualify as "sustainable," interventions needed to aim (explicitly or implicitly) to positively impact at least two dimensions of the integrated framework for sustainable development and had to include measures of health impact. Results In total, 47 systematic reviews and 10 economic evaluations met the inclusion criteria. The most promising interventions, such as agricultural policies, were identified for each of the four topics. While the evidence for the interventions is not strong because of the limited number of studies, there is no evidence of a definite negative impact on health. The only possible exception is that of taxes and subsidies-though this intervention also has the potential to be pro-equity with higher relative impacts for lower income groups. Conclusions The evidence found for effective interventions is useful for guiding countries toward the best options for non-health sector interventions that can positively impact health. This overviews shows that intersectoral work benefits every sector involved.

Application of the Intervention Mapping Framework to Develop an Integrated Twenty-First Century Core Curriculum-Part 1: Mobilizing the Community to Revise the Masters of Public Health Core Competencies.

PubMed

DeBate, Rita; Corvin, Jaime A; Wolfe-Quintero, Kate; Petersen, Donna J

2017-01-01

Twenty-first century health challenges have significantly altered the expanding role and functions of public health professionals. Guided by a call from the Association of Schools and Programs of Public Health's (ASPPH) and the Framing the Future: The Second 100 Years of Education for Public Health report to adopt new and innovative approaches to prepare public health leaders, the University of South Florida College of Public Health aimed to self-assess the current Masters of Public Health (MPH) core curriculum with regard to preparing students to meet twenty-first century public health challenges. This paper describes how Intervention Mapping was employed as a framework to increase readiness and mobilize the COPH community for curricular change. Intervention Mapping provides an ideal framework, allowing organizations to access capacity, specify goals, and guide the change process from curriculum development to implementation and evaluation of competency-driven programs. The steps outlined in this paper resulted in a final set of revised MPH core competencies that are interdisciplinary in nature and fulfill the emergent needs to address changing trends in both public health education and challenges in population health approaches. Ultimately, the competencies developed through this process were agreed upon by the entire College of Public Health faculty, signaling one college's readiness for change, while providing the impetus to revolutionize the delivery of public health education at the University of South Florida.

Application of the Intervention Mapping Framework to Develop an Integrated Twenty-First Century Core Curriculum—Part 1: Mobilizing the Community to Revise the Masters of Public Health Core Competencies

PubMed Central

DeBate, Rita; Corvin, Jaime A.; Wolfe-Quintero, Kate; Petersen, Donna J.

2017-01-01

Twenty-first century health challenges have significantly altered the expanding role and functions of public health professionals. Guided by a call from the Association of Schools and Programs of Public Health’s (ASPPH) and the Framing the Future: The Second 100 Years of Education for Public Health report to adopt new and innovative approaches to prepare public health leaders, the University of South Florida College of Public Health aimed to self-assess the current Masters of Public Health (MPH) core curriculum with regard to preparing students to meet twenty-first century public health challenges. This paper describes how Intervention Mapping was employed as a framework to increase readiness and mobilize the COPH community for curricular change. Intervention Mapping provides an ideal framework, allowing organizations to access capacity, specify goals, and guide the change process from curriculum development to implementation and evaluation of competency-driven programs. The steps outlined in this paper resulted in a final set of revised MPH core competencies that are interdisciplinary in nature and fulfill the emergent needs to address changing trends in both public health education and challenges in population health approaches. Ultimately, the competencies developed through this process were agreed upon by the entire College of Public Health faculty, signaling one college’s readiness for change, while providing the impetus to revolutionize the delivery of public health education at the University of South Florida. PMID:29164095

A Business Case Framework for Planning Clinical Nurse Specialist-Led Interventions.

PubMed

Bartlett Ellis, Rebecca J; Embree, Jennifer L; Ellis, Kurt G

2015-01-01

The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development. Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense. We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes. The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation. Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.

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 secondary prevention will emerge when the results of our randomised controlled trial are published.

Storybridging: Four steps for constructing effective health narratives

PubMed Central

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2017-01-01

Objective: To develop a practical step-by-step approach to constructing narrative health interventions in response to the mixed results and wide diversity of narratives used in health-related narrative persuasion research. Method: Development work was guided by essential narrative characteristics as well as principles enshrined in the Health Action Process Approach. Results: The ‘storybridging’ method for constructing health narratives is described as consisting of four concrete steps: (a) identifying the stage of change, (b) identifying the key elements, (c) building the story, and (d) pre-testing the story. These steps are illustrated by means of a case study in which an effective narrative health intervention was developed for Dutch truck drivers: a high-risk, underprivileged occupational group. Conclusion: Although time and labour intensive, the Storybridging approach suggests integrating the target audience as an important stakeholder throughout the development process. Implications and recommendations are provided for health promotion targeting truck drivers specifically and for constructing narrative health interventions in general. PMID:29276232

Bridging Health Care and the Workplace: Formulation of a Return-to-Work Intervention for Breast Cancer Patients Using an Intervention Mapping Approach.

PubMed

Désiron, Huguette A M; Crutzen, Rik; Godderis, Lode; Van Hoof, Elke; de Rijk, Angelique

2016-09-01

Purpose An increasing number of breast cancer (BC) survivors of working age require return to work (RTW) support. Objective of this paper is to describe the development of a RTW intervention to be embedded in the care process bridging the gap between hospital and workplace. Method The Intervention Mapping (IM) approach was used and combined formative research results regarding RTW in BC patients with published insights on occupational therapy (OT) and RTW. Four development steps were taken, starting from needs assessment to the development of intervention components and materials. Results A five-phased RTW intervention guided by a hospital-based occupational therapist is proposed: (1) assessing the worker, the usual work and contextual factors which impacts on (re-)employment; (2) exploration of match/differences between the worker and the usual work; (3) establishing long term goals, broken down into short term goals; (4) setting up tailored actions by carefully implementing results of preceding phases; (5) step by step, the program as described in phase 4 will be executed. The occupational therapist monitors, measures and reviews goals and program-steps in the intervention to secure the tailor-made approach of each program-step of the intervention. Conclusion The use of IM resulted in a RTW oriented OT intervention. This unique intervention succeeds in matching individual BC patient needs, the input of stakeholders at the hospital and the workplace.

Effect of an intervention mapping approach to promote the consumption of fruits and vegetables among young adults in junior college: A quasi-experimental study.

PubMed

Boucher, Danielle; Gagné, Camille; Côté, Françoise

2015-01-01

This study evaluates the effectiveness of an intervention mapping developed to promote fruit and vegetable consumption. Students (n = 394) from two similar public colleges in the Quebec City area (Canada) were asked to participate. A quasi-experimental design was used with a 14-week pause between the pretest and posttest. The control and experimental groups both received information on Canada's Food Guide recommendations. The experimental group was submitted to an intervention consisting of six interactive workshops carried out inside the college, and three personal exercises to be completed at home. proportion of respondents consuming at least five servings of fruits and vegetables daily. psychosocial variables assessed (theory of planned behaviour). The data collected from 344 participants by means of a self-administered questionnaire were analysed (167 experimental and 177 control). The posttest revealed a significant increase (15%) in the number of participants in the experimental group achieving the primary outcome (d = .38). The intervention also had a significant effect on the targeted psychosocial variables (η(2) = .03 to .06). Regularity of consumption acts as a mediator between intention and behaviour. These results may be used to guide health promoters working with college students.

The effectiveness of a parental guide for prevention of problematic video gaming in children: A public health randomized controlled intervention study.

PubMed

Krossbakken, Elfrid; Torsheim, Torbjørn; Mentzoni, Rune Aune; King, Daniel Luke; Bjorvatn, Bjørn; Lorvik, Ingjerd Meen; Pallesen, Ståle

2018-03-01

Background and aims Excessive use of video games among children and adolescents is a growing concern. The aim of this study was to investigate the effectiveness of a brief parental guide with advices and strategies for regulating video gaming in children. Methods A random sample of guardians of children between the age of 8-12 years old (N = 5,864) was drawn from the Norwegian Population Registry and equally randomized into an intervention and a control condition. A parental guide based on clinical and research literature was distributed by postal mail to those in the intervention condition. A 4-month follow-up survey comprising questions about problematic video gaming, gaming behavior, sleep activity, and parental video game regulation behavior was administered. Results Independent t-tests revealed no significant differences between the two conditions (N = 1,657, response rate 30.1%) on any outcome measure. An ANOVA with planned comparisons showed that respondents who reported that they had read and followed the parental guide reported more video game problems and used more parental mediation strategies than those who did not read and follow the guide. Conclusions We found no evidence for the effectiveness of the psychoeducational parental guide on preventing problematic video gaming in children. However, the guide was read and positively assessed by a significant proportion of guardians. Differences between those who studied the guide and those who did not may indicate that parental guides are better aimed at providing important information to those who already have problems rather than as a mean of primary prevention.

Comparing treatment outcomes of fractional flow reserve-guided and angiography-guided percutaneous coronary intervention in patients with multi-vessel coronary artery diseases: a systematic review and meta-analysis.

PubMed

Xiu, Jiancheng; Chen, Gangbin; Zheng, Hua; Wang, Yuegang; Chen, Haibin; Liu, Xuewei; Wu, Juefei; Bin, Jianping

2016-02-01

Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is used to assess the need for angioplasty in vessels with intermediate blockages. The treatment outcomes of FFR-guided vs. conventional angiography-guided PCI were evaluated in patients with multi-vessel coronary artery disease (CAD). Prospective and retrospective studies comparing FFR-guided vs. angiography-guided PCI in patients with multi-vessel CAD were identified from medical databases by two independent reviewers using the terms "percutaneous coronary intervention, fractional flow reserve, angiography, coronary heart disease, major adverse cardiac events (MACE) and myocardial infarction". The primary outcome was the number of stents placed, and the secondary outcomes were procedure time, mortality, myocardial infarction (MI) and MACE rates. Seven studies (three retrospective and four prospective), which included 49,517 patients, were included in this review. A total of 4,755 patients underwent FFR, while 44,697 received angiography-guided PCI. The mean patient age ranged from 58 to 71.7 years. The average number of stents used in FFR patients ranged from 0.3-1.9, and in angiography-guided PCI patients ranged from 0.7-2.7. Analysis indicated there was a greater number of stents placed in the angiography-guided group compared with the FFR group (pooled difference in means: -0.64, 95% confidence interval [CI]: -0.81 to -0.47, P < 0.001). There were no differences in the secondary outcomes between the two groups. Both procedures produce similar clinical outcomes, but the fewer number of stents used with FFR may have clinical as was as cost implications.

Recruitment of racial and ethnic minorities to clinical trials conducted within specialty clinics: an intervention mapping approach.

PubMed

Amorrortu, Rossybelle P; Arevalo, Mariana; Vernon, Sally W; Mainous, Arch G; Diaz, Vanessa; McKee, M Diane; Ford, Marvella E; Tilley, Barbara C

2018-02-17

Despite efforts to increase diversity in clinical trials, racial/ethnic minority groups generally remain underrepresented, limiting researchers' ability to test the efficacy and safety of new interventions across diverse populations. We describe the use of a systematic framework, intervention mapping (IM), to develop an intervention to modify recruitment behaviors of coordinators and specialist investigators with the goal of increasing diversity in trials conducted within specialty clinics. To our knowledge IM has not been used in this setting. The IM framework was used to ensure that the intervention components were guided by health behavior theories and the evidence. The IM steps consisted of (1) conducting a needs assessment, (2) identification of determinants and objectives, (3) selection of theory-informed methods and practical applications, (4) development and creation of program components, (5) development of an adoption and implementation plan, and (6) creation of an evaluation plan. The intervention included five educational modules, one in-person and four web-based, plus technical assistance calls to coordinators. Modules addressed the intervention rationale, development of clinic-specific plans to obtain minority-serving physician referrals, physician-centered and patient-centered communication, and patient navigation. The evaluation, a randomized trial, was recently completed in 50 specialty clinics and is under analysis. Using IM we developed a recruitment intervention that focused on building relationships with minority-serving physicians to encourage minority patient referrals. IM enhanced our understanding of factors that may influence minority recruitment and helped us integrate strategies from multiple disciplines that were relevant for our audience.

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar.

PubMed

Murray, Jennifer; Williams, Brian; Hoskins, Gaylor; Skar, Silje; McGhee, John; Treweek, Shaun; Sniehotta, Falko F; Sheikh, Aziz; Brown, Gordon; Hagen, Suzanne; Cameron, Linda; Jones, Claire; Gauld, Dylan

2016-01-01

Visualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing. Our final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions. We have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.

Beyond Basic Feedback in Mobile Brief Interventions: Designing SMS Message Content for Delivery to Young Adults During Risky Drinking Events

PubMed Central

Dietze, Paul M; Lim, Megan S C

2017-01-01

Background Brief interventions can reduce alcohol consumption in young people through screening and delivery of personally relevant feedback. Recently, Web and mobile platforms have been harnessed to increase the reach of brief interventions. Existing literature on mobile-based alcohol brief interventions indicates mixed use of theory in developing interventions. There is no research available to guide the development of SMS text messaging (short message service, SMS) interventions delivered during risky drinking events. Objective The aim of this study was to develop and pilot an alcohol-related risk-reduction brief intervention delivered by SMS to Australian young adults during drinking events. This paper describes the development of intervention message content, with specific focus on the context of delivery during drinking events. Methods A sample of 42 young adults attended 4 workshops; these comprised focus-group style discussion on drinking habits and motivations, discussion of intervention design, analysis of existing alcohol media campaigns, and participant development of message content. Data were analyzed thematically. Results Participants described a focus on having fun and blocking out any incongruent negative influences during drinking episodes. For content to be acceptable, nonjudgmental and non-authoritative language was deemed essential. A preference for short, actionable messages was observed, including suggestions for reminders around drinking water, organizing transport home, checking on friends, and plans the next day. Participants were excited about the potential for messages to be tailored to individuals, as previous alcohol-related campaigns were deemed too generic and often irrelevant. Normative-based messages were also perceived as largely irrelevant as participants felt that they understood the drinking-related norms of their immediate peers already. Conclusions Findings from this study offer insights into young adults’ drinking events and practical advice for designing alcohol-related brief interventions. During our formative development process, we demonstrated a neat correspondence between young people’s preferences for alcohol harm reduction interventions and the theoretical principles of brief interventions, including acceptable topics and message style. PMID:28634153

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.

Societal interventions to prevent child abuse and neglect.

PubMed

Hay, T; Jones, L

1994-01-01

A framework for understanding child maltreatment in terms of complex and interacting factors from the individual to the societal level can aid in conceptualizing and implementing prevention efforts. Research on interventions at the societal level can guide a broad range of activities, increasing their effectiveness and viability. Fundamental approaches include evaluation of specific interventions and systems-level research on implementation and development of best practice in prevention activities for different portions of society. Research can indicate the roles that each individual, agency, organization, community, and level of government can play. The U.N. Convention on the Rights of the Child provides a useful framework for societal level change to improve the welfare of children and families.

Upper Extremity Proprioception After Stroke: Bridging the Gap Between Neuroscience and Rehabilitation.

PubMed

Findlater, Sonja E; Dukelow, Sean P

2017-01-01

Proprioception is an important aspect of function that is often impaired in the upper extremity following stroke. Unfortunately, neurorehabilitation has few evidence based treatment options for those with proprioceptive deficits. The authors consider potential reasons for this disparity. In doing so, typical assessments and proprioceptive intervention studies are discussed. Relevant evidence from the field of neuroscience is examined. Such evidence may be used to guide the development of targeted interventions for upper extremity proprioceptive deficits after stroke. As researchers become more aware of the impact of proprioceptive deficits on upper extremity motor performance after stroke, it is imperative to find successful rehabilitation interventions to target these deficits and ultimately improve daily function.

Cognitive defusion and guided imagery tasks reduce naturalistic food cravings and consumption: A field study.

PubMed

Schumacher, Sophie; Kemps, Eva; Tiggemann, Marika

2018-08-01

The present study investigated the effect of two craving reduction techniques, namely, cognitive defusion and guided imagery, on naturalistic food cravings. These techniques targeted the intrusion and elaboration stages of the craving process, respectively (Kavanagh, Andrade, & May, 2005). Participants underwent a seven-day baseline period followed by a seven-day intervention period, during which they recorded their food cravings as they occurred using online diaries accessed via smartphone. In the intervention period, participants were randomly assigned to one of cognitive defusion, guided imagery or control conditions. Participants in the cognitive defusion and guided imagery conditions listened to three-minute audio clips containing their respective instructions every time they experienced a food craving, and rated their craving intensity before and after the intervention, while the control participants recorded their cravings as they did in the baseline week. Results showed that both cognitive defusion and guided imagery techniques reduced craving frequency, intensity, the likelihood of consumption following cravings, and craving-related calorie intake, consistent with predictions. These findings show that cognitive defusion and guided imagery are useful for dealing with naturally occurring cravings across a range of foods, and can reduce craving-related consumption in everyday life. Copyright © 2018 Elsevier Ltd. All rights reserved.

A psychological approach to providing self-management education for people with type 2 diabetes: the Diabetes Manual

PubMed Central

Sturt, Jackie; Taylor, Hafrun; Docherty, Andrea; Dale, Jeremy; Louise, Taylor

2006-01-01

Background The objectives of this study were twofold (i) to develop the Diabetes Manual, a self-management educational intervention aimed at improving biomedical and psychosocial outcomes (ii) to produce early phase evidence relating to validity and clinical feasibility to inform future research and systematic reviews. Methods Using the UK Medical Research Council's complex intervention framework, the Diabetes Manual and associated self management interventions were developed through pre-clinical, and phase I evaluation phases guided by adult-learning and self-efficacy theories, clinical feasibility and health policy protocols. A qualitative needs assessment and an RCT contributed data to the pre-clinical phase. Phase I incorporated intervention development informed by the pre-clinical phase and a feasibility survey. Results The pre-clinical and phase I studies resulted in the production in the Diabetes Manual programme for trial evaluation as delivered within routine primary care consultations. Conclusion This complex intervention shows early feasibility and face validity for both diabetes health professionals and people with diabetes. Randomised trial will determine effectiveness against clinical and psychological outcomes. Further study of some component parts, delivered in alternative combinations, is recommended. PMID:17129376

Characterization of optically actuated MRI-compatible active needles for medical interventions

NASA Astrophysics Data System (ADS)

Black, Richard J.; Ryu, Seokchang; Moslehi, Behzad; Costa, Joannes M.

2014-03-01

The development of a Magnetic Resonance Imaging (MRI) compatible optically-actuated active needle for guided percutaneous surgery and biopsy procedures is described. Electrically passive MRI-compatible actuation in the small diameter needle is provided by non-magnetic materials including a shape memory alloy (SMA) subject to precise fiber laser operation that can be from a remote (e.g., MRI control room) location. Characterization and optimization of the needle is facilitated using optical fiber Bragg grating (FBG) temperature sensors arrays. Active bending of the needle during insertion allows the needle to be accurately guided to even relatively small targets in an organ while avoiding obstacles and overcoming undesirable deviations away from the planned path due to unforeseen or unknowable tissue interactions. This feature makes the needle especially suitable for use in image-guided surgical procedures (ranging from MRI to CT and ultrasound) when accurate targeting is imperative for good treatment outcomes. Such interventions include reaching small tumors in biopsies, delineating freezing areas in, for example, cryosurgery and improving the accuracy of seed placement in brachytherapy. Particularly relevant are prostate procedures, which may be subject to pubic arch interference. Combining diagnostic imaging and actuation assisted biopsy into one treatment can obviate the need for a second exam for guided biopsy, shorten overall procedure times (thus increasing operating room efficiencies), address healthcare reimbursement constraints and, most importantly, improve patient comfort and clinical outcomes.

Sheathless guide catheter in transradial percutaneous coronary intervention for ST-segment elevation myocardial infarction.

PubMed

Miyasaka, Masaki; Tada, Norio; Kato, Shigeaki; Kami, Masahiro; Horie, Kazunori; Honda, Taku; Takizawa, Kaname; Otomo, Tatsushi; Inoue, Naoto

2016-05-01

The aim of this study was to assess the safety and efficacy of sheathless guide catheters in transradial percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Transradial PCI for STEMI offers significant clinical benefits, including a reduced incidence of vascular complications. As the size of the radial artery is small, the radial artery is frequently damaged in this procedure using large-bore catheters. A sheathless guide catheter offers a solution to this problem as it does not require an introducer sheath. However, the efficacy and safety of sheathless guide catheters remain to be fully determined in emergent transradial PCI for STEMI. Data on consecutive STEMI patients undergoing primary PCI at the Sendai Kousei Hospital between September 2010 and May 2013 were analyzed. The primary endpoint was the rate of acute procedural success without access site crossover. Secondary endpoints included door-to-balloon time, fluoroscopy time, volume of contrast, and radial artery stenosis or occlusion rate. We conducted transradial PCI for 478 patients with STEMI using a sheathless guide catheter. Acute procedural success was achieved in 466 patients (97.5%). The median door-to-balloon time was 45 min (range, 15-317 min). The median fluoroscopy time was 16.4 min (range, 10-90 min). The median volume of contrast was 134 mL (range, 31-431 mL). Radial stenosis or occlusion developed in 14 (3.8%) of the 370 evaluable patients. This study showed that use of a sheathless guide catheter taking a transradial approach was effective and safe in primary PCI for STEMI. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Academic/State/Federal collaborations and the improvement of practices in disaster mental health services and evaluation.

PubMed

Watson, Patricia J; Ruzek, Josef I

2009-05-01

Academic, state, and federal agencies collaborated over the last 9 years to improve disaster mental health services and evaluation. This process, which included literature reviews, a number of expert panels, and case studies, is described. The products resulting from this process have included the development of a systematic cross-site evaluation of the federally funded crisis counseling program and field guides for interventions aimed at providing services to distressed individuals in the immediate aftermath of disasters and to individuals needing resilience skills training weeks or months after the event. Future improvement of disaster mental health services calls for continued research, evaluation, training, and intervention development.

Public health approaches to family maltreatment prevention: resetting family psychology's sights from the home to the community.

PubMed

Slep, Amy M Smith; Heyman, Richard E

2008-08-01

The authors review recent trends within the family maltreatment research field toward a public health approach, discuss the rationale for community-level interventions for family maltreatment, and sketch the history and development of community-level prevention approaches. Next, to illustrate the both the logistic and the scientific challenges of such work, the authors discuss the development and testing of an empirically guided, research-community partnership for the prevention of family maltreatment, the United States Air Force's NORTH STAR initiative (New Orientation to Reduce Threats to Health From Secretive Problems That Affect Readiness). Finally, recommendations are made for effective and disseminable family maltreatment prevention interventions.

Methods for fostering a community academic partnership in a firefighter community.

PubMed

Delisle, Anthony T; Delisle, Alexis L; Chaney, Beth H; Stopka, Christine B; Northcutt, William

2013-11-01

To describe how a community academic partnership (CAP) created a cardiovascular disease (CVD) prevention program for firefighters. Principles of community based participatory research (CBPR) were integrated with intervention mapping (IM) to guide the development of a physical activity program. Key elements of the CAP program include instituting annual CVD screenings; creating a department-wide program and a pilot intervention for high-risk firefighters; training firefighters to become peer health mentors; improving access to physical activity equipment; instituting policy to promote physical activity, and validating instrumentation for assessing cardiorespiratory fitness. Integrating CBPR with IM was an efficacious approach for engaging firefighters in research for developing an ecological approach to cardiovascular health in firefighters.

[Guided self-help interventions for parents of children with ADHD--concept, referral and effectiveness in a nationwide trial. An observational study].

PubMed

Mokros, Laura; Benien, Nicole; Mütsch, Anna; Kinnen, Claudia; Schürmann, Stephanie; Metternich-Kaizman, Tanja Wolff; Breuer, Dieter; Hautmann, Christopher; Ravens-Sieberer, Ulrike; Klasen, Fionna; Döpfner, Manfred

2015-07-01

The effects of guided self-help interventions for parents of children with ADHD have already been proven in randomized controlled trials. The objective of this study was to assess the effectiveness of this novel form of intervention under routine care conditions in a nationwide trial. Registered pediatricians as well as child and youth psychiatrists enrolled 274 children between 6 and 12 years old (83.6% male) diagnosed with ADHD to a self-help program for parents of children with ADHD. The program lasted for 1 year and consisted of eight booklets with advice for parenting children with ADHD as well as complementary telephone consultations (14 calls, up to 20 minutes each). The course of the ADHD symptoms and the comorbid symptoms as well as the development of the child’s individual problems were assessed in a pre-post design. 63% of the enrolled parents adhered to the program until the end. The families who cancelled the program did not differ concerning the severity of ADHD symptoms, but they did more often show an impaired familial and social background, and their children received pharmacological treatment more often. Three-fourths of the children who completed the program had received pharmacological treatment at the beginning of the program. The children had more severe ADHD symptoms than a clinical control group. During the intervention, ADHD symptoms as well as psychosocial functioning improved with large effect sizes of d>0.9. Additionally, comorbid oppositional and emotional symptoms decreased. These results indicate that guided self-help programs for families with children with ADHD are effective, also as an addition to pharmacological treatment.

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

PubMed

Annett, R D; Erickson, S J

2009-07-01

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

Evaluation of Healthy Living Wellness Program With Minority Underserved Economically Disadvantaged Older Adults.

PubMed

Tallier, Peggy C; Reineke, Patricia R; Frederickson, Keville

2017-04-01

The purpose of this Roy adaptation model-guided study was to test the effectiveness of a student registered nurse intern-led nursing intervention entitled the Healthy Living Wellness Program. A one-group pretest/posttest preexperimental design was used. The intervention was imparted to minority, underserved, economically disadvantaged older adults ( N = 30). Significant findings pre- and postintervention were reported for body mass index, waist circumference, self-reported blood glucose, and weight. The findings supported the effectiveness of the nursing intervention, the Healthy Living Wellness Program, guided by the Roy adaptation model.

A hypnotically mediated guided imagery intervention for intrusive imagery: creating ground for figure.

PubMed

Appel, P R

1999-04-01

Intrusive imagery can be seen as a cognitive dysfunction in the assimilation and accommodation of the psychological material represented by those images. From a gestalt psychological perspective, the intrusive image represents a figure without a ground that can provide meaning and context. Hypnotically mediated guided imagery interventions can be used to create a ground for the rogue image that metaphorically is an unassimilated figure; and thus allow for the creation of a new cognitive scheme. Four case examples are presented as well as a model for the intervention.

Real-time MRI-guided needle intervention for cryoablation: a phantom study

NASA Astrophysics Data System (ADS)

Gao, Wenpeng; Jiang, Baichuan; Kacher, Dan F.; Fetics, Barry; Nevo, Erez; Lee, Thomas C.; Jayender, Jagadeesan

2017-03-01

MRI-guided needle intervention for cryoablation is a promising way to relieve the pain and treat the cancer. However, the limited size of MRI bore makes it impossible for clinicians to perform the operation in the bore. The patients had to be moved into the bore for scanning to verify the position of the needle's tip and out for adjusting the needle's trajectory. Real-time needle tracking and shown in MR images is of importance for clinicians to perform the operation more efficiently. In this paper, we have instrumented the cryotherapy needle with a MRI-safe electromagnetic (EM) sensor and optical sensor to measure the needle's position and orientation. To overcome the limitation of line-of-sight for optical sensor and the poor dynamic performance of the EM sensor, Kalman filter based data fusion is developed. Further, we developed a navigation system in open-source software, 3D Slicer, to provide accurate visualization of the needle and the surrounding anatomy. Experiment of simulation the needle intervention at the entrance was performed with a realistic spine phantom to quantify the accuracy of the navigation using the retrospective analysis method. Eleven trials of needle insertion were performed independently. The target accuracy with the navigation using only EM sensor, only optical sensor and data fusion are 2.27 +/-1.60 mm, 4.11 +/- 1.77 mm and 1.91 - 1.10 mm, respectively.

MRI-guided and CT-guided cervical nerve root infiltration therapy: a cost comparison.

PubMed

Maurer, M H; Froeling, V; Röttgen, R; Bretschneider, T; Hartwig, T; Disch, A C; de Bucourt, M; Hamm, B; Streitparth, F

2014-06-01

To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. The mean intervention time was 24.9 min. (range: 12 - 36 min.) for MRI-guided infiltration and 19.7 min. (range: 5 - 54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. © Georg Thieme Verlag KG Stuttgart · New York.

'Talking of Sex': developing and piloting a sexual health communication tool for use in primary care.

PubMed

Macdowall, Wendy; Parker, Rachael; Nanchahal, Kiran; Ford, Chris; Lowbury, Ruth; Robinson, Angela; Sherrard, Jackie; Martins, Helen; Fasey, Nicky; Wellings, Kaye

2010-12-01

To develop and pilot a communication aid aimed at increasing the frequency with which sexual health issues are raised proactively with young people in primary care. Group interviews among primary health care professionals to guide development of the tool, simulated consultations to pre-test it, and a pilot study to assess effectiveness. We developed an electronic consultation aid: Talking of Sex and piloted it in eight general practices across the UK. 188 patients and 58 practitioners completed questionnaires pre-intervention, and 92 patients and 45 practitioners post-intervention. There was a modest increase in the proportion of consultations in which sexual health was raised, from 28.1% pre-intervention to 32.6% post-intervention. In consultations with nurses the rise was more marked. More patients reported discussing preventive practices such as condom use post-intervention. Patients unanimously welcomed the opportunity to discuss sexual health matters with their practitioner. The tool has capacity to increase the frequency with which sexual health is raised in primary care, particularly by nurses, to influence the topics discussed, and to improve patient satisfaction. The tool has potential in increasing the proportion of young people whose sexual health needs are addressed in general practice. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Development of a cancer clinical trials multi-media intervention: clinical trials: are they right for you?

PubMed

Wells, Kristen J; Quinn, Gwendolyn P; Meade, Cathy D; Fletcher, Michelle; Tyson, Dinorah Martinez; Jim, Heather; Jacobsen, Paul B

2012-08-01

To describe processes used to develop a multi-media psycho-educational intervention to prepare patients for a discussion about cancer clinical trials (CTs). Guided by a Steering Committee, formative research was conducted to develop an informative and engaging tool about cancer CTs. Twenty-three patients and caregivers participated in formative in-depth interviews to elicit information about perceptions of cancer CTs to inform production of a new media product. Formative research revealed participants had concerns about experimentation, held beliefs that cancer CTs were for patients who had no other treatment options, and wanted a balance of information about pros and cons of CT participation. The value of physicians as credible spokespersons and the use of patients as role-models were supported. Using iterative processes, the production team infused the results into creation of a multimedia psycho-educational intervention titled Clinical Trials: Are they Right for You? An intervention, developed through an iterative consumer-focused process involving multiple stakeholders and formative research, may result in an engaging informative product. If found to be efficacious, Clinical Trials: Are they Right for You? is a low-cost and easily disseminated multimedia psycho-educational intervention to assist cancer patients with making an informed decision about cancer CTs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Open-source platforms for navigated image-guided interventions.

PubMed

Ungi, Tamas; Lasso, Andras; Fichtinger, Gabor

2016-10-01

Navigation technology is changing the clinical standards in medical interventions by making existing procedures more accurate, and new procedures possible. Navigation is based on preoperative or intraoperative imaging combined with 3-dimensional position tracking of interventional tools registered to the images. Research of navigation technology in medical interventions requires significant engineering efforts. The difficulty of developing such complex systems has been limiting the clinical translation of new methods and ideas. A key to the future success of this field is to provide researchers with platforms that allow rapid implementation of applications with minimal resources spent on reimplementing existing system features. A number of platforms have been already developed that can share data in real time through standard interfaces. Complete navigation systems can be built using these platforms using a layered software architecture. In this paper, we review the most popular platforms, and show an effective way to take advantage of them through an example surgical navigation application. Copyright © 2016 Elsevier B.V. All rights reserved.

A strategic approach for prioritizing research and action to prevent suicide.

PubMed

Pringle, Beverly; Colpe, Lisa J; Heinssen, Robert K; Schoenbaum, Michael; Sherrill, Joel T; Claassen, Cynthia A; Pearson, Jane L

2013-01-01

It is time to strategically apply science and accountability to the public health problem of preventable suicide. U.S. suicide rates have remained stable for decades. More than 36,000 individuals now die by suicide each year. A public health-based approach to quickly and substantially reduce suicides requires strategic deployment of existing evidence-based interventions, rapid development of new interventions, and measures to increase accountability for results. The purpose of this Open Forum is to galvanize researchers to further develop and consolidate knowledge needed to guide these actions. As researchers overcome data limitations and methodological challenges, they enable better prioritization of high-risk subgroups for targeted suicide prevention efforts, identification of effective interventions ready for deployment, estimation of the implementation impact of effective interventions in real-world settings, and assessment of time horizons for taking implementation to scale. This new knowledge will permit decision makers to take strategic action to reduce suicide and stakeholders to hold them accountable for results.

A Service Delivery Model for Children with DCD Based on Principles of Best Practice.

PubMed

Camden, Chantal; Léger, France; Morel, Julie; Missiuna, Cheryl

2015-01-01

In this perspective article, we propose the Apollo model as an example of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on function and participation. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. The Apollo model has 5 components: first contact, service delivery coordination, community-, group-, and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD.

Changes in One Teacher's Proportional Reasoning Instruction after Participating in a CGI Professional Development Workshop

ERIC Educational Resources Information Center

de la Cruz, Jessica A.

2016-01-01

This study examined how one teacher used research-based knowledge of how adolescents think about proportions. Observations, interviews, document collection, and a workshop intervention were utilized. The design of the workshop was inspired by the cognitively guided instruction studies and its purpose was to explore the research findings on…

Physical Activity Energy Expenditure in Dutch Adolescents: Contribution of Active Transport to School, Physical Education, and Leisure Time Activities

ERIC Educational Resources Information Center

Slingerland, Menno; Borghouts, Lars B.; Hesselink, Matthijs K. C.

2012-01-01

Background: Detailed knowledge about physical activity energy expenditure (PAEE) can guide the development of school interventions aimed at reducing overweight in adolescents. However, relevant components of PAEE have never been objectively quantified in this population. This study investigated the contribution of active transport to and from…

Focus Groups with Working Parents of School-Aged Children: What's Needed to Improve Family Meals?

ERIC Educational Resources Information Center

Fulkerson, Jayne A.; Kubik, Martha Y.; Rydell, Sarah; Boutelle, Kerri N.; Garwick, Ann; Story, Mary; Neumark-Sztainer, Dianne; Dudovitz, Bonnie

2011-01-01

Objective: To conduct focus groups to identify parents' perceptions of barriers to family meals and elucidate ideas to guide the development of interventions to overcome barriers. Methods: Focus groups were conducted with a convenience sample of 27 working parents in urban community settings. Results: Parents reported enjoying the sharing/bonding…

Anorexia and Bulimia: An Inventory of Public Awareness and Popular Questions.

ERIC Educational Resources Information Center

Zimmer, Marc A.

Prevention and early intervention in cases of anorexia and bulimia require that both professionals and the general public have knowledge about these eating disorders. A study was conducted to identify the questions about these disorders most often asked by the general public and to develop a guide to answer those questions for individuals of…

Understanding Family Involvement in the Preparation of Graduate Students: Measuring Family-Centered Beliefs, Skills, Systems, and Practices

ERIC Educational Resources Information Center

Giallourakis, Angie; Kent, Kristie Pretti-Frontczak; Cook, Bryan

2005-01-01

This research project sought to develop a measure to examine the family-centered beliefs, skills, work systems, and work practices of early childhood intervention, (ECI) and early childhood education (ECE) graduate students. The study was guided by four research questions: (1) To what extent do graduate students from preservice preparation…

From Family Deficit to Family Strength: Viewing Families' Contributions to Children's Learning from a Family Resilience Perspective

ERIC Educational Resources Information Center

Amatea, Ellen S.; Smith-Adcock, Sondra; Villares, Elizabeth

2006-01-01

This article presents an overview of a research-informed family resilience framework, developed as a conceptual map to guide school counselors' preventive and interventive efforts with students and their families. Key processes that characterize children's and families' resilience are outlined along with recommendations for how school counselors…

Guiding Math Students to Campus Services: An Impact Evaluation of the Beacon Program at South Texas College

ERIC Educational Resources Information Center

Visher, Mary; Butcher, Kristin F.; Cerna, Oscar S.

2011-01-01

This research rigorously evaluates whether a low-cost intervention can improve students' performance in developmental math. The "Beacon Mentoring Program" was developed at South Texas College by professors, administrators, and staff at the college. Surveys of students revealed that many did not have someone on campus whom they felt they…

Don't Worry, They'll Grow Up: A Parent's Survival Guide.

ERIC Educational Resources Information Center

Tubbs, Janet

This workbook was developed as part of an arts-based prevention and primary intervention program for preschools, parochial and elementary schools, day care centers, churches, and homes. It is designed to help parents identify potential or existing problems and create feelings of value and self-reliance in young children. The importance of enjoying…

Pre-Layoff Intervention: A Response to Unemployment. Second Edition.

ERIC Educational Resources Information Center

Stone, Judson; And Others

Based on a program provided by a consortium of mental health centers in the Detroit, Michigan, area, this manual is intended to assist in the development and delivery of programs that allay or prevent the devastating human impact of plant shutdowns and large-scale layoffs. The guide focuses on delivery of programs that promote more effective use…

A Parent's Guide to Services for Children, from Birth to Three Years of Age, with Special Needs

ERIC Educational Resources Information Center

Tennessee Department of Education, 2008

2008-01-01

This booklet introduces parents to "Tennessee's Early Intervention System" (TEIS). This system is funded through the Tennessee Department of Education. Through TEIS parents can get answers about their baby's growth and development and find the special services their child may need. Parents can also use this system to determine which…

Supplemental Driver Safety Program Development Volume II--Pilot and Field Test Module Materials. Final Report.

ERIC Educational Resources Information Center

McPherson, Kenard; Weidman, James R.

This volume contains materials to supplement existing driver education programming offered by high schools to youthful (16- to 18-year old) drivers. Section I contains three drinking/driving modules: an information-only module, a self-image module, and a three-unit peer intervention module. An instructor's guide provided for each module includes…

Elder Abuse and Neglect: The Illinois Response.

ERIC Educational Resources Information Center

Illinois State Dept. on Aging, Springfield.

This document outlines the ideas of the Illinois Department of Aging on the implementation and management of the Elder Abuse and Neglect Intervention Program. These topics are addressed in order to provide a basis for discussion of key elements of the proposed program and serve as a guide in the development of rules, policies, and procedures for…

Intervention planning for the REDUCE maintenance intervention: a digital intervention to reduce reulceration risk among patients with a history of diabetic foot ulcers

PubMed Central

Sivyer, Katy; Vedhara, Kavita; Yardley, Lucy; Game, Frances; Chalder, Trudie; Richards, Gayle; Drake, Nikki; Gray, Katie; Weinman, John; Bradbury, Katherine

2018-01-01

Objectives To develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk. Methods Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I of intervention planning, evidence was collated from a scoping review of the literature and qualitative interviews with patients who have had DFUs (n=20). This was used to identify the psychosocial needs and challenges of this population and barriers and facilitators to the intervention’s target behaviours: regular foot checking, rapid self-referral in the event of changes in foot health, graded and regular physical activity and emotional management. In phase II, this evidence was combined with expert consultation to develop the intervention plan. Brief ‘guiding principles’ for shaping intervention development were created. ‘Behavioural analysis’ and ‘logic modelling’ were used to map intervention content onto behaviour change theory to comprehensively describe the intervention and its hypothesised mechanisms. Results Key challenges to the intervention’s target behaviours included patients’ uncertainty regarding when to self-refer, physical limitations affecting foot checking and physical activity and, for some, difficulties managing negative emotions. Important considerations for the intervention design included a need to increase patients’ confidence in making a self-referral and in using the maintenance intervention and a need to acknowledge that some intervention content might be relevant to only some patients (emotional management, physical activity). The behavioural analysis identified the following processes hypothesised to facilitate long-term behaviour maintenance including increasing patients’ skills, self-efficacy, knowledge, positive outcome expectancies, sense of personal control, social support and physical opportunity. Conclusions This research provides a transparent description of the intervention planning for the REDUCE maintenance intervention. It provides insights into potential barriers and facilitators to the target behaviours and potentially useful behaviour change techniques to use in clinical practice. PMID:29779008

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

PubMed

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

2012-11-19

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

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

PubMed Central

2012-01-01

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

Promoting Early Child Development With Interventions in Health and Nutrition: A Systematic Review.

PubMed

Vaivada, Tyler; Gaffey, Michelle F; Bhutta, Zulfiqar A

2017-08-01

Although effective health and nutrition interventions for reducing child mortality and morbidity exist, direct evidence of effects on cognitive, motor, and psychosocial development is lacking. To review existing evidence for health and nutrition interventions affecting direct measures of (and pathways to) early child development. Reviews and recent overviews of interventions across the continuum of care and component studies. We selected systematic reviews detailing the effectiveness of health or nutrition interventions that have plausible links to child development and/or contain direct measures of cognitive, motor, and psychosocial development. A team of reviewers independently extracted data and assessed their quality. Sixty systematic reviews contained the outcomes of interest. Various interventions reduced morbidity and improved child growth, but few had direct measures of child development. Of particular benefit were food and micronutrient supplementation for mothers to reduce the risk of small for gestational age and iodine deficiency, strategies to reduce iron deficiency anemia in infancy, and early neonatal care (appropriate resuscitation, delayed cord clamping, and Kangaroo Mother Care). Neuroprotective interventions for imminent preterm birth showed the largest effect sizes (antenatal corticosteroids for developmental delay: risk ratio 0.49, 95% confidence interval 0.24 to 1.00; magnesium sulfate for gross motor dysfunction: risk ratio 0.61, 95% confidence interval 0.44 to 0.85). Given the focus on high-quality studies captured in leading systematic reviews, only effects reported within studies included in systematic reviews were captured. These findings should guide the prioritization and scale-up of interventions within critical periods of early infancy and childhood, and encourage research into their implementation at scale. Copyright © 2017 by the American Academy of Pediatrics.

Culturally-grounded mother-daughter communication-focused intervention for Thai female adolescents.

PubMed

Powwattana, Arpaporn; Thammaraksa, Pimrat; Manora, Sroy

2018-02-05

Teenage pregnancy-prevention interventions have fallen short in significantly decreasing risk of pregnancy for Thai populations. The "breaking the voice" ("rak luk khun tong pood") culture-appropriate teenage pregnancy-prevention program was developed using community-based research. Qualitative analyses of focus group data identified salient factors related to sexual communication and behavior. The integration of focus group results with theoretical constructs guided the development of an intervention to reduce risky sexual behavior by increasing communication between mothers and their adolescent daughters. A total of 157 mother-daughter dyads from congested areas in Bangkok participated in pilot testing of the intervention by the use of a survey. The findings indicated a significant increase in the frequency of and number of sexual risk communication (P < .05). There was a significant increase in perceived power in relationship control, ability to prevent sexual risk, assertiveness, and ability to decrease sexual risk among daughters (P < .05). "Breaking the voice" represents a female-focused and culturally-relevant intervention to combat teenage pregnancy. © 2018 John Wiley & Sons Australia, Ltd.

Improving the well-being of children and youths: a randomized multicomponent, school-based, physical activity intervention.

PubMed

Smedegaard, Søren; Christiansen, Lars Breum; Lund-Cramer, Pernille; Bredahl, Thomas; Skovgaard, Thomas

2016-10-28

The benefits of physical activity for the mental health and well-being of children and young people are well-established. Increased physical activity during school hours is associated with better physical, psychological and social health and well-being. Unfortunately many children and young people exercise insufficiently to benefit from positive factors like well-being. The main aim of this study is to develop, implement and evaluate a multi-component, school-based, physical activity intervention to improve psychosocial well-being among school-aged children and youths from the 4 th to the 6 th grade (10-13 years). A four-phased intervention - design, pilot, RCT, evaluation - is carried out for the development, implementation and evaluation of the intervention which are guided by The Medical Research Council framework for the development of complex interventions. 24 schools have been randomized and the total study population consists of 3124 children (baseline), who are followed over a period of 9 months. Outcome measure data at the pupil level are collected using an online questionnaire at baseline and at follow-up, 9 months later with instruments for measuring primary (general physical self-worth) and secondary outcomes (self-perceived sport competences, body attractiveness, scholastic competences, social competences and global self-worth; enjoyment of PA; self-efficacy; and general well-being) that are both valid and manageable in setting-based research. The RE-AIM framework is applied as an overall instrument to guide the evaluation. The intervention focuses on the mental benefits of physical activity at school, which has been a rather neglected theme in health promotion research during recent decades. This is unfortunate as mental health has been proclaimed as one of the most important health concerns of the 21 st century. Applying a cluster RCT study design, evaluating the real-world effectiveness of the intervention, this study is one of the largest physical activity intervention projects promoting psychosocial well-being among children and youths. Through a comprehensive effectiveness evaluation and a similar substantial process evaluation, this study is designed to gain knowledge on a broad variety of implementation issues and give detailed information on project delivery and challenges at the school level - among other things to better inform future practice. Date of registration: 24 April 2015 retrospectively registered at Current Controlled Trials with study ID ISRCTN12496336.

Partners in Parenting: A Multi-Level Web-Based Approach to Support Parents in Prevention and Early Intervention for Adolescent Depression and Anxiety

PubMed Central

Lawrence, Katherine A; Rapee, Ronald M; Cardamone-Breen, Mairead C; Green, Jacqueline; Jorm, Anthony F

2017-01-01

Depression and anxiety disorders in young people are a global health concern. Various risk and protective factors for these disorders are potentially modifiable by parents, underscoring the important role parents play in reducing the risk and impact of these disorders in their adolescent children. However, cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. In this paper, we propose a multi-level public health approach involving a Web-based parenting intervention, Partners in Parenting (PIP). We describe the components of the Web-based intervention and how each component was developed. Development of the intervention was guided by principles of the persuasive systems design model to maximize parental engagement and adherence. A consumer-engagement approach was used, including consultation with parents and adolescents about the content and presentation of the intervention. The PIP intervention can be used at varying levels of intensity to tailor to the different needs of parents across the population. Challenges and opportunities for the use of the intervention are discussed. The PIP Web-based intervention was developed to address the dearth of evidence-based resources to support parents in their important role in their adolescents’ mental health. The proposed public health approach utilizes this intervention at varying levels of intensity based on parents’ needs. Evaluation of each separate level of the model is ongoing. Further evaluation of the whole approach is required to assess the utility of the intervention as a public health approach, as well as its broader effects on adolescent functioning and socioeconomic outcomes. PMID:29258974

Development of a Web-Based Quality Dashboard Including a Toolbox to Improve Pain Management in Dutch Intensive Care.

PubMed

Roos-Blom, Marie-José; Gude, Wouter T; de Jonge, Evert; Spijkstra, Jan Jaap; van der Veer, Sabine N; Dongelmans, Dave A; de Keizer, Nicolette F

2017-01-01

Audit and feedback (A&F) is a common strategy to improve quality of care. Meta-analyses have indicated that A&F may be more effective in realizing desired change when baseline performance is low, it is delivered by a supervisor or colleague, it is provided frequently and in a timely manner, it is delivered in both verbal and written formats, and it includes specific targets and an action plan. However, there is little information to guide operationalization of these factors. Researchers have consequently called for A&F interventions featuring well-described and carefully justified components, with their theoretical rationale made explicit. This paper describes the rationale and development of a quality dashboard including an improvement toolbox for four previous developed pain indicators, guided by Control Theory.

Short-term improvement in oral self-care of adolescents with social-cognitive theory-guided intervention.

PubMed

Hall-Scullin, Emma P

2015-12-01

Cluster randomised controlled trial. Clusters of adolescents (classrooms of 15- to 16-year-olds) in each school were allocated either into a control group or into an intervention group. The interventions consisted of peer cooperation (peer support) and peer interactive learning (observational learning) facilitated through feedback from a dentist (professional support). Three intervention sessions with preselected pairs of adolescents were delivered in the first three weeks. Gender, family socio-economic status (baseline) and different social-cognitive domain variables (baseline, six, and 12 months) were assessed using a questionnaire. Dental plaque levels were the primary outcome measure and they were measured at baseline, after the intervention measured only in the social-cognitive theory-guided group, at six and 12 months. At the six-month follow-up there was a statistically significant difference in means ± SD between the social-cognitive intervention group (27.4 ± 19.4) and the control group (35.1 ± 20.0). At the 12-month follow-up, there was no statistically significant difference in means ± SD between the social-cognitive intervention group (27.4 ± 18.5) and the control group (31.9 ± 17.8). Variations in dental plaque levels at different time periods were explained by the following predictors: family's socio-economic status, social-cognitive domain variables, group affiliation and baseline plaque levels. Social-cognitive theory-guided interventions improved oral self-care of adolescents in the short term. This improvement lasted only for five months after the intervention was discontinued.

Cost Effectiveness of the Instrumentalism in Occupational Therapy (IOT) Conceptual Model as a Guide for Intervention with Adolescents with Emotional and Behavioral Disorders (EBD)

ERIC Educational Resources Information Center

Ikiugu, Moses N.; Anderson, Lynne

2007-01-01

The purpose of this paper was to demonstrate the cost-effectiveness of using the Instrumentalism in Occupational Therapy (IOT) conceptual practice model as a guide for intervention to assist teenagers with emotional and behavioral disorders (EBD) transition successfully into adulthood. The cost effectiveness analysis was based on a project…

Use of Study Guide as Intervention Tool in Enhancing Students' Motivation in Grade 8 Genetics Concepts

ERIC Educational Resources Information Center

Balan, Hazel R.

2018-01-01

Genetics is considered as one of the topics in science that students have difficulty and trouble in understanding. This study used study guide as an intervention tool to address the difficulties of students in learning genetics concepts. The main purpose of this study was to determine the perceptions of students on the effectiveness of study guide…

IN-HOME EXPOSURE THERAPY FOR VETERANS WITH POST TRAUMATIC STRESS DISORDER

DTIC Science & Technology

2016-10-01

study protocol. 5 Our treatment clinicians are providing the manual-guided evidence - based PE PTSD intervention. Therapists attend a weekly PE...with PTSD confirming the noninferiority of using CVT to deliver an evidence - based treatment (EBT) for PTSD, Cognitive Processing Therapy (CPT; Resick...g. Treatment clinicians will conduct a manual-guided evidence based PTSD intervention, Prolonged Exposure Therapy (PE), with approximately 175

Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials.

PubMed

Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

2015-05-12

Total knee replacement can be a successful operation for pain relief. However, 10-34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Adult patients receiving total knee replacement. Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. 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.

Empowering adolescent girls in Sub-Saharan Africa to prevent unintended pregnancy and HIV: A critical research gap.

PubMed

Phillips, Sharon J; Mbizvo, Michael T

2016-01-01

The need to prevent early pregnancy and HIV among adolescent girls in Sub-Saharan Africa has been recognized increasingly over recent years. Although extensive work has been done to determine appropriate interventions for girls in high-income countries, very little evidence is available to guide programmatic interventions in Sub-Saharan Africa. The available evidence has been equivocal regarding improved outcomes. While knowledge and self-reported behaviors frequently change with interventions, including those performed at the community level, educational programs, and direct contraceptive provision, downstream outcomes rarely reflect a significant effect of the interventions; however, provision of financial or other interventions to incentivize continued school enrollment are a promising development. We suggest directions for future research to fill this critical gap in the literature. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Psychosocial Intervention Use in Long-Stay Dementia Care: A Classic Grounded Theory.

PubMed

Hunter, Andrew; Keady, John; Casey, Dympna; Grealish, Annmarie; Murphy, Kathy

2016-12-01

The objective of this study was to develop a substantive grounded theory of staff psychosocial intervention use with residents with dementia in long-stay care. "Becoming a person again" emerged as the core category accounting for staffs' psychosocial intervention use within long-stay care. Interview data were collected from participants in nine Irish long-stay settings: 14 residents with dementia, 19 staff nurses, one clinical facilitator, seven nurse managers, 21 nursing assistants, and five relatives. Constant comparative method guided the data collection and analysis. The researcher's theoretical memos, based on unstructured observation, and applicable extant literature were also included as data. By identifying the mutuality of the participants' experiences, this classic grounded theory explains staff motivation toward psychosocial intervention use within long-stay care. It also explains how institutional factors interact with those personal factors that incline individuals toward psychosocial intervention use. © The Author(s) 2016.

A mass mediated intervention on Hispanic live kidney donation.

PubMed

Alvaro, Eusebio M; Siegel, Jason T; Crano, William D; Dominick, Alexander

2010-06-01

This research examines the impact of a Spanish language mass media campaign on living organ donation attitudes and behavioral intentions among Spanish dominant Hispanics in Tucson, Arizona. Impact was assessed via a pretest/posttest control group quasiexperimental design with Tucson, Arizona, as the intervention community and Phoenix, Arizona, as the control. Preintervention focus groups provided qualitative data to guide intervention development, while telephone surveys in both communities provided quantitative data to assess campaign impact. Analyses reveal pretest/posttest differences in the intervention community such that posttest intentions regarding living organ donation behaviors increased from pretest. No such differences were observed in the control community. Subsequent analyses revealed differences between respondents in the intervention community exposed to the campaign vs. those in the same community not exposed to the campaign. Exposed respondents reported more positive living organ donation behavioral intentions than nonexposed respondents. Implications for research and practice are discussed.

TechCare: mobile assessment and therapy for psychosis - an intervention for clients in the Early Intervention Service: A feasibility study protocol.

PubMed

Husain, Nusrat; Gire, Nadeem; Kelly, James; Duxbury, Joy; McKeown, Mick; Riley, Miv; Taylor, Christopher Dj; Taylor, Peter J; Emsley, Richard; Farooq, Saeed; Caton, Neil; Naeem, Farooq; Kingdon, David; Chaudhry, Imran

2016-01-01

Technological advances in healthcare have shown promise when delivering interventions for mental health problems such as psychosis. The aim of this project is to develop a mobile phone intervention for people with psychosis and to conduct a feasibility study of the TechCare App. The TechCare App will assess participant's symptoms and respond with a personalised guided self-help-based psychological intervention with the aim of exploring feasibility and acceptability. The project will recruit 16 service users and 8-10 health professionals from the Lancashire Care NHS Foundation Trust Early Intervention Service. In strand 1 of the study, we will invite people to discuss their experience of psychosis and give their opinions on the existing evidence-based treatment (cognitive behavioural therapy) and how the mobile app can be developed. In strand 2, we will complete a test run with a small number of participants (n = 4) to refine the mobile intervention (TechCare). Finally, in strand 3 of the study, the TechCare App will be examined in a feasibility study with 12 participants. It has been suggested that there is a need for a rapid increase in the efforts to develop the evidence base for the clinical effectiveness of digital technologies, considering mHealth research can potentially be helpful in addressing the demand on mental health services globally.

Use of theory in computer-based interventions to reduce alcohol use among adolescents and young adults: a systematic review.

PubMed

Tebb, Kathleen P; Erenrich, Rebecca K; Jasik, Carolyn Bradner; Berna, Mark S; Lester, James C; Ozer, Elizabeth M

2016-06-17

Alcohol use and binge drinking among adolescents and young adults remain frequent causes of preventable injuries, disease, and death, and there has been growing attention to computer-based modes of intervention delivery to prevent/reduce alcohol use. Research suggests that health interventions grounded in established theory are more effective than those with no theoretical basis. The goal of this study was to conduct a literature review of computer-based interventions (CBIs) designed to address alcohol use among adolescents and young adults (aged 12-21 years) and examine the extent to which CBIs use theories of behavior change in their development and evaluations. This study also provides an update on extant CBIs addressing alcohol use among youth and their effectiveness. Between November and December of 2014, a literature review of CBIs aimed at preventing or reducing alcohol in PsychINFO, PubMed, and Google Scholar was conducted. The use of theory in each CBI was examined using a modified version of the classification system developed by Painter et al. (Ann Behav Med 35:358-362, 2008). The search yielded 600 unique articles, 500 were excluded because they did not meet the inclusion criteria. The 100 remaining articles were retained for analyses. Many articles were written about a single intervention; thus, the search revealed a total of 42 unique CBIs. In examining the use of theory, 22 CBIs (52 %) explicitly named one or more theoretical frameworks. Primary theories mentioned were social cognitive theory, transtheoretical model, theory of planned behavior and reasoned action, and health belief model. Less than half (48 %), did not use theory, but mentioned either use of a theoretical construct (such as self-efficacy) or an intervention technique (e.g., manipulating social norms). Only a few articles provided detailed information about how the theory was applied to the CBI; the vast majority included little to no information. Given the importance of theory in guiding interventions, greater emphasis on the selection and application of theory is needed. The classification system used in this review offers a guiding framework for reporting how theory based principles can be applied to computer based interventions.

If You Build It, They Will Come: How to Establish an Academic Innovation Enterprise.

PubMed

Srimathveeravalli, Govindarajan; Balesh, Elie; Cheng, Christopher P; Chen, David

2017-06-01

The rapid growth of minimally invasive, image-guided intervention has redefined the procedural management of multiple disease entities. The process of innovation which has characterized the growth of interventional radiology can be best described as "needs-based," whereby practicing interventionalists identify unmet clinical needs and subsequently invent solutions to achieve desired technical and clinical outcomes. Historically, catheters and other percutaneous devices were developed with rudimentary manufacturing techniques and subsequently translated to patients with relatively little regulatory oversight. Since then, the resources required and financial costs of interventional technology development have grown exponentially. Fortunately, advances in software development, new methods of rapid prototyping, and commoditization of hardware components have made in-house engineering feasible once again. This has created an opportunity for academic medical centers to translate their research into testable prototypes in humans sooner and at reduced costs, and academic interventional radiology divisions are now leveraging these developments to create collaborative centers of innovation. This article describes five such organizational formats for collaboration and innovation in the academic setting, describing the structure, opportunities, requirements, and caveats of each model. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-11-04

Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions. A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and researchers through publication in journals and presentation at conferences. This is the first study to investigate guided self-help interventions for mental health problems in children with neurological conditions, a group which is currently under-represented in mental health research. The intervention is modular and adapted from an empirically supported cognitive behavioural treatment. The generalisability and broad inclusion criteria are strengths but may also lead to some weaknesses. Current Controlled Trials: ISRCTN21184717 . Registered on 25 September 2015.

Real-Time MRI-Guided Endovascular Recanalization of Chronic Total Arterial Occlusion in a Swine Model

PubMed Central

Raval, Amish N.; Karmarkar, Parag V.; Guttman, Michael A.; Ozturk, Cengizhan; Sampath, Smita; DeSilva, Ranil; Aviles, Ronnier J.; Xu, Minnan; Wright, Victor J.; Schenke, William H.; Kocaturk, Ozgur; Dick, Alexander J.; Raman, Venkatesh K.; Atalar, Ergin; McVeigh, Elliot R.; Lederman, Robert J.

2006-01-01

Background Endovascular recanalization (guidewire traversal) of peripheral artery chronic total occlusion (CTO) can be challenging. X-Ray angiography resolves CTO poorly. Virtually “blind” device advancement during X-ray-guided interventions can lead to procedure failure, perforation and hemorrhage. Alternatively, magnetic resonance imaging (MRI) may delineate the artery within the occluded segment to enhance procedural safety and success. We hypothesized that real-time MRI (rtMRI) guided CTO recanalization can be accomplished in an animal model. Methods and Results Carotid artery CTO was created by balloon injury in 19 lipid overfed swine. After 6–8 weeks, two underwent direct necropsy analysis for histology, three underwent primary X-ray-guided CTO recanalization attempts, and the remaining 14 underwent rtMRI-guided recanalization attempts in a 1.5T interventional MRI system. rtMRI intervention used custom CTO catheters and guidewires that incorporated MRI receiver antennae to enhance device visibility. The mean length of the occluded segments was 13.3 ± 1.6cm. rtMRI-guided CTO recanalization was successful in 11/14 swine and only 1/3 swine using X-ray alone. After unsuccessful rtMRI (n = 3), X-ray-guided attempts also were all unsuccessful. Conclusions Recanalization of long CTO is feasible entirely using rtMRI guidance. Low profile clinical-grade devices will be required to translate this experience to humans. Endovascular recanalization of chronic total arterial occlusion (CTO) is challenging under conventional X-ray guidance because devices are advanced almost blindly. MRI can image CTO borders and luminal contents, and could potentially guide these procedures. We test the feasibility of real-time MRI guided wire traversal in a swine model of peripheral artery CTO using custom active MRI catheters. PMID:16490819

Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue.

PubMed

Soo, Mary Scott; Jarosz, Jennifer A; Wren, Anava A; Soo, Adrianne E; Mowery, Yvonne M; Johnson, Karen S; Yoon, Sora C; Kim, Connie; Hwang, E Shelley; Keefe, Francis J; Shelby, Rebecca A

2016-05-01

To evaluate the impact of guided meditation and music interventions on patient anxiety, pain, and fatigue during imaging-guided breast biopsy. After giving informed consent, 121 women needing percutaneous imaging-guided breast biopsy were randomized into three groups: (1) guided meditation; (2) music; (3) standard-care control group. During biopsy, the meditation and music groups listened to an audio-recorded, guided, loving-kindness meditation and relaxing music, respectively; the standard-care control group received supportive dialogue from the biopsy team. Immediately before and after biopsy, participants completed questionnaires measuring anxiety (State-Trait Anxiety Inventory Scale), biopsy pain (Brief Pain Inventory), and fatigue (modified Functional Assessment of Chronic Illness Therapy-Fatigue). After biopsy, participants completed questionnaires assessing radiologist-patient communication (modified Questionnaire on the Quality of Physician-Patient Interaction), demographics, and medical history. The meditation and music groups reported significantly greater anxiety reduction (P values < .05) and reduced fatigue after biopsy than the standard-care control group; the standard-care control group reported increased fatigue after biopsy. The meditation group additionally showed significantly lower pain during biopsy, compared with the music group (P = .03). No significant difference in patient-perceived quality of radiologist-patient communication was noted among groups. Listening to guided meditation significantly lowered biopsy pain during imaging-guided breast biopsy; meditation and music reduced patient anxiety and fatigue without compromising radiologist-patient communication. These simple, inexpensive interventions could improve women's experiences during core-needle breast biopsy. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Advancements in Magnetic Resonance–Guided Robotic Interventions in the Prostate

PubMed Central

Macura, Katarzyna J.; Stoianovici, Dan

2011-01-01

Magnetic resonance imaging (MRI) provides more detailed anatomical images of the prostate compared with the transrectal ultrasound imaging. Therefore, for the purpose of intervention in the prostate gland, diagnostic or therapeutic, MRI guidance offers a possibility of more precise targeting that may be crucial to the success of prostate interventions. However, access within the scanner is limited for manual instrument handling and the MR environment is most demanding among all imaging equipment with respect to the instrumentation used. A solution to this problem is the use of MR-compatible robots purposely designed to operate in the space and environmental restrictions inside the MR scanner allowing real-time interventions. Building an MRI-compatible robot is a very challenging engineering task because, in addition to the material restrictions that MRI instruments have, the robot requires actuators and sensors that limit the type of energies that can be used. Several important design problems have to be overcome before a successful MR-compatible robot application can be built. A number of MR-compatible robots, ranging from a simple manipulator to a fully automated system, have been developed, proposing ingenious solutions to the design challenge. Several systems have been already tested clinically for prostate biopsy and brachytherapy. As technology matures, precise image guidance for prostate interventions performed or assisted by specialized MR-compatible robotic devices may provide a uniquely accurate solution for guiding the intervention directly based on MR findings and feedback. Such an instrument would become a valuable clinical tool for biopsies directly targeting imaged tumor foci and delivering tumor-centered focal therapy. PMID:19512852

Development of a dynamic computational model of social cognitive theory.

PubMed

Riley, William T; Martin, Cesar A; Rivera, Daniel E; Hekler, Eric B; Adams, Marc A; Buman, Matthew P; Pavel, Misha; King, Abby C

2016-12-01

Social cognitive theory (SCT) is among the most influential theories of behavior change and has been used as the conceptual basis of health behavior interventions for smoking cessation, weight management, and other health behaviors. SCT and other behavior theories were developed primarily to explain differences between individuals, but explanatory theories of within-person behavioral variability are increasingly needed as new technologies allow for intensive longitudinal measures and interventions adapted from these inputs. These within-person explanatory theoretical applications can be modeled as dynamical systems. SCT constructs, such as reciprocal determinism, are inherently dynamical in nature, but SCT has not been modeled as a dynamical system. This paper describes the development of a dynamical system model of SCT using fluid analogies and control systems principles drawn from engineering. Simulations of this model were performed to assess if the model performed as predicted based on theory and empirical studies of SCT. This initial model generates precise and testable quantitative predictions for future intensive longitudinal research. Dynamic modeling approaches provide a rigorous method for advancing health behavior theory development and refinement and for guiding the development of more potent and efficient interventions.

Improved nurse-parent communication in neonatal intensive care unit: evaluation and adjustment of an implementation strategy.

PubMed

Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

2014-12-01

To evaluate and adjust systematic implementation of guided family-centred care in a neonatal intensive care unit. Family-centred care is valued in neonatal intensive care units internationally, but innovative strategies are needed to realise the principles. Guided family-centred care was developed to facilitate person-centred communication by bridging the gap between theory and practice in family-centred care. Main mechanisms of guided family-centred care are structured dialogue, reflection and person-centred communication. Qualitative and quantitative data were used to monitor participatory implementation of a systematic approach to training and certification of nurses delivering guided family-centred care. Systematic implementation of guided family-centred care included workshops, supervised delivery and certification. Evaluation and adjustment of nurse adherence to guided family-centred care was conducted by monitoring (1) knowledge, (2) delivery, (3) practice uptake and (4) certification. Implementation was improved by the development of a strategic framework and by adjusting the framework according to the real-life context of a busy neonatal care unit. Promoting practice uptake was initially underestimated, but nurse guided family-centred care training was improved by increasing the visibility of the study in the unit, demonstrating intervention progress to the nurses and assuring a sense of ownership among nurse leaders and nonguided-family-centred-care-trained nurses. An adjusted framework for guided family-centred care implementation was successful in overcoming barriers and promoting facilitators. Insights gained from our pioneering work might help nurses in a similar context to reach their goals of improving family-centred care. © 2014 John Wiley & Sons Ltd.

Effectiveness of a focused, brief psychoeducation program for parents of ADHD children: improvement of medication adherence and symptoms.

PubMed

Bai, Guan-Nan; Wang, Yu-Feng; Yang, Li; Niu, Wen-Yi

2015-01-01

To evaluate the efficacy of a psychoeducation program for parents of children with ADHD in enhancing adherence to pharmacological treatment and improving clinical symptoms. We developed a psychoeducation program based on the theory of planned behavior (TPB). Eighty-nine children with ADHD were cluster randomly assigned for their families to receive 3 months of well-structured psychoeducation (intervention group, n=44) or only general clinical counseling (control group, n=45). Parents in the intervention group were given an expert lecture (with slides and a parent manual), attended two expert-guided parent group sessions, and were invited to join a professional-guided online community. Measurement of parents' knowledge about ADHD, components of the TPB model, and child ADHD symptoms were taken before and after intervention. Medication adherence was assessed thoroughly at the end of the first and third months. Satisfaction with the psychoeducation program was assessed only in the intervention group. Two-independent-samples t-test, ANOVA, and chi-square test were employed to compare differences between groups. Compared to the control group, medication adherence in the intervention group was significantly higher after 1 and 3 months (97.7% intervention vs 75.6% control, P=0.002, and 86.4% intervention vs 53.3% control, P=0.001, respectively). Accordingly, the ADHD rating scale scores were lower in the intervention group than the control group after intervention (33.7±5.4 vs 45.1±7.9, P=0.008). Greater improvements in parents' knowledge about ADHD and many components of the TPB model were observed in the intervention group, especially increased intention to adhere to medication, compared to the control group (P<0.001). This psychoeducation program had a positive impact on both medication adherence and clinical symptoms of ADHD children. It could be considered as a potential beneficial supplement to clinical practice.

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

PubMed

Ammerlaan, Judy; van Os-Medendorp, Harmieke; de Boer-Nijhof, Nienke; Scholtus, Lieske; Kruize, Aike A; van Pelt, Philomine; Prakken, Berent; Bijlsma, Hans

2017-10-13

A web-based self-management intervention guided by peer-trainers was developed to support young adults' self-management in coping with Juvenile Idiopathic Arthritis (JIA). To investigate its effectiveness, a randomized controlled trial (RCT) was conducted. In addition, the content of the chat and participants' goals were studied to identify underlying processes. An RCT with a six-month follow up period was conducted among 72 young adults with JIA, aged between 16 and 25 years old, randomly assigned to the intervention or to the usual care control group. After 24 weeks, in both groups 24 participants completed all measurements. Intentions to treat analyses were carried out by means of linear mixed models for longitudinal measurements. With self-efficacy as primary outcome, self-management, disease activity, quality of life, absenteeism of school/work, health care medication use and adherence to the intervention were studied. The participants' goals, personal achievements, interactions on the chat, and their appreciation of the intervention were analyzed using thematic analyses. No significant differences were found on self-efficacy, quality of life, and self-management between the participants of the control group and the intervention group. In the intervention group, modeling and sharing experiences were the most recognized themes. Fifty-five goals were formulated and divided into the following categories: improvement and maintaining balance, setting and recognizing boundaries, communicating and coping with incomprehension. Adherence, appreciation of the own learning experience, and personal achievements were rated positively. The web-based intervention did not lead to an improvement of self-efficacy. However, additional qualitative analyses showed that the intervention was appreciated and valuable for the participants. More research is needed on how to measure the added value of this intervention compared to the usual care. Trial registration number NTR4679 .

Personalized Feedback on Staff Dose in Fluoroscopy-Guided Interventions: A New Era in Radiation Dose Monitoring.

PubMed

Sailer, Anna M; Vergoossen, Laura; Paulis, Leonie; van Zwam, Willem H; Das, Marco; Wildberger, Joachim E; Jeukens, Cécile R L P N

2017-11-01

Radiation safety and protection are a key component of fluoroscopy-guided interventions. We hypothesize that providing weekly personal dose feedback will increase radiation awareness and ultimately will lead to optimized behavior. Therefore, we designed and implemented a personalized feedback of procedure and personal doses for medical staff involved in fluoroscopy-guided interventions. Medical staff (physicians and technicians, n = 27) involved in fluoroscopy-guided interventions were equipped with electronic personal dose meters (PDMs). Procedure dose data including the dose area product and effective doses from PDMs were prospectively monitored for each consecutive procedure over an 8-month period (n = 1082). A personalized feedback form was designed displaying for each staff individually the personal dose per procedure, as well as relative and cumulative doses. This study consisted of two phases: (1) 1-5th months: Staff did not receive feedback (n = 701) and (2) 6-8th months: Staff received weekly individual dose feedback (n = 381). An anonymous evaluation was performed on the feedback and occupational dose. Personalized feedback was scored valuable by 76% of the staff and increased radiation dose awareness for 71%. 57 and 52% reported an increased feeling of occupational safety and changing their behavior because of personalized feedback, respectively. For technicians, the normalized dose was significantly lower in the feedback phase compared to the prefeedback phase: [median (IQR) normalized dose (phase 1) 0.12 (0.04-0.50) µSv/Gy cm 2 versus (phase 2) 0.08 (0.02-0.24) µSv/Gy cm 2 , p = 0.002]. Personalized dose feedback increases radiation awareness and safety and can be provided to staff involved in fluoroscopy-guided interventions.

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 involvement in research activities (χ(2)=5.23, p=0.019), consultation with colleagues from other EDs (χ(2)=6.37, p=0.01) and perception of organizational expectations to use research evidence to guide practice (χ(2)=5.52, p=0.015). Most clinicians (95/105 or 92%) reported relying on colleagues from their own ED as a primary knowledge source. Urban clinicians were more likely than their rural counterparts to perceive that use of research evidence to guide practice was an expectation. Rural clinicians were more likely to rely on physicians from their own ED as a preferred knowledge source. The decision made by emergency clinicians to participate in a Web-based knowledge exchange intervention was influenced by a number of individual and contextual factors. Differences in these factors and preferences for knowledge sources require further characterization to enhance engagement of rural ED clinicians in online knowledge exchange interventions.