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

ERIC Educational Resources Information Center

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

2014-01-01

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

Health by Design: Interweaving Health Promotion into Environments and Settings

PubMed Central

Springer, Andrew E.; Evans, Alexandra E.; Ortuño, Jaquelin; Salvo, Deborah; Varela Arévalo, Maria Teresa

2017-01-01

The important influence of the environmental context on health and health behavior—which includes place, settings, and the multiple environments within place and settings—has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population’s health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context, defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments (the policy environment, the information environment, the social/cultural/organizational environment, and the physical environment), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet one which merits further intentionality as a specific health promotion planning design approach. PMID:29043248

Health by Design: Interweaving Health Promotion into Environments and Settings.

PubMed

Springer, Andrew E; Evans, Alexandra E; Ortuño, Jaquelin; Salvo, Deborah; Varela Arévalo, Maria Teresa

2017-01-01

The important influence of the environmental context on health and health behavior-which includes place, settings, and the multiple environments within place and settings-has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population's health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context , defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments ( the policy environment, the information environment, the social/cultural/organizational environment , and the physical environment ), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet one which merits further intentionality as a specific health promotion planning design approach.

Pilot of a computer-based brief multiple-health behavior intervention for college students.

PubMed

Moore, Michele J; Werch, Chudley E; Bian, Hui

2012-01-01

Given the documented multiple health risks college students engage in, and the dearth of effective programs addressing them, the authors developed a computer-based brief multiple-health behavior intervention. This study reports immediate outcomes and feasibility of a pilot of this program. Two hundred students attending a midsized university participated. Participants were randomly assigned to the intervention or control program, both delivered via computer. Immediate feedback was collected with the computer program. Results indicate that the intervention had an early positive impact on alcohol and cigarette use intentions, as well as related constructs underlying the Behavior-Image Model specific to each of the 3 substances measured. Based on the implementation process, the program proved to be feasible to use and acceptable to the population. Results support the potential efficacy of the intervention to positively impact behavioral intentions and linkages between health promoting and damaging behaviors among college students.

Effectiveness of an intervention promoting the female condom to patients at sexually transmitted disease clinics.

PubMed Central

Artz, L; Macaluso, M; Brill, I; Kelaghan, J; Austin, H; Fleenor, M; Robey, L; Hook, E W

2000-01-01

OBJECTIVES: This study evaluated a behavioral intervention designed to promote female condoms and reduce unprotected sex among women at high risk for acquiring sexually transmitted diseases (STDs). METHODS: The effect of the intervention on barrier use was evaluated with a pretest-posttest design with 1159 female STD clinic patients. RESULTS: Among participants with follow-up data, 79% used the female condom at least once and often multiple times. More than one third of those who completed the study used female condoms throughout follow-up. Use of barrier protection increased significantly after the intervention, and high use was maintained during a 6-month follow-up. To account for attrition, the use of protection by all subjects was projected under 3 conservative assumptions. The initial visit and termination visit projections suggest that use increased sharply after the intervention and declined during follow-up but remained elevated compared with the baseline. CONCLUSIONS: Many clients of public STD clinics will try, and some will continue, to use female condoms when they are promoted positively and when women are trained to use them correctly and to promote them to their partners. A behavioral intervention that promotes both female and male condoms can increase barrier use. PMID:10667185

Mixed-Methods for Comparing Tobacco Cessation Interventions.

PubMed

Momin, Behnoosh; Neri, Antonio; Zhang, Lei; Kahende, Jennifer; Duke, Jennifer; Green, Sonya Goode; Malarcher, Ann; Stewart, Sherri L

2017-03-01

The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions. This paper outlines the methodology used to conduct a comparative effectiveness research study of traditional and Web-based tobacco cessation and quitline promotion approaches. A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states. The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates 7 months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs. This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making.

"Act Healthy": Promoting Health Behaviors and Self-Efficacy in the Workplace

ERIC Educational Resources Information Center

Schopp, Laura H.; Bike, Denise H.; Clark, Mary J.; Minor, Marian A.

2015-01-01

Chronic health conditions and multiple health risk factors afflict Americans and burden employers, but effective, affordable, workplace-based health promotion interventions have not been widely implemented. This is the first study to adapt the empirically validated Chronic Disease Self-Management Program for a general employee population in a…

Promoting Social Communication in a Child with Specific Language Impairment

ERIC Educational Resources Information Center

O'Handley, Roderick D.; Radley, Keith C.; Lum, John D. K.

2016-01-01

Social difficulties represent a major area of concern in children with specific language impairment (SLI). Social skills interventions targeting communication or language skills of children with SLI have been generally ineffective. The current study tested the efficacy of a social skills intervention consisting of multiple behavioral interventions…

Efficacy of the Fun For Wellness Online Intervention to Promote Multidimensional Well-Being: a Randomized Controlled Trial.

PubMed

Myers, Nicholas D; Prilleltensky, Isaac; Prilleltensky, Ora; McMahon, Adam; Dietz, Samantha; Rubenstein, Carolyn L

2017-11-01

Subjective well-being refers to people's level of satisfaction with life as a whole and with multiple dimensions within it. Interventions that promote subjective well-being are important because there is evidence that physical health, mental health, substance use, and health care costs may be related to subjective well-being. Fun For Wellness (FFW) is a new online universal intervention designed to promote growth in multiple dimensions of subjective well-being. The purpose of this study was to provide an initial evaluation of the efficacy of FFW to increase subjective well-being in multiple dimensions in a universal sample. The study design was a prospective, double-blind, parallel group randomized controlled trial. Data were collected at baseline and 30 and 60 days-post baseline. A total of 479 adult employees at a major university in the southeast of the USA were enrolled. Recruitment, eligibility verification, and data collection were conducted online. Measures of interpersonal, community, occupational, physical, psychological, economic (i.e., I COPPE), and overall subjective well-being were constructed based on responses to the I COPPE Scale. A two-class linear regression model with complier average causal effect estimation was imposed for each dimension of subjective well-being. Participants who complied with the FFW intervention had significantly higher subjective well-being, as compared to potential compliers in the Usual Care group, in the following dimensions: interpersonal at 60 days, community at 30 and 60 days, psychological at 60 days, and economic at 30 and 60 days. Results from this study provide some initial evidence for both the efficacy of, and possible revisions to, the FFW intervention.

Population Health Management for Older Adults

PubMed Central

Tkatch, Rifky; Musich, Shirley; MacLeod, Stephanie; Alsgaard, Kathleen; Hawkins, Kevin; Yeh, Charlotte S.

2016-01-01

Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted. PMID:28680938

The effectiveness of different interventions to promote poison prevention behaviours in households with children: a network meta-analysis.

PubMed

Achana, Felix A; Sutton, Alex J; Kendrick, Denise; Wynn, Persephone; Young, Ben; Jones, David R; Hubbard, Stephanie J; Cooper, Nicola J

2015-01-01

There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a "usual care or no intervention" which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children. Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model. 28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants. The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison prevention practices they wish to promote. Network meta-analysis is useful for comparing multiple injury-prevention interventions. More intensive poison prevention interventions were more effective than education alone. Education and low cost/free equipment was most effective in promoting safe storage of medicines. Education, low cost/free equipment, home safety inspection and fitting was most effective in promoting safe storage of household products and poisons. Education, low cost/free equipment and home inspection were most effective in promoting possession of a poison control centre number. None of the intervention packages was more effective than the others in promoting safe storage of poisonous plants.

Multiple Balances in Workplace Dialogue: Experiences of an Intervention in Health Care

ERIC Educational Resources Information Center

Grill, Christina; Ahlborg, Gunnar, Jr.; Wikström, Ewa; Lindgren, Eva-Carin

2015-01-01

Purpose: This paper aims to illuminate and analyse the participants' experiences of the influences of a dialogue intervention. Cooperation and coordination in health care require planning of dialogically oriented communication to prevent stress and ill health and to promote health, well-being, learning, and efficiency in the organisation.…

A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects

PubMed Central

Fleig, Lena; Wiedemann, Amelie U; Schwarzer, Ralf

2015-01-01

Background Preventive health behaviors, such as regular physical activity and healthy nutrition, are recommended to maintain employability and to facilitate the health of employees. Theory-based workplace health promotion needs to include psychological constructs and consider the motivational readiness (so-called stages of change) of employees. According to the stages, people can be grouped as nonintenders (not motivated to change and not performing the goal behavior), intenders (decided to adopt the goal behavior but not started yet), or actors (performing the goal behavior already). The tailoring to these stages can be done computer based and should make workplace health promotion more effective. Objective It was tested whether a parsimonious computer-based health promotion program implemented at the workplace was effective in terms of lifestyle changes and psychological outcomes as well as body weight. We hypothesized that the stage-matched intervention would outperform the one-size-fits-all active control condition (standard care intervention). Methods In a randomized controlled trial, a total of 1269 employees were recruited by a trained research assistant at their workplace during a routine medical examination. After excluding noneligible employees, 560 completed Time 1 (T1), and 384 also completed Time 2 (T2), achieving a retention rate of 68.6%. Two fully automated computer-based treatments were adopted: (1) an active control condition with information about benefits of exercise and healthy nutrition (n=52), or (2) a stage-matched multiple-behavior intervention that provided different psychological treatments to 9 subgroups, addressing stages of change (nonintenders, intenders, and actors per behavior; n=332). Baseline assessments (T1) on behavior, psychological constructs, and body weight were repeated after 4 weeks (T2). Results The stage-matched intervention outperformed the active control condition for lifestyle changes containing physical activity and nutrition (χ2 1=3.5; P=.04, for N=384) as well as psychological variables (physical activity intention, P=.04; nutrition intention, P=.03; nutrition planning, P=.02; and general social support to live healthily, P=.01). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR, 2.25, 95% CI 1.73-2.92; P<.01) and the intervention (OR 1.96, 95% CI 1.00-3.82; P=.05) were found to be significant predictors. Physical activity planning mediated the effect of the intervention on the adoption of an overall healthy lifestyle (consisting of activity and nutrition, R 2 adj=.08; P<.01), indicating that if the stage-matched intervention increased planning, the adoption of a healthy lifestyle was more likely. Conclusions Matching an intervention to the motivational readiness of employees can make a health promotion program effective. Employees’ motivation, planning, social support, and lifestyle can be supported by a stage-matched intervention that focuses on both physical activity and healthy nutrition. Occupational settings provide a potential to implement parsimonious computer-based health promotion programs and to facilitate multiple behavior change. PMID:26429115

A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects.

PubMed

Lippke, Sonia; Fleig, Lena; Wiedemann, Amelie U; Schwarzer, Ralf

2015-10-01

Preventive health behaviors, such as regular physical activity and healthy nutrition, are recommended to maintain employability and to facilitate the health of employees. Theory-based workplace health promotion needs to include psychological constructs and consider the motivational readiness (so-called stages of change) of employees. According to the stages, people can be grouped as nonintenders (not motivated to change and not performing the goal behavior), intenders (decided to adopt the goal behavior but not started yet), or actors (performing the goal behavior already). The tailoring to these stages can be done computer based and should make workplace health promotion more effective. It was tested whether a parsimonious computer-based health promotion program implemented at the workplace was effective in terms of lifestyle changes and psychological outcomes as well as body weight. We hypothesized that the stage-matched intervention would outperform the one-size-fits-all active control condition (standard care intervention). In a randomized controlled trial, a total of 1269 employees were recruited by a trained research assistant at their workplace during a routine medical examination. After excluding noneligible employees, 560 completed Time 1 (T1), and 384 also completed Time 2 (T2), achieving a retention rate of 68.6%. Two fully automated computer-based treatments were adopted: (1) an active control condition with information about benefits of exercise and healthy nutrition (n=52), or (2) a stage-matched multiple-behavior intervention that provided different psychological treatments to 9 subgroups, addressing stages of change (nonintenders, intenders, and actors per behavior; n=332). Baseline assessments (T1) on behavior, psychological constructs, and body weight were repeated after 4 weeks (T2). The stage-matched intervention outperformed the active control condition for lifestyle changes containing physical activity and nutrition (χ(2) 1=3.5; P=.04, for N=384) as well as psychological variables (physical activity intention, P=.04; nutrition intention, P=.03; nutrition planning, P=.02; and general social support to live healthily, P=.01). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR, 2.25, 95% CI 1.73-2.92; P<.01) and the intervention (OR 1.96, 95% CI 1.00-3.82; P=.05) were found to be significant predictors. Physical activity planning mediated the effect of the intervention on the adoption of an overall healthy lifestyle (consisting of activity and nutrition, R(2) adj=.08; P<.01), indicating that if the stage-matched intervention increased planning, the adoption of a healthy lifestyle was more likely. Matching an intervention to the motivational readiness of employees can make a health promotion program effective. Employees' motivation, planning, social support, and lifestyle can be supported by a stage-matched intervention that focuses on both physical activity and healthy nutrition. Occupational settings provide a potential to implement parsimonious computer-based health promotion programs and to facilitate multiple behavior change.

The Effectiveness of Different Interventions to Promote Poison Prevention Behaviours in Households with Children: A Network Meta-Analysis

PubMed Central

Achana, Felix A.; Sutton, Alex J.; Kendrick, Denise; Wynn, Persephone; Young, Ben; Jones, David R.; Hubbard, Stephanie J.; Cooper, Nicola J.

2015-01-01

Background There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a “usual care or no intervention” which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children. Methods Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model. Results 28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants. Conclusion The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison prevention practices they wish to promote. Highlights Network meta-analysis is useful for comparing multiple injury-prevention interventions. More intensive poison prevention interventions were more effective than education alone. Education and low cost/free equipment was most effective in promoting safe storage of medicines. Education, low cost/free equipment, home safety inspection and fitting was most effective in promoting safe storage of household products and poisons. Education, low cost/free equipment and home inspection were most effective in promoting possession of a poison control centre number. None of the intervention packages was more effective than the others in promoting safe storage of poisonous plants. PMID:25894385

Mixed-Methods for Comparing Tobacco Cessation Interventions

PubMed Central

Momin, Behnoosh; Neri, Antonio; Zhang, Lei; Kahende, Jennifer; Duke, Jennifer; Green, Sonya Goode; Malarcher, Ann; Stewart, Sherri L.

2017-01-01

Introduction The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions. Aims This paper outlines the methodology used to conduct a comparative effectiveness research study of traditional and Web-based tobacco cessation and quitline promotion approaches. Methods A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states. Results/Findings The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates 7 months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs. Conclusions This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making. PMID:28243318

Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study.

PubMed

Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N

2016-05-01

Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessing Health Promotion Interventions: Limitations of Traditional Research Methods in Community-Based Studies.

PubMed

Dressel, Anne; Schneider, Robert; DeNomie, Melissa; Kusch, Jennifer; Welch, Whitney; Sosa, Mirtha; Yeldell, Sally; Maida, Tatiana; Wineberg, Jessica; Holt, Keith; Bernstein, Rebecca

2017-09-01

Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A "Biking for Health" study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.

Integrating Early Child Development and Violence Prevention Programs: A Systematic Review.

PubMed

Efevbera, Yvette; McCoy, Dana C; Wuermli, Alice J; Betancourt, Theresa S

2018-03-01

Limited evidence describes promoting development and reducing violence in low- and middle-income countries (LMICs), a missed opportunity to protect children and promote development and human capital. This study presents a systematic literature review of integrated early childhood development plus violence prevention (ECD+VP) interventions in LMICs. The search yielded 5,244 unique records, of which N = 6 studies met inclusion criteria. Interventions were in Chile, Jamaica, Lebanon, Mexico, Mozambique, and Turkey. Five interventions were parent education programs, including center-based sessions (n = 3) and home visiting (n = 2), while one intervention was a teacher education program. All but one study reported improvements in both child development and maltreatment outcomes. The dearth of evidence on ECD+VP interventions suggests additional research is needed. Integrated ECD+VP interventions may improve multiple child outcome domains while leveraging limited resources in LMICs. © 2018 Wiley Periodicals, Inc.

Promoting ambulation responses among children with multiple disabilities through walkers and microswitches with contingent stimuli.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Smaldone, Angela; La Martire, Maria L; Stasolla, Fabrizio; Castagnaro, Francesca; Groeneweg, Jop

2010-01-01

Children with severe or profound intellectual and motor disabilities often present problems of balance and ambulation and spend much of their time sitting or lying, with negative consequences for their development and social status. Recent research has shown the possibility of using a walker (support) device and microswitches with preferred stimuli to promote ambulation with these children. This study served as a replication of the aforementioned research and involved five new children with multiple disabilities. For four children, the study involved an ABAB design. For the fifth child, only an AB sequence was used. All children succeeded in increasing their frequencies of step responses during the B (intervention) phase(s) of the study, although the overall frequencies of those responses varied largely across them. These findings support the positive evidence already available about the effectiveness of this intervention approach in motivating and promoting children's ambulation. Practical implications of the findings are discussed. 2010 Elsevier Ltd. All rights reserved.

Intersystem Implications of the Developmental Origins of Health and Disease: Advancing Health Promotion in the 21st Century.

PubMed

Barnes, Michael D; Heaton, Thomas L; Goates, Michael C; Packer, Justin M

2016-07-15

The developmental origins of health and disease (DOHaD) theory and life course theory (LCT) are emerging fields of research that have significant implications for the public health and health promotion professions. Using a DOHaD/LCT perspective, social determinants of health (SDH) take on new critical meaning by which health promotion professionals can implement DOHaD/LCT guided interventions, including recommended policies. Through these interventions, public health could further address the sources of worldwide chronic disease epidemics and reduce such disease rates substantially if related policy, programs, and interdisciplinary and multi-sector collaboration are emphasized. Additional characteristics of the most effective interventions involve context-specific adaptation and societal structures that impact upstream, early life environments on a broad scale, influencing multiple locations and/or diseases.

Using Multiple Schedules during Functional Communication Training to Promote Rapid Transfer of Treatment Effects

ERIC Educational Resources Information Center

Fisher, Wayne W.; Greer, Brian D.; Fuhrman, Ashley M.; Querim, Angie C.

2015-01-01

Multiple schedules with signaled periods of reinforcement and extinction have been used to thin reinforcement schedules during functional communication training (FCT) to make the intervention more practical for parents and teachers. We evaluated whether these signals would also facilitate rapid transfer of treatment effects across settings and…

Men’s Mental Health Promotion Interventions: A Scoping Review

PubMed Central

Seaton, Cherisse L.; Bottorff, Joan L.; Jones-Bricker, Margaret; Oliffe, John L.; DeLeenheer, Damen; Medhurst, Kerensa

2017-01-01

There is an increasing need for mental health promotion strategies that effectively engage men. Although researchers have examined the effectiveness of diverse mental wellness interventions in male-dominated industries, and reviewed suicide prevention, early intervention, and health promotion interventions for boys and men, few have focused on sex-specific program effects. The purpose of this review was to (a) extend the previous reviews to examine the effectiveness of mental health promotion programs in males, and (b) evaluate the integration of gender-specific influences in the content and delivery of men’s mental health promotion programs. A search of MEDLINE, CINAHL, PsycINFO, and EMBASE databases for articles published between January 2006 and December 2016 was conducted. Findings from the 25 included studies indicated that a variety of strategies offered within (9 studies) and outside (16 studies) the workplace show promise for promoting men’s mental health. Although stress was a common area of focus (14 studies), the majority of studies targeted multiple outcomes, including some indicators of positive well-being such as self-efficacy, resilience, self-esteem, work performance, and happiness/quality of life. The majority of programs were offered to both men and women, and six studies explicitly integrated gender-related influences in male-specific programs in ways that recognized men’s interests and preferences. PMID:28884637

Promoting Handwriting Fluency in Fifth Graders with Slow Handwriting: A Single-Subject Design Study

ERIC Educational Resources Information Center

Limpo, Teresa; Parente, Naiana; Alves, Rui A.

2018-01-01

This study used a multiple-probe design across three participants to test the effectiveness of a handwriting intervention for fifth graders (age 10-11) displaying less handwriting fluency than their peers, but without spelling disorders. The 5-h handwriting intervention provided students with explicit instruction and intensive practice in writing…

Randomized controlled pilot study of customized pamphlets to promote physical activity and symptom self-management in women with multiple sclerosis.

PubMed

Plow, Matthew; Bethoux, Francois; McDaniel, Corey; McGlynn, Mark; Marcus, Bess

2014-02-01

Investigate the feasibility and potential efficacy of a customized print-based intervention to promote physical activity and symptom self-management in women with multiple sclerosis. A randomly allocated two-group repeated measures design, with a delayed-treatment contact group serving as the control. Participants were randomized to receive the intervention immediately (n =14) or receive it at week 12 (n =16). Outcome measures were administered at weeks 1, 12, and 24. Community-based in metropolitan area. Thirty women with multiple sclerosis. Prescribing a home-exercise program and following up with customized pamphlets, which are matched to participants' stage of readiness to change physical activity behavior and physical activity barriers (e.g. encouraging self-management of symptoms). Physical Activity and Disability Survey-revised, Godin Leisure-Time Exercise Questionnaire, SF-12, Symptoms of Multiple Sclerosis Scale, and 6-minute walk test. Intent-to-treat analyses using mixed multivariate analysis of variance (MANOVA) were conducted on (1) physical activity levels and (2) health and function outcomes. The mixed MANOVAs for physical activity levels and health and function outcomes indicated significant improvements in the immediate group compared with the delayed group (i.e. condition by time interaction was significant, Wilks' λ = 0.59, F(2, 27) = 9.31, P = 0.001 and Wilks' λ = 0.70, F(4, 25) = 2.72, P = 0.052, respectively). The intervention had moderate to large effect sizes in improving physical activity levels (d = 0.63 to 0.89), perceptions of physical function (d = 0.63), and 6-minute walk test (d=0.86). This pilot study indicates that a customized print-based intervention shows promise in improving physical activity levels and health and function in women with multiple sclerosis.

Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives.

PubMed

Fleischhacker, Sheila; Roberts, Erica; Camplain, Ricky; Evenson, Kelly R; Gittelsohn, Joel

2016-12-01

Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.

Promoting physical activity among Native American youth: A systematic review of the methodology and current evidence of physical activity interventions and community-wide initiatives

PubMed Central

Roberts, Erica; Camplain, Ricky; Evenson, Kelly R.; Gittelsohn, Joel

2015-01-01

Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally-led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally-driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth. PMID:27294756

Reclaiming Our Spirits: Development and Pilot Testing of a Health Promotion Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence.

PubMed

Varcoe, Colleen; Browne, Annette J; Ford-Gilboe, Marilyn; Dion Stout, Madeleine; McKenzie, Holly; Price, Roberta; Bungay, Victoria; Smye, Victoria; Inyallie, Jane; Day, Linda; Khan, Koushambhi; Heino, Angela; Merritt-Gray, Marilyn

2017-06-01

Indigenous women are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), in the context of ongoing colonization and neo-colonization. Health promotion interventions for women who experience violence have not been tailored specifically for Indigenous women. Reclaiming Our Spirits (ROS) is a health promotion intervention designed for Indigenous women living in an urban context in Canada. In this paper, we describe the development of the intervention, results of a pilot study, and the revised subsequent intervention. Building on a theory-based health promotion intervention (iHEAL) showing promising results in feasibility studies, ROS was developed using a series of related approaches including (a) guidance from Indigenous women with research expertise specific to IPV and Indigenous women's experiences; (b) articulation of an Indigenous lens, including using Cree (one of the largest Indigenous language groups in North America) concepts to identify key aspects; and (c) interviews with Elders (n = 10) living in the study setting. Offered over 6-8 months, ROS consists of a Circle, led by an Indigenous Elder, and 1:1 visits with a Registered Nurse, focused on six areas for health promotion derived from previous research. Pilot testing with Indigenous women (n = 21) produced signs of improvement in most measures of health from pre- to post-intervention. Women found the pilot intervention acceptable and helpful but also offered valuable suggestions for improvement. A revised intervention, with greater structure within the Circle and nurses with stronger knowledge of Indigenous women's experience and community health, is currently undergoing testing. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Practical guidelines for development of web-based interventions.

PubMed

Chee, Wonshik; Lee, Yaelim; Chee, Eunice; Im, Eun-Ok

2014-10-01

Despite a recent high funding priority on technological aspects of research and a high potential impact of Web-based interventions on health, few guidelines for the development of Web-based interventions are currently available. In this article, we propose practical guidelines for development of Web-based interventions based on an empirical study and an integrative literature review. The empirical study aimed at development of a Web-based physical activity promotion program that was specifically tailored to Korean American midlife women. The literature review included a total of 202 articles that were retrieved through multiple databases. On the basis of the findings of the study and the literature review, we propose directions for development of Web-based interventions in the following steps: (1) meaningfulness and effectiveness, (2) target population, (3) theoretical basis/program theory, (4) focus and objectives, (5) components, (6) technological aspects, and (7) logistics for users. The guidelines could help promote further development of Web-based interventions at this early stage of Web-based interventions in nursing.

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

PubMed

Cosbey, Joanna; Muldoon, Deirdre

2017-03-01

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

Parenting Skills and Emotional Availability: An RCT.

PubMed

Yousafzai, Aisha K; Rasheed, Muneera A; Rizvi, Arjumand; Armstrong, Robert; Bhutta, Zulfiqar A

2015-05-01

To investigate whether a responsive stimulation intervention delivered to caregivers of young children either alone or integrated with nutrition interventions would benefit parenting skills and emotional availability to promote children's development and growth compared with either a nutrition intervention alone or the usual standard of care. A cluster randomized factorial effectiveness trial was implemented in an impoverished community in Pakistan. The 4 trial arms were control (usual standard of care), responsive stimulation (responsive care and stimulation), enhanced nutrition (education and multiple micronutrients), and a combination of both enriched interventions. The 4 intervention packages were delivered by community health workers to 1489 mother-infant dyads in the first 2 years of life. Parenting skills and emotional availability indexed by mother-child interaction, caregiving environment, knowledge and practices pertaining to early childhood care and feeding, and maternal depressive symptoms were assessed at multiple intervals. An intention-to-treat factorial analysis was conducted. Intervention groups were comparable at baseline. Responsive stimulation significantly benefitted parenting skills with large effect sizes on mother-child interaction (Cohen's d 0.8), caregiving environment (Cohen's d 0.9-1.0), and knowledge and practices (Cohen's d 0.7-1.1) compared with small-modest significant effects as a result of nutrition intervention on mother-child interaction and caregiving environment only (Cohen's d 0.4 and 0.2, respectively). The combined intervention had a small significant effect on decreasing maternal depressive symptoms over time (Cohen's d 0-0.2). A responsive stimulation intervention can promote positive caregiving behaviors among impoverished families. Additional research is needed on interventions to reduce maternal depressive symptoms. Copyright © 2015 by the American Academy of Pediatrics.

The critical role of communications in a multilevel obesity-prevention intervention: Lessons learned for alcohol educators.

PubMed

Hatfield, Daniel P; Sliwa, Sarah A; Folta, Sara C; Economos, Christina D; Goldberg, Jeanne P

2017-01-01

Multilevel interventions to prevent underage drinking are more effective than individual-level strategies, and messaging campaigns are key to such approaches. Recognizing the benefits of translating best practices across public health domains, this paper details the communications campaign from Shape Up Somerville (SUS), an exemplar for multilevel community-based approaches to address pediatric obesity, highlighting lessons learned for alcohol educators. All elements of SUS, including the communications strategy, were developed collaboratively with local partners. Communication initiatives included community-engaged brand development to unify diverse intervention components; school-based communications to promote new opportunities for healthy eating and physical activity; and media partnerships to promote healthy behaviors community-wide. The overall SUS intervention was effective in reducing prevalence of overweight/obesity among first- to third-graders in Somerville relative to control communities. Process evaluation showed that communications successfully reached diverse community segments and raised awareness of and receptivity to changes. Communications campaigns are essential components of multilevel interventions addressing public health challenges including obesity and underage drinking. Such communications should be developed collaboratively with the target audience and stakeholders, designed to engage community members at multiple levels through multiple channels within a systems framework, and sustained through local partnerships. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review.

PubMed

Jongen, Crystal Sky; McCalman, Janya; Bainbridge, Roxanne Gwendalyn

2017-01-01

Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts. Examined together, these intervention strategies and outcomes provide a framework that can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.

Unjustifiable Non-Therapy: Response to the Issue of Growth Attenuation for Young People on the Basis of Disability

ERIC Educational Resources Information Center

Bersani, Hank, Jr.; Rotholz, David A.; Eidelman, Steven M.; Pierson, Joanna L.; Bradley, Valerie J.; Gomez, Sharon C.; Havercamp, Susan M.; Silverman, Wayne P.; Yeager, Mark H.; Morin, Diane; Wehmeyer, Michael L.; Carabello, Bernard J.; Croser, M. Doreen

2007-01-01

Gunther and Diekema (2006) have described a controversial intervention they provided to Ashley, a 6-year-old girl with profound and multiple impairments, which they refer to as "growth-attenuation therapy." This intervention, approved and apparently promoted by the parents, consisted of high doses of estrogen to bring about a permanent attenuation…

Feasibility of a health promotion intervention for a group of predominantly African American women with type 2 diabetes.

PubMed

Rimmer, James H; Silverman, Katie; Braunschweig, Carol; Quinn, Laurie; Liu, Yang

2002-01-01

This feasibility study was undertaken to determine if a group of predominantly low-income, low-education, African American women with type 2 diabetes could achieve good compliance and improved health outcomes with a carefully structured health promotion intervention. The sample consisted of 30 participants from an urban setting who were diagnosed with type 2 diabetes but also had multiple chronic conditions (e.g., obesity, hypertension, joint pain, and depression). Participants attended a university-based health promotion program where they completed a 12-week intervention that addressed diet, nutrition, and health behavior. Transportation was provided at no cost to the participants. Compliance with the 12-week program was 72.5%. Participants made significant improvements in total cholesterol and LDL-cholesterol levels, cardiovascular fitness, muscular strength and endurance, and nutrition knowledge. African American women with type 2 diabetes residing in difficult living environments (i.e., poverty, high crime, and lack of family support) can achieve good compliance and health outcomes with a structured health promotion program provided that barriers to participation (e.g., transportation, cost, and commitment) are removed prior to and during the intervention.

Application of Intervention Mapping to develop a community-based health promotion pre-pregnancy intervention for adolescent girls in rural South Africa: Project Ntshembo (Hope).

PubMed

Draper, Catherine E; Micklesfield, Lisa K; Kahn, Kathleen; Tollman, Stephen M; Pettifor, John M; Dunger, David B; Norris, Shane A

2014-01-01

South Africa (SA) is undergoing multiple transitions with an increasing burden of non-communicable diseases and high levels of overweight and obesity in adolescent girls and women. Adolescence is key to addressing trans-generational risk and a window of opportunity to intervene and positively impact on individuals' health trajectories into adulthood. Using Intervention Mapping (IM), this paper describes the development of the Ntshembo intervention, which is intended to improve the health and well-being of adolescent girls in order to limit the inter-generational transfer of risk of metabolic disease, in particular diabetes risk. This paper describes the application of the first four steps of IM. Evidence is provided to support the selection of four key behavioural objectives: viz. to eat a healthy, balanced diet, increase physical activity, reduce sedentary behaviour, and promote reproductive health. Appropriate behaviour change techniques are suggested and a theoretical framework outlining components of relevant behaviour change theories is presented. It is proposed that the Ntshembo intervention will be community-based, including specialist adolescent community health workers who will deliver a complex intervention comprising of individual, peer, family and community mobilisation components. The Ntshembo intervention is novel, both in SA and globally, as it is: (1) based on strong evidence, extensive formative work and best practice from evaluated interventions; (2) combines theory with evidence to inform intervention components; (3) includes multiple domains of influence (community through to the individual); (4) focuses on an at-risk target group; and (5) embeds within existing and planned health service priorities in SA.

Illustrating the multiple facets and levels of fidelity of implementation to a teacher classroom management intervention.

PubMed

Reinke, Wendy M; Herman, Keith C; Stormont, Melissa; Newcomer, Lori; David, Kimberly

2013-11-01

Many school-based interventions to promote student mental health rely on teachers as implementers. Thus, understanding the interplay between the multiple domains of fidelity to the intervention and intervention support systems such as coaching and teacher implementation of new skills is an important aspect of implementation science. This study describes a systematic process for assessing multiple domains of fidelity. Data from a larger efficacy trial of the Incredible Years Teacher Classroom Management (IY TCM) program are utilized. Data on fidelity to the IY TCM workshop training sessions and onsite weekly coaching indicate that workshop leaders and the IY TCM coach implemented the training and coaching model with adequate adherence. Further, workshop leaders' ratings of engagement were associated with teacher implementation of specific praise, following training on this content. Lastly, the IY TCM coach differentiation of teacher exposure to coaching was evaluated and found to be associated with teacher implementation of classroom management practices and student disruptive behavior.

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

PubMed Central

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

2011-01-01

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

Interventions that promote retention of experienced registered nurses in health care settings: a systematic review.

PubMed

Lartey, Sarah; Cummings, Greta; Profetto-McGrath, Joanne

2014-11-01

The aim of this review was to report the effectiveness of strategies for retaining experienced Registered Nurses. Nursing researchers have noted that the projected nursing shortage, if not rectified, is expected to affect healthcare cost, job satisfaction and quality patient care. Retaining experienced nurses would help to mitigate the shortage, facilitate the transfer of knowledge and provision of quality care to patients. A systematic review of studies on interventions that promote the retention of experienced Registered Nurses in health care settings. Twelve studies were included in the final analysis. Most studies reported improved retention as a result of the intervention. Team work and individually targeted strategies including mentoring, leadership interest and in-depth orientation increased job satisfaction and produced higher retention results. Few published studies have examined interventions that promote the retention of experienced Registered Nurses in healthcare. Retention was highest when multiple interventions were used. Further research is needed to inform nurse leaders of ways to retain nurses and to maintain quality care in health care settings. Programmes targeting the retention of experienced nurses need to be considered when implementing measures to decrease the nursing shortage and its effects on quality care. © 2013 John Wiley & Sons Ltd.

Microswitch-aided programs to support physical exercise or adequate ambulation in persons with multiple disabilities.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Alberti, Gloria; Perilli, Viviana; Oliva, Doretta; Buono, Serafino

2014-09-01

Three microswitch-aided programs were assessed in three single-case studies to enhance physical exercise or ambulation in participants with multiple disabilities. Study I was aimed at helping a woman who tended to have the head bending forward and the arms down to exercise a combination of appropriate head and arms movements. Study II was aimed at promoting ambulation continuity with a man who tended to have ambulation breaks. Study III was aimed at promoting ambulation with appropriate foot position in a girl who usually showed toe walking. The experimental designs of the studies consisted of a multiple probe across responses (Study I), an ABAB sequence (Study II), and an ABABB(1) sequence (Study III). The last phase of each study was followed by a post-intervention check. The microswitches monitored the target responses selected for the participants and triggered a computer system to provide preferred stimuli contingent on those responses during the intervention phases of the studies. Data showed that the programs were effective with each of the participants who learned to exercise head and arms movements, increased ambulation continuity, and acquired high levels of appropriate foot position during ambulation, respectively. The positive performance levels were retained during the post-intervention checks. The discussion focused on (a) the potential of technology-aided programs for persons with multiple disabilities and (b) the need of replication studies to extend the evidence available in the area. Copyright © 2014 Elsevier Ltd. All rights reserved.

Impact of a population based intervention to increase the adoption of multiple physical activity practices in centre based childcare services: a quasi experimental, effectiveness study

PubMed Central

2012-01-01

Background There is considerable scope to improve the delivery of practices that increase the physical activity of children in centre based childcare services. Few studies have reported the effectiveness of interventions to address this, particularly at a population level. The primary aim of this study was to describe the impact of an intervention to increase the adoption of multiple policies and practices to promote physical activity in centre based childcare services. Methods A quasi experimental study was conducted in centre based childcare services (n =228) in New South Wales (NSW), Australia and involved a three month intervention to increase the adoption of eight practices within childcare services that have been suggested to promote child physical activity. Intervention strategies to support the adoption of practices included staff training, resources, incentives, follow-up support and performance monitoring and feedback. Randomly selected childcare services in the remainder of NSW acted as a comparison group (n = 164) and did not receive the intervention but may have been exposed to a concurrent NSW government healthy eating and physical activity initiative. Self reported information on physical activity policies, fundamental movement skills sessions, structured physical activity opportunities, staff involvement in active play and provision of verbal prompts to encourage physical activity, small screen recreation opportunities, sedentary time, and staff trained in physical activity were collected by telephone survey with childcare service managers at baseline and 18 months later. Results Compared with the comparison area, the study found significantly greater increases in the prevalence of intervention services with a written physical activity policy, with policy referring to placing limits on small screen recreation, and with staff trained in physical activity. In addition, non-significant trends towards a greater increase in the proportion of intervention services conducting daily fundamental movement skill sessions, and such services having a physical activity policy supporting physical activity training for staff were also evident. Conclusion The intervention was effective in improving a number of centre based childcare service policies and practices associated with promoting child physical activity. Adoption of a broader range of practices may require more intensive and prolonged intervention support. PMID:22929434

Evaluation of a Community-Based Intervention to Promote Rear Seating for Children

PubMed Central

Greenberg-Seth, Jennifer; Hemenway, David; Gallagher, Susan S.; Ross, Julie B.; Lissy, Karen S.

2004-01-01

Objectives. We evaluated the short-term effect of a community-based effort to promote child rear seating in a low-income Hispanic community. Methods. Child seating patterns were observed pre- and postintervention at intersections in 1 intervention and 2 control cities. Brief interviews assessed exposure to program messages. Results. Child rear seating increased from 33% to 49% in the intervention city (P < .0001), which represented a greater increase than that in the control cities (P < .0001). The greatest improvement was observed in relatively higher-income areas. Rear seating was significantly correlated with reported program exposure. Incentives and exposure to the program across multiple channels seemed to have the greatest effect. Conclusions. Independent of legislation, community-based programs incorporating incentives can increase child rear seating. PMID:15249307

Act Healthy: promoting health behaviors and self-efficacy in the workplace.

PubMed

Schopp, Laura H; Bike, Denise H; Clark, Mary J; Minor, Marian A

2015-08-01

Chronic health conditions and multiple health risk factors afflict Americans and burden employers, but effective, affordable, workplace-based health promotion interventions have not been widely implemented. This is the first study to adapt the empirically validated Chronic Disease Self-Management Program for a general employee population in a workplace setting with an emphasis on disease prevention and health promotion. A quasi-experimental, wellness standard of care comparison, prospective cohort design was used among employee participants at a large University employer. Ninety-one individuals participated in the program. Participants reported significantly increased health behavior frequency and self-efficacy after the intervention, compared with their pre-intervention scores, and improvements were sustained at 3-month follow-up [self-rated abilities for health practices scale (SRA): F = 30.89, P < 0.001; health promoting lifestyle profile-II (HPLP-II): F = 36.30 P < 0.001]. Individuals in the intervention group reported improved self-efficacy and health behaviors compared with the wellness standard of care comparison group at post intervention (SRA: F = 12.45, P < 0.001; HPLP-II: F = 25.28, P < 0.001). Adapting lay-facilitated self-management for the workplace offers promise as a replicable, scalable, affordable model for culture change in organizations. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Office-Based Physical Activity and Nutrition Intervention: Barriers, Enablers, and Preferred Strategies for Workplace Obesity Prevention, Perth, Western Australia, 2012

PubMed Central

Jancey, Jonine; Howat, Peter; Ledger, Melissa; Lee, Andy H.

2013-01-01

Introduction Workplace health promotion programs to prevent overweight and obesity in office-based employees should be evidence-based and comprehensive and should consider behavioral, social, organizational, and environmental factors. The objective of this study was to identify barriers to and enablers of physical activity and nutrition as well as intervention strategies for health promotion in office-based workplaces in the Perth, Western Australia, metropolitan area in 2012. Methods We conducted an online survey of 111 employees from 55 organizations. The online survey investigated demographics, individual and workplace characteristics, barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. We used χ2 and Mann–Whitney U statistics to test for differences between age and sex groups for barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. Stepwise multiple regression analysis determined factors that affect physical activity and nutrition behaviors. Results We identified several factors that affected physical activity and nutrition behaviors, including the most common barriers (“too tired” and “access to unhealthy food”) and enablers (“enjoy physical activity” and “nutrition knowledge”). Intervention-strategy preferences demonstrated employee support for health promotion in the workplace. Conclusion The findings provide useful insights into employees’ preferences for interventions; they can be used to develop comprehensive programs for evidence-based workplace health promotion that consider environmental and policy influences as well as the individual. PMID:24028834

Queer as F**k: Reaching and Engaging Gay Men in Sexual Health Promotion through Social Networking Sites

PubMed Central

Hellard, Margaret; Gold, Judy; Ata, Nadine; Chang, Shanton; Howard, Steve; Asselin, Jason; Ilic, Olivia; Batrouney, Colin; Stoove, Mark

2013-01-01

Background A growing number of health promotion interventions are taking advantage of the popularity and interactivity of new social media platforms to foster and engage communities for health promotion. However, few health promotion interventions using social networking sites (SNS) have been rigorously evaluated. "Queer as F**k"(QAF) began as pilot project in 2010 to deliver sexual health promotion via short "webisodes" on SNS to gay men. Now in its fifth season, QAF is among the few published examples internationally to demonstrate the sexual health promotion potential of SNS. Objective The objective of this evaluation is to assess reach, interactivity, and engagement generated by QAF to inform future health interventions and evaluations using SNS. Methods We undertook a mixed method process evaluation using an uncontrolled longitudinal study design that compared multiple measurements over time to assess changes in reach and engagement. We adapted evaluation methods from the health promotion, information systems, and creative spheres. We incorporated online usage statistics, interviews informed by user diary-scrapbooks, and user focus groups to assess intervention reach and engagement. Results During Series 1-3 (April 2010 to April 2011), 32 webisodes were posted on the QAF Facebook and YouTube pages. These webisodes attracted over 30,000 views; ranging from 124-3092 views per individual episode. By April 2011, the QAF Facebook page had 2929 predominantly male fans. Interview and focus group participants supported the balance of education and entertainment. They endorsed the narrative "soap opera" format as an effective way to deliver sexual health messages in an engaging, informative, and accessible manner that encouraged online peer discussion of sexual health and promoted community engagement. Conclusions QAF offers a successful example of exploiting the reach, interactivity, and engagement potential of SNS; findings from this process evaluation provide a model to inform the delivery and evaluation of future health promotion interventions on SNS. PMID:23391459

Queer as F**k: reaching and engaging gay men in sexual health promotion through social networking sites.

PubMed

Pedrana, Alisa; Hellard, Margaret; Gold, Judy; Ata, Nadine; Chang, Shanton; Howard, Steve; Asselin, Jason; Ilic, Olivia; Batrouney, Colin; Stoove, Mark

2013-02-07

A growing number of health promotion interventions are taking advantage of the popularity and interactivity of new social media platforms to foster and engage communities for health promotion. However, few health promotion interventions using social networking sites (SNS) have been rigorously evaluated. "Queer as F**k"(QAF) began as pilot project in 2010 to deliver sexual health promotion via short "webisodes" on SNS to gay men. Now in its fifth season, QAF is among the few published examples internationally to demonstrate the sexual health promotion potential of SNS. The objective of this evaluation is to assess reach, interactivity, and engagement generated by QAF to inform future health interventions and evaluations using SNS. We undertook a mixed method process evaluation using an uncontrolled longitudinal study design that compared multiple measurements over time to assess changes in reach and engagement. We adapted evaluation methods from the health promotion, information systems, and creative spheres. We incorporated online usage statistics, interviews informed by user diary-scrapbooks, and user focus groups to assess intervention reach and engagement. During Series 1-3 (April 2010 to April 2011), 32 webisodes were posted on the QAF Facebook and YouTube pages. These webisodes attracted over 30,000 views; ranging from 124-3092 views per individual episode. By April 2011, the QAF Facebook page had 2929 predominantly male fans. Interview and focus group participants supported the balance of education and entertainment. They endorsed the narrative "soap opera" format as an effective way to deliver sexual health messages in an engaging, informative, and accessible manner that encouraged online peer discussion of sexual health and promoted community engagement. QAF offers a successful example of exploiting the reach, interactivity, and engagement potential of SNS; findings from this process evaluation provide a model to inform the delivery and evaluation of future health promotion interventions on SNS.

Application of Intervention Mapping to develop a community-based health promotion pre-pregnancy intervention for adolescent girls in rural South Africa: Project Ntshembo (Hope)

PubMed Central

2014-01-01

Background South Africa (SA) is undergoing multiple transitions with an increasing burden of non-communicable diseases and high levels of overweight and obesity in adolescent girls and women. Adolescence is key to addressing trans-generational risk and a window of opportunity to intervene and positively impact on individuals’ health trajectories into adulthood. Using Intervention Mapping (IM), this paper describes the development of the Ntshembo intervention, which is intended to improve the health and well-being of adolescent girls in order to limit the inter-generational transfer of risk of metabolic disease, in particular diabetes risk. Methods This paper describes the application of the first four steps of IM. Evidence is provided to support the selection of four key behavioural objectives: viz. to eat a healthy, balanced diet, increase physical activity, reduce sedentary behaviour, and promote reproductive health. Appropriate behaviour change techniques are suggested and a theoretical framework outlining components of relevant behaviour change theories is presented. It is proposed that the Ntshembo intervention will be community-based, including specialist adolescent community health workers who will deliver a complex intervention comprising of individual, peer, family and community mobilisation components. Conclusions The Ntshembo intervention is novel, both in SA and globally, as it is: (1) based on strong evidence, extensive formative work and best practice from evaluated interventions; (2) combines theory with evidence to inform intervention components; (3) includes multiple domains of influence (community through to the individual); (4) focuses on an at-risk target group; and (5) embeds within existing and planned health service priorities in SA. PMID:25080940

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.

Impact of school-based health promotion interventions aimed at different behavioral domains: a systematic review.

PubMed

Lima-Serrano, Marta; Lima-Rodríguez, Joaquín S

2014-01-01

Given that lifestyleshave similar determinants and that school-based interventions are usually targeted at all the risks that affect adolescents, the objective of this systematic review was to summarize the characteristics and effects of school-based interventions acting on different behavioral domains of adolescent health promotion. The review process was conducted by two independent reviewers who searched PubMed, Scopus, PsycINFO, and ERIC databases for experimental or observational studies with at least two measures of results published from 2007 to 2011, given that the research information available doubles every 5 years. Methodological quality was assessed with a standardized tool. Information was extracted from 35 studies aiming to prevent risk behaviors and promote healthy nutrition, physical activity, and mental and holistic health. Activities were based on theoretical models and were classified into interactive lessons, peer mediation, environmental changes, parents' and community activities, and tailored messages by computer-assisted training or other resources, usually including multiple components. In some cases, we identified some moderate to large, short- and long-term effects on behavioral and intermediate variable. This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

The relationship between attitudes toward aging and health-promoting behaviours in older adults.

PubMed

Korkmaz Aslan, Gülbahar; Kartal, Asiye; Özen Çınar, İlgün; Koştu, Nazan

2017-12-01

Identifying the factors that are associated with health-promoting behaviours in older adults is necessary to increase their willingness and motivation to participate in health-promotion activities. Understanding context-specific attitudes in relation to their influence on health-promoting behaviours is crucial in designing efficient interventions that foster health-promoting behaviours among older adults. This study aimed to examine the relationships between attitudes towards aging and health-promoting behaviours in older adults in Turkey. The study used a descriptive-correlational design. A convenience sample of 448 community-dwelling older adults who were 65 years and older and cognitively intact were selected from 6 family health centres in the city of Denizli in Turkey. The data were collected between March and June of 2014 using the Attitudes to Aging Questionnaire and the Health-Promoting Lifestyle Profile II. Multiple linear regression analysis was performed to explore the predictors of health-promoting behaviours. Attitudes toward aging, the psychosocial loss subscale, and education were statistically significant predictors of health-promoting behaviours. Attitudes toward aging were the strongest predictor of health-promoting behaviours in older adults. Attitude towards aging is a factor that affects health-promoting behaviours, and it should be considered during interventions for improving health promoting behaviours. © 2017 John Wiley & Sons Australia, Ltd.

Mediators of improved child diet quality following a health promotion intervention: the Melbourne InFANT Program.

PubMed

Spence, Alison C; Campbell, Karen J; Crawford, David A; McNaughton, Sarah A; Hesketh, Kylie D

2014-11-04

Young children's diets are currently suboptimal. Given that mothers have a critical influence on children' diets, they are typically a target of interventions to improve early childhood nutrition. Understanding the maternal factors which mediate an intervention's effect on young children's diets is important, but has not been well investigated. This research aimed to test whether maternal feeding knowledge, maternal feeding practices, maternal self-efficacy, and maternal dietary intakes acted as mediators of the effect of an intervention to improve child diet quality. The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a cluster-randomized controlled trial, conducted from 2008-2010. This novel, low-dose, health promotion intervention was delivered quarterly over 15 months and involved educational activities, promotion of peer discussion, a DVD and written materials. Post-intervention, when children were approximately 18 months of age, child diets were assessed using multiple 24-hour recalls and a purpose-developed index of diet quality, the Obesity Protective Dietary Index. Maternal mediators were assessed using a combination of previously validated and purpose-deigned tools. Mediation analysis was conducted using the test of joint significance and difference of coefficients methods. Across 62 parents' groups in Melbourne, Australia, 542 parents were recruited. Post- intervention, higher maternal feeding knowledge and lower use of foods as rewards was found to mediate the direct intervention effect on child diet quality. While other aspects of maternal feeding practices, self-efficacy and dietary intakes did not act as mediators, they were associated with child diet quality. Mediation analysis of this novel health promotion intervention showed the importance of maternal feeding knowledge and use of foods as rewards in impacting child diet quality. The other maternal factors assessed were appropriate targets but further research on how to impact these in an intervention is important. This evidence of intervention efficacy and mediation provides important insights for planning future interventions. Current Controlled Trials ISRCTN81847050, registered 23 November 2007.

Nurturing care: promoting early childhood development.

PubMed

Britto, Pia R; Lye, Stephen J; Proulx, Kerrie; Yousafzai, Aisha K; Matthews, Stephen G; Vaivada, Tyler; Perez-Escamilla, Rafael; Rao, Nirmala; Ip, Patrick; Fernald, Lia C H; MacMillan, Harriet; Hanson, Mark; Wachs, Theodore D; Yao, Haogen; Yoshikawa, Hirokazu; Cerezo, Adrian; Leckman, James F; Bhutta, Zulfiqar A

2017-01-07

The UN Sustainable Development Goals provide a historic opportunity to implement interventions, at scale, to promote early childhood development. Although the evidence base for the importance of early childhood development has grown, the research is distributed across sectors, populations, and settings, with diversity noted in both scope and focus. We provide a comprehensive updated analysis of early childhood development interventions across the five sectors of health, nutrition, education, child protection, and social protection. Our review concludes that to make interventions successful, smart, and sustainable, they need to be implemented as multi-sectoral intervention packages anchored in nurturing care. The recommendations emphasise that intervention packages should be applied at developmentally appropriate times during the life course, target multiple risks, and build on existing delivery platforms for feasibility of scale-up. While interventions will continue to improve with the growth of developmental science, the evidence now strongly suggests that parents, caregivers, and families need to be supported in providing nurturing care and protection in order for young children to achieve their developmental potential. Copyright © 2017 Elsevier Ltd. All rights reserved.

Process evaluation of a community-based mental health promotion intervention for refugee children

PubMed Central

Nakkash, Rima T.; Alaouie, Hala; Haddad, Pascale; El Hajj, Taghreed; Salem, Heba; Mahfoud, Ziyad; Afifi, Rema A.

2012-01-01

Public health interventions are complex in nature and composed of multiple components. Evaluation of process and impact is necessary to build evidence of effectiveness. Process evaluation involves monitoring extent of implementation and comparison against the program plan. This article describes the process evaluation of the ‘Qaderoon’ (We are Capable) intervention; a community-based mental health promotion intervention for children living in a Palestinian refugee camp of Beirut, Lebanon. The manuscript describes the context of Palestinian refugees in Lebanon, the intervention, the process evaluation plan and results. The process evaluation was guided by the literature and by a Community Youth Committee. Findings indicated that attendance was 54 and 38% for summer and fall sessions, respectively. Session objectives and activities were commonly achieved. Over 78.4% of activities were reported to be implemented fully as planned. Over 90% of the children indicated high satisfaction with the sessions. Contextual facilitators and challenges to implementing the intervention are discussed. The most challenging were maintaining attendance and the actual implementation of the process evaluation plan. Findings from process evaluation will strengthen interpretation of impact evaluation results. PMID:21908850

Community health worker interventions to promote psychosocial outcomes among people living with HIV—A systematic review

PubMed Central

Kim, Kyounghae; Murphy, Jeanne; Cudjoe, Joycelyn; Wilson, Patty; Sharps, Phyllis; Farley, Jason E.

2018-01-01

Background Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH. Methods We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria. Results Half of the studies were conducted in the United States. Social cognitive theory was used more than once in nine theory-guided studies. CHW interventions were largely focused on reducing depression (n = 6) or stigma related to HIV (n = 4), or promoting quality of life (n = 4), social support (n = 4), and self-efficacy (n = 4). Didactic methods and role-playing were used to train CHWs. CHWs played multiple roles in delivering intervention, including a counselor and a supporter (n = 10), educator (n = 5), or a navigator (n = 3). CHW intervention fidelity was assessed in 4 studies. Five studies found positive changes in six psychosocial outcomes including quality of life (2 of 4) and self-efficacy (2 of 4). CHW interventions had no effect on social support in 2 of 4 studies, and stigma in 3 of 4 studies. None of the CHW interventions were successful in reducing depressive symptoms among PLWH. Conclusions Evidence partially supported the use of CHWs in promoting psychosocial outcomes in PLWH. Future CHW intervention should be expanded in scope to address key psychosocial determinants of HIV/AIDS outcomes such as health literacy. Further, fidelity measures should be incorporated into intervention delivery. PMID:29689054

A Pilot Test of a Church-Based Intervention to Promote Multiple Cancer-Screening Behaviors among Latinas

PubMed Central

Allen, Jennifer D.; Pérez, John E.; Tom, Laura; Leyva, Bryan; Diaz, Daisy; Torres, Maria Idali

2013-01-01

We assessed the feasibility, acceptability, and initial impact of a church-based educational program to promote breast, cervical, and colorectal cancer screening among Latinas ages 18 and over. We used a one-group pre/post evaluation within a low-income, Latino Baptist church in Boston, MA. Participants completed interviewer-administered assessments at baseline and at the end of the six-month intervention. Under the guidance of a patient navigator (PN), women from the church (peer health advisors, or PHAs) were trained to deliver evidence-based screening interventions, including one-to-one outreach, small group education, client reminders, and reduction of structural barriers to screening. The PN and PHAs also implemented a health fair and the pastor integrated health information into regular sermons. At pre-intervention, nearly half of the sample did not meet screening guidelines. The majority (97%, n = 35) of those who completed the post-intervention assessment participated in intervention activities. Two-thirds (67%) reported talking with the PN or PHAs about health issues. Participation in small group education sessions was highest (72%), with health fairs (61%), and goal setting (50%) also being popular activities. Fourteen percent also reported receiving help from the PN to access screening tests. This study supports the feasibility and acceptability of churches as a setting to promote cancer screening among Latinas. PMID:24132541

Professional development programs in health promotion: tools and processes to favor new practices.

PubMed

Torres, Sara; Richard, Lucie; Guichard, Anne; Chiocchio, François; Litvak, Eric; Beaudet, Nicole

2017-06-01

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children's vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde's (Une grille d'analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297-312, 2010) analytical grid to assess deductively the program participants' use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change.

PubMed

Wilson, Kristina; Senay, Ibrahim; Durantini, Marta; Sánchez, Flor; Hennessy, Michael; Spring, Bonnie; Albarracín, Dolores

2015-03-01

A meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded 3 main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to nonpatient (vs. patient) populations, were implemented in nonclinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions. PsycINFO Database Record (c) 2015 APA, all rights reserved.

When It Comes to Lifestyle Recommendations, More is Sometimes Less: A Meta-Analysis of Theoretical Assumptions Underlying the Effectiveness of Interventions Promoting Multiple Behavior Domain Change

PubMed Central

Wilson, Kristina; Senay, Ibrahim; Durantini, Marta; Sánchez, Flor; Hennessy, Michael; Spring, Bonnie; Albarracín, Dolores

2016-01-01

A meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded three main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to non-patient (vs. patient) populations, were implemented in non-clinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions. PMID:25528345

Civilising Recalcitrant Boys' Bodies: Pursuing Social Fitness through the Anti-Obesity Offensive

ERIC Educational Resources Information Center

Monaghan, Lee F.

2014-01-01

Obesity discourse provides a commonly recycled rationale for multiple, ostensibly well-intended, interventions. Formal educational settings sometimes operate as sites for these biopedagogies which putatively promote "good health" among young people as they transition to "responsible" adulthood. Yet, regulation and control, or…

Feasibility Study of a Novel Diet-Based Intervention for Prostate Cancer

DTIC Science & Technology

2010-09-01

broccoli and cabbage. Isothiocyanates induce expression of cytoprotective phase 2 enzymes in multiple prostate tumor cell lines (26, 31) promote...83-90. 29. Caruso AJ, Yegnasubramanian S, Lin X, Kesler TW, Nelson WG. Hot water extracts from broccoli sprouts trigger induction of carcinogen

Multilevel linear modelling of the response-contingent learning of young children with significant developmental delays.

PubMed

Raab, Melinda; Dunst, Carl J; Hamby, Deborah W

2018-02-27

The purpose of the study was to isolate the sources of variations in the rates of response-contingent learning among young children with multiple disabilities and significant developmental delays randomly assigned to contrasting types of early childhood intervention. Multilevel, hierarchical linear growth curve modelling was used to analyze four different measures of child response-contingent learning where repeated child learning measures were nested within individual children (Level-1), children were nested within practitioners (Level-2), and practitioners were nested within the contrasting types of intervention (Level-3). Findings showed that sources of variations in rates of child response-contingent learning were associated almost entirely with type of intervention after the variance associated with differences in practitioners nested within groups were accounted for. Rates of child learning were greater among children whose existing behaviour were used as the building blocks for promoting child competence (asset-based practices) compared to children for whom the focus of intervention was promoting child acquisition of missing skills (needs-based practices). The methods of analysis illustrate a practical approach to clustered data analysis and the presentation of results in ways that highlight sources of variations in the rates of response-contingent learning among young children with multiple developmental disabilities and significant developmental delays. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease.

PubMed

Park, Linda G; Beatty, Alexis; Stafford, Zoey; Whooley, Mary A

2016-01-01

Mobile health in the form of text messaging and mobile applications provides an innovative and effective approach to promote prevention and management of cardiovascular disease (CVD); however, the magnitude of these effects is unclear. Through a comprehensive search of databases from 2002-2016, we conducted a quantitative systematic review. The selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. A large majority of studies (22 of 28, 79%) demonstrated text messaging, mobile applications, and telemonitoring via mobile phones were effective in improving outcomes. Some key factors associated with successful interventions included personalized messages with tailored advice, greater engagement (2-way text messaging, higher frequency of messages), and use of multiple modalities. Overall, text messaging appears more effective than smartphone-based interventions. Incorporating principles of behavioral activation will help promote and sustain healthy lifestyle behaviors in patients with CVD that result in improved clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease

PubMed Central

Park, Linda G.; Beatty, Alexis; Stafford, Zoey; Whooley, Mary A.

2016-01-01

Mobile health in the form of text messaging and mobile applications provides an innovative and effective approach to promote prevention and management of cardiovascular disease (CVD); however, the magnitude of these effects is unclear. Through a comprehensive search of databases from 2002–2016, we conducted a quantitative systematic review. The selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. A large majority of studies (22 of 28, 79%) demonstrated text messaging, mobile applications, and telemonitoring via mobile phones were effective in improving outcomes. Some key factors associated with successful interventions included personalized messages with tailored advice, greater engagement (2-way text messaging, higher frequency of messages), and use of multiple modalities. Overall, text messaging appears more effective than smartphone-based interventions. Incorporating principles of behavioral activation will help promote and sustain healthy lifestyle behaviors in patients with CVD that result in improved clinical outcomes. PMID:27001245

"Bill is now singing": joint engagement and the emergence of social communication of three young children with autism.

PubMed

Vaiouli, Potheini; Grimmet, Kharon; Ruich, Lawrence J

2015-01-01

Young children with autism spectrum disorder meet significant challenges in joint attention skills and in social communication. A child-centered, improvisational, music therapy intervention model was implemented to promote engagement in three young children with autism in a kindergarten classroom. A multiple baseline design compared the children's performance through three phases of intervention: focus on faces, response to joint attention, and initiation of joint attention. A complimentary qualitative analysis of teacher and parent experiences allowed for an in-depth understanding of the role of social environment in supporting emerging social communication skills among three children. As all children showed improvement in joint attention and actions of social engagement, this study bears evidence on the potential of music therapy as a promising intervention for promoting social skills of young children with autism spectrum disorder. © The Author(s) 2013.

Examining Individual and Ecological Predictors of the Self-Determination of Students with Disabilities

ERIC Educational Resources Information Center

Shogren, Karrie A.; Wehmeyer, Michael L.; Palmer, Susan B.; Soukup, Jane Helen; Little, Todd D.; Garner, Nancy; Lawrence, Margaret

2007-01-01

This article examines the impact of multiple individual and ecological factors on the self-determination of students with learning disabilities, mild and moderate mental retardation, and other health impairments. Baseline data from a multistate, longitudinal research project evaluating interventions to promote self-determination were examined…

Promoting prosocial pupil behaviour: 2-secondary school intervention and pupil effects.

PubMed

Mooij, T

1999-12-01

In an earlier article (Mooij, 1999c) a theoretical multilevel model to promote prosocial pupil behaviour by stimulating specific educational conditions was developed. To carry out school interventions to check empirically whether pupil level effects occur because of educational changes at the classroom and school level. Seven secondary schools with relatively high degrees of pupil aggression were selected. Four schools took part as intervention schools, three schools served as control schools. In 1995 (pretest) and 1997 (post-test) pupils and form teachers of the first and third school years participated by completing questionnaires. Within the pupil cohorts, a longitudinal group of 352 pupils was included. Pretest questionnaires in 1995 were followed by intervention in the intervention schools. Teachers collaborated with staff and researchers to increase pupils' participation and responsibility in specifying and controlling behavioural and didactic rules, related to didactic differentiation during lessons. The validity of the intervention implementation was checked using qualitative information and quantitative data from both pre- and post-test. Longitudinal intervention effects were tested by applying two-level multiple regression analyses. After controlling for pretest and covariables in school year 1, school intervention effects were found in school year 3 with the prediction of being a perpetrator of aggressive behaviour at school, aggressive behaviour outside school, and criminal behaviour. Some small effects were found with respect to victim behaviour. Social-pedagogical and didactic class and school variables, but also home variables and support by peers without problematic behaviour, could be integrated more systematically to promote prosocial development of a pupil's behaviour from the beginning in school.

Optimizing the Scientific Yield from a Randomized Controlled Trial (RCT): Evaluating Two Behavioral Interventions and Assessment Reactivity with a Single Trial

PubMed Central

Carey, Michael P.; Senn, Theresa E.; Coury-Doniger, Patricia; Urban, Marguerite A.; Vanable, Peter A.; Carey, Kate B.

2013-01-01

Randomized controlled trials (RCTs) remain the gold standard for evaluating intervention efficacy but are often costly. To optimize their scientific yield, RCTs can be designed to investigate multiple research questions. This paper describes an RCT that used a modified Solomon four-group design to simultaneously evaluate two, theoretically-guided, health promotion interventions as well as assessment reactivity. Recruited participants (N = 1010; 56% male; 69% African American) were randomly assigned to one of four conditions formed by crossing two intervention conditions (i.e., general health promotion vs. sexual risk reduction intervention) with two assessment conditions (i.e., general health vs. sexual health survey). After completing their assigned baseline assessment, participants received the assigned intervention, and returned for follow-ups at 3, 6, 9, and 12 months. In this report, we summarize baseline data, which show high levels of sexual risk behavior; alcohol, marijuana, and tobacco use; and fast food consumption. Sexual risk behaviors and substance use were correlated. Participants reported high satisfaction with both interventions but ratings for the sexual risk reduction intervention were higher. Planned follow-up sessions, and subsequent analyses, will assess changes in health behaviors including sexual risk behaviors. This study design demonstrates one way to optimize the scientific yield of an RCT. PMID:23816489

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

PubMed Central

Estebsari, Fatemeh; Dastoorpoor, Maryam; Mostafaei, Davoud; Khanjani, Narges; Khalifehkandi, Zahra Rahimi; Foroushani, Abbas Rahimi; Aghababaeian, Hamidreza; Taghdisi, Mohammad Hossein

2018-01-01

Background Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. Methods This parallel randomized controlled trial was conducted in 2014–2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ2 tests, multiple linear and logistic regression, and structural equation modeling (SEM). Results The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (P<0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P<0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P<0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P<0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=−0.406, β=−0.340, SE=0.03, P<0.05), and through social support, self-efficacy, and health promoting behaviors. Conclusion Educational interventions can be effective in preventing elder abuse. PMID:29713151

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial.

PubMed

Estebsari, Fatemeh; Dastoorpoor, Maryam; Mostafaei, Davoud; Khanjani, Narges; Khalifehkandi, Zahra Rahimi; Foroushani, Abbas Rahimi; Aghababaeian, Hamidreza; Taghdisi, Mohammad Hossein

2018-01-01

Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ 2 tests, multiple linear and logistic regression, and structural equation modeling (SEM). The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher ( P <0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P <0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P <0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P <0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, P <0.05), and through social support, self-efficacy, and health promoting behaviors. Educational interventions can be effective in preventing elder abuse.

The effects of Promoting Alternative Thinking Strategies Preschool Program on teacher-children relationships and children's social competence in Turkey.

PubMed

Bilir Seyhan, Gamze; Ocak Karabay, Sakire; Arda Tuncdemir, Tugce B; Greenberg, Mark T; Domitrovich, Celene

2017-05-02

This quasi-experimental study examined the effects of the Promoting Alternative Thinking Strategies (PATHS) Preschool Program on the outcomes of children's social-emotional competence, perceived relationships between teacher and children and teachers' ability to create a positive classroom atmosphere. Two hundred and eighty five children (48-72 months) and teachers in Izmir participated in the intervention, and 280 children (48-72 months) and teachers participated as comparison group. Intervention teachers implemented PATHS in their classrooms. For data triangulation, multiple sources of data were collected in the study. Classrooms were observed using two different scales. Teacher rated students using another two different scales. Children were assessed with an interview to evaluate their perceptions of relationships. Intervention group teachers reported greater improvement of children's social-emotional skills, interpersonal relationship skills and emotion regulation. Furthermore, when observed intervention group children showed higher levels of pro-social behaviour, increased levels of compliance, better problem solving skills and more positive feelings. Intervention group children also described their relationships with their teachers as significantly more positively. Finally, intervention group teachers perceived more dependency in their relationships with children. © 2017 International Union of Psychological Science.

Leveraging cultural differences to promote educational equality.

PubMed

Brady, Laura M; Germano, Adriana L; Fryberg, Stephanie A

2017-12-01

This paper theorizes that academic interventions will be maximally effective when they are culturally grounded. Culturally grounded interventions acknowledge cultural differences and validate multiple cultural models in a given context. This review highlights the importance of considering culture in academic interventions and draws upon the culture cycle framework to provide a blueprint for those interested in building more efficacious interventions. Specifically, the paper reviews literature in education and psychology to argue: first, when working-class and racial minority students' cultural models are not valued in mainstream academic domains, these students underperform; and second, many current academic interventions intended to improve working-class and racial minority students' academic outcomes could be further enhanced by cultural grounding. Copyright © 2017 Elsevier Ltd. All rights reserved.

Examining the role of implementation quality in school-based prevention using the PATHS curriculum. Promoting Alternative THinking Skills Curriculum.

PubMed

Kam, Chi-Ming; Greenberg, Mark T; Walls, Carla T

2003-03-01

In order for empirically validated school-based prevention programs to "go to scale," it is important to understand the processes underlying program dissemination. Data collected in effectiveness trials, especially those measuring the quality of program implementation and administrative support, are valuable in explicating important factors influencing implementation. This study describes findings regarding quality of implementation in a recent effectiveness trial conducted in a high-risk, American urban community. This delinquency prevention trial is a locally owned intervention, which used the Promoting Alternative THinking Skills Curriculum as its major program component. The intervention involved 350 first graders in 6 inner-city public schools. Three schools implemented the intervention and the other 3 were comparison schools from the same school district. Although intervention effects were not found for all the intervention schools, the intervention was effective in improving children's emotional competence and reducing their aggression in schools which effectively supported the intervention. This study, utilizing data from the 3 intervention schools (13 classrooms and 164 students), suggested that 2 factors contributed to the success of the intervention: (a) adequate support from school principals and (b) high degree of classroom implementation by teachers. These findings are discussed in light of the theory-driven models in program evaluation that emphasized the importance of the multiple factors influencing the implementation of school-based interventions.

Building health promotion capacity in a primary health care workforce in the Northern Territory: some lessons from practice.

PubMed

Judd, Jenni; Keleher, Helen

2013-12-01

Reorientation of the workforce in primary health care is a complex process and requires specific strategies and interventions. Primary health care providers are a key health care workforce that is expected to deliver tangible outcomes from disease prevention and health promotion strategies. This paper describes a training intervention that occurred as part of a broader participatory action research process for building health promotion capacity in the primary health care workforce. Participatory action research (PAR) was conducted over six action and reflection cycles in a two-year period (2001-02) in an urban community health setting in the Northern Territory. One of the PAR cycles was a training intervention that was identified as a need from a survey in the first action and reflection cycle. This training was facilitated by a health promotion specialist, face-to-face and comprised five 3.5-h sessions over a 5-month period. A pre-post questionnaire was used to measure the knowledge and skills components of the training intervention. The results reinforced the importance of using a participatory approach that involved the primary health care providers themselves. Multiple strategies such as workforce development within capacity building frameworks assisted in shifting work practice more upstream. Additionally, these strategies encouraged more reflective practice and built social capital within the primary health care workforce. Lessons from practice reinforce that workforce development influenced work practice change and is an important element in building the health promotion capacity of primary health care centres. SO WHAT?: Workforce development is critical for reorienting health services. Health promotion specialists play an important role in reorienting practice, which is only effective when combined with other strategies, and driven and led by the primary health care workforce.

Interventions for older persons reporting memory difficulties: a randomized controlled pilot study.

PubMed

Cohen-Mansfield, Jiska; Cohen, Rinat; Buettner, Linda; Eyal, Nitza; Jakobovits, Hanna; Rebok, George; Rotenberg-Shpigelman, Shlomit; Sternberg, Shelley

2015-05-01

The objective of this study is to compare three different interventions for persons who report memory difficulties: health promotion, cognitive training, and a participation-centered course, using a single-blind, randomized controlled design. Participants were 44 Israeli adults with memory complaints, aged 65 years or older. The main outcome variable was the Global Cognitive Score assessed using the MindStreams(®) mild cognitive impairment assessment, a computerized cognitive assessment. The Mini-Mental State Examination and the self-report of memory difficulties were also utilized. To assess well-being, the UCLA Loneliness Scale-8 was used. Health was evaluated by self-report instruments. All three interventions resulted in significant improvement in cognitive function as measured by the computerized cognitive assessment. All approaches seemed to decrease loneliness. The only variable which showed a significant difference among the groups is the self-report of memory difficulties, in which the cognitive training group participants reported greater improvement than the other groups. Multiple approaches should be offered to older persons with memory complaints. The availability of diverse options would help fit the needs of a heterogeneous population. An educational media effort to promote the public's understanding of the efficacy of these multiple approaches is needed. Copyright © 2014 John Wiley & Sons, Ltd.

Effects of a 10-Day Intensive Health Promotion Program Combining Diet and Physical Activity on Body Composition, Physical Fitness, and Blood Factors of Young Adults: A Randomized Pilot Study

PubMed Central

Lee, Kyoung Soon; Lee, Jae Koo; Yeun, Young Ran

2017-01-01

Background A lifestyle characterized by poor eating habits and physical inactivity is a risk factor for multiple lifestyle diseases in young adults. This study assessed the effects of implementing an intensive 10-day health promotion program combining diet and physical activities on body composition, physical fitness, and biochemical parameters of young adults. Material/Methods In this randomized pilot study, 30 female undergraduate students were randomly allocated to an intervention and a control group. The health promotion program consisted of unlimited amounts of vegetarian food; aerobic, flexibility, and strength exercises (3 hours/day); lectures on health (3 hours/day); massage practice (2 hours/day); and healthy cooking practice (1 hour/day). The effects of the intervention were analyzed using the Mann-Whitney U test and the Wilcoxon signed-rank test. Results The intensive 10-day health promotion program significantly reduced body weight, body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, blood glucose, and the homeostasis model assessment of insulin resistance. At the same time, participants demonstrated increased back muscle, leg muscle, and grip strength; waist and shoulder flexibility; balance; and cardiorespiratory endurance. Conclusions The intensive 10-day health promotion program is a viable intervention for improving body composition, physical fitness, glycemic control, and blood lipid levels in young adults. PMID:28399076

Increasing referral of at-risk travelers to travel health clinics: evaluation of a health promotion intervention targeted to travel agents.

PubMed

MacDougall, L A; Gyorkos, T W; Leffondré, K; Abrahamowicz, M; Tessier, D; Ward, B J; MacLean, J D

2001-01-01

Increases in travel-related illness require new partnerships to ensure travelers are prepared for health risks abroad. The travel agent is one such partner and efforts to encourage travel agents to refer at-risk travelers to travel health clinics may help in reducing travel-attributable morbidity. A health promotion intervention encouraging travel agents to refer at-risk travelers to travel health clinics was evaluated. Information on the knowledge, attitudes, and behaviors of travel agents before and after the intervention was compared using two self-administered questionnaires. The Wilcoxon signed rank test was used to compare the mean difference in overall scores to evaluate the overall impact of the intervention and also subscores for each of the behavioral construct groupings (attitudes, barriers, intent, and subjective norms). Multiple regression techniques were used to evaluate which travel agent characteristics were independently associated with a stronger effect of the intervention. A small improvement in travel agents overall attitudes and beliefs (p =.03) was found, in particular their intention to refer (p =.01). Sixty-five percent of travel agents self-reported an increase in referral behavior; owners or managers of the agency were significantly more likely to do so than other travel agents (OR = 7.25; 95% CI: 1.64 32.06). Older travel agents, those that worked longer hours and those with some past referral experience, had significantly higher post-intervention scores. Travel agents can be willing partners in referral, and agencies should be encouraged to develop specific referral policies. Future research may be directed toward investigating the role of health education in certification curricula, the effectiveness of different types of health promotion interventions, including Internet-facilitated interventions, and the direct impact that such interventions would have on travelers attending travel health clinics.

Predictors of the Health-Promoting Behaviors of Nepalese Migrant Workers.

PubMed

Bhandari, Pratibha; Kim, MiYoung

2016-09-01

Health-promoting behaviors assist individuals to prevent disease, promote health, increase longevity, and enjoy a better quality of life. A number of interpersonal, social, and environmental factors have been shown to influence health-promoting behaviors. Little empirical evidence exists about the predictors of health-promoting behaviors among migrant workers. This study uses Pender's health promotion model to describe and identify the predictors of health-promoting behaviors in Nepalese migrant workers in Korea. A cross-sectional research design was used. Nepalese migrants who had been working in South Korea (n = 169) for over 6 months were surveyed between July and December 2012. Self-efficacy was measured using the Perceived Health Competence Scale, the Health-Promoting Lifestyle Profile II was used to measure health-promoting lifestyle behaviors, and perceived health status was measured using a single-item question. Descriptive statistics, correlation analysis, and multiple regression analysis were used to analyze data. Spiritual activity was the highest reported health-promoting behavior, whereas physical activity was the least practiced behavior. Self-efficacy was the only significant predictor of health-promoting behavior. The results of this study suggest that future health-promoting interventions should enhance the self-efficacy of target populations for individual health behaviors. Factors such as working conditions, culture, and economic background that may affect the health-promoting behaviors of migrant workers must be considered when planning nursing interventions. Multicultural nursing structures and policies are needed to reach out proactively to all adult migrant groups.

Successful mental health promotion with men: the evidence from 'tacit knowledge'.

PubMed

Robertson, Steve; Gough, Brendan; Hanna, Esmée; Raine, Gary; Robinson, Mark; Seims, Amanda; White, Alan

2018-04-01

There remains significant concern about men's mental health, particularly in terms of personal and societal barriers to help-seeking, negative coping mechanisms and high suicide rates. This article presents findings from a multi-phase study looking at 'what works' in mental health promotion for men. Work here reports the collection and analysis of the tacit knowledge of those working within mental health promotion interventions for men. A 'multiple hub and spoke' approach was used to assist data collection. Thirteen key players, active in the men's mental health field, half from the UK and half beyond, formed an Investigative Network collecting data, mainly through interviews, from wider geographical and professional community contexts where they had networks. The focus of data collection was on 'what works' in mental health promotion for men. Data was analysed using thematic analysis techniques. Findings suggest that settings which created safe male spaces acted to promote trust, reduce stigma and normalize men's engagement in interventions. Embedding interventions within the communities of men being engaged, fully involving these men, and holding 'male-positive' values engendered familiarity and consolidated trust. Using 'male-sensitive' language and activity-based approaches allowed for positive expressions of emotions, facilitated social engagement, and provided a base for open communication. Appropriate partnerships were also seen as a necessary requirement for success and as crucial for maximizing intervention impact. The importance of gender and 'masculinity' was apparent throughout these findings and taking time to understand gender could facilitate positive ways of working alongside men, increasing levels of engagement and successful outcomes.

Promoting mental health and preventing substance abuse and violence in elementary students: a randomized control study of the Michigan Model for Health.

PubMed

O'neill, James M; Clark, Jeffrey K; Jones, James A

2011-06-01

In elementary grades, comprehensive health education curricula mostly have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on multiple health issues, including social and emotional skills, prosocial behavior, and drug use and aggression. Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received 24 lessons in grade 4 (over 12 weeks) and 28 more lessons in grade 5 (over 14 weeks), including material focusing on social and emotional health, interpersonal communication, social pressure resistance skills, drug use prevention, and conflict resolution skills. The 40-minute lessons were taught by the classroom or health teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (n = 2512) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade. Students who received the curriculum had better interpersonal communication skills, social and emotional skills, and drug refusal skills than the control group students. Intervention students also reported lower intentions to use alcohol and tobacco, less alcohol and tobacco use initiated during the study and in the past 30 days, and reduced levels of aggression. The effectiveness of the MMH in promoting mental health and preventing drug use and aggression supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools. © 2011, American School Health Association.

Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

PubMed Central

Classen, Sherrilene; Lopez, Ellen DS; Winter, Sandra; Awadzi, Kezia D; Ferree, Nita; Garvan, Cynthia W

2007-01-01

The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research), and views (qualitative research) of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long-term outcomes. After completing the detailed plan we will test the effectiveness of this intervention on multiple levels. PMID:18225470

Substantiating the need for primary care-based sexual health promotion interventions for ethnic minority adolescent women experiencing health disparities.

PubMed

Champion, Jane Dimmitt; Young, Cara; Rew, Lynn

2016-09-01

Assess the context of psychological distress, violence, and substance use among African- and Mexican-American adolescent women with a history of STI, violence, or high sexual risk behavior. These adolescents experience multiple health disparities, limited access to care, and are at particularly high risk of adverse sexual health outcomes. The results will inform sexual health promotion interventions provided by advanced practice nurses in primary care-based settings for women experiencing these disparities. Analysis of self-report data obtained at study entry from African- and Mexican-American adolescent women (n = 559) enrolled in a randomized trial of a behavioral intervention for sexual risk reduction. High levels of psychological distress, sexual risk behavior, sexually transmitted infection (STI), personal and friend/peer substance use, alcohol use, and violence were reported by women at study entry. Analyses found that STI, physical violence, and substance-using friends were twice as likely associated with personal substance use. Alcohol users were five times more likely to use other substances. Mexican Americans were three times more likely than African Americans to use substances. Recommendation is made for integration of multicomponent sexual health promotion interventions as advanced practice nurse provider services addressing these health disparities within primary care-based settings. ©2016 American Association of Nurse Practitioners.

Self-Monitoring Interventions for Students with Behavior Problems: A Systematic Review of Current Research

ERIC Educational Resources Information Center

Bruhn, Allison; McDaniel, Sara; Kreigh, Christi

2015-01-01

Explicitly teaching skills associated with self-determination has been promoted to support students' independence and control over their own lives. This is especially important for students with behavior problems. One self-determination skill or behavior that has been studied widely is self-monitoring. Although multiple reviews of various…

Promoting Conceptual Change for Complex Systems Understanding: Outcomes of an Agent-Based Participatory Simulation

ERIC Educational Resources Information Center

Rates, Christopher A.; Mulvey, Bridget K.; Feldon, David F.

2016-01-01

Components of complex systems apply across multiple subject areas, and teaching these components may help students build unifying conceptual links. Students, however, often have difficulty learning these components, and limited research exists to understand what types of interventions may best help improve understanding. We investigated 32 high…

Can Parenting Intervention Prevent Cascading Effects From Placement Instability to Insecure Attachment to Externalizing Problems in Maltreated Toddlers?

PubMed

Pasalich, Dave S; Fleming, Charles B; Oxford, Monica L; Zheng, Yao; Spieker, Susan J

2016-08-01

Multiple placement changes disrupt continuity in caregiving and undermine well-being in children in child welfare. This study conducted secondary data analysis of a randomized controlled trial to examine whether a relationship-based intervention, Promoting First Relationships(©) (PFR), reduced risk for a maladaptive cascade from placement instability to less secure attachment to elevated externalizing problems. Participants included caregivers (birth or foster/kin) of toddlers (10-24 months) recently transitioned to their care because of child welfare placement decisions. Although main effects of PFR on security and externalizing problems were not previously observed, this study's results revealed that PFR attenuated the association between multiple placement changes (baseline) and less security (postintervention) and that the indirect effect of placement instability on greater externalizing problems (6-month follow-up) via less security was evident only in toddlers in the comparison condition. These findings shed light on how a history of multiple caregiver changes may influence toddlers' risk for poor adjustment in subsequent placements, and the promise of supporting caregivers through a parenting intervention to prevent such risk. © The Author(s) 2016.

Can parenting intervention prevent cascading effects from placement instability to insecure attachment to externalizing problems in maltreated toddlers?

PubMed Central

Pasalich, Dave S.; Fleming, Charles B.; Oxford, Monica L.; Zheng, Yao; Spieker, Susan J.

2016-01-01

Multiple placement changes disrupt continuity in caregiving and undermine well-being in children in child welfare. This study conducted secondary data analysis of a randomized controlled trial to examine whether a relationship-based intervention, Promoting First Relationships© (PFR), reduced risk for a maladaptive cascade from placement instability to less secure attachment to elevated externalizing problems. Participants included caregivers (birth or foster/kin) of toddlers (10–24 months) recently transitioned to their care because of child welfare placement decisions. Although main effects of PFR on security and externalizing problems were not previously observed, this study’s results revealed that PFR attenuated the association between multiple placement changes (baseline) and less security (postintervention), and that the indirect effect of placement instability on greater externalizing problems (6-month follow-up) via less security was evident only in toddlers in the comparison condition. These findings shed light on how a history of multiple caregiver changes may influence toddlers’ risk for poor adjustment in subsequent placements, and the promise of supporting caregivers through a parenting intervention to prevent such risk. PMID:27381935

Metabolic pathways as possible therapeutic targets for progressive multiple sclerosis.

PubMed

Heidker, Rebecca M; Emerson, Mitchell R; LeVine, Steven M

2017-08-01

Unlike relapsing remitting multiple sclerosis, there are very few therapeutic options for patients with progressive forms of multiple sclerosis. While immune mechanisms are key participants in the pathogenesis of relapsing remitting multiple sclerosis, the mechanisms underlying the development of progressive multiple sclerosis are less well understood. Putative mechanisms behind progressive multiple sclerosis have been put forth: insufficient energy production via mitochondrial dysfunction, activated microglia, iron accumulation, oxidative stress, activated astrocytes, Wallerian degeneration, apoptosis, etc . Furthermore, repair processes such as remyelination are incomplete. Experimental therapies that strive to improve metabolism within neurons and glia, e.g. , oligodendrocytes, could act to counter inadequate energy supplies and/or support remyelination. Most experimental approaches have been examined as standalone interventions; however, it is apparent that the biochemical steps being targeted are part of larger pathways, which are further intertwined with other metabolic pathways. Thus, the potential benefits of a tested intervention, or of an established therapy, e.g. , ocrelizumab, could be undermined by constraints on upstream and/or downstream steps. If correct, then this argues for a more comprehensive, multifaceted approach to therapy. Here we review experimental approaches to support neuronal and glial metabolism, and/or promote remyelination, which may have potential to lessen or delay progressive multiple sclerosis.

Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners

PubMed Central

Springer, Andrew E.; Evans, Alexandra E.

2016-01-01

Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning. PMID:27579254

Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

PubMed

Springer, Andrew E; Evans, Alexandra E

2016-01-01

Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning.

Integrating Worksite Health Protection and Health Promotion: A Conceptual Model for Intervention and Research

PubMed Central

Sorensen, Glorian; McLellan, Deborah L.; Sabbath, Erika L.; Dennerlein, Jack T.; Nagler, Eve M.; Hurtado, David A.; Pronk, Nicolaas P.; Wagner, Gregory R.

2016-01-01

There is increasing recognition of the value added by integrating traditionally separate efforts to protect and promote worker safety and health. This paper presents an innovative conceptual model to guide research on determinants of worker safety and health and to inform the design, implementation and evaluation of integrated approaches to promoting and protecting worker health. This model is rooted in multiple theories and the premise that the conditions of work are important determinants of individual safety and health outcomes and behaviors, and outcomes important to enterprises such as absence and turnover. Integrated policies, programs and practices simultaneously address multiple conditions of work, including the physical work environment and the organization of work (e.g., psychosocial factors, job tasks and demands). Findings from two recent studies conducted in Boston and Minnesota (2009–2015) illustrate the application of this model to guide social epidemiological research. This paper focuses particular attention on the relationships of the conditions of work to worker health-related behaviors, musculoskeletal symptoms, and occupational injury; and to the design of integrated interventions in response to specific settings and conditions of work of small and medium size manufacturing businesses, based on a systematic assessment of priorities, needs, and resources within an organization. This model provides an organizing framework for both research and practice by specifying the causal pathways through which work may influence health outcomes, and for designing and testing interventions to improve worker safety and health that are meaningful for workers and employers, and responsive to that setting’s conditions of work. PMID:27527576

Effects of Active Videogames on Physical Activity and Related Outcomes Among Healthy Children: A Systematic Review.

PubMed

Liang, Yan; Lau, Patrick W C

2014-06-01

This review systematically evaluated the effects of active videogames (AVGs) on physical activity (PA) and related outcomes in healthy children. Electronic databases were searched to retrieve articles published from January 2000 through August 2013. Included were original studies published in English, in peer-reviewed journals, that included at least one subgroup of healthy participants not older than 18 years, and that measured at least one PA-related cognitive, psychosocial, or behavioral outcome. All study designs were included, but only intervention studies with PA comparison between groups or across time were assessed for methodological quality. Evidence strength for intervention studies was stratified by settings (including the free-living home setting, the school, community, or primary care setting with structured AVG sessions [i.e., AVG play of participants was organized by teachers or researchers], and multiple settings). Fifty-four articles were identified, including 32 studies that examined the immediate PA effects (i.e., energy expenditure and PA levels during AVG play), one survey study, and 21 intervention studies aimed to promote PA. AVGs led to light- to moderate-intensity PA among studies of immediate PA outcomes. No effect was identified of AVGs on PA in the home setting. Moderate evidence was found that structured AVG play could improve PA. Inconclusive evidence was found for the effect of AVGs on PA in multiple settings. The present review does not support using AVGs alone in the home setting to promote PA. Structured AVG play has the potential to promote PA in children.

Cumulative effects of mothers' risk and promotive factors on daughters' disruptive behavior.

PubMed

van der Molen, Elsa; Hipwell, Alison E; Vermeiren, Robert; Loeber, Rolf

2012-07-01

Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043). Maternal risk and promotive factors were operative at different time points in girls' development. Maternal warmth explained variance in girls' disruptive behavior, even after controlling for maternal risk factors and relevant child and neighborhood factors. In addition, findings supported the cumulative hypothesis that the number of risk factors increased the chance on girls' disruptive behavior disorder (DBD), while the number of promotive factors decreased this probability. Daughters of mothers with a history of Conduct Disorder (CD) were exposed to more risk factors and fewer promotive factors compared to daughters of mothers without prior CD. The identification of malleable maternal factors that can serve as targets for intervention has important implications for intergenerational intervention. Cumulative effects show that the focus of prevention efforts should not be on single factors, but on multiple factors associated with girls' disruptive behavior.

Cumulative Effects of Mothers’ Risk and Promotive Factors on Daughters’ Disruptive Behavior

PubMed Central

Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

2012-01-01

Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls’ disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls’ disruptive behavior were assessed annually among girls’ ages 7–12 in an urban community sample (N=2043). Maternal risk and promotive factors were operative at different time points in girls’ development. Maternal warmth explained variance in girls’ disruptive behavior, even after controlling for maternal risk factors and relevant child and neighborhood factors. In addition, findings supported the cumulative hypothesis that the number of risk factors increased the chance on girls’ disruptive behavior disorder (DBD), while the number of promotive factors decreased this probability. Daughters of mothers with a history of Conduct Disorder (CD) were exposed to more risk factors and fewer promotive factors compared to daughters of mothers without prior CD. The identification of malleable maternal factors that can serve as targets for intervention has important implications for intergenerational intervention. Cumulative effects show that the focus of prevention efforts should not be on single factors, but on multiple factors associated with girls’ disruptive behavior. PMID:22127641

Optimizing the scientific yield from a randomized controlled trial (RCT): evaluating two behavioral interventions and assessment reactivity with a single trial.

PubMed

Carey, Michael P; Senn, Theresa E; Coury-Doniger, Patricia; Urban, Marguerite A; Vanable, Peter A; Carey, Kate B

2013-09-01

Randomized controlled trials (RCTs) remain the gold standard for evaluating intervention efficacy but are often costly. To optimize their scientific yield, RCTs can be designed to investigate multiple research questions. This paper describes an RCT that used a modified Solomon four-group design to simultaneously evaluate two, theoretically-guided, health promotion interventions as well as assessment reactivity. Recruited participants (N = 1010; 56% male; 69% African American) were randomly assigned to one of four conditions formed by crossing two intervention conditions (i.e., general health promotion vs. sexual risk reduction intervention) with two assessment conditions (i.e., general health vs. sexual health survey). After completing their assigned baseline assessment, participants received the assigned intervention, and returned for follow-ups at 3, 6, 9, and 12 months. In this report, we summarize baseline data, which show high levels of sexual risk behavior; alcohol, marijuana, and tobacco use; and fast food consumption. Sexual risk behaviors and substance use were correlated. Participants reported high satisfaction with both interventions but ratings for the sexual risk reduction intervention were higher. Planned follow-up sessions, and subsequent analyses, will assess changes in health behaviors including sexual risk behaviors. This study design demonstrates one way to optimize the scientific yield of an RCT. © 2013 Elsevier Inc. All rights reserved.

Keeping a Step Ahead: formative phase of a workplace intervention trial to prevent obesity.

PubMed

Zapka, Jane; Lemon, Stephenie C; Estabrook, Barbara B; Jolicoeur, Denise G

2007-11-01

Ecological interventions hold promise for promoting overweight and obesity prevention in worksites. Given the paucity of evaluative research in the hospital worksite setting, considerable formative work is required for successful implementation and evaluation. This paper describes the formative phases of Step Ahead, a site-randomized controlled trial of a multilevel intervention that promotes physical activity and healthy eating in six hospitals in central Massachusetts. The purpose of the formative research phase was to increase the feasibility, effectiveness, and likelihood of sustainability of the intervention. The Step Ahead ecological intervention approach targets change at the organization, interpersonal work environment, and individual levels. The intervention was developed using fundamental steps of intervention mapping and important tenets of participatory research. Formative research methods were used to engage leadership support and assistance and to develop an intervention plan that is both theoretically and practically grounded. This report uses observational data, program minutes and reports, and process tracking data. Leadership involvement (key informant interviews and advisory boards), employee focus groups and advisory boards, and quantitative environmental assessments cultivated participation and support. Determining multiple foci of change and designing measurable objectives and generic assessment tools to document progress are complex challenges encountered in planning phases. Multilevel trials in diverse organizations require flexibility and balance of theory application and practice-based perspectives to affect impact and outcome objectives. Formative research is an essential component.

A Qualitative Meta-Synthesis of Interpersonal Violence Prevention Programs Focused on Males.

PubMed

Taliep, Naiema; Lazarus, Sandy; Naidoo, Anthony V

2017-12-01

Exceptionally high levels of interpersonal violence have triggered a call by many experts for the need to determine effective ways to address the onset and effects of exposure to interpersonal violence. The specific aim of this study was to identify and draw on existing promising practices to make a more informed decision on strategies to develop a contextually relevant intervention that focused on the promotion of positive forms of masculinity to create safety and peace. This study used a qualitative meta-synthesis (QMS) technique to integrate and interpret findings from various intervention studies that focused on males and/or gender. An in-depth literature search yielded a total of 827 papers that met the search criteria. After removal of duplicates, abstract review, and review of the full texts, the subsequent sample for this meta-synthesis included 12 intervention programs and 23 studies. This QMS revealed the value of a comprehensive approach, using multiple strategies, employing participatory and interactive methods, and promoting social mobilization to address interpersonal violence. The promotion of positive forms of masculinity as an interpersonal violence prevention strategy is a much-needed, relatively untapped approach to generating safety and peace for both males and females.

Adaptive Interventions and SMART Designs: Application to child behavior research in a community setting.

PubMed

Kidwell, Kelley M; Hyde, Luke W

2016-09-01

Heterogeneity between and within people necessitates the need for sequential personalized interventions to optimize individual outcomes. Personalized or adaptive interventions (AIs) are relevant for diseases and maladaptive behavioral trajectories when one intervention is not curative and success of a subsequent intervention may depend on individual characteristics or response. AIs may be applied to medical settings and to investigate best prevention, education, and community-based practices. AIs can begin with low-cost or low-burden interventions and followed with intensified or alternative interventions for those who need it most. AIs that guide practice over the course of a disease, program, or school year can be investigated through sequential multiple assignment randomized trials (SMARTs). To promote the use of SMARTs, we provide a hypothetical SMART in a Head Start program to address child behavior problems. We describe the advantages and limitations of SMARTs, particularly as they may be applied to the field of evaluation.

Lifestyle Approaches for People With Intellectual Disabilities: A Systematic Multiple Case Analysis.

PubMed

Steenbergen, Henderika Annegien; Van der Schans, Cees P; Van Wijck, Ruud; De Jong, Johan; Waninge, Aly

2017-11-01

Health care organizations supporting individuals with intellectual disabilities (IDs) carry out a range of interventions to support and improve a healthy lifestyle. However, it is difficult to implement an active and healthy lifestyle into daily support. The presence of numerous intervention components, multiple levels of influence, and the explicit use of theory are factors that are considered to be essential for implementation in practice. A comprehensive written lifestyle policy provides for sustainability of a lifestyle approach. It is unknown to what extent these crucial factors for successful implementation are taken into consideration by health care organizations supporting this population. To analyze the intervention components, levels of influence, explicit use of theory, and conditions for sustainability of currently used lifestyle interventions within lifestyle approaches aiming at physical activity and nutrition in health care organizations supporting people with ID. In this descriptive multiple case study of 9 health care organizations, qualitative data of the lifestyle approaches with accompanying interventions and their components were compiled with a newly developed online inventory form. From 9 health care organizations, 59 interventions were included, of which 31% aimed to improve physical activity, 10% nutrition, and 59% a combination of both. Most (49%) interventions aimed at the educational component and less at daily (19%) and generic activities (16%) and the evaluation component (16%). Most interventions targeted individuals with ID and the professionals whereas social levels were underrepresented. Although 52% of the interventions were structurally embedded, only 10 of the 59 interventions were theory-driven. Health care organizations could improve their lifestyle approaches by using an explicit theoretical basis by expanding the current focus of the interventions that primarily concentrate on their clients and professionals toward also targeting the social and external environment as well as the introduction of a written lifestyle policy. This policy should encompass all interventions and should be the responsibility of those in the organization working with individuals with ID. In conclusion, comprehensive, integrated, and theory-driven approaches at multiple levels should be promoted. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

A Multiple-Case Study of Intersectoral Collaboration in Comprehensive School Health Promotion Using the Diagnosis of Sustainable Collaboration (DISC) Model

ERIC Educational Resources Information Center

Pucher, K. K.; Candel, M. J. J. M.; Boot, N. M. W. M.; van Raak, A. J. A.; de Vries, N. K.

2015-01-01

Purpose: Intersectoral collaboration is often a prerequisite for effective interventions in public health. The purpose of this paper is to assess the facilitating and hindering conditions regarding intersectoral collaboration between health authorities, public health services (PHSs), public services stakeholders (PPSs) and the education sector in…

Experiences of Adolescents in Residential Treatment at the Orthogenic School 2013-2015: A Qualitative Study

ERIC Educational Resources Information Center

Scholom, Elizabeth

2017-01-01

The expansion of treatment interventions in child and adolescent residential milieu therapy in recent decades to include a multiplicity of approaches and techniques has resulted in the reformulation of residential treatment as a "tapestry of therapies" as opposed to a unified effort to maintain a uniquely growth-promoting total…

"Bill Is Now Singing": Joint Engagement and the Emergence of Social Communication of Three Young Children with Autism

ERIC Educational Resources Information Center

Vaiouli, Potheini; Grimmet, Kharon; Ruich, Lawrence J.

2015-01-01

Young children with autism spectrum disorder meet significant challenges in joint attention skills and in social communication. A child-centered, improvisational, music therapy intervention model was implemented to promote engagement in three young children with autism in a kindergarten classroom. A multiple baseline design compared the children's…

Mid-Level District Leadership Influences in Promoting Formative Assessment Practices in Secondary Schools: A Qualitative Multiple-Case Study

ERIC Educational Resources Information Center

Thompson, Jeff Roland

2017-01-01

A growing body of research evidence has suggested Assessment for Learning (AfL) practices represent a powerful intervention strategy that enhances learning for all students. Yet, grades 7-12 teachers in particular, generally continue to rely almost entirely on traditional summative assessment practices. However, some school principals in the…

Capacity building in the health sector to improve care for child nutrition and development.

PubMed

Yousafzai, Aisha K; Rasheed, Muneera A; Daelmans, Bernadette; Manji, Sheila; Arnold, Caroline; Lingam, Raghu; Muskin, Joshua; Lucas, Jane E

2014-01-01

The effectiveness of interventions promoting healthy child growth and development depends upon the capacity of the health system to deliver a high-quality intervention. However, few health workers are trained in providing integrated early child-development services. Building capacity entails not only training the frontline worker, but also mobilizing knowledge and support to promote early child development across the health system. In this paper, we present the paradigm shift required to build effective partnerships between health workers and families in order to support children's health, growth, and development, the practical skills frontline health workers require to promote optimal caregiving, and the need for knowledge mobilization across multiple institutional levels to support frontline health workers. We present case studies illustrating challenges and success stories around capacity development. There is a need to galvanize increased commitment and resources to building capacity in health systems to deliver early child-development services. © 2014 New York Academy of Sciences.

The Experience of Peer Mentors in an Intervention to Promote Smoking Cessation in Persons with Psychiatric Illness.

PubMed

Dickerson, Faith; Savage, Christina L G; Schweinfurth, Lucy A B; Goldberg, Richard W; Bennett, Melanie; Dixon, Lisa; Daumit, Gail; Chinman, Matthew; Lucksted, Alicia

2016-05-01

Peer support is an important component of services for persons with psychiatric illness but the experience of peer mentors is not well understood. This study explored the experiences of peer mentors, all former smokers and persons with psychiatric illness, who provided smoking cessation counseling as part of a 6 month professionally-led intervention. Data was obtained from 383 contact log entries and in-depth interviews with eight peer mentors. Qualitative analysis indicated that mentor roles were unexpectedly varied beyond the focus on smoking cessation. Of the two aspects of "peer-ness," shared smoking history was more prominent, while the shared experience of psychiatric illness was sometimes overlooked. Peer mentors experienced multiple challenges trying to help participants to change their smoking behaviors. Nonetheless, they described their experience as personally rewarding. Future interventions may be improved by anticipating peer mentor role complexity and the inherent tension between providing person-centered support and promoting behavior change.

Effects of worksite health promotion interventions on employee diets: a systematic review.

PubMed

Ni Mhurchu, Cliona; Aston, Louise M; Jebb, Susan A

2010-02-10

Public health strategies place increasing emphasis on opportunities to promote healthy behaviours within the workplace setting. Previous research has suggested worksite health promotion programmes have positive effects on physical activity and weight loss, yet little is known regarding their effects on dietary behaviour. The aim of this review was to assess the effects of worksite interventions on employee diets. Electronic databases (MEDLINE, The Cochrane Library, PsycINFO, EMBASE, LexisNexis) were searched for relevant articles published between 1995 and April 2009. Studies were eligible for inclusion if they were peer-reviewed English language publications describing a worksite-based health promotion intervention with minimum study duration of eight weeks. All study designs were eligible. Studies had to report one or more diet-related outcome (energy, fat, fruit, or vegetable intakes). Methodological quality was assessed using a checklist that included randomisation methods, use of a control group, and study attrition rates. Sixteen studies were included in the review. Eight programmes focussed on employee education, and the remainder targeted change to the worksite environment, either alone or in combination with education. Study methodological quality was moderate. In general, worksite interventions led to positive changes in fruit, vegetable and total fat intake. However, reliance on self-reported methods of dietary assessment means there is a significant risk of bias. No study measured more robust outcomes such as absenteeism, productivity, or healthcare utilisation. The findings of this review suggest that worksite health promotion programmes are associated with moderate improvement in dietary intake. The quality of studies to date has been frequently sub-optimal and further, well designed studies are needed in order to reliably determine effectiveness and cost-effectiveness. Future programmes to improve employee dietary habits should move beyond individual education and aim to intervene at multiple levels of the worksite environment.

Strengthening health services to deliver nutrition education to promote complementary feeding and healthy growth of infants and young children: formative research for a successful intervention in peri-urban Trujillo, Peru.

PubMed

Robert, Rebecca C; Creed-Kanashiro, Hilary M; Villasante, Ruben; Narro, M Rocio; Penny, Mary E

2017-04-01

Formative research is critical for developing effective nutrition-specific interventions to improve infant and young child (IYC) feeding practices and promote healthy growth. Health workers interact with caregivers during health facility visits, yet there is limited research about how to optimize delivery of such interventions during these visits. The extensive reach of IYC health services globally calls for research to address this gap. In Trujillo, Peru, formative research was conducted to explore complementary feeding practices with caregivers as well as health worker routines and interactions with caregivers related to feeding and healthy growth; results informed the development and delivery of an educational intervention. Multiple qualitative methods were used to collect data on a purposive sample of health workers and caregivers from three health facilities and communities: household trials followed. Complementary feeding messages with doable behaviours were developed, and three were selected as key to promote based on their nutritional impact and cultural acceptability. In the health facilities, medical consultation, well-child visits and nutrition consultation all dealt with aspects of IYC nutrition/growth during their interactions with caregivers but were independent and inconsistent in approach. A nutrition education strategy was developed based on consistency, quality and coverage in the IYC health services. We conclude that formative research undertaken in the community and IYC health services was critical to developing a successful and culturally relevant intervention to promote optimal complementary feeding practices and healthy growth during interactions between health workers and caregivers at routine health facility visits. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

A systematic review of selected interventions for worksite health promotion. The assessment of health risks with feedback.

PubMed

Soler, Robin E; Leeks, Kimberly D; Razi, Sima; Hopkins, David P; Griffith, Matt; Aten, Adam; Chattopadhyay, Sajal K; Smith, Susan C; Habarta, Nancy; Goetzel, Ron Z; Pronk, Nicolaas P; Richling, Dennis E; Bauer, Deborah R; Buchanan, Leigh Ramsey; Florence, Curtis S; Koonin, Lisa; MacLean, Debbie; Rosenthal, Abby; Matson Koffman, Dyann; Grizzell, James V; Walker, Andrew M

2010-02-01

Many health behaviors and physiologic indicators can be used to estimate one's likelihood of illness or premature death. Methods have been developed to assess this risk, most notably the use of a health-risk assessment or biometric screening tool. This report provides recommendations on the effectiveness of interventions that use an Assessment of Health Risks with Feedback (AHRF) when used alone or as part of a broader worksite health promotion program to improve the health of employees. The Guide to Community Preventive Services' methods for systematic reviews were used to evaluate the effectiveness of AHRF when used alone and when used in combination with other intervention components. Effectiveness was assessed on the basis of changes in health behaviors and physiologic estimates, but was also informed by changes in risk estimates, healthcare service use, and worker productivity. The review team identified strong evidence of effectiveness of AHRF when used with health education with or without other intervention components for five outcomes. There is sufficient evidence of effectiveness for four additional outcomes assessed. There is insufficient evidence to determine effectiveness for others such as changes in body composition and fruit and vegetable intake. The team also found insufficient evidence to determine the effectiveness of AHRF when implemented alone. The results of these reviews indicate that AHRF is useful as a gateway intervention to a broader worksite health promotion program that includes health education lasting > or =1 hour or repeating multiple times during 1 year, and that may include an array of health promotion activities. These reviews form the basis of the recommendations by the Task Force on Community Preventive Services presented elsewhere in this supplement. Published by Elsevier Inc.

Facilitating Medication Adherence in Patients with Multiple Sclerosis

PubMed Central

Rodriguez, Yolanda; Logan, Diana; Williamson, Caroline; Treadaway, Katherine

2013-01-01

This article reviews adherence to medication in multiple sclerosis (MS) patients from the perspective of nurse and social worker authors. It reviews data on patient adherence and offers practical, evidence-based strategies that health-care providers can use to facilitate adherence. In addition, it examines how emerging MS therapies may affect patient adherence and associated interventions. To promote adherence, interventions need to incorporate new and creative approaches. A proactive approach includes assessing patient needs and lifestyle before the start of medication and selecting the most appropriate disease-modifying therapy for each individual patient. Including multidisciplinary expertise and services in the treatment plan can be part of a comprehensive, holistic approach to helping patients and families. Optimization of health-care provider roles is likely to facilitate improved adherence. PMID:24453761

Concept Mapping as an Approach to Facilitate Participatory Intervention Building.

PubMed

L Allen, Michele; Schaleben-Boateng, Dane; Davey, Cynthia S; Hang, Mikow; Pergament, Shannon

2015-01-01

A challenge to addressing community-defined need through community-based participatory intervention building is ensuring that all collaborators' opinions are represented. Concept mapping integrates perspectives of individuals with differing experiences, interests, or expertise into a common visually depicted framework, and ranks composite views on importance and feasibility. To describe the use of concept mapping to facilitate participatory intervention building for a school-based, teacher-focused, positive youth development (PYD) promotion program for Latino, Hmong, and Somali youth. Particiants were teachers, administrators, youth, parents, youth workers, and community and university researchers on the projects' community collaborative board. We incorporated previously collected qualitative data into the process. In a mixed-methods process we 1) generated statements based on key informant interview and focus group data from youth workers, teachers, parents, and youth in multiple languages regarding ways teachers promote PYD for Somali, Latino and Hmong youth; 2) guided participants to individually sort statements into meaningful groupings and rate them by importance and feasibility; 3) mapped the statements based on their relation to each other using multivariate statistical analyses to identify concepts, and as a group identified labels for each concept; and 4) used labels and statement ratings to identify feasible and important concepts as priorities for intervention development. We identified 12 concepts related to PYD promotion in schools and prioritized 8 for intervention development. Concept mapping facilitated participatory intervention building by formally representing all participants' opinions, generating visual representation of group thinking, and supporting priority setting. Use of prior qualitative work increased the diversity of viewpoints represented.

Integrating Participatory Design and Health Literacy to Improve Research and Interventions.

PubMed

Neuhauser, Linda

2017-01-01

Health communication is an essential health promotion strategy to convert scientific findings into actionable, empowering information for the public. Health communication interventions have shown positive outcomes, but many efforts have been disappointing. A key weakness is that expert-designed health communication is often overly generic and not adequately aligned with the abilities, preferences and life situations of specific audiences. The emergence of the field of health literacy is providing powerful theoretical guidance and practice strategies. Health literacy, in concert with other determinants of health, has greatly advanced understanding of factors that facilitate or hinder health promotion at individual, organizational and community settings. However, health literacy models are incomplete and interventions have shown only modest success to date. A challenge is to move beyond the current focus on individual comprehension and address deeper factors of motivation, self-efficacy and empowerment, as well as socio-environmental influences, and their impact to improve health outcomes and reduce health disparities. Integrating participatory design theory and methods drawn from social sciences and design sciences can significantly improve health literacy models and interventions. Likewise, researchers and practitioners using participatory design can greatly benefit from incorporating health literacy principles into their efforts. Such interventions at multiple levels are showing positive health outcomes and reduction of health disparities, but this approach is complex and not yet widespread. This chapter focuses on research findings about health literacy and participatory design to improve health promotion, and practical guidance and case examples for researchers, practitioners and policymakers.

Rehabilitation interventions in multiple sclerosis: an overview.

PubMed

Beer, Serafin; Khan, Fary; Kesselring, Jürg

2012-09-01

Multiple sclerosis is a complex, heterogeneous disease associated with long-term disability. Despite the availability of advanced disease-modifying and symptomatic therapies that may decrease activity and progression of disease and alleviate complaints to a certain extent, there is still a need for comprehensive rehabilitation interventions in order to reduce sequels and symptoms of the disease on personal activities and social participation to achieve the highest possible independence and the best quality of life. Timing and setting of rehabilitation interventions should be selected individually depending on disease phase, functional deficits, personal requirements, as well as specific goals. In addition, limitations and disease-specific characteristics that may influence rehabilitation outcome should be noted. Rehabilitation interventions should be considered early for maintaining functional capacity and reducing risk for losing important abilities or independence. Due to gradual failure of adaptive compensatory mechanisms along the course of disease, benefits of rehabilitation interventions are generally higher in earlier phases of MS. Inpatient and outpatient multidisciplinary rehabilitation has been shown to be beneficial in improving disability, participation and quality of life despite progression of the disease. Good evidence exists for different specific interventions improving physical and cognitive performance. Other important issues responsible for beneficial effects of comprehensive rehabilitation in MS include education, instruction, and information of patients and caregivers. Comprehensive assessment of health domains in MS patients using standardized framework and common language for describing the impact of disease at different levels, using International Classification of Functioning, Disability and Health (ICF) core sets may increase the knowledge of needs of these patients for more efficient and adapted rehabilitation interventions meeting these individual requirements, and promote perception and acceptance of rehabilitation as a valuable treatment option in MS. ICF core sets may increase the knowledge of more efficient and adapted rehabilitation measures meeting more properly individual requirements, and promote perception and acceptance of rehabilitation as a valuable treatment option in MS.

Do Interventions that Promote Awareness of Rights Increase Use of Maternity Care Services? A Systematic Review

PubMed Central

George, Asha S.; Branchini, Casey; Portela, Anayda

2015-01-01

Twenty years after the rights of women to go through pregnancy and childbirth safely were recognized by governments, we assessed the effects of interventions that promote awareness of these rights to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, we searched published and grey literature from one database of studies on maternal health, two search engines, an internet search and contact with experts. From the 707 unique documents found, 219 made reference to rights, with 22 detailing interventions promoting awareness of rights for maternal and newborn health. Only four of these evaluated effects on health outcomes. While all four interventions promoted awareness of rights, they did so in different ways. Interventions included highly-scripted dissemination meetings with educational materials and other visual aids, participatory approaches that combined raising awareness of rights with improving accountability of services, and broader multi-stakeholder efforts to improve maternal health. Study quality ranged from weak to strong. Measured health outcomes included increased antenatal care and facility birth. Improvements in human rights outcomes such as availability, acceptability, accessibility, quality of care, as well as the capacity of rights holders and duty bearers were also reported to varying extents. Very little information on costs and almost no information on harms or risks were described. Despite searching multiple sources of information, while some studies did report on activities to raise awareness of rights, few detailed how they did so and very few measured effects on health outcomes. Promoting awareness of rights is one element of increasing demand for and use of quality maternity care services for women during pregnancy, birth and after birth. To date efforts have not been well documented in the literature and the program theories, processes and costs, let alone health effects have not been well evaluated. PMID:26444291

More than just tracking time: Complex measures of user engagement with an internet-based health promotion intervention.

PubMed

Baltierra, Nina B; Muessig, Kathryn E; Pike, Emily C; LeGrand, Sara; Bull, Sheana S; Hightow-Weidman, Lisa B

2016-02-01

There has been a rise in internet-based health interventions without a concomitant focus on new methods to measure user engagement and its effect on outcomes. We describe current user tracking methods for internet-based health interventions and offer suggestions for improvement based on the design and pilot testing of healthMpowerment.org (HMP). HMP is a multi-component online intervention for young Black men and transgender women who have sex with men (YBMSM/TW) to reduce risky sexual behaviors, promote healthy living and build social support. The intervention is non-directive, incorporates interactive features, and utilizes a point-based reward system. Fifteen YBMSM/TW (age 20-30) participated in a one-month pilot study to test the usability and efficacy of HMP. Engagement with the intervention was tracked using a customized data capture system and validated with Google Analytics. Usage was measured in time spent (total and across sections) and points earned. Average total time spent on HMP was five hours per person (range 0-13). Total time spent was correlated with total points earned and overall site satisfaction. Measuring engagement in internet-based interventions is crucial to determining efficacy. Multiple methods of tracking helped derive more comprehensive user profiles. Results highlighted the limitations of measures to capture user activity and the elusiveness of the concept of engagement. Copyright © 2016 Elsevier Inc. All rights reserved.

Pre-pregnancy community-based intervention for couples in Malaysia: application of intervention mapping.

PubMed

Norris, Shane A; Ho, Julius Cheah Chee; Rashed, Aswir Abd; Vinding, Vibeke; Skau, Jutta K H; Biesma, Regien; Aagaard-Hansen, Jens; Hanson, Mark; Matzen, Priya

2016-11-17

Malaysia is experiencing a nutrition transition with burgeoning obesity, particularly in women, and a growing prevalence of non-communicable disease. These health burdens have severe implications not only for adult health but also across generations. Pre-conception health promotion could address the intergenerational risk of metabolic disease. This paper describes the development of the "Jom Mama" intervention using Intervention Mapping (IM). The Jom Mama intervention aims to improve the health of young adult couples in Malaysia prior to conception. IM comprises of five steps prior to the last one, which involves the evaluation of the intervention. We used the five steps to develop the Jom Mama intervention. Both the process and evidence is documented providing the rationale to the selection of the key objectives of the intervention: (i) increasing healthy dietary practice; (ii) increasing physical activity levels, (iii) reducing sedentary activity; and (iv) improving social support to offset stressful lifestyles. From the IM process, Jom Mama will be health-system centred approach that uniquely combines both community health promoters and an electronic-health platform to deliver the complex intervention. IM is an iterative process that systematically gathers "best" evidence, selects appropriate theories of behaviour change, and facilitates formative research so as to develop a complex intervention. Though the IM process is time consuming, complex, and costly, it has enriched the Jom Mama intervention with a number of notable advantages: (i) intervention fashioned on formative work with stakeholders and in the target group; (ii) intervention combines research evidence with theory; (iii) intervention acknowledges multiple dynamics of influence; and (iv) intervention is embedded within health service priorities in Malaysia for greater scale-up possibility.

Adolescents from families of divorce: vulnerability to physiological and psychological disturbances.

PubMed

Thompson, P

1998-03-01

Multiple factors contribute to the vulnerability of adolescents to physiological and psychological disturbances following parental divorce. These include father absence, interparental conflict, economic distress, multiple life stressors, parent adjustment, and short-term crisis. Clinical and societal problems manifested in these vulnerable adolescents are discussed. Systems theory is used to explain this vulnerability of adolescents and to identify appropriate interventions and policies to promote health in this population. Policies recommended include required divorce mediation, early referrals for family and sibling therapy, and school programs to identify and support those most vulnerable.

Design and protocol of a randomized multiple behavior change trial: Make Better Choices 2 (MBC2).

PubMed

Pellegrini, Christine A; Steglitz, Jeremy; Johnston, Winter; Warnick, Jennifer; Adams, Tiara; McFadden, H G; Siddique, Juned; Hedeker, Donald; Spring, Bonnie

2015-03-01

Suboptimal diet and inactive lifestyle are among the most prevalent preventable causes of premature death. Interventions that target multiple behaviors are potentially efficient; however the optimal way to initiate and maintain multiple health behavior changes is unknown. The Make Better Choices 2 (MBC2) trial aims to examine whether sustained healthful diet and activity change are best achieved by targeting diet and activity behaviors simultaneously or sequentially. Study design approximately 250 inactive adults with poor quality diet will be randomized to 3 conditions examining the best way to prescribe healthy diet and activity change. The 3 intervention conditions prescribe: 1) an increase in fruit and vegetable consumption (F/V+), decrease in sedentary leisure screen time (Sed-), and increase in physical activity (PA+) simultaneously (Simultaneous); 2) F/V+ and Sed- first, and then sequentially add PA+ (Sequential); or 3) Stress Management Control that addresses stress, relaxation, and sleep. All participants will receive a smartphone application to self-monitor behaviors and regular coaching calls to help facilitate behavior change during the 9 month intervention. Healthy lifestyle change in fruit/vegetable and saturated fat intakes, sedentary leisure screen time, and physical activity will be assessed at 3, 6, and 9 months. MBC2 is a randomized m-Health intervention examining methods to maximize initiation and maintenance of multiple healthful behavior changes. Results from this trial will provide insight about an optimal technology supported approach to promote improvement in diet and physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

Female Condoms=Missed Opportunities: Lessons Learned from Promotion-centered Interventions.

PubMed

Maksut, Jessica L; Eaton, Lisa A

2015-01-01

The female condom is a barrier contraceptive device that is underutilized despite its effectiveness at preventing both unintended pregnancy and sexually transmitted infections (STIs). Prior research has highlighted that the underuse of the female condom as a contraceptive option is owing in large part to social stigma, and lacking or incorrect information about the product. In an attempt to better understand the discrepancy between the female condom's documented effectiveness and its general lack of uptake, we conducted a systematic search and qualitatively reviewed 20 published intervention studies that focus on efforts to promote the female condom. The strategies that each intervention used were coded and carefully examined. We obtained information regarding relevant characteristics of the studies, including intervention setting, sampling strategy, participant demographics, and methodology used. We found that the majority of the studies had significant positive findings concerning the female condom, for example, many were effective at demonstrating participant uptake as well as increasing the number of protected sex acts. Additionally, perceived ability to use the device was a significant predictor of female condom use in multiple studies. Finally, the studies tended to include younger women; only 10.0% (n=2) reported having participants with a mean age older than 30), meaning that older women generally have not been well-served by previous efforts to promote the use of the female condom. We offer guidelines for improving female condom uptake and recommendations for future research that seeks to establish and utilize best practice promotional strategies for female condoms. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

The Happy Older Latinos are Active (HOLA) health promotion and prevention study: study protocol for a pilot randomized controlled trial.

PubMed

Jimenez, Daniel E; Reynolds, Charles F; Alegría, Margarita; Harvey, Philip; Bartels, Stephen J

2015-12-18

Results of previous studies attest to the greater illness burden of common mental disorders (anxiety and depression) in older Latinos and the need for developing preventive interventions that are effective, acceptable, and scalable. Happy Older Latinos are Active (HOLA) is a newly developed intervention that uses a community health worker (CHW) to lead a health promotion program in order to prevent common mental disorders among at-risk older Latinos. This pilot study tests the feasibility and acceptability of delivering HOLA to older, at-risk Latinos. HOLA is a multi-component, health promotion intervention funded by the National Institute of Mental Health (NIMH). This prevention approach will be tested against a fotonovela, an enhanced psychoeducation control condition, in a sample of Latino elderly with minor or subthreshold depression or anxiety. A total of 60 older Latinos (aged 60+) will be randomized to receive HOLA or the fotonovela. The primary outcomes of interest are recruitment, adherence, retention, and acceptability. Data will also be collected on: preemption of incident and recurrent major depression, generalized anxiety, and social phobia; reduction in depression and anxiety symptom severity; physical functioning; sedentary behaviors; social engagement; and self-efficacy. The results of this study could have implications for other high-risk, highly disadvantaged populations. The development of a health promotion intervention designed to prevent common mental disorders could be a means of addressing multiple disparities (for example, mental health outcomes, mental health service use, stigma) among racial/ethnic minority elderly. CLINICALTRIALS. NCT02371954 . Date of registration: 21 January 2015.

Entrepreneurialism and health-promoting retail food environments in Canadian city-regions.

PubMed

Mah, Catherine L; Hasdell, Rebecca; Minaker, Leia M; Soo, Stephanie D; Cook, Brian; Demaio, Alessandro R

2017-09-02

The retail sector is a dynamic and challenging component of contemporary food systems with an important influence on population health and nutrition. Global consensus is clear that policy and environmental changes in retail food environments are essential to promote healthier diets and reduce the burden of obesity and non-communicable diseases. In this article, we explore entrepreneurialism as a form of social change-making within retail food environments, focusing on small food businesses. Small businesses face structural barriers within food systems. However, conceptual work in multiple disciplines and evidence from promising health interventions tested in small stores suggest that these retail places may have a dual role in health promotion: settings to strengthen regional economies and social networks, and consumer environments to support healthier diets. We will discuss empirical examples of health-promoting entrepreneurialism based on two sets of in-depth interviews we conducted with public health intervention actors in Toronto, Canada, and food entrepreneurs and city-region policy actors in St. John's, Canada. We will explore the practices of entrepreneurialism in the retail food environment and examine the implications for population health interventions. We contend that entrepreneurialism is important to understand on its own and also as a dimension of population health intervention context. A growing social scientific literature offers a multifaceted lens through which we might consider entrepreneurialism not only as a set of personal characteristics but also as a practice in networked and intersectoral cooperation for public and population health. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sexual behavior, risk perception, and HIV transmission can respond to HIV antiviral drugs and vaccines through multiple pathways.

PubMed

Tully, Stephen; Cojocaru, Monica; Bauch, Chris T

2015-10-28

There has been growing use of highly active antiretroviral treatment (HAART) for HIV and significant progress in developing prophylactic HIV vaccines. The simplest theories of counterproductive behavioral responses to such interventions tend to focus on single feedback mechanisms: for instance, HAART optimism makes infection less scary and thus promotes risky sexual behavior. Here, we develop an agent based, age-structured model of HIV transmission, risk perception, and partner selection in a core group to explore behavioral responses to interventions. We find that interventions can activate not one, but several feedback mechanisms that could potentially influence decision-making and HIV prevalence. In the model, HAART increases the attractiveness of unprotected sex, but it also increases perceived risk of infection and, on longer timescales, causes demographic impacts that partially counteract HAART optimism. Both HAART and vaccination usually lead to lower rates of unprotected sex on the whole, but intervention effectiveness depends strongly on whether individuals over- or under-estimate intervention coverage. Age-specific effects cause sexual behavior and HIV prevalence to change in opposite ways in old and young age groups. For complex infections like HIV-where interventions influence transmission, demography, sexual behavior and risk perception-we conclude that evaluations of behavioral responses should consider multiple feedback mechanisms.

Promoting Imitation in Young Children with Autism: A Comparison of Reciprocal Imitation Training and Video Modeling

ERIC Educational Resources Information Center

Cardon, Teresa A.; Wilcox, M. Jeanne

2011-01-01

The inability to imitate is a salient diagnostic marker for autism. It has been suggested that for children with autism, imitation may be a prerequisite skill that can assist in the development of various skills. Using a multiple baseline design across subjects, the purpose of this research was to determine if two interventions, reciprocal…

Use of Activity Schedule to Promote Independent Performance of Individuals with Autism and Other Intellectual Disabilities: A Review

ERIC Educational Resources Information Center

Koyama, Takanori; Wang, Hui-Ting

2011-01-01

A literature review was conducted on the effectiveness of activity schedules. Twenty three studies that a) were peer-reviewed, b) were experimental, c) implemented activity schedule as a primary intervention, d) incorporated multiple activities, and e) aimed to teach learners to self-manage individual schedules were included in the review. The…

Promoting Effective Teacher-Feedback: From Theory to Practice through a Multiple Component Trajectory for Professional Development

ERIC Educational Resources Information Center

Voerman, Lia; Meijer, Paulien C.; Korthagen, Fred; Simons, Robert Jan

2015-01-01

This study describes an evaluation of a theory-based trajectory for professional development called FeTiP (Feedback-Theory into Practice) that aims to have an observable effect on teacher classroom behavior. FeTiP is a multicomponent trajectory for professional development and combines several types of interventions. Its goal is to help teachers…

Using organization theory to understand the determinants of effective implementation of worksite health promotion programs.

PubMed

Weiner, Bryan J; Lewis, Megan A; Linnan, Laura A

2009-04-01

The field of worksite health promotion has moved toward the development and testing of comprehensive programs that target health behaviors with interventions operating at multiple levels of influence. Yet, observational and process evaluation studies indicate that such programs are challenging for worksites to implement effectively. Research has identified several organizational factors that promote or inhibit effective implementation of comprehensive worksite health promotion programs. However, no integrated theory of implementation has emerged from this research. This article describes a theory of the organizational determinants of effective implementation of comprehensive worksite health promotion programs. The model is adapted from theory and research on the implementation of complex innovations in manufacturing, education and health care settings. The article uses the Working Well Trial to illustrate the model's theoretical constructs. Although the article focuses on comprehensive worksite health promotion programs, the conceptual model may also apply to other types of complex health promotion programs. An organization-level theory of the determinants of effective implementation of worksite health promotion programs.

PubMed Central

PANATTO, D.; ARATA, L.; BEVILACQUA, I.; APPRATO, L.; GASPARINI, R.; AMICIZIA, D.

2015-01-01

Summary Introduction. Health-related knowledge is often assessed through multiple-choice tests. Among the different types of formats, researchers may opt to use multiple-mark items, i.e. with more than one correct answer. Although multiple-mark items have long been used in the academic setting – sometimes with scant or inconclusive results – little is known about the implementation of this format in research on in-field health education and promotion. Methods. A study population of secondary school students completed a survey on nutrition-related knowledge, followed by a single- lecture intervention. Answers were scored by means of eight different scoring algorithms and analyzed from the perspective of classical test theory. The same survey was re-administered to a sample of the students in order to evaluate the short-term change in their knowledge. Results. In all, 286 questionnaires were analyzed. Partial scoring algorithms displayed better psychometric characteristics than the dichotomous rule. In particular, the algorithm proposed by Ripkey and the balanced rule showed greater internal consistency and relative efficiency in scoring multiple-mark items. A penalizing algorithm in which the proportion of marked distracters was subtracted from that of marked correct answers was the only one that highlighted a significant difference in performance between natives and immigrants, probably owing to its slightly better discriminatory ability. This algorithm was also associated with the largest effect size in the pre-/post-intervention score change. Discussion. The choice of an appropriate rule for scoring multiple- mark items in research on health education and promotion should consider not only the psychometric properties of single algorithms but also the study aims and outcomes, since scoring rules differ in terms of biasness, reliability, difficulty, sensitivity to guessing and discrimination. PMID:26900331

Study Protocol for a Home-based Obesity Prevention Program in Latino Preschool Children.

PubMed

Taverno Ross, Sharon E; Documet, Patricia I; Pate, Russell R; Smith-Tapia, Ivonne; Wisniewski, Lisa M; Gibbs, Bethany B

2017-07-15

This paper describes the study design for ANDALE Pittsburgh, a culturally-appropriate, family-based intervention to promote a healthy weight in Latino preschool children. The study was organized into two major phases: Phase I: Conduct focus groups with 30 Latino parents of preschool children to inform the development of a culturally-appropriate intervention; Phase II: Test the feasibility and effectiveness of the intervention with 50 families. Participants were recruited from an emerging Latino community through community gatherings, flyers, and word of mouth. Six promotoras (females >18 years, active in community) received 25 hours of training using the intervention curriculum finalized after Phase I. Promotoras delivered the home-based intervention to families over 10, 90-minute weekly sessions that included education, practice, and action (i.e., goal setting). Behavior modification constructs and strategies (e.g., goal setting, problem solving, social support), and building of self-efficacy through healthy recipe preparation and physical activity breaks, were also included. Outcomes (e.g., child BMI) were assessed pre- and post-intervention. Process evaluation assessed fidelity, dose, reach, recruitment, and contextual factors using multiple data sources and mixed methods. The ANDALE Pittsburgh study will expand the body of knowledge on interventions to promote a healthy weight in Latino preschool children living in an emerging Latino community. If successful, this approach will be evaluated in a future, larger-scale intervention and provide a potential model to help to address and prevent obesity in this population.

KEEPING A STEP AHEAD - FORMATIVE PHASE OF A WORKPLACE INTERVENTION TRIAL TO PREVENT OBESITY

PubMed Central

Zapka, Jane; Lemon, Stephenie C.; Estabrook, Barbara B.; Jolicoeur, Denise G.

2008-01-01

Background Ecological interventions hold promise for promoting overweight and obesity prevention in worksites. Given the paucity of evaluative research in the hospital worksite setting, considerable formative work is required for successful implementation and evaluation. Purpose This paper describes the formative phases of Step Ahead, a site-randomized controlled trial of a multi-level intervention that promotes physical activity and healthy eating in 6 hospitals in central Massachusetts. The purpose of the formative research phase was to increase the feasibility, effectiveness and likelihood of sustainability of the intervention. Design and Procedures The Step Ahead ecological intervention approach targets change at the organization, the interpersonal work environment and the individual levels. The intervention was developed using fundamental steps of intervention mapping and important tenets of participatory research. Formative research methods were used to engage leadership support and assistance and to develop an intervention plan that is both theoretically and practically grounded. This report uses observational data, program minutes and reports, and process tracking data. Developmental Strategies and Observations Leadership involvement (key informant interviews and advisory boards), employee focus groups and advisory boards, and quantitative environmental assessments cultivated participation and support. Determining multiple foci of change and designing measurable objectives and generic assessment tools to document progress are complex challenges encountered in planning phases. Lessons Learned Multi-level trials in diverse organizations require flexibility and balance of theory application and practice-based perspectives to affect impact and outcome objectives. Formative research is an essential component. PMID:18073339

Sustaining self-management in diabetes mellitus.

PubMed

Mitchell-Brown, Fay

2014-01-01

Successful management of diabetes depends on the individual's ability to manage and control symptoms. Self-management of diabetes is believed to play a significant role in achieving positive outcomes for patients. Adherence to self-management behaviors supports high-quality care, which reduces and delays disease complications, resulting in improved quality of life. Because self-management is so important to diabetes management and involves a lifelong commitment for all patients, health care providers should actively promote ways to maintain and sustain behavior change that support adherence to self-management. A social ecological model of behavior change (McLeroy, Bibeau, Steckler, & Glanz, 1988) helps practitioners provide evidence-based care and optimizes patients' clinical outcomes. This model supports self-management behaviors through multiple interacting interventions that can help sustain behavior change. Diabetes is a complex chronic disease; successful management must use multiple-level interventions.

A Community-Based Participatory Planning Process and Multilevel Intervention Design: Toward Eliminating Cardiovascular Health Inequities

PubMed Central

Schulz, Amy J.; Israel, Barbara A.; Coombe, Chris M.; Gaines, Causandra; Reyes, Angela G.; Rowe, Zachary; Sand, Sharon; Strong, Larkin L.; Weir, Sheryl

2010-01-01

The elimination of persistent health inequities requires the engagement of multiple perspectives, resources and skills. Community-based participatory research is one approach to developing action strategies that promote health equity by addressing contextual as well as individual level factors, and that can contribute to addressing more fundamental factors linked to health inequity. Yet many questions remain about how to implement participatory processes that engage local insights and expertise, are informed by the existing public health knowledge base, and build support across multiple sectors to implement solutions. We describe a CBPR approach used to conduct a community assessment and action planning process, culminating in development of a multilevel intervention to address inequalities in cardiovascular disease in Detroit, Michigan. We consider implications for future efforts to engage communities in developing strategies toward eliminating health inequities. PMID:21873580

Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis.

PubMed

Ghafari, Somayeh; Ahmadi, Fazlolah; Nabavi, Masoud; Anoshirvan, Kazemnejad; Memarian, Robabe; Rafatbakhsh, Mohamad

2009-08-01

To identify the effects of applying Progressive Muscle Relaxation Technique on Quality of Life of patients with multiple Sclerosis. In view of the growing caring options in Multiple Sclerosis, improvement of quality of life has become increasingly relevant as a caring intervention. Complementary therapies are widely used by multiple sclerosis patients and Progressive Muscle Relaxation Technique is a form of complementary therapies. Quasi-experimental study. Multiple Sclerosis patients (n = 66) were selected with no probability sampling then assigned to experimental and control groups (33 patients in each group). Means of data collection included: Individual Information Questionnaire, SF-8 Health Survey, Self-reported checklist. PMRT performed for 63 sessions by experimental group during two months but no intervention was done for control group. Statistical analysis was done by SPSS software. Student t-test showed that there was no significant difference between two groups in mean scores of health-related quality of life before the study but this test showed a significant difference between two groups, one and two months after intervention (p < 0.05). anova test with repeated measurements showed that there is a significant difference in mean score of whole and dimensions of health-related quality of life between two groups in three times (p < 0.05). Although this study provides modest support for the effectiveness of Progressive Muscle Relaxation Technique on quality of life of multiple sclerosis patients, further research is required to determine better methods to promote quality of life of patients suffer multiple sclerosis and other chronic disease. Progressive Muscle Relaxation Technique is practically feasible and is associated with increase of life quality of multiple sclerosis patients; so that health professionals need to update their knowledge about complementary therapies.

Development and Implementation: B’More Healthy Communities for Kid’s Store and Wholesaler Intervention

PubMed Central

Schwendler, Teresa; Shipley, Cara; Budd, Nadine; Trude, Angela; Surkan, Pamela J.; Steeves, Elizabeth Anderson; de Morais Sato, Priscila; Eckmann, Thomas; Loh, Hong; Gittelsohn, Joel

2017-01-01

Higher rates of obesity and obesity-related chronic disease are prevalent in communities where there is limited access to affordable, healthy food. The B’More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment including food wholesalers and corner stores to improve the surrounding community’s access to healthy food. The objective of this article is to describe the development and implementation of BHCK’s corner store and wholesaler interventions through formal process evaluation. Researchers evaluated each level of the intervention to assess reach, dose delivered, and fidelity. Corner store and wholesaler reach, dose delivered, and fidelity were measured by number of interactions, promotional materials distributed, and maintenance of study materials, respectively. Overall, the corner store implementation showed moderate reach, dose delivered, and high fidelity. The wholesaler intervention was implemented with high reach, dose, and fidelity. The program held 355 corner store interactive sessions and had 9,347 community member interactions, 21% of which were with children between the ages of 10 and 14 years. There was a 15% increase in corner store promoted food stocking during Wave 1 and a 17% increase during Wave 2. These findings demonstrate a successfully implemented food retailer intervention in a low-income urban setting. PMID:28343413

The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change

PubMed Central

Dishion, Thomas; Forgatch, Marion; Chamberlain, Patricia; Pelham, William E.

2017-01-01

This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children’s adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training–Oregon model), and family attenuation and dissolution (Treatment Foster Care–Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements. PMID:27993335

Development of bilingual tools to assess functional health patterns.

PubMed

Krozy, R E; McCarthy, N C

1999-01-01

The theory and process of developing bilingual assessment tools based on Gordon's 11 functional health patterns. To facilitate assessing the individual, family, and community in a student clinical practicum in a Spanish-speaking country. Multiple family and community health promotion theories; translation theories, Gordon's Manual of Nursing Diagnosis (1982); translation/back-translation involving Ecuadorian faculty and students; student community assessments; faculty and staff workshops in Ecuador. Bilingual, culturally sensitive health assessment tools facilitate history taking, establish nursing diagnoses and interventions, and promote mutual learning. These outcomes demonstrate potential application to other systems in the international nursing community.

Development of assessment tools to measure organizational support for employee health.

PubMed

Golaszewski, Thomas; Barr, Donald; Pronk, Nico

2003-01-01

To develop systems that measure and effect organizational support for employee health. Multiple studies and developmental projects were reviewed that show the process of instrument development, metric quality testing, utilization within intervention studies, and prediction modeling efforts. Demographic patterns indicate high support levels and relationships of subsections to various employee health risks. Successes with the initial version have given rise to 2 additional evaluation tools. The availability of these systems illustrates how ecological models can be practically applied. Such efforts contribute to the paradigm shift in worksite health promotion that focuses on the organization as the target of intervention.

Opportunities and Challenges of Digital Technology for HIV Treatment and Prevention.

PubMed

Simoni, Jane M; Kutner, Bryan A; Horvath, Keith J

2015-12-01

Novel eHealth interventions are creating exciting opportunities for health promotion along the continuum of HIV care and prevention. Reviews of recent work indicate the use of multiple platforms (e.g., smartphones, social media), with trends toward individualized approaches and real-time assessments. However, the field needs more rigorous investigations to provide evidence of long-term impact on clinical indicators and should expand its targets beyond men who have sex with men and medication adherence. Challenges to the field include working within restricted funding timelines and disseminating eHealth interventions to those most in need.

An Overview of International Literature on School Interventions to Promote Mental Health and Well-being in Children and Adolescents.

PubMed

Carta, Mauro Giovanni; Fiandra, Teresa Di; Rampazzo, Lorenzo; Contu, Paolo; Preti, Antonio

2015-01-01

Mental disorders are the largest cause of the burden of disease in the world. Most of the burden affecting adult life has its onset during childhood and adolescence. The European Pact for Mental Health and Wellbeing calls for immediate action and investments in the mental health of children and adolescents. Schools may be the ideal location for promoting health and delivering healthcare services, since schools are a location where young people usually spend their daytime and socialize, schools are easily accessible to families, can provide non-stigmatizing health actions, and form links with the community. Aims and Goals of this Special Issue: This issue is developed within the framework of the Joint Action on Mental Health promoted by the European Commission. This special issue presents a set of systematic reviews on the evidence of the international literature on school interventions for the promotion of the mental health and wellbeing of children and adolescents. It is focused on five topical main areas: promoting general health and wellbeing; programs targeting specific mental disorders and conditions and integration of adolescents with mental health problems; Bullying; Sport; Alcohol and Drugs. An additional paper on the results of the largest epidemiological study conducted in some European countries on the prevalence and relative risk factors of mental disorders in school-age completes the issue. These reviews are a first contribution to address future European research and interventions, in particular about the multiple ways through which European policies could support the schooling and wellbeing of children and adolescents.

Interventions for preventing unintended pregnancies among adolescents.

PubMed

Oringanje, Chioma; Meremikwu, Martin M; Eko, Hokehe; Esu, Ekpereonne; Meremikwu, Anne; Ehiri, John E

2016-02-03

Unintended pregnancy among adolescents represents an important public health challenge in high-income countries, as well as middle- and low-income countries. Numerous prevention strategies such as health education, skills-building and improving accessibility to contraceptives have been employed by countries across the world, in an effort to address this problem. However, there is uncertainty regarding the effects of these interventions, hence the need to review the evidence-base. To assess the effects of primary prevention interventions (school-based, community/home-based, clinic-based, and faith-based) on unintended pregnancies among adolescents. We searched all relevant studies regardless of language or publication status up to November 2015. We searched the Cochrane Fertility Regulation Group Specialised trial register, The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015 Issue 11), MEDLINE, EMBASE, LILACS, Social Science Citation Index and Science Citation Index, Dissertations Abstracts Online, The Gray Literature Network, HealthStar, PsycINFO, CINAHL and POPLINE and the reference lists of articles. We included both individual and cluster randomised controlled trials (RCTs) evaluating any interventions that aimed to increase knowledge and attitudes relating to risk of unintended pregnancies, promote delay in the initiation of sexual intercourse and encourage consistent use of birth control methods to reduce unintended pregnancies in adolescents aged 10 years to 19 years. Two authors independently assessed trial eligibility and risk of bias, and extracted data. Where appropriate, binary outcomes were pooled using a random-effects model with a 95% confidence interval (Cl). Where appropriate, we combined data in meta-analyses and assessed the quality of the evidence using the GRADE approach. We included 53 RCTs that enrolled 105,368 adolescents. Participants were ethnically diverse. Eighteen studies randomised individuals, 32 randomised clusters (schools (20), classrooms (6), and communities/neighbourhoods (6). Three studies were mixed (individually and cluster randomised). The length of follow up varied from three months to seven years with more than 12 months being the most common duration. Four trials were conducted in low- and middle- income countries, and all others were conducted in high-income countries. Multiple interventionsResults showed that multiple interventions (combination of educational and contraceptive-promoting interventions) lowered the risk of unintended pregnancy among adolescents significantly (RR 0.66, 95% CI 0.50 to 0.87; 4 individual RCTs, 1905 participants, moderate quality evidence. However, this reduction was not statistically significant from cluster RCTs. Evidence on the possible effects of interventions on secondary outcomes (initiation of sexual intercourse, use of birth control methods, abortion, childbirth, sexually transmitted diseases) was not conclusive.Methodological strengths included a relatively large sample size and statistical control for baseline differences, while limitations included lack of biological outcomes, possible self-report bias, analysis neglecting clustered randomisation and the use of different statistical tests in reporting outcomes. Educational interventionsEducational interventions were unlikely to significantly delay the initiation of sexual intercourse among adolescents compared to controls (RR 0.95, 95% CI 0.71 to 1.27; 2 studies, 672 participants, low quality evidence).Educational interventions significantly increased reported condom use at last sex in adolescents compared to controls who did not receive the intervention (RR 1.18, 95% CI 1.06 to 1.32; 2 studies, 1431 participants, moderate quality evidence).However, it is not clear if the educational interventions had any effect on unintended pregnancy as this was not reported by any of the included studies. Contraceptive-promoting interventionsFor adolescents who received contraceptive-promoting interventions, there was little or no difference in the risk of unintended first pregnancy compared to controls (RR 1.01, 95% CI 0.81 to 1.26; 2 studies, 3,440 participants, moderate quality evidence).The use of hormonal contraceptives was significantly higher in adolescents in the intervention group compared to those in the control group (RR 2.22, 95% CI 1.07 to 4.62; 2 studies, 3,091 participants, high quality evidence) A combination of educational and contraceptive-promoting interventions appears to reduce unintended pregnancy among adolescents.  Evidence for programme effects on biological measures is limited. The variability in study populations, interventions and outcomes of included trials, and the paucity of studies directly comparing different interventions preclude a definitive conclusion regarding which type of intervention is most effective.

The Choice Project: Peer Workers Promoting Shared Decision Making at a Youth Mental Health Service.

PubMed

Simmons, Magenta Bender; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deb

2017-08-01

In youth mental health services, consumer participation is essential, but few implementation strategies exist to engage young consumers. This project evaluated an intervention implemented in an Australian youth mental health service that utilized peer workers to promote shared decision making via an online tool. All new clients ages 16-25 were invited to participate in this nonrandomized comparative study, which used a historical comparison group (N=80). Intervention participants (N=149) engaged with a peer worker and used the online tool before and during their intake assessment. Pre- and postintake data were collected for both groups; measures included decisional conflict, perceived shared decision making, and satisfaction. A series of paired t tests, analyses of variance, and multiple regressions were conducted to assess differences in scores across intervention and comparison groups and pre- and postintake assessments. Ratings of perceived shared decision making with intake workers were higher in the intervention group than in the comparison group (p=.015). In both groups, decisional conflict scores were significantly lower after the intake assessment (p<.001 for both groups). Both perceived shared decision making and lower decisional conflict were associated with satisfaction (p<.015). Young people who participated in an intervention that combined peer work and shared decision making reported feeling more involved in their assessment. Feeling involved and having lower decisional conflict after seeing an intake worker were important for client satisfaction. These findings demonstrate the importance of both peer work and shared decision making for promoting optimal outcomes in youth mental health services.

The 'balance intervention' for promoting caloric compensatory behaviours in response to overeating: a formative evaluation.

PubMed

Wammes, Birgitte; Breedveld, Boudewijn; Kremers, Stef; Brug, Johannes

2006-08-01

To help people prevent weight gain, the Netherlands Nutrition Centre initiated the 'balance intervention', which promotes moderation of food intake and/or increased physical activity in response to occasions of overeating. The aim of this study was to determine whether intervention materials were appreciated, encouraged information seeking and increased motivation and caloric compensatory behaviours. A three-group randomized trial with pre-intervention measures (n = 963, response 86%) and post-intervention measures (n = 857) using electronic questionnaires was conducted among participants aged 25-40 years, recruited from an Internet research panel. The first group received a printed brochure and electronic newsletters (print group), the second group was exposed to radio advertisements (radio group) and the third group was the control group. Multiple regression analyses were used to investigate the impact of the materials on self-reported prevalence of overeating, attitudes, perceived behavioural control, intentions and compensatory behaviours. At follow-up, we found significantly more positive attitudes, intentions and dietary action in the print and radio groups. However, participants who received the radio advertisement had a significantly lower perceived behavioural control. No effects were found on the prevalence of overeating. The results indicate that the intervention materials have potential for increasing people's attitudes, motivation and self-reported behaviour actions, with a possible negative side-effect on perceived behavioural control.

Health-promotion research over three decades: The social-ecological model and challenges in implementation of interventions.

PubMed

Wold, Bente; Mittelmark, Maurice B

2018-02-01

This debate paper traces the development of innovative methods for undertaking health promotion research with a socialecological orientation, with a few examples drawn from 30 years of research on adolescent health promotion research at the University of Bergen. We aim to show how the social-ecological model is becoming more evident as a guide to research, using three cases that illustrate progress and potential. The first case is the Norwegian part of the European Network of Health Promoting Schools. The second case is a project just underway, The COMPLETE study, which is a community-led effort to promote students' mental health and create a good psychosocial learning environment. The third case is a developing idea for the next generation of social-ecological research on adolescent well-being, using an asset approach to foster social inclusion and sense of community in multiple settings.

A Randomized Controlled Trial Examination of a Remote Parenting Intervention: Engagement and Effects on Parenting Behavior and Child Abuse Potential.

PubMed

Baggett, Kathleen; Davis, Betsy; Feil, Edward; Sheeber, Lisa; Landry, Susan; Leve, Craig; Johnson, Ursula

2017-11-01

Technology advances increasingly allow for access to remotely delivered interventions designed to promote early parenting practices that protect against child maltreatment. Among low-income families, at somewhat elevated risk for child maltreatment, there is some evidence that parents do engage in and benefit from remote-coaching interventions. However, little is known about the effectiveness of such programs to engage and benefit families at high risk for child maltreatment due to multiple stressors associated with poverty. To address this limitation, we examined engagement and outcomes among mothers at heightened risk for child abuse, who were enrolled in a randomized controlled, intent-to-treat trial of an Internet adaptation of an evidence-based infant parenting intervention. We found that engagement patterns were similar between higher and lower risk groups. Moreover, an intervention dose by condition effect was found for increased positive parent behavior and reduced child abuse potential.

Adaptive Interventions and SMART Designs: Application to child behavior research in a community setting

PubMed Central

Kidwell, Kelley M.; Hyde, Luke W.

2016-01-01

Heterogeneity between and within people necessitates the need for sequential personalized interventions to optimize individual outcomes. Personalized or adaptive interventions (AIs) are relevant for diseases and maladaptive behavioral trajectories when one intervention is not curative and success of a subsequent intervention may depend on individual characteristics or response. AIs may be applied to medical settings and to investigate best prevention, education, and community-based practices. AIs can begin with low-cost or low-burden interventions and followed with intensified or alternative interventions for those who need it most. AIs that guide practice over the course of a disease, program, or school year can be investigated through sequential multiple assignment randomized trials (SMARTs). To promote the use of SMARTs, we provide a hypothetical SMART in a Head Start program to address child behavior problems. We describe the advantages and limitations of SMARTs, particularly as they may be applied to the field of evaluation. PMID:28239254

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

PubMed Central

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

2009-01-01

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

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

PubMed

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

2009-08-01

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

A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

PubMed Central

2012-01-01

Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening uptake. Intervention effectiveness appears to vary with ethnic population, methods of program delivery, and study setting. Conclusions Despite some limitations, our review has demonstrated that the effectiveness of existing interventions to promote breast and cervical cancer screening uptake in Asian women may hinge on a variety of factors, such as type of intervention and study population characteristics. While some studies demonstrated the effectiveness of certain intervention programs, the cost effectiveness and long-term sustainability of these programs remain questionable. When adopting an intervention program, it is important to consider the impacts of social-and cultural factors specific to the Asian population on cancer screening uptake. Future research is needed to develop new interventions and tools, and adopt vigorous study design and evaluation methodologies to increase cancer screening among Asian women to promote population health and health equity. PMID:22676147

A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women.

PubMed

Lu, Mingshan; Moritz, Sabina; Lorenzetti, Diane; Sykes, Lindsay; Straus, Sharon; Quan, Hude

2012-06-07

The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening uptake. Intervention effectiveness appears to vary with ethnic population, methods of program delivery, and study setting. Despite some limitations, our review has demonstrated that the effectiveness of existing interventions to promote breast and cervical cancer screening uptake in Asian women may hinge on a variety of factors, such as type of intervention and study population characteristics. While some studies demonstrated the effectiveness of certain intervention programs, the cost effectiveness and long-term sustainability of these programs remain questionable. When adopting an intervention program, it is important to consider the impacts of social-and cultural factors specific to the Asian population on cancer screening uptake. Future research is needed to develop new interventions and tools, and adopt vigorous study design and evaluation methodologies to increase cancer screening among Asian women to promote population health and health equity.

Fair Play Game: A Group Contingency Strategy to Increase Students' Active Behaviours in Physical Education

ERIC Educational Resources Information Center

Vidoni, Carla; Lee, Chang-Hung; Azevedo, L. B.

2014-01-01

A dependent group contingency strategy called Fair Play Game was applied to promote increase in number of steps during physical education classes for sixth-grade students. Results from a multiple baseline design across three classes showed that the mean number of steps for baseline vs. intervention were: Class 1: 43 vs. 64 steps/minute; Class 2:…

An Evaluation of a Teaching Intervention to Promote Students' Ability to Use Multiple Levels of Representation when Describing and Explaining Chemical Reactions

ERIC Educational Resources Information Center

Chandrasegaran, A. L.; Treagust, David F.; Mocerino, Mauro

2008-01-01

Students are generally known to memorise and regurgitate chemical equations without sufficient understanding of the changes that occur at the particulate level. In addition, they often fail to recognise the significance of the symbols and formulas that are used to represent chemical reactions. This article describes an evaluation of the ability of…

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

PubMed Central

Damschroder, Laura J; Aron, David C; Keith, Rosalind E; Kirsh, Susan R; Alexander, Jeffery A; Lowery, Julie C

2009-01-01

Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings. PMID:19664226

Correlates of STI testing among vocational school students in the Netherlands

PubMed Central

2010-01-01

Background Adolescents are at risk for acquiring sexually transmitted infections (STIs). However, test rates among adolescents in the Netherlands are low and effective interventions that encourage STI testing are scarce. Adolescents who attend vocational schools are particularly at risk for STI. The purpose of this study is to inform the development of motivational health promotion messages by identifying the psychosocial correlates of STI testing intention among adolescents with sexual experience attending vocational schools. Methods This study was conducted among 501 students attending vocational schools aged 16 to 25 years (mean 18.3 years ± 2.1). Data were collected via a web-based survey exploring relationships, sexual behavior and STI testing behavior. Items measuring the psychosocial correlates of testing were derived from Fishbein's Integrative Model. Data were subjected to multiple regression analyses. Results Students reported substantial sexual risk behavior and low intention to participate in STI testing. The model explained 39% of intention to engage in STI testing. The most important predictor was attitude. Perceived norms, perceived susceptibility and test site characteristics were also significant predictors. Conclusions The present study provides important and relevant empirical input for the development of health promotion interventions aimed at motivating adolescents at vocational schools in the Netherlands to participate in STI testing. Health promotion interventions developed for this group should aim to change attitudes, address social norms and increase personal risk perception for STI while also promoting the accessibility of testing facilities. PMID:21106064

A Whole Community Approach toward Child and Youth Resilience Promotion: A Review of Resilience Literature.

PubMed

Khanlou, Nazilla; Wray, Ron

2014-01-01

A literature review of child and youth resilience with a focus on: definitions and factors of resilience; relationships between resilience, mental health and social outcomes; evidence for resilience promoting interventions; and implications for reducing health inequities. To conduct the review, the first two following steps were conducted iteratively and informed the third step: 1) Review of published peer-review literature since 2000; and 2) Review of grey literature; and 3) Quasi-realist synthesis of evidence. Evidence from three perspectives were examined: i) whether interventions can improve 'resilience' for vulnerable children and youth; ii) whether there is a differential effect among different populations; and, iii) whether there is evidence that resilience interventions 'close the gap' on health and social outcome measures. Definitions of resilience vary as do perspectives on it. We argue for a hybrid approach that recognizes the value of combining multiple theoretical perspectives, epistemologies (positivistic and constructivist/interpretive/critical) in studying resilience. Resilience is: a) a process (rather than a single event), b) a continuum (rather than a binary outcome), and c) likely a global concept with specific dimensions. Individual, family and social environmental factors influence resilience. A social determinants perspective on resilience and mental health is emphasized. Programs and interventions to promoting resilience should be complimentary to public health measures addressing the social determinants of health. A whole community approach to resilience is suggested as a step toward closing the public health policy gap. Local initiatives that stimulate a local transformation process are needed. Recognition of each child's or youth's intersections of gender, lifestage, family resources within the context of their identity markers fits with a localized approach to resilience promotion and, at the same time, requires recognition of the broader determinants of population health.

Pediatric multiple sclerosis: current perspectives on health behaviors.

PubMed

Sikes, Elizabeth Morghen; Motl, Robert W; Ness, Jayne M

2018-01-01

Pediatric-onset multiple sclerosis (POMS) accounts for ~5% of all multiple sclerosis cases, and has a prevalence of ~10,000 children in the USA. POMS is associated with a higher relapse rate, and results in irreversible disability on average 10 years earlier than adult-onset multiple sclerosis. Other manifestations of POMS include mental and physical fatigue, cognitive impairment, and depression. We believe that the health behaviors of physical activity, diet, and sleep may have potential benefits in POMS, and present a scoping review of the existing literature. We identified papers by searching three electronic databases (PubMed, GoogleScholar, and CINAHL). Search terms included: pediatric multiple sclerosis OR pediatric onset multiple sclerosis OR POMS AND health behavior OR physical activity OR sleep OR diet OR nutrition OR obesity. Papers were included in this review if they were published in English, referenced nutrition, diet, obesity, sleep, exercise, or physical activity, and included pediatric-onset multiple sclerosis as a primary population. Twenty papers were identified via the literature search that addressed health-promoting behaviors in POMS, and 11, 8, and 3 papers focused on diet, activity, and sleep, respectively. Health-promoting behaviors were associated with markers of disease burden in POMS. Physical activity participation was associated with reduced relapse rate, disease burden, and sleep/rest fatigue symptoms. Nutritional factors, particularly vitamin D intake, may be associated with relapse rate. Obesity has been associated with increased risk of developing POMS. POMS is associated with better sleep hygiene, and this may benefit fatigue and quality of life. Participation in health behaviors, particularly physical activity, diet, and sleep, may have benefits for POMS. Nevertheless, there are currently no interventions targeting promotion of these behaviors and examining the benefits of managing the primary and secondary manifestations of POMS.

Using Multiple Schedules During Functional Communication Training to Promote Rapid Transfer of Treatment Effects

PubMed Central

Fisher, Wayne W.; Greer, Brian D.; Fuhrman, Ashley M.; Querim, Angie C.

2016-01-01

Multiple schedules with signaled periods of reinforcement and extinction have been used to thin reinforcement schedules during functional communication training (FCT) to make the intervention more practical for parents and teachers. We evaluated whether these signals would also facilitate rapid transfer of treatment effects from one setting to the next and from one therapist to the next. With two children, we conducted FCT in the context of mixed (baseline) and multiple (treatment) schedules introduced across settings or therapists using a multiple baseline design. Results indicated that when the multiple schedules were introduced, the functional communication response came under rapid discriminative control, and problem behavior remained at near-zero rates. We extended these findings with another individual by using a more traditional baseline in which problem behavior produced reinforcement. Results replicated those of the previous participants and showed rapid reductions in problem behavior when multiple schedules were implemented across settings. PMID:26384141

Using multiple schedules during functional communication training to promote rapid transfer of treatment effects.

PubMed

Fisher, Wayne W; Greer, Brian D; Fuhrman, Ashley M; Querim, Angie C

2015-12-01

Multiple schedules with signaled periods of reinforcement and extinction have been used to thin reinforcement schedules during functional communication training (FCT) to make the intervention more practical for parents and teachers. We evaluated whether these signals would also facilitate rapid transfer of treatment effects across settings and therapists. With 2 children, we conducted FCT in the context of mixed (baseline) and multiple (treatment) schedules introduced across settings or therapists using a multiple baseline design. Results indicated that when the multiple schedules were introduced, the functional communication response came under rapid discriminative control, and problem behavior remained at near-zero rates. We extended these findings with another individual by using a more traditional baseline in which problem behavior produced reinforcement. Results replicated those of the previous participants and showed rapid reductions in problem behavior when multiple schedules were implemented across settings. © Society for the Experimental Analysis of Behavior.

[Posttraumatic retroperitoneal hematoma in injured persons with severe closed multiple and combined abdominal trauma].

PubMed

Rylov, A I; Kravets, N S

2001-01-01

The experience of treatment of 69 injured persons with posttraumatic retroperitoneal hematoma suffering severe multiple combined abdominal trauma was analyzed. Application of the classification proposed permits to formulate diagnosis and to choose the tactic of treatment correctly. The intraoperative tactics algorithm was elaborated. It promotes the correct analysis of intraoperative findings and reduction of the diagnostic mistakes frequency as well. In the presence of vast defect, making impossible to suture over the parietal peritoneum, extraperitonization using cerebral dura mater was done. Operative intervention was concluded by drainage with subsequent laserotherapy.

Community, culture and sustainability in multilevel dynamic systems intervention science.

PubMed

Schensul, Jean J

2009-06-01

This paper addresses intertwined issues in the conceptualization, implementation and evaluation of multilevel dynamic systems intervention science (MDSIS). Interventions are systematically planned, conducted and evaluated social science-based cultural products intercepting the lives of people and institutions in the context of multiple additional events and processes (which also may be referred to as interventions) that may speed, slow or reduce change towards a desired outcome. Multilevel interventions address change efforts at multiple social levels in the hope that effects at each level will forge synergistic links, facilitating movement toward desired change. This paper utilizes an ecological framework that identifies macro (policy and regulatory institutions), meso (organizations and agencies with resources, and power) and micro (individuals, families and friends living in communities) interacting directly and indirectly. An MDSIS approach hypothesizes that change toward a goal will occur faster and more effectively when synchronized and supported across levels in a social system. MDSIS approaches by definition involve "whole" communities and cannot be implemented without the establishments of working community partnerships This paper takes a dynamic systems approach to science as conducted in communities, and discusses four concepts that are central to MDSIS--science, community, culture, and sustainability. These concepts are important in community based participatory research and to the targeting, refinement, and adaptation of enduring interventions. Consistency in their meaning and use can promote forward movement in the field of MDSIS, and in community-based prevention science.

Can Population Levels of Physical Activity be Increased? Global Evidence and Experience

PubMed Central

Pratt, Michael; Perez, Lilian G.; Goenka, Shifalika; Brownson, Ross C.; Bauman, Adrian; Sarmiento, Olga Lucia; Hallal, Pedro C.

2016-01-01

Physical inactivity is one of the most important contributors to the global burden of disease and has become a global public health priority. We review the evidence on physical activity (PA) interventions, actions, and strategies that have the greatest potential to increase PA at the population level. Using the socio-ecological framework to conceptualize PA interventions, we show that PA can be targeted at multiple levels of influence and by multiple sectors outside the health system. Examples of promoting PA on a national scale are presented from Finland, Canada, Brazil, and Colombia. A strong policy framework, consistent investment in public health programs, multi-sectoral support and actions, and good surveillance characterize each of these success stories. Increasing PA globally will depend on successfully applying and adapting these lessons around the world taking into account country, culture, and context. PMID:25304047

Sexual Relationship Power, Intimate Partner Violence, and Condom Use Among Minority Urban Girls

PubMed Central

Teitelman, Anne M.; Ratcliffe, Sarah J.; Morales-Aleman, Mercedes M.; Sullivan, Cris M.

2011-01-01

This study examined the association between sexual relationship power, intimate partner violence, and condom use among African American and Hispanic urban girls. In this sample of 56 sexually active girls, 50% did not use condoms consistently and therefore were at higher risk for acquiring HIV or sexually transmitted diseases (STDs). Teens who experienced more intimate partner violence had a significantly higher likelihood of inconsistent condom use and therefore a greater risk for HIV/STDs. Girls' sense of sexual control in their relationships was not directly associated with inconsistent condom use but was inversely related to verbal and emotional abuse. Interventions aimed at reducing HIV/STD risk for adolescent girls need to address patterns of dominance and control in adolescent relationships as well as multiple forms of partner violence. This suggests the need for multilevel intervention approaches that promote girls' agency and multiple ways to keep girls safe from perpetrators of partner abuse. PMID:18349344

Can population levels of physical activity be increased? Global evidence and experience.

PubMed

Pratt, Michael; Perez, Lilian G; Goenka, Shifalika; Brownson, Ross C; Bauman, Adrian; Sarmiento, Olga Lucia; Hallal, Pedro C

2015-01-01

Physical inactivity is one of the most important contributors to the global burden of disease and has become a global public health priority. We review the evidence on physical activity (PA) interventions, actions, and strategies that have the greatest potential to increase PA at the population level. Using the socio-ecological framework to conceptualize PA interventions, we show that PA can be targeted at multiple levels of influence and by multiple sectors outside the health system. Examples of promoting PA on a national scale are presented from Finland, Canada, Brazil, and Colombia. A strong policy framework, consistent investment in public health programs, multi-sectoral support and actions, and good surveillance characterize each of these success stories. Increasing PA globally will depend on successfully applying and adapting these lessons around the world taking into account country, culture, and context. Published by Elsevier Inc.

Creating a Community of Practice to Prevent Suicide Through Multiple Channels: Describing the Theoretical Foundations and Structured Learning of PC CARES.

PubMed

Wexler, Lisa; McEachern, Diane; DiFulvio, Gloria; Smith, Cristine; Graham, Louis F; Dombrowski, Kirk

2016-01-01

It is critical to develop practical, effective, ecological, and decolonizing approaches to indigenous suicide prevention and health promotion for the North American communities. The youth suicide rates in predominantly indigenous small, rural, and remote Northern communities are unacceptably high. This health disparity, however, is fairly recent, occurring over the last 50 to 100 years as communities experienced forced social, economic, and political change and intergenerational trauma. These conditions increase suicide risk and can reduce people's access to shared protective factors and processes. In this context, it is imperative that suicide prevention includes--at its heart--decolonization, while also utilizing the "best practices" from research to effectively address the issue from multiple levels. This article describes such an approach: Promoting Community Conversations About Research to End Suicide (PC CARES). PC CARES uses popular education strategies to build a "community of practice" among local and regional service providers, friends, and families that fosters personal and collective learning about suicide prevention in order to spur practical action on multiple levels to prevent suicide and promote health. This article will discuss the theoretical underpinnings of the community intervention and describe the form that PC CARES takes to structure ongoing dialogue, learning, solidarity, and multilevel mobilization for suicide prevention. © The Author(s) 2016.

Creating a Community of Practice to Prevent Suicide Through Multiple Channels: Describing the Theoretical Foundations and Structured Learning of PC CARES

PubMed Central

Wexler, Lisa; McEachern, Diane; DiFulvio, Gloria; Smith, Cristine; Graham, Louis F.; Dombrowski, Kirk

2016-01-01

It is critical to develop practical, effective, ecological, and decolonizing approaches to indigenous suicide prevention and health promotion for the North American communities. The youth suicide rates in predominantly indigenous small, rural, and remote Northern communities are unacceptably high. This health disparity, however, is fairly recent, occurring over the last 50 to 100 years as communities experienced forced social, economic, and political change and intergenerational trauma. These conditions increase suicide risk and can reduce people’s access to shared protective factors and processes. In this context, it is imperative that suicide prevention includes—at its heart—decolonization, while also utilizing the “best practices” from research to effectively address the issue from multiple levels. This article describes such an approach: Promoting Community Conversations About Research to End Suicide (PC CARES). PC CARES uses popular education strategies to build a “community of practice” among local and regional service providers, friends, and families that fosters personal and collective learning about suicide prevention in order to spur practical action on multiple levels to prevent suicide and promote health. This article will discuss the theoretical underpinnings of the community intervention and describe the form that PC CARES takes to structure ongoing dialogue, learning, solidarity, and multilevel mobilization for suicide prevention. PMID:26880738

Using health promotion guidelines for persons with disabilities to develop and evaluate a physical activity program for individuals with multiple sclerosis: A feasibility study.

PubMed

Dixon-Ibarra, Alicia; Nery-Hurwit, Mara; Driver, Simon; MacDonald, Megan

2017-04-01

The Health Education for Persons with Multiple Sclerosis (HEMS) program was developed in response to the need for interventions aimed at increasing physical activity for individuals with Multiple Sclerosis (MS). It was developed and evaluated using Drum and colleagues (2009) guidelines for implementing health promotion programs for individuals with disabilities. The purpose of this feasibility study is to describe the development, implementation, and evaluation of the HEMS program. Thirteen individuals with MS completed the 8-week health education program. A mixed method approach for evaluation was implemented (i.e., survey and focus groups). Process and resource feasibility demonstrated that over half of the participants attended at least 80% of the weekly sessions. Focus group data provided valuable feedback for future iterations of the program including critiques on the delivery, content, and group support provided. Outcome evaluation showed increases in self-efficacy (survey), improvements in theoretical constructs (focus groups), and increased physical activity (focus groups). Results show that health promotion programs for persons with MS can improve physical activity and related constructs. Next steps will be to revise, implement, and reevaluate the HEMS program in a larger randomized control trial. Published by Elsevier Ltd.

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.

A worksite intervention to reduce the cardiovascular risk: proposal of a study design easy to integrate within Italian organization of occupational health surveillance.

PubMed

Mastrangelo, Giuseppe; Marangi, Gianluca; Bontadi, Danilo; Fadda, Emanuela; Cegolon, Luca; Bortolotto, Melania; Fedeli, Ugo; Marchiori, Luciano

2015-01-21

Despite the substantial amount of knowledge on effectiveness of worksite health promotion (WHP) in reducing cardiovascular disease (CVD) risk, WHP programs are not systematically applied in Italy. The aim was to design an intervention easy to integrate within the Italian organization of workplace health surveillance. We used the "pretest-posttest design". Workers were employed in multiple occupations and resident in Veneto region, Italy. Occupational physicians (OPs) performed all examinations, including laboratory evaluation (capillary blood sampling and measure of glycaemia and cholesterolemia with portable devices), during the normal health surveillance at worksite. CVD risk was computed based on sex, age, smoking habit, diabetes, systolic pressure and cholesterol level. After excluding those with <40 years of age, missing consent, CVD diagnosis or current therapy for CVD, missing information, CVD risk <5%, out of 5,536 workers 451 underwent the intervention and 323 male workers were re-examined at 1 year. CVD risk was the most compelling argument for changing lifestyle. The counseling was based on the individual risk factors. Individuals examined at posttest were a small fraction of the whole (6% = 323/5,536). In these workers we computed the ratio pretest/posttest of proportions (such as percent of subjects with cardiovascular risk >5%) as well as the exact McNemar significance probability or the exact test of table symmetry. CVD risk decreased by 24% (McNemar p = 0.0000) after the intervention; in a sensitivity analysis assuming that all subjects lost to follow-up kept their pretest cardiovascular risk value, the effect (-18%) was still significant (symmetry p < 0.0000). Each prevented CVD case was expected to cost about 5,700 euro. The present worksite intervention promoted favorable changes of CVD risk that were reasonably priced and consistent across multiple occupations.

Promoting Fitness and Safety in Elementary Students: A Randomized Control Study of the Michigan Model for Health.

PubMed

O'Neill, James M; Clark, Jeffrey K; Jones, James A

2016-07-01

In elementary grades, comprehensive health education curricula have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on nutrition, physical fitness, and safety knowledge and skills. Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received MMH with 24 lessons in grade 4 and 28 more lessons in grade 5 including material focusing on nutrition, physical fitness, and safety attitudes and skills. The 40-minute lessons were taught by the classroom teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (N = 1983) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade. Analysis of the scales was conducted using a mixed-model approach. Students who received the curriculum had better nutrition, physical activity, and safety skills than the control-group students. Intervention students also reported higher consumption of fruits; however, no difference was reported for other types of food consumption. The effectiveness of the MMH in promoting fitness and safety supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools. © 2016, American School Health Association.

Identification of Altered Metabolomic Profiles Following a Panchakarma-based Ayurvedic Intervention in Healthy Subjects: The Self-Directed Biological Transformation Initiative (SBTI).

PubMed

Peterson, Christine Tara; Lucas, Joseph; John-Williams, Lisa St; Thompson, J Will; Moseley, M Arthur; Patel, Sheila; Peterson, Scott N; Porter, Valencia; Schadt, Eric E; Mills, Paul J; Tanzi, Rudolph E; Doraiswamy, P Murali; Chopra, Deepak

2016-09-09

The effects of integrative medicine practices such as meditation and Ayurveda on human physiology are not fully understood. The aim of this study was to identify altered metabolomic profiles following an Ayurveda-based intervention. In the experimental group, 65 healthy male and female subjects participated in a 6-day Panchakarma-based Ayurvedic intervention which included herbs, vegetarian diet, meditation, yoga, and massage. A set of 12 plasma phosphatidylcholines decreased (adjusted p < 0.01) post-intervention in the experimental (n = 65) compared to control group (n = 54) after Bonferroni correction for multiple testing; within these compounds, the phosphatidylcholine with the greatest decrease in abundance was PC ae C36:4 (delta = -0.34). Application of a 10% FDR revealed an additional 57 metabolites that were differentially abundant between groups. Pathway analysis suggests that the intervention results in changes in metabolites across many pathways such as phospholipid biosynthesis, choline metabolism, and lipoprotein metabolism. The observed plasma metabolomic alterations may reflect a Panchakarma-induced modulation of metabotypes. Panchakarma promoted statistically significant changes in plasma levels of phosphatidylcholines, sphingomyelins and others in just 6 days. Forthcoming studies that integrate metabolomics with genomic, microbiome and physiological parameters may facilitate a broader systems-level understanding and mechanistic insights into these integrative practices that are employed to promote health and well-being.

Evaluating the effect of integrated microfinance and health interventions: an updated review of the evidence.

PubMed

Lorenzetti, Lara M J; Leatherman, Sheila; Flax, Valerie L

2017-06-01

Solutions delivered within firm sectoral boundaries are inadequate in achieving income security and better health for poor populations. Integrated microfinance and health interventions leverage networks of women to promote financial inclusion, build livelihoods, and safeguard against high cost illnesses. Our understanding of the effect of integrated interventions has been limited by variability in intervention, outcome, design, and methodological rigour. This systematic review synthesises the literature through 2015 to understand the effect of integrated microfinance and health programs. We searched PubMed, Scopus, Embase, EconLit, and Global Health databases and sourced bibliographies, identifying 964 articles exclusive of duplicates. Title, abstract, and full text review yielded 35 articles. Articles evaluated the effect of intentionally integrated microfinance and health programs on client outcomes. We rated the quality of evidence for each article. Most interventions combined microfinance with health education, which demonstrated positive effects on health knowledge and behaviours, though not health status. Among programs that integrated microfinance with other health components ( i.e. health micro-insurance, linkages to health providers, and access to health products), results were generally positive but mixed due to the smaller number and quality of studies. Interventions combining multiple health components in a given study demonstrated positive effects, though it was unclear which component was driving the effect. Most articles (57%) were moderate in quality. Integrated microfinance and health education programs were effective, though longer intervention periods are necessary to measure more complex pathways to health status. The effect of microfinance combined with other health components was less clear. Stronger randomized research designs with multiple study arms are required to improve evidence and disentangle the effects of multiple component microfinance and health interventions. Few studies attempted to understand changes in economic outcomes, limiting our understanding of the relationship between health and income effects. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[Health knowledge, health promoting behavior and factors influencing health promoting behavior of north korean defectors in South Korea].

PubMed

Choe, Myoung Ae; Yi, Myungsun; Choi, Jung An; Shin, Gisoo

2012-10-01

The purpose of this study was to identify health knowledge, health promoting behavior and factors influencing health promoting behavior of North Korean defectors in South Korea. Participants in this study were 410 North Korean defectors, over 20 years of age residing in Seoul. They were recruited by snowball sampling. Data were collected from April to June, 2010. Health knowledge, health promoting behavior, self-efficacy, perceived barriers to health promoting behavior and social support were measured by structured questionnaires, and perceived physical and mental health status were measured by one item with 10-point numeric rating scale. The data were analyzed using t-test, ANOVA, and multiple regression. Health knowledge, health promoting behavior, and perceived barriers to health promoting behavior were moderate while self-efficacy and social support were high. Factors influencing health promoting behavior of the participants were found to be self-efficacy, social support and perceived barrier to health promoting behavior. The results of this study indicate that nursing intervention programs enhancing self-efficacy, social support and reducing perceived barriers to health promoting behavior need to be developed for North Korean defectors in South Korea.

Inflammatory response and extracorporeal circulation.

PubMed

Kraft, Florian; Schmidt, Christoph; Van Aken, Hugo; Zarbock, Alexander

2015-06-01

Patients undergoing cardiac surgery with extracorporeal circulation (EC) frequently develop a systemic inflammatory response syndrome. Surgical trauma, ischaemia-reperfusion injury, endotoxaemia and blood contact to nonendothelial circuit compounds promote the activation of coagulation pathways, complement factors and a cellular immune response. This review discusses the multiple pathways leading to endothelial cell activation, neutrophil recruitment and production of reactive oxygen species and nitric oxide. All these factors may induce cellular damage and subsequent organ injury. Multiple organ dysfunction after cardiac surgery with EC is associated with an increased morbidity and mortality. In addition to the pathogenesis of organ dysfunction after EC, this review deals with different therapeutic interventions aiming to alleviate the inflammatory response and consequently multiple organ dysfunction after cardiac surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep, health behaviors, and behavioral interventions: Reducing the risk of cardiovascular disease in adults

PubMed Central

Kaar, Jill L; Luberto, Christina M; Campbell, Kirsti A; Huffman, Jeff C

2017-01-01

Numerous health behaviors, including physical activity, diet, smoking, and sleep, play a major role in preventing the development and progression of cardiovascular disease (CVD). Among these behaviors, sleep may play a pivotal role, yet it has been studied somewhat less than other behaviors and there have been few well-designed sleep intervention studies targeting CVD. Furthermore, despite the fact that these behaviors are often interrelated, interventions tend to focus on changing one health behavior rather than concurrently intervening on multiple behaviors. Psychological constructs from depression to positive affect may also have a major effect on these health behaviors and ultimately on CVD. In this review, we summarize the existing literature on the impact of sleep and other cardiac health behaviors on CVD onset and prognosis. We also describe interventions that may promote these behaviors, from established interventions such as motivational interviewing and cognitive behavioral therapy, to more novel approaches focused on mindfulness and other positive psychological constructs. Finally, we outline population-health-level care management approaches for patients with psychiatric conditions (e.g., depression) that may impact cardiac health, and discuss their potential utility in improving mental health, promoting health behaviors, and reducing CVD-related risk. Much work is still needed to better understand how sleep and other health behaviors may uniquely contribute to CVD risk, and additional high-quality studies of interventions designed to modify cardiac health behaviors are required to improve cardiovascular health in individuals and the population at large. PMID:28603586

[Motivational interviewing of unemployed acceptance and effects of counselling to improve health-related behaviour].

PubMed

Hanewinkel, R; Wewel, M; Stephan, C; Isensee, B; Wiborg, G

2006-04-01

Conception, implementation and evaluation of a risk-reducing and health-promoting brief intervention addressed to unemployed. Control-group-study with repeated measurement. 131 unemployed took part in the intervention group and 95 persons were matched according to age and sex and served as a reference group. The intervention group were recruited via flyers, press articles and several institutions, the reference group via the journal of a health insurance company. The reference group received a questionnaire twice assessing the same health-related variables as the intervention group. In the intervention group, life style-related variables - eating habits, exercising, smoking, alcohol consumption - were assessed via questionnaire. In a one-hour counselling session based on Motivational Interviewing, participants received an individual feedback on their results of the questionnaire, including a comparison against standards and a review of their personal risks and negative consequences as well as advice and recommendations, while the decision for or against a behaviour change was left to the participant. 85.2 % of the participants of the intervention reported that the counselling met their expectations, and 86.2 % would recommend the intervention to a friend. Statistically significant effects for the intervention group compared to the control group from pre- to post-measurement could be shown for alcohol consumption, eating habits, and exercise (p

Outsmart HPV: Acceptability and short-term effects of a web-based HPV vaccination intervention for young adult gay and bisexual men.

PubMed

McRee, Annie-Laurie; Shoben, Abigail; Bauermeister, Jose A; Katz, Mira L; Paskett, Electra D; Reiter, Paul L

2018-01-10

Effective interventions to promote human papillomavirus (HPV) vaccination are needed, particularly among populations at increased risk of HPV-related disease. We developed and pilot tested a web-based intervention, Outsmart HPV, to promote HPV vaccination among young gay and bisexual men (YGBM). In 2016, we recruited a national sample (n = 150) of YGBM ages 18-25 in the United States who had not received any doses of HPV vaccine. Participants were randomized to receive either standard HPV vaccination information (control) or population-targeted, individually-tailored content (Outsmart HPV intervention). We assessed between group differences in HPV vaccination attitudes and beliefs immediately following the intervention using multiple linear regression. There were no differences in HPV vaccination attitudes, beliefs and intentions between groups at baseline. Compared to participants in the control group, intervention participants reported: greater perception that men who have sex with men are at higher risk for anal cancer relative to other men (b = 0.34); greater HPV vaccination self-efficacy (b = 0.15); and fewer perceived harms of HPV vaccine (b = -0.34) on posttest surveys (all p < .05). Overall, intervention participants reported high levels of acceptability and satisfaction with the Outsmart HPV intervention (all > 4.4 on a 5-point scale). Findings from this study provide preliminary support for a brief, tailored web-based intervention in improving HPV vaccination attitudes and beliefs among YGBM. An important next step is to determine the effects of Outsmart HPV on HPV vaccine uptake. ClinicalTrials.gov identifier NCT02835755. Copyright © 2018 Elsevier Ltd. All rights reserved.

A multicontext approach to promoting transfer of strategy use and self regulation after brain injury: An exploratory study.

PubMed

Toglia, Joan; Johnston, Mark V; Goverover, Yael; Dain, Barry

2010-01-01

Persons with brain injury frequently demonstrate decreased ability to monitor and apply strategies learned in treatment to everyday situations. The aim of this study is to refine, explore and provide preliminary testing of the multicontext approach in promoting strategy use across situations and increasing self-regulation, awareness and functional performance. This study used a single-subject design with repeated measures pre- and post-intervention, with data analysed descriptively and graphically. Four persons with difficulty following multi-step directions, 3-5 years post-TBI, received a nine session intervention programme. Outcome measures included the Awareness Questionnaire, Self-Regulation Skills Interview, Behavior Rating Inventory of Executive Function, Multiple Errands Test and an Executive Function Performance Test sub-task. The process of change within each treatment session was examined with strategy and awareness ratings. All participants demonstrated positive changes in self-regulatory skills and strategy use that was observed across tasks. As expected, general awareness of deficits remained unchanged. Examination of individual participants revealed important, varying patterns of change in strategy use, learning transfer and self-awareness across intervention. Results provide preliminary support for the feasibility and efficacy of the multicontext approach in promoting transfer of strategy use to enhance functional performance and selective aspects of awareness. Further investigation, including a larger controlled study, is needed to confirm or limit these observations.

Methods for the cultural adaptation of a diabetes lifestyle intervention for Latinas: an illustrative project.

PubMed

Osuna, Diego; Barrera, Manuel; Strycker, Lisa A; Toobert, Deborah J; Glasgow, Russell E; Geno, Cristy R; Almeida, Fabio; Perdomo, Malena; King, Diane; Doty, Alyssa Tinley

2011-05-01

Because Latinas experience a high prevalence of type 2 diabetes and its complications, there is an urgent need to reach them with interventions that promote healthful lifestyles. This article illustrates a sequential approach that took an effective multiple-risk-factor behavior-change program and adapted it for Latinas with type 2 diabetes. Adaptation stages include (a) information gathering from literature and focus groups, (b) preliminary adaptation design, and (c) preliminary adaptation test. In this third stage, a pilot study finds that participants were highly satisfied with the intervention and showed improvement across diverse outcomes. Key implications for applications include the importance of a model for guiding cultural adaptations, and the value of procedures for obtaining continuous feedback from staff and participants during the preliminary adaptation test.

The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit.

PubMed

Picheansathian, Wilawan; Pearson, Alan; Suchaxaya, Prakin

2008-08-01

This quasi-experimental study aimed to identify the impact of a promotion programme on hand hygiene practices and its effect on nosocomial infection rates in a neonatal intensive care unit of a university hospital in Thailand. The study populations were 26 nursing personnel. After implementing a hand hygiene promotion programme, compliance with hand hygiene among nursing personnel improved significantly from 6.3% before the programme to 81.2% 7 months after the programme. Compliance rate did not correlate with the intensity of patient care. Nosocomial infection rate did not decrease after the intervention, probably because of the multifactorial nature of infections. All participants agreed that promotion programme implemented in this project motivated them to practise better hand hygiene. This study indicated that multiple approaches and persistent encouragement are key factors leading to a sustained high level of appropriate hand hygiene practices among nursing personnel.

Reframing Health Promotion for People With Intellectual Disabilities

PubMed Central

2015-01-01

The World Health Organization calls for health promotion to expand beyond the health care system by considering social determinants of health, engaging multiple levels, targeting policy change, and including social action. This qualitative study embraces this holistic stance as a means to address the health disparities and inequities experienced by people with intellectual disabilities (ID) by supporting the development of interventions that consider components of social justice along with embracing this population’s potential and acknowledging influences of the context. A content analysis of the data is presented to illustrate how an occupational viewpoint can promote positive health and well-being of people with ID. The four gerunds of Wilcock’s Occupational Perspective on Health—doing, being, belonging, and becoming—are utilized and supported by the literature to offer actions that can be taken by health promotion professionals to address the health needs of people with ID. PMID:28462304

Health promotion in supplementary health care: outsourcing, microregulation and implications for care.

PubMed

Silva, Kênia Lara; Sena, Roseni Rosângela; Rodrigues, Andreza Trevenzoli; Araújo, Fernanda Lopes; Belga, Stephanie Marques Moura Franco; Duarte, Elysângela Dittz

2015-01-01

to analyze health promotion programs in the supplementary health care. This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis. Home care has been described as the main action in the field of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the beneficiaries. Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.

Promoting self-transcendence and well-being in community-dwelling older adults: A pilot study of a psychoeducational intervention.

PubMed

McCarthy, Valerie Lander; Ling, Jiying; Bowland, Sharon; Hall, Lynne A; Connelly, Jennifer

2015-01-01

Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being in older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, p = .004). This feasibility study supports further investigation to assess the effectiveness of the intervention in a larger sample. Copyright © 2015 Elsevier Inc. All rights reserved.

Preventing Obesity Across Generations: Evidence for Early Life Intervention.

PubMed

Haire-Joshu, Debra; Tabak, Rachel

2016-01-01

To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life.

Preventing Obesity Across Generations: Evidence for Early Life Intervention

PubMed Central

Haire-Joshu, Debra; Tabak, Rachel

2017-01-01

To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life. PMID:26989828

Fe en Accion/Faith in Action: Design and implementation of a church-based randomized trial to promote physical activity and cancer screening among churchgoing Latinas

PubMed Central

Arredondo, Elva M.; Haughton, Jessica; Ayala, Guadalupe X.; Slymen, Donald J.; Sallis, James F.; Burke, Kari; Holub, Christina; Chanson, Dayana; Perez, Lilian G.; Valdivia, Rodrigo; Ryan, Sherry; Elder, John

2015-01-01

Objectives To describe both conditions of a two-group randomized trial, one that promotes physical activity and one that promotes cancer screening, among churchgoing Latinas. The trial involves promotoras (community health workers) targeting multiple levels of the Ecological Model. This trial builds on formative and pilot research findings. Design Sixteen churches were randomly assigned to either the physical activity intervention or cancer screening comparison condition (approximately 27 women per church). In both conditions, promotoras from each church intervened at the individual- (e.g., beliefs), interpersonal- (e.g., social support), and environmental- (e.g., park features and access to health care) levels to affect change on target behaviors. Measurements The study’s primary outcome is min/wk of moderate-to-vigorous physical activity (MVPA) at baseline and 12 and 24 months following implementation of intervention activities. We enrolled 436 Latinas (aged 18–65 years) who engaged in less than 250 min/wk of MVPA at baseline as assessed by accelerometer, attended church at least four times per month, lived near their church, and did not have a health condition that could prevent them from participating in physical activity. Participants were asked to complete measures assessing physical activity and cancer screening as well as their correlates at 12- and 24-months. Summary Findings from the current study will address gaps in research by showing the long term effectiveness of multi-level faith-based interventions promoting physical activity and cancer screening among Latino communities. PMID:26358535

Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care.

PubMed

Grandes, Gonzalo; Sanchez, Alvaro; Cortada, Josep M; Pombo, Haizea; Martinez, Catalina; Balagué, Laura; Corrales, Mary Helen; de la Peña, Enrique; Mugica, Justo; Gorostiza, Esther

2017-12-06

Evidence-based interventions are more likely to be adopted if practitioners collaborate with researchers to develop an implementation strategy. This paper describes the steps to plan and execute a strategy, including the development of structure and supports needed for implementing proven health promotion interventions in primary and community care. Between 10 and 13 discussion and consensus sessions were performed in four highly-motivated primary health care centers involving 80% of the primary care staff and 21 community-based organizations. All four centers chose to address physical activity, diet, and smoking. They selected the 5 A's evidence-based clinical intervention to be adapted to the context of the health centers. The planned implementation strategy worked at multiple levels: bottom-up primary care organizational change, top-down support from managers, community involvement, and the development of innovative e-health information and communication tools. Shared decision making and practice facilitation were perceived as the most positive aspects of the collaborative modeling process, which took more time than expected, especially the development of the new e-health tools integrated into electronic health records. Collaborative modeling of an implementation strategy for the integration of health promotion in primary and community care was feasible in motivated centers. However, it was difficult, being hindered by the heavy workload in primary care and generating uncertainty inherent to a bottom-up decision making processes. Lessons from this experience could be useful in diverse settings and for other clinical interventions. Two companion papers report the evaluation of its feasibility and assess quantitatively and qualitatively the implementation process.

Mass media health communication campaigns combined with health-related product distribution: a community guide systematic review.

PubMed

Robinson, Maren N; Tansil, Kristin A; Elder, Randy W; Soler, Robin E; Labre, Magdala P; Mercer, Shawna L; Eroglu, Dogan; Baur, Cynthia; Lyon-Daniel, Katherine; Fridinger, Fred; Sokler, Lynn A; Green, Lawrence W; Miller, Therese; Dearing, James W; Evans, William D; Snyder, Leslie B; Kasisomayajula Viswanath, K; Beistle, Diane M; Chervin, Doryn D; Bernhardt, Jay M; Rimer, Barbara K

2014-09-01

Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury. Using methods previously developed for the Community Guide, a systematic review (search period, January 1980-December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products. Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns. Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics. Published by Elsevier Inc.

AMPK at the Nexus of Energetics and Aging

PubMed Central

Burkewitz, Kristopher; Zhang, Yue; Mair, William B.

2014-01-01

When energy supply is low, organisms respond by slowing aging and increasing resistance to diverse age-related pathologies. Targeting the mechanisms underpinning this response may therefore treat multiple disorders through a single intervention. Here we discuss AMP-activated protein kinase (AMPK) as an integrator and mediator of several pathways and processes linking energetics to longevity. Activated by low energy, AMPK is both pro-longevity and druggable, but its role in some pathologies may not be beneficial. As such, activating AMPK may modulate multiple longevity pathways to promote healthy aging, but unlocking its full potential may require selective targeting towards substrates involved in longevity-assurance. PMID:24726383

[Nursing care systematization for outpatient treatment care of patients with multiple sclerosis].

PubMed

Corso, Nair Assunta Antônia; Gondim, Ana Paula Soares; Dalmeida, Patrícia Chagas Rocha; Albuquerque, Maria Girlene de Freitas

2013-06-01

An experience report of nurses in the implementation of care systematization in ambulatory care in an interdisciplinary care center for patients with multiple sclerosis of a public hospital in Fortaleza, Ceará, Brazil. This implementation is based on the NANDA International, Inc., Nursing Interventions Classification, and Nursing Outcomes Classifications. One of the results concerns systemized nursing care, which has enabled the identification and understanding of the responses of MS patients to potential and current health problems. Systematization entails expanding knowledge through a practice based on approach and encourage further research scientific evidence, in addition to promoting the role of the nurse in acomprehensive approachand encourage further research.

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

Effects of Yoga on Physiological Indices, Anxiety and Social Functioning in Multiple Sclerosis Patients: A Randomized Trial

PubMed Central

Hasanpour-Dehkordi, Ali; Solati, Kamal

2016-01-01

Introduction Multiple sclerosis (MS) as a chronic disease could affect patients’ various domains of life. Aim This study was conducted to study the effect of yoga on the physiological indices, anxiety and social functioning of patients with MS in southwest, Iran. Materials and Methods In this clinical trial study, 60 MS patients were enrolled according to inclusion criteria and randomly assigned to two groups of 30 each. Prior to and after intervention, the patients’ vital signs were measured. For case group yoga exercises were performed three sessions a week for 12 weeks while control group performed no exercise. The data were gathered by questionnaire and analysed by descriptive and analytical statistics in SPSS. Results Prior to intervention, there was no significant difference in fatigue severity and pain between the two groups but the mean fatigue severity and pain in case group decreased compared to the control group after the intervention. Prior to intervention, there was no significant difference in mean physiological indices between the two groups but the mean physiological indices in case group decreased significantly after the intervention (p<0.05). Conclusion Yoga is likely to increase self-efficacy of MS patients through enhancing physical activity, increasing the strength of lower limbs and balance, and decreasing fatigue and pain, and finally to promote social functioning and to relieve stress and anxiety in these patients. PMID:27504387

A formative evaluation of customized pamphlets to promote physical activity and symptom self-management in women with multiple sclerosis.

PubMed

Plow, Matthew; Bethoux, Francois; Mai, Kimloan; Marcus, Bess

2014-10-01

Inactivity is a prevalent problem in the population affected with multiple sclerosis (MS). Thus, there is a need to develop and test physical activity (PA) interventions that can be widely disseminated. We conducted a formative evaluation as part of a randomized controlled trial of a pamphlet-based PA intervention among 30 women with MS. Pamphlets were customized to sub-sets of participants who shared similar symptoms and barriers to PA. Mixed methods were used to examine the intervention's influence on self-efficacy, social support, processes of change and stages of change placement, as well as explore participants' perceived barriers, motivators and strategies for engaging in a PA program. Results indicated that the intervention group significantly improved stages of change placement (F = 16.64, P < 0.01) and social support (F = 4.08, P = 0.05) in comparison to the control group. Fatigue, pain and lack of time were the commonly cited barriers to engage in the PA program; whereas the pamphlets, phone calls and action planning were cited as motivators. Participants used fatigue management strategies, enlisted social support and modified their environment to routinely engage in the PA program. Strategies were identified to improve the PA intervention in future research. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Community-Engaged Modeling of Geographic and Demographic Patterns of Multiple Public Health Risk Factors

PubMed Central

Basra, Komal; Fabian, M. Patricia; Holberger, Raymond R.; French, Robert

2017-01-01

Many health risk factors are intervention targets within communities, but information regarding high-risk subpopulations is rarely available at a geographic resolution that is relevant for community-scale interventions. Researchers and community partners in New Bedford, Massachusetts (USA) collaboratively identified high-priority behaviors and health outcomes of interest available in the Behavioral Risk Factor Surveillance System (BRFSS). We developed multivariable regression models from the BRFSS explaining variability in exercise, fruit and vegetable consumption, body mass index, and diabetes prevalence as a function of demographic and behavioral characteristics, and linked these models with population microdata developed using spatial microsimulation to characterize high-risk populations and locations. Individuals with lower income and educational attainment had lower rates of multiple health-promoting behaviors (e.g., fruit and vegetable consumption and exercise) and higher rates of self-reported diabetes. Our models in combination with the simulated population microdata identified census tracts with an elevated percentage of high-risk subpopulations, information community partners can use to prioritize funding and intervention programs. Multi-stressor modeling using data from public databases and microsimulation methods for characterizing high-resolution spatial patterns of population attributes, coupled with strong community partner engagement, can provide significant insight for intervention. Our methodology is transferrable to other communities. PMID:28684710

A formative evaluation of customized pamphlets to promote physical activity and symptom self-management in women with multiple sclerosis

PubMed Central

Plow, Matthew; Bethoux, Francois; Mai, Kimloan; Marcus, Bess

2014-01-01

Inactivity is a prevalent problem in the population affected with multiple sclerosis (MS). Thus, there is a need to develop and test physical activity (PA) interventions that can be widely disseminated. We conducted a formative evaluation as part of a randomized controlled trial of a pamphlet-based PA intervention among 30 women with MS. Pamphlets were customized to sub-sets of participants who shared similar symptoms and barriers to PA. Mixed methods were used to examine the intervention’s influence on self-efficacy, social support, processes of change and stages of change placement, as well as explore participants’ perceived barriers, motivators and strategies for engaging in a PA program. Results indicated that the intervention group significantly improved stages of change placement (F = 16.64, P < 0.01) and social support (F = 4.08, P = 0.05) in comparison to the control group. Fatigue, pain and lack of time were the commonly cited barriers to engage in the PA program; whereas the pamphlets, phone calls and action planning were cited as motivators. Participants used fatigue management strategies, enlisted social support and modified their environment to routinely engage in the PA program. Strategies were identified to improve the PA intervention in future research. PMID:24989822

Impact of Commercials on Food Preferences of Low-Income Minority Preschoolers

PubMed Central

Nicklas, Theresa A.; Goh, Eugenia Tsuei; Goodell, Lora S.; Acuff, Daniel S.; Reiher, Robert; Buday, Richard; Ottenbacher, Allison

2010-01-01

Objective To determine if fruit and vegetable (FV) commercials have an impact on preschool children’s preferences for specific FV. Design A year of extensive formative assessment was conducted to develop two 30-second commercials; “Judy Fruity” promoted apples and bananas and “Reggie Veggie” promoted broccoli and carrots. The commercials were embedded into a 15-minute TV program. FV preferences were assessed before and after four exposures to each of the commercials. Setting/Participants One hundred eighty-three preschool children (39% African-American; 61% Hispanic-American) from four Head Start centers in Houston, Texas. Main Outcome/Analysis A general linear model was used to assess whether FV preferences were significantly higher in the treatment group than the control group, controlling for baseline FV preferences, age, race and intervention dose in the model. Results There was a significantly higher preference for broccoli and carrots (p = 0.02) in the intervention group compared to the control group after multiple exposures to the vegetable commercial. Conclusions/Implications Data suggest that commercials promoting vegetables may be an effective strategy to influence young children’s preferences for vegetables. This may not be the case with fruit preferences which are already high in this age group. PMID:20851053

Impact of commercials on food preferences of low-income, minority preschoolers.

PubMed

Nicklas, Theresa A; Goh, Eugenia Tsuei; Goodell, L Suzanne; Acuff, Daniel S; Reiher, Robert; Buday, Richard; Ottenbacher, Allison

2011-01-01

To determine whether fruit and vegetable (FV) commercials have an impact on preschool children's preferences for specific FV. A year of extensive formative assessment was conducted to develop 2 30-second commercials: "Judy Fruity" promoted apples and bananas and "Reggie Veggie" promoted broccoli and carrots. The commercials were embedded into a 15-minute TV program. Fruit and vegetable preferences were assessed before and after 4 exposures to each of the commercials. Four Head Start centers in Houston, Texas. One hundred eighty-three preschool children (39% African American; 61% Hispanic American). Assessment of whether FV preferences were significantly higher in the treatment group than the control group, controlling for baseline FV preferences, age, race, and intervention dose in the model. A general linear model was used. There was a significantly higher preference for broccoli and carrots (P = .02) in the intervention group compared to the control group after multiple exposures to the vegetable commercial. Data suggest that commercials promoting vegetables may be an effective strategy to influence young children's preferences for vegetables. This may not be the case with fruit preferences, which are already high in this age group. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Independent Associations and Interactions of Perceived Neighborhood and Psychosocial Constructs on Adults' Physical Activity.

PubMed

Dwyer, Laura A; Patel, Minal; Nebeling, Linda C; Oh, April Y

2018-05-01

Neighborhood and psychosocial variables are related to physical activity (PA), yet interactions between these factors in predicting PA are infrequently studied. This analysis examines the independent associations and interactions between self-reported neighborhood and psychosocial variables in relation to moderate to vigorous PA (MVPA) among adults from a US panel sample. In adjusted models, neighborhood social capital was positively associated with meeting MVPA guidelines. Fewer barriers, greater self-efficacy, and greater autonomous motivation also corresponded with greater odds of meeting MVPA guidelines. An interaction between social capital and autonomous motivation showed that social capital was only associated with MVPA when autonomous motivation was high. Participants who reported both high autonomous motivation and high social capital were most likely to meet MVPA guidelines. Neighborhood social capital, barriers, self-efficacy, and autonomous motivation may be important correlates in promoting adults' PA. Future directions include using objective neighborhood and PA data in similar analyses and investigating associations of neighborhood and psychosocial variables with multiple PA activities. Intervention research to promote PA should also examine whether effects of interventions targeting psychosocial constructs are moderated by features of an individual's neighborhood or whether perceived social capital can be addressed in interventions in conjunction with psychosocial variables.

Use of active video games to increase physical activity in children: a (virtual) reality?

PubMed

Foley, Louise; Maddison, Ralph

2010-02-01

There has been increased research interest in the use of active video games (in which players physically interact with images onscreen) as a means to promote physical activity in children. The aim of this review was to assess active video games as a means of increasing energy expenditure and physical activity behavior in children. Studies were obtained from computerized searches of multiple electronic bibliographic databases. The last search was conducted in December 2008. Eleven studies focused on the quantification of the energy cost associated with playing active video games, and eight studies focused on the utility of active video games as an intervention to increase physical activity in children. Compared with traditional nonactive video games, active video games elicited greater energy expenditure, which was similar in intensity to mild to moderate intensity physical activity. The intervention studies indicate that active video games may have the potential to increase free-living physical activity and improve body composition in children; however, methodological limitations prevent definitive conclusions. Future research should focus on larger, methodologically sound intervention trials to provide definitive answers as to whether this technology is effective in promoting long-term physical activity in children.

The tug-of-war: fidelity versus adaptation throughout the health promotion program life cycle.

PubMed

Bopp, Melissa; Saunders, Ruth P; Lattimore, Diana

2013-06-01

Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a "program life cycle" framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

Annual Research Review: Improved nutrition--pathway to resilience.

PubMed

Yousafzai, Aisha K; Rasheed, Muneera A; Bhutta, Zulfiqar A

2013-04-01

Early child nutritional deficiencies are prevalent in low- and middle-countries with consequences linked not only to poor survival and growth, but also to poor development outcomes. Children in disadvantaged communities face multiple risks for nutritional deficiencies, yet some children may be less susceptible or may recover more quickly from malnutrition. A greater understanding is needed about factors which moderate the effects of nutrition-related risks and foster resilience to protect against or ameliorate poor development outcomes. A literature review was undertaken from August to December 2011 and updated in August 2012. Key word searches using terms Nutrition, Malnutrition, Child Development, Responsive Care, Stimulation, Low and Middle Income Countries and Resilience were undertaken using PubMed and Psychinfo. Dietary adequacy is critical for growth and development, but current evidence indicates that nutrition supplementation alone is insufficient to foster resilience to protect against, mitigate, and recover from nutritional threats and to promote healthy development. The combination of nutrition interventions with stimulation and responsive care is necessary. Combined nutrition and psychosocial stimulation approaches can potentially work effectively together to promote protective factors and mitigate risks for poor cognitive, motor, social, and affective functioning helping children to adapt in times of adversity. However, there are gaps in our existing knowledge to combine nutrition and psychosocial stimulation interventions effectively and promote these interventions at scale. Research needs to address barriers at the level of family, community, programme, and policy which have prevented thus far the uptake of combined nutrition and psychosocial intervention strategies. Further investigations are needed on how to provide support to caregivers, enabling them to implement appropriate care for feeding and stimulation. Finally, the effect of combined interventions on pathways of care and protective mediators that foster resilience need to be better understood to determine focus areas for content of combined intervention curricula which help families in high-risk settings. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Evaluating the impact of a school-based health intervention using a randomized field experiment.

PubMed

Greve, Jane; Heinesen, Eskil

2015-07-01

We conduct an econometric evaluation of a health-promoting programme in primary and lower secondary schools in Denmark. The programme includes health-related measurements of the students, communication of knowledge about health, and support of health-promoting projects for students. Half of the schools in the fourth largest municipality in Denmark were randomly selected into a treatment group implementing the programme, while the remainder served as a control group. We estimate both OLS models using only post-intervention observations and difference in differences (DID) models using also pre-intervention observations. We estimate effects of the initiative on BMI, waist/height ratio, overweight and obesity for the entire sample and by gender and grade. We find no consistent effect of the programme. When we use the entire sample, no estimates are statistically significant at conventional levels, although the point estimates for the effect on BMI, indicating an average reduction in the range of 0.10-0.15 kg/m(2), are consistent with the results in a recent Cochrane review evaluating 55 studies of diet and exercise interventions targeting children; and DID estimates which are marginally significant (at the 10% level) indicate that the intervention reduces the risk of obesity by 1% point. Running separate estimations by gender and grade we find a few statistically significant estimates: OLS estimates indicate that the intervention reduces BMI in females in grade 5 by 0.39 kg/m(2) and reduces the risk of obesity in females in grade 9 by 2.6% points; DID estimates indicate an increase in waist for females in preschool class by 1.2 cm and an increase in the risk of obesity in grade 9 males by 4% points. However, if we corrected for multiple hypotheses testing these estimates would be insignificant. There is no statistically significant correlation between participation in the programme and the number of other health-promoting projects at the schools. Copyright © 2015 Elsevier B.V. All rights reserved.

A Review of HIV Prevention Studies that Use Social Networking Sites: Implications for Recruitment, Health Promotion Campaigns, and Efficacy Trials.

PubMed

Jones, Jamal; Salazar, Laura F

2016-11-01

This review describes the use of social networking sites (SNS) in the context of primary prevention of HIV. A review was conducted to assess the published literature for HIV interventions using SNS. Sixteen articles describing twelve interventions were included. SNS were instrumental in recruiting hard-to-reach populations within a short amount of time; were able to reach wide audiences beyond the targeted population for HIV prevention campaigns; and helped to significantly reduce sexual risk behaviors and increase HIV testing. SNS are a viable option to recruit hidden populations, engage the target audience, and disseminate HIV prevention messages. Researchers should use SNS to generate sampling frames that can be used to select participants. Practitioners should use SNS to post images of preventive behavior within health promotion campaigns. Researchers should use multiple SNS platforms to engage participants. As more studies are published using SNS for HIV prevention, meta-analyses will be needed.

Early Childhood to Young Adulthood: An Introduction to the Special Issue

PubMed Central

Reynolds, Arthur J.; Ou, Suh-Ruu

2012-01-01

The identification and understanding of alterable influences on well-being are at the nexus of developmental science and social policy. These influences span the life course but child, family, and school experiences in the first two decades are particularly instrumental to health and well-being. To investigate some of these influences, we report data from the Chicago Longitudinal Study. The study investigates the life course development of 1,539 children (93% African American and 7% Hispanic) who were born in 1979-1980, grew up in the highest-poverty neighborhoods in Chicago, and attended early childhood intervention programs beginning in preschool. The goals of the study are to determine the effects of participation in the Child-Parent Center Program, document patterns of child and family well-being over time, and identify child, family, school, and community factors that can promote children’s well being. We describe major intervention findings and summarize the contributions of a variety of personal, family, and school experiences in promoting multiple domains of well-being. PMID:23858276

Neglected diseases of neglected populations: Thinking to reshape the determinants of health in Latin America and the Caribbean

PubMed Central

2005-01-01

Background People living in poverty throughout the developing world are heavily burdened with neglected communicable diseases and often marginalized by the health sector. These diseases are currently referred to as Neglected Diseases of Neglected Populations. The neglected diseases create social and financial burdens to the individual, the family, the community, and the nation. Discussion Numerous studies of successful individual interventions to manage communicable disease determinants in various types of communities have been published, but few have applied multiple interventions in an integrated, coordinated manner. We have identified a series of successful interventions and developed three hypothetical scenarios where such interventions could be applied in an integrated, multi-disease, inter-programmatic, and/or inter-sectoral approach for prevention and control of neglected diseases in three different populations: a slum, an indigenous community, and a city with a mix of populations. Summary The objective of this paper is to identify new opportunities to address neglected diseases, improve community health and promote sustainable development in neglected populations by highlighting examples of key risk and protective factors for neglected diseases which can be managed and implemented through multi-disease-based, integrated, inter-programmatic, and/or inter-sectoral approaches. Based on a literature review, analysis and development of scenarios we visualize how multiple interventions could manage multiple disease problems and propose these as possible strategies to be tested. We seek to stimulate intra- and inter-sectoral dialogue which will help in the construction of new strategies for neglected diseases (particularly for the parasitic diseases) which could benefit the poor and marginalized based on the principle of sustainability and understanding of key determinants of health, and lead to the establishment of pilot projects and activities which can contribute to the achievement of the Millennium Development Goals. PMID:16283932

[Lumbar stabilization exercises].

PubMed

Vásquez-Ríos, Jorge Rodrigo; Nava-Bringas, Tania Inés

2014-01-01

Exercise is the intervention with the highest level of evidence on efficacy for treatment of chronic low back pain, with a higher benefit in terms of pain and function compared to any other intervention. A wide variety of exercises programs have been designed; however, "lumbar stabilization exercises" have become increasingly popular among clinicians who are in contact with spine diseases. However, there is controversy regarding the adequate prescription and there are multiple protocols. The aim of this literature review is to analyze the information about these exercises to promote better decision-making among clinicians and design the best program for each patient. We found the program an essential tool in the treatment of low back pain in both therapeutic and preventive phases.

A review of health promotion funding for older adults in Europe: a cross-country comparison.

PubMed

Arsenijevic, Jelena; Groot, Wim; Tambor, Marzena; Golinowska, Stanislawa; Sowada, Christoph; Pavlova, Milena

2016-09-05

Health promotion interventions for older adults are important as they can decrease the onset and evolution of diseases and thus can reduce the medical costs related to those diseases. However, there is no comparative evidence on how those interventions are funded in European countries. The aim of this study is to explore the funding of health promotion interventions in general and health promotion interventions for older adults in particular in European countries. We use desk research to identify relevant sources of information such as official national documents, international databases and scientific articles. Fora descriptive overview on how health promotion is funded, we focus on three dimensions: who is funding health promotion, what are the contribution mechanisms and who are the collecting agents. In addition to general information on funding of health promotion, we explore how programs on health promotion for older population groups are funded. There is a great diversity in funding of health promotion in European countries. Although public sources (tax and social health insurance revenues) are still most often used, other mechanisms of funding such as private donations or European funds are also common. Furthermore, there is no clear pattern in the funding of health promotion for different population groups. This is of particular importance for health promotion for older adults where information is limited across European countries. This study provides an overview of funding of health promotion interventions in European countries. The main obstacles for funding health promotion interventions are lack of information and the fragmentation in the funding of health promotion interventions for older adults.

Systematic framework to evaluate the status of physical activity research for persons with multiple sclerosis.

PubMed

Dixon-Ibarra, Alicia; Vanderbom, Kerri; Dugala, Anisia; Driver, Simon

2014-04-01

Exploring the current state of health behavior research for individuals with multiple sclerosis is essential to understanding the next steps required to reducing preventable disability. A way to link research to translational health promotion programs is by utilizing the Behavioral Epidemiological Framework, which describes a sequence of phases used to categorize health-related behavioral research. This critical audit of the literature examines the current state of physical activity research for persons with multiple sclerosis by utilizing the proposed Behavioral Epidemiological Framework. After searching MEDLINE, PUBMED, PsycINFO, Google Scholar and several major areas within EBSCOHOST (2000 to present), retrieved articles were categorized according to the framework phases and coding rules. Of 139 articles, 49% were in phase 1 (establishing links between behavior and health), 18% phase 2 (developing methods for measuring behavior), 24% phase 3 (identifying factors influencing behavior and implications for theory), and 9% phase 4 and 5 (evaluating interventions to change behavior and translating research into practice). Emphasis on phase 1 research indicates the field is in its early stages of development. Providing those with multiple sclerosis with necessary tools through health promotion programs is needed to reduce secondary conditions and co-morbidities. Reassessment of the field of physical activity and multiple sclerosis in the future could provide insight into whether the field is evolving over time or remaining stagnant. Published by Elsevier Inc.

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

PubMed Central

Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

2014-01-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol.

PubMed

Hogue, Aaron; Bobek, Molly; Tau, Gregory Z; Levin, Frances R

2014-10-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions.

HIV in Young Men Who Have Sex with Men: A Review of Epidemiology, Risk, and Protector Factors, and Interventions

PubMed Central

Mustanski, Brian S.; Newcomb, Michael E.; Bois, Steve Nicholas Du; Garcia, Steve C.; Grov, Christian

2012-01-01

Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the U.S. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. We conclude that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, we suggest that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors. PMID:21409715

Effects of lifestyle change interventions for people with intellectual disabilities: Systematic review and meta-analysis of randomized controlled trials.

PubMed

Willems, Mariël; Waninge, Aly; Hilgenkamp, Thessa I M; van Empelen, Pepijn; Krijnen, Wim P; van der Schans, Cees P; Melville, Craig A

2018-05-08

Promotion of a healthy lifestyle for people with intellectual disabilities is important; however, the effectiveness of lifestyle change interventions is unclear. This research will examine the effectiveness of lifestyle change interventions for people with intellectual disabilities. Randomized controlled trials (RCTs) of lifestyle change interventions for people with intellectual disabilities were included in a systematic review and meta-analysis. Data on study and intervention characteristics were extracted, as well as data on outcome measures and results. Internal validity of the selected papers was assessed using the Cochrane Collaboration's risk bias tool. Eight RCTs were included. Multiple outcome measures were used, whereby outcome measures targeting environmental factors and participation were lacking and personal outcome measures were mostly used by a single study. Risks of bias were found for all studies. Meta-analysis showed some effectiveness for lifestyle change interventions, and a statistically significant decrease was found for waist circumference. Some effectiveness was found for lifestyle change interventions for people with intellectual disabilities. However, the effects were only statistically significant for waist circumference, so current lifestyle change interventions may not be optimally tailored to meet the needs of people with intellectual disabilities. © 2018 John Wiley & Sons Ltd.

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

PubMed

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

2014-02-01

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

National policies for the promotion of physical activity and healthy nutrition in the workplace context: a behaviour change wheel guided content analysis of policy papers in Finland.

PubMed

Seppälä, Tuija; Hankonen, Nelli; Korkiakangas, Eveliina; Ruusuvuori, Johanna; Laitinen, Jaana

2017-08-02

Health policy papers disseminate recommendations and guidelines for the development and implementation of health promotion interventions. Such documents have rarely been investigated with regard to their assumed mechanisms of action for changing behaviour. The Theoretical Domains Framework (TDF) and Behaviour Change Techniques (BCT) Taxonomy have been used to code behaviour change intervention descriptions, but to our knowledge such "retrofitting" of policy papers has not previously been reported. This study aims first to identify targets, mediators, and change strategies for physical activity (PA) and nutrition behaviour change in Finnish policy papers on workplace health promotion, and second to assess the suitability of the Behaviour Change Wheel (BCW) approach for this purpose. We searched all national-level health policy papers effectual in Finland in August 2016 focusing on the promotion of PA and/or healthy nutrition in the workplace context (n = 6). Policy recommendations targeting employees' nutrition and PA including sedentary behaviour (SB) were coded using BCW, TDF, and BCT Taxonomy. A total of 125 recommendations were coded in the six policy papers, and in two additional documents referenced by them. Psychological capability, physical opportunity, and social opportunity were frequently identified (22%, 31%, and 24%, respectively), whereas physical capability was almost completely absent (1%). Three TDF domains (knowledge, skills, and social influence) were observed in all papers. Multiple intervention functions and BCTs were identified in all papers but several recommendations were too vague to be coded reliably. Influencing individuals (46%) and changing the physical environment (44%) were recommended more frequently than influencing the social environment (10%). The BCW approach appeared to be useful for analysing the content of health policy papers. Paying more attention to underlying assumptions regarding behavioural change processes may help to identify neglected aspects in current policy, and to develop interventions based on recommendations, thus helping to increase the impact of policy papers.

The development, feasibility and acceptability of an Internet-based STI–HIV prevention intervention for young Chilean women

PubMed Central

Villegas, N.; Santisteban, D.; Cianelli, R.; Ferrer, L.; Ambrosia, T.; Peragallo, N.; Lara, L.

2014-01-01

Background Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI–HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI–HIV prevention interventions and avoiding barriers to services. Aims The study aimed to develop a culturally informed Internet-based STI–HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. Methods The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. Results The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. Discussion and conclusion This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI–HIV prevention and sex-related content. Implications for nursing and health policy The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI–HIV prevention strategies among women. PMID:24512261

In Psycho-Spiritual Integrative Therapy for Women with Primary Breast Cancer, What Factors Account for the Benefits? Insights from a Multiple Case Analysis.

PubMed

Rettger, John; Wall, Kathleen; Corwin, Diana; Davidson, Alexandra N; Lukoff, David; Koopman, Cheryl

2015-05-12

This study sought to understand the context in which Psycho-Spiritual Integrative Therapy (PSIT), a group intervention, promotes varying degrees of spiritual growth and quality of life change in breast cancer survivors. A secondary aim was to explore the relationship between spiritual well-being (SWB) and Quality of Life (QL) in PSIT participants. A qualitative, multiple case analysis was undertaken to examine the experiences of two participants with the highest change scores on the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale-Expanded Version (FACIT-Sp-Ex) and two participants with among the lowest change scores on this measure. The participant factors thought to contribute to SWB and QL changes included utilization of metacognitive psychological skills and spiritual/religious frameworks, while PSIT factors included application of PSIT core intervention components, cognitive restructuring, group dynamics, and the role of the facilitator. The nature and extent of participant use of spiritual practices appeared to shape the relationship between SWB and OL. The findings suggest directions for future research to investigate potential moderators and mediators of treatment efficacy of PSIT specifically, as well as other psycho-spiritual interventions for cancer survivors more generally.

Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss.

PubMed

Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

2016-01-01

To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. © 2016 S. Karger GmbH, Freiburg.

Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss

PubMed Central

Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

2016-01-01

Objective To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. Methods 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. Results 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Conclusion Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. PMID:26745715

Understanding and Changing Food Consumption Behavior Among Children: The Comprehensive Child Consumption Patterns Model.

PubMed

Jeffries, Jayne K; Noar, Seth M; Thayer, Linden

2015-01-01

Current theoretical models attempting to explain diet-related weight status among children center around three individual-level theories. Alone, these theories fail to explain why children are engaging or not engaging in health-promoting eating behaviors. Our Comprehensive Child Consumption Patterns model takes a comprehensive approach and was developed specifically to help explain child food consumption behavior and addresses many of the theoretical gaps found in previous models, including integration of the life course trajectory, key influencers, perceived behavioral control, and self-regulation. Comprehensive Child Consumption Patterns model highlights multiple levels of the socioecological model to explain child food consumption, illustrating how negative influence at multiple levels can lead to caloric imbalance and contribute to child overweight and obesity. Recognizing the necessity for multi-level and system-based interventions, this model serves as a template for holistic, integrated interventions to improve child eating behavior, ultimately impacting life course health development. © The Author(s) 2015.

Information provision for people with multiple sclerosis.

PubMed

Köpke, Sascha; Solari, Alessandra; Khan, Fary; Heesen, Christoph; Giordano, Andrea

2014-04-21

People with multiple sclerosis (MS) are confronted with a number of important uncertainties concerning many aspects of the disease. Among others, these include diagnosis, prognosis, disease course, disease-modifying therapies, symptomatic therapies and non-pharmacological interventions. It has been shown that people with MS demand adequate information to be able to actively participate in medical decision making and to self-manage their disease. On the other hand, it has been found that patients' disease-related knowledge is poor. Therefore, guidelines have recommended clear and concise high-quality information at all stages of the disease. Several studies have outlined communication and information deficits in the care of people with MS and, accordingly, a number of information and decision support programmes have been published. To evaluate the effectiveness of information provision interventions for people with MS that aim to promote informed choice and improve patient-relevant outcomes. We searched the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Group Specialised Register which contains trials from CENTRAL (The Cochrane Library 2013, Issue 6), MEDLINE, EMBASE, CINAHL, LILACS, PEDro and clinical trials registries (12 June 2013) as well as other sources. In addition, we searched PsycINFO, trial registries, and reference lists of identified articles. We also contacted trialists. Randomised controlled trials, cluster randomised controlled trials and quasi-randomised trials comparing information provision for people with MS or suspected MS (intervention groups) with usual care or other types of information provision (control groups) were eligible. Two review authors independently assessed the retrieved articles for relevance and methodological quality, and extracted data. Critical appraisal of studies addressed the risk of selection bias, performance bias, attrition bias and detection bias. We contacted authors of relevant studies for additional information. Ten randomised controlled trials involving a total of 1314 participants met the inclusion criteria and were analysed. The interventions addressed a variety of topics using different approaches for information provision in different settings. Topics included disease-modifying therapy, relapse management, self-care strategies, fatigue management, family planning and general health promotion. The interventions contained decision aids, educational programmes, self-care interventions and personal interviews with physicians. All interventions were complex interventions using more than one active component, but the number and extent of the intervention components differed markedly between studies. The studies had a variable risk of bias. We did not perform meta-analyses due to marked clinical heterogeneity. All four studies assessing MS-related knowledge (524 participants; moderate-quality evidence) detected significant differences between groups as a result of the interventions indicating that information provision may successfully increase participants' knowledge. There were mixed results from four studies reporting effects on decision making (836 participants; low-quality evidence) and from five studies assessing quality of life (605 participants; low-quality evidence). There were no adverse events in the six studies reporting on adverse events. Information provision for people with MS seems to increase disease-related knowledge, with less clear results on decision making and quality of life. There seem to be no negative side effects from informing patients about their disease. Interpretation of study results remains challenging due to the marked heterogeneity of the interventions and outcome measures.

Physical activity text messaging interventions in adults: a systematic review.

PubMed

Buchholz, Susan Weber; Wilbur, JoEllen; Ingram, Diana; Fogg, Louis

2013-08-01

Physical inactivity is a leading health risk factor for mortality worldwide. Researchers are examining innovative techniques including the use of mobile technology to promote physical activity. One such technology, text messaging, is emerging internationally as a method to communicate with and motivate individuals to engage in healthy behaviors, including physical activity. Review the existing scientific literature on adult physical activity text messaging interventions. This systematic review examined research papers that addressed physical activity text messaging intervention studies in adults. Using multiple databases, the search strategy included published English language studies through October 1, 2011. An author-developed data collection tool was used independently by two reviewers to extract and examine the selected study variables. The initial search resulted in the identification of 200 publications. Eleven publications representing 10 studies were included in the final review. Studies were conducted in seven countries with over half the studies being randomized controlled trials. Participants of the studies were predominantly young to middle aged women. Physical activity data were mainly obtained by self-report although three studies used pedometers or accelerometers. Interventions ranged from only sending out text messages to combining text messages with educational materials, staff support, and/or Internet technology. Minimal information was given regarding development or number of text messages used. The median effect size for the studies was 0.50. To date, using text messaging as a method to promote physical activity has only been studied by a small group of researchers. Current physical activity text messaging literature is characterized by small sample sizes, heterogeneous but positive effect sizes, and a lack of specificity as to the development of the text messages used in these studies. Further research in this area is imperative to facilitate the expansion of mobile technology to promote physical activity. © 2013 Sigma Theta Tau International.

EFFICACY OF A MOTIVATIONAL BEHAVIORAL INTERVENTION TO PROMOTE CHLAMYDIA AND GONORRHEA SCREENING IN YOUNG WOMEN: A RANDOMIZED CONTROLLED TRIAL

PubMed Central

Chacko, Mariam R.; Wiemann, Constance M.; Kozinetz, Claudia A.; von Sternberg, Kirk; Velasquez, Mary M.; Smith, Peggy B.; DiClemente, Ralph

2009-01-01

Background Seeking screening and treatment for chlamydia (CT) and gonorrhea (GC) by young women is critical to reduction of asymptomatic cervicitis and its complications. Objectives To evaluate the efficacy of a client-centered motivational behavioral intervention (MBI), to promote seeking of STI check-ups by young women. Methods 376 of 770 eligible sexually active, non-pregnant, English-speaking women (mean age 18.5 years) were recruited from an urban reproductive health clinic and randomized to two groups: intervention plus standard care (MBI) or standard-care alone (SC). MBI (two sessions plus booster) was based on the Transtheoretical Model of Change and employed motivational interviewing. Outcome measures monitored for 12 months included: client-initiated clinic visits for STI check-ups in response to seven high-risk sexual behaviors by self report (primary), consistent condom use, number of CT and GC episodes, and movement along the stages of change obtained at baseline and 6- and 12-month follow-up assessments (secondary). Analyses included chi square, logistic regression and generalized estimating equations. Results At baseline >70% endorsed the action stage of change for seeking STI check-ups for three of seven high-risk sexual behaviors. No significant differences were noted between the two groups for the primary or secondary outcomes. Across groups, having multiple partners and being pregnant or thinking one might be pregnant were associated with STI check-ups. Conclusions This is the first known client-centered clinical trial to promote STI screening. Risk-taking and health seeking behaviors are complex and interrelated with STI and pregnancy-concerns. The intervention may have an effect if it is targeted to women in a less medically connected community-based sample. PMID:20113921

Reduced Reward-driven Eating Accounts for the Impact of a Mindfulness-Based Diet and Exercise Intervention on Weight Loss: Data from the SHINE Randomized Controlled Trial

PubMed Central

Mason, Ashley E.; Epel, Elissa S.; Aschbacher, Kirstin; Lustig, Robert H.; Acree, Michael; Kristeller, Jean; Cohn, Michael; Dallman, Mary; Moran, Patricia J.; Bacchetti, Peter; Laraia, Barbara; Hecht, Frederick M.; Daubenmier, Jennifer

2016-01-01

Many individuals with obesity report overeating despite intentions to maintain or lose weight. Two barriers to long-term weight loss are reward-driven eating, which is characterized by a lack of control over eating, a preoccupation with food, and a lack of satiety; and psychological stress. Mindfulness training may address these barriers by promoting awareness of hunger and satiety cues, self-regulatory control, and stress reduction. We examined these two barriers as potential mediators of weight loss in the Supporting Health by Integrating Nutrition and Exercise (SHINE) randomized controlled trial, which compared the effects of a 5.5-month diet and exercise intervention with or without mindfulness training on weight loss among adults with obesity. Intention-to-treat multiple mediation models tested whether post-intervention reward-driven eating and psychological stress mediated the impact of intervention arm on weight loss at 12-and 18-months post-baseline among 194 adults with obesity (BMI: 30–45). Mindfulness (relative to control) participants had significant reductions in reward-driven eating at 6 months (post-intervention), which, in turn, predicted weight loss at 12 months. Post-intervention reward-driven eating mediated 47.1% of the total intervention arm effect on weight loss at 12 months [β=-0.06, SE(β)=0.03, p=.030, 95% CI (−0.12, −0.01)]. This mediated effect was reduced when predicting weight loss at 18 months (p=.396), accounting for 23.0% of the total intervention effect, despite similar weight loss at 12 months. Psychological stress did not mediate the effect of intervention arm on weight loss at 12 or 18 months. In conclusion, reducing reward-driven eating, which can be achieved using a diet and exercise intervention that includes mindfulness training, may promote weight loss (clinicaltrials.gov registration: NCT00960414). PMID:26867697

Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial.

PubMed

Mason, Ashley E; Epel, Elissa S; Aschbacher, Kirstin; Lustig, Robert H; Acree, Michael; Kristeller, Jean; Cohn, Michael; Dallman, Mary; Moran, Patricia J; Bacchetti, Peter; Laraia, Barbara; Hecht, Frederick M; Daubenmier, Jennifer

2016-05-01

Many individuals with obesity report over eating despite intentions to maintain or lose weight. Two barriers to long-term weight loss are reward-driven eating, which is characterized by a lack of control over eating, a preoccupation with food, and a lack of satiety; and psychological stress. Mindfulness training may address these barriers by promoting awareness of hunger and satiety cues, self-regulatory control, and stress reduction. We examined these two barriers as potential mediators of weight loss in the Supporting Health by Integrating Nutrition and Exercise (SHINE) randomized controlled trial, which compared the effects of a 5.5-month diet and exercise intervention with or without mindfulness training on weight loss among adults with obesity. Intention-to-treat multiple mediation models tested whether post-intervention reward-driven eating and psychological stress mediated the impact of intervention arm on weight loss at 12- and 18-months post-baseline among 194 adults with obesity (BMI: 30-45). Mindfulness (relative to control) participants had significant reductions in reward-driven eating at 6 months (post-intervention), which, in turn, predicted weight loss at 12 months. Post-intervention reward-driven eating mediated 47.1% of the total intervention arm effect on weight loss at 12 months [β = -0.06, SE(β) = 0.03, p = .030, 95% CI (-0.12, -0.01)]. This mediated effect was reduced when predicting weight loss at 18 months (p = .396), accounting for 23.0% of the total intervention effect, despite similar weight loss at 12 months. Psychological stress did not mediate the effect of intervention arm on weight loss at 12 or 18 months. In conclusion, reducing reward-driven eating, which can be achieved using a diet and exercise intervention that includes mindfulness training, may promote weight loss (clinicaltrials.gov registration: NCT00960414). Published by Elsevier Ltd.

What makes online substance-use interventions engaging? A systematic review and narrative synthesis

PubMed Central

Milward, Joanna; Drummond, Colin; Fincham-Campbell, Stephanie; Deluca, Paolo

2018-01-01

Background Online substance-use interventions are effective in producing reductions in harmful-use. However, low user engagement rates with online interventions reduces overall effectiveness of interventions. Identifying optimal strategies with which to engage users with online substance-use interventions may improve usage rates and subsequent effectiveness. Objectives (1) To identify the most prevalent engagement promoting strategies utilised to increase use of online substance-use interventions. (2) To determine whether the identified engagement promoting strategies increased said use of online substance-use interventions. Review methods The reviewed followed Cochrane methodology. Databases were searched for online substance-use interventions and engagement promoting strategies limited by study type (randomised controlled trial). Due to heterogeneity between engagement promoting strategies and engagement outcomes, meta-analytic techniques were not possible. Narrative synthesis methods were used. Results Fifteen studies were included. Five different engagement promoting strategies were identified: (1) tailoring; (2) delivery strategies; (3) incentives; (4) reminders; (5) social support. The most frequently reported engagement promoting strategies was tailoring (47% of studies), followed by reminders and social support (40% of studies) and delivery strategies (33% of studies). The narrative synthesis demonstrated that tailoring, multimedia delivery of content and reminders are potential techniques for promoting engagement. The evidence for social support was inconclusive and negative for incentives. Conclusions This review was the first to examine engagement promoting strategies in solely online substance-use interventions. Three strategies were identified that may be integral in promoting engagement with online substance-use interventions. However, the small number of eligible extracted studies, inconsistent reporting of engagement outcomes and diversity of engagement features prevent firmer conclusions. More high-quality trials examining engagement are required.

Post-coma persons with multiple disabilities use assistive technology for their leisure engagement and communication.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Buonocunto, Francesca; Sacco, Valentina; D'Amico, Fiora; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa

2014-01-01

Interventions for post-coma persons, who have emerged from a minimally conscious state but present with extensive neuro-motor impairment and lack of or minimal verbal skills, need to promote occupation and communication through the use of assistive technology. These two studies were aimed at assessing two technology-aided programs to promote leisure engagement and communication for three post-coma participants with multiple disabilities. Study I assessed a program to allow a woman and a man with extensive neuro-motor impairment and lack of speech to switch on music and videos, make requests to caregivers, and send messages to (communicate with) relevant partners and receive messages from those partners. Study II assessed a program to allow a post-coma woman with extensive motor impairment and reduced verbal behavior to activate music, videos and requests, send and receive messages, and make telephone calls. Data showed that both programs were successful. The participants of Study I managed leisure engagement, requests, as well as text messaging. The participant of Study II showed consistent leisure engagement, text messaging, and telephone calls. Assistive technology can be profitably used to provide post-coma persons with multiple disabilities relevant leisure and communication opportunities.

Exploring drivers and challenges in implementation of health promotion in community mental health services: a qualitative multi-site case study using Normalization Process Theory.

PubMed

Burau, Viola; Carstensen, Kathrine; Fredens, Mia; Kousgaard, Marius Brostrøm

2018-01-24

There is an increased interest in improving the physical health of people with mental illness. Little is known about implementing health promotion interventions in adult mental health organisations where many users also have physical health problems. The literature suggests that contextual factors are important for implementation in community settings. This study focused on the change process and analysed the implementation of a structural health promotion intervention in community mental health organisations in different contexts in Denmark. The study was based on a qualitative multiple-case design and included two municipal and two regional provider organisations. Data were various written sources and 13 semi-structured interviews with 22 key managers and frontline staff. The analysis was organised around the four main constructs of Normalization Process Theory: Coherence, Cognitive Participation, Collective Action, and Reflexive Monitoring. Coherence: Most respondents found the intervention to be meaningful in that the intervention fitted well into existing goals, practices and treatment approaches. Cognitive Participation: Management engagement varied across providers and low engagement impeded implementation. Engaging all staff was a general problem although some of the initial resistance was apparently overcome. Collective Action: Daily enactment depended on staff being attentive and flexible enough to manage the complex needs and varying capacities of users. Reflexive Monitoring: During implementation, staff evaluations of the progress and impact of the intervention were mostly informal and ad hoc and staff used these to make on-going adjustments to activities. Overall, characteristics of context common to all providers (work force and user groups) seemed to be more important for implementation than differences in the external political-administrative context. In terms of research, future studies should adopt a more bottom-up, grounded description of context and pay closer attention to the interplay between different dimensions of implementation. In terms of practice, future interventions need to better facilitate the translation of the initial sense of general meaning into daily practice by active local management support that occurs throughout the implementation process and that systematically connects the intervention to existing practices.

Systematic review of interventions to promote social-emotional development in young children with or at risk for disability.

PubMed

Case-Smith, Jane

2013-01-01

This systematic review synthesized the research on interventions used by occupational therapy practitioners to promote social-emotional development in young children (birth-5 yr) with or at risk for disabilities. After a comprehensive search of the research literature, 23 studies were reviewed and then synthesized into five themes: (1) touch-based interventions to enhance calming and parent-infant bonding, (2) relationship-based interventions to promote positive caregiver-child interactions, (3) joint attention interventions, (4) naturalistic preschool interventions to promote peer-to-peer engagement, and (5) instruction-based interventions to teach children appropriate social behaviors. The interventions for infants primarily involved coaching parents in specific strategies to promote positive interactions; interventions for preschool-age children typically involved encouraging peer support, instructing children, and applying naturalistic behavioral techniques to develop higher-level social competence. The studies demonstrated low to moderate positive effects for interventions used by occupational therapy practitioners to improve social-emotional development across ages, diagnoses, and settings. Copyright © 2013 by the American Occupational Therapy Association, Inc.

The impact of a mind-body program on multiple dimensions of resiliency among geographically diverse patients with neurofibromatosis.

PubMed

Zale, Emily L; Pierre-Louis, Catherine; Macklin, Eric A; Riklin, Eric; Vranceanu, Ana-Maria

2018-04-01

The neurofibromatoses (NF) are incurable genetic disorders that can cause nerve sheath tumors, chronic pain, and disfiguration. Patients with NF report lower quality of life and greater distress, and may benefit from programs that promote resiliency. To test effects of an 8-week mind-body program (Relaxation Response Resiliency Program for NF [3RP-NF]) on resiliency, using data derived from a larger randomized controlled trial of the 3RP-NF versus attention placebo control (Vranceanu et al. in Neurology 87:806-814, 2016). Participants (N = 63; 46 female; 52 White) were randomized to 3RP-NF (n = 32, M age = 42.86) or control (n = 31, M age = 39.90), completed intervention sessions via group videoconferencing, and provided self-report measures of resiliency (i.e., perceived coping abilities, perceived social support, gratitude, optimism, spiritual well-being, mindfulness) at baseline, post-intervention, and 6-month follow-up. All participants attended at least 6/8 sessions and 83% (N = 52) provided 6-month follow-up data. The 3RP-NF (vs. control) produced greater improvements from pre- to post-intervention in perceived coping abilities (M difference = 6.68; p = .008), perceived social support (M difference = 9.16; p = .032), and mindfulness (M difference = 2.23; p = .035), which were maintained at 6-month follow up. We did not observe group differences in spiritual well-being, optimism, or gratitude. The 3RP-NF produced sustained increases in multiple dimensions of resiliency (perceived coping abilities, perceived social support, and mindfulness). Promoting resiliency may be particularly important for a population that is underserved and living with a chronic, incurable illness.

Dimensions of sustainability for a health communication intervention in African American churches: a multi-methods study.

PubMed

Scheirer, Mary Ann; Santos, Sherie Lou Z; Tagai, Erin K; Bowie, Janice; Slade, Jimmie; Carter, Roxanne; Holt, Cheryl L

2017-03-28

Sustainability of evidence-based health promotion interventions has received increased research attention in recent years. This paper reports sustainability data from Project HEAL (Health through Early Awareness and Learning) a cancer communication implementation trial about early detection, based in African American churches. In this paper, we used a framework by Scheirer and Dearing (Am J Publ Health 101:2059-2067, 2011) to evaluate multiple dimensions of sustainability from Project HEAL. We examined the following dimensions of sustainability: (a) continued benefits for intervention recipients, (b) continuation of intervention activities, c) maintaining community partnerships, (d) changes in organizational policies or structures, (e) sustained attention to the underlying issues, (f) diffusion to additional sites, or even (g) unplanned consequences of the intervention. Project HEAL provided a three-workshop cancer educational series delivered by trained lay peer community health advisors (CHAs) in their churches. Multiple sources of sustainability were collected at 12 and 24 months after the intervention that reflect several levels of analysis: participant surveys; interviews with CHAs; records from the project's management database; and open-ended comments from CHAs, staff, and community partners. Outcomes differ for each dimension of sustainability. For continued benefit, 39 and 37% of the initial 375 church members attended the 12- and 24-month follow-up workshops, respectively. Most participants reported sharing the information from Project HEAL with family or friends (92% at 12 months; 87% at 24 months). For continuation of intervention activities, some CHAs reported that the churches held at least one additional cancer educational workshop (33% at 12 months; 24% at 24 months), but many more CHAs reported subsequent health activities in their churches (71% at 12 months; 52% at 24 months). No church replicated the original series of three workshops. Additional data confirm the maintenance of community partnerships, some changes in church health policies, and continued attention to health issues by churches and CHAs. The multiple dimensions of sustainability require different data sources and levels of analysis and show varied sustainability outcomes in this project. The findings reinforce the dynamic nature of evidence-based health interventions in community contexts.

Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012

PubMed Central

Kohatsu, Neal D.; Paciotti, Brian M.; Byrne, Jennifer V.; Kizer, Kenneth W.

2015-01-01

Introduction Prevention is the most cost-effective approach to promote population health, yet little is known about the delivery of health promotion interventions in the nation’s largest Medicaid program, Medi-Cal. The purpose of this study was to inventory health promotion interventions delivered through Medi-Cal Managed Care Plans; identify attributes of the interventions that plans judged to have the greatest impact on their members; and determine the extent to which the plans refer members to community assistance programs and sponsor health-promoting community activities. Methods The lead health educator from each managed care plan was asked to complete a 190-item online survey in January 2013; 20 of 21 managed care plans responded. Survey data on the health promotion interventions with the greatest impact were grouped according to intervention attributes and measures of effectiveness; quantitative data were analyzed using descriptive statistics. Results Health promotion interventions judged to have the greatest impact on Medi-Cal members were delivered in various ways; educational materials, one-on-one education, and group classes were delivered most frequently. Behavior change, knowledge gain, and improved disease management were cited most often as measures of effectiveness. Across all interventions, median educational hours were limited (2.4 h), and median Medi-Cal member participation was low (265 members per intervention). Most interventions with greatest impact (120 of 137 [88%]) focused on tertiary prevention. There were mixed results in referring members to community assistance programs and investing in community activities. Conclusion Managed care plans have many opportunities to more effectively deliver health promotion interventions. Establishing measurable, evidence-based, consensus standards for such programs could facilitate improved delivery of these services. PMID:26564012

Randomized controlled trial of a behavioral intervention targeting symptoms and physical activity in multiple sclerosis.

PubMed

Pilutti, L A; Dlugonski, D; Sandroff, B M; Klaren, R; Motl, R W

2014-04-01

Exercise training is beneficial, but most persons with multiple sclerosis (MS) are sedentary and physically inactive. This has prompted a new focus on the promotion of lifestyle physical activity in MS. We previously designed, tested, and refined a behavioral intervention delivered through the Internet that successfully increased lifestyle physical activity in MS, but have not evaluated the effects on secondary symptomatic and health-related quality of life (HRQOL) outcomes. We conducted a 6-month randomized controlled trial (RCT) that examined the efficacy of an Internet-delivered, behavioral intervention for improving outcomes of fatigue, depression, anxiety, pain, sleep quality, and HRQOL in 82 ambulatory persons with MS. The secondary aim was to replicate previous results regarding change in free-living physical activity. There was a significant and positive effect of the intervention on fatigue severity (p=.001, η ρ (2)=.15) and its physical impact (p=.008, η ρ (2)=.09), depression (p=.006, η ρ (2)=.10), and anxiety (p=.006, η ρ (2)=.10). There were non-significant improvements in pain (p=.08, η ρ (2)=.04), sleep quality (p=.06, η ρ (2)=.05), and physical HRQOL (p=.06, η ρ (2)=.05). We replicated our previous results by demonstrating an increase in self-reported physical activity (p=.001, η ρ (2)=.13). Our results support behavioral interventions targeting lifestyle physical activity as an alternative approach for managing symptoms in MS.

NET-Works: Linking families, communities and primary care to prevent obesity in preschool-age children.

PubMed

Sherwood, Nancy E; French, Simone A; Veblen-Mortenson, Sara; Crain, A Lauren; Berge, Jerica; Kunin-Batson, Alicia; Mitchell, Nathan; Senso, Meghan

2013-11-01

Obesity prevention in children offers a unique window of opportunity to establish healthful eating and physical activity behaviors to maintain a healthful body weight and avoid the adverse proximal and distal long-term health consequences of obesity. Given that obesity is the result of a complex interaction between biological, behavioral, family-based, and community environmental factors, intervention at multiple levels and across multiple settings is critical for both short- and long-term effectiveness. The Minnesota NET-Works (Now Everybody Together for Amazing and Healthful Kids) study is one of four obesity prevention and/or treatment trials that are part of the Childhood Obesity Prevention and Treatment (COPTR) Consortium. The goal of the NET-Works study is to evaluate an intervention that integrates home, community, primary care and neighborhood strategies to promote healthful eating, activity patterns, and body weight among low income, racially/ethnically diverse preschool-age children. Critical to the success of this intervention is the creation of linkages among the settings to support parents in making home environment and parenting behavior changes to foster healthful child growth. Five hundred racially/ethnically diverse, two-four year old children and their parent or primary caregiver will be randomized to the multi-component intervention or to a usual care comparison group for a three-year period. This paper describes the study design, measurement and intervention protocols, and statistical analysis plan for the NET-Works trial. © 2013 Elsevier Inc. All rights reserved.

Systematic Review of Knowledge Translation Strategies to Promote Research Uptake in Child Health Settings.

PubMed

Albrecht, Lauren; Archibald, Mandy; Snelgrove-Clarke, Erna; Scott, Shannon D

2016-01-01

Strategies to assist evidence-based decision-making for healthcare professionals are crucial to ensure high quality patient care and outcomes. The goal of this systematic review was to identify and synthesize the evidence on knowledge translation interventions aimed at putting explicit research evidence into child health practice. A comprehensive search of thirteen electronic databases was conducted, restricted by date (1985-2011) and language (English). Articles were included if: 1) studies were randomized controlled trials (RCT), controlled clinical trials (CCT), or controlled before-and-after (CBA) studies; 2) target population was child health professionals; 3) interventions implemented research in child health practice; and 4) outcomes were measured at the professional/process, patient, or economic level. Two reviewers independently extracted data and assessed methodological quality. Study data were aggregated and analyzed using evidence tables. Twenty-one studies (13 RCT, 2 CCT, 6 CBA) were included. The studies employed single (n=9) and multiple interventions (n=12). The methodological quality of the included studies was largely moderate (n=8) or weak (n=11). Of the studies with moderate to strong methodological quality ratings, three demonstrated consistent, positive effect(s) on the primary outcome(s); effective knowledge translation interventions were two single, non-educational interventions and one multiple, educational intervention. This multidisciplinary systematic review in child health setting identified effective knowledge translation strategies assessed by the most rigorous research designs. Given the overall poor quality of the research literature, specific recommendations were made to improve knowledge translation efforts in child health. Copyright © 2016 Elsevier Inc. All rights reserved.

Current Trends in Exercise Intervention Research, Technology, and Behavioral Change Strategies for People With Disabilities: A Scoping Review.

PubMed

Lai, Byron; Young, Hui-Ju; Bickel, C Scott; Motl, Robert W; Rimmer, James H

2017-10-01

This review synthesized physical activity and exercise intervention literature for the past 10 yrs for people with physical and cognitive disabilities including intervention characteristics, behavior change strategies, and types of technologies used to improve targeted outcomes. Systematic searches yielded 132 eligible studies. The major disability groups were multiple sclerosis (41%), stroke (15%), and spinal cord injury (12%). Research designs primarily involved randomized controlled trials (61%) versus quasi-experimental designs (39%). Approximately 20% of the interventions used some form of the following technology: information and communication technology (48%), interactive technology (37%), or electronic gauges (30%). Eighteen percent of studies used intervention strategies based on behavioral theory, which was typically combined with technology to promote activity and increase adherence in generally larger study samples. The three prevailing theories included social cognitive theory (58%), supportive accountability theory (21%), and transtheoretical model (21%). Upon completing the intervention, studies reported primarily significant outcomes (80%). Exercise research for PWD has grown in both quantity and quality, but several gaps remain. Study findings provide a roadmap for future exercise trials on understudied populations and highlight technology and behavior change theory as drivers of future intervention research.

The challenge of promoting safe sex at sites where persons meet new sex partners in Jamaica: results of the Kingston PLACE randomized controlled trial.

PubMed

Figueroa, J Peter; Weir, Sharon S; Byfield, Lovette; Hall, Alison; Cummings, Stirling M; Suchindran, Chirayath M

2010-08-01

To determine whether a site-based Priorities for Local AIDS Control Efforts (PLACE) HIV prevention intervention in Kingston, Jamaica increased condom use among persons with new or multiple sex partners. A total of 147 sites where persons go to meet new sex partners were grouped into 50 geographic clusters and randomized to receive or not receive a multilevel PLACE prevention intervention. Baseline cross-sectional surveys of sites and patrons at sites were conducted in 2005 to determine the nature of social activities at sites to better plan the intervention and to ensure that the two arms of the trial were similar. The intervention was delivered by 50 trained outreach workers between January and June 2006. After the intervention two cross-sectional surveys were conducted to assess the extent of intervention implementation and to estimate the proportion of patrons at sites with recent new or concurrent partnerships and inconsistent condom use. Characteristics of sites and patrons were similar for most variables at intervention and control sites at both baseline and post-intervention. A total of 1535 patrons (723 men, 812 women) were interviewed at intervention sites and 1324 patrons (661 men, 663 women) at control sites 6-9 months after the intervention. There were no significant differences between intervention and control groups in the proportions of men (37.8% and 31.6%) and women (24.6% and 22.6%) who reported new or multiple relationships in the past year and inconsistent condom use. There was no significant difference in the proportion of men or women showing a condom at interview, having a HIV test in the past 12 months or being exposed to the intervention. An intent-to-treat analysis did not show any intervention effect. This was probably because of difficulty in implementing the intervention, the extent of patron mixing among sites, the intensity of national education campaigns, delay in conducting the post-intervention survey and evidence of other interventions at some control sites.

Hypoxia and Mucosal Inflammation

PubMed Central

Colgan, Sean P.; Campbell, Eric L.; Kominsky, Douglas J.

2016-01-01

Sites of inflammation are defined by significant changes in metabolic activity. Recent studies have suggested that O2 metabolism and hypoxia play a prominent role in inflammation so-called “inflammatory hypoxia,” which results from a combination of recruited inflammatory cells (e.g., neutrophils and monocytes), the local proliferation of multiple cell types, and the activation of multiple O2-consuming enzymes during inflammation. These shifts in energy supply and demand result in localized regions of hypoxia and have revealed the important function off the transcription factor HIF (hypoxia-inducible factor) in the regulation of key target genes that promote inflammatory resolution. Analysis of these pathways has provided multiple opportunities for understanding basic mechanisms of inflammation and has defined new targets for intervention. Here, we review recent work addressing tissue hypoxia and metabolic control of inflammation and immunity. PMID:27193451

Social inclusion/exclusion as matters of social (in)justice: a call for nursing action.

PubMed

Yanicki, Sharon M; Kushner, Kaysi E; Reutter, Linda

2015-06-01

Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses--discourses on recognition, capabilities, and equality and citizenship--are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursing's moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice. © 2014 John Wiley & Sons Ltd.

Evidences to validate public policies: a review with an international research perspective.

PubMed

Gregori, Dario

2014-01-01

Nutrition and related health issues are nowadays topics of general interest. The prevalence of overweight and obesity has increased with alarming speed over the past twenty years, being described by the World Health Organization as a global epidemic. An evidence-based approach to public health interventions should be based on the best available information. Given the substantial investment of society in fundamental and applied health research, and the high expectations of society for reducing the burden of illness, attention to these matters should have high priority. There's an urgent need to foster the development of international standards, such as food labeling and profiling. Considering the complex network involved in obesity development, it is necessary to promote multiple-concurrent interventions, taking into account that by focusing on a single intervention in isolation, all other factors being constant, each individual policy change is likely to appear ineffective.

Generating Gratitude in the Workplace to Improve Faculty Job Satisfaction.

PubMed

Stegen, Amy; Wankier, Jamie

2018-06-01

The current nursing shortage affects all settings. In an effort to promote retention of nursing faculty, an "attitude of gratitude" was cultivated to improve job satisfaction and increase collaboration in one school of nursing. This was a quantitative study using a convenience sample of faculty at one school of nursing. A presurvey of faculty on perceived gratitude levels and job satisfaction was administered prior to the start of the school year. Multiple gratitude interventions were implemented throughout the year and a postsurvey was administered to measure the effectiveness of interventions. The findings of this study show an improvement of 17.9% in overall job satisfaction, which is consistent with other studies on the topic. Collaboration was not affected by gratitude interventions. Implementing gratitude is a cost-effective and easy way to improve job satisfaction to increase faculty retention rates. [J Nurs Educ. 2018;57(6):375-378.]. Copyright 2018, SLACK Incorporated.

Preventive strategies for mental health.

PubMed

Arango, Celso; Díaz-Caneja, Covadonga M; McGorry, Patrick D; Rapoport, Judith; Sommer, Iris E; Vorstman, Jacob A; McDaid, David; Marín, Oscar; Serrano-Drozdowskyj, Elena; Freedman, Robert; Carpenter, William

2018-05-14

Available treatment methods have shown little effect on the burden associated with mental health disorders. We review promising universal, selective, and indicated preventive mental health strategies that might reduce the incidence of mental health disorders, or shift expected trajectories to less debilitating outcomes. Some of these interventions also seem to be cost-effective. In the transition to mental illness, the cumulative lifetime effect of multiple small effect size risk factors progressively increases vulnerability to mental health disorders. This process might inform different levels and stages of tailored interventions to lessen risk, or increase protective factors and resilience, especially during sensitive developmental periods. Gaps between knowledge, policy, and practice need to be bridged. Future steps should emphasise mental health promotion, and improvement of early detection and interventions in clinical settings, schools, and the community, with essential support from society and policy makers. Copyright © 2018 Elsevier Ltd. All rights reserved.

An analysis of maintenance following functional communication training.

PubMed Central

Durand, V M; Carr, E G

1992-01-01

The multiple and long-term effects of functional communication training relative to a common reductive procedure (time-out from positive reinforcement) were evaluated. Twelve children participated in a functional analysis of their challenging behaviors (Study 1), which implicated adult attention as a maintaining variable. The children were then matched for chronological age, mental age, and language age and assigned to two groups. One group received functional communication training as an intervention for their challenging behavior, and the second group received time-out as a contrast. Both interventions were initially successful (Study 2), but durable results were achieved only with the group that received functional communication training across different stimulus conditions (Study 3). Students whose challenging behaviors were previously reduced with time-out resumed these behaviors in the presence of naive teachers unaware of the children's intervention history. The value of teaching communicative responses to promote maintenance is discussed as it relates to the concept of functional equivalence. PMID:1478902

Using blended and guided technologies in a university course for scientist-practitioners: teaching applied behaviour analysis to autism professionals.

PubMed

Roll-Pettersson, Lise; Ala'i-Rosales, Shahla

2009-06-01

Although the incidence of autism spectrum disorders is increasing worldwide, there is a shortage of professionals trained to provide effective interventions. The article describes an advanced university course in Applied Behaviour Analysis (ABA) and autism tailored to meet the needs of Swedish professionals from multiple disciplines. The course implemented both blended-learning technologies (web, telecommunication, and in vivo) and guided-design (problem-solving) exercises to promote the scientist-practitioner model. Overall, students advanced their skills related to identifying extant scientific literature, choosing appropriate single-subject design evaluation methods, and critically analysing the effects of attempted interventions. Students rated the course as having high social validity and predicted the course content would positively affect their professional practice. The relevance of the course and future directions are discussed in the context of meeting the global need for effective autism intervention professionals.

Women, Poverty, and Trauma: An Empowerment Practice Approach.

PubMed

East, Jean Francis; Roll, Susan J

2015-10-01

This article describes an empowerment approach for working with diverse women who experience poverty, trauma, and multiple structural oppressions. The approach is the result of 20 years of experience developing, implementing, and evaluating this practice in a metropolitan community, and is grounded in women's empowerment theory and relational-cultural theory. The interventions combine social work's clinical interventions with community organizing strategies to promote personal and collective empowerment, supporting the "personal is political" tenet of feminist practice. The interventions, including nonclinical interviews, story circles, and leadership and advocacy education and training, can guide practitioners in providing services and programs that create a space for women to make changes in their personal lives and in their community. Program outcomes report successful changes for women in improving symptoms, increasing self-efficacy, and engaging in community advocacy. Women who participated also reported an increased sense of power, balancing commonality and difference among women, and a sense of hope for their future.

Promoting imitation in young children with autism: a comparison of reciprocal imitation training and video modeling.

PubMed

Cardon, Teresa A; Wilcox, M Jeanne

2011-05-01

The inability to imitate is a salient diagnostic marker for autism. It has been suggested that for children with autism, imitation may be a prerequisite skill that can assist in the development of various skills. Using a multiple baseline design across subjects, the purpose of this research was to determine if two interventions, reciprocal imitation training and video modeling were effective in promoting imitation acquisition in young children with autism. Six boys were matched across various features (i.e., age, language, autism severity) and randomly placed in a treatment condition. Results indicated that all six participants increased their imitation skills to varying degrees in both conditions, and imitation maintained and generalized at higher than baseline levels post treatment.

Feasibility and potential efficacy of the family-centered Prevent-Teach-Reinforce model with families of children with developmental disorders.

PubMed

Bailey, Kathleen M; Blair, Kwang-Sun Cho

2015-12-01

This study examined the feasibility and potential efficacy of the family-centered Prevent-Teach-Reinforce (PTR) model with three families of young children with an autism spectrum disorder or language delay with sensory processing problems. Particularly, the study assessed the family adherence to the PTR intervention, changes in child behavior, family use of the Individualized Behavior Rating Scale Tool (IBRST), procedural integrity, and social validity. A multiple-baseline design across families was used to examine the functional relation between parent-implemented PTR intervention and changes in child behavior. Results indicated that the family-centered PTR process was successful in promoting parents to design and implement the PTR intervention plans with fidelity, and the parents' implemented intervention plans were effective in increasing replacement behavior and decreasing problem behavior across children. The results also indicated that the parents successfully used the IBRST to monitor their child's progress and were highly satisfied with the PTR intervention process and outcomes for their children. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving executive function in childhood: evaluation of a training intervention for 5-year-old children

PubMed Central

Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

2015-01-01

Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school. PMID:25983706

Improving executive function in childhood: evaluation of a training intervention for 5-year-old children.

PubMed

Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

2015-01-01

Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school.

Developing Health Promotion Interventions on Social Networking Sites: Recommendations from The FaceSpace Project

PubMed Central

Pedrana, Alisa E; Stoove, Mark A; Chang, Shanton; Howard, Steve; Asselin, Jason; Ilic, Olivia; Batrouney, Colin; Hellard, Margaret E

2012-01-01

Online social networking sites offer a novel setting for the delivery of health promotion interventions due to their potential to reach a large population and the possibility for two-way engagement. However, few have attempted to host interventions on these sites, or to use the range of interactive functions available to enhance the delivery of health-related messages. This paper presents lessons learnt from “The FaceSpace Project”, a sexual health promotion intervention using social networking sites targeting two key at-risk groups. Based on our experience, we make recommendations for developing and implementing health promotion interventions on these sites. Elements crucial for developing interventions include establishing a multidisciplinary team, allowing adequate time for obtaining approvals, securing sufficient resources for building and maintaining an online presence, and developing an integrated process and impact evaluation framework. With two-way interaction an important and novel feature of health promotion interventions in this medium, we also present strategies trialled to generate interest and engagement in our intervention. Social networking sites are now an established part of the online environment; our experience in developing and implementing a health promotion intervention using this medium are of direct relevance and utility for all health organizations creating a presence in this new environment. PMID:22374589

Adaptive Intervention Design in Mobile Health: Intervention Design and Development in the Cell Phone Intervention for You (CITY) Trial

PubMed Central

Lin, Pao-Hwa; Intille, Stephen; Bennett, Gary; Bosworth, Hayden B; Corsino, Leonor; Voils, Corrine; Grambow, Steven; Lazenka, Tony; Batch, Bryan C; Tyson, Crystal; Svetkey, Laura P

2015-01-01

Background/Aims The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this manuscript is to describe the design and development of the intervention tested in the Cell Phone Intervention for You (CITY) study and to highlight the importance of adaptive intervention design (AID) that made it possible. The CITY study was an NHLBI-sponsored, controlled 24-month randomized clinical trial (RCT) comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (BMI ≥ 25 kg/m2) young adults. Methods Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, AID, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The AID strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. AID was made possible by exploiting the mobile phone's remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. Results The cellphone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive – providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools for self-tracking and receiving tailored feedback. The intervention changed over two years to promote and sustain engagement. The personal coaching intervention, alternatively, was primarily personal coaching with trained coaches based on a proven intervention, enhanced with a mobile application, but where all interaction with the technology was participant-initiated. Conclusions The complexity and length of the technology-based RCT created challenges in engagement and technology adaptation, which were generally discovered using novel remote monitoring technology and addressed using the AID. Investigators should plan to develop tools and procedures that explicitly support continuous remote monitoring of interventions to support AID in long-term, technology-based studies, as well as developing the interventions themselves. PMID:26229119

'Keep fit' exercise interventions to improve health, fitness and well-being of children and young people who use wheelchairs: mixed-method systematic review protocol.

PubMed

O'Brien, Thomas D; Noyes, Jane; Spencer, Llinos Haf; Kubis, Hans-Peter; Hastings, Richard P; Edwards, Rhiannon T; Bray, Nathan; Whitaker, Rhiannon

2014-12-01

This mixed-method systematic review aims to establish the current evidence base for 'keep fit', exercise or physical activity interventions for children and young people who use wheelchairs. Nurses have a vital health promotion, motivational and monitoring role in optimizing the health and well-being of disabled children. Children with mobility impairments are prone to have low participation levels in physical activity, which reduces fitness and well-being. Effective physical activity interventions that are fun and engaging for children are required to promote habitual participation as part of a healthy lifestyle. Previous intervention programmes have been trialled, but little is known about the most effective types of exercise to improve the fitness of young wheelchair users. Mixed-method design using Cochrane systematic processes. Evidence regarding physiological and psychological effectiveness, health economics, user perspectives and service evaluations will be included and analysed under distinct streams. The project was funded from October 2012. Multiple databases will be searched using search strings combining relevant medical subheadings and intervention-specific terms. Articles will also be identified from ancestral references and by approaching authors to identify unpublished work. Only studies or reports evaluating the effectiveness, participation experiences or cost of a physical activity programme will be included. Separate analyses will be performed for each data stream, including a meta-analysis if sufficient homogeneity exists and thematic analyses. Findings across streams will be synthesized in an overarching narrative summary. Evidence from the first systematic review of this type will inform development of effective child-centred physical activity interventions and their evaluation. © 2014 John Wiley & Sons Ltd.

Narratives of community engagement: a systematic review-derived conceptual framework for public health interventions.

PubMed

Brunton, Ginny; Thomas, James; O'Mara-Eves, Alison; Jamal, Farah; Oliver, Sandy; Kavanagh, Josephine

2017-12-11

Government policy increasingly supports engaging communities to promote health. It is critical to consider whether such strategies are effective, for whom, and under what circumstances. However, 'community engagement' is defined in diverse ways and employed for different reasons. Considering the theory and context we developed a conceptual framework which informs understanding about what makes an effective (or ineffective) community engagement intervention. We conducted a systematic review of community engagement in public health interventions using: stakeholder involvement; searching, screening, appraisal and coding of research literature; and iterative thematic syntheses and meta-analysis. A conceptual framework of community engagement was refined, following interactions between the framework and each review stage. From 335 included reports, three products emerged: (1) two strong theoretical 'meta-narratives': one, concerning the theory and practice of empowerment/engagement as an independent objective; and a more utilitarian perspective optimally configuring health services to achieve defined outcomes. These informed (2) models that were operationalized in subsequent meta-analysis. Both refined (3) the final conceptual framework. This identified multiple dimensions by which community engagement interventions may differ. Diverse combinations of intervention purpose, theory and implementation were noted, including: ways of defining communities and health needs; initial motivations for community engagement; types of participation; conditions and actions necessary for engagement; and potential issues influencing impact. Some dimensions consistently co-occurred, leading to three overarching models of effective engagement which either: utilised peer-led delivery; employed varying degrees of collaboration between communities and health services; or built on empowerment philosophies. Our conceptual framework and models are useful tools for considering appropriate and effective approaches to community engagement. These should be tested and adapted to facilitate intervention design and evaluation. Using this framework may disentangle the relative effectiveness of different models of community engagement, promoting effective, sustainable and appropriate initiatives.

Short-term impact of a stress management and health promotion program on perceived stress, parental stress, health locus of control, and cortisol levels in parents of children and adolescents with diabetes type 1: a pilot randomized controlled trial.

PubMed

Tsiouli, Eleni; Pavlopoulos, Vassilis; Alexopoulos, Evangelos C; Chrousos, George; Darviri, Christina

2014-01-01

Parents of children and adolescents with diabetes type 1 (DT1) usually experience high stress levels, as they have to cope with multiple demands in their everyday life. Different complex interventions have been implemented, which sometimes have led to opposite results. The purpose of this study was to assess stress levels in parents of children and adolescents with DT1 and to evaluate the effectiveness of a stress management program (progressive muscle relaxation combined with diaphragmatic breathing) in reducing perceived and parenting stress, increasing internal locus of control, promoting healthy lifestyle, and normalizing cortisol levels. Randomized controlled trial. A total of 44 parents were randomly assigned to the intervention group (performing relaxation for eight weeks, n = 19) and control group (n = 25). Pre-post measurements included cortisol levels, lifestyle characteristics, perceived stress, perception of health, and parenting stress. A statistically significant decrease in perceived stress (from 27.21 to 19.00, P = .001), as well as in parenting stress (from 85.79 to 73.68, P = .003), was observed in the intervention group. A statistically significant difference was found in perceived stress between the two groups after the intervention (Dmean = 6.64, P = .010). No significant difference was revealed between or within the groups in cortisol levels. Significant improvement was reported by the subjects of the intervention group in various lifestyle parameters. Relaxation techniques seem to have a positive impact on stress and on various lifestyle factors in parents of children and adolescents with DT1. Future research on long-term benefits of an intervention program comprising of various relaxation schemes is warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

Challenges in doing multi-disciplinary health promotion research in Germany.

PubMed

Igel, Ulrike; Gausche, Ruth; Lück, Martina; Lipek, Tobias; Spielau, Ulrike; Garz, Maria; Kiess, Wieland; Grande, Gesine

2017-08-23

Health problems such as obesity are increasingly addressed by complex intervention programmes which operate at multiple levels of influence (e.g. families, schools, neighbourhoods) involving partners from various academic, professional and cultural backgrounds. Following a complex participatory health promotion approach is challenging, because conflicting interests as well as contextual constraints may occur which are rarely discussed empirically. Process evaluations of some programmes investigate factors influencing the implementation process. However, researchers' perspectives on inter- and transdisciplinary work are mostly neglected. This paper aims at illustrating and critically analysing challenges that arose in the planning and implementation of a health promotion project in a socially deprived neighbourhood in Germany. Drawing on minutes, email conversations, and research diary entries we reflect on discrepancies and difficult interactions within the research team, with collaborating (academic) institutions (interdisciplinary work) and with the community partners (transdisciplinary work) respectively. Differences in language, interests, success criteria, professional preferences and habits as well as contextual factors are worked out and coping strategies or solutions are proposed. According to our experiences, bringing to light researchers' positions, preferences and interactions with the community is necessary to find a balance between research and practice, to develop adequate solutions for challenging situations and to evaluate the process, effectiveness and transferability of a programme. Health promotion research should report not only on the effectiveness of interventions but also on struggles, unsuccessful attempts and useful (or useless) strategies to fuel discourse on opportunities in and the efficacy and transferability of health promotion projects. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Health promotion and cardiovascular disease prevention in sub-Saharan Africa.

PubMed

Sampson, Uchechukwu K A; Amuyunzu-Nyamongo, Mary; Mensah, George A

2013-01-01

Recent population studies demonstrate an increasing burden of cardiovascular disease (CVD) and related risk factors in sub-Saharan Africa (SSA). The mitigation or reversal of this trend calls for effective health promotion and preventive interventions. In this article, we review the core principles, challenges, and progress in promoting cardiovascular health with special emphasis on interventions to address physical inactivity, poor diet, tobacco use, and adverse cardiometabolic risk factor trends in SSA. We focus on the five essential strategies of the Ottawa Charter for Health Promotion. Successes highlighted include community-based interventions in Ghana, Nigeria, South Africa, and Mauritius and school-based programs in Kenya, Namibia, and Swaziland. We address the major challenge of developing integrated interventions, and showcase partnerships opportunities. We conclude by calling for intersectoral partnerships for effective and sustainable intervention strategies to advance cardiovascular health promotion and close the implementation gap in accordance with the 2009 Nairobi Call to Action on Health Promotion. © 2013.

Effectiveness of Social Marketing Interventions to Promote Physical Activity Among Adults: A Systematic Review.

PubMed

Xia, Yuan; Deshpande, Sameer; Bonates, Tiberius

2016-11-01

Social marketing managers promote desired behaviors to an audience by making them tangible in the form of environmental opportunities to enhance benefits and reduce barriers. This study proposed "benchmarks," modified from those found in the past literature, that would match important concepts of the social marketing framework and the inclusion of which would ensure behavior change effectiveness. In addition, we analyzed behavior change interventions on a "social marketing continuum" to assess whether the number of benchmarks and the role of specific benchmarks influence the effectiveness of physical activity promotion efforts. A systematic review of social marketing interventions available in academic studies published between 1997 and 2013 revealed 173 conditions in 92 interventions. Findings based on χ 2 , Mallows' Cp, and Logical Analysis of Data tests revealed that the presence of more benchmarks in interventions increased the likelihood of success in promoting physical activity. The presence of more than 3 benchmarks improved the success of the interventions; specifically, all interventions were successful when more than 7.5 benchmarks were present. Further, primary formative research, core product, actual product, augmented product, promotion, and behavioral competition all had a significant influence on the effectiveness of interventions. Social marketing is an effective approach in promoting physical activity among adults when a substantial number of benchmarks are used and when managers understand the audience, make the desired behavior tangible, and promote the desired behavior persuasively.

Body mass index and the impact of a health promotion intervention on health services use and expenditures.

PubMed

Meng, Hongdao; Liebel, Dianne; Wamsley, Brenda R

2011-06-01

To examine the effect of body mass index (BMI) on the impact of a health promotion intervention on health services use and expenditures among Medicare beneficiaries with disabilities. We analyzed data from 452 Medicare beneficiaries who participated in a Medicare demonstration. The intervention included the following components: patient education, health promotion coaching, medication management, and physician care management. We performed the analysis by using generalized linear models (GLM) to examine the impact of BMI and the intervention on total health care expenditures. The intervention was cost neutral over the 2-year study period. Participants in the intervention group used less home health aide services (p = .03) and had fewer nursing home days (p = .05). The intervention appeared to have smaller effects on expenditures as BMI level increased. The findings suggest that a health promotion intervention may achieve better beneficiary outcomes without an increase in resource use in this Medicare population.

Applying systems theory to the evaluation of a whole school approach to violence prevention.

PubMed

Kearney, Sarah; Leung, Loksee; Joyce, Andrew; Ollis, Debbie; Green, Celia

2016-02-01

Issue addressed Our Watch led a complex 12-month evaluation of a whole school approach to Respectful Relationships Education (RRE) implemented in 19 schools. RRE is an emerging field aimed at preventing gender-based violence. This paper will illustrate how from an implementation science perspective, the evaluation was a critical element in the change process at both a school and policy level. Methods Using several conceptual approaches from systems science, the evaluation sought to examine how the multiple systems layers - student, teacher, school, community and government - interacted and influenced each other. A distinguishing feature of the evaluation included 'feedback loops'; that is, evaluation data was provided to participants as it became available. Evaluation tools included a combination of standardised surveys (with pre- and post-intervention data provided to schools via individualised reports), reflection tools, regular reflection interviews and summative focus groups. Results Data was shared during implementation with project staff, department staff and schools to support continuous improvement at these multiple systems levels. In complex settings, implementation can vary according to context; and the impact of evaluation processes, tools and findings differed across the schools. Interviews and focus groups conducted at the end of the project illustrated which of these methods were instrumental in motivating change and engaging stakeholders at both a school and departmental level and why. Conclusion The evaluation methods were a critical component of the pilot's approach, helping to shape implementation through data feedback loops and reflective practice for ongoing, responsive and continuous improvement. Future health promotion research on complex interventions needs to examine how the evaluation itself is influencing implementation. So what? The pilot has demonstrated that the evaluation, including feedback loops to inform project activity, were an asset to implementation. This has implications for other health promotion activities, where evaluation tools could be utilised to enhance, rather than simply measure, an intervention. The findings are relevant to a range of health promotion research activities because they demonstrate the importance of meta-evaluation techniques that seek to understand how the evaluation itself was influencing implementation and outcomes.

A Pilot Study of a Creative Bonding Intervention to Promote Nursing Students' Attitudes towards Taking Care of Older People

PubMed Central

Lamet, Ann R.; Sonshine, Rosanne; Walsh, Sandra M.; Molnar, David; Rafalko, Sharon

2011-01-01

Although numbers of older people are increasing, nursing students have negative attitudes towards older people and do not plan to care for them following graduation. Multiple strategies have been implemented to reverse students' attitudes with mixed results. The purpose of this pilot quasi-experimental study was to test a Creative-Bonding Intervention (CBI) with students implementing art activities with older people to promote students' willingness to take care of them. Using a self-transcendence conceptual framework, control (n = 56) and experimental (n = 14) student groups were pre- and post-tested on attitudes toward older people, self-transcendence, and willingness to serve. The CBI improved attitudes towards older people with negative attitudes significantly changed (P = .008) but with no significant differences on self-transcendence and willingness to serve. However, willingness to serve results approached significance (P = .08). The willingness measure (one question) should be expanded. Curricula changes that incorporate creative activities such as the CBI with larger and equal numbers in student groups and longitudinal follow up to determine long-term results after graduation are suggested. PMID:21994833

Promoting IEP Participation: Effects of Interventions, Considerations for CLD Students

ERIC Educational Resources Information Center

Griffin, Megan M.

2011-01-01

Various interventions have been developed to promote student individualized education program (IEP) participation. Although they are generally endorsed by educators and researchers, critics argue that interventions to promote self-determination and IEP participation may be counter to the values of culturally and linguistically diverse (CLD)…

Promotion, Prevention and Early Intervention for Mental Health: National Consultation.

ERIC Educational Resources Information Center

2003

This report provides a description of a national consultation that was undertaken in 2001-2002 to provide feedback on two companion national policy documents: "National Action Plan for Promotion, Prevention and Early Intervention for Mental Health 2000" and "Promotion, Prevention and Early Intervention for Mental Health: A…

76 FR 41771 - Applications for New Awards; Rehabilitation Research and Training Center-Interventions To Promote...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... DEPARTMENT OF EDUCATION [CFDA Number: 84.133B-1] Applications for New Awards; Rehabilitation Research and Training Center--Interventions To Promote Community Living Among Individuals With Disabilities...)--Interventions to Promote Community Living Among Individuals with Disabilities fiscal year (FY) 2011 competition...

Review of mental health promotion interventions in schools.

PubMed

O'Reilly, Michelle; Svirydzenka, Nadzeya; Adams, Sarah; Dogra, Nisha

2018-05-11

The prevalence of mental disorders amongst children and adolescents is an increasing global problem. Schools have been positioned at the forefront of promoting positive mental health and well-being through implementing evidence-based interventions. The aim of this paper is to review current evidence-based research of mental health promotion interventions in schools and examine the reported effectiveness to identify those interventions that can support current policy and ensure that limited resources are appropriately used. The authors reviewed the current state of knowledge on school mental health promotion interventions globally. Two major databases, SCOPUS and ERIC were utilised to capture the social science, health, arts and humanities, and education literature. Initial searches identified 25 articles reporting on mental health promotion interventions in schools. When mapped against the inclusion and exclusion criteria, 10 studies were included and explored. Three of these were qualitative and seven were quantitative. A range of interventions have been tested for mental health promotion in schools in the last decade with variable degrees of success. Our review demonstrates that there is still a need for a stronger and broader evidence base in the field of mental health promotion, which should focus on both universal work and targeted approaches to fully address mental health in our young populations.

The Efficacy of Behavioral Interventions in Reducing HIV Risk Behaviors and Incident Sexually Transmitted Diseases in Heterosexual African Americans

PubMed Central

Darbes, Lynae; Crepaz, Nicole; Lyles, Cynthia; Kennedy, Gail; Rutherford, George

2009-01-01

Objective To conduct a meta-analytic review of HIV interventions for heterosexual African Americans to determine the overall efficacy in reducing HIV-risk sex behaviors and incident sexually transmitted diseases (STD) and identify intervention characteristics associated with efficacy. Methods Comprehensive searches included electronic databases from 1988 to 2005, handsearches of journals, reference lists of articles, and contacts with researchers. Thirty-eight randomized controlled trials met the selection criteria. Random-effects models were used to aggregate data. Results Interventions significantly reduced unprotected sex (OR = 0.75, 95% CI = 0.67, 0.84, 35 trials, N = 14,682) and marginally significantly decreased incident STD (OR = 0.88, 95% CI = 0.72, 1.07, 10 trials, n = 10,944). Intervention characteristics associated with efficacy include: (1) culturally tailored, (2) aiming to influence social norms in promoting safe sex behaviour, (3) utilizing peer education, (4) providing skills training on correct use of condoms and communication skills needed for negotiating safer sex, and (5) multiple sessions and opportunities to practice learned skills. Conclusion Interventions targeting heterosexual African Americans are efficacious in reducing HIV-risk sex behaviors. Efficacious intervention components identified in this review should be incorporated into the development of future interventions and further evaluated for effectiveness. PMID:18525264

Reducing Risk Behaviors Linked to Noncommunicable Diseases in Mongolia: A Randomized Controlled Trial

PubMed Central

Wang, Wei; Riedel, Marion; Witte, Susan S.

2013-01-01

Objectives. We tested the efficacy of a 6-session, evidence-based health promotion intervention aimed at reducing noncommunicable disease (NCD) risk behaviors. Methods. Two hundred male and female factory workers in Ulaanbaatar, Mongolia were randomly assigned to groups receiving either the health promotion intervention or a time-matched financial literacy control intervention. Results. The health promotion intervention increased daily fruit and vegetable intake and physical activity, increased readiness for NCD risk behavior reduction and health promotion knowledge, and reduced the number of daily alcoholic drinks and diabetes symptoms 3 months after the intervention. Conclusions. The findings support the efficacy of the intervention to reduce risk behaviors associated with NCDs. Dissemination of the intervention may improve productivity, reduce costs of health services, and better the quality of life for Mongolians. PMID:23865647

A randomised controlled trial of an exercise plus behaviour change intervention in people with multiple sclerosis: the step it up study protocol.

PubMed

Coote, Susan; Gallagher, Stephen; Msetfi, Rachel; Larkin, Aidan; Newell, John; Motl, Robert W; Hayes, Sara

2014-12-21

Exercise has consistently yielded short-term, positive effects on health outcomes in people with multiple sclerosis (MS). However, these effects have not been maintained in the long-term. Behaviour change interventions aim to promote long-term positive lifestyle change. This study, namely, "Step it Up" will compare the effect of an exercise plus Social Cognitive Theory (SCT)-based behaviour change intervention with an exercise plus control education intervention on walking mobility among people with MS. People with a diagnosis of MS who walk independently, score of 0-3 on the Patient Determined Disease Steps, who have not experienced an MS relapse or change in their MS medication in the last 12 weeks and who are physically inactive will be randomised to one of two study conditions. The experimental group will undergo a 10-week exercise plus SCT-based behavioural change intervention. The control group will undergo a 10-week exercise plus education intervention to control for contact. Participants will be assessed at weeks 1, 12, 24 and 36. The primary outcome will be walking mobility. Secondary outcomes will include: aerobic capacity, lower extremity muscle strength, participant adherence to the exercise programme, self-report exercise intensity, self-report enjoyment of exercise, exercise self-efficacy, outcome expectations for exercise, goal-setting for exercise, perceived benefits and barriers to exercise, perceptions of social support, physical and psychological impact of MS and fatigue. A qualitative evaluation of Step it Up will be completed among participants post-intervention. This randomised controlled trial will examine the effectiveness of an exercise plus SCT-based behaviour change intervention on walking mobility among people with MS. To this end, Step it Up will serve to inform future directions of research and clinical practice with regard to sustainable exercise interventions for people with MS. ClinicalTrials.gov, NCT02301442.

Food ordering for children in restaurants: multiple sources of influence on decision making.

PubMed

Castro, Iana A; Williams, Christine B; Madanat, Hala; Pickrel, Julie L; Jun, Hee-Jin; Zive, Michelle; Gahagan, Sheila; Ayala, Guadalupe X

2016-09-01

Restaurants are playing an increasingly important role in children's dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants. A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child's gender, person ordering for the child and server interactions with the dining party. Interview data included: child's age, restaurant visit frequency, timing of child's decision making, and factors influencing decision making. Ten independent, table-service restaurants in San Diego, CA, USA participated. Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3-14 years). Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children's) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children's menu. Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants.

Promoting Health in Early Childhood Environments: A Health-Promotion Approach

ERIC Educational Resources Information Center

Minniss, Fiona Rowe; Wardrope, Cheryl; Johnston, Donni; Kendall, Elizabeth

2013-01-01

This paper investigates the mechanisms by which a health-promotion intervention might influence the health-promoting behaviours of staff members working in early childhood centres. The intervention was an ecological health-promotion initiative that was implemented within four early childhood centres in South-East Queensland, Australia. In-depth,…

Implementation Planning to Promote Parents' Treatment Integrity of Behavioral Interventions for Children with Autism

ERIC Educational Resources Information Center

Fallon, Lindsay M.; Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Feinberg, Adam B.; Kratochwill, Thomas R.

2016-01-01

Behavioral interventions delivered across home and school settings can promote positive outcomes for youth with autism spectrum disorders (ASD). Yet, stakeholders who deliver these interventions may struggle to implement interventions as intended. Low levels of treatment integrity can undermine potentially positive intervention outcomes. One way…

Interventions promoting healthy eating as a tool for reducing social inequalities in diet in low- and middle-income countries: a systematic review.

PubMed

Mayén, Ana-Lucia; de Mestral, Carlos; Zamora, Gerardo; Paccaud, Fred; Marques-Vidal, Pedro; Bovet, Pascal; Stringhini, Silvia

2016-12-22

Diet is a major risk factor for non-communicable diseases (NCDs) and is also strongly patterned by socioeconomic factors. Whether interventions promoting healthy eating reduce social inequalities in diet in low- and middle-income countries (LMICs) remains uncertain. This paper aims to summarize current evidence on interventions promoting healthy eating in LMICs, and to establish whether they reduce social inequalities in diet. Systematic review of cross-sectional or quasi-experimental studies (pre- and post-assessment of interventions) in Pubmed, Scielo and Google Scholar databases, including adults in LMICs, assessing at least one outcome of healthy eating and showing results stratified by socioeconomic status. Seven intervention studies including healthy eating promotion, conducted in seven LMICs (Brazil, Chile, Colombia, Iran, Panama, Trinidad and Tobago, and Tunisia), met our inclusion criteria. To promote healthy eating, all interventions used nutrition education and three of them combined nutrition education with improved acces to foods or social support. Interventions targeted mostly women and varied widely regarding communication tools and duration of the nutrition education sessions. Most interventions used printed material, media use or face-to-face training and lasted from 6 weeks to 5 years. Four interventions targeted disadvantaged populations, and three targeted the entire population. In three out of four interventions targeting disadvantaged populations, healthy eating outcomes were improved suggesting they were likely to reduce social inequalities in diet. All interventions directed to the entire population showed improved healthy eating outcomes in all social strata, and were considered as having no impact on social inequalities in diet. In LMICs, agentic interventions promoting healthy eating reduced social inequalities in diet when specifically targeting disadvantaged populations. Further research should assess the impact on social inequalities in diet of a combination of agentic and structural approaches in interventions promoting healthy eating.

Theory-Based Interventions Combining Mental Simulation and Planning Techniques to Improve Physical Activity: Null Results from Two Randomized Controlled Trials.

PubMed

Meslot, Carine; Gauchet, Aurélie; Allenet, Benoît; François, Olivier; Hagger, Martin S

2016-01-01

Interventions to assist individuals in initiating and maintaining regular participation in physical activity are not always effective. Psychological and behavioral theories advocate the importance of both motivation and volition in interventions to change health behavior. Interventions adopting self-regulation strategies that foster motivational and volitional components may, therefore, have utility in promoting regular physical activity participation. We tested the efficacy of an intervention adopting motivational (mental simulation) and volitional (implementation intentions) components to promote a regular physical activity in two studies. Study 1 adopted a cluster randomized design in which participants ( n = 92) were allocated to one of three conditions: mental simulation plus implementation intention, implementation intention only, or control. Study 2 adopted a 2 (mental simulation vs. no mental simulation) × 2 (implementation intention vs. no implementation intention) randomized controlled design in which fitness center attendees ( n = 184) were randomly allocated one of four conditions: mental simulation only, implementation intention only, combined, or control. Physical activity behavior was measured by self-report (Study 1) or fitness center attendance (Study 2) at 4- (Studies 1 and 2) and 19- (Study 2 only) week follow-up periods. Findings revealed no statistically significant main or interactive effects of the mental simulation and implementation intention conditions on physical activity outcomes in either study. Findings are in contrast to previous research which has found pervasive effects for both intervention strategies. Findings are discussed in light of study limitations including the relatively small sample sizes, particularly for Study 1, deviations in the operationalization of the intervention components from previous research and the lack of a prompt for a goal intention. Future research should focus on ensuring uniformity in the format of the intervention components, test the effects of each component alone and in combination using standardized measures across multiple samples, and systematically explore effects of candidate moderators.

Theory-Based Interventions Combining Mental Simulation and Planning Techniques to Improve Physical Activity: Null Results from Two Randomized Controlled Trials

PubMed Central

Meslot, Carine; Gauchet, Aurélie; Allenet, Benoît; François, Olivier; Hagger, Martin S.

2016-01-01

Interventions to assist individuals in initiating and maintaining regular participation in physical activity are not always effective. Psychological and behavioral theories advocate the importance of both motivation and volition in interventions to change health behavior. Interventions adopting self-regulation strategies that foster motivational and volitional components may, therefore, have utility in promoting regular physical activity participation. We tested the efficacy of an intervention adopting motivational (mental simulation) and volitional (implementation intentions) components to promote a regular physical activity in two studies. Study 1 adopted a cluster randomized design in which participants (n = 92) were allocated to one of three conditions: mental simulation plus implementation intention, implementation intention only, or control. Study 2 adopted a 2 (mental simulation vs. no mental simulation) × 2 (implementation intention vs. no implementation intention) randomized controlled design in which fitness center attendees (n = 184) were randomly allocated one of four conditions: mental simulation only, implementation intention only, combined, or control. Physical activity behavior was measured by self-report (Study 1) or fitness center attendance (Study 2) at 4- (Studies 1 and 2) and 19- (Study 2 only) week follow-up periods. Findings revealed no statistically significant main or interactive effects of the mental simulation and implementation intention conditions on physical activity outcomes in either study. Findings are in contrast to previous research which has found pervasive effects for both intervention strategies. Findings are discussed in light of study limitations including the relatively small sample sizes, particularly for Study 1, deviations in the operationalization of the intervention components from previous research and the lack of a prompt for a goal intention. Future research should focus on ensuring uniformity in the format of the intervention components, test the effects of each component alone and in combination using standardized measures across multiple samples, and systematically explore effects of candidate moderators. PMID:27899904

Towards evidence-based, quality-controlled health promotion: the Dutch recognition system for health promotion interventions

PubMed Central

Brug, Johannes; van Dale, Djoeke; Lanting, Loes; Kremers, Stef; Veenhof, Cindy; Leurs, Mariken; van Yperen, Tom; Kok, Gerjo

2010-01-01

Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and effectiveness of available health promotion interventions and to promote use of good-practice and evidence-based interventions by health promotion organizations. The quality assessments are supervised by the Netherlands Organization for Public Health and the Environment and the Netherlands Youth Institute and conducted by two committees, one for interventions aimed at youth and one for adults. These committees consist of experts in the fields of research, policy and practice. Four levels of recognition are distinguished inspired by the UK Medical Research Council's evaluation framework for complex interventions to improve health: (i) theoretically sound, (ii) probable effectiveness, (iii) established effectiveness, and (iv) established cost effectiveness. Specific criteria have been set for each level of recognition, except for Level 4 which will be included from 2011. This point of view article describes and discusses the rationale, organization and criteria of this Dutch recognition system and the first experiences with the system. PMID:20841318

Achieving Developmental Synchrony in Young Children With Hearing Loss

PubMed Central

Mellon, Nancy K.; Ouellette, Meredith; Greer, Tracy; Gates-Ulanet, Patricia

2009-01-01

Children with hearing loss, with early and appropriate amplification and intervention, demonstrate gains in speech, language, and literacy skills. Despite these improvements many children continue to exhibit disturbances in cognitive, behavioral, and emotional control, self-regulation, and aspects of executive function. Given the complexity of developmental learning, educational settings should provide services that foster the growth of skills across multiple dimensions. Transdisciplinary intervention services that target the domains of language, communication, psychosocial functioning, motor, and cognitive development can promote academic and social success. Educational programs must provide children with access to the full range of basic skills necessary for academic and social achievement. In addition to an integrated curriculum that nurtures speech, language, and literacy development, innovations in the areas of auditory perception, social emotional learning, motor development, and vestibular function can enhance student outcomes. Through ongoing evaluation and modification, clearly articulated curricular approaches can serve as a model for early intervention and special education programs. The purpose of this article is to propose an intervention model that combines best practices from a variety of disciplines that affect developmental outcomes for young children with hearing loss, along with specific strategies and approaches that may help to promote optimal development across domains. Access to typically developing peers who model age-appropriate skills in language and behavior, small class sizes, a co-teaching model, and a social constructivist perspective of teaching and learning, are among the key elements of the model. PMID:20150187

Registry Assessment of Peripheral Interventional Devices (RAPID)　- Registry Assessment of Peripheral Interventional Devices Core Data Elements.

PubMed

Jones, W Schuyler; Krucoff, Mitchell W; Morales, Pablo; Wilgus, Rebecca W; Heath, Anne H; Williams, Mary F; Tcheng, James E; Marinac-Dabic, J Danica; Malone, Misti L; Reed, Terrie L; Fukaya, Rie; Lookstein, Robert; Handa, Nobuhiro; Aronow, Herbert D; Bertges, Daniel J; Jaff, Michael R; Tsai, Thomas T; Smale, Joshua A; Zaugg, Margo J; Thatcher, Robert J; Cronenwett, Jack L; Nc, Durham; Md, Silver Spring; Japan, Tokyo; Ny, New York; Ri, Providence; Vt, Burlington; Mass, Newton; Colo, Denver; Ariz, Tempe; Calif, Santa Clara; Minn, Minneapolis; Nh, Lebanon

2018-01-25

The current state of evaluating patients with peripheral artery disease and more specifically of evaluating medical devices used for peripheral vascular intervention (PVI) remains challenging because of the heterogeneity of the disease process, the multiple physician specialties that perform PVI, the multitude of devices available to treat peripheral artery disease, and the lack of consensus about the best treatment approaches. Because PVI core data elements are not standardized across clinical care, clinical trials, and registries, aggregation of data across different data sources and physician specialties is currently not feasible.Methods and Results:Under the auspices of the U.S. Food and Drug Administration's Medical Device Epidemiology Network initiative-and its PASSION (Predictable and Sustainable Implementation of the National Registries) program, in conjunction with other efforts to align clinical data standards-the Registry Assessment of Peripheral Interventional Devices (RAPID) workgroup was convened. RAPID is a collaborative, multidisciplinary effort to develop a consensus lexicon and to promote interoperability across clinical care, clinical trials, and national and international registries of PVI. The current manuscript presents the initial work from RAPID to standardize clinical data elements and definitions, to establish a framework within electronic health records and health information technology procedural reporting systems, and to implement an informatics-based approach to promote the conduct of pragmatic clinical trials and registry efforts in PVI. Ultimately, we hope this work will facilitate and improve device evaluation and surveillance for patients, clinicians, health outcomes researchers, industry, policymakers, and regulators.

Cognitive and Behavioral Resilience Among Young Gay and Bisexual Men Living with HIV.

PubMed

Hussen, Sophia A; Harper, Gary W; Rodgers, Caryn R R; van den Berg, Jacob J; Dowshen, Nadia; Hightow-Weidman, Lisa B

2017-08-01

HIV/AIDS disproportionately affects young gay, bisexual, and other men who have sex with men (Y-GBMSM). Resilience remains understudied among Y-GBMSM living with HIV, but represents a potentially important framework for improving HIV-related outcomes in this population. We sought to explore cognitive and behavioral dimensions of resilience and their correlates among Y-GBMSM to gain insights to inform future interventions. Our study sample consisted of 200 Y-GBMSM living with HIV enrolled in a multisite study of the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Participants completed a one-time, self-administered structured questionnaire, including validated scales capturing a range of cognitive, behavioral, demographic, and psychosocial data. Utilizing these data, we examined cognitive and behavioral dimensions of resilience and their potential psychosocial correlates using linear regression modeling. Multiple regression analyses demonstrated that education, stigma, social support, ethnic identity, internalized homonegativity, and behavioral resilience were statistically significant predictors of cognitive resilience (P < 0.001, R 2  = 0.678). Social support satisfaction and cognitive resilience were significant predictors of behavioral resilience (P < 0.001, R 2  = 0.141). Our findings point to potential strategies for incorporating resilience-promoting features into future interventions to support Y-GBMSM living with HIV. Specifically, strengths-based interventions in this population should seek to enhance social support, promote positive identity development, and encourage education. Future research can also seek to utilize and refine our measures of resilience among youth.

Identifying Synergies in Multilevel Interventions.

PubMed

Lewis, Megan A; Fitzgerald, Tania M; Zulkiewicz, Brittany; Peinado, Susana; Williams, Pamela A

2017-04-01

Social ecological models of health often describe multiple levels of influence that interact to influence health. However, it is still common for interventions to target only one or two of these levels, perhaps owing in part to a lack of guidance on how to design multilevel interventions to achieve optimal impact. The convergence strategy emphasizes that interventions at different levels mutually reinforce each other by changing patterns of interaction among two or more intervention audiences; this strategy is one approach for combining interventions at different levels to produce synergistic effects. We used semistructured interviews with 65 representatives in a cross-site national initiative that enhanced health and outcomes for patients with diabetes to examine whether the convergence strategy was a useful conceptual model for multilevel interventions. Using a framework analysis approach to analyze qualitative interview data, we found three synergistic themes that match the convergence strategy and support how multilevel interventions can be successful. These three themes were (1) enhancing engagement between patient and provider and access to quality care; (2) supporting communication, information sharing, and coordination among providers, community stakeholders, and systems; and (3) building relationships and fostering alignment among providers, community stakeholders, and systems. These results support the convergence strategy as a testable conceptual model and provide examples of successful intervention strategies for combining multilevel interventions to produce synergies across levels and promote diabetes self-management and that may extend to management of other chronic illnesses as well.

The role of exercise in modifying outcomes for people with multiple sclerosis: a randomized trial

PubMed Central

2013-01-01

Background Despite the commonly known benefits of exercise and physical activity evidence shows that persons Multiple Sclerosis (MS) are relatively inactive yet physical activity may be even more important in a population facing functional deterioration. No exercise is effective if it is not done and people with MS face unique barriers to exercise engagement which need to be overcome. We have developed and pilot tested a Multiple Sclerosis Tailored Exercise Program (MSTEP) and it is ready to be tested against general guidelines for superiority and ultimately for its impact on MS relevant outcomes. The primary research question is to what extent does an MS Tailored Exercise Program (MSTEP) result in greater improvements in exercise capacity and related outcomes over a one year period in comparison to a program based on general guidelines for exercise among people with MS who are sedentary and wish to engage in exercise as part of MS self-management. Methods/Design The proposed study is an assessor-blind, parallel-group, randomized controlled trial (RCT). The duration of the intervention will be one year with follow-up to year two. The targeted outcomes are exercise capacity, functional ambulation, strength, and components of quality of life including frequency and intensity of fatigue symptoms, mood, global physical function, health perception, and objective measures of activity level. Logistic regression will be used to test the main hypothesis related to the superiority of the MSTEP program based on a greater proportion of people making a clinically relevant gain in exercise capacity at 1 year and at 2 years, using an intention-to-treat approach. Sample size will be 240 (120 per group). Discussion The MS community is clearly looking for interventions to help alleviate the disabling sequelae of MS and promote health. Exercise is a well-known intervention which has known benefits to all, yet few exercise regularly. For people with MS, the role of exercise in MS management needs to be rigorously assessed to inform people as to how best to use exercise to reduce disability and promote health. Trial registration Clinical Trials.gov: NCT01611987 PMID:23809312

Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.

PubMed

Lin, Pao-Hwa; Intille, Stephen; Bennett, Gary; Bosworth, Hayden B; Corsino, Leonor; Voils, Corrine; Grambow, Steven; Lazenka, Tony; Batch, Bryan C; Tyson, Crystal; Svetkey, Laura P

2015-12-01

The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this article is to describe the design and development of the intervention tested in the Cell Phone Intervention for You study and to highlight the importance of adaptive intervention design that made it possible. The Cell Phone Intervention for You study was a National Heart, Lung, and Blood Institute-sponsored, controlled, 24-month randomized clinical trial comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (body mass index≥25 kg/m2) young adults. Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, adaptive intervention design, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The adaptive intervention design strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. Adaptive intervention design was made possible by exploiting the mobile phone's remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. The cell phone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive-providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools for self-tracking and receiving tailored feedback. The intervention changed over 2 years to promote and sustain engagement. The personal coaching intervention, alternatively, was primarily personal coaching with trained coaches based on a proven intervention, enhanced with a mobile application, but where all interactions with the technology were participant-initiated. The complexity and length of the technology-based randomized clinical trial created challenges in engagement and technology adaptation, which were generally discovered using novel remote monitoring technology and addressed using the adaptive intervention design. Investigators should plan to develop tools and procedures that explicitly support continuous remote monitoring of interventions to support adaptive intervention design in long-term, technology-based studies, as well as developing the interventions themselves. © The Author(s) 2015.

Sustainability of Physical Activity Promoting Environments and Influences on Sustainability Following a Structural Intervention in Residential Children's Homes

ERIC Educational Resources Information Center

Dominick, Gregory M.; Tudose, Alina; Pohlig, Ryan T.; Saunders, Ruth P.

2016-01-01

Research examining sustainability of health promotion programs within organizational settings is limited. The Environmental Interventions in Residential Children's Homes (ENRICH) was a structural intervention that trained Wellness Teams (WTs) within residential children's homes (RCH) to target environmental changes that promote physical activity…

Interventions to promote cancer awareness and early presentation: systematic review

PubMed Central

Austoker, J; Bankhead, C; Forbes, L J L; Atkins, L; Martin, F; Robb, K; Wardle, J; Ramirez, A J

2009-01-01

Background: Low cancer awareness contributes to delay in presentation for cancer symptoms and may lead to delay in cancer diagnosis. The aim of this study was to review the evidence for the effectiveness of interventions to raise cancer awareness and promote early presentation in cancer to inform policy and future research. Methods: We searched bibliographic databases and reference lists for randomised controlled trials of interventions delivered to individuals, and controlled or uncontrolled studies of interventions delivered to communities. Results: We found some evidence that interventions delivered to individuals modestly increase cancer awareness in the short term and insufficient evidence that they promote early presentation. We found limited evidence that public education campaigns reduce stage at presentation of breast cancer, malignant melanoma and retinoblastoma. Conclusions: Interventions delivered to individuals may increase cancer awareness. Interventions delivered to communities may promote cancer awareness and early presentation, although the evidence is limited. PMID:19956160

Evidence-based lifestyle interventions in the workplace--an overview.

PubMed

Schröer, S; Haupt, J; Pieper, C

2014-01-01

Lifestyle-related health issues affect the economic position of organizations and contribute to reduced productivity, increased absenteeism and health care costs. To summarize the effectiveness of different workplace health interventions for promoting healthy lifestyle, preventing diseases and reducing health care costs. We searched MEDLINE via Pubmed, EMBASE, Cochrane Library, NelH, HighWire Press and Google Scholar in March 2012. Systematic reviews and meta-analyses of workplace interventions aimed at promoting physical activity, healthy weight and good nutrition were included. Three authors assessed the quality of the reviews and extracted data on methods, interventions, outcomes, results and effect sizes. We identified 15 publications covering a total of 379 original studies. Three systematic reviews found beneficial effects of workplace nutrition interventions on employees' dietary behaviour. Three reviews found multi-component physical activity interventions to be effective in increasing employees' physical activity and fitness. The other activity promotion interventions were less effective regarding physical activity and weight-related outcomes. In terms of weight management, our findings favour multi-component interventions that focus on both physical activity and nutrition over single dietary programmes. Workplace health promotion interventions may improve physical activity, dietary behaviour and healthy weight. There is no evidence of increased efficacy associated with specific intervention types. Workplace health promotion should focus on either physical activity or weight or nutrition behaviour to maximize effectiveness. Best evidence is available for multi-component interventions.

Promoting Children's Social-Emotional Skills in Preschool Can Enhance Academic and Behavioral Functioning in Kindergarten: Findings from Head Start REDI

PubMed Central

Nix, Robert L.; Bierman, Karen L.; Domitrovich, Celene E.; Gill, Sukhdeep

2013-01-01

This study examined processes of change associated with the positive preschool and kindergarten outcomes of children who received the Head Start REDI intervention, compared to “usual practice” Head Start. In a large-scale randomized-controlled trial (N = 356 children, 42% African American or Latino, all from low-income families), this study tests the logic model that improving preschool social-emotional skills (e.g., emotion understanding, social problem solving, and positive social behavior) as well as language/emergent literacy skills will promote cross-domain academic and behavioral adjustment after children transition into kindergarten. Validating this logic model, the present study finds that intervention effects on three important kindergarten outcomes (e.g., reading achievement, learning engagement, and positive social behavior) were mediated by preschool gains in the proximal social-emotional and language/emergent literacy skills targeted by the REDI intervention. Importantly, preschool gains in social-emotional skills made unique contributions to kindergarten outcomes in reading achievement and learning engagement, even after accounting for the concurrent preschool gains in vocabulary and emergent literacy skills. These findings highlight the importance of fostering at-risk children's social-emotional skills during preschool as a means of promoting school readiness. The REDI (Research-Based, Developmentally-Informed) enrichment intervention was designed to complement and strengthen the impact of existing Head Start programs in the dual domains of language/emergent literacy skills and social-emotional competencies. REDI was one of several projects funded by the Interagency School Readiness Consortium, a partnership of four federal agencies (the National Institute of Child Health and Human Development, the Administration for Children and Families, the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services, and the Office of Special Education and Rehabilitation Services in the Department of Education). The projects funded through this partnership were designed to assess how integrative early interventions for at-risk children could promote learning and development across multiple domains of functioning. In addition, the projects were charged with examining processes of change and identifying mechanisms of action by which the early childhood interventions fostered later school adjustment and academic achievement. This study examined such processes of change, with the goal of documenting hypothesized cross-domain influences on kindergarten outcomes. In particular, this study tested whether gains in the proximal language/emergent literacy and social-emotional competencies targeted during Head Start would mediate the REDI intervention effects on kindergarten academic and behavioral outcomes. In addition, it tested the hypothesis that gains in social-emotional competencies during preschool would make unique contributions to intervention effects on both academic and behavioral outcomes, even after accounting for the effects of preschool gains in language and emergent literacy skills. PMID:24311939

[Are Interventions Promoting Physical Activity Cost-Effective? A Systematic Review of Reviews].

PubMed

Rütten, Alfred; Abu-Omar, Karim; Burlacu, Ionut; Schätzlein, Valentin; Suhrcke, Marc

2017-03-01

On the basis of international published reviews, this systematic review aims to determine the health economic benefits of interventions promoting physical activity.This review of reviews is based on a systematic literature research in 10 databases (e. g. PubMed, Scopus, SPORTDiscus) supplemented by hand searches from January 2000 to October 2015. Publications were considered in the English or German language only. Results of identified reviews were derived.In total, 18 reviews were identified that could be attributed to interventions promoting physical activity (2 reviews focusing on population-based physical activity interventions, 10 reviews on individual-based and 6 reviews on both population-based and individual-based physical activity interventions). Results showed that population-based physical activity interventions are of great health economic potential if reaching a wider population at comparably low costs. Outstanding are political and environmental strategies, as well as interventions supporting behavioural change through information. The most comprehensive documentation for interventions promoting physical activity could be found for individual-based strategies (i. e. exercise advice or exercise programs). However, such programs are comparatively less cost-effective due to limited reach and higher utilization of resources.The present study provides an extensive review and analysis of the current international state of research regarding the health economic evaluation of interventions promoting physical activity. Results show favourable cost-effectiveness for interventions promoting physical activity, though significant differences in the effectiveness between various interventions were noticed. The greatest potential for cost-effectiveness can be seen in population-based interventions. At the same time, there is a need to acknowledge the limitations of the economic evidence in this field which are attributable to methodological challenges and research deficits. © Georg Thieme Verlag KG Stuttgart · New York.

Implementing healthy lifestyle promotion in primary care: a quasi-experimental cross-sectional study evaluating a team initiative.

PubMed

Thomas, Kristin; Krevers, Barbro; Bendtsen, Preben

2015-01-22

Non-communicable diseases are a leading cause of death and can largely be prevented by healthy lifestyles. Health care organizations are encouraged to integrate healthy lifestyle promotion in routine care. This study evaluates the impact of a team initiative on healthy lifestyle promotion in primary care. A quasi-experimental, cross-sectional design compared three intervention centres that had implemented lifestyle teams with three control centres that used a traditional model of care. Outcomes were defined using the RE-AIM framework: reach, the proportion of patients receiving lifestyle promotion; effectiveness, self-reported attitudes and competency among staff; adoption, proportion of staff reporting regular practice of lifestyle promotion; implementation, fidelity to the original lifestyle team protocol. Data collection methods included a patient questionnaire (n = 888), a staff questionnaire (n = 120) and structured interviews with all practice managers and, where applicable, team managers (n = 8). The chi square test and problem-driven content analysis was used to analyse the questionnaire and interview data, respectively. Reach: patients at control centres (48%, n = 211) received lifestyle promotion significantly more often compared with patients at intervention centres (41%, n = 169). Effectiveness: intervention staff was significantly more positive towards the effectiveness of lifestyle promotion, shared competency and how lifestyle promotion was prioritized at their centre. Adoption: 47% of staff at intervention centres and 58% at control centres reported that they asked patients about their lifestyle on a daily basis. all intervention centres had implemented multi-professional teams and team managers and held regular meetings but struggled to implement in-house referral structures for lifestyle promotion, which was used consistently among staff. Intervention centres did not show higher rates than control centres on reach of patients or adoption among staff at this stage. All intervention centres struggled to implement working referral structures for lifestyle promotion. Intervention centres were more positive on effectiveness outcomes, attitudes and competency among staff, however. Thus, lifestyle teams may facilitate lifestyle promotion practice in terms of increased responsiveness among staff, illustrated by positive attitudes and perceptions of shared competency. More research is needed on lifestyle promotion referral structures in primary care regarding their configuration and implementation.

Lifestyle physical activity in persons with multiple sclerosis: the new kid on the MS block.

PubMed

Motl, Robert W

2014-07-01

Supervised exercise training has substantial benefits for persons with multiple sclerosis (MS), yet 80% of those with MS do not meet recommended levels of moderate-to-vigorous physical activity (MVPA). This same problem persisted for decades in the general population of adults and prompted a paradigm shift away from "exercise training for fitness" toward "physical activity for health." The paradigm shift reflects a public health approach of promoting lifestyle physical activity through behavioral interventions that teach people the skills, techniques, and strategies based on established theories for modifying and self-regulating health behaviors. This paper describes: (a) the definitions of and difference between structured exercise training and lifestyle physical activity; (b) the importance and potential impact of the paradigm shift; (c) consequences of lifestyle physical activity in MS; and (d) behavioral interventions for changing lifestyle physical activity in MS. The paper introduces the "new kid on the MS block" with the hope that lifestyle physical activity might become an accepted partner alongside exercise training for inclusion in comprehensive MS care. © The Author(s) 2014.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18.

PubMed

Dobbins, Maureen; De Corby, Kara; Robeson, Paula; Husson, Heather; Tirilis, Daiva

2009-01-21

The World Health Organization estimates that 1.9 million deaths worldwide are attributable to physical inactivity. Chronic diseases associated with physical inactivity include cancer, diabetes and coronary heart disease. The purpose of this systematic review is to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents. The search strategy included searching several databases. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information. To be included, the intervention had to be relevant to public health practice, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, report on outcomes for children and adolescents (aged 6 to 18 years), and use a prospective design with a control group. Standardized tools were used by two independent reviewers to rate each study's methodological quality and for data extraction. Where discrepancies existed discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated and outcomes measured. 13,841 titles were identified and screened and 482 articles were retrieved. Multiple publications on the same project were combined and counted as one project, resulting in 395 distinct project accounts (studies). Of the 395 studies 104 were deemed relevant and of those, four were assessed as having strong methodological quality, 22 were of moderate quality and 78 were considered weak. In total 26 studies were included in the review. There is good evidence that school-based physical activity interventions have a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally school-based interventions had no effect on leisure time physical activity rates, systolic and diastolic blood pressure, body mass index, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity result in positive effects. Given that there are no harmful effects and that there is some evidence of positive effects on lifestyle behaviours and physical health status measures, ongoing physical activity promotion in schools is recommended at this time.

Individual versus systemic risk and the Regulator's Dilemma.

PubMed

Beale, Nicholas; Rand, David G; Battey, Heather; Croxson, Karen; May, Robert M; Nowak, Martin A

2011-08-02

The global financial crisis of 2007-2009 exposed critical weaknesses in the financial system. Many proposals for financial reform address the need for systemic regulation--that is, regulation focused on the soundness of the whole financial system and not just that of individual institutions. In this paper, we study one particular problem faced by a systemic regulator: the tension between the distribution of assets that individual banks would like to hold and the distribution across banks that best supports system stability if greater weight is given to avoiding multiple bank failures. By diversifying its risks, a bank lowers its own probability of failure. However, if many banks diversify their risks in similar ways, then the probability of multiple failures can increase. As more banks fail simultaneously, the economic disruption tends to increase disproportionately. We show that, in model systems, the expected systemic cost of multiple failures can be largely explained by two global parameters of risk exposure and diversity, which can be assessed in terms of the risk exposures of individual actors. This observation hints at the possibility of regulatory intervention to promote systemic stability by incentivizing a more diverse diversification among banks. Such intervention offers the prospect of an additional lever in the armory of regulators, potentially allowing some combination of improved system stability and reduced need for additional capital.

Impact of a Health Promotion Nurse Intervention on Disability and Health Care Costs among Elderly Adults with Heart Conditions

ERIC Educational Resources Information Center

Meng, Hongdao; Wamsley, Brenda R.; Eggert, Gerald M.; Van Nostrand, Joan F.

2007-01-01

Context: Patients with heart conditions in rural areas may have different responses to health promotion-disease Self-management interventions compared to their urban counterparts. Purpose: To estimate the impact of a multi-component health promotion nurse intervention on physical function and total health care expenditures among elderly adults…

Promotion of Social and Emotional Competence: Experiences from a Mental Health Intervention Applying a Whole School Approach

ERIC Educational Resources Information Center

Nielsen, Line; Meilstrup, Charlotte; Nelausen, Malene Kubstrup; Koushede, Vibeke; Holstein, Bjørn Evald

2015-01-01

Purpose: Within the framework of Health Promoting Schools "Up" is an intervention using a whole school approach aimed at promoting mental health by strengthening social and emotional competence among schoolchildren. Social and emotional competence is an integral part of many school-based mental health interventions but only a minority of…

An Intervention to Promote the Female Condom to Sexually Transmitted Disease Clinic Patients

ERIC Educational Resources Information Center

Artz, Lynn; Macaluso, Maurizio; Kelaghan, Joseph; Austin, Harland; Fleenor, Michael; Robey, Lawrence; Hook, III, Edward W.; Brill, Ilene

2005-01-01

This article describes a 1-hour behavioral intervention designed to promote female condoms and safer sex to women at a high risk for sexually transmitted diseases (STDs). The intervention includes a promotional videotape; a skills-oriented counseling session with a nurse clinician; assorted take-home items, including a videotape for men; and free…

Host-dependent Induction of Transient Antibiotic Resistance: A Prelude to Treatment Failure

PubMed Central

Kubicek-Sutherland, Jessica Z.; Heithoff, Douglas M.; Ersoy, Selvi C.; Shimp, William R.; House, John K.; Marth, Jamey D.; Smith, Jeffrey W.; Mahan, Michael J.

2015-01-01

Current antibiotic testing does not include the potential influence of host cell environment on microbial susceptibility and antibiotic resistance, hindering appropriate therapeutic intervention. We devised a strategy to identify the presence of host–pathogen interactions that alter antibiotic efficacy in vivo. Our findings revealed a bacterial mechanism that promotes antibiotic resistance in vivo at concentrations of drug that far exceed dosages determined by standardized antimicrobial testing. This mechanism has escaped prior detection because it is reversible and operates within a subset of host tissues and cells. Bacterial pathogens are thereby protected while their survival promotes the emergence of permanent drug resistance. This host-dependent mechanism of transient antibiotic resistance is applicable to multiple pathogens and has implications for the development of more effective antimicrobial therapies. PMID:26501114

Host-dependent Induction of Transient Antibiotic Resistance: A Prelude to Treatment Failure.

PubMed

Kubicek-Sutherland, Jessica Z; Heithoff, Douglas M; Ersoy, Selvi C; Shimp, William R; House, John K; Marth, Jamey D; Smith, Jeffrey W; Mahan, Michael J

2015-09-01

Current antibiotic testing does not include the potential influence of host cell environment on microbial susceptibility and antibiotic resistance, hindering appropriate therapeutic intervention. We devised a strategy to identify the presence of host-pathogen interactions that alter antibiotic efficacy in vivo. Our findings revealed a bacterial mechanism that promotes antibiotic resistance in vivo at concentrations of drug that far exceed dosages determined by standardized antimicrobial testing. This mechanism has escaped prior detection because it is reversible and operates within a subset of host tissues and cells. Bacterial pathogens are thereby protected while their survival promotes the emergence of permanent drug resistance. This host-dependent mechanism of transient antibiotic resistance is applicable to multiple pathogens and has implications for the development of more effective antimicrobial therapies.

Promoting Expressive Language in Young Children with or At-Risk for Autism Spectrum Disorder in a Preschool Classroom.

PubMed

Lane, Justin D; Shepley, Collin; Lieberman-Betz, Rebecca

2016-10-01

Young children with autism spectrum disorder (ASD) often demonstrate delays in expressive communication, impacting their ability to independently function in typical environments. Individuals with ASD who develop expressive language during early childhood experience better outcomes later in life; therefore, examination of naturalistic language interventions (NLIs) remain an important area of investigation. The current study used a multiple probe design across participants to examine the effects of a classroom-based NLI on various expressive language targets in three preschool-aged children demonstrating characteristics of ASD. Findings suggest the intervention had positive and maintained effects on trial-based use of language targets, as well as concomitant changes in commenting, requesting, and phrase complexity. Implications regarding implementation of NLIs within typical classroom play activities are discussed.

Soul mate: exploring the concept of soul.

PubMed

Fenske, Joan M

2011-09-01

This article describes an "advanced practice" registered nurse's skill in using multiple theoretical frameworks to make meaning of her severely developmentally disabled son's untimely death. Aspects of religion, spirituality, and philosophy are presented plus how related practices, such as used within Alcoholics Anonymous, are incorporated into everyday life are referenced. Creating unique rituals and ceremonies demonstrates the power of the mind as a partner in the healing process when grief seems insurmountable. This article, titled "Soul Mate" discusses how individuals create their own healing narratives when confronted with grief and tragedy. Nursing interventions, sensitive to this process, support and promote the grief process. Eliciting, recognizing, and accepting a patient's unique self-made rituals and ceremonies as they cope with a beloved's death and dying enhances their nursing interventions. © 2011 The Author(s)

Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: A modified Delphi consultation.

PubMed

Perry, Lin; Nicholls, Rachel; Duffield, Christine; Gallagher, Robyn

2017-11-01

To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce. The nursing workforce experiences rates of ill health above that of other workforces, yet there is little investment in workplace health promotion. The study used a modified Delphi design conducted between September and November 2015. Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility. Mental health strategies were prioritized as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions; smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups. Study findings prompt consideration of health promotion opportunities to support nurses' health and well-being. Findings identified key workplace health promotion priorities and provide direction for policy makers and managers to promote nursing and midwifery workforce health. © 2017 John Wiley & Sons Ltd.

Eat Right-Live Well! Supermarket Intervention Impact on Sales of Healthy Foods in a Low-Income Neighborhood.

PubMed

Surkan, Pamela J; Tabrizi, Maryam J; Lee, Ryan M; Palmer, Anne M; Frick, Kevin D

2016-02-01

To evaluate a multifaceted supermarket intervention promoting healthier alternatives to commonly purchased foods. Sales of 385 foods promoted between July and October, 2012 in the Eat Right-Live Well! intervention supermarket were compared with sales in a control supermarket. Two supermarkets in geographically separate, low-income, urban neighborhoods. One control and 1 intervention supermarket. Product labeling, employee training, community outreach, and in-store promotions, including taste tests. Number of items sold; absolute and percent differences in sales. Difference-in-difference analyses compared absolute and percent changes between stores and over time within stores. Sub-analyses examined taste-tested items and specific food categories, and promoted items labeled with high fidelity. Comparing pre- and postintervention periods, within-store difference-in-differences for promoted products in the intervention store (25,776 items; 23.1%) was more favorable than the control (9,429 items; 6.6%). The decrease in taste-tested items' sales was smaller in the intervention store (946 items; 5.5%) than the control store (14,666 items; 26.6%). Increased sales of foods labeled with high fidelity were greater in the intervention store (25,414 items; 28.0%) than the control store (7,306 items; 6.3%). Store-based interventions, particularly high-fidelity labeling, can increase promoted food sales. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Health-promotion theories in nutritional interventions for community-dwelling older adults: a systematic review.

PubMed

Raffaele, Barbara; Matarese, Maria; Alvaro, Rosaria; De Marinis, Maria Grazia

2017-01-01

To identify theories applied in interventions promoting healthy nutrition among community-dwelling older adults and determine the efficacy of theories in changing knowledge, attitudes, and behaviors. The PubMed, PsycINFO, Embase, and ERIC databases were searched for English articles from January 1990 to December 2015. Mono or multicomponent randomized controlled trial studies were included, whereas research on nutritional interventions related to acute or chronic diseases were excluded. Eight articles satisfied the inclusion criteria. Only three articles referred explicitly to health promotion theories. Nutritional programs varied in terms of contents, outcomes, lengths of interventions and follow-up. Pooling the results and identifying the most effective theories were therefore impossible. Although researchers and practitioners recognize the significance of theoretical models in guiding the health-promoting interventions, referring to a theoretical model for such interventions is still relatively recent.

Perspectives on Physical Activity Among People with Multiple Sclerosis Who Are Wheelchair Users

PubMed Central

Learmonth, Yvonne C.; Rice, Ian M.; Ostler, Teresa; Rice, Laura A.

2015-01-01

Background: People with advanced multiple sclerosis (MS) are less physically active than those with milder forms of the disease, and wheelchair use has a negative association with physical activity participation. Thus, wheelchair users with MS are doubly disadvantaged for accruing the benefits of physical activity and exercise. Appropriate physical activity and exercise interventions are needed for this population. Methods: We undertook a qualitative study to explore the meanings, motivations, and outcomes of physical activity in wheelchair users with MS. We sought to understand daily opportunities to accumulate physical activity and exercise, and to identify perceived barriers, facilitators, and benefits that might inform the design of future interventions. Results: We interviewed 15 wheelchair users (mean age, 52 ± 8.8 years; n = 12 women). Data were transcribed and analyzed to identify and explore common themes. Our first theme was the reduced opportunity to participate in physical activity due to participants' dependence on mobility devices, environmental adaptations, and tangible support. Our second theme was the importance of incorporating physical activity and exercise into the everyday environment, highlighting the need for adaptive exercise and accessible environments. This indicated the need to incorporate behavior change modulators into physical activity and exercise interventions for those with advanced MS. Health-care professionals played an important role in promoting increased physical activity and exercise participation in those with advanced MS. Conclusions: Our findings may inform future interventions to increase initiation and maintenance of physical activity and exercise among people with advanced MS. PMID:26052256

A mixed methods study of multiple health behaviors among individuals with stroke.

PubMed

Plow, Matthew; Moore, Shirley M; Sajatovic, Martha; Katzan, Irene

2017-01-01

Individuals with stroke often have multiple cardiovascular risk factors that necessitate promoting engagement in multiple health behaviors. However, observational studies of individuals with stroke have typically focused on promoting a single health behavior. Thus, there is a poor understanding of linkages between healthy behaviors and the circumstances in which factors, such as stroke impairments, may influence a single or multiple health behaviors. We conducted a mixed methods convergent parallel study of 25 individuals with stroke to examine the relationships between stroke impairments and physical activity, sleep, and nutrition. Our goal was to gain further insight into possible strategies to promote multiple health behaviors among individuals with stroke. This study focused on physical activity, sleep, and nutrition because of their importance in achieving energy balance, maintaining a healthy weight, and reducing cardiovascular risks. Qualitative and quantitative data were collected concurrently, with the former being prioritized over the latter. Qualitative data was prioritized in order to develop a conceptual model of engagement in multiple health behaviors among individuals with stroke. Qualitative and quantitative data were analyzed independently and then were integrated during the inference stage to develop meta-inferences. The 25 individuals with stroke completed closed-ended questionnaires on healthy behaviors and physical function. They also participated in face-to-face focus groups and one-to-one phone interviews. We found statistically significant and moderate correlations between hand function and healthy eating habits ( r  = 0.45), sleep disturbances and limitations in activities of daily living ( r  =  - 0.55), BMI and limitations in activities of daily living ( r  =  - 0.49), physical activity and limitations in activities of daily living ( r  = 0.41), mobility impairments and BMI ( r  =  - 0.41), sleep disturbances and physical activity ( r  =  - 0.48), sleep disturbances and BMI ( r  = 0.48), and physical activity and BMI ( r  =  - 0.45). We identified five qualitative themes: (1) Impairments: reduced autonomy, (2) Environmental forces: caregivers and information, (3) Re-evaluation: priorities and attributions, (4) Resiliency: finding motivation and solutions, and (5) Negative affectivity: stress and self-consciousness. Three meta-inferences and a conceptual model described circumstances in which factors could influence single or multiple health behaviors. This is the first mixed methods study of individuals with stroke to elaborate on relationships between multiple health behaviors, BMI, and physical function. A conceptual model illustrates addressing sleep disturbances, activity limitations, self-image, and emotions to promote multiple health behaviors. We discuss the relevance of the meta-inferences in designing multiple behavior change interventions for individuals with stroke.

Efficacy of a group-based multimedia HIV prevention intervention for drug-involved women under community supervision: project WORTH.

PubMed

El-Bassel, Nabila; Gilbert, Louisa; Goddard-Eckrich, Dawn; Chang, Mingway; Wu, Elwin; Hunt, Tim; Epperson, Matt; Shaw, Stacey A; Rowe, Jessica; Almonte, Maria; Witte, Susan

2014-01-01

This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02-0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57-0.90). The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system. ClinicalTrials.gov NCT01784809.

76 FR 37336 - Applications for New Awards; Rehabilitation Research and Training Center-Interventions To Promote...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

...--Interventions To Promote Community Living Among Individuals With Disabilities AGENCY: Office of Special... Research Projects and Centers Program-- Rehabilitation Research and Training Center (RRTC)-- Interventions... Program, published in the Federal Register on February 1, 2008 (73 FR 6132) and the RRTC on Interventions...

Creating neighbourhood groupings based on built environment features to facilitate health promotion activities.

PubMed

Schopflocher, Donald; VanSpronsen, Eric; Spence, John C; Vallianatos, Helen; Raine, Kim D; Plotnikoff, Ronald C; Nykiforuk, Candace I J

2012-07-26

Detailed assessments of the built environment often resist data reduction and summarization. This project sought to develop a method of reducing built environment data to an extent that they can be effectively communicated to researchers and community stakeholders. We aim to help in an understanding of how these data can be used to create neighbourhood groupings based on built environment characteristics and how the process of discussing these neighbourhoods with community stakeholders can result in the development of community-informed health promotion interventions. We used the Irvine Minnesota Inventory (IMI) to assess 296 segments of a semi-rural community in Alberta. Expert raters "created" neighbourhoods by examining the data. Then, a consensus grouping was developed using cluster analysis, and the number of IMI variables to characterize the neighbourhoods was reduced by multiple discriminant function analysis. The 296 segments were reduced to a consensus set of 10 neighbourhoods, which could be separated from each other by 9 functions constructed from 24 IMI variables. Biplots of these functions were an effective means of summarizing and presenting the results of the community assessment, and stimulated community action. It is possible to use principled quantitative methods to reduce large amounts of information about the built environment into meaningful summaries. These summaries, or built environment neighbourhoods, were useful in catalyzing action with community stakeholders and led to the development of health-promoting built environment interventions.

Longitudinal change in physical activity and its correlates in relapsing-remitting multiple sclerosis.

PubMed

Motl, Robert W; McAuley, Edward; Sandroff, Brian M

2013-08-01

Physical activity is beneficial for people with multiple sclerosis (MS), but this population is largely inactive. There is minimal information on change in physical activity and its correlates for informing the development of behavioral interventions. This study examined change in physical activity and its symptomatic, social-cognitive, and ambulatory or disability correlates over a 2.5-year period of time in people with relapsing-remitting multiple sclerosis. On 6 occasions, each separated by 6 months, people (N=269) with relapsing-remitting multiple sclerosis completed assessments of symptoms, self-efficacy, walking impairment, disability, and physical activity. The participants wore an accelerometer for 7 days. The change in study variables over 6 time points was examined with unconditional latent growth curve modeling. The association among changes in study variables over time was examined using conditional latent growth curve modeling, and the associations were expressed as standardized path coefficients (β). There were significant linear changes in self-reported and objectively measured physical activity, self-efficacy, walking impairment, and disability over the 2.5-year period; there were no changes in fatigue, depression, and pain. The changes in self-reported and objective physical activity were associated with change in self-efficacy (β=.49 and β=.61, respectively), after controlling for other variables and confounders. The primary limitations of the study were the generalizability of results among those with progressive multiple sclerosis and inclusion of a single variable from social-cognitive theory. Researchers should consider designing interventions that target self-efficacy for the promotion and maintenance of physical activity in this population.

Efficacy of a Clinic-Based Safer Sex Program for Human Immunodeficiency Virus-Uninfected and Human Immunodeficiency Virus-Infected Young Black Men Who Have Sex With Men: A Randomized Controlled Trial.

PubMed

Crosby, Richard A; Mena, Leandro; Salazar, Laura F; Hardin, James W; Brown, Tim; Vickers Smith, Rachel

2018-03-01

To test the efficacy of a single-session, clinic-based intervention designed to promote condom use among young black men who have sex with men (YBMSM). Six hundred YBMSM were enrolled in a randomized controlled trial, using a 12-month observation period. An intent-to-treat analysis was performed, with multiple imputation for missing data. Compared with the reference group, human immunodeficiency virus (HIV)-infected men in the intervention group had 64% greater odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 1.64; 95% confidence interval, 1.23-2.17, P = 0.001). Also, compared with the reference group, HIV-uninfected men in the intervention group had more than twice the odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 2.14; 95% confidence interval, 1.74-2.63, P < 0.001). Significant intervention effects relative to incident sexually transmitted diseases were not observed. A single-session, clinic-based, intervention may help protect HIV-uninfected YBMSM against HIV acquisition and HIV-infected YBMSM from transmitting the virus to insertive partners.

Best practices in family-centered early intervention for children who are deaf or hard of hearing: an international consensus statement.

PubMed

Moeller, Mary Pat; Carr, Gwen; Seaver, Leeanne; Stredler-Brown, Arlene; Holzinger, Daniel

2013-10-01

A diverse panel of experts convened in Bad Ischl, Austria, in June of 2012 for the purpose of coming to consensus on essential principles that guide family-centered early intervention with children who are deaf or hard of hearing (D/HH). The consensus panel included parents, deaf professionals, early intervention program leaders, early intervention specialists, and researchers from 10 nations. All participants had expertise in working with families of children who are D/HH, and focus was placed on identifying family-centered practice principles that are specific to partnering with these families. Panel members reported that the implementation of family-centered principles was uneven or inconsistent in their respective nations. During the consensus meeting, they identified 10 agreed-upon foundational principles. Following the conference, they worked to refine the principles and to develop a document that described the principles themselves, related program and provider behaviors, and evidence supporting their use (drawing upon studies from multiple disciplines and nations). The goal of this effort was to promote widespread implementation of validated, evidence-based principles for family-centered early intervention with children who are deaf and hard of hearing and their families.

School intervention for promoting psychological well-being in adolescence.

PubMed

Ruini, Chiara; Ottolini, Fedra; Tomba, Elena; Belaise, Carlotta; Albieri, Elisa; Visani, Dalila; Offidani, Emanuela; Caffo, Ernesto; Fava, Giovanni A

2009-12-01

to test the efficacy of a new school program for the promotion of psychological well-being. In this study a school program for promoting psychological well-being has been compared to an attention-placebo intervention in a high school setting. Nine classes (227 students) were randomly assigned to: a) Well-Being intervention (5 classes); b)attention-placebo (4 classes). Assessment was performed at pre and post-intervention, and after six months using: 1) Symptom Questionnaire (SQ); 2) Psychological Well-Being Scales (PWB); 3) Revised Children's Manifest Anxiety Scale (RCMAS). A significant effect of WB school intervention in improving Personal Growth (PWB), and in decreasing distress (Somatization (SQ), Physical Well-being (SQ), Anxiety (SQ), and RCMAS Physiological Anxiety) emerged. A school intervention based on promoting positive emotions and well-being was effective not only in increasing psychological well-being among adolescents, but also in decreasing distress, in particular anxiety and somatization.

Inducing a health-promoting change process within an organization: the effectiveness of a large-scale intervention on social capital, openness, and autonomous motivation toward health.

PubMed

van Scheppingen, Arjella R; de Vroome, Ernest M M; Ten Have, Kristin C J M; Bos, Ellen H; Zwetsloot, Gerard I J M; van Mechelen, W

2014-11-01

To examine the effectiveness of an organizational large-scale intervention applied to induce a health-promoting organizational change process. A quasi-experimental, "as-treated" design was used. Regression analyses on data of employees of a Dutch dairy company (n = 324) were used to examine the effects on bonding social capital, openness, and autonomous motivation toward health and on employees' lifestyle, health, vitality, and sustainable employability. Also, the sensitivity of the intervention components was examined. Intervention effects were found for bonding social capital, openness toward health, smoking, healthy eating, and sustainable employability. The effects were primarily attributable to the intervention's dialogue component. The change process initiated by the large-scale intervention contributed to a social climate in the workplace that promoted health and ownership toward health. The study confirms the relevance of collective change processes for health promotion.

Cost-effectiveness of targeted versus tailored interventions to promote mammography screening among women military veterans in the United States.

PubMed

Lairson, David R; Chan, Wen; Chang, Yu-Chia; del Junco, Deborah J; Vernon, Sally W

2011-05-01

We conducted an economic evaluation of mammography promotion interventions in a population-based, nationally representative sample of 5500 women veterans. Women 52 years and older were randomly selected from the National Registry of Women Veterans and randomly assigned to a survey-only control group and two intervention groups that varied in the extent of personalization (tailored vs. targeted). Effectiveness measures were the prevalence of at least one self-reported post-intervention mammogram and two post-intervention mammograms 6-15 months apart. Incremental cost-effectiveness ratios (ICERs) were the incremental cost per additional person screened. Uncertainty was examined with sensitivity analysis and bootstrap simulation. The targeted intervention cost $25 per person compared to $52 per person for the tailored intervention. About 27% of the cost was incurred in identifying and recruiting the eligible population. The percent of women reporting at least one mammogram were .447 in the control group, .469 in the targeted group, and .460 in the tailored group. The ICER was $1116 comparing the targeted group to the control group (95% confidence interval (CI)=$493 to dominated). The tailored intervention was dominated (more costly and less effective) by the targeted intervention. Decision-makers should consider effectiveness evidence and the full recruitment and patient time costs associated with the implementation of screening interventions when making investments in mammography screening promotion programs. Identification and recruitment of eligible participants add substantial costs to outreach screening promotion interventions. Tailoring adds substantial cost to the targeted mammography promotion strategy without a commensurate increase in effectiveness. Although cost-effectiveness has been reported to be higher for some in-reach screening promotion interventions, a recent meta-analysis revealed significant heterogeneity in the effect sizes of published health-plan based intervention studies for repeat mammography (i.e., some studies reported null effects compared with control groups). Copyright © 2010 Elsevier Ltd. All rights reserved.

A randomised controlled trial for overweight and obese parents to prevent childhood obesity--Early STOPP (STockholm Obesity Prevention Program).

PubMed

Sobko, Tanja; Svensson, Viktoria; Ek, Anna; Ekstedt, Mirjam; Karlsson, Håkan; Johansson, Elin; Cao, Yingting; Hagströmer, Maria; Marcus, Claude

2011-05-18

Overweight and obesity have a dramatic negative impact on children's health not only during the childhood but also throughout the adult life. Preventing the development of obesity in children is therefore a world-wide health priority. There is an obvious urge for sustainable and evidenced-based interventions that are suitable for families with young children, especially for families with overweight or obese parents. We have developed a prevention program, Early STOPP, combating multiple obesity-promoting behaviors such unbalanced diet, physical inactivity and disturbed sleeping patterns. We also aim to evaluate the effectiveness of the early childhood obesity prevention in a well-characterized population of overweight or obese parents. This protocol outlines methods for the recruitment phase of the study. This randomized controlled trial (RCT) targets overweight and/or obese parents with infants, recruited from the Child Health Care Centers (CHCC) within the Stockholm area. The intervention starts when infants are one year of age and continues until they are six and is regularly delivered by a trained coach (dietitian, physiotherapist or a nurse). The key aspects of Early STOPP family intervention are based on Swedish recommendations for CHCC, which include advices on healthy food choices and eating patterns, increasing physical activity/reducing sedentary behavior and regulating sleeping patterns. The Early STOPP trial design addresses weaknesses of previous research by recruiting from a well-characterized population, defining a feasible, theory-based intervention and assessing multiple measurements to validate and interpret the program effectiveness. The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge, this longitudinal RCT is the first attempt to demonstrate whether an early, long-term, targeted health promotion program focusing on healthy eating, physical activity/reduced sedentary behaviors and normalizing sleeping patterns could be effective. If proven so, Early STOPP may protect children from the development of overweight and obesity. The protocol for this study is registered with the clinical trials registry clinicaltrials.gov, ID: ES-2010).

Enhancing adherence in trials promoting change in diet and physical activity in individuals with a diagnosis of colorectal adenoma; a systematic review of behavioural intervention approaches.

PubMed

McCahon, Deborah; Daley, Amanda J; Jones, Janet; Haslop, Richard; Shajpal, Arjun; Taylor, Aliki; Wilson, Sue; Dowswell, George

2015-07-07

Little is known about colorectal adenoma patients' ability to adhere to behavioural interventions promoting a change in diet and physical activity. This review aimed to examine health behaviour intervention programmes promoting change in diet and/or physical activity in adenoma patients and characterise interventions to which this patient group are most likely to adhere. Searches of eight databases were restricted to English language publications 2000-2014. Reference lists of relevant articles were also reviewed. All randomised controlled trials (RCTs) of diet and physical activity interventions in colorectal adenoma patients were included. Eligibility and quality were assessed and data were extracted by two reviewers. Data extraction comprised type, intensity, provider, mode and location of delivery of the intervention and data to enable calculation of four adherence outcomes. Data were subject to narrative analysis. Five RCTs with a total of 1932 participants met the inclusion criteria. Adherence to the goals of the intervention ranged from 18 to 86 % for diet and 13 to 47 % for physical activity. Diet interventions achieving ≥ 50 % adherence to the goals of the intervention were clinic based, grounded in cognitive theory, delivered one to one and encouraged social support. The findings of this review indicate that behavioural interventions can encourage colorectal adenoma patients to improve their diet. This review was not however able to clearly characterise effective interventions promoting increased physical activity in this patient group. Further research is required to establish effective interventions to promote adherence to physical activity in this population.

Mental health promotion in comprehensive schools.

PubMed

Onnela, A M; Vuokila-Oikkonen, P; Hurtig, T; Ebeling, H

2014-09-01

The purpose of this paper is to describe a participatory action research process on the development of a professional practice model of mental health nurses in mental health promotion in a comprehensive school environment in the city of Oulu, Finland. The developed model is a new method of mental health promotion for mental health nurses working in comprehensive schools. The professional practice model has been developed in workshops together with school staff, interest groups, parents and students. Information gathered from the workshops was analysed using action research methods. Mental health promotion interventions are delivered at three levels: universal, which is an intervention that affects the whole school or community; selective, which is an intervention focusing on a certain group of students; and indicated, which is an individually focused intervention. All interventions are delivered within the school setting, which is a universal setting for all school-aged children. The interventions share the goal of promoting mental health. The purposes of the interventions are enhancing protective factors, reducing risk factors relating to mental health problems and early identification of mental health problems as well as rapid delivery of support or referral to specialized services. The common effect of the interventions on all levels is the increase in the experience of positive mental health. © 2014 John Wiley & Sons Ltd.

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

Activity-dependent plasticity in spinal cord injury

PubMed Central

Lynskey, James V.; Belanger, Adam; Jung, Ranu

2008-01-01

The adult mammalian central nervous system (CNS) is capable of considerable plasticity, both in health and disease. After spinal neurotrauma, the degrees and extent of neuroplasticity and recovery depend on multiple factors, including the level and extent of injury, postinjury medical and surgical care, and rehabilitative interventions. Rehabilitation strategies focus less on repairing lost connections and more on influencing CNS plasticity for regaining function. Current evidence indicates that strategies for rehabilitation, including passive exercise, active exercise with some voluntary control, and use of neuroprostheses, can enhance sensorimotor recovery after spinal cord injury (SCI) by promoting adaptive structural and functional plasticity while mitigating maladaptive changes at multiple levels of the neuraxis. In this review, we will discuss CNS plasticity that occurs both spontaneously after SCI and in response to rehabilitative therapies. PMID:18566941

An Evaluation Study of the Young Empowered Sisters (YES!) Program: Promoting Cultural Assets among African American Adolescent Girls through a Culturally Relevant School-Based Intervention

ERIC Educational Resources Information Center

Thomas, Oseela; Davidson, William; McAdoo, Harriette

2008-01-01

The present study examines the effects of a culturally relevant school-based intervention in promoting cultural assets (i.e., ethnic identity, collectivist orientation, racism awareness, and liberatory youth activism) among a group of African American adolescent girls. The overall goal of the intervention was to promote cultural factors that can…

[Economic analysis of health promotion conducted in an enterprise].

PubMed

Wang, Zhi-chun; Yang, Xue-ying; Kang, Wen-long; Wang, Wen-jing

2013-12-01

To take intervention measures for health promotion after investigation of occupational health needs among employees, to analyze the economic input and output of the intervention measures, and to analyze the feasibility of health promotion through cost-effectiveness analysis and cost-benefit analysis. A survey was conducted in an enterprise using a self-designed questionnaire to investigate the general information on enterprise, occupational history of each employee, awareness of occupational health knowledge, awareness of general health knowledge, awareness of hypertension, acquired immune deficiency syndrome, etc., lifestyle, and needs for health knowledge. Intervention measures were taken in the enterprise according to the investigation results, and then investigation and economic analysis of investment in health promotion, economic benefit, and absence of employees were performed using the questionnaire. After intervention, the awareness rate of the Code of Occupational Disease Prevention increased from 4.5% to 15.3%, the awareness rate of the definition of occupational diseases increased from 4.5% to 73.5%, and the awareness rate of the prevention and control measures for occupational diseases increased from 38.4% to 85.8%. Before intervention, 25.4%of all employees thought salt intake needed to be reduced, and this proportion increased to 92.5% after intervention. After the control strategy for health promotion, the benefit of health promotion that results from avoiding absence of employees and preventing occupational diseases was more than ten times the investment in health promotion, suggesting a significant benefit of health promotion conducted in the enterprise. The return on health promotion's investment for enterprise is worth. Health promotion really not just contribute to improve hygienic knowledge but increase the economic benefit.

Promoting and protecting the health of children and young people.

PubMed

Licence, K

2004-11-01

The health-related behaviours adopted by children and young people can have both immediate and long-term health effects. Health promotion interventions that target children and young people can lay the foundations of a healthy lifestyle that may be sustained into adulthood. This paper is based on a selective review of evidence relating to health promotion in childhood, carried out to support the external working group on the 'Healthy Child' module of the Children's National Service Framework. This is a selective review of mainly secondary research. It focuses on injury prevention, support for parenting and the promotion of good mental health, and promoting a healthy diet and physical activity amongst children and young people. In many areas, the quality of primary research into health promotion interventions aimed at children and young people is poor. Interventions are heterogeneous and not described in sufficient detail. Sample sizes tend to be small, and there are commonly problems of bias. Despite these difficulties, there is good evidence for a range of interventions, including (1) area road safety schemes; (2) combining a variety of approaches to the promotion of the use of safety equipment, including legislation and enforcement, loan/assisted purchase/giveaway schemes, education, fitting and maintenance of safety equipment; (3) school-based mental health promotion; (4) parenting support; (5) interventions that promote and facilitate 'lifestyle' activity for children, such as walking and cycling to school, and those that aim to reduce sedentary behaviours such as parent education to reduce the time children spend watching TV and using computers; and (6) controlling advertising of unhealthy food that is aimed at children. There are effective interventions to promote and protect the health of children and young people that require action across the five areas described in the Ottawa Charter. Health, social care and education services have a direct role in the delivery of many of these interventions and, in other areas, a role in collaborative work with other agencies, in lobbying for policy change and in raising the profile of child health promotion. Further research is needed using larger study populations, and closely defined interventions, both targeted and universal, in order to fill some of the current gaps in the evidence base for health promotion in children and young people.

Web-based versus in-person methods for training lay community health advisors to implement health promotion workshops: participant outcomes from a cluster-randomized trial.

PubMed

Holt, Cheryl L; Tagai, Erin K; Santos, Sherie Lou Zara; Scheirer, Mary Ann; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie

2018-06-28

Project HEAL (Health through Early Awareness and Learning) is an implementation trial that compared two methods of training lay peer community health advisors (CHAs)-in-person ("Traditional") versus web-based ("Technology")-to conduct a series of three evidence-based cancer educational workshops in African American churches. This analysis reports on participant outcomes from Project HEAL. Fifteen churches were randomized to the two CHA training methods and the intervention impact was examined over 24 months. This study was conducted in Prince George's County, MD, and enrolled 375 church members age 40-75. Participants reported on knowledge and screening behaviors for breast, prostate, and colorectal cancer. Overall, cancer knowledge in all areas increased during the study period (p < .001). There were significant increases in digital rectal exam (p < .05), fecal occult blood test (p < .001), and colonoscopy (p < .01) at 24 months; however, this did not differ by study group. Mammography maintenance (56% overall) was evidenced by women reporting multiple mammograms within the study period. Participants attending all three workshops were more likely to report a fecal occult blood test or colonoscopy at 24 months (p < .05) than those who attended only one. These findings suggest that lay individuals can receive web-based training to successfully implement an evidence-based health promotion intervention that results in participant-level outcomes comparable with (a) people trained using the traditional classroom method and (b) previous efficacy trials. Findings have implications for resources and use of technology to increase widespread dissemination of evidence-based health promotion interventions through training lay persons in community settings.

New Media but Same Old Tricks: Food Marketing to Children in the Digital Age.

PubMed

Kelly, Bridget; Vandevijvere, Stefanie; Freeman, Becky; Jenkin, Gabrielle

2015-03-01

'New media' refers to digital technologies, which offer unmatched opportunities for food companies to engage with young people. This paper explores the emergence of food marketing using new media, the potential impact of this marketing on young people, and current and potential policy responses to limit exposure to these promotions. Foremost in any informed policy discussion is the need for robust evidence to demonstrate the need for intervention. In this case, such evidence relates to the extent of children's exposures to commercial food promotions via new media, and the nature of these promotions. Approaches to, and challenges of, collecting and assessing these data are discussed. There is accumulating evidence that food marketing on new media is increasing and influences children's food preferences and choices. The impact of integrated campaigns, which reinforce commercial messages across multiple platforms, and of new media, which engage personally with potential consumers, is likely to be greater than that of traditional marketing.

Taxonomy for colorectal cancer screening promotion: Lessons from recent randomized controlled trials.

PubMed

Ritvo, Paul; Myers, Ronald E; Serenity, Mardie; Gupta, Samir; Inadomi, John M; Green, Beverly B; Jerant, Anthony; Tinmouth, Jill; Paszat, Lawrence; Pirbaglou, Meysam; Rabeneck, Linda

2017-08-01

To derive a taxonomy for colorectal cancer screening that advances Randomized Controlled Trials (RCTs) and screening uptake. Detailed publication review, multiple interviews with principal investigators (PIs) and collaboration with PIs as co-authors produced a CRCS intervention taxonomy. Semi-structured interview questions with PIs (Drs. Inadomi, Myers, Green, Gupta, Jerant and Ritvo) yielded details about trial conduct. Interview comparisons led to an iterative process informing serial interviews until a consensus was obtained on final taxonomy structure. These taxonomy headings (Engagement Sponsor, Population Targeted, Alternative Screening Tests, Delivery Methods, and Support for Test Performance (EPADS)) were used to compare studies. Exemplary insights emphasized: 1) direct test delivery to patients; 2) linguistic-ethnic matching of staff to minority subjects; and 3) authorization of navigators to schedule or refer for colonoscopies and/or distribute stool blood tests during screening promotion. PIs of key RCTs (2012-2015) derived a CRCS taxonomy useful in detailed examination of CRCS promotion and design of future RCTs. Copyright © 2017 Elsevier Inc. All rights reserved.

Promoting Early Intervention Referral through a Randomized Controlled Home-Visiting Program

ERIC Educational Resources Information Center

Schwarz, Donald F.; O'Sullivan, Ann L.; Guinn, Judith; Mautone, Jennifer A.; Carlson, Elyse C.; Zhao, Huaqing; Zhang, Xuemei; Esposito, Tara L.; Askew, Megan; Radcliffe, Jerilynn

2012-01-01

The MOM Program is a randomized, controlled trial of an intervention to promote mothers' care for the health and development of their children, including accessing early intervention (EI) services. Study aims were to determine whether, relative to controls, this intervention increased receipt of and referral to EI services. Mothers (N = 302)…

Interventions to promote cycling: systematic review

PubMed Central

Yang, Lin; Sahlqvist, Shannon; McMinn, Alison; Griffin, Simon J

2010-01-01

Objectives To determine what interventions are effective in promoting cycling, the size of the effects of interventions, and evidence of any associated benefits on overall physical activity or anthropometric measures. Design Systematic review. Data sources Published and unpublished reports in any language identified by searching 13 electronic databases, websites, reference lists, and existing systematic reviews, and papers identified by experts in the field. Review methods Controlled “before and after” experimental or observational studies of the effect of any type of intervention on cycling behaviour measured at either individual or population level. Results Twenty five studies (of which two were randomised controlled trials) from seven countries were included. Six studies examined interventions aimed specifically at promoting cycling, of which four (an intensive individual intervention in obese women, high quality improvements to a cycle route network, and two multifaceted cycle promotion initiatives at town or city level) were found to be associated with increases in cycling. Those studies that evaluated interventions at population level reported net increases of up to 3.4 percentage points in the population prevalence of cycling or the proportion of trips made by bicycle. Sixteen studies assessing individualised marketing of “environmentally friendly” modes of transport to interested households reported modest but consistent net effects equating to an average of eight additional cycling trips per person per year in the local population. Other interventions that targeted travel behaviour in general were not associated with a clear increase in cycling. Only two studies assessed effects of interventions on physical activity; one reported a positive shift in the population distribution of overall physical activity during the intervention. Conclusions Community-wide promotional activities and improving infrastructure for cycling have the potential to increase cycling by modest amounts, but further controlled evaluative studies incorporating more precise measures are required, particularly in areas without an established cycling culture. Studies of individualised marketing report consistent positive effects of interventions on cycling behaviour, but these findings should be confirmed using more robust study designs. Future research should also examine how best to promote cycling in children and adolescents and through workplaces. Whether interventions to promote cycling result in an increase in overall physical activity or changes in anthropometric measures is unclear. PMID:20959282

Interventions to promote cycling: systematic review.

PubMed

Yang, Lin; Sahlqvist, Shannon; McMinn, Alison; Griffin, Simon J; Ogilvie, David

2010-10-18

To determine what interventions are effective in promoting cycling, the size of the effects of interventions, and evidence of any associated benefits on overall physical activity or anthropometric measures. Systematic review. Published and unpublished reports in any language identified by searching 13 electronic databases, websites, reference lists, and existing systematic reviews, and papers identified by experts in the field. Review methods Controlled "before and after" experimental or observational studies of the effect of any type of intervention on cycling behaviour measured at either individual or population level. Twenty five studies (of which two were randomised controlled trials) from seven countries were included. Six studies examined interventions aimed specifically at promoting cycling, of which four (an intensive individual intervention in obese women, high quality improvements to a cycle route network, and two multifaceted cycle promotion initiatives at town or city level) were found to be associated with increases in cycling. Those studies that evaluated interventions at population level reported net increases of up to 3.4 percentage points in the population prevalence of cycling or the proportion of trips made by bicycle. Sixteen studies assessing individualised marketing of "environmentally friendly" modes of transport to interested households reported modest but consistent net effects equating to an average of eight additional cycling trips per person per year in the local population. Other interventions that targeted travel behaviour in general were not associated with a clear increase in cycling. Only two studies assessed effects of interventions on physical activity; one reported a positive shift in the population distribution of overall physical activity during the intervention. Community-wide promotional activities and improving infrastructure for cycling have the potential to increase cycling by modest amounts, but further controlled evaluative studies incorporating more precise measures are required, particularly in areas without an established cycling culture. Studies of individualised marketing report consistent positive effects of interventions on cycling behaviour, but these findings should be confirmed using more robust study designs. Future research should also examine how best to promote cycling in children and adolescents and through workplaces. Whether interventions to promote cycling result in an increase in overall physical activity or changes in anthropometric measures is unclear.

Development and Implementation of a School-based Obesity Prevention Intervention: Lessons Learned from Community-Based Participatory Research

PubMed Central

Uyeda, Kimberly; Bogart, Laura M.; Hawes-Dawson, Jennifer; Schuster, Mark A.

2010-01-01

Background National, state, and local policies aim to change school environments to prevent child obesity. Community-based participatory research (CBPR) can be effective in translating public health policy into practice. Objectives We describe lessons learned from developing and pilot testing a middle school-based obesity prevention intervention using CBPR in Los Angeles, California. Methods We formed a community–academic partnership between the Los Angeles Unified School District (LAUSD) and the UCLA/RAND Center for Adolescent Health Promotion to identify community needs and priorities for addressing adolescent obesity and to develop and pilot test a school-based intervention. Lessons Learned Academic partners need to be well-versed in organizational structures and policies. Partnerships should be built on relationships of trust, shared vision, and mutual capacity building, with genuine community engagement at multiple levels. Conclusion These lessons are critical, not only for partnering with schools on obesity prevention, but also for working in other community settings and on other health issues. PMID:20208226

The Influence of Social Context on Changes in Fruit and Vegetable Consumption: Results of the Healthy Directions Studies

PubMed Central

Sorensen, Glorian; Stoddard, Anne M.; Dubowitz, Tamara; Barbeau, Elizabeth M.; Bigby, JudyAnn; Emmons, Karen M.; Berkman, Lisa F.; Peterson, Karen E.

2007-01-01

As part of the Harvard Cancer Prevention Program Project, we used a social contextual model of health behavior change to test an intervention targeting multiple risk-related behaviors in working-class, multiethnic populations. We examined the relationships between the social contextual factors in our conceptual model and changes in fruit and vegetable consumption from baseline to completion of intervention in health centers and small business studies. We analyzed change in fruit and vegetable consumption, measured at baseline and final assessments by self-report, in 2 randomized controlled prevention trials: 1 in small businesses (n = 974) and 1 in health centers (n = 1954). Stronger social networks, social norms that were more supportive, food sufficiency, and less household crowding were associated with greater change in fruit and vegetable intake. We also observed differences between our intervention sites. Social context can play an important role in promoting changes in fruit and vegetable consumption. PMID:17538059

Building a multiple modality, theory-based physical activity intervention: The development of CardiACTION!

PubMed

Estabrooks, Paul A; Glasgow, Russ E; Xu, Stan; Dzewaltowski, David A; Lee, Rebecca E; Thomas, Deborah; Almeida, Fabio A; Thayer, Amy N; Smith-Ray, Renae L

2011-01-01

OBJECTIVES: Despite the widely acknowledged benefits of regular physical activity (PA), specific goals for increased population levels of PA, and strongly recommended strategies to promote PA, there is no evidence suggesting that the prevalence of PA is improving. If PA intervention research is to be improved, theory should be used as the basis for intervention development, participant context or environment should be considered in the process, and intervention characteristics that will heighten the likelihood of translation into practice should be implemented (e.g., ease of implementation, low human resource costs). The purpose of this paper is to describe the implementation of the aforementioned concepts within the intervention development process associated with CardiACTION an ongoing randomized 2 × 2 factorial trial. METHODS: The Ecological Model of Physical Activity integrated with Protection Motivation Theory was used to inform the design of the interventions. This integrated model was selected to allow for the development of theory-based individual, environmental, and individually + environmentally targeted physical activity interventions. All intervention strategies were matched to proposed mediators of behavior change. Strategies were then matched to the most appropriate interactive technology (i.e., interactive computer session, automated telephone counseling, and tailored mailings) delivery channel. CONCLUSIONS: The potential implications of this study include determining the independent and combined influence of individual and environment mechanisms of behavior change on intervention effectiveness. In addition, all intervention models are developed to be scalable and disseminable to a broad audience at a low cost.

The Impact of Setting the Standards of Health Promoting Hospitals on Hospital Indicators in Iran

PubMed Central

Amiri, Mohammad; Khosravi, Ahmad; Riyahi, Leila

2016-01-01

Hospitals play a critical role in the health promotion of the society. This study aimed to determine the impact of establishing standards of health promoting hospitals on hospital indicators in Shahroud. This applied study was a quasi-experimental one which was conducted in 2013. Standards of health promoting hospitals were established as an intervention procedure in the Fatemiyeh hospital. Parameters of health promoting hospitals were compared in intervention and control hospitals before and after of intervention (6 months). The data were analyzed using chi-square and t-test. With the establishment of standards for health promotion hospitals, standard scores in intervention and control hospitals were found to be 72.26 ± 4.1 and 16.26 ± 7.5, respectively. T-test showed a significant difference between the mean scores of the hospitals under study (P = 0.001).The chi-square test also showed a significant relationship between patient satisfaction before and after the intervention so that patients’ satisfaction was higher after the intervention (P = 0.001). Commenting on the short-term or long-term positive impacts of establishing standards of health promoting hospitals on all hospital indicators is a bit difficult but preliminary results show the positive impact of the implementation of standards in case hospitals which has led to the improvement of many indicators in the hospital. PMID:27959930

Correlates of health-promoting lifestyle behaviors among Vietnamese female immigrants in Taiwan.

PubMed

Hsiao, Chiu-Yueh; Chien, Maio-Ju; Wu, Hua-Shan; Chiao, Chia-Yi

2017-03-01

Immigration is a demanding and challenging life event that may cause married immigrant women to be likely to adopt unhealthy lifestyle behaviors. The aim of the authors of this study was to assess the prevalence of health-promoting lifestyle behaviors and their correlates among Vietnamese female immigrants in Taiwan. A cross-sectional study was conducted with 140 Vietnamese female immigrants from November 2012 to October 2013. Measures included demographic information, the Chinese Health Questionnaire, the General Functioning Scale of the Family Assessment Device, and a short version of the Chinese Health-Promoting Lifestyle Profile. Data analyses included descriptive statistics, Pearson's product-moment correlation coefficients, t-tests, one-way analysis of variance, and a hierarchical multiple regression analysis. Vietnamese female immigrants with better individual health status, higher education from their original country, greater communication ability, better health status of the husband, and adaptive family functioning demonstrated greater participation in health-promoting lifestyle behaviors. Particularly, better husband's health status and family functioning correlated with greater practices of health-promoting lifestyle behaviors after controlling for individual characteristics and experiences, with 38% of the total variance explained. Findings may serve to guide and design culturally specific, family-focused health promotion interventions to assist Vietnamese female immigrants and their families.

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

Real World Evidence: A Quantitative and Qualitative Glance at Participant Feedback from a Free-Response Survey Investigating Experiences of a Structured Exercise Intervention for Men with Prostate Cancer.

PubMed

Fox, L; Cahill, F; Burgess, C; Peat, N; Rudman, S; Kinsella, J; Cahill, D; George, G; Santaolalla, A; Van Hemelrijck, M

2017-01-01

To explore patient experiences of a structured exercise intervention for men with prostate cancer (PCa). 41 men with either localised or advanced PCa who had been referred for a structured exercise programme by their physician and then subsequently consented to a telephone survey. Participants underwent a 10-week supervised exercise programme within a large cancer centre hospital consisting of 8 sessions. They then completed a short multiple choice telephone survey, elaborating on their responses where appropriate. Views expressed by participants were analysed using an affinity diagram and common themes were identified. Feedback from our telephone surveys was consistently positive and suggests that the structured exercise intervention provides exercise confidence, motivation to exercise, and social support and promotes positive health behaviour change in the context of exercise. Individual differences arose amongst participants in their perceived utility of the intervention, with 73.3% expressing a preference for structured exercise classes and 19.5% expressing a preference for exercising independently. Design of a structured exercise intervention for patients with PCa should embrace the positive aspects outlined here but consider patients' individual differences. Ongoing feedback from patients should be utilised alongside traditional study designs to inform intervention design in this area.

Integrating physical activity into mental health services for persons with serious mental illness.

PubMed

Richardson, Caroline R; Faulkner, Guy; McDevitt, Judith; Skrinar, Gary S; Hutchinson, Dori S; Piette, John D

2005-03-01

This article reviews evidence supporting the need for interventions to promote physical activity among persons with serious mental illness. Principles of designing effective physical activity interventions are discussed along with ways to adapt such interventions for this population. Individuals with serious mental illness are at high risk of chronic diseases associated with sedentary behavior, including diabetes and cardiovascular disease. The effects of lifestyle modification on chronic disease outcomes are large and consistent across multiple studies. Evidence for the psychological benefits for clinical populations comes from two meta-analyses of outcomes of depressed patients that showed that effects of exercise were similar to those of psychotherapeutic interventions. Exercise can also alleviate secondary symptoms such as low self-esteem and social withdrawal. Although structured group programs can be effective for persons with serious mental illness, especially walking programs, lifestyle changes that focus on accumulation of moderate-intensity activity throughout the day may be most appropriate. Research suggests that exercise is well accepted by people with serious mental illness and is often considered one of the most valued components of treatment. Adherence to physical activity interventions appears comparable to that in the general population. Mental health service providers can provide effective, evidence-based physical activity interventions for individuals with serious mental illness.

MIXED-METHODS EVALUATION OF PARTICIPANT RECRUITMENT AND RETENTION IN THE MOM POWER PARENTING INTERVENTION PROGRAM.

PubMed

Mucka, Lilia E; Dayton, Carolyn J; Lawler, Jamie; Kirk, Rosalind; Alfafara, Emily; Schuster, Melisa M; Miller, Nicole; Ribaudo, Julie; Rosenblum, Katherine Lisa; Muzik, Maria

2017-07-01

Parenting group success begins with attendance. Using archival pilot data from 99 mothers who enrolled in the Mom Power (MP) parenting intervention, this study sought to understand the factors that influenced participant engagement and retention. MP is a group-based, early intervention program grounded in attachment theory that utilizes motivational interviewing as a core component to enhance program engagement. Study aims were to qualitatively describe the reasons why mothers were interested in participating in the program, including what they hoped to gain from the experience, and to quantitatively examine the extent to which attendance was associated with demographic, experiential, and psychosocial factors. The qualitative analysis of intake interviews revealed that mothers expected the MP intervention to provide a warm environment for themselves and their children as well as to support and enhance their parenting, and 95% revealed their hopes that the intervention would help them grow and develop as women. Attendance rates were relatively high, with 62% of mothers missing less than one group session. Quantitative analyses using multiple regression to test associations of demographic, experiential, and psychosocial factors with attendance rates were not significant. Results suggest that motivational interviewing may be an important component in promoting participant engagement efforts in parenting interventions. © 2017 Michigan Association for Infant Mental Health.

Registry Assessment of Peripheral Interventional Devices (RAPID): Registry assessment of peripheral interventional devices core data elements.

PubMed

Jones, W Schuyler; Krucoff, Mitchell W; Morales, Pablo; Wilgus, Rebecca W; Heath, Anne H; Williams, Mary F; Tcheng, James E; Marinac-Dabic, J Danica; Malone, Misti L; Reed, Terrie L; Fukaya, Rie; Lookstein, Robert A; Handa, Nobuhiro; Aronow, Herbert D; Bertges, Daniel J; Jaff, Michael R; Tsai, Thomas T; Smale, Joshua A; Zaugg, Margo J; Thatcher, Robert J; Cronenwett, Jack L

2018-02-01

The current state of evaluating patients with peripheral artery disease and more specifically of evaluating medical devices used for peripheral vascular intervention (PVI) remains challenging because of the heterogeneity of the disease process, the multiple physician specialties that perform PVI, the multitude of devices available to treat peripheral artery disease, and the lack of consensus about the best treatment approaches. Because PVI core data elements are not standardized across clinical care, clinical trials, and registries, aggregation of data across different data sources and physician specialties is currently not feasible. Under the auspices of the U.S. Food and Drug Administration's Medical Device Epidemiology Network initiative-and its PASSION (Predictable and Sustainable Implementation of the National Registries) program, in conjunction with other efforts to align clinical data standards-the Registry Assessment of Peripheral Interventional Devices (RAPID) workgroup was convened. RAPID is a collaborative, multidisciplinary effort to develop a consensus lexicon and to promote interoperability across clinical care, clinical trials, and national and international registries of PVI. The current manuscript presents the initial work from RAPID to standardize clinical data elements and definitions, to establish a framework within electronic health records and health information technology procedural reporting systems, and to implement an informatics-based approach to promote the conduct of pragmatic clinical trials and registry efforts in PVI. Ultimately, we hope this work will facilitate and improve device evaluation and surveillance for patients, clinicians, health outcomes researchers, industry, policymakers, and regulators. Copyright © 2017 Society for Vascular Surgery. All rights reserved.

Food ordering for children in restaurants: multiple sources of influence on decision making

PubMed Central

Castro, Iana A; Williams, Christine B; Madanat, Hala; Pickrel, Julie L; Jun, Hee-Jin; Zive, Michelle; Gahagan, Sheila; Ayala, Guadalupe X

2017-01-01

Objective Restaurants are playing an increasingly important role in children’s dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants. Design A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child’s gender, person ordering for the child and server interactions with the dining party. Interview data included: child’s age, restaurant visit frequency, timing of child’s decision making, and factors influencing decision making. Setting Ten independent, table-service restaurants in San Diego, CA, USA participated. Subjects Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3–14 years). Results Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children’s) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children’s menu. Conclusions Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants. PMID:27334904

Effectiveness of and User Experience With Web-Based Interventions in Increasing Physical Activity Levels in People With Multiple Sclerosis: A Systematic Review.

PubMed

Dennett, Rachel; Gunn, Hilary; Freeman, Jennifer A

2018-05-15

Supporting people with multiple sclerosis (MS) to achieve and maintain recommended levels of physical activity is important but challenging. Web-based interventions are increasingly being used to deliver targeted exercise programs and promote physical activity. The purpose of this study was to systematically review current evidence regarding the effectiveness and user experience of web-based interventions in increasing physical activity in people with MS. MEDLINE, EMBASE, CINAHL, AMED, PEDro, PsychInfo, Web of Sciences, The Cochrane Library, and gray literature were searched from 1990 to September 2016. English language articles reporting the use of web-based interventions to increase physical activity in adults with MS were included. Eligible quantitative studies were of any design and reported a measure of physical activity. Qualitative studies exploring users' experiences in any context were included. Of the 881 articles identified, 9 met the inclusion criteria. Two reviewers independently assessed methodological quality and extracted data using standardized critical appraisal and data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Meta-analysis of self-reported physical activity questionnaire data from 4 studies demonstrated a standardized mean difference of 0.67 (95% CI = 0.43-0.92), indicating a positive effect in favor of the web-based interventions. Narrative review of accelerometry data from 3 studies indicated increases in objectively measured physical activity. No qualitative studies met the inclusion criteria. In the 9 included articles, only 2 different interventions (used with people who were ambulant) were reported. Web-based interventions had a short-term positive effect on self-reported physical activity in people who had MS and were ambulant. Evidence is not currently available to support or refute their use in the long-term or with people who are not ambulant.

Are interventions to promote healthy eating equally effective for all? Systematic review of socioeconomic inequalities in impact.

PubMed

McGill, Rory; Anwar, Elspeth; Orton, Lois; Bromley, Helen; Lloyd-Williams, Ffion; O'Flaherty, Martin; Taylor-Robinson, David; Guzman-Castillo, Maria; Gillespie, Duncan; Moreira, Patricia; Allen, Kirk; Hyseni, Lirije; Calder, Nicola; Petticrew, Mark; White, Martin; Whitehead, Margaret; Capewell, Simon

2015-05-02

Interventions to promote healthy eating make a potentially powerful contribution to the primary prevention of non communicable diseases. It is not known whether healthy eating interventions are equally effective among all sections of the population, nor whether they narrow or widen the health gap between rich and poor. We undertook a systematic review of interventions to promote healthy eating to identify whether impacts differ by socioeconomic position (SEP). We searched five bibliographic databases using a pre-piloted search strategy. Retrieved articles were screened independently by two reviewers. Healthier diets were defined as the reduced intake of salt, sugar, trans-fats, saturated fat, total fat, or total calories, or increased consumption of fruit, vegetables and wholegrain. Studies were only included if quantitative results were presented by a measure of SEP. Extracted data were categorised with a modified version of the "4Ps" marketing mix, expanded to 6 "Ps": "Price, Place, Product, Prescriptive, Promotion, and Person". Our search identified 31,887 articles. Following screening, 36 studies were included: 18 "Price" interventions, 6 "Place" interventions, 1 "Product" intervention, zero "Prescriptive" interventions, 4 "Promotion" interventions, and 18 "Person" interventions. "Price" interventions were most effective in groups with lower SEP, and may therefore appear likely to reduce inequalities. All interventions that combined taxes and subsidies consistently decreased inequalities. Conversely, interventions categorised as "Person" had a greater impact with increasing SEP, and may therefore appear likely to reduce inequalities. All four dietary counselling interventions appear likely to widen inequalities. We did not find any "Prescriptive" interventions and only one "Product" intervention that presented differential results and had no impact by SEP. More "Place" interventions were identified and none of these interventions were judged as likely to widen inequalities. Interventions categorised by a "6 Ps" framework show differential effects on healthy eating outcomes by SEP. "Upstream" interventions categorised as "Price" appeared to decrease inequalities, and "downstream" "Person" interventions, especially dietary counselling seemed to increase inequalities. However the vast majority of studies identified did not explore differential effects by SEP. Interventions aimed at improving population health should be routinely evaluated for differential socioeconomic impact.

Moving from idea to action: promoting physical activity by empowering adolescents.

PubMed

Lindqvist, Anna-Karin; Mikaelsson, Katarina; Westerberg, Mats; Gard, Gunvor; Kostenius, Catrine

2014-11-01

Physical activity provides fundamental health benefits for children and youth. The aim of the study was to explore the possibility of conducting an empowerment-inspired intervention and examine the impact of the intervention in promoting moderate and vigorous physical activity (MVPA) among adolescents. A nonrandomized trial with a concurrent control group was carried out. Physical activity data were collected before and after the intervention with daily questions by short message service. Self-efficacy, social support, and attitude were also measured before and after the intervention since they were possible mediators. The intervention was created by the students, the researchers, and the teachers using an empowerment-based approach. Students in the intervention group (n = 21) increased their MVPA on average by 4.9 (SD = 28.9) minutes per day, and students in the control group (n = 25) reduced their MVPA on average by 25.4 (SD = 23.0) minutes per day (p = .000). The intervention might have contributed to a promotion of physical activity among students in the intervention group. The most valuable contribution this study provides is the knowledge that it is possible to develop and conduct an empowerment-inspired intervention to promote adolescent physical activity. © 2014 Society for Public Health Education.

Using signage to promote stair use on a university campus in hidden and visible stairwells.

PubMed

Grimstvedt, Megan E; Kerr, Jacqueline; Oswalt, Sara B; Fogt, Donovan L; Vargas-Tonsing, Tiffanye M; Yin, Zenong

2010-03-01

This study tested the effectiveness of a stair use promotion strategy in visible and hidden stairwells during intervention and post intervention follow up. A quasi-experimental study design was used with a 1 week baseline, a 3 week intervention, and post intervention at 2 and 4 weeks in 4 university buildings in San Antonio, Texas with stairwells varying in visibility. Participants were students, faculty, staff, and visitors to the 4 buildings. A total of 8431 observations were made. The intervention incorporated motivational signs with direction to nearby stairwells placed by elevators to promote stair use. Stair and elevator use was directly observed and recorded. Logistic regression analyses were used to test whether stair versus elevator use varied by intervention phase and stairwell visibility. Stair use increased significantly (12% units) during the intervention period and remained above baseline levels during post intervention follow-up. At baseline, visible stairs were 4 times more likely to be used than hidden stairs; however, the increase in stair use during intervention was similar in both types of stairwells. Motivational and directional signage can significantly increase stair use on a university campus. Furthermore, stairwell visibility is an important aspect of stair use promotion.

Increasing Pediatricians' Smoking Cessation Promotion and Knowledge of the Smoking Cessation Trust.

PubMed

Thomas, Katharine E H; Kisely, Steve; Urrego, Fernando

2017-05-01

The link between second hand smoke exposure (SHSe) and health issues in children has been well established. The objective of this study was to determine if a short intervention implemented among pediatricians promotes improvement in the promotion of smoking cessation to caregivers and increase pediatricians' awareness of the Smoking Cessation Trust (SCT). Pediatricians from 6 clinics were randomly assigned to the control or intervention group. All pediatricians received a survey to assess baseline knowledge, confidence and behaviors in smoking cessation promotion and utilization of the SCT. Pediatricians in intervention group received an educational lecture delivered by a physician. Two months post intervention, pediatricians in the control and intervention group received a survey to assess changes from baseline. Out of 36 general pediatricians, 27 completed the surveys for use in the analysis of this study (75%). Intervention group made more referrals to the SCT, compared to controls (p=0.048) and to baseline (p=0.0065). Pediatricians in the intervention group were more confident in recommending the use of NRT (0.040) and schedule a follow up to discuss smoking cessation (p=0.029) after the intervention. The intervention group was more likely to refer caregivers to smoking cessation programs (p=0.027), discuss a child's health risk from SHSe (0.031) and recommending the use of NRT to help quit (p=0.047) post intervention. The results from this study indicate that a short intervention can increase confidence and behavior in various parameters of smoking cessation promotion and significantly improve the rate in which pediatricians refer smoking caregivers to the SCT.

EARLY CHILDHOOD INVESTMENTS SUBSTANTIALLY BOOST ADULT HEALTH

PubMed Central

Campbell, Frances; Conti, Gabriella; Heckman, James J.; Moon, Seong Hyeok; Pinto, Rodrigo; Pungello, Elizabeth; Pan, Yi

2014-01-01

High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report the long-term health impacts of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143, while only 126 among the treated. One in four males in the control group is affected by metabolic syndrome, while none in the treatment group is. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health. PMID:24675955

Physical Activity Outcomes of Nurse-Delivered Lifestyle Interventions.

PubMed

Richards, Elizabeth A; Cai, Yun

2016-02-01

Promotion of physical activity has been a public health priority for decades. Over two million home healthcare nurses are at the front line to deliver effective health education and health promotion interventions in the United States. The purpose of this systematic review is to examine the effectiveness of nurse-delivered lifestyle physical interventions on physical activity outcomes conducted in home settings. Computerized database and ancestry search strategies located distinct intervention trials between 1990 and 2015. A total of eight quantitative studies were reviewed. Four of the eight studies were randomized control trials and four studies used an uncontrolled pretest-posttest design. The eight studies represented a total of 1,221 participants with mean ages from 43 to 81. Study sample sizes ranged from 16 to 504. Seven of the eight studies demonstrated modest effect of nurse-delivered home-based interventions on physical activity behaviors. Home-based physical activity promotion was most often incorporated into secondary prevention of postacute diseases, chronic disease management, or disease prevention/health promotion. Findings indicate that nurse-delivered home-based physical activity promotion show overall effectiveness in general adult populations. Possible effective intervention domains were also discussed in this review to guide future home-based health promotion. More large randomized controlled trials with longer study/follow-up periods and studies with cost-effectiveness data are warranted in future research.

Towards Evidence-Based, Quality-Controlled Health Promotion: The Dutch Recognition System for Health Promotion Interventions

ERIC Educational Resources Information Center

Brug, Johannes; van Dale, Djoeke; Lanting, Loes; Kremers, Stef; Veenhof, Cindy; Leurs, Mariken; van Yperen, Tom; Kok, Gerjo

2010-01-01

Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and…

Mother-child relationship quality and effective discipline as mediators of the 6-year effects of the New Beginnings Program for children from divorced families.

PubMed

Zhou, Qing; Sandler, Irwin N; Millsap, Roger E; Wolchik, Sharlene A; Dawson-McClure, Spring R

2008-08-01

This study examines whether program effects on mother-child relationship quality and effective discipline mediated the 6-year longitudinal effects of the New Beginnings Program (NBP) to improve mental health and competence outcomes in 218 adolescents from divorced families in a randomized experimental trial. The NBP is a theory-based and parenting-focused preventive intervention to help children adjust to divorce, and it has previously shown significant main and/or Program x Baseline Risk interaction effects to reduce adolescents' mental health and social adaptation problems and to promote competence. Mediation analyses were conducted using single- and two-group (high and low baseline risk) structural equation modeling. A multiple-methods and multiple-informants approach was used to assess the putative mediators and adolescents' outcomes. Results indicated that program-induced improvement in maternal effective discipline at posttest mediated the intervention effect on adolescents' GPA at the 6-year follow-up. Moreover, program-induced improvement in mother-child relationship quality mediated the intervention effect on adolescents' mental health problems for those with high baseline risk for maladjustment. The discussion focuses on the implications of the mediation findings for advancing the developmental theories that informed the design of the NBP and the implications for implementation of the NBP in community settings. Copyright 2008 APA, all rights reserved.

Animal assisted interventions in neurorehabilitation: a review of the most recent literature.

PubMed

Muñoz Lasa, S; Máximo Bocanegra, N; Valero Alcaide, R; Atín Arratibel, M A; Varela Donoso, E; Ferriero, G

2015-01-01

While conventional wisdom has always affirmed the value of animals in promoting human health and well-being, only recently has their therapeutic role in medicine become a topic for dedicated research. Animal assisted interventions (AAI) can be classified as animal-assisted activities, animal-assisted therapy, and service animal programs. The aim of this review is to analyse original papers addressing AAI and neurological diseases and published in the most influential medical journals between 2001 and 2012, and discuss their findings in the light of what may be of interest in the field of neurology. We selected a total of 23 articles on neurorehabilitation in cerebral palsy, pervasive developmental disorders, multiple sclerosis, spinal cord injury, stroke, and mental disorders. The main therapeutic results were improvement on the Gross Motor Function Classification Scale and in upper limb dexterity (cerebral palsy); improvement in social functioning and interaction; reductions in stress, anxiety, and loneliness (pervasive developmental disorders and mental disorders); and decreased spasticity with improved balance (multiple sclerosis, spinal cord injury, stroke). These interventions, performed with highly specialised animals in very specific neurological populations, deliver an increasing body of scientific evidence suggesting that they are an effective complement to other existing therapies. In these diseases, further high-quality studies are warranted in order to define the most appropriate programmes for therapy. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

INTEGRATING HEALTH INTO BUILDINGS OF THE FUTURE.

PubMed

Heidari, Leila; Younger, Margalit; Chandler, George; Gooch, James; Schramm, Paul

2016-01-01

The health and wellbeing of building occupants should be a key priority in the design, building, and operation of new and existing buildings. Buildings can be designed, renovated, and constructed to promote healthy environments and behaviors and mitigate adverse health outcomes. This paper highlights health in terms of the relationship between occupants and buildings, as well as the relationship of buildings to the community. In the context of larger systems, smart buildings and green infrastructure strategies serve to support public health goals. At the level of the individual building, interventions that promote health can also enhance indoor environmental quality and provide opportunities for physical activity. Navigating the various programs that use metrics to measure a building's health impacts reveals that there are multiple co-benefits of a "healthy building," including those related to the economy, environment, society, transportation, planning, and energy efficiency.

Using behavioral economics to promote healthy behavior toward sun exposure in adolescents and young adults.

PubMed

García-Romero, Maria T; Geller, Alan C; Kawachi, Ichiro

2015-12-01

Skin cancer represents an important public health problem, and it is associated with ultraviolet radiation exposure, particularly at early ages. Unhealthy sun exposure and intentional tanning continue to be the trend among young people. Multiple interventions to raise awareness of the risks of sun exposure have been implemented, without necessarily translating into decreased unhealthy behaviors or skin cancer incidence rates. Behavioral economics adds a set of concepts and tools to potentially boost the efficacy of existing approaches to decrease unhealthy sun exposure. This paper reviews public health interventions that have been based in behavioral economics concepts and their results, and provides examples of new and creative ways physicians and health professionals can actively apply insights from behavioral economics to counsel teenagers and young adults about skin cancer prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

The Flexibility Hypothesis of Healing.

PubMed

Hinton, Devon E; Kirmayer, Laurence J

2017-03-01

Theories of healing have attempted to identify general mechanisms that may work across different modalities. These include altering expectations, remoralization, and instilling hope. In this paper, we argue that many forms of healing and psychotherapy may work by inducing positive psychological states marked by flexibility or an enhanced ability to shift cognitive sets. Healing practices may induce these states of cognitive and emotional flexibility through specific symbolic interventions we term "flexibility primers" that can include images, metaphors, music, and other media. The flexibility hypothesis suggests that cognitive and emotional flexibility is represented, elicited, and enacted through multiple modalities in healing rituals. Identifying psychological processes and cultural forms that evoke and support cognitive and emotional flexibility provides a way to understand the cultural specificity and potential efficacy of particular healing practices and can guide the design of interventions that promote resilience and well-being.

Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families.

PubMed

Hilliard, Marisa E; Powell, Priscilla W; Anderson, Barbara J

2016-10-01

As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals' and families' unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Evidence-Based Behavioral Interventions to Promote Diabetes Management in Children, Adolescents, and Families

PubMed Central

Hilliard, Marisa E.; Powell, Priscilla W.; Anderson, Barbara J.

2017-01-01

As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals’ and families’ unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. PMID:27690487

Factors influencing primary health care professionals' physical activity promotion behaviors: a systematic review.

PubMed

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

2015-02-01

Despite the promising findings related to the efficacy of interventions aimed at promoting physical activity (PA) in primary health care (PHC), the translation of these interventions to PHC practice does not always happen as desired. To help understand why efficacious PHC-based PA interventions are not effectively translated to practice, this study systematically reviewed the literature on factors influencing PHC professionals' PA promotion practices. Literature searches were conducted in Web of Science, PubMed, and PsycINFO for peer-reviewed articles published in English from 1990 onwards. Studies were included that met the following criteria: (1) involving PHC-based PA interventions, and (2) reporting factors influencing PHC professionals' PA promotion behaviors. Two researchers independently screened studies and extracted data. A narrative synthesis using thematic analysis was conducted to identify factors. Of the 4,469 identified articles, 59 were included in the review. Factors were identified by qualitative methods, barrier/facilitator ratings, and the examination of the relationship between factors and PA promotion, and the effectiveness of introduction strategies. Many factors related to the development, delivery, and effects of the innovation, the sociopolitical and organizational culture, resources, and support, patient and PHC professional characteristics, and innovation strategies were identified as potential influences on PHC professionals' PA promotion practices. However, the lack of evidence on the relationship between factors and PA promotion indicated insufficient evidence on PA promotion determinants. This extensive overview of potential factors can inform intervention developers and implementers on which factors may play a role when introducing PA interventions in PHC. Future research should further investigate relationships between factors and PA promotion, which should be guided by qualitative in-depth knowledge on influencing factors.

Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review protocol.

PubMed

Muellmann, Saskia; Forberger, Sarah; Möllers, Tobias; Zeeb, Hajo; Pischke, Claudia R

2016-03-16

It is known that regular physical activity (PA) is associated with improvements in physical, psychological, cognitive, and functional health outcomes. The World Health Organization recommends 150 min of moderate exercise per week for older adults to achieve these health benefits. However, only 20-60 % of adults aged 60 years and above currently meet these recommendations for exercise. The widespread use of the internet and mobile phones among older adults may open new opportunities to promote PA in this population. Findings of previous reviews suggest that eHealth interventions are effective in promoting PA in adults of various ages. However, to date, none of these reviews have provided a differentiated picture of engagement in such interventions and effects on PA among older adults. Also, we are unaware of any studies comparing effects of participation in eHealth vs. traditional paper-and-pencil interventions on PA in this population. The aim of this systematic review and meta-analysis is to compare the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with either a non-eHealth PA intervention or a group that is not exposed to any intervention. Eight electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, PEI, PsycINFO, Web of Science, and OpenGrey) will be searched to identify experimental and quasi-experimental studies examining the effectiveness of eHealth interventions for PA promotion in adults aged 55 years and above. Two authors will independently select and review references, extract data, and assess the quality of the included studies by using the Cochrane Collaboration's risk of bias tool. Disagreements between authors will be resolved by discussion involving a third author. If feasible, a meta-analysis will be conducted. Narrative synthesis using harvest plots will be performed, should a meta-analysis not be feasible. The proposed systematic review will be the first review that compares the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with control groups exposed to a non-eHealth intervention or to no intervention. The results of this review will provide new information regarding the question whether eHealth interventions are an effective intervention vehicle for PA promotion in this population. PROSPERO CRD42015023875.

Increasing condom use: evaluation of a theory-based intervention to prevent sexually transmitted diseases in young women.

PubMed

Bryan, A D; Aiken, L S; West, S G

1996-09-01

A multicomponent intervention to increase condom use in sexually active young women was designed, implemented, and evaluated in a randomized experiment. Participants were 198 unmarried female college students (mean age = 18.6 years) who received a 1-session condom promotion intervention or a control (stress management) intervention. The condom promotion intervention led to increased self-reported condom use up to 6 months following intervention as well as positive changes in perceived benefits of condom use, affective attitudes toward condom use and condom users, perceived acceptance of sexuality, control over the sexual encounter, perceived self-efficacy for condom use, and intentions to use condoms. Mediational analysis illustrated the mechanisms of the condom promotion intervention effects, linking psychological constructs affected by the intervention (perceived benefits, acceptance of sexuality, control over the sexual encounter, attitudes toward condoms, and self-efficacy for condom use) to condom use intentions.

Individual and family factors associated with self-esteem in young people with epilepsy: A multiple mediation analysis.

PubMed

Chew, Judith; Haase, Anne M; Carpenter, John

2017-01-01

As young people experience added demands from living with epilepsy, which may lead to poor psychosocial adjustment, it is essential to examine mechanisms of change to provide practitioners with knowledge to develop effective interventions. The aim of this study was to examine individual and family-level factors - stress and illness perceptions, coping behaviors and family resilience - that promote or maintain young people's self-esteem. From November 2013 to August 2014, young people attending a neurology clinic in KK Women's and Children's Hospital, Singapore, participated in a cross-sectional survey (n=152; 13-16years old). Multiple mediation analyses were conducted to evaluate whether these variables mediated the relationship between illness severity (i.e., low, moderate, high) and self-esteem. Multiple mediation analyses demonstrated that illness severity had a direct effect on young people's self-esteem. Compared to those with moderate illness severity (reference group), young people with low severity had significantly higher self-esteem (c=3.42, p<0.05); while those with high severity had a more negative view of themselves (c=-3.93, p<0.001). Illness severity also had an indirect influence on self-esteem through its effects on mediators, such as perceived stress, illness perceptions and family resilience (D 1 : Total ab=3.46, 95% CI 1.13, 5.71; D 2 : Total ab=-2.80, 95% CI -4.35, -1.30). However, young people's coping levels did not predict their self-esteem, when accounting for the effects of other variables. The continued presence of seizure occurrences is likely to place greater demands on young people and their families: in turn, increased stress and negative illness perceptions negatively affected family processes that promote resilience. As the mediating effect of these modifiable factors were above and beyond the contributions of illness characteristics and young people's levels of coping, this has implications for developing individual and family interventions aimed to support young people living with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

A systematic review of online youth mental health promotion and prevention interventions.

PubMed

Clarke, Aleisha M; Kuosmanen, Tuuli; Barry, Margaret M

2015-01-01

The rapid growth in the use of online technologies among youth provides an opportunity to increase access to evidence-based mental health resources. The aim of this systematic review is to provide a narrative synthesis of the evidence on the effectiveness of online mental health promotion and prevention interventions for youth aged 12-25 years. Searching a range of electronic databases, 28 studies conducted since 2000 were identified. Eight studies evaluating six mental health promotion interventions and 20 studies evaluating 15 prevention interventions were reviewed. The results from the mental health promotion interventions indicate that there is some evidence that skills-based interventions presented in a module-based format can have a significant impact on adolescent mental health, however, an insufficient number of studies limits this finding. The results from the online prevention interventions indicate the significant positive effect of computerized cognitive behavioral therapy on adolescents' and emerging adults' anxiety and depression symptoms. The rates of non-completion were moderate to high across a number of studies. Implementation findings provide some evidence that participant face-to-face and/or web-based support was an important feature in terms of program completion and outcomes. Additional research examining factors affecting exposure, adherence and outcomes is required. The quality of evidence across the studies varied significantly, thus highlighting the need for more rigorous, higher quality evaluations conducted with more diverse samples of youth. Although future research is warranted, this study highlights the potential of online mental health promotion and prevention interventions in promoting youth wellbeing and reducing mental health problems.

Stress self-management: an intervention for women with physical disabilities.

PubMed

Hughes, Rosemary B; Robinson-Whelen, Susan; Taylor, Heather B; Hall, John W

2006-01-01

We sought to develop and evaluate the efficacy of an innovative, theory-driven, group stress self-management intervention designed to ameliorate stress and promote health among women with physical disabilities such as spinal cord injury, multiple sclerosis, and arthritis. We recruited a voluntary sample of 78 community-living women with disabilities who were randomly assigned to either the group stress management intervention or the wait-listed control group, and we used a within- and between-groups pretest/posttest design with a 3-month follow-up. Group differences in changes over time on measures of perceived stress and mental health offer support for the efficacy of the intervention. At the 3-month follow-up assessment, the intervention group also showed greater improvement on measures of pain and role limitations owing to physical health when compared the wait-listed control group. Perceived stress was supported as a mediator of the effect of the intervention on mental health. We found support for social connectedness and self-efficacy as mediators of the relation between the intervention and perceived stress; however, there was relatively weak evidence for differential change over time in those proposed mediators. This study provides the first of its kind, that is, an evaluation of the efficacy of a stress self-management intervention designed specifically for women with physical disabilities. The results are consistent with a model in which the stress management intervention enhances self-efficacy and social connectedness, which leads to reduced stress, which then contributes to improved mental health.

Effect of breastfeeding promotion interventions on cost-effectiveness of rotavirus immunization in Indonesia.

PubMed

Suwantika, Auliya A; Postma, Maarten J

2013-12-01

Rotavirus infection has been reported to be responsible for the majority of severe diarrhea in children under-5-years-old in Indonesia. Breast milk is considered to give protection against rotavirus infection. Increasing breastfeeding promotion programs could be an alternative target to reduce the incidence of rotavirus diarrhea. This study aims to investigate the effect of breastfeeding promotion interventions on cost-effectiveness of rotavirus immunization in Indonesia, focusing on breastfeeding education and support interventions. An age-structured cohort model was developed for the 2011 Indonesia birth cohort. We compared four interventions in scenarios: (i) base-case (I₀) reflecting the current situation for the population of under-5-years-old, (ii) with an additional breastfeeding education intervention (I₁), (iii) with a support intervention on initiation and duration (I₂) and (iv) with both of these two interventions combined (I₃). The model applied a 5-years time horizon, with 1 month analytical cycles for children less than 1 year of age and annually thereafter. Monte Carlo simulations were used to examine the economic acceptability and affordability of rotavirus vaccination. Rotavirus immunization would effectively reduce severe cases of rotavirus during the first 5 years of a child's life even assuming various breastfeeding promotion interventions. The total yearly vaccine cost would amount to US$ 64 million under the market vaccine price. Cost-effectiveness would increase to US$ 153 per quality-adjusted-life-year (societal perspective) with an optimal breastfeeding promotion intervention. Obviously, this is much lower than the 2011 Gross Domestic Product (GDP) per capita of US$ 3,495. Affordability results showed that at the market vaccine price, rotavirus vaccination could be affordable for the Indonesian health system. Rotavirus immunization would be a highly cost-effective public health intervention for Indonesia even under various breastfeeding promotion interventions based on the WHO's criteria for cost-effectiveness in universal immunization.

Promoting physical activity in rheumatoid arthritis: a narrative review of behaviour change theories.

PubMed

Larkin, Louise; Kennedy, Norelee; Gallagher, Stephen

2015-01-01

Despite physical activity having significant health benefits for people with rheumatoid arthritis (RA), current levels of physical activity in this population are suboptimal. Changing behaviour is challenging and interventions aimed at increasing physical activity in this context have had varying levels of success. This review provides an overview of common behaviour change theories used in interventions to promote physical activity and their application for promoting physical activity in people with RA. A scoping, narrative review was conducted of English language literature, using the search terms "physical activity/exercise" and keywords, which are associated with behaviour change interventions. The theoretical basis of such interventions in people with RA was assessed using the "theory coding scheme". Six theories which have been used in physical activity research are discussed. Further, four studies which aimed to increase physical activity levels in people with RA are explored in detail. To date, behaviour change interventions conducted in RA populations to increase physical activity levels have not had a strong theoretical underpinning. It is proposed that an intervention utilising the theory of planned behaviour is developed with the aim of increasing physical activity in people with RA. Implications for Rehabilitation Interventions to promote physical activity in the rheumatoid arthritis (RA) population have failed to change participants' behaviour. A small number of studies have used behaviour change theories in the development and delivery of interventions. The theory of planned behaviour is recommended as the theoretical basis for an intervention to promote physical activity in the RA population.

Can job redesign interventions influence a broad range of employee outcomes by changing multiple job characteristics? A quasi-experimental study.

PubMed

Holman, David; Axtell, Carolyn

2016-07-01

Many job redesign interventions are based on a multiple mediator-multiple outcome model in which the job redesign intervention indirectly influences a broad range of employee outcomes by changing multiple job characteristics. As this model remains untested, the aim of this study is to test a multiple mediator-multiple outcome model of job redesign. Multilevel analysis of data from a quasi-experimental job redesign intervention in a call center confirmed the hypothesized model and showed that the job redesign intervention affected a broad range of employee outcomes (i.e., employee well-being, psychological contract fulfillment, and supervisor-rated job performance) through changes in 2 job characteristics (i.e., job control and feedback). The results provide further evidence for the efficacy and mechanisms of job redesign interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

PubMed

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

2016-01-22

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

Gender-transformative Bandebereho couples' intervention to promote male engagement in reproductive and maternal health and violence prevention in Rwanda: Findings from a randomized controlled trial.

PubMed

Doyle, Kate; Levtov, Ruti G; Barker, Gary; Bastian, Gautam G; Bingenheimer, Jeffrey B; Kazimbaya, Shamsi; Nzabonimpa, Anicet; Pulerwitz, Julie; Sayinzoga, Felix; Sharma, Vandana; Shattuck, Dominick

2018-01-01

Rigorous evidence of the effectiveness of male engagement interventions, particularly on how these interventions impact relationship power dynamics and women's decision-making, remains limited. This study assessed the impact of the Bandebereho gender-transformative couples' intervention on impact on multiple behavioral and health-related outcomes influenced by gender norms and power relations. We conducted a multi-site randomised controlled trial in four Rwandan districts with expectant/current fathers and their partners, who were randomised to the intervention (n = 575 couples) or control group (n = 624 couples). Primary outcomes include women's experience of physical and sexual IPV, women's attendance and men's accompaniment at ANC, modern contraceptive use, and partner support during pregnancy. At 21-months post-baseline, 1123 men and 1162 partners were included in intention to treat analysis. Generalized estimating equations with robust standard errors were used to fit the models. The Bandebereho intervention led to substantial improvements in multiple reported outcomes. Compared to the control group, women in the intervention group reported: less past-year physical (OR 0.37, p<0.001) and sexual IPV (OR 0.34, p<0.001); and greater attendance (IRR 1.09, p<0.001) and male accompaniment at antenatal care (IRR 1.50, p<0.001); and women and men in the intervention group reported: less child physical punishment (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005); greater modern contraceptive use (women: OR 1.53, p = 0.004; men: OR 1.65, p = 0.001); higher levels of men's participation in childcare and household tasks (women: beta 0.39, p<0.001; men: beta 0.33, p<0.001); and less dominance of men in decision-making. Our study strengthens the existing evidence on male engagement approaches; together with earlier studies our findings suggest that culturally adapted gender-transformative interventions with men and couples can be effective at changing deeply entrenched gender inequalities and a range of health-related behavioral outcomes. ClinicalTrials.gov NCT02694627.

Gender-transformative Bandebereho couples’ intervention to promote male engagement in reproductive and maternal health and violence prevention in Rwanda: Findings from a randomized controlled trial

PubMed Central

Barker, Gary; Bastian, Gautam G.; Bingenheimer, Jeffrey B.; Kazimbaya, Shamsi; Nzabonimpa, Anicet; Pulerwitz, Julie; Sayinzoga, Felix; Sharma, Vandana; Shattuck, Dominick

2018-01-01

Background Rigorous evidence of the effectiveness of male engagement interventions, particularly on how these interventions impact relationship power dynamics and women’s decision-making, remains limited. This study assessed the impact of the Bandebereho gender-transformative couples’ intervention on impact on multiple behavioral and health-related outcomes influenced by gender norms and power relations. Methods We conducted a multi-site randomised controlled trial in four Rwandan districts with expectant/current fathers and their partners, who were randomised to the intervention (n = 575 couples) or control group (n = 624 couples). Primary outcomes include women’s experience of physical and sexual IPV, women’s attendance and men’s accompaniment at ANC, modern contraceptive use, and partner support during pregnancy. At 21-months post-baseline, 1123 men and 1162 partners were included in intention to treat analysis. Generalized estimating equations with robust standard errors were used to fit the models. Findings The Bandebereho intervention led to substantial improvements in multiple reported outcomes. Compared to the control group, women in the intervention group reported: less past-year physical (OR 0.37, p<0.001) and sexual IPV (OR 0.34, p<0.001); and greater attendance (IRR 1.09, p<0.001) and male accompaniment at antenatal care (IRR 1.50, p<0.001); and women and men in the intervention group reported: less child physical punishment (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005); greater modern contraceptive use (women: OR 1.53, p = 0.004; men: OR 1.65, p = 0.001); higher levels of men’s participation in childcare and household tasks (women: beta 0.39, p<0.001; men: beta 0.33, p<0.001); and less dominance of men in decision-making. Conclusions Our study strengthens the existing evidence on male engagement approaches; together with earlier studies our findings suggest that culturally adapted gender-transformative interventions with men and couples can be effective at changing deeply entrenched gender inequalities and a range of health-related behavioral outcomes. Trial registration ClinicalTrials.gov NCT02694627 PMID:29617375

A randomized controlled trial testing a social network intervention to promote physical activity among adolescents.

PubMed

van Woudenberg, Thabo J; Bevelander, Kirsten E; Burk, William J; Smit, Crystal R; Buijs, Laura; Buijzen, Moniek

2018-04-23

The current study examined the effectiveness of a social network intervention to promote physical activity among adolescents. Social network interventions utilize peer influence to change behavior by identifying the most influential individuals within social networks (i.e., influence agents), and training them to promote the target behavior. A total of 190 adolescents (46.32% boys; M age = 12.17, age range: 11-14 years) were randomly allocated to either the intervention or control condition. In the intervention condition, the most influential adolescents (based on peer nominations of classmates) in each classroom were trained to promote physical activity among their classmates. Participants received a research smartphone to complete questionnaires and an accelerometer to measure physical activity (steps per day) at baseline, and during the intervention one month later. A multilevel model tested the effectiveness of the intervention, controlling for clustering of data within participants and days. No intervention effect was observed, b = .04, SE = .10, p = .66. This was one of the first studies to test whether physical activity in adolescents could be promoted via influence agents, and the first social network intervention to use smartphones to do so. Important lessons and implications are discussed concerning the selection criterion of the influence agents, the use of smartphones in social network intervention, and the rigorous analyses used to control for confounding factors. Dutch Trial Registry (NTR): NTR6173 . Registered 5 October 2016 Study procedures were approved by the Ethics Committee of the Radboud University (ECSW2014-100614-222).

Individual versus systemic risk and the Regulator's Dilemma

PubMed Central

Beale, Nicholas; Rand, David G.; Battey, Heather; Croxson, Karen; May, Robert M.; Nowak, Martin A.

2011-01-01

The global financial crisis of 2007–2009 exposed critical weaknesses in the financial system. Many proposals for financial reform address the need for systemic regulation—that is, regulation focused on the soundness of the whole financial system and not just that of individual institutions. In this paper, we study one particular problem faced by a systemic regulator: the tension between the distribution of assets that individual banks would like to hold and the distribution across banks that best supports system stability if greater weight is given to avoiding multiple bank failures. By diversifying its risks, a bank lowers its own probability of failure. However, if many banks diversify their risks in similar ways, then the probability of multiple failures can increase. As more banks fail simultaneously, the economic disruption tends to increase disproportionately. We show that, in model systems, the expected systemic cost of multiple failures can be largely explained by two global parameters of risk exposure and diversity, which can be assessed in terms of the risk exposures of individual actors. This observation hints at the possibility of regulatory intervention to promote systemic stability by incentivizing a more diverse diversification among banks. Such intervention offers the prospect of an additional lever in the armory of regulators, potentially allowing some combination of improved system stability and reduced need for additional capital. PMID:21768387

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.

Efficacy of a Group-Based Multimedia HIV Prevention Intervention for Drug-Involved Women under Community Supervision: Project WORTH

PubMed Central

El-Bassel, Nabila; Gilbert, Louisa; Goddard-Eckrich, Dawn; Chang, Mingway; Wu, Elwin; Hunt, Tim; Epperson, Matt; Shaw, Stacey A.; Rowe, Jessica; Almonte, Maria; Witte, Susan

2014-01-01

Importance This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. Objective We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. Design, Setting, Participants, and Intervention We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. Main Outcomes and Measures Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. Results Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02–0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57–0.90). Conclusion and Relevance The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system. Trial Registration ClinicalTrials.gov NCT01784809 PMID:25372149

Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services.

PubMed

Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard

2013-03-04

Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers' access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers' control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services - including peer interventions, condom promotion and STI screening - would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are required to enhance access to HIV testing and ART for sex workers, using current CD4 thresholds, or possibly earlier for prevention. Services implemented at sufficient scale and intensity also serve as a platform for subsequent community mobilization and sex worker empowerment, and alleviate a major source of incident infection sustaining even generalized HIV epidemics. Ultimately, structural and legal changes that align public health and human rights are needed to ensure that sex workers on the continent are adequately protected from HIV.

A four-year, systems-wide intervention promoting interprofessional collaboration

PubMed Central

2012-01-01

Background A four-year action research study was conducted across the Australian Capital Territory health system to strengthen interprofessional collaboration (IPC) though multiple intervention activities. Methods We developed 272 substantial IPC intervention activities involving 2,407 face-to-face encounters with health system personnel. Staff attitudes toward IPC were surveyed yearly using Heinemann et al's Attitudes toward Health Care Teams and Parsell and Bligh's Readiness for Interprofessional Learning scales (RIPLS). At study's end staff assessed whether project goals were achieved. Results Of the improvement projects, 76 exhibited progress, and 57 made considerable gains in IPC. Educational workshops and feedback sessions were well received and stimulated interprofessional activities. Over time staff scores on Heinemann's Quality of Interprofessional Care subscale did not change significantly and scores on the Doctor Centrality subscale increased, contrary to predictions. Scores on the RIPLS subscales of Teamwork & Collaboration and Professional Identity did not alter. On average for the assessment items 33% of staff agreed that goals had been achieved, 10% disagreed, and 57% checked neutral. There was most agreement that the study had resulted in increased sharing of knowledge between professions and improved quality of patient care, and least agreement that between-professional rivalries had lessened and communication and trust between professions improved. Conclusions Our longitudinal interventional study of IPC involving multiple activities supporting increased IPC achieved many project-specific goals. However, improvements in attitudes over time were not demonstrated and neutral assessments predominated, highlighting the difficulties faced by studies targeting change at the systems level and over extended periods. PMID:22520869

Reasons for Engagement: SME Owner-manager Motivations for Engaging in a Workplace Mental Health and Wellbeing Intervention.

PubMed

Dawkins, Sarah; Martin, Angela; Kilpatrick, Michelle; Scott, Jenn

2018-05-30

Small-to-medium enterprises (SMEs) require specialized attention regarding workplace mental health (WMH), but can be challenging to engage in WMH promotion interventions. This cross-sectional study analyzed self-reported motivations of SME owner/managers who engaged in a WMH promotion intervention specifically designed for SMEs. Data from 297 SME owner/managers was thematically coded prior to conducting multinominal logistical regression analyses to determine reasons for engagement based on a series of predictors, including owner/manager psychological distress, recent experience of a stressful work event, and business confidence. Owner/manager psychological distress, experience of a recent stressful workplace, and low 12-month business confidence incident were important predictors of engagement. The findings provide important insights into the uptake of a WMH promotion intervention, which can inform the design and future recruitment strategies for WMH promotion interventions within the SME sector.

Tailored weight loss intervention in obese adults within primary care practice: rationale, design, and methods of Choose to Lose.

PubMed

Hartman, Sheri J; Risica, Patricia M; Gans, Kim M; Marcus, Bess H; Eaton, Charles B

2014-07-01

Although there are efficacious weight loss interventions that can improve health and delay onset of diabetes and hypertension, these interventions have not been translated into clinical practice. The primary objective of this study is to evaluate the effectiveness and cost effectiveness of a tailored lifestyle intervention in primary care patients. Patients were recruited by their primary care physicians and eligible participants were randomized to an enhanced intervention or standard intervention. All participants met with a lifestyle counselor to set calorie and physical activity goals and to discuss behavioral strategies at baseline, 6 and 12 months. During the first year, enhanced intervention participants receive monthly counseling phone calls to assist in attaining and maintaining their goals. Enhanced intervention participants also receive weekly mailings consisting of tailored and non-tailored print materials and videos focusing on weight loss, physical activity promotion and healthy eating. The second year focuses on maintenance with enhanced intervention participants receiving tailored and non-tailored print materials and videos regularly throughout the year. Standard intervention participants receive five informational handouts on weight loss across the two years. This enhanced intervention that consists of multiple modalities of print, telephone, and video with limited face-to-face counseling holds promise for being effective for encouraging weight loss, increasing physical activity and healthy eating, and also for being cost effective and generalizable for wide clinical use. This study will fill an important gap in our knowledge regarding the translation and dissemination of research from efficacy studies to best practices in clinical settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Quality of life among people with multiple sclerosis: Replication of a three-factor prediction model.

PubMed

Bishop, Malachy; Rumrill, Phillip D; Roessler, Richard T

2015-01-01

This article presents a replication of Rumrill, Roessler, and Fitzgerald's 2004 analysis of a three-factor model of the impact of multiple sclerosis (MS) on quality of life (QOL). The three factors in the original model included illness-related, employment-related, and psychosocial adjustment factors. To test hypothesized relationships between QOL and illness-related, employment-related, and psychosocial variables using data from a survey of the employment concerns of Americans with MS (N = 1,839). An ex post facto, multiple correlational design was employed incorporating correlational and multiple regression analyses. QOL was positively related to educational level, employment status, job satisfaction, and job-match, and negatively related to number of symptoms, severity of symptoms, and perceived stress level. The three-factor model explained approximately 37 percent of the variance in QOL scores. The results of this replication confirm the continuing value of the three-factor model for predicting the QOL of adults with MS, and demonstrate the importance of medical, mental health, and vocational rehabilitation interventions and services in promoting QOL.

Promoting Healthy Aging in Adults with Developmental Disabilities

ERIC Educational Resources Information Center

Heller, Tamar; Sorensen, Amy

2013-01-01

This article reviews the research on health promotion for adults aging with developmental disabilities. First, it examines barriers to healthy aging, including health behaviors and access to health screenings and services. Second, it reviews the research on health promotion interventions, including physical activity interventions, health education…

An Investigation of an Intervention to Promote Inference Generation by Adolescent Poor Comprehenders

ERIC Educational Resources Information Center

Denton, Carolyn A.; York, Mary J.; Francis, David J.; Haring, Christa; Ahmed, Yusra; Bidulescu, Adrian

2017-01-01

This brief experimental study investigated the initial promise of an intervention designed to promote inference generation in adolescents with reading comprehension difficulties. The intervention, provided for nine sessions, included multisyllable word study, teacher explanation and modeling of inference generation and other comprehension…

The development and pilot testing of a multicomponent health promotion intervention (SEHER) for secondary schools in Bihar, India

PubMed Central

Shinde, Sachin; Pereira, Bernadette; Khandeparkar, Prachi; Sharma, Amit; Patton, George; Ross, David A; Weiss, Helen A; Patel, Vikram

2017-01-01

ABSTRACT Background: Schools can play an important role in health promotion by improving students’ health literacy, attitudes, health-related behaviours, social connection and self-efficacy. These interventions can be particularly valuable in low- and middle-income countries with low health literacy and high burden of disease. However, the existing literature provides poor guidance for the implementation of school-based interventions in low-resource settings. This paper describes the development and pilot testing of a multicomponent school-based health promotion intervention for adolescents in 75 government-run secondary schools in Bihar, India. Method: The intervention was developed in three stages: evidence review of the content and delivery of effective school health interventions; formative research to contextualize the proposed content and delivery, involving intervention development workshops with experts, teachers and students and content analysis of intervention manuals; and pilot testing in situ to optimize its feasibility and acceptability. Results: The three-stage process defined the intervention elements, refining their content and format of delivery. This intervention focused on promoting social skills among adolescents, engaging adolescents in school decision making, providing factual information, and enhancing their problem-solving skills. Specific intervention strategies were delivered at three levels (whole school, student group, and individual counselling) by either a trained teacher or a lay counsellor. The pilot study, in 50 schools, demonstrated generally good acceptability and feasibility of the intervention, though the coverage of intervention activities was lower in the teacher delivery schools due to competing teaching commitments, the participation of male students was lower than that of females, and one school dropped out because of concerns regarding the reproductive and sexual health content of the intervention. Conclusion: This SEHER approach provides a framework for adolescent health promotion in secondary schools in low-resource settings. We are now using a cluster-randomized trial to evaluate its effectiveness and cost-effectiveness. PMID:29115194

The development and pilot testing of a multicomponent health promotion intervention (SEHER) for secondary schools in Bihar, India.

PubMed

Shinde, Sachin; Pereira, Bernadette; Khandeparkar, Prachi; Sharma, Amit; Patton, George; Ross, David A; Weiss, Helen A; Patel, Vikram

2017-01-01

Schools can play an important role in health promotion by improving students' health literacy, attitudes, health-related behaviours, social connection and self-efficacy. These interventions can be particularly valuable in low- and middle-income countries with low health literacy and high burden of disease. However, the existing literature provides poor guidance for the implementation of school-based interventions in low-resource settings. This paper describes the development and pilot testing of a multicomponent school-based health promotion intervention for adolescents in 75 government-run secondary schools in Bihar, India. The intervention was developed in three stages: evidence review of the content and delivery of effective school health interventions; formative research to contextualize the proposed content and delivery, involving intervention development workshops with experts, teachers and students and content analysis of intervention manuals; and pilot testing in situ to optimize its feasibility and acceptability. The three-stage process defined the intervention elements, refining their content and format of delivery. This intervention focused on promoting social skills among adolescents, engaging adolescents in school decision making, providing factual information, and enhancing their problem-solving skills. Specific intervention strategies were delivered at three levels (whole school, student group, and individual counselling) by either a trained teacher or a lay counsellor. The pilot study, in 50 schools, demonstrated generally good acceptability and feasibility of the intervention, though the coverage of intervention activities was lower in the teacher delivery schools due to competing teaching commitments, the participation of male students was lower than that of females, and one school dropped out because of concerns regarding the reproductive and sexual health content of the intervention. This SEHER approach provides a framework for adolescent health promotion in secondary schools in low-resource settings. We are now using a cluster-randomized trial to evaluate its effectiveness and cost-effectiveness.

THE CULTURAL CONTEXT OF POLIO BIOGRAPHIES

PubMed Central

Scheer, Jessica; Luborsky, Mark L.

2014-01-01

Cultural contexts influence the ways individuals interpret and experience functional losses associated with post-polio sequelae. Using in-depth multiple interview case studies from two National Institute on Aging projects, the concept of “biographies” is presented to place the individuals’ polio-related experiences within the context of their lives. Two major cultural contexts shape the construction of polio biographies: normative life course expectations and developmental tasks; and traditions associated with polio recovery and rehabilitation. The authors identify key dimensions of personal concern among polio survivors that can be used as entrance points for effective clinical intervention and to promote treatment compliance. PMID:1758785

[Factors associated with physical activity among Chinese immigrant women].

PubMed

Cho, Sung-Hye; Lee, Hyeonkyeong

2013-12-01

This study was done to assess the level of physical activity among Chinese immigrant women and to determine the relationships of physical activity with individual characteristics and behavior-specific cognition. A cross-sectional descriptive study was conducted with 161 Chinese immigrant women living in Busan. A health promotion model of physical activity adapted from Pender's Health Promotion Model was used. Self-administered questionnaires were used to collect data during the period from September 25 to November 20, 2012. Using SPSS 18.0 program, descriptive statistics, t-test, analysis of variance, correlation analysis, and multiple regression analysis were done. The average level of physical activity of the Chinese immigrant women was 1,050.06 ± 686.47 MET-min/week and the minimum activity among types of physical activity was most dominant (59.6%). As a result of multiple regression analysis, it was confirmed that self-efficacy and acculturation were statistically significant variables in the model (p<.001), with an explanatory power of 23.7%. The results indicate that the development and application of intervention strategies to increase acculturation and self-efficacy for immigrant women will aid in increasing the physical activity in Chinese immigrant women.

Supporting inquiry learning by promoting normative understanding of multivariable causality

NASA Astrophysics Data System (ADS)

Keselman, Alla

2003-11-01

Early adolescents may lack the cognitive and metacognitive skills necessary for effective inquiry learning. In particular, they are likely to have a nonnormative mental model of multivariable causality in which effects of individual variables are neither additive nor consistent. Described here is a software-based intervention designed to facilitate students' metalevel and performance-level inquiry skills by enhancing their understanding of multivariable causality. Relative to an exploration-only group, sixth graders who practiced predicting an outcome (earthquake risk) based on multiple factors demonstrated increased attention to evidence, improved metalevel appreciation of effective strategies, and a trend toward consistent use of a controlled comparison strategy. Sixth graders who also received explicit instruction in making predictions based on multiple factors showed additional improvement in their ability to compare multiple instances as a basis for inferences and constructed the most accurate knowledge of the system. Gains were maintained in transfer tasks. The cognitive skills and metalevel understanding examined here are essential to inquiry learning.

The value of partnerships in state obesity prevention and control programs.

PubMed

Hersey, James; Kelly, Bridget; Roussel, Amy; Curtis, LaShawn; Horne, Joseph; Williams-Piehota, Pamela; Kuester, Sarah; Farris, Rosanne

2012-03-01

State health departments funded by the Centers for Disease Control and Prevention's Nutrition, Physical Activity, and Obesity Program collaborate with multiple partners to develop and implement comprehensive obesity prevention and control programs. A mixed-methods evaluation of 28 state programs over a 5-year period assessed states' progress on program requirements, including developing statewide partnerships and coordinating with partners to support obesity prevention and control efforts. States with greater partnership involvement leveraged more funding support for their programs, passed more obesity-related policies, and were more likely to implement obesity interventions in multiple settings. Case studies provided guidance for establishing and maintaining strong partnerships. Findings from this study offer emerging evidence to support assumptions about the centrality of partnerships to states' success in obesity program development and implementation and related health promotion activities.

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

PubMed

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

2013-04-11

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

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

PubMed Central

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

2013-01-01

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

A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries

PubMed Central

2013-01-01

Background This systematic review provides a narrative synthesis of the evidence on the effectiveness of mental health promotion interventions for young people in low and middle-income countries (LMICs). Commissioned by the WHO, a review of the evidence for mental health promotion interventions across the lifespan from early years to adulthood was conducted. This paper reports on the findings for interventions promoting the positive mental health of young people (aged 6–18 years) in school and community-based settings. Methods Searching a range of electronic databases, 22 studies employing RCTs (N = 11) and quasi-experimental designs conducted in LMICs since 2000 were identified. Fourteen studies of school-based interventions implemented in eight LMICs were reviewed; seven of which included interventions for children living in areas of armed conflict and six interventions of multicomponent lifeskills and resilience training. Eight studies evaluating out-of-school community interventions for adolescents were identified in five countries. Using the Effective Public Health Practice Project (EPHPP) criteria, two reviewers independently assessed the quality of the evidence. Results The findings from the majority of the school-based interventions are strong. Structured universal interventions for children living in conflict areas indicate generally significant positive effects on students’ emotional and behavioural wellbeing, including improved self-esteem and coping skills. However, mixed results were also reported, including differential effects for gender and age groups, and two studies reported nonsignficant findings. The majority of the school-based lifeskills and resilience programmes received a moderate quality rating, with findings indicating positive effects on students’ self-esteem, motivation and self-efficacy. The quality of evidence from the community-based interventions for adolescents was moderate to strong with promising findings concerning the potential of multicomponent interventions to impact on youth mental health and social wellbeing. Conclusions The review findings indicate that interventions promoting the mental health of young people can be implemented effectively in LMIC school and community settings with moderate to strong evidence of their impact on both positive and negative mental health outcomes. There is a paucity of evidence relating to interventions for younger children in LMIC primary schools. Evidence for the scaling up and sustainability of mental health promotion interventions in LMICs needs to be strengthened. PMID:24025155

Nutritional supplements for people being treated for active tuberculosis.

PubMed

Abba, Katharine; Sudarsanam, Thambu D; Grobler, Liesl; Volmink, Jimmy

2008-10-08

Tuberculosis is a serious infection affecting mainly the lungs. It may contribute to nutritional deficiencies which in turn may delay recovery by depressing immune functions. Nutritional supplements might therefore promote recovery in people being treated for tuberculosis. To assess the provision of oral nutritional supplements to promote the recovery of people being treated with antituberculous drug therapy for active tuberculosis. We searched the Cochrane Infectious Disease Group Specialized Register (June 2008), CENTRAL (The Cochrane Library 2008, Issue 2), MEDLINE (June 2008), EMBASE (June 2008), LILACS (June 2008), mRCT (June 2008), the Indian Journal of Tuberculosis (1983 to June 2008), and checked the reference lists of all included studies. Randomized controlled trials comparing any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. Two authors independently selected trials, extracted data, and assessed risk of bias. We calculated risk ratios (RR) for dichotomous variables and mean differences (MD) for continuous variables, with 95% confidence intervals (CI). We pooled data from trials with similar interventions and outcomes. Twelve trials (3393 participants) were included. Five trials had adequate allocation concealment. Interventions included a high energy supplement, high cholesterol diet, vitamin D, vitamin A, zinc, arginine, multiple micronutrient supplements, combined multiple micronutrient supplements and zinc, combined vitamin A and zinc, and combined vitamin A and selenium. The following supplements were associated with increased body weight at follow up: high energy supplements (MD 1.73 kg, 95% CI 0.81 to 2.65; 34 participants, 1 trial); multiple micronutrients plus additional zinc (MD 2.37 kg, 95% CI 2.21 to 2.53; 192 participants, 1 trial); and vitamin A plus zinc (MD 3.10 kg, 95% CI 0.74 to 5.46; 80 participants, 1 trial). There was no evidence that any supplement affected the number of deaths or number of participants with sputum test positive results at the end of treatment. There is limited evidence that high energy supplements and some combinations of zinc with other micronutrients may help people with tuberculosis to gain weight. There is not enough evidence to assess the effect of other combinations of nutrients. A number of relevant trials are in progress, and, where appropriate, the results will be incorporated into future updates of this review.

Implementing and Evaluating Environmental and Policy Interventions for Promoting Physical Activity in Rural Schools

ERIC Educational Resources Information Center

Baker, Elizabeth A.; Elliott, Michael; Barnidge, Ellen; Estlund, Amy; Brownson, Ross C.; Milne, Anne; Kershaw, Freda; Hashimoto, Derek

2017-01-01

Background: Schools are an important setting for improving behaviors associated with obesity, including physical activity. However, within schools there is often a tension between spending time on activities promoting academic achievement and those promoting physical activity. Methods: A community-based intervention provided administrators and…

Interventions to Promote Colorectal Cancer Screening: An Integrative Review

PubMed Central

Rawl, Susan M.; Menon, Usha; Burness, Allison; Breslau, Erica S.

2012-01-01

Behavior change interventions to promote colorectal cancer (CRC) screening have targeted people in community and primary care settings, health care providers, and health systems. Randomized controlled trials provide the strongest evidence of intervention efficacy. The purpose of this integrative review was to evaluate trials of CRC screening interventions published between 1997 and 2007 and to identify knowledge gaps and future directions for research. Thirty-three randomized trials that met inclusion criteria were evaluated using a modified version of the TREND criteria. Significant intervention effects were reported in six out of ten trials focused on increasing fecal occult blood testing, four of seven trials focused on sigmoidoscopy or colonoscopy completion, and nine of 16 focused on completion of any screening test. Several effective interventions to promote CRC screening were identified. Future trials need to use theory to guide interventions, examine moderators and mediators, consistently report results, and use comparable outcome measures. PMID:22261002

Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program

ERIC Educational Resources Information Center

Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.

2007-01-01

The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.

Promoting equity in the mental wellbeing of children and young people: a scoping review.

PubMed

Welsh, Jennifer; Strazdins, Lyndall; Ford, Laura; Friel, Sharon; O'Rourke, Kerryn; Carbone, Stephen; Carlon, Leanne

2015-09-01

There is increasing emphasis on wellbeing as a target for mental health promotion, especially during the formative period of childhood. Despite growing research on the importance of mental wellbeing, there is little information on how to effectively promote it or how to promote it equitably. This article presents a scoping review of interventions which seek to promote mental wellbeing and reduce inequities in children and young people living in high income countries. We used Fair Foundations: The VicHealth framework for health equity (VicHealth (2013) Melbourne, Australia: The Victorian Health Promotion Foundation) to identify points of entry at three layers of influence: (i) socioeconomic, cultural and political contexts, (ii) daily living conditions, and (iii) individual and family health-related factors. We identified more than 1000 interventions which aimed to prevent or treat childhood mental illness, but there were far fewer that aimed to promote children's or young people's mental wellbeing. The interventions we studied were either universal or specifically targeted children from disadvantaged families: none explicitly used an equity framework to guide their design or evaluation or addressed social gradients in wellbeing. Most interventions remained focused on proximate factors, although we also identified a handful of interventions that sought to address children's access to services and their educational and neighbourhood environments. However, we found encouraging evidence that interventions in family and educational settings were successful in building children's strengths and supporting positive parenting, universally and within disadvantaged groups. Such positive programme evaluations signal the potential for using a proportionate universalism approach that emphasizes equity in the promotion of mental wellbeing. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review.

PubMed

Spoelstra, Sandra L; Schueller, Monica; Hilton, Melissa; Ridenour, Kimberly

2015-05-01

This article presents an integrative review of the evidence for combined motivational interviewing and cognitive behavioural interventions that promote medication adherence. We undertook this review to establish a scientific foundation for development of interventions to promote medication adherence and to guide clinical practice. The World Health Organization has designated medication adherence as a global problem. Motivational interviewing and cognitive behaviour interventions have been found to individually promote medication adherence. However, there is a gap in the literature on the effect of combined motivational interviewing and cognitive behavioural approaches to promote medication adherence. Integrative review. COCHRANE, PubMed and CINAHL were searched to access relevant studies between 2004-2014. Inclusion criteria were interventions combining motivational interviewing and cognitive behavioural therapy with medication adherence as the outcome. Articles were assessed for measures of adherence and methodological rigour. Analysis was performed using an integrative review process. Six articles met the inclusion criteria. A randomised controlled trial reported pretreatment missed doses of 5·58 and post-treatment of 0·92 and trended towards significance. Four cohort studies had effect sizes of 0·19-0·35 (p < 0·05). A case study had a pretreatment adherence rate of 25% and post-treatment 77% (p < 0·01). Although there were a limited number of studies on combined motivational interviewing and cognitive behavioural interventions, five out of six were effective at improving medication adherence. Future studies with large rigorous randomised trials are needed. This review provides clinicians with the state of the science in relation to combined motivational interviewing and cognitive behavioural therapy interventions that promote medication adherence. A summary of intervention components and talking points are provided to aid nurses in informing decision-making and translating evidence into practice. © 2014 John Wiley & Sons Ltd.

Improving the self-efficacy of teachers in schools: results of health promotion program.

PubMed

Farokhzadian, Jamileh; Sabzi, Amirreza; Mangolian Shahrbabaki, Parvin

2018-06-12

Background In order to effectively facilitate behavior change, it is essential to conduct health promotion programs on self-efficacy. Given the importance of the role of teachers in fostering the next generation, it appears that the promotion of self-efficacy in them can greatly contribute to the health of the community. The present study aimed to evaluate the impact of a health promotion training workshop on self-efficacy for health practices and also, on general self-efficacy of teachers in schools. Methods This study was a quasi-experimental study, in which 120 teachers were selected by random sampling and randomly divided into two equal intervention and control groups (60 in each group). A health promotion training workshop was conducted for the intervention group. Data were collected by a three-section questionnaire (demographic, self-rated ability for health practices scale and general self-efficacy) before and 1 month after the training intervention. Results The self-efficacy scores for health practices and general self-efficacy were not significantly different between the intervention and control groups before the intervention (p > 0.05). However, participants in the intervention group reported higher scores on both the self-efficacy for health practices (t = 4.05, p = 0.001) and general self-efficacy (t = 2.92, p = 0.004) compared to those in the control group one month after the intervention. Conclusion The health promotion training program had improving effects on the self-efficacy for health practices and general self-efficacy. This program was potentially a valid community health nursing intervention that can be presented and evaluated in various community settings.

Effectiveness of exercise intervention and health promotion on cardiovascular risk factors in middle-aged men: a protocol of a randomized controlled trial.

PubMed

From, Svetlana; Liira, Helena; Leppävuori, Jenni; Remes-Lyly, Taina; Tikkanen, Heikki; Pitkälä, Kaisu

2013-02-11

Although cardiovascular disease has decreased, there is still potential for prevention as obesity and diabetes increase. Exercise has a positive effect on many cardiovascular risk factors, and it can significantly reduce the components of metabolic syndrome. The main challenge with exercise in primary care is how to succeed in motivating the patients at risk to change and increase their exercise habits. The objective of this study is to modify the cardiovascular risk in middle-aged men, either through a health promotion intervention alone or combined with an exercise intervention. During a two-year period we recruit 300 men aged from 35 to 45 years with elevated cardiovascular risk (> two traditional risk factors). The men are randomized into three arms: 1) a health promotion intervention alone, 2) both health promotion and exercise intervention, or 3) control with usual community care and delayed health promotion (these men receive the intervention after one year). The main outcome measures will be the existence of metabolic syndrome and physical activity frequency (times per week). The participants are assessed at baseline, and at 3, 6, and 12 months. The follow-up of the study will last 12 months. This pragmatic trial in primary health care aimed to assess the effect of a health promotion programme with or without exercise intervention on cardiovascular risk and physical activity in middle-aged men. The results of this study may help to plan the primary care interventions to further reduce cardiovascular mortality.The study was registered at the Controlled Trials ( http://www.controlled-trials.com). ISRCTN80672011. The study received ethics approval from the Coordinating Ethics Committee at Helsinki University Hospital on 8 June 2009 (ref: 4/13/03/00/09).

Swallowing interventions for the treatment of dysphagia after head and neck cancer: a systematic review of behavioural strategies used to promote patient adherence to swallowing exercises.

PubMed

Govender, Roganie; Smith, Christina H; Taylor, Stuart A; Barratt, Helen; Gardner, Benjamin

2017-01-10

Dysphagia is a significant side-effect following treatment for head and neck cancers, yet poor adherence to swallowing exercises is frequently reported in intervention studies. Behaviour change techniques (BCTs) can be used to improve adherence, but no review to date has described the techniques or indicated which may be more associated with improved swallowing outcomes. A systematic review was conducted to identify behavioural strategies in swallowing interventions, and to explore any relationships between these strategies and intervention effects. Randomised and quasi-randomised studies of head and neck cancer patients were included. Behavioural interventions to improve swallowing were eligible provided a valid measure of swallowing function was reported. A validated and comprehensive list of 93 discrete BCTs was used to code interventions. Analysis was conducted via a structured synthesis approach. Fifteen studies (8 randomised) were included, and 20 different BCTs were each identified in at least one intervention. The BCTs identified in almost all interventions were: instruction on how to perform the behavior, setting behavioural goals and action planning. The BCTs that occurred more frequently in effective interventions, were: practical social support, behavioural practice, self-monitoring of behaviour and credible source for example a skilled clinician delivering the intervention. The presence of identical BCTs in comparator groups may diminish effects. Swallowing interventions feature multiple components that may potentially impact outcomes. This review maps the behavioural components of reported interventions and provides a method to consistently describe these components going forward. Future work may seek to test the most effective BCTs, to inform optimisation of swallowing interventions.

Health promotion interventions in social economy companies in Flanders (Belgium).

PubMed

Hublet, Anne; Maes, Lea; Mommen, Jasmine; Deforche, Benedicte; De Bourdeaudhuij, Ilse

2016-01-05

Disadvantaged groups are often not reached by mainstream health promotion interventions. Implementing health promotion (HP) interventions in social economy companies, can be an opportunity to reach those people. The implementation of these interventions in social economy companies was studied. Factors that could be related to the implementation of HP and being supportive towards implementation in the future, were investigated. An online, quantitative survey was sent to all 148 sheltered and social workshops in Flanders. In the questionnaire, the status of HP interventions and characteristics of the workshop were explored. Personal factors (such as attitudes towards HP, behavioural control, social norms and moral responsibility) were asked to the person responsible for implementation of HP interventions. Univariate and multivariate logistic regressions were performed. Respondents of 88 workshops completed the questionnaire. Almost 60% of the workshops implemented environmental or policy interventions. Having a positive attitude towards HP, being more morally responsible, and having the subjective norm that employees are positive towards health promotion at work, were related to being more supportive towards the implementation of HP in the univariate analyses. Only attitude stayed significantly related to being more supportive towards the implementation of HP in the multivariate analyses. Sheltered and social workshops are open to HP interventions, but more can be done to optimize the implementation. To persuade persons responsible for the implementation of HP to invest more in HP, changing attitudes concerning the benefits of health promotion for the employee and the company, is an important strategy.

Impact of a targeted direct marketing price promotion intervention (Buywell) on food-purchasing behaviour by low income consumers: a randomised controlled trial.

PubMed

Stead, M; MacKintosh, A M; Findlay, A; Sparks, L; Anderson, A S; Barton, K; Eadie, D

2017-08-01

Price promotions are a promising intervention for encouraging healthier food purchasing. We aimed to assess the impact of a targeted direct marketing price promotion combined with healthy eating advice and recipe suggestions on the purchase of selected healthier foods by low income consumers. We conducted a randomised controlled trial (n = 53 367) of a direct marketing price promotion (Buywell) combined with healthy eating advice and recipe suggestions for low income consumers identified as 'less healthy' shoppers. Impact was assessed using electronic point of sale data for UK low income shoppers before, during and after the promotion. The proportion of customers buying promoted products in the intervention month increased by between 1.4% and 2.8% for four of the five products. There was significantly higher uptake in the promotion month (P < 0.001) for the intervention group than would have been expected on the basis of average uptake in the other months. When product switching was examined for semi-skimmed/skimmed milk, a modest increase (1%) was found in the intervention month of customers switching from full-fat to low-fat milk. This represented 8% of customers who previously bought only full-fat milk. The effects were generally not sustained after the promotion period. Short-term direct marketing price promotions combined with healthy eating advice and recipe suggestions targeted at low income consumers are feasible and can have a modest impact on short-term food-purchasing behaviour, although further approaches are needed to help sustain these changes. © 2017 The British Dietetic Association Ltd.

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

PubMed

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

2017-12-06

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

Health promotion and cervical cancer in South Africa: why adolescent daughters can teach their mothers about early detection

PubMed Central

Mosavel, Maghboeba

2012-01-01

The notion that adolescent daughters can provide their mothers with health information that could actually impact the mothers’ behavior is a novel area of health promotion research. The goal of this study is to explore the reasons why adolescent daughters would give their mothers cervical cancer information, and why mothers would have the intent to listen to advice to obtain a Pap smear. We randomly selected and interviewed 157 mother and daughter dyads in Cape Town, South Africa. Almost one-fourth of mothers (22%) indicated never having had a Pap smear, while 92% of their daughters said their mother has never talked to them about cervical cancer or a Pap smear. Willingness of daughters to ask their mothers to obtain a Pap smear was high (80%). Motivations included the important health benefit and the sense of responsibility to share life saving information. Most mothers said they would definitely obtain a Pap smear when advised by their daughter (74%), while 25% said they would have to think about it and 1% said they would not listen. Mothers’ main motivations included the direct health benefit and a strong sense of duty and responsibility to listen to her daughter. This study provides important information about the reasons why an upward (child to parent) health intervention may be feasible. The values of duty and responsibility, especially as it manifests within the family, hold promise for informing health promotion interventions directed at multiple generations. PMID:21421580

Overweight and Obese Adolescent Girls: The Importance of Promoting Sensible Eating and Activity Behaviors from the Start of the Adolescent Period

PubMed Central

Todd, Alwyn S.; Street, Steven J.; Ziviani, Jenny; Byrne, Nuala M.; Hills, Andrew P.

2015-01-01

The adolescent period is associated with changes in eating and activity behaviors in girls. Less reliance on parental provision and choice of food, coupled with a decrease in participation in physical activity and sport, can create an energy imbalance, predisposing to weight gain. Physiological alterations to body composition, reduction in insulin sensitivity, and psychological adjustments may further amplify the risk of becoming overweight and maintaining an unhealthy level of body fat into childbearing years. During pregnancy excess body fat is a risk factor for poor pregnancy outcomes and may predispose an infant to a lifelong heightened risk of being overweight and developing chronic disease. Interventions aimed at preventing the accumulation of body fat in adolescent girls and young women may have far reaching impact and be critically important in reducing intergenerational weight gain. Lifestyle interventions in adolescence have the potential to modify adult obesity risk by switching at-risk individuals from a high to lower obesity risk trajectory. This paper discusses multiple approaches to assist at-risk individuals reduce obesity risk. A key focus is placed on engagement in food preparation and choice, and opportunities for physical activity and sport. Support, education, and opportunity at home and at school, are often associated with the success of lifestyle interventions, and may enable adolescents to make positive choices, and engage in health promoting behaviors during adolescence and childbearing years. PMID:25690003

Fine Motor Skills Predict Maths Ability Better than They Predict Reading Ability in the Early Primary School Years

PubMed Central

Pitchford, Nicola J.; Papini, Chiara; Outhwaite, Laura A.; Gulliford, Anthea

2016-01-01

Fine motor skills have long been recognized as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the UK. Two key findings were revealed. First, despite being in the first 2 years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the UK that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills. PMID:27303342

Fine Motor Skills Predict Maths Ability Better than They Predict Reading Ability in the Early Primary School Years.

PubMed

Pitchford, Nicola J; Papini, Chiara; Outhwaite, Laura A; Gulliford, Anthea

2016-01-01

Fine motor skills have long been recognized as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the UK. Two key findings were revealed. First, despite being in the first 2 years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the UK that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills.

[Environmental justice as an approach to tackle environmental health inequalities].

PubMed

Bolte, Gabriele; Bunge, Christiane; Hornberg, Claudia; Köckler, Heike

2018-06-01

Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.

A Pilot Study of a Mindfulness Intervention for Adolescents and the Potential Role of Self-Compassion in Reducing Stress.

PubMed

Bluth, Karen; Roberson, Patricia N E; Gaylord, Susan A

2015-01-01

In this pilot study, we sought to investigate the effects of a mindfulness intervention for adolescents on a community sample of teens. Specifically, we explored the effects of mindfulness training on emotional well-being outcomes. Also, we examined the relationship between mindfulness and self-compassion at baseline-predicted outcome measures. This design was a pre-/post-pilot intervention study. Paired t-tests were conducted to examine change in outcome measures before and after the mindfulness intervention. Multiple regression was also conducted to investigate the influence of baseline mindfulness and self-compassion on outcome measures. The study took place after school in a classroom at a local university. Overall 28 adolescents age 10-18 years from two different cohorts participated in this study. Learning to BREATHE, a mindfulness curriculum designed specifically for adolescents and taught in six 1.5h sessions, was implemented. The outcome measures, life satisfaction and perceived stress, were included in an online survey before and after the mindfulness intervention. Results indicated that mindfulness, self-compassion, perceived stress, and life satisfaction improved from pre-intervention to post-intervention. Further, self-compassion (taught within the mindfulness intervention) was negatively related to perceived stress post-intervention while controlling for baseline stress. These findings suggest that mindfulness may be an effective intervention for improving indicators of emotional well-being among an adolescent population. Additionally, self-compassion may be a pathway through which youth can lower stress. Future research should examine self-compassion as a potential factor in promoting emotional well-being. Copyright © 2015 Elsevier Inc. All rights reserved.

A comparison of Omaha worksite health promotion activities to the 1992 national survey with a special perspective on program intervention.

PubMed

Eickhoff-Shemek, J M; Ryan, K F

1995-01-01

The purpose of this study was to compare the results from a survey of Omaha worksite health promotion activities with the results of a 1992 national survey. Comparisons were made on: (1) the kinds of health promotion activities offered, (2) progress toward the Healthy People 2000 worksite objectives, (3) types of program intervention offered, and (4) administrative factors. A one-time, written, mail-out/mail-back survey design was used. The study took place in Omaha, Nebraska. All area public and private worksites with 250 or more employees were sent surveys. Individuals who were preselected and identified as the best qualified within the company completed the survey instrument. Of the 176 worksites surveyed, 86 completed the survey (49%). Descriptive statistics (percentages) were used to compare the two surveys on kinds of programs offered, progress toward Healthy People 2000 related to worksite health promotion, the types of program intervention offered, and administrative factors. Generally, a greater percentage of respondent worksites from the national survey are offering more health promotion activities and have made more progress toward the Healthy People 2000 worksite objectives than the Omaha worksites. Results from both surveys showed that low levels of intervention are more prevalent than high levels of intervention, and that health promotion activities in most worksites are coordinated by human resources departments and not by someone professionally prepared in health education. Traditionally, major goals of worksite health promotion programs have focused on important organizational outcomes such as improved productivity/morale, reduction in absenteeism, and health care cost-containment. It is important to recognize, however, that low levels of intervention have less impact than more intensive programs on these desired outcomes. Future goals for local and national worksite health promotion programs may need to encourage implementation of more intensive intervention programs.

Effects of Promotion and Compunction Interventions on Real Intergroup Interactions: Promotion Helps but High Compunction Hurts

PubMed Central

Greenland, Katy; Xenias, Dimitrios; Maio, Gregory R.

2017-01-01

HIGHLIGHTS  We show the promotion intervention has positive effects during intergroup contact, but that high levels of compunction can have negative effects. Intergroup contact is probably the longest standing and most comprehensively researched intervention to reduce discrimination. It is also part of ordinary social experience, and a key context in which discrimination is played out. In this paper, we explore two additional interventions which are also designed to reduce discrimination, but which have not yet been applied to real intergroup interactions. The promotion intervention encourages participants to relax and enjoy an interaction, while the compunction intervention motivates participants to avoid discrimination. Across two studies, we tested the separate effects of promotion (Study 1) and then compunction (Study 2) on participants' interactions with a confederate whom they believed to have a history of schizophrenia. In Study 1, participants received either a promotion intervention to “relax and have an enjoyable dialogue” or no intervention (control; n = 67). In Study 2, participants completed a Single-Category Implicit Attitude Test before being told that they were high in prejudice (high compunction condition) or low in prejudice (low compunction condition; n = 62). Results indicated that promotion was associated with broadly positive effects: participants reported more positive experience of the interaction (enjoyment and interest in a future interaction), and more positive evaluations of their contact partner (increased friendliness and reduced stereotyping). There were no effects on participants' reported intergroup anxiety. In contrast, high compunction had broadly negative effects: participants reported more negative experiences of the interaction and more negative evaluations of their contact partner (using the same dependent measures outlined above). In addition, participants in the high compunction condition reported increased intergroup anxiety and increased self-anxiety (anxiety around thinking or doing something that is prejudiced). Participants in the high compunction condition also reported reduced expectancies of self-efficacy (i.e., they were less confident that they would be able to make a good impression). PMID:28439248

Effects of Promotion and Compunction Interventions on Real Intergroup Interactions: Promotion Helps but High Compunction Hurts.

PubMed

Greenland, Katy; Xenias, Dimitrios; Maio, Gregory R

2017-01-01

HIGHLIGHTS   We show the promotion intervention has positive effects during intergroup contact, but that high levels of compunction can have negative effects. Intergroup contact is probably the longest standing and most comprehensively researched intervention to reduce discrimination. It is also part of ordinary social experience, and a key context in which discrimination is played out. In this paper, we explore two additional interventions which are also designed to reduce discrimination, but which have not yet been applied to real intergroup interactions. The promotion intervention encourages participants to relax and enjoy an interaction, while the compunction intervention motivates participants to avoid discrimination. Across two studies, we tested the separate effects of promotion (Study 1) and then compunction (Study 2) on participants' interactions with a confederate whom they believed to have a history of schizophrenia. In Study 1, participants received either a promotion intervention to "relax and have an enjoyable dialogue" or no intervention (control; n = 67). In Study 2, participants completed a Single-Category Implicit Attitude Test before being told that they were high in prejudice (high compunction condition) or low in prejudice (low compunction condition; n = 62). Results indicated that promotion was associated with broadly positive effects: participants reported more positive experience of the interaction (enjoyment and interest in a future interaction), and more positive evaluations of their contact partner (increased friendliness and reduced stereotyping). There were no effects on participants' reported intergroup anxiety. In contrast, high compunction had broadly negative effects: participants reported more negative experiences of the interaction and more negative evaluations of their contact partner (using the same dependent measures outlined above). In addition, participants in the high compunction condition reported increased intergroup anxiety and increased self-anxiety (anxiety around thinking or doing something that is prejudiced). Participants in the high compunction condition also reported reduced expectancies of self-efficacy (i.e., they were less confident that they would be able to make a good impression).

"Kind and Grateful": A Context-Sensitive Smartphone App Utilizing Inspirational Content to Promote Gratitude.

PubMed

Ghandeharioun, Asma; Azaria, Asaph; Taylor, Sara; Picard, Rosalind W

Previous research has shown that gratitude positively influences psychological wellbeing and physical health. Grateful people are reported to feel more optimistic and happy, to better mitigate aversive experiences, and to have stronger interpersonal bonds. Gratitude interventions have been shown to result in improved sleep, more frequent exercise and stronger cardiovascular and immune systems. These findings call for the development of technologies that would inspire gratitude. This paper presents a novel system designed toward this end. We leverage pervasive technologies to naturally embed inspiration to express gratitude in everyday life. Novel to this work, mobile sensor data is utilized to infer optimal moments for stimulating contextually relevant thankfulness and appreciation. Sporadic mood measurements are inventively obtained through the smartphone lock screen, investigating their interplay with grateful expressions. Both momentary thankful emotion and dispositional gratitude are measured. To evaluate our system, we ran two rounds of randomized control trials (RCT), including a pilot study (N = 15, 2 weeks) and a main study (N = 27, 5 weeks). Studies' participants were provided with a newly developed smartphone app through which they were asked to express gratitude; the app displayed inspirational content to only the intervention group, while measuring contextual cues for all users. In both rounds of the RCT, the intervention was associated with improved thankful behavior. Significant increase was observed in multiple facets of practicing gratitude in the intervention groups. The average frequency of practicing thankfulness increased by more than 120 %, comparing the baseline weeks with the intervention weeks of the main study. In contrast, the control group of the same study exhibited a decrease of 90 % in the frequency of thankful expressions. In the course of the study's 5 weeks, increases in dispositional gratitude and in psychological wellbeing were also apparent. Analyzing the relation between mood and gratitude expressions, our data suggest that practicing gratitude increases the probability of going up in terms of emotional valence and down in terms of emotional arousal. The influences of inspirational content and contextual cues on promoting thankful behavior were also analyzed: We present data suggesting that the more successful times for eliciting expressions of gratitude tend to be shortly after a social experience, shortly after location change, and shortly after physical activity. The results support our intervention as an impactful method to promote grateful affect and behavior. Moreover, they provide insights into design and evaluation of general behavioral intervention technologies.

Promoting Physical Activity Through a Manual Wheelchair Propulsion Intervention in Persons With Multiple Sclerosis.

PubMed

Rice, Ian M; Rice, Laura A; Motl, Robert W

2015-10-01

To examine the efficacy and feasibility of a multifactorial intervention to increase lifestyle physical activity in nonambulatory persons with multiple sclerosis (MS) based on wheelchair optimization, propulsion skill/technique training, and behavioral strategies based on social cognitive theory. Randomized controlled trial, 3-month postintervention follow-up. Home and general community, and university research laboratory. Nonambulatory individuals with MS (N=14; mean age ± SD, 53.6±8.7y) were randomly assigned to an intervention group (IG) or a control group (CG). After baseline testing, the IG participants received custom-fit, ultralightweight manual wheelchairs with propulsion/skills training, followed by 3 months of at-home use with the custom ultralightweight wheelchair and weekly phone calls to deliver support through a multifactorial intervention. The CG participants received no training and used their own wheelchairs at home during this time. All subjects were assessed at baseline and 3 months later for fatigue (Fatigue Severity Scale), upper extremity strength (digital handheld dynamometer), and propulsion technique (on a treadmill [0.5m/s] with instrumented wheels). Two 1-week bouts of physical activity were measured in both groups from home with wrist-worn accelerometry at the beginning (IG and CG in own wheelchairs) and end (IG in study wheelchair, CG in own) of the 3-month period of home use. The intervention was well tolerated, and no adverse events were reported. The IG demonstrated increased strength (P=.008) and a trend toward less fatigue (P=.068), both with large effect sizes (d>0.8), as well as reduced application of braking torque during propulsion (P=.003) with a moderate/large effect size (d=.73), compared with the CG. Findings suggest a 3-month physical activity intervention based on manual wheelchair propulsion and training is safe and feasible for some wheelchair users living with MS and may produce secondary benefits in strength, fatigue, and propulsion technique. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Preventing delirium in dementia: Managing risk factors.

PubMed

Ford, Andrew H

2016-10-01

Delirium is a common, disabling medical condition that is associated with numerous adverse outcomes. A number of inter-related factors, including pre-existing cognitive impairment, usually contribute to the development of delirium in a particular susceptible individual. Non-pharmacological approaches to prevention typically target multiple risk factors in a systematic manner (multicomponent interventions). There is generally good evidence that multicomponent interventions reduce the incidence of delirium in hospital populations but there are limited data in people with dementia and those living in the community. It is likely that there is a differential effect of specific interventions in those with cognitive impairment (e.g. people with dementia may respond better to simpler, more pragmatic interventions rather than complex procedures) but this cannot be determined from the existing data. Targeted interventions focussed on hydration, medication rationalization and sleep promotion may also be effective in reducing the incidence of delirium, as well as the active involvement of family members in the care of the elderly hospitalized patient. Hospitalization itself is a potential risk factor for delirium and promising data are emerging of the benefits of home-based care as an alternative to hospitalization but this is restricted to specific sub-populations of patients and is reliant on these services being available. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Behavioral Intervention in the Overweight and Obese Employee: The Challenge of Promoting Weight Loss and Physical Activity

PubMed Central

Maniwa, Rumi; Iwamoto, Mamiko; Nogi, Akiko; Yamasaki, Masayuki; Yang, Jian-jun; Hanaoka, Hideaki; Shiwaku, Kuninori

2012-01-01

Effects of gender and employment situation on weight loss and lifestyle modification were assessed in a 3-month intervention study done for overweight and obesity. A total of 384 individuals in Izumo City Japan, participated from 2000 to 2006. Lifestyle modifications were quantitatively evaluated by calculating calories of energy intake and expenditure. Eleven men and 15 women failed to complete the intervention; they were significantly younger in both genders, and the women had a higher rate of employment than the completing group (91 men and 267 women). Intervention induced a weight loss of 1.9 kg for men and 1.6 kg for women, with no significant differences by gender. Significant differences were found in changes in energy intake and expenditure in both genders, but these disappeared after adjusting for weight. There were significant decreases in weight (1.6 kg in unemployed, 2.5 kg in employed) in men. Increases in walking and exercise for the employed were smaller than those for the unemployed. The relationship between changes in weight and energy balance by employment status was independently significant using multiple regression analysis. Employment is associated with difficulty in losing weight due to limited exercise time in behavioral intervention. PMID:25648082

The unique effects of environmental strategies in health promotion campaigns: a review.

PubMed

Randolph, Karen A; Whitaker, Pippin; Arellano, Adriana

2012-08-01

Various strategies are used as tools in health promotion campaigns to increase health-related outcomes among target populations. Evaluations of these campaigns examine effects on changing people's knowledge, attitudes, and/or behaviors. Most evaluations examine the combined impact of multiple strategies. Less is known about the unique effects of particular strategies. To address this gap, we used highly systematic methods to identify and review scientifically rigorous evaluations of 18 campaigns that examined the unique effects of three sets of intervention strategies (entertainment education, law enforcement, and mass media) on changes in knowledge, attitudes, and practice with regard to various health behaviors. Results showed differences in evaluation processes based on the type of strategy used to promote campaign messages. For instance, evaluations of mass-media based campaigns were more likely to examine changes in knowledge, relative to evaluations of campaigns that used law enforcement strategies. In addition, campaign effects varied by particular strategies. Mass media-based campaigns were more likely to affect knowledge, relative to behaviors. Law enforcement and entertainment education-based campaigns showed positive effects on behaviors. The implications for planning and evaluating health promotion campaigns are described. Copyright © 2012 Elsevier Ltd. All rights reserved.

Social media interventions to prevent HIV: A review of interventions and methodological considerations.

PubMed

Tso, Lai Sze; Tang, Weiming; Li, Haochu; Yan, H Yanna; Tucker, Joseph D

2016-06-01

Persistent new HIV infections and risky behaviors underscore the need for enhanced HIV prevention. Social media interventions may promote safe sexual behaviors, increase HIV testing uptake, and promote safe injection behaviors. This review discusses how social media interventions tap into the wisdom of crowds through crowdsourcing, build peer-mentored communities, and deliver interventions through social networks. Social media HIV prevention interventions are constrained by ethical issues, low social media usage among some key populations, and implementation issues. Comprehensive measurement of social media interventions to prevent HIV is necessary, but requires further development of metrics.

Social media interventions to prevent HIV: A review of interventions and methodological considerations

PubMed Central

Tso, Lai Sze; Tang, Weiming; Li, Haochu; Yan, H. Yanna; Tucker, Joseph D.

2015-01-01

Persistent new HIV infections and risky behaviors underscore the need for enhanced HIV prevention. Social media interventions may promote safe sexual behaviors, increase HIV testing uptake, and promote safe injection behaviors. This review discusses how social media interventions tap into the wisdom of crowds through crowdsourcing, build peer-mentored communities, and deliver interventions through social networks. Social media HIV prevention interventions are constrained by ethical issues, low social media usage among some key populations, and implementation issues. Comprehensive measurement of social media interventions to prevent HIV is necessary, but requires further development of metrics. PMID:26516632

A Network Analysis Perspective to Implementation: The Example of Health Links to Promote Coordinated Care.

PubMed

Yousefi Nooraie, Reza; Khan, Sobia; Gutberg, Jennifer; Baker, G Ross

2018-01-01

Although implementation models broadly recognize the importance of social relationships, our knowledge about applying social network analysis (SNA) to formative, process, and outcome evaluations of health system interventions is limited. We explored applications of adopting an SNA lens to inform implementation planning, engagement and execution, and evaluation. We used Health Links, a province-wide program in Canada aiming to improve care coordination among multiple providers of high-needs patients, as an example of a health system intervention. At the planning phase, an SNA can depict the structure, network influencers, and composition of clusters at various levels. It can inform the engagement and execution by identifying potential targets (e.g., opinion leaders) and by revealing structural gaps and clusters. It can also be used to assess the outcomes of the intervention, such as its success in increasing network connectivity; changing the position of certain actors; and bridging across specialties, organizations, and sectors. We provided an overview of how an SNA lens can shed light on the complexity of implementation along the entire implementation pathway, by revealing the relational barriers and facilitators, the application of network-informed and network-altering interventions, and testing hypotheses on network consequences of the implementation.

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

PubMed

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

2016-02-01

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

Partner violence, power and gender differences in South African adolescents’ HIV/STI behaviors

PubMed Central

TEITELMAN, Anne M.; JEMMOTT, John B.; BELLAMY, Scarlett L.; ICARD, Larry D.; O'LEARY, Ann; HEEREN, G. Anita; NGWANE, Zolani; RATCLIFFE, Sarah J.

2016-01-01

Objectives Low relationship power and victimization by intimate partner violence (IPV) have been linked to HIV risks among adult females and adolescent girls. This article examines associations of IPV and relationship power with sexual-risk behaviors and whether the associations differ by gender among South African adolescents. Methods Sexual-risk behaviors (multiple partners in past 3 months; condom use at last sex), IPV, and relationship power were collected from 786 sexually experienced adolescents (mean age = 16.9) in Eastern Cape Province, South Africa during the 54-month follow-up of a HIV/STI risk-reduction intervention trial. Logistic regression examined associations of sexual-risk behaviors with IPV and relationship power and whether the associations differed by gender. Results Adolescent boys were less likely to report condom use at last sex (p=.001) and more likely to report multiple partners (p< .001). A Gender x IPV interaction (p=.002) revealed that as IPV victimization increased, self-reported condom use at last sex decreased among girls, but increased among boys. A Gender x Relationship Power interaction (p=.004) indicated that as relationship power increased, self-reported condom use at last sex increased among girls, but decreased among boys. A Gender x IPV interaction (p=.004) indicated that as IPV victimization increased, self-reports of having multiple partners increased among boys, but not among girls. As relationship power increased, self-reports of having multiple partners decreased irrespective of gender. Conclusions HIV risk-reduction interventions and policies should address gender differences in sexual-risk consequences of IPV and relationship power among adolescents and promote gender equity. PMID:27111184

Partner violence, power, and gender differences in South African adolescents' HIV/sexually transmitted infections risk behaviors.

PubMed

Teitelman, Anne M; Jemmott, John B; Bellamy, Scarlett L; Icard, Larry D; O'Leary, Ann; Heeren, G Anita; Ngwane, Zolani; Ratcliffe, Sarah J

2016-07-01

Low relationship power and victimization by intimate partner violence (IPV) have been linked to HIV risks among adult and adolescent women. This article examines associations of IPV and relationship power with sexual-risk behaviors and whether the associations differ by gender among South African adolescents. Sexual-risk behaviors (multiple partners in past 3 months; condom use at last sex), IPV, and relationship power were collected from 786 sexually experienced adolescents (mean age = 16.9) in Eastern Cape Province, South Africa, during the 54-month follow-up of a HIV/sexually transmitted infection (STI) risk-reduction intervention trial. The data were analyzed with logistic regression models. Adolescent boys were less likely to report condom use at last sex (p = .001) and more likely to report multiple partners (p < .001). A Gender × IPV interaction (p = .002) revealed that as IPV victimization increased, self-reported condom use at last sex decreased among girls, but increased among boys. A Gender × Relationship Power interaction (p = .004) indicated that as relationship power increased, self-reported condom use at last sex increased among girls, but decreased among boys. A Gender × IPV interaction (p = .004) indicated that as IPV victimization increased, self-reports of having multiple partners increased among boys, but not among girls. As relationship power increased, self-reports of having multiple partners decreased irrespective of gender. HIV risk-reduction interventions and policies should address gender differences in sexual-risk consequences of IPV and relationship power among adolescents and promote gender equity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Profiles of youth in therapeutic group care: Associations with involuntary psychiatric examinations and readmissions.

PubMed

Yampolskaya, Svetlana; Mowery, Debra

2017-01-01

The study aims were to identify distinct subgroups among youth placed in therapeutic group care (TGC) and to examine the effect of specific constellations of risk factors on readmission to residential mental health care and involuntary psychiatric examination among youth in TGC. Several administrative databases were merged to examine outcomes for youth placed in TGC during fiscal year FY04-05 through FY07-08 (N = 1,009). Latent class analysis (LCA) was conducted. Two classes were identified: youth with multiple needs (Class 1) and lower risk youth (Class 2). Class 1 represented 45% of youth in TGC. Compared with Class 2, these youth had a greater probability of having physical health problems, parents with substance abuse problems, and more extensive histories of maltreatment. Compared with Class 2, youth with multiple needs were almost twice more likely to exhibit self-injurious behavior leading to involuntary mental health examinations, but they were less likely to be readmitted to a residential mental health care of higher level of restrictiveness, such as state inpatient psychiatric programs (SIPPs). Youth placed in Florida TGC represent a heterogeneous population and services tailored to these youth's needs are important. Youth with multiple risk factors would benefit from interventions that would address multiple areas of risk. Lower risk youth (Class 2) would benefit from interventions that would focus on promoting mental health, especially among those who have experienced threatened harm, and providing services and supports necessary for stabilizing these youth in the community. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

PubMed

Helfrich, Christian D; Kohn, Marlana J; Stapleton, Austin; Allen, Claire L; Hammerback, Kristen Elizabeth; Chan, K C Gary; Parrish, Amanda T; Ryan, Daron E; Weiner, Bryan J; Harris, Jeffrey R; Hannon, Peggy A

2018-01-01

Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (-0.39) and interventions sites (-0.29) from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites over time and (2) intervention sites exhibited significantly higher changes in wellness program effort relative to control sites. Contrary to our hypothesis, change commitment declined significantly at both Healthlinks and control sites, even as wellness-program effort increased significantly at HealthLinks sites. Regression to the mean may explain the decline in change commitment. Future research needs to assess whether baseline commitment is an independent predictor of wellness-program effort or an effect modifier of the HealthLinks intervention.

The Praise and Price of Pokémon GO: A Qualitative Study of Children's and Parents' Experiences.

PubMed

Lindqvist, Anna-Karin; Castelli, Darla; Hallberg, Josef; Rutberg, Stina

2018-01-03

Physical activity has multiple health benefits; however, the majority of children around the world do not attain the recommended levels of daily physical activity. Research has shown that the game Pokémon GO has increased the amount of physical activity of players and that the game has the potential to reach populations that traditionally have low levels of physical activity. Therefore, there is a need to understand which game components can promote initial and sustained physical activity. By using a qualitative research approach, it is possible to achieve rich descriptions and enhance a deep understanding of the components promoting physical activity among children in a game such as Pokémon GO. The objective of this study was to explore children's and parents' experiences playing Pokémon GO. Eight families comprising 13 children (aged 7-12 years) and 9 parents were selected using purposeful sampling. Data collected using focus groups were analyzed using qualitative latent content analysis. The following three themes were revealed: (1) exciting and enjoyable exploration; (2) dangers and disadvantages; and (3) cooperation conquers competition. The first centers around the present and possible future aspects of Pokémon GO that promote physical activity. The second focuses on unwanted aspects and specific threats to safety when playing the game. The third shows that cooperation and togetherness are highly valued by the participants and that competition is fun but less important. Components from Pokémon GO could enhance the efficacy of physical activity interventions. Cooperation and exploration are aspects of the game that preferably could be transferred into interventions aimed at promoting children's physical activity. ©Anna-Karin Lindqvist, Darla Castelli, Josef Hallberg, Stina Rutberg. Originally published in JMIR Serious Games (http://games.jmir.org), 03.01.2018.

The Praise and Price of Pokémon GO: A Qualitative Study of Children’s and Parents’ Experiences

PubMed Central

Castelli, Darla; Hallberg, Josef; Rutberg, Stina

2018-01-01

Background Physical activity has multiple health benefits; however, the majority of children around the world do not attain the recommended levels of daily physical activity. Research has shown that the game Poké mon GO has increased the amount of physical activity of players and that the game has the potential to reach populations that traditionally have low levels of physical activity. Therefore, there is a need to understand which game components can promote initial and sustained physical activity. By using a qualitative research approach, it is possible to achieve rich descriptions and enhance a deep understanding of the components promoting physical activity among children in a game such as Poké mon GO. Objective The objective of this study was to explore children’s and parents’ experiences playing Poké mon GO. Methods Eight families comprising 13 children (aged 7-12 years) and 9 parents were selected using purposeful sampling. Data collected using focus groups were analyzed using qualitative latent content analysis. Results The following three themes were revealed: (1) exciting and enjoyable exploration; (2) dangers and disadvantages; and (3) cooperation conquers competition. The first centers around the present and possible future aspects of Poké mon GO that promote physical activity. The second focuses on unwanted aspects and specific threats to safety when playing the game. The third shows that cooperation and togetherness are highly valued by the participants and that competition is fun but less important. Conclusions Components from Poké mon GO could enhance the efficacy of physical activity interventions. Cooperation and exploration are aspects of the game that preferably could be transferred into interventions aimed at promoting children’s physical activity. PMID:29298750

Siglang Buhay: nutrition and physical activity promotion in Filipino-Americans through community organizations.

PubMed

Dirige, Ofelia V; Carlson, Jordan A; Alcaraz, John; Moy, Karen L; Rock, Cheryl L; Oades, Riz; Sallis, James F

2013-01-01

Intervening in organizations allows for targeting multiple levels of influence and greater potential for sustainability. To evaluate an 18-month nutrition and physical activity (NPA) intervention (Siglang Buhay) conducted through culturally specific organizations. Site randomized trial with an active control group. Eighteen Filipino-American social clubs in San Diego County, California. Members of Filipino-American social clubs randomly assigned to NPA (n = 337) or cancer education (CE; n = 336) conditions. Two to 3 members from each organization were trained to implement the interventions. The NPA focused on promoting fruit and vegetable consumption and physical activity and on decreasing dietary fat intake using health education, behavior change skills development, and organizational policy change. Cancer education focused on cancer education and cancer screening. Outcomes measured at baseline and at 18 months included 7-day self-reported physical activity and consumption of fruits and vegetables and low-fat foods, as well as stage of change for these 3 behaviors. Longitudinal mixed-effects regression models indicated that the NPA participants showed significant increases in physical activity (B = 4.04; P < .05), adoption of a low-fat diet (OR = 3.72; P < .05), and stage of change for fruit and vegetables (B = 0.61; P < .05), dietary fat intake (B = 0.67; P < .01), and physical activity (B = 0.80; P < .01). The intervention did not lead to increases in the number of participants eating 5 servings of fruits and vegetables per day or more (OR = 2.26; P = not significant). Using culturally specific organizations to deliver NPA interventions was feasible and effective among Filipino-Americans. Similar multilevel approaches should be investigated in other cultures.

Randomized controlled trial of storytelling compared to a personal risk tool intervention on colorectal cancer screening in low-income patients.

PubMed

Larkey, Linda K; McClain, Darya; Roe, Denise J; Hector, Richard D; Lopez, Ana Maria; Sillanpaa, Brian; Gonzalez, Julie

2015-01-01

Screening rates for colorectal cancer (CRC) lag for low-income, minority populations, contributing to poorer survival rates. A model of storytelling as culture-centric health promotion was tested for promoting CRC screening. A two-group parallel randomized controlled trial. Primary care, safety-net clinics. Low-income patients due for CRC screening, ages 50 to 75 years, speaking English or Spanish. Patients were exposed to either a video created from personal stories composited into a drama about "Papa" receiving CRC screening, or an instrument estimating level of personal cancer risk. Patients received a health care provider referral for CRC screening and were followed up for 3 months to document adherence. Behavioral factors related to the narrative model (identification and engagement) and theory of planned behavior. Main effects of the interventions on screening were tested, controlling for attrition factors, and demographic factor associations were assessed. Path analysis with model variables was used to test the direct effects and multiple mediator models. Main effects on CRC screening (roughly half stool-based tests, half colonoscopy) did not indicate significant differences (37% and 42% screened for storytelling and risk-based messages, respectively; n = 539; 33.6% male; 62% Hispanic). Factors positively associated with CRC screening included being female, Hispanic, married or living with a partner, speaking Spanish, having a primary care provider, lower income, and no health insurance. Engagement, working through positive attitudes toward the behavior, predicted CRC screening. A storytelling and a personalized risk-tool intervention achieved similar levels of screening among unscreened/underscreened, low-income patients. Factors usually associated with lower rates of screening (e.g., no insurance, being Hispanic) were related to more adherence. Both interventions' engagement factor facilitated positive attitudes about CRC screening associated with behavior change.

PubMed Central

Marotta, C.; Ventura, G.; Casuccio, N.; Dieli, F.; D'Angelo, C.; Restivo, V.; Costantino, C.; Vitale, F.; Casuccio, A.

2017-01-01

Summary Introduction. Vaccination coverages threaten to decrease because of false beliefs in their unsafety and inefficacy. Therefore formation of future health-care workers on this topic is fundamental to deal with any doubt and to promote active immunization among general population. Methods. In order to assess health-care students' knowledge about vaccination before an integrated seminar on this topic, and to evaluate their improvement after the educational intervention, an integrated educational intervention was held by a multidisciplinary team. Before and after the seminar, 118 students of medicine and biology schools at Palermo University were asked to answer 10 multiple-choice questions regarding vaccine history, mechanism of action, side effects, composition, use and nowadays issues (hesitancy). Two more questions investigating possible changes on students' attitudes towards vaccination and the usefulness of the formative intervention, were added at the post-test phase of the survey. Results. Eighty-one out of 118 students (68.6%) answered to both pre- and post-test questions. 97.6% and 81.5% of the participating group also completed the two additional questions about their improvement in knowledge (question 11) and attitudes (question 12) towards vaccinations. The post-test results showed a significant improvement for all questions administered, except for number 3 (about a specific immunological content), with an overall percentage of correct answers increasing from 38.8% to 77.6% (p©< 0.001). Conclusions. The present explorative study put the basis for future studies, stronger in the methodology, and highlights the importance of educating health-care professions students by integrated extra-curricular intervention to be held early in their degree curricula and in order to improve knowledge and attitudes towards vaccinations and to prepare them to promote vaccines among the general population. PMID:28900348

The "Balance Intervention" for Promoting Caloric Compensatory Behaviours in Response to Overeating: A Formative Evaluation

ERIC Educational Resources Information Center

Wammes, Birgitte; Breedveld, Boudewijn; Kremers, Stef; Brug, Johannes

2006-01-01

To help people prevent weight gain, the Netherlands Nutrition Centre initiated the "balance intervention", which promotes moderation of food intake and/or increased physical activity in response to occasions of overeating. The aim of this study was to determine whether intervention materials were appreciated, encouraged information…

Moderators of Theory-Based Interventions to Promote Physical Activity in 77 Randomized Controlled Trials

ERIC Educational Resources Information Center

Bernard, Paquito; Carayol, Marion; Gourlan, Mathieu; Boiché, Julie; Romain, Ahmed Jérôme; Bortolon, Catherine; Lareyre, Olivier; Ninot, Gregory

2017-01-01

A meta-analysis of randomized controlled trials (RCTs) has recently showed that theory-based interventions designed to promote physical activity (PA) significantly increased PA behavior. The objective of the present study was to investigate the moderators of the efficacy of these theory-based interventions. Seventy-seven RCTs evaluating…

Process Evaluation of a Comprehensive Supermarket Intervention in a Low-Income Baltimore Community.

PubMed

Lee, Ryan M; Rothstein, Jessica D; Gergen, Jessica; Zachary, Drew A; Smith, Joyce C; Palmer, Anne M; Gittelsohn, Joel; Surkan, Pamela J

2015-11-01

Supermarket-based interventions are one approach to improving the local food environment and reducing obesity and chronic disease in low-income populations. We implemented a multicomponent intervention that aimed to reduce environmental barriers to healthy food purchasing in a supermarket in Southwest Baltimore. The intervention, Eat Right-Live Well! used: shelf labels and in-store displays promoting healthy foods, sales and promotions on healthy foods, in-store taste tests, increasing healthy food products, community outreach events to promote the intervention, and employee training. We evaluated program implementation through store environment, taste test session, and community event evaluation forms as well as an Employee Impact Questionnaire. The stocking, labeling, and advertising of promoted foods were implemented with high and moderate fidelity. Taste test sessions were implemented with moderate reach and low dose. Community outreach events were implemented with high reach and dose. Supermarket employee training had no significant impact on employees' knowledge, self-efficacy, or behavioral intention for helping customers with healthy purchasing or related topics of nutrition and food safety. In summary, components of this intervention to promote healthy eating were implemented with varying success within a large supermarket. Greater participation from management and employees could improve implementation. © 2015 Society for Public Health Education.

Effectiveness of health-promoting media literacy education: a systematic review.

PubMed

Bergsma, Lynda J; Carney, Mary E

2008-06-01

Media literacy education to promote health among youth involves them in a critical examination of media messages that promote risky behaviors and influence their perceptions and practices. Research on its effectiveness is in its infancy. Studies to date have been conducted with more or less rigor and achieved differing results, leaving many questions about effectiveness unanswered. To elucidate some of these questions, we conducted a systematic review of selected health-promoting media literacy education evaluation/research studies, guided by the following research question: What are the context and process elements of an effective health-promoting media literacy education intervention? Based on extensive analysis of 28 interventions, our findings provide a detailed picture of a small, 16- to 17-year (1990 to July 2006) body of important research, including citation information, health issue, target population/N/age, research design, intervention length and setting, concepts/skills taught, who delivered the intervention and ratings of effectiveness. The review provides a framework for organizing research about media literacy education which suggests that researchers should be more explicit about the media literacy core concepts/skills they are including in their interventions, and should more carefully address who delivered the intervention with what fidelity, in what setting, for how long and utilizing what pedagogical approach.

The effects of school gardens on students and schools: conceptualization and considerations for maximizing healthy development.

PubMed

Ozer, Emily J

2007-12-01

There are thousands of school gardens in the United States, and there is anecdotal evidence that school garden programs can enhance students' learning in academic, social, and health-related domains. There has been little rigorous research, however, on the effects of school gardens or on the factors that promote the sustainability of these programs. This review draws on ecological theory to conceptualize school gardens as systemic interventions with the potential for promoting the health and well-being of individual students in multiple interdependent domains and for strengthening the school environment as a setting for positive youth development. This review (a) summarizes the small literature regarding the impact of school garden curricula on student or school functioning, (b) provides a conceptual framework to guide future inquiry, (c) discusses implications of this conceptualization for practice, and (d) suggests further research needed to better inform practice.

Creating Nurturing Environments: A Science-Based Framework for Promoting Child Health and Development within High-Poverty Neighborhoods

PubMed Central

Komro, Kelli A.; Flay, Brian R.; Biglan, Anthony

2013-01-01

Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods Research Consortium describes a science-based framework for the promotion of child health and development within distressed high-poverty neighborhoods. We lay out a model of child and adolescent developmental outcomes, and integrate knowledge of potent and malleable influences to define a comprehensive intervention framework to bring about a significant increase in the proportion of young people in high-poverty neighborhoods who will develop successfully. Based on a synthesis of research from diverse fields, we designed the Creating Nurturing Environments framework to guide community-wide efforts to improve child outcomes and reduce health and educational inequalities. PMID:21468644

[Quality-of-life-related factors in adolescents].

PubMed

Lima-Serrano, Marta; Martínez-Montilla, José Manuel; Guerra-Martín, María Dolores; Vargas-Martínez, Ana Magdalena; Lima-Rodríguez, Joaquín S

To determine quality of life (QoL) and its relationship to lifestyles in adolescents in high schools. Cross-sectional, observational study with 256 students aged 12 to 17 in Seville (Spain). Multiple linear regression models were tested (p <0.05). The boys had higher scores in most of the QoL areas. The female gender was inversely related to physical, psychological, familial QoL areas and the general QoL index. Family functionality and performing physical activity were the factors most associated with better QoL in all areas. All multivariate models were statistically significant and explained from 11% of social QoL variability to 35% of the general QoL index. The findings could be useful for developing interventions to promote health in schools, with the objective of promoting healthy lifestyles and QoL. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Promoting children's health: Toward a consensus statement on food literacy.

PubMed

Truman, Emily; Raine, Kim; Mrklas, Kelly; Prowse, Rachel; Carruthers Den Hoed, Rebecca; Watson-Jarvis, Katherine; Loewen, Jewel; Gorham, Megan; Ricciardi, Carolin; Tyminski, Sheila; Elliott, Charlene

2017-06-16

This consensus statement reflects the views of a diverse group of stakeholders convened to explore the concept of "food literacy" as it relates to children's health. Evidence-based conceptions of food literacy are needed in light of the term's popularity in health promotion and educational interventions designed to increase food skills and knowledge that contribute to overall health. Informed by a comprehensive scoping review that identified seven main themes of food literacy, meeting participants ranked those themes in terms of importance. Discussions highlighted two key points in conceptualizing food literacy: the need to recognize varying food skill and knowledge levels, and the need to recognize critical food contexts. From these discussions, meeting participants created two working definitions of food literacy, as well as the alternative conception of "radical food literacy". We conclude that multiple literacies in relation to food skills and knowledge are needed, and underline the importance of ongoing dialogue in this emergent area of research.

INTEGRATING HEALTH INTO BUILDINGS OF THE FUTURE

PubMed Central

Heidari, Leila; Younger, Margalit; Chandler, George; Gooch, James; Schramm, Paul

2018-01-01

The health and wellbeing of building occupants should be a key priority in the design, building, and operation of new and existing buildings. Buildings can be designed, renovated, and constructed to promote healthy environments and behaviors and mitigate adverse health outcomes. This paper highlights health in terms of the relationship between occupants and buildings, as well as the relationship of buildings to the community. In the context of larger systems, smart buildings and green infrastructure strategies serve to support public health goals. At the level of the individual building, interventions that promote health can also enhance indoor environmental quality and provide opportunities for physical activity. Navigating the various programs that use metrics to measure a building’s health impacts reveals that there are multiple co-benefits of a “healthy building,” including those related to the economy, environment, society, transportation, planning, and energy efficiency. PMID:29375173

What we have learnt (so far) about deliberative dialogue for evidence-based policymaking in West Africa

PubMed Central

Dagenais, Christian

2017-01-01

Policy decisions do not always take into account research results, and there is still little research being conducted on interventions that promote their use, particularly in Africa. To promote the use of research evidence in Africa, deliberative dialogue workshops are increasingly recommended as a means to establish evidence-informed dialogue among multiple stakeholders engaged in policy decision-making. In this paper, we reflect on our experiences of conducting national workshops in six African countries, and we propose operational recommendations for those wishing to organise deliberative dialogue. Our reflective and cross-sectional analysis of six national deliberative dialogue workshops in which we participated shows there are many specific challenges that should be taken into account when organising such encounters. In conclusion, we offer operational recommendations, drawn from our experience, to guide the preparation and conduct of deliberative workshops. PMID:29259821

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Using social marketing principles to guide the development of a nutrition education initiative for preschool-aged children.

PubMed

Young, Laura; Anderson, Jennifer; Beckstrom, Leslie; Bellows, Laura; Johnson, Susan L

2004-01-01

Within the field of nutrition education, social marketing has become a promising framework to systematically approach problems related to nutrition behavior. In 1997, the Colorado Nutrition Network began developing a social marketing campaign to promote healthful food choices among low-income Coloradans. A multifaceted formative evaluation plan that included focus groups, campaign concept pretesting, and a food frequency questionnaire was used to segment and scrutinize the target audience. The resulting pilot program was a blend of educational and marketing strategies targeting preschoolers that was implemented in Head Start classrooms. The 12-week intervention contained a narrow, behavior-based "try new foods" message, multiple nutrition education activities, and repeated opportunities to taste 13 novel foods. Key strategies used and findings from the formative evaluation process are presented herein in an effort to provide insight for nutrition educators interested in developing similar interventions.

Emerging Trends Could Exacerbate Health Inequities In The United States.

PubMed

Arcaya, Mariana C; Figueroa, José F

2017-06-01

Health inequities among people of different races and ethnicities, geographical locations, and social classes are not a new phenomenon, although the size of the inequities has changed since researchers first began documenting them. While interventions to improve the health of targeted disadvantaged groups may help combat disparities, broader trends that disproportionately benefit privileged groups or harm vulnerable populations can eclipse the progress made through isolated interventions. These trends threaten equity in health and health care in the United States either through direct effects on health or through impacts on the distribution of resources, risks, and power. We highlight trends in four domains: health care technologies, health reform policies, widening socioeconomic inequality, and environmental hazards. We suggest ways of countering the effects of these trends to promote health equity, focusing on strategies that promise co-benefits across multiple sectors. Project HOPE—The People-to-People Health Foundation, Inc.

Employment as a health promotion intervention for persons with multiple sclerosis.

PubMed

Chiu, Chung-Yi; Chan, Fong; Edward Sharp, Seneca; Dutta, Alo; Hartman, Ellie; Bezyak, Jill

2015-01-01

To examine the relationship between employment status (no employment, part-time employment, and full-time employment) and functional disability, health-related quality of life, and life satisfaction of people with MS. 157 individuals with MS completed a survey packet, including employment status, self-report disability severity, and health-related scales. A series of multivariate analysis of variance was performed to determine the differences between employment groups in health-related outcomes. The unemployed group had the highest levels of incapacity and social impairments among the three groups. They also had the lowest physical health-related quality of life and life satisfaction. The part-time employed group had the lowest levels of depression and higher levels of physical activity participation among the three groups of individuals with MS. Employment is significantly related to health-related quality of life, and as a result, it should be considered an important public health intervention for people with MS.

Sensitivity, child regulatory processes, and naturally occurring declines in antisocial behavior across childhood.

PubMed

Buck, Katharine Ann

2014-12-01

Despite considerable research on why antisocial behavior develops and interventions that reduce it, aspects of everyday family processes that may promote naturally occurring declines in antisocial behavior or that may result from such declines in most children without intervention are poorly understood. The current study explored family processes that may enable children to replace antisocial tendencies and the effects that declines in antisocial behavior may have on parenting and child regulatory processes. Longitudinal data from 1,022 children (54 months-6th grade) from the NICHD Study of Early Child Care and Youth Development were examined. Findings demonstrated that naturally occurring declines in antisocial behavior both predicted and were predicted by maternal sensitivity, emotion regulation, and social skills. These declines predicted but were not predicted by declines in hostile attributions. The data revealed multiple indirect paths, which highlight the complex nature of these variables across development.

TSLP-dependent basophils promote TH2 cytokine responses following intestinal helminth infection1

PubMed Central

Giacomin, Paul R.; Siracusa, Mark C.; Walsh, Kevin P.; Grencis, Richard K.; Kubo, Masato; Comeau, Michael R.; Artis, David

2012-01-01

CD4+ T helper type 2 (TH2) cytokine responses promote the development of allergic inflammation and are critical for immunity to parasitic helminth infection. Recent studies highlighted that basophils can promote TH2 cytokine-mediated inflammation and that phenotypic and functional heterogeneity exists between classical IL-3-elicited basophils versus TSLP-elicited basophils. However, whether distinct basophil populations develop following helminth infection, and their relative contributions to anti-helminth immune responses remain to be defined. Following Trichinella spiralis infection of mice, we show that basophil responses are rapidly induced in multiple tissue compartments, including intestinal-draining lymph nodes. Trichinella-induced basophil responses were IL-3-IL-3R-independent but critically dependent on TSLP-TSLPR interactions. Selective depletion of basophils following Trichinella infection impaired infection-induced CD4+ TH2 cytokine responses, suggesting that TSLP-dependent basophils augment TH2 cytokine responses following helminth infection. The identification and functional classification of TSLP-dependent basophils in a helminth infection model, coupled with their recently-described role in promoting atopic dermatitis, suggests these cells may be a critical population in promoting TH2 cytokine-associated inflammation in a variety of inflammatory or infectious settings. Collectively, these data suggest that the TSLP-basophil pathway may represent a new target in the design of therapeutic intervention strategies to promote or limit TH2 cytokine-dependent immunity and inflammation. PMID:23024277

Effect of health-promoting posters placed on the platforms of two train stations in Copenhagen, Denmark, on the choice between taking the stairs or the escalators: a secondary publication.

PubMed

Iversen, M K; Händel, M N; Jensen, E N; Frederiksen, P; Heitmann, B L

2007-06-01

The purpose of this study was to determine whether posters placed on the platforms of two train stations in Copenhagen, promoting use of the stairs, would encourage people to use the stairs rather than the adjacent escalator. An additional purpose was to see if the effect of the intervention was maintained for a week after the poster was removed. The number of people using stairs and escalators at Copenhagen Central Station and Østerport Train Station in Copenhagen was recorded before and during posters promoting stair use were placed on the platforms, and a week after the posters were removed. Two years after the posters were removed, data were collected for 1 week at Østerport Train Station (long-term post-intervention). At Copenhagen Central Station, the overall stair use increased from 12% before the intervention to 16% (P<0.0001) during the intervention, giving an odds ratio (OR) of 1.5 for stair use. At Østerport Train Station in Copenhagen, the overall stair use increased from 23 to 31% during the intervention (P<0.0001), and dropped to 27% (P<0.0001) after the intervention (during the intervention, OR=1.5 (P<0.0001); after the intervention, OR=1.2 (P<0.0001)). At the long-term post-intervention recording, the overall stair use was 25%, which was not significantly different from the stair use found before the intervention. Posters promoting stair use placed on the platforms of train stations can result in increased stair use, during and after 1 week of intervention, and thereby seem useful only when up and immediately following intervention in changing health-promoting behavior among Danish men and women. These results agree well with results from other countries.

Real World Evidence: A Quantitative and Qualitative Glance at Participant Feedback from a Free-Response Survey Investigating Experiences of a Structured Exercise Intervention for Men with Prostate Cancer

PubMed Central

Cahill, F.; Burgess, C.; Peat, N.; Rudman, S.; Kinsella, J.; Cahill, D.; George, G.; Santaolalla, A.; Van Hemelrijck, M.

2017-01-01

Aim To explore patient experiences of a structured exercise intervention for men with prostate cancer (PCa). Sample 41 men with either localised or advanced PCa who had been referred for a structured exercise programme by their physician and then subsequently consented to a telephone survey. Method Participants underwent a 10-week supervised exercise programme within a large cancer centre hospital consisting of 8 sessions. They then completed a short multiple choice telephone survey, elaborating on their responses where appropriate. Views expressed by participants were analysed using an affinity diagram and common themes were identified. Results Feedback from our telephone surveys was consistently positive and suggests that the structured exercise intervention provides exercise confidence, motivation to exercise, and social support and promotes positive health behaviour change in the context of exercise. Individual differences arose amongst participants in their perceived utility of the intervention, with 73.3% expressing a preference for structured exercise classes and 19.5% expressing a preference for exercising independently. Conclusion Design of a structured exercise intervention for patients with PCa should embrace the positive aspects outlined here but consider patients' individual differences. Ongoing feedback from patients should be utilised alongside traditional study designs to inform intervention design in this area. PMID:28758113

Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention.

PubMed

Mustanski, Brian; Greene, George J; Ryan, Daniel; Whitton, Sarah W

2015-01-01

Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.

Cost Effectiveness of Interventions to Promote Screening for Colorectal Cancer: A Randomized Trial

PubMed Central

Misra, Swati; Chan, Wenyaw; Chang, Yu-Chia; Bartholomew, L. Kay; Greisinger, Anthony; McQueen, Amy; Vernon, Sally W.

2011-01-01

Objectives Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and cost-effectiveness of interventions to increase colorectal cancer screening. PMID:21617335

Scoping review of health promotion and disease prevention interventions addressed to elderly people.

PubMed

Duplaga, Mariusz; Grysztar, Marcin; Rodzinka, Marcin; Kopec, Agnieszka

2016-09-05

The ageing of modern societies remains one of the greatest challenges for health and social systems. To respond to this challenge, we need effective strategies assuring healthy active life for elderly people. Health promotion and related activities are perceived as a key intervention, which can improve wellbeing in later life. The main aim of this study is the identification and classification of such interventions addressed to older adults and elderly. Therefore, the strategy based on the scoping review as a feasible tool for exploring this domain, summarizing research findings and identifying gaps of evidence, was applied. The scoping review relies on the analysis of previous reviews of interventions aimed at older adults (55-64 years old) and elderly persons (65 years and above) assessed for their effectiveness in the framework of a systematic review and/or meta-analysis. The search strategy was based on the identification of interventions reported as health promotion, primary disease prevention, screening or social support. In the analysis, the reviews published from January 2000 to April 2015 were included. The search strategy yielded 334 systematic reviews and/or meta-analyses addressed to target groups of interest, 182 of them assessed interventions belonging to health promotion, 219 to primary prevention, 34 to screening and 35 to social support. The studies focused on elderly (65 years and above) made up 40.4 % of all retrieved reviews and those addressing population of 55 years and above accounted for 24.0 %. Interventions focused on health maintenance and improvement in elderly and older adults represent frequently combined health promotion and disease prevention actions. Many interventions of this type are not addressed exclusively to elderly populations and/or older adults but are designed for the general population. The most common types of interventions addressed to elderly and older adults in the area of health promotion include health education, behavior modification and health communication.

[Research on health education and promotion in Spanish nursery and primary schools. A systematic review of studies published between 1995 and 2005].

PubMed

Davó, Mari Carmen; Gil-González, Diana; Vives-Cases, Carmen; Alvarez-Dardet, Carlos; La Parra, Daniel

2008-01-01

To identify the characteristics of health education and promotion interventions in Spanish nursery and primary schools, through the studies published in scientific journals. We performed a review of studies on health education and promotion interventions in Spanish nursery and primary schools, published from 1995 to 2005. The information sources were Medline (through Pubmed), Cinhal, Eric, Sociological Abstracts, Science Citation Index, and Isooc (CSIC). Studies performed in Spanish nursery and primary schools that incorporated health education and promotion interventions were selected. The studies' general features, main subject and aims, methodology, the kind of intervention described, and compliance with the criteria for Healthy Schools were analyzed. Only 26 of the 346 articles identified met the inclusion criteria. Health education programs focussed more on disease prevention than on health promotion and only a few studies were performed in nursery and primary schools. The criteria for health promotion in schools were included in 5 articles (19.2%). The importance of health institutions (n = 7; 26.9%) and universities (n = 8; 30.8%) as promoters of programs was notable. The most frequent subject was smoking (n = 11; 42.3%). Teachers play a lesser role in health promotion in schools than health institutions in the implementation and dissemination of health programs. Research into health promotion in nursery and primary schools is scarce.

Effective self-regulation change techniques to promote mental wellbeing among adolescents: a meta-analysis.

PubMed

van Genugten, Lenneke; Dusseldorp, Elise; Massey, Emma K; van Empelen, Pepijn

2017-03-01

Mental wellbeing is influenced by self-regulation processes. However, little is known on the efficacy of change techniques based on self-regulation to promote mental wellbeing. The aim of this meta-analysis is to identify effective self-regulation techniques (SRTs) in primary and secondary prevention interventions on mental wellbeing in adolescents. Forty interventions were included in the analyses. Techniques were coded into nine categories of SRTs. Meta-analyses were conducted to identify the effectiveness of SRTs, examining three different outcomes: internalising behaviour, externalising behaviour, and self-esteem. Primary interventions had a small-to-medium ([Formula: see text] = 0.16-0.29) on self-esteem and internalising behaviour. Secondary interventions had a medium-to-large short-term effect (average [Formula: see text] = 0.56) on internalising behaviour and self-esteem. In secondary interventions, interventions including asking for social support [Formula: see text] 95% confidence interval, CI = 1.11-1.98) had a great effect on internalising behaviour. Interventions including monitoring and evaluation had a greater effect on self-esteem [Formula: see text] 95% CI = 0.21-0.57). For primary interventions, there was not a single SRT that was associated with a greater intervention effect on internalising behaviour or self-esteem. No effects were found for externalising behaviours. Self-regulation interventions are moderately effective at improving mental wellbeing among adolescents. Secondary interventions promoting 'asking for social support' and promoting 'monitoring and evaluation' were associated with improved outcomes. More research is needed to identify other SRTs or combinations of SRTs that could improve understanding or optimise mental wellbeing interventions.

Adapting health promotion interventions to meet the needs of ethnic minority groups: mixed-methods evidence synthesis.

PubMed

Liu, Jj; Davidson, E; Bhopal, Rs; White, M; Johnson, Mrd; Netto, G; Deverill, M; Sheikh, A

2012-01-01

There is now a considerable body of evidence revealing that a number of ethnic minority groups in the UK and other economically developed countries experience disproportionate levels of morbidity and mortality compared with the majority white European-origin population. Across these countries, health-promoting approaches are increasingly viewed as the long-term strategies most likely to prove clinically effective and cost-effective for preventing disease and improving health outcomes in those with established disease. To identify, appraise and interpret research on the approaches employed to maximise the cross-cultural appropriateness and effectiveness of health promotion interventions for smoking cessation, increasing physical activity and improving healthy eating for African-, Chinese- and South Asian-origin populations. Two national conferences; seven databases of UK guidelines and international systematic reviews of health promotion interventions aimed at the general population, including the Clinical Evidence, National Institute for Health and Clinical Excellence and Scottish Intercollegiate Guidelines Network databases (1950-2009); 11 databases of research on adapted health promotion interventions for ethnic minority populations, including BIOSIS, EMBASE and MEDLINE (1950-2009); and in-depth qualitative interviews with a purposive sample of researchers and health promoters. Theoretically based, mixed-methods, phased programme of research that involved user engagement, systematic reviews and qualitative interviews, which were integrated through a realist synthesis. Following a launch conference, two reviewers independently identified and extracted data from guidelines and systematic reviews on the effectiveness of interventions for the general population and any guidance offered in relation to how to interpret this evidence for ethnic minority populations. Data were thematically analysed. Reviewers then independently identified and critically appraised studies of adapted interventions and summarised data to assess feasibility, acceptability, equity, clinical effectiveness and cost-effectiveness. Interviews were transcribed, coded and thematically analysed. The quantitative and qualitative data were then synthesised using a realist framework to understand better how adapted interventions work and to assess implementation considerations and prioritise future research. Our preliminary findings were refined through discussion and debate at an end-of-study national user engagement conference. Initial user engagement emphasised the importance of extending this work beyond individual-centred behavioural interventions to also include examination of community- and ecological-level interventions; however, individual-centred behavioural approaches dominated the 15 relevant guidelines and 111 systematic reviews we identified. The most consistent evidence of effectiveness was for pharmacological interventions for smoking cessation. This body of work, however, provided scant evidence on the effectiveness of these interventions for ethnic minority groups. We identified 173 reports of adapted health promotion interventions, the majority of which focused on US-based African Americans. This body of evidence was used to develop a 46-item Typology of Adaptation and a Programme Theory of Adapted Health Promotion Interventions. Only nine empirical studies directly compared the effectiveness of culturally adapted interventions with standard health promotion interventions, these failing to yield any consistent evidence; no studies reported on cost-effectiveness. The 26 qualitative interviews highlighted the need to extend thinking on ethnicity from conventional dimensions to more contextual considerations. The realist synthesis enabled the production of a decision-making tool (RESET) to support future research. The lack of robust evidence of effectiveness for physical activity and healthy-eating interventions in the general population identified at the outset limited the comparative synthesis work we could undertake in the latter phases. Furthermore, the majority of studies undertaking an adapted intervention were conducted within African American populations; this raises important questions about the generalisability of findings to, for example, a UK context and other ethnic minority groups. Lastly, given our focus on three health areas and three populations, we have inevitably excluded many studies of adapted interventions for other health topics and other ethnic minority populations. There is currently a lack of evidence on how best to deliver smoking cessation, physical activity and healthy eating-related health promotion interventions to ethnic minority populations. Although culturally adapting interventions can increase salience, acceptability and uptake, there is as yet insufficient evidence on the clinical effectiveness or cost-effectiveness of these adapted approaches. More head-to-head comparisons of adapted compared with standard interventions are warranted. The Typology of Adaptation, Programme Theory of Adapted Health Promotion Interventions and RESET tool should help researchers to develop more considered approaches to adapting interventions than has hitherto been the case. The National Institute for Health Research Health Technology Assessment programme.

Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors

PubMed Central

Joseph, Rodney P.; Daniel, Casey L.; Thind, Herpreet; Benitez, Tanya J.; Pekmezi, Dori

2014-01-01

Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed. PMID:28217036

Stakeholders' perceptions of transferability criteria for health promotion interventions: a case study.

PubMed

Trompette, Justine; Kivits, Joëlle; Minary, Laetitia; Cambon, Linda; Alla, François

2014-11-04

The effects of health promotion interventions are the result not only of the interventions themselves, but also of the contexts in which they unfold. The objective of this study was to analyze, through stakeholders' discourse, the characteristics of an intervention that can influence its outcomes. This case study was based on semi-structured interviews with health promotion stakeholders involved in a regional program (PRALIMAP). General hypotheses on transferability and on how the intervention is presumed to produce its effects were used to construct an interview guide. Interviews were analyzed using thematic coding. Twenty-three stakeholders were interviewed. Results showed stakeholders made few references to population and environment characteristics. Three themes emerged as significant for the stakeholders: implementation modalities and methodology, modalities used to mobilize actors; and transferability-promoting factors and barriers. Our work contributes to a better understanding not only of transferability factors, but also of stakeholders' perceptions of them, which are just as important, because those perceptions themselves are a factor in mobilization of actors, implementation, and transferability.

Promotion of responsible drinking in hotels.

PubMed

McLean, S; Wood, L J; Montgomery, I M; Davidson, J; Jones, M E

1994-01-01

This study reports on an intervention programme to promote responsible drinking in hotels. The licensees of eight hotels agreed to participate in a trial of measures designed to assist patrons to avoid drink-driving, and seven other hotels were used as controls. The interventions acceptable to licensees comprised commercial-quality promotional material with the theme "0.05 Know Your Limits", and a breath analysis machine and poster on its use. Patrons leaving the hotels on Thursday, Friday and Saturday nights were interviewed and breath-tested. Although the intervention material had been seen by one-third of patrons in the intervention hotels, there was no significant difference between them and control hotel patrons in either median BAC or the proportion who were going to drive with BAC over the legal limit. There was poor compliance by hotels with the intervention procedures, indicating that a major impediment to the implementation and evaluation of programmes to promote responsible drinking is a lack of motivation by many licensees, despite support by some licensees and the Australian Hotels Association.

Design and Implementation of a Randomized Controlled Social and Mobile Weight Loss Trial for Young Adults (project SMART)

PubMed Central

Patrick, K; Marshall, SJ; Davila, EP; Kolodziejczyk, JK; Fowler, J; Calfas, KJ; Huang, J; Rock, CL; Griswold, W; Gupta, A; Merchant, G; Norman, GJ; Raab, F; Donohue, M; Fogg, BJ; Robinson, TN

2014-01-01

Purpose To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. Methods A total of 404 overweight or obese college students from three Southern California universities (Mage = 22(±4) years; MBMI=29(±2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, SMS, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, physical activity (PA), sedentary behavior (SED), diet, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. Conclusion Theory-driven, evidence-based strategies for PA, SED, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. PMID:24215774

Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART).

PubMed

Patrick, K; Marshall, S J; Davila, E P; Kolodziejczyk, J K; Fowler, J H; Calfas, K J; Huang, J S; Rock, C L; Griswold, W G; Gupta, A; Merchant, G; Norman, G J; Raab, F; Donohue, M C; Fogg, B J; Robinson, T N

2014-01-01

To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. A total of 404 overweight or obese college students from three Southern California universities (M(age) = 22( ± 4) years; M(BMI) = 29( ± 2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, text messaging, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, diet, physical activity, sedentary behavior, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. Theory-driven, evidence-based strategies for physical activity, sedentary behavior, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. Copyright © 2013 Elsevier Inc. All rights reserved.

Achieving social change on gender-based violence: a report on the impact evaluation of Soul City's fourth series.

PubMed

Usdin, S; Scheepers, E; Goldstein, Susan; Japhet, Garth

2005-12-01

The Soul City Institute for Health and Development Communication--a South African multi-media health promotion project--together with the National Network on Violence Against Women, formulated an intervention to address domestic violence. Recognising that behavioural change interventions aimed solely at individuals have limited impact, the intervention was designed to impact at multiple mutually reinforcing levels; individual, community and socio-political environment. The intervention and its evaluation results are presented. Soul City successfully reached 86%, 25% and 65% of audiences through television, print booklets and radio, respectively. On an individual level there was a shift in knowledge around domestic violence including 41% of respondents hearing about the helpline. Attitude shifts were also associated with the intervention, with a 10% increase in respondents disagreeing that domestic violence was a private affair. There was also a 22% shift in perceptions of social norms on this issue. Qualitative data analysis suggests the intervention played a role in enhancing women's and communities' sense of efficacy, enabling women to make more effective decisions around their health and facilitating community action. The evaluation concluded that implementation of the Domestic Violence Act can largely be attributed to the intervention. While demonstrating actual reductions in levels of domestic violence was not possible, the evaluation shows a strong association between exposure to intervention components and a range of intermediary factors indicative of, and necessary to bring about social change. This paper reports on the evaluation, discusses its limitations and challenges as well as lessons learned regarding multi-level interventions on domestic violence.

Gender-transformative health promotion for women: a framework for action

PubMed Central

Pederson, Ann; Greaves, Lorraine; Poole, Nancy

2015-01-01

Gender inequity is a pervasive global challenge to health equity. Health promotion, as a field, has paid only limited attention to gender inequity to date, but could be an active agent of change if gender equity became an explicit goal of health promotion research, policy and programmes. As an aspect of gendered health systems, health promotion interventions may maintain, exacerbate or reduce gender-related health inequities, depending upon the degree and quality of gender-responsiveness within the programme or policy. This article introduces a framework for gender-transformative health promotion that builds on understanding gender as a determinant of health and outlines a continuum of actions to address gender and health. Gender-transformative health promotion interventions could play a significant role in improving the lives of millions of girls and women worldwide. Gender-related principles of action are identified that extend the core principles of health promotion but reflect the significance of attending to gender in the development and use of evidence, engagement of stakeholders and selection of interventions. We illustrate the framework with examples from a range of women's health promotion activities, including cardiovascular disease prevention, tobacco control, and alcohol use. The literature suggests that gender-responsiveness will enhance the acceptance, relevance and effectiveness of health promotion interventions. By moving beyond responsiveness to transformation, gender-transformative health promotion could enhance both health and social outcomes for large numbers of women and men, girls and boys. PMID:25231058

Use of social media for sexual health promotion: a scoping review

PubMed Central

Gabarron, Elia; Wynn, Rolf

2016-01-01

Background In order to prevent sexually transmitted infections (STIs), the World Health Organization recommends educating people on sexual health. With more than 2 billion active users worldwide, online social media potentially represent powerful channels for health promotion, including sexual health. Objective To review the scientific literature on the use of online social media for sexual health promotion. Design A search was conducted of scientific and medical databases, and grey literature was also included. The selected publications were classified according to their study designs, sexual health promotion main subject, target audience age, and social media use. Results Fifty-one publications were included; 4 publications presenting randomized intervention studies, 39 non-randomized intervention studies, and 8 observational studies. In 29 publications (56.9%), the main subject of the sexual health promotion was ‘general’ or to increase STI testing. Thirty publications (58.8%) specifically focused on youth or young people (aged 11–29 years). Fourteen publications that used social media either as unique channels for sexual health promotion interventions or as a tool supporting the sexual health promotion reported an effect on behavior (27%), and two of those studies found a reduction in the number of positive chlamydia and gonorrhea cases linked to social media intervention. Forty-four publications (86.3%) involved Facebook in some way. Conclusions Although billions of people worldwide actively use social media, we identified only 51 publications on the use of social media for promoting sexual health. About a quarter of the publications have identified promising results, and the evidence for positive effects of social media interventions for promoting sexual health is increasing. There is a need for more studies that explicitly discuss their theoretical framework, and that have strong research designs, in order to further increase the evidence base of the field. PMID:27649758

Use of social media for sexual health promotion: a scoping review.

PubMed

Gabarron, Elia; Wynn, Rolf

2016-01-01

In order to prevent sexually transmitted infections (STIs), the World Health Organization recommends educating people on sexual health. With more than 2 billion active users worldwide, online social media potentially represent powerful channels for health promotion, including sexual health. To review the scientific literature on the use of online social media for sexual health promotion. A search was conducted of scientific and medical databases, and grey literature was also included. The selected publications were classified according to their study designs, sexual health promotion main subject, target audience age, and social media use. Fifty-one publications were included; 4 publications presenting randomized intervention studies, 39 non-randomized intervention studies, and 8 observational studies. In 29 publications (56.9%), the main subject of the sexual health promotion was 'general' or to increase STI testing. Thirty publications (58.8%) specifically focused on youth or young people (aged 11-29 years). Fourteen publications that used social media either as unique channels for sexual health promotion interventions or as a tool supporting the sexual health promotion reported an effect on behavior (27%), and two of those studies found a reduction in the number of positive chlamydia and gonorrhea cases linked to social media intervention. Forty-four publications (86.3%) involved Facebook in some way. Although billions of people worldwide actively use social media, we identified only 51 publications on the use of social media for promoting sexual health. About a quarter of the publications have identified promising results, and the evidence for positive effects of social media interventions for promoting sexual health is increasing. There is a need for more studies that explicitly discuss their theoretical framework, and that have strong research designs, in order to further increase the evidence base of the field.

Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial.

PubMed

Kamada, Masamitsu; Kitayuguchi, Jun; Abe, Takafumi; Taguri, Masataka; Inoue, Shigeru; Ishikawa, Yoshiki; Bauman, Adrian; Lee, I-Min; Miyachi, Motohiko; Kawachi, Ichiro

2018-04-01

Evidence from a limited number of short-term trials indicates the difficulty in achieving population-level improvements in physical activity (PA) through community-wide interventions (CWIs). We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster randomized design. We randomized 12 communities in Unnan, Japan, to either intervention (9) or control (3). Additionally, intervention communities were randomly allocated to three subgroups by different PA types promoted. Randomly sampled residents aged 40-79 years responded to the baseline survey (n = 4414; 74%) and were followed at 1, 3 and 5 years (78-83% response rate). The intervention was a 5-year CWI using social marketing to promote PA. The primary outcome was a change in recommended levels of PA. Compared with control communities, adults achieving recommended levels of PA increased in intervention communities [adjusted change difference = 4.6 percentage points (95% confidence interval: 0.4, 8.8)]. The intervention was effective for promoting all types of recommended PAs, i.e. aerobic (walking, 6.4%), flexibility (6.1%) and muscle-strengthening activities (5.7%). However, a bundled approach, which attempted to promote all forms of PAs above simultaneously, was not effective (1.3-3.4%, P ≥ 0.138). Linear dose-response relationships between the CWI awareness and changes in PA were observed (P ≤ 0.02). Pain intensity decreased in shoulder (intervention and control) and lower back (intervention only) but there was little change difference in all musculoskeletal pain outcomes between the groups. The 5-year CWI using the focused social marketing strategy increased the population-level of PA.

Interventions in the workplace to support breastfeeding for women in employment.

PubMed

Abdulwadud, Omar A; Snow, Mary Elizabeth

2012-10-17

In recent years there has been a rise in the participation rate of women in employment. Some may become pregnant while in employment and subsequently deliver their babies. Most may decide to return early to work after giving birth for various reasons. Unless these mothers get support from their employers and fellow employees, they might give up breastfeeding when they return to work. As a result, the duration and exclusivity of breastfeeding to the recommended age of the babies would be affected.Workplace environment can play a positive role to promote breastfeeding. For women going back to work, various types of workplace support interventions are available and this should not be ignored by employers. Notably, promoting breastfeeding in a workplace may have benefits for the women, the baby and also the employer. To assess the effectiveness of workplace interventions to support and promote breastfeeding among women returning to paid work after the birth of their children, and its impact on process outcomes pertinent to employees and employers. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 August 2012). Two authors independently assessed all identified studies for randomised controlled trials and quasi-randomised controlled trials that compared workplace interventions with no intervention or two or more workplace interventions against each other. Two authors planned to evaluate the methodological quality of the eligible trials and extract data. There were no randomised controlled trials or quasi-randomised controlled trials identified. No trials have evaluated the effectiveness of workplace interventions in promoting breastfeeding among women returning to paid work after the birth of their child. The impact of such intervention on process outcomes is also unknown. Randomised controlled trials are required to establish the benefits of various types of workplace interventions to support, encourage and promote breastfeeding among working mothers.

Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial

PubMed Central

Kamada, Masamitsu; Kitayuguchi, Jun; Abe, Takafumi; Taguri, Masataka; Inoue, Shigeru; Ishikawa, Yoshiki; Bauman, Adrian; Lee, I-Min; Miyachi, Motohiko; Kawachi, Ichiro

2018-01-01

Abstract Background Evidence from a limited number of short-term trials indicates the difficulty in achieving population-level improvements in physical activity (PA) through community-wide interventions (CWIs). We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster randomized design. Methods We randomized 12 communities in Unnan, Japan, to either intervention (9) or control (3). Additionally, intervention communities were randomly allocated to three subgroups by different PA types promoted. Randomly sampled residents aged 40–79 years responded to the baseline survey (n = 4414; 74%) and were followed at 1, 3 and 5 years (78–83% response rate). The intervention was a 5-year CWI using social marketing to promote PA. The primary outcome was a change in recommended levels of PA. Results Compared with control communities, adults achieving recommended levels of PA increased in intervention communities [adjusted change difference = 4.6 percentage points (95% confidence interval: 0.4, 8.8)]. The intervention was effective for promoting all types of recommended PAs, i.e. aerobic (walking, 6.4%), flexibility (6.1%) and muscle-strengthening activities (5.7%). However, a bundled approach, which attempted to promote all forms of PAs above simultaneously, was not effective (1.3–3.4%, P ≥ 0.138). Linear dose–response relationships between the CWI awareness and changes in PA were observed (P ≤ 0.02). Pain intensity decreased in shoulder (intervention and control) and lower back (intervention only) but there was little change difference in all musculoskeletal pain outcomes between the groups. Conclusions The 5-year CWI using the focused social marketing strategy increased the population-level of PA. PMID:29228255

Intervention-engagement and its role in the effectiveness of stage-matched interventions promoting physical exercise.

PubMed

Richert, Jana; Lippke, Sonia; Ziegelmann, Jochen P

2011-01-01

Intervention-engagement has received little attention in sports medicine as well as research and promotion of physical exercise. The construct is important, however, in the understanding of why interventions work. This study aimed at shedding more light on the interplay of engagement and the subsequent effectiveness of physical exercise interventions. A three-stage model differentiating among nonintenders, intenders, and actors informed the intervention design in this study. In an Internet-based randomized controlled trial (RCT) with two measurement points, N = 326 participants received a stage-matched, stage-mismatched, or control treatment. Assessed variables were goal setting, planning, behavior, and intervention-engagement. It was found that regarding goal setting, nonintenders in the stage-matched intervention and those who engaged highly in the stage-matched intervention improved significantly over time. Regarding planning, intenders in the matched condition as well as all actors increased their levels over time. Regarding behavior, nonintenders and intenders having engaged highly in the intervention improved more than those having engaged little. In order to help nonintenders progress on their way toward goal behavior, it is necessary that they engage highly in a stage-matched intervention. Implications for exercise promotion are that interventions should also aim at increasing participants' intervention-engagement.

Why and How to Promote Adolescents' Prosocial Behaviors: Direct, Mediated and Moderated Effects of the CEPIDEA School-Based Program.

PubMed

Caprara, Gian Vittorio; Luengo Kanacri, Bernadette Paula; Zuffianò, Antonio; Gerbino, Maria; Pastorelli, Concetta

2015-12-01

Prosocial behaviors are considered integral to intervention goals that seek to promote successful youth development. This study examines the effect of a school-based intervention program entirely designed to promote prosocial behaviors called Promoting Prosocial and Emotional Skills to Counteract Externalizing Problems in Adolescence (Italian acronym CEPIDEA). The CEPIDEA curriculum was incorporated into routine educational practices and included five major components that reflect the personal determinants of prosocial behavior during adolescence. The present study assessed 151 students (48.7% female; M(age) = 12.4) of the intervention school and 140 students (51.2% female; M(age) = 13.0) of the control school at three points. A multi-group latent curve analysis revealed that the intervention group, compared with the control group, showed an increase in prosocial behavior, interpersonal self-efficacy beliefs, and agreeableness along with a decrease in physical aggression above and beyond the normative developmental trend of the these variables. Participants of the intervention also obtained higher grades than the control group at the end of middle school. Moderation effects for prosocial behavior and agreeableness evidenced that those who benefited most from the intervention were those adolescents with lower normative development of prosocial behavior, low initial level of agreeableness, and high initial level of physical aggression. The results also showed that the increase of prosocial behaviors mediated the decline of verbal aggression in adolescents who had attended the intervention. These findings suggest that interventions aimed at promoting prosocial behaviors while having the potential to support positive outcomes may also counteract or redirect negative trajectories of functioning.

Achieving long-term use of solar water disinfection in Zimbabwe.

PubMed

Mosler, H-J; Kraemer, S M; Johnston, R B

2013-01-01

To use a psychological theory of behavioural change to measure and interpret the effectiveness of different promotional strategies for achieving long-term usage of a household water treatment and safe storage (HWTS) system in peri-urban Zimbabwe. Solar disinfection (SODIS) was introduced into five peri-urban communities near Harare, Zimbabwe. Six different interventions were developed and were applied in four communities in different combinations, with the fifth remaining as a control area where no interventions were implemented. Throughout the 26 months of the study nine longitudinal panel surveys were conducted in which SODIS usage was estimated using three separate metrics: reported, calculated, and observed. A total of 1551 people were interviewed. The three indicators of SODIS usage broadly agreed with one another. By any measure, the most effective intervention was household visits by trained promoters in combination with persuasion. Households which received household visits maintained SODIS usage rates of 65% or more, even six months after the cessation of all promotional activities. Households receiving other interventions were significantly less effective. Interventions like prompts or public commitment after the application of household visits were effective at maintaining good practices once these were established. Household promotion in combination with persuasion appears more effective than other approaches, especially when followed with interventions targeting the maintenance of the new behaviour. With this intervention it is possible that around 65% of the households continue to use solar water disinfection (SODIS) more than two years after the initial promotion, and six months after the end of all interventions. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

PubMed

von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

2015-02-01

To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

[The impact of breastfeeding promotion in women with formal employment].

PubMed

Brasileiro, Aline Alves; Possobon, Rosana de Fátima; Carrascoza, Karina Camilo; Ambrosano, Gláucia Maria Bovi; Moraes, Antônio Bento Alves de

2010-09-01

This study focused on programs to promote breastfeeding in order to prevent early weaning of working mothers' infant children. A non-randomized intervention study was conducted using a survey of mothers who had returned to work after childbirth, including both participants and non-participants in a program to promote breastfeeding. The sample consisted of 200 mothers of infants ranging from 6 to 10 months of age. Factors associated with early weaning were analyzed with the chi-square and Fisher's exact tests and multiple logistic regression (α = 0.05). The results showed statistical differences between the groups in relation to exclusive breastfeeding (p < 0.0001) and breastfeeding (p < 0.0001). There was a statistically significant difference (p = 0.0056) between the groups in relation to time between childbirth and return to work. There was no difference between the end of maternity leave and weaning time. Mothers that were unable to nurse their infants during the work shift showed 4.98 times higher odds (95%CI: 1.27-19.61) of weaning them before the fourth month of age.

Latino Adolescents’ Perceived Discrimination in Online and Offline Settings: An Examination of Cultural Risk and Protective Factors

PubMed Central

Umaña-Taylor, Adriana J.; Tynes, Brendesha M.; Toomey, Russell B.; Williams, David R.; Mitchell, Kimberly J.

2015-01-01

Guided by a risk and resilience framework, the current study examined the associations between Latino adolescents’ (n = 219; Mage 14.35; SD = 1.75) perceptions of ethnic discrimination in multiple settings (e.g., online, school) and several domains of adjustment (e.g., mental health, academic), and tested whether developmentally salient cultural assets (i.e., ethnic identity) directly promoted youth adjustment or moderated the negative impact of discrimination on adjustment. Each of the 3 ethnic identity components (i.e., exploration, resolution, affirmation) demonstrated evidence of promoting positive outcomes among Latino youth; furthermore, there was some evidence that the promotive effects of affirmation and resolution were significantly stronger for older versus younger adolescents. In addition, with the exception of experiences with discrimination from adults outside of the school setting, there was evidence of ethnic identity interacting with each type of discrimination to predict Latino adolescents’ self-esteem, depressive symptoms, and externalizing problems. Findings suggest directions for future research and identify potential targets for intervention that may prove fruitful in programming efforts with Latino adolescents. PMID:25546597

Promoting physical activity: development and testing of self-determination theory-based interventions

PubMed Central

2012-01-01

A growing number of studies have pulled from Deci and Ryan's Self-Determination Theory to design interventions targeting health behavior change. More recently, researchers have begun using SDT to promote the adoption and maintenance of an active lifestyle. In this review, we aim to highlight how researchers and practitioners can draw from the SDT framework to develop, implement, and evaluate intervention efforts centered on increasing physical activity levels in different contexts and different populations. In the present paper, the rationale for using SDT to foster physical activity engagement is briefly reviewed before particular attention is given to three recent randomized controlled trials, the Canadian Physical Activity Counseling (PAC) Trial, the Empower trial from the UK, and the Portuguese PESO (Promotion of Health and Exercise in Obesity) trial, each of which focused on promoting physical activity behavior. The SDT-based intervention components, procedures, and participants are highlighted, and the key findings that have emanated from these three trials are presented. Lastly, we outline some of the limitations of the work conducted to date in this area and we acknowledge the challenges that arise when attempting to design, deliver, and test SDT-grounded interventions in the context of physical activity promotion. PMID:22385751

An effective intervention algorithm for promoting cooperation in the prisoner's dilemma game with multiple stable states

NASA Astrophysics Data System (ADS)

Li, Y. S.; Xu, C.; Hui, P. M.

2018-07-01

Multiple stable states, hysteresis, sensitivity to initial distributions, and a control algorithm for promoting cooperation are studied in an evolutionary prisoner's dilemma with agents connected into a regular random network. A system could evolve into states of different cooperative frequencies xc in different runs, even starting with the same initial cooperative frequency xc(in) and payoff parameters. For a large reward R, some values of xc(in) either take the system to a group of low cooperative frequency (LCF) states or to a few high cooperative frequency (HCF) states. These states differ by their network structures, with cooperative players connected into ring-like structure in LCF states and compact clusters in HCF states. Hysteresis in xc is observed when R is swept down and up, when the final state of the previous R is used as the initial state of the next R. The analysis led us to propose a closed pack cluster algorithm that gives HCF states effectively. The algorithm intervenes the system at some point in time by selectively switching some non-cooperative D-agents into cooperative C-agents at the peripheral of an existing cluster of C-agents. It ensures protection of a small C-cluster from which more cooperation can be induced. Practically, a governing body may first allow a society to evolve freely and then derive suitable policy to promote selected pockets of good practices for attaining a higher level of common good.

Managers' Support for Employee Wellness Programs: An Integrative Review.

PubMed

Passey, Deborah G; Brown, Meagan C; Hammerback, Kristen; Harris, Jeffrey R; Hannon, Peggy A

2018-01-01

The aim of this integrative literature review is to synthesize the existing evidence regarding managers' support for employee wellness programs. The search utilized multiple electronic databases and libraries. Inclusion criteria comprised peer-reviewed research published in English, between 1990 and 2016, and examining managers' support in the context of a worksite intervention. The final sample included 21 articles for analysis. Two researchers extracted and described results from each of the included articles using a content analysis. Two researchers independently rated the quality of the included articles. Researchers synthesized data into a summary table by study design, sample, data collected, key findings, and quality rating. Factors that may influence managers' support include their organization's management structure, senior leadership support, their expected roles, training on health topics, and their beliefs and attitudes toward wellness programs and employee health. Managers' support may influence the organizational culture, employees' perception of support, and employees' behaviors. When designing interventions, health promotion practitioners and researchers should consider strategies that target senior, middle, and line managers' support. Interventions need to include explicit measures of managers' support as part of the evaluation plan.

Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

PubMed

Barnason, Susan; White-Williams, Connie; Rossi, Laura P; Centeno, Mae; Crabbe, Deborah L; Lee, Kyoung Suk; McCabe, Nancy; Nauser, Julie; Schulz, Paula; Stamp, Kelly; Wood, Kathryn

2017-06-01

The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions. There was variability in methodological approaches across settings and disease conditions. The most effective interventions were tailored to individual patient needs, used multiple components to improve self-management outcomes, and often used multidisciplinary approaches. This synthesis of evidence expands the base of knowledge related to the development of patient self-management skills and provides direction for more rigorous research. Recommendations are provided to guide the implementation of therapeutic patient education in clinical practice and the design of comprehensive self-management interventions to improve outcomes for cardiovascular patients. © 2017 American Heart Association, Inc.

Case Study of a Participatory Health-Promotion Intervention in School

ERIC Educational Resources Information Center

Simovska, Venka

2012-01-01

This article discusses the findings from a case study focusing on processes involving pupils to bring about health-promotion changes. The study is related to an EU intervention project aiming to promote health and well-being among children (4-16 years). Qualitative research was carried out in a school in the Netherlands. Data sources include…

Effect of Intervention with the Self-Determined Learning Model of Instruction on Access and Goal Attainment

ERIC Educational Resources Information Center

Shogren, Karrie A.; Palmer, Susan B.; Wehmeyer, Michael L.; Williams-Diehm, Kendra; Little, Todd D.

2012-01-01

Promoting self-determination has been identified as best practice in special education and transition services and as a means to promote goal attainment and access to the general education curriculum for students with disabilities. There have been, however, limited evaluations of the effects of interventions to promote self-determination on…

Process Evaluation of an Integrated Health Promotion/Occupational Health Model in WellWorks-2

ERIC Educational Resources Information Center

Hunt, Mary Kay; Lederman, Ruth; Stoddard, Anne M.; LaMontagne, Anthony D.; McLellan, Deborah; Combe, Candace; Barbeau, Elizabeth; Sorensen, Glorian

2005-01-01

Disparities in chronic disease risk by occupation call for new approaches to health promotion. WellWorks-2 was a randomized, controlled study comparing the effectiveness of a health promotion/occupational health program (HP/OHS) with a standard intervention (HP). Interventions in both studies were based on the same theoretical foundations. Results…

Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity Recovery

PubMed Central

Hatem, Samar M.; Saussez, Geoffroy; della Faille, Margaux; Prist, Vincent; Zhang, Xue; Dispa, Delphine; Bleyenheuft, Yannick

2016-01-01

Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients' mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training, and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed. At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning, and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation. PMID:27679565

Measurement of compliance with New York City's regulations on beverages, physical activity, and screen time in early child care centers.

PubMed

Lessard, Laura; Lesesne, Catherine; Kakietek, Jakub; Breck, Andrew; Jernigan, Jan; Dunn, Lillian; Nonas, Cathy; O'Dell, Sarah Abood; Stephens, Robert L; Xu, Ye; Kettel Khan, Laura

2014-10-16

Policy interventions designed to change the nutrition environment and increase physical activity in child care centers are becoming more common, but an understanding of the implementation of these interventions is yet to be developed. The objective of this study was to explore the extent and consistency of compliance with a policy intervention designed to promote nutrition and physical activity among licensed child care centers in New York City. We used a multimethod cross-sectional approach and 2 independent components of data collection (Center Evaluation Component and Classroom Evaluation Component). The methods were designed to evaluate the impact of regulations on beverages served, physical activity, and screen time at child care centers. We calculated compliance scores for each evaluation component and each regulation and percentage agreement between compliance in the center and classroom components. Compliance with certain requirements of the beverage regulations was high and fairly consistent between components, whereas compliance with the physical activity regulation varied according to the data collection component. Compliance with the regulation on amount and content of screen time was high and consistent. Compliance with the physical activity regulation may be a more fluid, day-to-day issue, whereas compliance with the regulations on beverages and television viewing may be easier to control at the center level. Multiple indicators over multiple time points may provide a more complete picture of compliance - especially in the assessment of compliance with physical activity policies.

What Do We Know about "How" to Promote Physical Activity to Adolescents? A Mapping Review

ERIC Educational Resources Information Center

Bush, Paula Louise; García Bengoechea, Enrique

2015-01-01

To date, adolescent physical activity (PA) intervention research has focused on the school setting and suggests a need to extend interventions beyond this setting to influence teenagers' overall level of PA. But, the relative effectiveness of PA promotion strategies that can be part of such multi-setting interventions remains unknown. We completed…

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

ERIC Educational Resources Information Center

Ha, Eun-Jeong; Caine-Bish, Natalie

2009-01-01

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

Public health interventions and behaviour change: reviewing the grey literature.

PubMed

Franks, H; Hardiker, N R; McGrath, M; McQuarrie, C

2012-01-01

This study identified and reviewed grey literature relating to factors facilitating and inhibiting effective interventions in three areas: the promotion of mental health and well-being, the improvement of food and nutrition, and interventions seeking to increase engagement in physical activity. Sourcing, reviewing and analysis of relevant grey literature. Evidence was collected from a variety of non-traditional sources. Thirty-six pieces of documentary evidence across the three areas were selected for in-depth appraisal and review. A variety of approaches, often short-term, were used both as interventions and outcome measures. Interventions tended to have common outcomes, enabling the identification of themes. These included improvements in participant well-being as well as identification of barriers to, and promoters of, success. Most interventions demonstrated some positive impact, although some did not. This was particularly the case for more objective measures of change, such as physiological measurements, particularly when used to evaluate short-term interventions. Objective health measurement as part of an intervention may act as a catalyst for future behaviour change. Time is an important factor that could either promote or impede the success of interventions for both participants and facilitators. Likewise, the importance of involving all stakeholders, including participants, when planning health promoting interventions was established as an important indicator of success. Despite its limited scope, this review suggests that interventions can be more efficient and effective. For example, larger-scale, longer-term interventions could be more efficient, whilst outcomes relating to the implementation and beyond could provide a clearer picture of effectiveness. Additionally, interventions and evaluations must be flexible, evolve in partnership with local communities, and reflect local need and context. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Behaviour change interventions to influence antimicrobial prescribing: a cross-sectional analysis of reports from UK state-of-the-art scientific conferences.

PubMed

Rawson, T M; Moore, L S P; Tivey, A M; Tsao, A; Gilchrist, M; Charani, E; Holmes, A H

2017-01-01

To improve the quality of antimicrobial stewardship (AMS) interventions the application of behavioural sciences supported by multidisciplinary collaboration has been recommended. We analysed major UK scientific research conferences to investigate AMS behaviour change intervention reporting. Leading UK 2015 scientific conference abstracts for 30 clinical specialties were identified and interrogated. All AMS and/or antimicrobial resistance(AMR) abstracts were identified using validated search criteria. Abstracts were independently reviewed by four researchers with reported behavioural interventions classified using a behaviour change taxonomy. Conferences ran for 110 days with >57,000 delegates. 311/12,313(2.5%) AMS-AMR abstracts (oral and poster) were identified. 118/311(40%) were presented at the UK's infectious diseases/microbiology conference. 56/311(18%) AMS-AMR abstracts described behaviour change interventions. These were identified across 12/30(40%) conferences. The commonest abstract reporting behaviour change interventions were quality improvement projects [44/56 (79%)]. In total 71 unique behaviour change functions were identified. Policy categories; "guidelines" (16/71) and "service provision" (11/71) were the most frequently reported. Intervention functions; "education" (6/71), "persuasion" (7/71), and "enablement" (9/71) were also common. Only infection and primary care conferences reported studies that contained multiple behaviour change interventions. The remaining 10 specialties tended to report a narrow range of interventions focusing on "guidelines" and "enablement". Despite the benefits of behaviour change interventions on antimicrobial prescribing, very few AMS-AMR studies reported implementing them in 2015. AMS interventions must focus on promoting behaviour change towards antimicrobial prescribing. Greater focus must be placed on non-infection specialties to engage with the issue of behaviour change towards antimicrobial use.

The effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries: A systematic review.

PubMed

Müller, Andre Matthias; Alley, Stephanie; Schoeppe, Stephanie; Vandelanotte, Corneel

2016-10-10

Promoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. Using modern information-and communication technologies to deliver physical activity and diet interventions is particularly promising considering the increased proliferation of such technologies in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries. Major databases and grey literature sources were searched to retrieve studies that quantitatively examined the effectiveness of e-& mHealth interventions on physical activity and diet outcomes in developing countries. Additional studies were retrieved through citation alerts and scientific social media allowing study inclusion until August 2016. The CONSORT checklist was used to assess the risk of bias of the included studies. A total of 15 studies conducted in 13 developing countries in Europe, Africa, Latin-and South America and Asia were included in the review. The majority of studies enrolled adults who were healthy or at risk of diabetes or hypertension. The average intervention length was 6.4 months, and text messages and the Internet were the most frequently used intervention delivery channels. Risk of bias across the studies was moderate (55.7 % of the criteria fulfilled). Eleven studies reported significant positive effects of an e-& mHealth intervention on physical activity and/or diet behaviour. Respectively, 50 % and 70 % of the interventions were effective in promoting physical activity and healthy diets. The majority of studies demonstrated that e-& mHealth interventions were effective in promoting physical activity and healthy diets in developing countries. Future interventions should use more rigorous study designs, investigate the cost-effectiveness and reach of interventions, and focus on emerging technologies, such as smart phone apps and wearable activity trackers. The review protocol can be retrieved from the PROSPERO database (Registration ID: CRD42015029240 ).

Systematic procedures to promote U.S. HIV medication adherence via Photovoice.

PubMed

Teti, Michelle; Shaffer, Victoria; Majee, Wilson; Farnan, Rose; Gerkovich, Mary

2017-06-21

Medication adherence is essential to promote the health of people living with HIV (PL-HIV) and prevent HIV transmission in the U.S. Novel medication health promotion interventions are needed that address patient-centeredness, understandability, and communication with providers. The aims of this article are to define the systematic stages we used to develop an effective health promotion intervention via the products (e.g. images and stories) of Photovoice. We designed an intervention to improve HIV adherence knowledge, attitudes, and communication with providers through Photovoice. 16 PL-HIV used Photovoice strategies to describe their experiences with medication via images and captions and create an intervention (10 adherence promotion posters) that integrated photo-stories of their adherence motivators, journeys from sickness to health, and how they manage and counter HIV stigma. We outline the systematic process we used to adapt Photovoice to create the effective intervention for replication. The process included six stages: (i) identify scope of the project; (ii) create collaborative project team; (iii) design project materials; (iv) review and revise materials with team members; (v) disseminate materials; and (vi) evaluate materials. Photovoice is used traditionally as a social action research method. In this project, it was adapted to create patient-driven images and stories for health promotion posters. Poster viewers experienced improved self-efficacy for HIV medication adherence. Describing the adaptation of the Photovoice process in a deliberate and transparent way can support fidelity to the essence of the participant-driven method, while also allowing researchers and practitioners to replicate Photovoice as a successful health promotion intervention. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Promotion and Provision of Colorectal Cancer Screening: A Comparison of Colorectal Cancer Control Program Grantees and Nongrantees, 2011–2012

PubMed Central

Hannon, Peggy A.; Escoffery, Cam; Vu, Thuy; Kohn, Marlana; Vernon, Sally W.; DeGroff, Amy

2014-01-01

Introduction Since 2009, the Centers for Disease Control and Prevention (CDC) has awarded nearly $95 million to 29 states and tribes through the Colorectal Cancer Control Program (CRCCP) to fund 2 program components: 1) providing colorectal cancer (CRC) screening to uninsured and underinsured low-income adults and 2) promoting population-wide CRC screening through evidence-based interventions identified in the Guide to Community Preventive Services (Community Guide). CRCCP is a new model for disseminating and promoting use of evidence-based interventions. If the program proves successful, CDC may adopt the model for future cancer control programs. The objective of our study was to compare the colorectal cancer screening practices of recipients of CRCCP funding (grantees) with those of nonrecipients (nongrantees). Methods We conducted parallel Web-based surveys in 2012 with CRCCP grantees (N = 29) and nongrantees (N = 24) to assess promotion and provision of CRC screening, including the use of evidence-based interventions. Results CRCCP grantees were significantly more likely than nongrantees to use Community Guide-recommended evidence-based interventions (mean, 3.14 interventions vs 1.25 interventions, P < .001) and to use patient navigation services (eg, transportion or language translation services) (72% vs 17%, P < .001) for promoting CRC screening. Both groups were equally likely to use other strategies. CRCCP grantees were significantly more likely to provide CRC screening than were nongrantees (100% versus 50%, P < .001). Conclusion Results suggest that CRCCP funding and support increases use of evidence-based interventions to promote CRC screening, indicating the program’s potential to increase population-wide CRC screening rates. PMID:25275807

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

PubMed

Wang, Dongxu; Stewart, Donald

2013-06-01

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

A randomized breast-feeding promotion intervention did not reduce child obesity in Belarus.

PubMed

Kramer, Michael S; Matush, Lidia; Vanilovich, Irina; Platt, Robert W; Bogdanovich, Natalia; Sevkovskaya, Zinaida; Dzikovich, Irina; Shishko, Gyorgy; Collet, Jean-Paul; Martin, Richard M; Smith, George Davey; Gillman, Matthew W; Chalmers, Beverley; Hodnett, Ellen; Shapiro, Stanley

2009-02-01

The evidence that breast-feeding protects against obesity is based on observational studies, with potential for confounding and selection bias. This article summarizes a previously published study in which we assessed whether an intervention designed to promote exclusive and prolonged breast-feeding affects children's height, weight, adiposity, and blood pressure (BP) at age 6.5 y. The Promotion of Breastfeeding Intervention Trial (PROBIT) is a cluster-randomized trial of a breast-feeding promotion intervention based on the WHO/UNICEF Baby-Friendly Hospital Initiative. A total of 17,046 healthy breast-fed infants were enrolled from 31 Belarussian maternity hospitals and affiliated clinics, of whom 13,889 (81.5%) were followed up at 6.5 y with duplicate measurements of height, weight, waist circumference, triceps and subscapular skinfold thicknesses, systolic and diastolic BP. Analysis was based on intention to treat, with statistical adjustment for clustering within hospitals/clinics to permit inferences at the individual level. The experimental intervention led to a large increase in exclusive breast-feeding at 3 mo (43.3% vs. 6.4%, P < 0.001) and a significantly higher prevalence of any breast-feeding throughout infancy. No significant intervention effects were observed on height, BMI, adiposity measures, or BP. The breast-feeding promotion intervention resulted in substantial increases in the duration and exclusivity of breast-feeding yet did not reduce measures of adiposity at age 6.5 y. Previous reports of protective effects against obesity may reflect uncontrolled bias caused by confounding and selection.

Increasing the health promotion practices of workplaces in Australia with a proactive telephone-based intervention.

PubMed

Daly, Justine; Licata, Milly; Gillham, Karen; Wiggers, John

2005-01-01

The aim of this study was to explore the potential effectiveness of a proactive telephone-based intervention in increasing workplace adoption of health promotion initiatives. A telephone-based direct marketing strategy was used to contact a sample of Australian workplaces to encourage the adoption of health promotion initiatives. Workplaces were offered free services and resources designed to facilitate adoption of health promotion initiatives. A total of 227 (71%) workplaces provided informed consent to participate in both baseline and 4-year follow-up surveys. Significant increases were evident for seven of the eight health promotion initiatives. The findings of this study suggest that a proactive telephone-based intervention has the potential to be effective in increasing the prevalence of health promotion initiatives across a range of health topics in a large population of workplaces. Given the capacity to reach an entire population of workplaces, this approach represents a promising means of achieving the established potential of workplace health promotion.

Attachment-based interventions for families with young children.

PubMed

Woodhouse, Susan S

2018-05-21

Given a large body of research indicating links between child attachment and later mental health outcomes, interventions that promote children's secure attachment to their caregivers have the potential to contribute to prevention of psychopathology and promotion of well-being. A number of attachment-based interventions have been developed to support parents, enhance caregiving quality, and promote children's attachment security with the aim of improving children's mental health. There is now a growing evidence base to support the efficacy of a number of these interventions. The present literature review and introduction to the special issue on attachment-based interventions for families with young children describes key aspects of attachment theory and research that form the theoretical and empirical background for attachment-based interventions, and introduces seven case studies illustrating five different attachment-based interventions. The case studies represent a variety of attachment-based models, including both group and individual treatments, and show applications across a range of caregiver contexts. © 2018 Wiley Periodicals, Inc.

Impact of adding hand-washing and water disinfection promotion to oral cholera vaccination on diarrhoea-associated hospitalization in Dhaka, Bangladesh: evidence from a cluster randomized control trial

PubMed Central

Najnin, Nusrat; Leder, Karin; Qadri, Firdausi; Forbes, Andrew; Unicomb, Leanne; Winch, Peter J; Ram, Pavani K; Leontsini, Elli; Nizame, Fosiul A; Arman, Shaila; Begum, Farzana; Biswas, Shwapon K; Clemens, John D; Ali, Mohammad; Cravioto, Alejandro; Luby, Stephen P

2017-01-01

Abstract Background Information on the impact of hygiene interventions on severe outcomes is limited. As a pre-specified secondary outcome of a cluster-randomized controlled trial among >400 000 low-income residents in Dhaka, Bangladesh, we examined the impact of cholera vaccination plus a behaviour change intervention on diarrhoea-associated hospitalization. Methods Ninety neighbourhood clusters were randomly allocated into three areas: cholera-vaccine-only; vaccine-plus-behaviour-change (promotion of hand-washing with soap plus drinking water chlorination); and control. Study follow-up continued for 2 years after intervention began. We calculated cluster-adjusted diarrhoea-associated hospitalization rates using data we collected from nearby hospitals, and 6-monthly census data of all trial households. Results A total of 429 995 people contributed 500 700 person-years of data (average follow-up 1.13 years). Vaccine coverage was 58% at the start of analysis but continued to drop due to population migration. In the vaccine-plus-behaviour-change area, water plus soap was present at 45% of hand-washing stations; 4% of households had detectable chlorine in stored drinking water. Hospitalization rates were similar across the study areas [events/1000 person-years, 95% confidence interval (CI), cholera-vaccine-only: 9.4 (95% CI: 8.3–10.6); vaccine-plus-behaviour-change: 9.6 (95% CI: 8.3–11.1); control: 9.7 (95% CI: 8.3–11.6)]. Cholera cases accounted for 7% of total number of diarrhoea-associated hospitalizations. Conclusions Neither cholera vaccination alone nor cholera vaccination combined with behaviour-change intervention efforts measurably reduced diarrhoea-associated hospitalization in this highly mobile population, during a time when cholera accounted for a small fraction of diarrhoea episodes. Affordable community-level interventions that prevent infection from multiple pathogens by reliably separating faeces from the environment, food and water, with minimal behavioural demands on impoverished communities, remain an important area for research. PMID:29025064

The efficacy of tailored print materials in promoting colorectal cancer screening: results from a randomized trial involving callers to the National Cancer Institute's Cancer Information Service.

PubMed

Marcus, Alfred C; Mason, Mondi; Wolfe, Pam; Rimer, Barbara K; Lipkus, Isaac; Strecher, Victor; Warneke, Richard; Morra, Marion E; Allen, Amy Reasinger; Davis, Sharon W; Gaier, Amy; Graves, Carlan; Julesberg, Karen; Nguyen, Lynne; Perocchia, Rosemarie; Speyer, Jo Beth; Wagner, Doug; Thomsen, Chris; Bright, Mary Anne

2005-01-01

In this large randomized trial among callers to the Cancer Information Service (CIS), tailored print materials were tested for efficacy in promoting colorectal cancer (CRC) screening (fecal occult blood test [FOBT], flexible sigmoidoscopy, or colonoscopy). All participants completed baseline interviews at the end of their usual service calls to the CIS, as well as short-term (6-month) and longer-term (14-month) telephone follow-up interviews. The study sample (n = 4,014) was restricted to English-speaking CIS callers 50 + years of age, who would be eligible for CRC screening at 14 months follow-up and did not call the CIS about CRC or CRC screening. Four experimental conditions were compared: a single untailored (SU) mailout of print material (the control condition); a single tailored (ST) mailout of print material; four (multiple) tailored (MT) mailouts of print materials spanning 12 months, all of which were tailored to information obtained at baseline; and four (multiple) retailored (MRT) mailouts also spanning 12 months, with retailoring of the print materials (mailouts 2, 3, and 4) based on updated information obtained from the 6-month follow-up interviews. Consistent with the main hypothesis of this trial, a significant linear trend across the SU, ST, MT, and MRT groups was found at 14 months (42%, 44%, 51%, and 48%, respectively, p = 0.05). Only for MT was there a significant difference compared with SU (p = 0.03) for the sample as a whole, while no differences were found for MT vs. MRT at 14 months. Significant moderator effects in the predicted direction were found among females, younger participants, and among those with a history of CRC screening, all of which involved the SU vs. MT MRT comparisons. Only among younger participants (ages 50-59) was there a difference between SU vs. ST at 14 months. Given these results, we conclude from this trial the following: (1) the MRT intervention failed to show added benefit beyond the MT intervention, (2) the significant intervention effects involving the MT and MRT conditions can be explained by tailoring and/or the longitudinal nature of both interventions, and (3) the most compelling evidence in support of tailoring was found for the ST condition among younger participants, where a significant need for interventions exists at the national level. Directions for future research are discussed in light of the results summarized above.